Module 3 Quiz Flashcards Preview

CALU - Kinesiology > Module 3 Quiz > Flashcards

Flashcards in Module 3 Quiz Deck (346):
1

What are the bones of the pelvis?

Sacrum, Coccyx, 2 Pelvic Bones

2

What are the three components of a pelvic bone that fused together?

Ilium
Ischium
Pubis

3

Why is the bony pelvis called the pelvic girdle?

It encircles the body and provides a firm, stable base of attachment for the femurs.

4

What are the 2 types of pelvic motion?

Intrapelvic (SIJ or pubic symphysis)
Entire pelvis (relative to trunk or thigh)

5

What is the major ligament of the pubic symphysis?

Arcuate pubic ligament

6

What type of joint is the SI joint?

Nonaxial plane

Mixed synovial/fibrous
Mixed diarth/amphiarthrotic

7

Why does the SI joint transition from a synovial joint to a fibrous joint as we age?

Weight-bearing forces from above, wedging the sacrum into pelvic bones, and forces transmitted up from the LEs

8

Aside from non axial gliding, what major motion can the SI joints do?

Nutation/counternutation (axial movements in the sagittal plane)

9

What is nutation and counternutation?

Sagittal plane

Nutation - sacral base move anterior and inferior (but pelvis posterior tilts)

Counternutation - sacral base move posterior and superior (but pelvis anterior tilts)

10

Major ligaments of the SIJ (4)

Sacroiliac ligaments (ant, post, interosseus)
Sacrotuberous ligament
Sacrospinous ligament
Iliolumbar ligament

11

What is the dividing point between the greater and lesser sciatic notch?

Ischial spine

12

The sciatic nerve exits the pelvis through the...?

Greater sciatic foramen (created by greater sciatic notch and sacrotuberous ligament)

13

What is the weight transfer occurring at the SIJ?

Weight of axial body to pelvic bones of lower extremities

14

What is reverse action of the lumbosacral joint?

When the pelvis moves relative to the lumbar spine at the LS

Also when lower lumbar spine moves relative to upper spine

15

Plane movements of the spine

Anterior/posterior tilt in sagittal plane

Depress/elevate in frontal plane (one side up one side down)

Rotation in transverse plane

16

Depression of the pelvis on one side is also called...

lateral tilt

(Ex: right side depressed = right lateral tilt)

17

What is reverse action at the hips?

When pelvis moves on fixed thighs

18

ROM of pelvis

Anterior Tilt: 30
Posterior Tilt: 15
R/L Depression: 30
R/L Rotation: 15

19

Posterior tilt of the pelvis at the lumbosacral joint is analogous to _____ of the trunk at lumbosacral joint

flexion

20

Muscles that perform flexion of the trunk also perform ________ of the pelvis at the lumbosacral joint

posterior tilt

21

Examples of muscles that would perform anterior tilt of the pelvis (extension of the trunk)

Erector spine group
Transversospinalis group
Quadratus lumborum
Latissimus dorsi

22

Examples of muscles that would perform posterior tilt of the pelvis (flexion of the trunk)

Rectus abdominis
External oblique
Internal oblique

23

Elevation of the right pelvis (depression of the left pelvis) at the LS is analogous to _________ of the trunk at the LS

right lateral flexion

24

Right rotation of the pelvis at the LS is analogous to _______ of the trunk at the LS

left rotation

25

Examples of muscles that would perform right rotation of the pelvis (left rotation of the trunk)

Left-sided ipsilateral rotators (left erector spinae, letter internal oblique) and right contralateral rotators (right transversospinalis group, right external oblique)

26

Anterior tilt of the pelvis at the hip joint is analogous to ______ of the thigh

flexion

27

Muscles that perform flexion of the thigh also perform ______ of the pelvis

anterior tilt

28

Muscles that perform extension of the thigh also perform ______ of the pelvis

posterior tilt

29

Muscles that perform depression of the right pelvis also perform _______ of the right thigh

abduction

30

Muscles that depress the pelvis on one side of the body also _______ on the opposite side of the body

elevate the pelvis

31

Hiking the left hip means what is happening at the right hip?

Elevation

32

Muscles that perform right rotation of the pelvis also perform ______ of the right thigh and _______ of the left thigh

medial rotation; lateral rotation

33

Which side of the pelvis is closer to midline anteriorly when rotating to the right?

Left side

34

Lateral rotators of the thigh at the hip joint can also perform ______ of the pelvis

Contralateral rotation

35

Sacral base angle is a measure of the degree of _____ tilt of the sacrum

anterior

36

Any change in the sacral base angle affects _______ of the spine

posture

37

Relationship between the posture and movement of the pelvis and spine is referred to as

lumbopelvic rhythm

38

What is a normal sacral base angle

30 degrees

39

A sacral base angle greater than 30 degrees results in _____ spinal curvature

increased

40

The desire of the body to bring the head to a level posture is known as

righting reflex

41

Why do we want the head level?

