MIDTERM #1 Flashcards
1
Q
arthrokinematics
A
movements that occur inside joint
(roll, spin, glide)
2
Q
osteokinematics
A
movement of body parts
(flex, ext, ADD, ABD)
3
Q
articulation classifications (3)
A
- structure (how they look)
- function (how much movement occurs)
- biomechanical properties (how they move)
4
Q
structural joints
A
fibrous
cartilaginous
synovial
5
Q
functional joints
A
synarthrosis - immovable
amphiarthrosis - slightly movable
diarthrosis - freely movable
6
Q
biomechanical properties
A
simple: two articulating surfaces
complex - two or more with articulating disc
compound - three or more
7
Q
3 types of structural joints
A
fibrous
cartilaginous
synovial
8
Q
3 types of fibrous joints
A
sutures
syndesmosis
interosseous membrane
9
Q
3 types of cartilaginous joints
A
synchondrosis
symphysis
epiphyseal cartilage
10
Q
synovial joints
A
-synovial cavity: synovial fluid
-hyaline cartilage: articular cartilage
-diarthrosis
11
Q
articular capsule: two membranes
A
fibrous (outside)
synovial (inside)
12
Q
synovial fluid functions
A
lubricates synovial cavity
reduces friction
shock absorbers
supplies oxygen & nutrients
takes away wastes like carbon dioxide
contains phagocytes to remove normal debris
13
Q
articular disc function
A
-act as shock absorbers
-make better fit between articular bones
-distribute weight & synovial fluid over greater surface area
14
Q
labrum
A
-fibrocartilaginous lip that extends from edge of joint socket
-helps deepen socket & increase surface area
*occurs in ball & socket
15
Q
tendon sheeth
A
-covering over tendon that reduces friction
-tube-like bursa that wraps around tendon (wrist & ankle)
-contains synovial fluid
-reduce friction in repetitive movements (back & forth)
16
Q
bursa
A
-fluid filled sac
-acts as cushion/ protection around joint
-reduce friction
17
Q
6 types of synovial joints
A
plane
hinge
pivot
condyloid
saddle
ball & socket
18
Q
plane joints
A
gliding
biaxial / triaxial
19
Q
hinge (ginglymus) joints
A
flexion & extension
uniaxial
20
Q
pivot (trochoid) joints
A
rotation
uniaxial
21
Q
condyloid (ellipsoid) joints
A
flexion/ extension, ABD/ADD, circumduction
biaxial
22
Q
saddle (sellar) joints
A
flexion/ extension, ABD/ADD, circumduction
biaxial
23
Q
ball & socket (spheroid) joints
A
flexion/ extension, ABD/ADD, rotation
triaxial / multiaxial
24
Q
factors affecting contact in synovial joint
A
-structure/ shape of articulating bones, how closely they fit together
-strength & tension/ tautness of ligaments around joint, in certain positions, restrict some ROM & direct movement at joint
-arrangement & tension of mm, flexed hip restricted by hamstrings
-contact of soft parts, may limit mobility
-hormones: relaxin produced at or near birth increases flexibility of fibrocartilage in pubic symphysis joint to expand the pelvic outlet for delivery
-disuse: restricts movement, decreases synovial fluid, mm atrophy, joint becomes less mobile & flexible
25
ROM
measurement of amount of movement around a specific joint
26
passive (relaxed) ROM
therapist makes motion of joint while patient is relaxed through unrestricted range
anatomic barrier = end of PROM
27
active ROM
patient “actively” contracts voluntary muscles crossing joint, moving joint through its ROM
physiological barrier = end of AROM
28
close packed position
-joint stability = greatest
-max mobility
-max stability
29
