Kinesiology Study Guide 1

Define Accessory motions of a joint:

Large motions (like flexion, adduction) must be accompanied by small accessory motions Also known as component motions. Motions that take place at a joint as a natural smooth accompaniment to active ROM. Example motions are slide spin and roll

Define the difference between joint hyper-mobility and joint hypo-mobility:

Hypermobility: joints move beyond normal position (finger, knees, etc) **Picture is example of this. Hypo-mobility: Decrease in the normal movement of a joint or body part, as may result from an articular surface dysfunction or from disease or injury that affects a bone, muscle, or joint.

Describe active insufficiency and provide an example:

When a muscle that crosses more then 1 joint is at its *shortest* position but the joint has more motion avaliable. The muscles actin and mysin overlaping sites are used up but the joint has not reached the end of its motion. Example: Hamstrings can extend at the hip but cannot flex at the knee simotaneously -book

Describe passive insufficiency and provide an example:

When the muscles becomes elongated over 2 or more joints simultaneously; they reach a *length* that does not allow further motion by the opposite muscle. When the hip is flexed &the knee is extended the hamstrings are streched over 2 joints, enlongating the hamstrings to their maxium length -book

Define types of muscle contractions: • Eccentric: • Concentric: • Isometric: • Isokinetic:

Studied these in SG 2

**ASK** 21. Name some functional applications for Goniometry/ROM and MMT?

(correct?) MMT: Do issues with strength limit client's ability to complete tasks? If OT plans to develop an intervention program that involves improving strength or managing issues related to strength, the OT need to measure the strength capacity of the client! ROM: ?

2nd class lever:

*E*ffort *A*xis *R*esistance *2nd Class Lever: mechanical advantage* A-R-E or E-R-A Examples: wheel barrow or on toes gastroc. in ankle p/f when standing on toes (axis on toes)

3rd class lever:

*E*ffort *A*xis *R*esistance *3rd Class Lever: Large Arc Movement* A-E-R or R-E-A *most common in body *least amount of mechanical advantage Examples: Axis: Elbow joint at una and humerous Effort: inserion at bicepts Resistance: weight of forearm and hand Other example: rectus femurs in motion at tibia

First class lever

*E*ffort *A*xis *R*esistance **neck** *1st Class Lever: Balance* E-A-R or R-A-E (axis between effort & resistance) Examples: tricepts (arm overhead) in elbow flexon Axis: elbow joint Effort: triceps insertion at alcronon process Resistance: weight of forward & hand Also exampels: soleus in ankle p/f Body in balance

Frontal plane: Motions? Axis? • Example:

*Motions:* -Abduction/Adduction -Neck or trunk lateral flexion -Body segements move away of toward midline. *Axis:* Z *Example:* Radial deviation Trunk Lateral Flexon Finger Abduction

Transverse or Horizontal plane: Motions? Axis? • Example:

*Motions?* Trunk or neck rotation pronation / supination Internal/external rotation Horizontal abduction/ adduction *Axis?* Y *Example:* Forearm pronation Shoulder Horizontal adduction Shoulder external rotation Neck rotation

19. Describe some ways to reduce errors when doing joint ROM goniometry and MMT.

*ROM:* Take test at same time in day Temp in room type of goniometer used tester experience Do in same or similar setting Same person testing OTHER SOURCES OF ERROR: Reading the wrong side of the goniometer Having expectations of "what reading should be" & not accurately looking at goniometer A change in a patient's motivation to perform Measurement procedure error Error in documentation *MMT:* -Interest of client cooperation -Ton of voice of tester -Distractions -Clients ability to understand direction -Posture or client or therapist -Fatigue -Therapist understanding of operational definitions of various grades.

4. Describe Newton's three laws of motion and how they affect human motion:

*google examples* *Law 1: Equilibrium or law of intera* Object in motion stays in motion unless acted upon by outside force. *Law 2: Law of acceleration* acceleration of body is proportional to the magnitude of force upon it and proportional to weight of body *Law 3: Law of reaction* for ever force there i s an equal and opposite reaction

10. List situations where doing a Manual Muscle Test is contraindicated.

*joint pain & inflammaion* Neurological condition BECAUSE it: Create spasticity Alters reflex (inability to control voluntary mvmnt.) Loss of cortical control (inability to follow or understand directions)

20. If an OT can't complete a MMT as directed, what are alternate ways to assess strength?

-Another prime mover -Stabilizing muscles -Other muscle that cross joint & can act on joint -Accessory insertion: if more than one muscle inserts at same location -Tendon action: example: passive insufficiency -Rebound phenomenon: sudden relaxation of stronger antagonist muscle giving appearance of agonist motion -Gravity: Is client positioning self to allow gravity to assist in the motion?

