Exam 1 - Clinical Kinesiology

Functional definition of *Ligaments*

Bands of fibrous connective tissue. - Support and hold the two bones of a joint together. - Prevent excessive joint movement. - Provide attachment for cartilage, fascia, or, in some cases, muscle. - Flexible but not elastic This flexibility is needed to allow joint motion, but the non-elasticity is needed to keep the bones in close approximation to each other and to provide some protection to the joint. When ligaments surround a joint, they are called *capsular ligaments*.

Tendon (functional definition, possible shapes)

Connect muscles to bones Two shapes: a cylindrical cord (e.g. the long head of the biceps tendon), or a flattened band (e.g. rotator cuff) Muscles provide the contractile force that causes joints to move. Therefore, they must span the joint to have an effect on that joint. Muscles are soft and cannot attach directly to the bone. A tendon must connect them to bone.

Planes of motion. How do they relate to axes?

Divisions of the body that describe the axis of rotation for joint motion

During a bicep curl, a _____ surface (ulna) moves on a fixed _____ surface (humerus), so the joint surface is moving in the *opposite* direction of the forearm. The ulna is rolling and gliding in the *same* direction.

During a bicep curl, a *concave* surface (ulna) moves on a fixed *convex* surface (humerus), so the joint surface is moving in the _______ direction of the forearm. The ulna is rolling and gliding in the _____ direction.

When a person "stretches" before exercise, he/she is demonstrating which muscle tissue characteristic?

Extensibility

T/F - Joints are less prone to injury in closed packed position, making this the best position for splinting/immobilization. If False, why?

F - Joints are *more* prone to injury bc this position. However, this is the best position for splinting/immobilization because ligaments and capsules are elongated/stretched. Prevents loss of ROM.

What type of cartilage with provides shock absorption for the joint?

Fibrocartilage

Joint motions and df - *Wrist* (define)

Flexion: palm toward forearm Extension: dorsum toward forearm Radial deviation: toward the thumb Ulnar deviation: toward the 5th digit

Resting position

Length of muscle at rest (un-stimulated or no forces)

We consider how biomechanics interact with our use of 'implements' (e.g. tennis racket, prosthesis, crutch) during various activities by looking at what two systems?

dynamic systems, static systems

Oblique muscles are shaped like...

feathers

Triangular

flat and fan shaped, narrow attachment at one end, broad at the other (Parallel; Pectoralis Major)

Aponeurosis

flat tendinous sheet (e.g. latissimus dorsi)

Kinetics (definition & what are the kinetics of the human body?)

forces causing movement; muscles

Elastic cartilage (functional definition)

found in ear and larynx (rigid but elastic properties) can be stretched and resume shape

Rhomboidal

four sided and flat (Parallel; Rhomboids)

Ventral/anterior

front of the body

Bony end feel

hard and abrupt limit to bone. bone contacts bone at the end of the range.

Accessory motion. 2 types of accessory motion.

involuntary motion. two types: 1. Joint play 2. Component movement

Superior / Inferior

upper / lower surface

Radial Deviation is what type of angular movement?

wrist ABduction

Ulnar deviation is what type of angular movement?

wrist ADduction

Capsular end feel (description and cause)

"leather-like" with give at the end of PROM. the result of limitation of the joint capsule tissues.

Articular cartilage (composition and functional definition)

(AKA hyaline cartilage) covers ends of bones has smooth, slick surface

Muscle tissue characteristics Stretch a muscle, and it will lengthen (a)_________. Remove the stretch, and it will return to its normal resting position (b)_________. Stimulate a muscle, and it will respond (c)_________ by shortening (d)_________; then remove the stimulus and it will return to its normal resting position (e)_________.

(a) Extensibility (b) Elasticity (c) Irritability d) Contractibility (e) Elasticity The properties of a muscle are summarized as follows: Stretch a muscle, and it will lengthen (*extensibility*). Remove the stretch, and it will return to its normal resting position (*elasticity*). Stimulate a muscle, and it will respond (*irritability*) by shortening (*contractility*); then remove the stimulus and it will return to its normal resting position (*elasticity*).

Fibrocartilage (composition and functional definition)

(meniscus, disks, labrum) provides shock absorption location: found in parts of the body where there is a great deal of pressure applied to joints

A synovial joint can be classified by which of the following: a) Number of axes b) Shape of bone c) Kind of joint motion d) Degrees of freedom

*NOT* (b) Shape of bone Joint type classified by: Number of axes, Kind of joint motion (shape of joint surface determines its type of movement), Degrees of freedom

Define the four types of Planes and Axes.