open (loose) packed position
-little congruity
-minimal stability
-minimal mobility
30
capsular pattern of restriction
predictable pattern of movement restriction that occurs in a synovial joint when entire joint capsule is injured / affected
-result of a total joint reaction
*most restricted to least
31
proprioception - kinesthesia
perception of body movements
sensory information travels to brain relaying information about what our joints are doing - our brain responds
32
3 types of proprioceptors around joints
muscle spindles: within skeletal muscles
tendon organs: within tendons
joint kinesthetic receptors: within synovial joint capsule
33
muscle spindles
measure LENGTH in skeletal muscle
-finely controlled: finger & eye movements, mm spindles plentiful
-coarser, forceful: thigh muscles, mm spindles fewer
34
golgi tendon organs
protect TENDONS
-tension & force
35
joint kinesthetic receptors
monitor STRETCH
-joint kinesthetic receptors
-free nerve endings
-Ruffini corpuscles
-small Pacinian corpuscles
-joint ligaments
36
common joint disorders
-sprain: stretching/ tearing of ligament
-dislocation: joint alignment interrupted
-subluxation: partial/ incomplete dislocation of joint
-bursitis: inflammation of bursa around joint
-tendinitis: inflammation of tendon / tendon sheath (tenosynovitis)
-arthritis: inflammation of joint, caused by age related degeneration, past trauma, inflammatory or autoimmune diseases or metabolic diseases (gout)
37
effects of aging on joints
-decreased production of synovial fluid
-decreased joint space
-articular cartilage becomes thinner
-ligaments shorten & lose some of their flexibility
-muscles weaken & weak joints
38
4 shoulder joints
glenohumeral (GH)
scapulothoracic
sternoclavicular (SC)
acromioclavicular (AC)
39
sternoclavicular (SC) joint - type & movements
synovial, saddle or plane, diarthrosis, multiaxial
elevation, depression, protraction, retraction, rotation
40
sternoclavicular (SC) joint - articular surfaces
convex/concave sternal head of clavicle on concave/convex manubrium of sternum
41
sternoclavicular (SC) joint - ligaments
joint capsule
sternoclavicular (anterior & posterior)
interclavicular
costcoclavicular
articular disc
42
acromioclavicular (AC) joint - type & movements
synovial, plane, diarthrosis, triaxial
elevation, depression, protraction, retraction, upward/ downward rotation
43
acromioclavicular (AC) joint- articular surfaces
convex acromion on convex lateral clavicle
44
acromioclavicular (AC) joint - ligaments
fibrous capsule
acromioclavicular
coracoclavicular (trapezoid & conoid)
coracoacromial
45
glenohumeral (GH) joint - type & movements
synovial, ball & socket, diarthrosis, multiaxial
flexion & extension, ABD & ADD, horizontal ABD & ADD, medial & lateral rotation, circumduction
46
glenohumeral (GH) joint - articular surfaces
convex head of humerus on concave glenoid cavity of scapula
47
glenohumeral (GH) joint - ligaments
ANTERIORLY: superior, middle, inferior humeral ligaments
POSTERIORLY: coracohumeral, transverse ligament
48
transverse ligament function
holds long head of biceps tendon in intertubercular groove
49
shoulder bursa (largest)
subacromial/ subdeltoid bursa
lies just below acromion & deltoid mm
50
glenoid labrum (shouder)
made of fibrocartilage attached to rim of glenoid cavity
deepens cavity & increases surface of joint
51
GH movements are coupled with...