6. Name 4 factors that affect stability:

1) Wide base of support 2) Low center of gravity 3) Gravity line at center of base of support 4) Heavy weight "WLGW"

1. What is a universal goniometer?

180 degrees or 360 degrees One stationary arm & one movable arm Different sizes Different types: Manual & Electronic A goniometer is an instrument that either measures an angle or allows an object to be rotated to a precise angular position.

When are negative values used when recording joint ROM?

20-150 of elbow flexion can be written as -20 extension which would be *hyperextension.*

14. If a patient is able to move a joint in full active range of motion against gravity, what letter or number grade is automatically given, before applying resistance?

3 or F for fair

• Define synarthroses and give an example:

A joint that produces no movement *primary purpose to offer stability *fibrous in nature

8. Explain how an OT would interpret this documentation of elbow ROM: 20-125:

Cant Fully Extend (full Extend 0) Cant Fully Flex (full flex should be around 145)

3. Define Center of gravity: • Where is the center of gravity when the human body is in the anatomical position?

Center of Gravity: point about which every particle of mass of the object is equally distributed. If the body were suspended at that point, it would balance. Often used to evaluate posture. Center of gravity of human body in anatomical position: S-2

15. How would an OT score these situations during manual muscle testing? a•Client demonstrates full ROM of shoulder abduction against gravity, but cannot take any resistance: b•Client demonstrates against gravity ROM of shoulder abduction for only this amount of AROM: 0 - 30: c•Client demonstrates against gravity ROM of shoulder abduction for only this amount of AROM: 0 - 100: d•Client demonstrates elbow flexion, in gravity eliminated position from 0 - 40: e•Client demonstrates elbow flexion, in gravity eliminated position from 0 - 100: f•Client asked to perform elbow flexion, in gravity eliminated position, but no motion was seen, and no muscle palpation was felt g•Client demonstrates full ROM of elbow flexion in a gravity eliminated position: h•Client asked to perform elbow flexion, in gravity eliminated position, but no motion was seen, and muscle palpation was felt:

Check: a. 3 or f b. 3+ or f c. 3- or f d. 2+ or p e. 2- or p f. 0 g. 2 or p h. 1 or t

Explain the difference between a close packed position and a loose or open packed position of a joint. -Closed Packed Position: -Open Packed Position

Closed: tight and compressed joint example: MCP at 90 degrees -Full flexion and extension Open: Loose and slack

Contraction of the biceps muscles in the arms while raising the body to do a chin-up:

Concentric

7. Define pressure and how can pressure be decreased?

Define: Force per area Can we decreased by increase area and decrease time. -Spliting & bracing -wheelchair cushions, bedding, adaptive eqiptment. -Tool handles

5. List situations where doing ROM measurements is contraindicated.

Dislocation Fracture Myosis Ossification Hemophiliac Ossification Surgery

16. When applying resistance during a Manual Muscle Test, should the OT place his/her hand proximal or distal to the joint of the muscle being tested? Why?

Distal to the joint/bone that is being moved by the muscle because of better mechanical advantage.

Contraction of the biceps muscles in the arms while lowering the body after doing a chin-up:

Eccentic

Contraction of the deltoid muscles while lowering your arm from 90 degrees of abduction to 0 degrees of abduction, while you are in a standing position:

Eccentric

Contraction of the hamstring musculature from 150 degrees of knee flexion to 0 degrees of knee flexion, while you are lying in prone position:

Eccentric

Contraction of the quadriceps femoris while lowering body from standing into sitting in a chair:

Eccentric

Contraction of the triceps while lowering the body during a push-up:

Eccentric

4. Define joint "End Feel"? • Define Normal End Feel: • Describe the following Normal End Feels: • Hard: • Soft: • Firm: • Define Abnormal End Feel: • Describe the following Abnormal End feels: • Hard: • Soft: *• Firm: • Empty: *• Spasm:

End feel: End range of PROM Normal End Feel: Exists with full ROM and normal joint anatomy stops movement Hard - bony (Locking out arm) Soft - soft tissue apposition (flexing arm) Firm - soft tissue stretch (tendon stretch in ulnar deviation) *Abnormal:* Structures other than normal anatomy stop movement Abnormal Hard (bone, loose bodies in joint, fracture, dislocation) Soft (edema, synovitis) Firm (muscular, capsular, or ligamentous shortening) Springy block (rebound, internal joint derangement) Empty (PROM could not be completed because of pain) Spasm (sudden stop)

Contraction of the triceps while raising the body during a push-up:

Essentric

Define functional classification of terminology of muscle activity •Flexors: •Extensors: •Rotators: •Prime mover or •Agonist: •Antagonist: •Co-Contraction: *•Synergist:* muscles that are synergist in elbow flexion prime mover??