*The sagittal plane* passes through the body from front to back and divides the body into right and left parts. *The sagittal axis* is a point that runs through a joint from front to back. *The frontal axis* or *coronal plane* runs through a joint from side to side. *The frontal plane* passes through the body from side to side and divides the body into front and back parts. The vertical axis, also called *the longitudinal axis*, runs through a joint from top to bottom. *The transverse plane* passes through the body horizontally and divides the body into top and bottom parts. It is also called *the horizontal plane*.

Joint Structures

1) Bones 2) Ligaments 3) Capsule 4) Synovial membrane and synovial fluid

6 classifications for synovial joints by shape of the adjoining articular surface. Categorize each by number of axes.

1) Plane = uniaxial 2) Hinge = uniaxial 3) Pivot = uniaxial 4) Saddle = biaxial 5) Ellipsoid = biaxial 6) Ball and socket = multiaxial

Segments of the trunk and name the body parts in each one. Does the trunk include the neck and head?

1) Thorax/chest (ribs, sternum, and mostly thoracic vertebrae) 2) Abdomen/lower trunk (pelvis, stomach, and mostly lumbar vertebrae) No - the *neck* (cervical vertebrae) and *head* (skull) are separate segments.

The body is divided into segments by bones. What are the segments of the UE? Describe their bones and location (by joints).

1) arm (humerus) 2) forearm (radius and ulna) 3) hand (bones distal to the wrist) In the upper extremity, the *arm* is the bone (humerus) between the shoulder and the elbow joint. Next, the *forearm* (radius and ulna) is between the elbow and the wrist. The *hand* is distal to the wrist.

Segments of the LE. Describe their bones and location (by joints).

1) thigh (femur) 2) leg (tibia and fibula) 3) foot (bones distal to the ankle) The lower extremity is made up of three segments similar to those of the UE. The thigh (femur) is between the hip and the knee joint. The leg (tibia and fibula) is between the knee and the ankle joint, and the foot is distal to the ankle.

Where is the midline of the foot?

2nd digit of the foot

Convex-Concave Rule for a concave joint surface moving on a fixed convex surface. Discuss for body part/segment and roll and glide motions.

A concave joint surface will move on a fixed convex surface in the *same direction as the body part* that is moving. The roll and glide occur in *opposite* directions (of one another).

During hip abduction, the femur rolls superiorly and glides inferiorly on a fixed acetabulum. Discuss in terms of concave-convex rule.

A convex joint surface will move in a fixed concave surface in the opposite direction of the body part, the roll and glide occur in opposite directions. Apply to hip abduction.

Functional definition of *Joints*

A joint is a connection between two bones. Fx: - Allow motion. - Help to bear the body's weight and to provide stability. This stability may be mostly due to: - the shape of the bones making up the joint - soft tissue features

Eversion is what type of angular movement?

ABduction + pronation of the foot

Protraction is what type of angular movement? Describe motion.

ABduction of the scapula: movement of the vertebral border away from the vertebral column

Retraction is what type of angular movement? Describe motion.

ADduction of the scapula: movement of the vertebral border toward the vertebral column

Inversion is what type of angular movement? Describe motion.

ADducton + supination of the foot

Capsulitis

AKA "frozen shoulder" Swelling (protein-rich fluid that lies does scar tissue) of the joint capsule that leads it to stick to itself. With movement of joint, joint capsule folds over itself (like an accordion), gets stuck bc of swelling and can't straighten.

Contractibility

Ability of muscle to contract/shorten. Can have contractibility without irritability (internal and external stimulus is what is going to make the difference)

Extensibility

Ability to stretch or lengthen in response to force. Stretching increases flexibility.

*Joint play* involves *externally applied* force to create which of the following motions? a) gliding b) sliding c) spinning d) rolling e) all of the above

All of these movements (e) are type of ________? a) gliding b) sliding c) spinning d) rolling

Plantar Flexion is what type of angular movement?

Ankle Extension

One way synovial joints can be classified is by type of movement, which refers to the number of ____. Define axes and differentiate four types of movement around axes.

Axis Axes are points that run through the center of a joint around which a part rotates. a) Nonaxial joint: small amounts of linear motion. No angular motion. Gliding usually occurs. b) Uniaxial: movement occurs around 1 axis. c) Biaxial: movement occurs around 2 axes, at right angles to one another. d) Multiaxial: movement occurs around 2+ axes.

What is the name for linear movement of a joint surface parallel to the adjoining joint surface?

Gliding/Sliding motion

Joint movement occurs in a _____ and around an ______

Joint movement occurs around an *axis* that is always perpendicular to its *plane*. Another way of stating this is that joint movement occurs *in a plane* and *around an axis*

Most synovial joints have which of the following joint surface shapes? Give example. a) ovoid b) sellar c) saddle d) flat

Most synovial joints *ovoid* (a) joint surface shape. e.g. MCP joint Ovoid: articulating bones have a convex/concave relationship

Angular motion, also called Rotary motion

Movement of an object around a fixed point. All the parts of the object move through the *same angle*, in the *same direction*, and at the *same time*, but they *do not move the same distance*. e.g. when a person flexes his or her knee, the foot travels farther through space than does the ankle or leg.

