EXW 330 Practical 1

Ball and socket joint

A partially spherical end lies in a socket, allowing multidirectional movement and rotation (hip, shoulder)

What is a synergist muscle

A synergist muscle is a muscle that aids the agonist muscle in performing a motion.

Modified hinge joint

Allows some rotation as well, not just flexion and extension (knee and elbow, fingers)

What is an agonist muscle

An agonist muscle is the main muscle used to perform a movement, the primary mover

What is an antagonist muscle

An antagonist muscle does the opposite of the agonist muscle. For example, if the agonist muscle contracts the antagonist muscle relaxes.

Hinge joint

Bones can move in only one axis to flex or extend (elbow, knee, ankle)

Isotonic muscle action

Dynamic action that can be concentric or eccentric. Muscle length changes and velocity can change but external load does not (bicep curl, walking, rotating arms)

Testing forearm pronation and supination for ROM

Elbow flexed at 90, fist holding pen straight up. Small goniometer. Fulcrum at middle finger on flat side of fist. stationary arm pointing up and moving arm follows pen. pronation and supination ~80-90

testing shoulder internal/external rotation for ROM

Elbow flexed, arm at 90 degrees held out. goniometer goes on elbow and stationary arm stays horizontal. internal <90, external ~90

1st class lever

Fulcrum is between the load(resisted force) and applied force. Can be mechanical advantage or disadvantage (neck extension) load V --------Force V _____________________________________________ ------fulcrum

2nd class lever

Fulcrum is on one side of the forces. Always mechanical advantage (calf raise) ---------Load V ________________________________________________ Fulcrum -----------Force ^

3rd class lever

Fulcrum is on one side of the forces. Always mechanical disadvantage (bicep curl) ----------------------- Load v ________________________________________________________ Fulcrum----- Force ^

Testing wrist radial and ulnar deviation for ROM

Hand on a table. Fulcrum at wrist. Stationary arm in line with forearm. Moveable arm down middle finger. Ulna is on the side of the pinky/ulnar deviation is horizontal abduction, radial deviation is moving medially/ horizontal adduction

Agonist actions of the rectus femoris

Hip flexion, knee extension

Purpose of Manual Muscle Testing

Looking for equilateral strength and weakness by comparing the two sides of the body. Testing if the muscle can resist the action

Coracobrachialis MMT

Patient is sitting in elbow flexion with hand in supinated fist, with the tester pushing down and out on humerus. Patient pushes up and in. Weakness would not allow horizontal adduction (closing a door, pulling a cable, pushing something closer)

Biceps Brachii and Brachialis MMT

Patient is supine or sitting, elbow flexed at 90 hand in supination. Tester pulls on forearm to apply pressure down on forearm toward extension. tester stabilizes elbow with one hand underneath it. Patient tries to increase elbow flexion. Weakness will cause difficult with elbow flexion (bicep curl, pull ups, drinking, holding a baby)

Triceps Brachii and Anconeus MMT

Patient lays prone with majority of arm on the table hand pointed down. Tester has one hand under elbow, another on forearm pressing down on it towards flexion. Weakness would cause difficult fully extending arm as with bowling or wiping a table down

Serratus Anterior

Patient lies supine with arm straight up in arm holding a fist. Tester stands at head pushing down on fist. Completely extended arm removes deltoid and pec action. Weakness can cause difficulty throwing a punch, swinging a bat, swimming, handstand, opening door, getting out of bed, picking something off a high shelf

Pectoralis Major MMT

Patient lies supine, arm lifted straight in air, being lowered to test the lower pectorals. Tester holds inner elbow to push laterally and cranially (obliquely pulling toward themselves) the patient resists the pressure towards adduction. Weakness would cause difficulty getting out of bed, push exercises, throwing, turning a steering wheel with opposite hand

Oblique Trunk Flexors MMT

Patient lies supine, arms crossed across chest, lifting trunk off the table and turning to the side. Tester is at the head helping lift and placing them in the position. Weakness can cause difficulty turning to look and gesture or reaching across your body like when locking your seatbelt in place. Can strengthen by Russian twists, twisting stretches and motions, anything across the body