Flexor: Anterior to joint Extensor: Posterior to joint Rotators: Medial & Lateral Prime-mover aka agonist: Responsible as primary muscle mover Antagonist: Muscle that is responsible for providing the *opposite* movement to the intended movement Co-contraction: *look up in p.p* the simultaneous activation of antagonist muscles around a joint provides the nervous system with a way to adapt the mechanical properties of the limb to changing task requirements—both in statics and during movement. Synergist: assist movement or help stabilize joints; so elbow flexion prime mover is biceps but pec major would be considered a synergist

Define diarthroses and give an example:

Joints whose primary purpose is to provide mobility, all uniaxial, biaxial and triaxial joints

Identify the type of muscle contraction: Contraction of the quadriceps femoris while coming up to stand from sitting in a chair:

KYLIE: CONCENTRIC

Define kinematic chain & describe the difference between an open and a closed kinematic chain:

Kinematic chain: combination of several joints uniting successive segments. Open: distal segments free Closed: distal segment fixed

**ASK** 2. Name the internal forces that influence body motion:

Ligament, muscle, bony

Why should an OT NOT do a manual muscle test when the joint is in a closed packed position?

MMT should be performed wit the joint in open packed position so that the client uses muscles and not joint soft tissue and/or boney structures to stabilize the joint

Sagittal plane: What movements? What axis? Example:

Movements: *Flexion* (2 body parts approach each other) *Extension* (2 body parts move away from each other) *Axis:* X *Examples:* elbow flexion ankle p/f hip flexon

18. What are substitution and trick motions? Provide an example.

Other muscle that cross joint & can act on joint -Accessory insertion: if more than one muscle inserts at same location -Tendon action: example: passive insufficiency -Rebound phenomenon: sudden relaxation of stronger antagonist muscle giving appearance of agonist motion -Gravity: Is client positioning self to allow gravity to assist in the motion? "Grat" Pg. 42-43 Clarkson

3. What is PROM & what is AROM? •Why is there a difference between the two measurements?

PROM: Therapist pushes further AROM: What you do without help Prom measurement is always the same or more *remember by PROM you go with someone*

5. Lever systems •Name the parts of a Lever: •Explain mechanical advantage:

Parts of lever: -Axis (joint) -moving force (muscles) , -Resistance (gravity +weight of limb + weight of object held) Mechanical Advantage: the ratio between the effort arm and the length of the resistance arm.

What should be assessed first, joint range of motion or manual muscle strength? Why?

ROM 1ST because you want to determine the joints integrity.

17. Why is it important to test and measure the uninvolved side first?

So you know the normal range and how far off the effected side may be. (correct?)

11. List situations where the OT should proceed with caution when doing a Manual Muscle Test.

Surgery -Eye -Abdomen -Nuero -History of cardiovascular problems -Over fatigue from: ms, md, polio syndrome, COPD, myasthenia gravis

Describe muscle length-tension relationship & why is this concept important. ME: GIVE EXAMPLE

The more our muscles are stretched, the less force they produce. Example: imagine carrying brick with arm fully extended; now imagine carrying brick with arm fully flexed Why is it like this? SARCOMERES

• Explain degrees of freedom, name the joint classification and give an example of a type of joint with: • One degree of freedom • Two degrees of freedom • Three degrees of freedom

The number of planes in which a joint in able to move. 1 degrees of freedom: uniaxial Hinge or pivot joints 2 degrees of freedom: bi-axial Condyloid, ellipsoidal, saddle 3 degrees of freedom: tri-axial glenohumeral and hip joints

10. Define Muscle tone:

The steady state of alert or arousal of muscle for the task demands to be placed on it determined by level of excitability

**ASK** Biomechanics: 1. Name the external forces that influence stability and mobility of body motion:

Weight, gravity, friction.

9. Explain the difference between a contracture and a contraction:

a contracture is more permanent - due to scars across joints, mouth, eyelid, etc. it's an abnormal bending of a joint in a fixed position (check in P.P)

Contraction of the triceps while pushing against a door that is struck:

isometric

6. List situations where the OT should proceed with caution when doing ROM.

ossification subluxation strain sprain hemophilic hyper-mobility pain inflammation infection ankylosis bone fragility medication

2. Goniometer placement: • Where should the axis be placed? • Where should the stationary arm be placed? • Where should the moveable arm be placed?

you know this.