Curvilinear motion

Movement that occurs in a curved path that isn't necessarily circular e.g. the path of a skier coming down a ski slope, the path a diver takes after leaving the diving board until entering the water, path of a thrown ball, a javelin thrown across a field, or the Earth's orbit around the sun

Rectilinear motion

Movement that occurs in a straight line e.g. the motion of a child sledding down a hill, a sailboarder moving across the water, or a baseball player running from home plate to first base.

Irritability

Muscles ability to respond to stimulus. Required for contractibility (must respond in order to contract)

Degrees of freedom

Number of planes in which a joint can move

Passive separation of joint surfaces can happen in this position

Open packed position (aka incongruent joint surface position, loose packed position, resting position)

You're less likely to hurt yourself in this position, but everything is also shortened. Capsule and supporting ligaments are lax.

Open packed position (aka incongruent joint surface position, loose packed position, resting position)

Angular movements

Produce an +/- in the angle between adjacent bones. Flexion (Dorsiflexion); Extension (Plantar Flexion); Hyperextension; Abduction (Protraction, Radial Deviation, Eversion); Adduction (Retraction, Ulnar Deviation, Inversion) Elevation (Scaption)

What is the name for rotation of joint surface on fixed adjacent surface?

Spin motion

Elasticity

ability to rebound to the resting length after removal of force.

Fibrocartilage (function, joints - location & e.g.)

acts as a shock absorber This is especially important in weight-bearing joints e.g. knee and vertebrae Intervertebral disks lie between the vertebral bones. Because of their very dense structure, these disks are capable of absorbing an amazing amount of shock that is transmitted upward from weight-bearing forces.

Functional definition of *Synovial membrane and synovial fluid*

Synovial membrane lines the inside of the synovial joint capsule and produces synovial fluid. Lubricates (allowing for free movement) Some shock absorption Provides nutrition for articular/hyaline cartilage

T/F - Body segments are rarely used to describe joint motion

True e.g. the surface of the proximal end of the humerus moves down, while the body segment (arm) moves up. The motion occurs at the joint (shoulder), and the body segment (arm) just goes along for the ride! An exception to this concept is the forearm. It is a body segment but functions as a joint as well. Technically, joint motion occurs at the proximal and distal radioulnar joints; however, common practice refers to this as forearm pronation and supination.

T/F - Depending on the moveable portion of the joint, the joint can use both portions of the convex-concave rule.

True - Convex-Concave: Femur (convex) rolling ad gliding (in opposite directions) on fixed tibia (concave) during a squat. Concave-Convex: Tibia (concave) rolling and gliding (in same direction) on the femur during leg extension. Tip: whichever portion of the joint is moving, the shape of that joint goes first

Match the description of each type of joint motion with its correct description (can use more than once): a) Roll b) Glide c) Slide d) Spin 1) Same point on each surface remains in contact with one another 2) New points on each surface come into contact throughout motion. 3) One joint on a joint surface contacts new points on the adjoining joint surface.

a-3) *Roll motion*: New points on each surface come into contact throughout motion. (e.g. GH joint) b-2) *Glide/slide motion*: One joint on a joint surface contacts new points on the adjoining joint surface. (e.g. carpal bones). Often occurs in uniaxial joints. c-1) *Roll motion*: Same point on each surface remains in contact with one another

When joint surfaces are *congruent*, they have maximum contact and are tightly compressed. This is also known as _________ position. Ligaments and capsules are in a _______ position, which provides *stability* to the joint.

When joint surfaces are _________, they have maximum contact and are tightly compressed. This is also known as *Close packed or Closed packed position* Ligaments and capsules are in a *stretched* position, which provides ______ to the joint.

*Accessory motion forces* (= the therapist) are used in joint mobilization. Select which of the following types of accessory motion forces are are used: a) Bending b) Traction c) Compression d) Rotary e) Shear

__________ (= the therapist) are used in joint mobilization. The following types are used: b) Traction <---- ----> c) Compression ----><---- e) Shear ^v Bending forces - don't apply to joints as much Rotary forces - should be intentionally avoided

Joint mobilization can improve ________ thus may lead to better ROM and pain free movement. a) joint mobility b) joint play c) component movement d) joint congruency

___________ can improve *joint play* (b) thus may lead to better ROM and pain free movement

*Component movements* are those that accompany _______ to allow full ROM. a) arthrokinematic motion b) articular motion c) kinetic motion d) osteokinetic motion e) kinematic motion

_____________ are those that accompany *osteokinetic motion* (d) to allow full ROM. e.g. upward rotation of scapula with shoulder abduction and flexion

*Joint mobilization* is performed in which of the following positions: a) Congruent b) Closed packed c) Incongruent d) Open packed e) Loose packed f) Resting position

_____________ is performed in *open packed position*, which is also known as: c) Incongruent d) Open packed e) Loose packed f) Resting position

Arthrokinematic motion

a joint's surface motion in relation to the body segment's motion

Pathological end feel (3 descriptions)

a) "empty" end feel; limited due to pain b) different than expected for the joint c) no resistance to movement

The best position for *splinting/immobilization* is: a) closed packed position b) open packed position c) resting position d) loose packed position

a) *closed packed position* is the best position for _____________. Elongated position of ligaments and capsules prevents loss of ROM.