movements in AC & SC joints at same time
52
GH - loose packed position
40-55º ABD
30º horizontal ADD (in scapular plane)
53
GH - close packed position
full ABD with lateral (external) rotation
54
GH - capsular pattern of restriction
1: lateral (external) rotation
2: ABD
3: medial (internal) rotation
55
GH - ROM
Flexion: 160-180º
Extension: 50-60º
Abduction: 170-180º
Adduction: 50-75º
Horizontal abduction/flexion: 130º
Horizontal adduction/ext: 45º
Internal/ external Rotation: 80-90º
56
GH - subacromial space
region between humerus & acromion
roof formed by: CORACOACROMIAL ligament
57
GH - subacromial space: 3 structures live inside
1. supraspinatus tendon
2. biceps (long head) tendon
3. subacromial bursa
58
scapulothoracic joint - type & movements
not a true joint, modified gliding, mostly mm tissue (serratus anterior, subscapularis), CT, fascia, large bursa (subscapular)
sliding/ gliding, protraction, retraction, elevation, depression, upward & downward rotation of glenoid fossa
59
scapulothoracic joint - articular surfaces
concave subscapular fossa surface on convex posterior ribs
(*no ligaments)
60
scapulothroacic - loose packed position
arm resting at side
*no close packed position
61
scapulothoracic rhythm - involves 3 joints moving together synchronized
humerus
scapula
clavicle
62
scapulothoracic joint movements - PHASE 1
humerus: 30º ABD
scapula: minimal movement
clavicle: 0-5º elevation
63
scapulothoracic joint movements - PHASE 2
humerus: 40º ABD
scapula: 20º upward rotation
clavicle: 15º elevation
64
scapulothoracic joint movements - PHASE 3
humerus: 60º ABD
scapula: 30º upward rotation
clavicle: 30-50º posterior rotation, 15º upward elevation
65
humeral-scapular ratio
= for every 2º motion of humerus there is 1º motion in scapula
66
scapulothoracic joint - AROM
protraction & retraction: 30º
elevation & depression: 30º
medial & lateral rotation: 50º
67
scapulothoracic joint - FUNCTIONS
1. increases ROM of shoulder for greater reach
2. maintains length-tension relationship with deltoid mm
3. provides GH stability: GH head alignment
4. injury prevention through shock absorption
5. permits elevation of body
68
muscles that move the shoulder - FLEXION
anterior deltoid
biceps brachii
pec major
69
muscles that move the shoulder - EXTENSION
posterior deltoid
triceps brachii
70
muscles that move the shoulder - ABD
middle deltoid
supraspinatus
71
muscles that move the shoulder - ADD
teres major
lats
72
muscles that move the shoulder - HORIZONTAL ADD
pec major
coracobrachialis
73
muscles that move the shoulder - INTERNAL ROTATION
subscapularis
pec major
lats
74
muscles that move the shoulder - EXTERNAL ROTATION
infraspinatus
teres minor
75
distal elbow joints - elbow joint complex
humeroulnar
humeroradial
proximal radioulnar
(mid & distal radioulnar)
76
humeroulnar/ trochlear joint - type & movements
synovial, hinge, diarthrosis, uniaxial
flexion & extension
77
humeroulnar/ trochlear joint - articular surfaces
concave surface of trochlear notch of ulna & convex trochlea of humerus
78
humeroulnar/ trochlear joint - ligaments
joint capsule
radial/ lateral & ulnar/medial collateral ligaments
79
pronation/ supination
during pronation, the radius crosses over the ulna
80
humeroulnar/ trochlear joint - loose packed position
70º elbow flexion
10º supination
81
humeroulnar/ trochlear joint - close packed position
extension & supination
82
humeroulnar/ trochlear joint - capsular pattern of restriction
1: flexion
2: extension
83
humeroulnar/ trochlear & humeroradial joints - ROM
Flexion: 140-150º
Extension: 0-10º
Supination: 90º
Pronation: 80-90º
84
humeroradial joint - type & movements
synovial, hinge, diarthrosis, uniaxial
flexion & extension
85
humeroradial joint - articular surfaces
concave surface radial head with convex surface capitulum of humerus
86
humeroradial joint - ligaments
joint capsule
radial/lateral & ulnar/medial collateral ligaments
87
humeroradial joint - loose packed position
full extension & full supination
88
humeroradial joint - close packed position
elbow flexed 90º
forearm supinated 5º
89
humeroradial joint - capsular pattern of restriction
1: flexion