Inner ear function for proprioception
Vision

42

ROM of hip joint

Flex: 90
Ext: 20
Abd: 40
Add: 20
IR: 40
ER: 50

43

Ligaments of the hip joint (7)

Fibrous joint capsule
Iliofemoral ligament
Ischiofemoral ligament
Pubofemoral ligament
Zona orbicularis
Transverse acetabular ligament
Ligamentum teres

44

What is the zone orbicularis?

Strong circular deep fibers of the hip joint capsule that surround the neck of the femur

45

The fibrous capsule of the hip joint is reinforced by which 3 capsular ligaments?

Iliofemoral ligament
Ischiofemoral ligament
Pubofemoral ligament

46

Location of the iliofemoral ligament?

Anterior-superior

Anterior inferior iliac spine --> intertrochanteric line

47

Function of the iliofemoral ligament?

Limits extension of the thigh at hip

Limits posterior tilt of pelvis at hip

48

What is the Y ligament?

The iliofemoral ligament (shaped like an upside down Y)

49

If someone stands with extension of the hip joint (extended thigh or posterior pelvic tilt), which ligament holds the body weight?

Y ligament (iliofemoral ligament) - super strong!

50

Location of the pubofemoral ligament?

Anterior-inferior

Pubis --> femur

51

Function of the pubofemoral ligament?

Limits abduction of thigh

Limits extreme extension of thigh

Limits ipsilateral depression of pelvis

52

Location of the ischiofemoral ligament?

Posterior

ischium --> femur

53

Function of the ischiofemoral ligament?

Limits medial rotation of thigh

Limits extension of thigh

Limits ipsilateral rotation of pelvis

54

What ligament runs from internal surface of acetabulum to head of the femur? Purpose?

Ligamentum teres

Conduit for blood vessels and nerves to femoral head

55

Closed-packed position of hip joint?

Full extension

56

Articular cartilage of the acetabulum is also called...

lunate cartilage (crescent-shaped)

57

What is the labrum made of?

fibrocartilage

58

Purpose of labrum?

Increase depth of socket --> increasing stability

59

At the inferior margin of the acetabulum, the two ends of the labrum are connected by the...

transverse acetabular ligament

60

What is the concern with abnormal femoral angles of inclination and torsion?

Bone alignment / muscle compensations

Decreased shock absorption

Increased degenerative changes

61

What is the femoral angle of inclination?

Head/neck relative to shaft in frontal plane

62

Normal femoral angle of inclination?

125 degrees

63

Femoral angle of inclination <125 degrees is called...

coxa vara

64

Femoral angle of inclination >125 degrees is called...

coxa valga

65

Which leads to a longer lower extremity? Coxa vara or valga?

Valga

66

What is the femoral torsion angle?

Head/neck relative to shaft in transverse plane (shaft twisted medially relative to head and neck)

67

Normal femoral torsion angle?

Head/neck 15 degrees away from the frontal plane (anteversion)

68

Femoral torsion angle less than 15 degrees is called...

retroversion (more medially rotated when foot straight)

69

Femoral torsion angle greater than 15 degrees is called...

excessive anteversion (more laterally rotated when foot straight)

70

Which results in toe-in posture: retroversion or excessive anteversion

excessive anteversion (need to compensate by medially rotating thigh to get proper alignment)

71

Why does toe-in or toe-out posture occur?

Compensation to optimally line up the articular surfaces of the femur and acetabulum

72

Why is flexion posterior from the knee but anterior from the elbow?

Upper limb buds laterally rotate (ventral surface anterior) and lower limb buds medially rotate (ventral surface posterior) during embryo development

73

Why are children prone to toe-in posture?

Femoral torsion angle starts at about 30-40 degrees and decreases to 15 at about age 6.

74

What is a coupled action?

Two different joint actions tend to be coupled together (if one occurs, the other also tends to occur)

75

What is the coupled action to when a person flexes the right thigh at the hip to kick a ball?

Pelvis is posteriorly tilted at left thigh to increase range of motion of the kick

76

Thigh extension of the right hip is coupled with...

left pelvic anterior tilt

77

Thigh abduction of the right hip is coupled with...

Left pelvic depression

78

Thigh adduction of the right hip is coupled with...

Left pelvic elevation

79

Thigh lateral rotation of the right hip is coupled with...

Left pelvic rotation

80

What are the articulations of the tibiofemoral joint?

Medial/lateral condyles of femur
Plateau of tibia

81

What are the articulations of the patellofemoral joint?