Dynamic systems can be divided into

a) kinetics b) kinematics

Functional definition of *Capsule*

and encases the joint and protects the articular surfaces of the bones The outer layer of the joint capsule consists of fibrous tissue and supports and protects the joint. It is usually reinforced by *ligaments*. The inner layer of the joint capsule is lined with a *synovial membrane*, a thick, vascular connective tissue that secretes *synovial fluid,* a thick, clear fluid (similar to an egg white).

Tendons

attach muscles to bones

Lateral / Medial

away from the midline / toward midline

When each joint surface is concave in one direction and convex in another, the joint surface shape is ________: Select all that apply. a) ovoid b) sellar c) saddle d) convex/concave

b & c) Sellar or Saddle shaped joint (Sellar or Saddle are two names for the same joint surface shape) e.g. CMC joint Describe the joint surface shape.

Dorsal/posterior

back of the body

Caudal / Cranial/cephalad

closer to the feet / closer to the head

e.g. a person who has had a stroke affecting the right side of the brain may have ______ paralysis of the left arm and left leg

contralateral

Name two examples of nonaxial joints

costovertebral joints, intervertebral joints, carpal bones...

Joint motions and df - *Elbow* Same motions as what other joint?

df = 1 Flexion & Extension Same motions as *knee*

Joint motions and df - *Forearm* (define)

df = 1 Pronation: palm down Supination: palm up

Joint motions and df - *Ankle*

df = 2 Dorsiflexion & Plantar flexion Eversion & Inversion

Joint motions and df - *Fingers*

df = 2 *exception!* df (thumb and 5th digit) = 3 Flexion & Extension AB & AD Thumb & 5th digit/small finger = Opposition

Joint motions and df - *Scapula*

df = 3 Elevation & Depression Protraction/AB & Retraction/AD Upward rotation & Downward rotation

Joint motions & df - *Shoulder* Same motions as what other joint?

df = 3 Flexion & Extension IR & ER AB & AD Horizontal AB & Horizontal AD Same motions as the *hip*

Strap Muscle (type and example)

long & thin, fibers run entire length (Parallel, Sternocleidomastoid)

Unipennate

look like one side of feather. have central tendon. (Oblique, Flexor Pollicis)

Bipennate

looks like whole feather. have central tendon. (Oblique; Interosseous)

Multipennate

many fibers with oblique tendons in between E.g. Deltoid 3 parts (anterior, middle, posterior). Each section of muscle has another action

Biomechanics

mechanical principles applied to the human body

Scaption is what type of angular movement? Describe motion.

midplane elevation of the scapula diagonal movement through plane of the scapula (~30-45˚ anterior to the frontal plane)

Abduction/adduction will always occur in the ______ plane around the _______ axis

movement in the frontal plane around the sagittal axis

Flexion/extension will always occur in the _____ plane and _______ axis

movement in the sagittal plane around the frontal axis

Shoulder Elevation is what type of angular movement? Describe motion.

movement of the arm above should level (i.e. 90˚) to a vertical position along side head (i.e. 180˚). Occurs either through the sagittal plane (i.e. shoulder flexion) or the frontal plane (i.e. shoulder ABduction)

Thumb flexion (describe motion)

moves across the palm of the hand

ABduction of the thumb (describe motion)

moves anteriorly in plane perpendicular to the palm

Linear motion, also called Translatory motion

occurs in a more or less straight line from one location to another. All the parts of the object move the *same distance*, in the *same direction*, and at the *same time*

Bursae

padlike sacs around most joints where friction is greatest

Proximal / Distal

toward / away from the trunk

Fusiform (type and example)

spindle shaped, attach to tendons - not all fibers run length of muscle (Parallel, Biceps)

End feel

the "feel" of a joint when pressure is (externally) applied at the end of PROM

Contralateral / Ipsilateral

the opposite side of the body / the same side of the body

Osteokinematics How is it different from Arthrokinematics?

the relationship of the movement of bones around a joint axis (e.g., humerus moving on scapula) *Arthrokinematics* deals with the relationship of joint surface movement (e.g. humeral head's movement within glenoid fossa of scapula).

Kinematics

time, space and mass aspects of moving systems