Lateral Trunk Flexors MMT

Patient lying on their side doing a side crunch to lift shoulder off the table. Tester standing behind their back towards there legs not using pressure but can stabilize the legs. Weakness could cause difficulty carrying groceries, getting out of bed, cartwheels. Can strengthen by side bending exercises, bicycles, side crunches, side planks

Deltoid MMT

Patient sitting with elbow lifted and out at 90 degrees. Tester pushes down on elbow with a flat hand. Weakness would cause difficulty rowing, any overhead lifting, jumping jacks, snow angels, pitching

Pivot joint

Rounded bone fitting into cup end of another bone allowing rotational movement (1st two vertebrae allow neck to shake the head)

Gliding joints

Synovial joint that forms between flat bones. allow the bones to glide past one another in any direction along the plane of the joint - up and down, left and right, and diagonally. (wrist, ankle, spine)

Antagonist muscles of shoulder joint abduction

Teres major, pectorals major, latissimus dorsi

Angle of pull

The angle between the line of pull and the fulcrum

Length-Tension relationship

There is an optimal length for greater force production. Too stretched would not allow for much movement. Fully flexed cannot allow for additional movement. Must be a balance

Isokinetic muscle action

Velocity stays the same but force output can change (used with machines like dynamometer)

Reciprocal Inhibition

When a muscle is contracted, its antagonist is automatically inhibited

How would reciprocal inhibition affect a test of muscular strength

When inhibiting one muscle you will lose force production because opposing muscles must work together for optimal strength

Primary mover of trunk flexion

abdominals

Force Velocity Curve

as force increases, velocity decreases. As velocity increases, torque and work decrease. As velocity increases power increases.

Primary mover of elbow flexion (bicep curl)

biceps brachii

Agonist actions of the biceps brachii

elbow flexion, shoulder flexion, forearm supination

Stabilizers for neutral trunk

erector spinae, rectus abdominus

Testing wrist flexion and extension for ROM

forearm straight, elbow flexion, hand in pronation. goniometer placed at 5th metacarpal lateral side of the hand, stationary arm along the ulna.

Agonist muscle for plantar flexion

gastrocnemius

Antagonist muscles for hip extension

gluteus maximus, pectineus, rectus femoris

Testing shoulder flexion and extension for ROM

goniometer on acromion process (seam of shirt), stationary arm pointed down. testers hand cups scapula and stops patient when it moves. ~90 flexion, ~45 hyperextension

Primary mover of leg flexion

hamstrings

Testing elbow flexion and extension for ROM

hand supinated, goniometer on olecranon process lateral side of elbow. Stationary arm on humerus, start with goniometer open and moving arm pointing down. flexion ~130-150, extension 0

Agonist muscle of shoulder extension

latissimus dorsi

Shoulder flexion and extension movement

moving the humerus in the Sagittal plane, frontal axis

shoulder abduction and adduction movement

moving the humerus in the frontal plane, sagittal axis

shoulder internal and external rotation

moving the humerus medially and laterally in the transverse plane, vertical axis

Example of a simple pulley in the body

neck extension

Saddle joint

one saddle shaped bone with the other sitting in it. Provides stability to the bones while providing more flexibility than a hinge or gliding joint. Allow biaxial movement (carpals)

Determining line of pull (3 pieces of info needed)

origin point, insertion point, joint type/location

6 methods of determining muscle action

palpation, lines of pull, dissection, models, EMG testing, Electric Muscle Stimulation

Teres Major MMT

patient lies prone with one arm crossed behind their back, hand resting on lumbar spine other arm out on table in elbow flexion. Tester pushes at the back of the elbow towards shoulder flexion, patient resist towards shoulder extension. Weakness would cause difficulty reaching back, pulling a cable

Agonist actions of the Gastrocnemius

plantar flexion, knee flexion

Antagonist muscles for internal rotation of the hip

psoas major, iliacus

Primary mover of leg extension

quadriceps

Stabilizers for knee extension

rectus femoris, vastus lateralis

Synergist muscle for plantar flexion

soleus

Isometric muscle action

static.Muscle contracts but does not shorten or lengthen (holding a plank, pushing against a wall)

Line of pull

the direction of muscular force

Stabilizers for Shoulder Girdle Retraction (adduction)

trapezius, rhomboids

Primary mover of elbow extension (dips)

tricep

Synergists muscles of Shoulder Extension

triceps brachii