2: extension
3: supination
4: pronation
90
proximal/ superior radioulnar joint - type & movements
synovial, pivot, diarthrosis, uniaxial
pronation & supination
91
proximal/ superior radioulnar joint - articular surfaces
convex radial head & concave radial notch of ulna
92
proximal/ superior radioulnar joint - ligaments
annular ligament
quadrate ligament
93
proximal/ superior radioulnar joint - loose packed position
35º supination
70º flexion
94
proximal/ superior radioulnar joint - close packed position
forearm supinated 5º
95
proximal/ superior radioulnar joint - capsular pattern of restriction
1: supination
2: pronation
96
elbow joint complex - accessory ligaments
radial/ lateral collateral (LCL)
ulnar/ medial collateral (MCL)
annular ligament
articular/ joint capsule
97
ulnar/ medial collateral ligament - 3 bundles
anterior
posterior
transverse
98
annular ligament
surrounds radial head & radial notch of ulna
keeps radial head in radial notch & allows for pronation/ supination
99
elbow joint complex - mm action summary
-flex: brachialis, biceps brachii, brachioradialis
-ext.: triceps brachii, anconeus
-sup: supinator, biceps brachii
-pro: pronator quadratus, pronator teres
100
mid radioulnar joint - type & movements
fibrous, syndesmosis (interosseous membrane), amphiarthrosis, uniaxial
supination & pronation
101
mid radioulnar joint - articular surface & ligaments
interosseous margins of radius & ulna (fibrous tissue binds bones together)
ligaments: interosseous membrane
102
mid radioulnar joint - movements
supination: 90º
pronation: 80-90º
103
distal radioulnar joint - type & movements
synovial, pivot, diarthrosis, uniaxial
supination & pronation
104
distal radioulnar joint - articular surfaces
head of ulna & ulnar notch of distal radius
105
distal radioulnar joint - ligaments
articular disc (triangular fibrocartilage complex - TFCC)
dorsal & palmar radioulnar ligaments
106
elbow joint complex - bursa
(bicipitoradial)
OLECRANON bursa:
-intratendinous (inside tendon)
-subtendinous (below tendon)
-subcutaneous (olecranon) (below skin)
107
elbow complex - carrying angle
angle measured between axis of radius & axis of humers
-normal to have small degree cubitus valgus (5-15º)
108
cubitus valgus
carrying angle = LOWER than normal
"L" shaped
109
cubitus varus
carrying angle = HIGHER than normal
110
radiocarpal (wrist) joint - type & movements
synovial, condyloid, diarthrosis, biaxial
flexion, extension, ADD (ulnar deviation), ABD (radial deviation)
111
radiocarpal (wrist) joint - articular surfaces
biconcave distal end of radius on biconvex proximal surface of scaphoid, lunate, part of triquetrum
disc/ TFCC separates radiocarpal from radioulnar joint
112
radiocarpal (wrist) joint - ligaments
fibrous capsule
ulnar & radial collateral
palmar & dorsal radiocarpal
113
triangular fibrocartilage complex (TFCC)
binds radius & ulna together -
separates distal radioulnar joint & ulna from radiocarpal joint
adds stability to wrist & acts as cushion
114
radiocarpal (wrist) joint - loose packed position
neutral with slight ulnar deviation
115
radiocarpal (wrist) joint - close packed position
extension with radial deviation
116
radiocarpal (wrist) joint - capsular pattern of restriction
flexion & extension equally limited
117
radiocarpal & intercarpal joints - ROM
flexion: 80-90º
Extension: 70-90º
radial deviation (ABD): 15º
ulnar deviation (ADD): 30-45º
118
midcarpal joint - type & movements
synovial, saddle, diarthrosis, biaxial
119
midcarpal joint - articular surfaces
proximal & distal row of carpals
-scaphoid articulates with trapezium, trapezoid, capitate
-lunate articulates with capitate
-triquetrum articulates with hamate
120
midcarpal joint - ligaments
transverse carpal ligament (flexor retinaculum)
121
midcarpal joint - movements (flex & ext)
flexion: 40º
extension: 20º
122
midcarpal joint - loose packed position
neutral / slight flexion with ulnar deviation
123
midcarpal joint - close packed positon
extension with ulnar deviation
124
midcarpal joint - capsular pattern of restriction
equal limitation of flexion & extension
125
3 transverse joints through wrist that allow for maximum movement & stability
radiocarpal joint
midcarpal joint
carpometacarpal joint
126
intercarpal joints - type & movements
synovial, plane, diarthrosis, uniaxial
slight gliding
127
intercarpal joints - articular surfaces
between all carpal bones & between proximal (scaphoid, lunate, triquetrum) & distal (trapezium, trapezoid, capitate, hamate) rows of carpals
128
intercarpal joints - ligaments
fibrous capsule
palmar & dorsal interosseous/ intercarpal ligaments
129
intercarpal joints - open packed position
neutral/ slight flexion
130
intercarpal joints - close packed position
extension
(*no capsular pattern of restriction)
131
carpometacarpal (CMC) joint - type & movements (thumb & fingers)
thumb (1st digit): synovial, saddle, diarthrosis, triaxial
fingers (2-5 digits): synovial, plane, diarthrosis, uniaxial
thumb: flex, ext, ADD, ABD, rotate, circ, opposition/ reposition
fingers: gliding
132
carpometacarpal (CMC) joint - articular surfaces (thumb & fingers)
thumb: trapezium with first metacarpal
fingers: distal surface of distal row of carpal bones & bases of metacarpals 2-5
133
carpometacarpal (CMC) joint - ligaments
fibrous capsule
carpometacarpal
interosseous carpometacarpal
134
carpometacarpal (CMC) joint - movements
-1st cmc (thumb): lots of movement
-2nd cmc: minimal movement
-3rd cmc: even less (acts as central pillar)
-4th cmc: 10-15º dorsovolar movement
-5th cmc: 25-30º dorsovolar movement
135
carpometacarpal (CMC) joint - ROM (thumb)
Flexion: 45-50º
Extension: 0º
ABD: 60-70º
ADD: 30º
Opposition: thumb tip to head of 5th metacarpal
136
carpometacarpal (CMC) joint - loose packed position (thumb & fingers)
thumb: midway between ABD & ADD, midway between flex & ext
fingers: midway between flex & ext
137
carpometacarpal (CMC) joint - close packed position (thumb & fingers)
thumb: full opposition
fingers: full extension
138
carpometacarpal (CMC) joint - capsular pattern of restriction (thumb & fingers)
thumb: ABD, extension
fingers: equal limitation in all directions
139
intermetacarpal joints - type & movements
synovial, plane, diarthrosis, uniaxial
gliding
140
intermetacarpal joints - articular surfaces
adjacent surfaces bases of metacarpals 2-5
141
intermetacarpal joints - ligaments
fibrous capsules
interosseous intermetacarpal (palmar, dorsal, deep transverse metacarpal)
142
metacarpophalangeal (MCP) joints - type & movements (thumb & fingers)
thumb (1st digit): synovial, condyloid, diarthrosis, triaxial
fingers (2-5 digits): synovial, condyloid, diarthrosis, biaxial
thumb: flex, ext, ADD, ABD
fingers: flex, ext, ADD, ABD
143
metacarpophalangeal (MCP) joints - articular surfaces (thumb & fingers)
thumb: distal end 1st metacarpal & proximal phalanx
fingers: convex distal end 2-5 metacarpals & concave ends proximal phalanges
144
metacarpophalangeal (MCP) joints - ligaments (thumb & fingers)
fibrous capsules
collateral ligaments
145
metacarpophalangeal (MCP) joints - ROM (thumb & fingers)
thumb: flexion 50-55º
fingers:
flexion: 85-90º
extension: 30-45º
ABD: 20-30º
146
metacarpophalangeal (MCP) joints - loose packed position
slight flexion
147
metacarpophalangeal (MCP) joints - close packed position (thumb & fingers)
thumb: full opposition
fingers: full flexion
148
metacarpophalangeal (MCP) joints - capsular pattern of restriction
flexion, extension
149
where are the interphalangeal (IP) joints ?
thumb (pollex)
proximal
distal
150
interphalangeal (IP) joints - type & movements
synovial, hinge, diarthrosis, uniaxial
flexion & extension
151
interphalangeal (IP) joints - articular surfaces
heads of most proximal phalanges & bases of most distal phalanges
152
interphalangeal (IP) joints - ligaments
fibrous capsules
palmar plate
medial & lateral collateral
153
interphalangeal (IP) joints - ROM (thumb & fingers)
Thumb: flexion: 85-90º
extension: 0-5º
fingers - proximal: flexion: 100-115º
fingers distal: flexion: 80-90º
extension: 20º
154
interphalangeal (IP) joints - loose packed position
slight flexion
155
interphalangeal (IP) joints - close packed position
full extension
156
interphalangeal (IP) joints - capsular pattern fo restriction
flexion, extension