Posterior surface of patella
Intercondylar groove of femur

82

What is the synovial subtype of the knee joint?

Modified hinge joint

(biaxial diarthrotic)

83

How much knee flexion is required to allow rotation?

30 degrees

84

Medial rotation of the leg at the tibiofemoral joint is equivalent to ______ of the thigh at the tibiofemoral joint.

lateral rotation

85

ROM of leg at tibiofemoral joint

F: 140
E: -5
IR: 15
ER: 30

86

Why are ligaments of tibiofemoral joint often injured?

Large forces transmitted to joint, weight-bearing, lack of bony stability - requires ligaments to work very hard at stability

87

Is the proximal tibiofibular joint in the knee joint capsule?

No

88

What is the anterior capsule of the tibiofemoral joint reinforced by?

Distal quadriceps femoris tendon
Patella
Infrapatellar ligament
Retinacular fibers (expansions of quads)

89

What is the lateral capsule of the tibiofemoral joint reinforced by?

Lateral collateral ligament
Iliotibial band
Lateral retinacular fibers

90

What is the medial capsule of the tibiofemoral joint reinforced by?

Medial collateral ligament
3 pes anserine muscle tendons
Medial retinacular fibers

91

What is the posterior capsule of the tibiofemoral joint reinforced by?

Oblique popliteal ligament
Arcuate popliteal ligament
Fibrous expansions of popliteus, gastrocnemius, and hamstrings

92

What does the medial collateral ligament limit?

Abduction of the leg at the tib-fem joint in frontal plane

93

What are the attachments of the MCL?

Medial epicondyle of femur
Medial proximal tibia

94

What are the attachments of the LCL?

Lateral epicondyle of femur
Head of fibula

95

What does the LCL limit?

Adduction of leg at tib-fem joint in frontal plane

96

Are the cruciate ligaments of the knee intra-articular? Intra-synovial?

Intra-articular
Extra-synovial

97

What are the attachments of the ACL?

Anterior tibia
Posteriolateral femur

98

What does the ACL limit?

Anterior translation of leg when thigh is fixed

Posterior translation of thigh when leg is fixed

Hyperextension of tibiofemoral joint

Rotation

99

What are the attachments of the PCL?

Posterior tibia
Anteromedial femur

100

What does the PCL limit?

Posterior translation of leg when thigh is fixed (anterior translation when leg is fixed)

End range flexion of tib-fem

101

If an impact from the lateral side causes abduction of the leg (genu valgum), what ligament will be torn?

MCL

102

Why is the LCL less injured than the MCL?

Would need a force from the medial side causing adduction of leg (genu varum) and this is less common

103

What is the test of translation of the knee joint?

Anterior/posterior drawer test

104

What is the most commonly injured ligament of the knee? How?

ACL

Anterior translation force of tibia on fixed thigh (posterior translation force of tibia on fixed leg); Hyperextension; rotation forces; "cutting" - forceful extension and rotation with planted foot

105

What does the oblique popliteal ligament limit?

Full extension of tib-fem

106

What does the arcuate popliteal ligament limit?

Full extension of tib-fem

107

Where is the patellar ligament?

Between patella and tibial tuberosity (part of distal tendon of quad fem)

108

What is the closed-packed position of the tib-fem joint?

Full extension

109

What are the 3 pes anserine muscles?

Sartorius
Gracilis
Semitendinosus

110

How do the pes anserine muscles stabilize the knee joint?

Stabilize medial side

111

What are the menisci made of?

fibrocartilage

112

What are the open ends of the menisci called?

Horns

113

Where are menisci thickest/thinnest?

Thick: peripheral
Thin: central

114

What is the function of the menisci?

Increase congruency of tib-fem joint and therefore stability (make sockets for the femoral condyles)

115

How much weight-bearing force do the menisci absorb

Half force through tib-fem joint

116

Why is the medial meniscus more frequently injured than lateral?

More firmly attached and therefore has decreased mobility

Also attached to the MCL and forces that stress the MCL also transfer to the medial meniscus

117

Why is healing difficult for menisci?

Blood supply is limited

118

What is the screw-home mechanism of the knee?

During last 30 degrees of tib-fem joint extension, concomitant rotation occurs

Lateral rotation of leg if thigh is fixed, medial rotation of thigh if leg is fixed

Locks joint and increases stability; decreases work of quads when in full extension

119

How much quad contraction is needed to maintain standing when knee joints are fully extended?

None (due to screw-home mechanism)

120

Mechanics of the screw-home mechanism?

Passive pull of ACL
Pull of vastus laterals

Larger lateral condyle keeps extending when medial condyle stops; lateral pivots around fixed medial condyle (medial rotation)

121

What is the most important muscle for unlocking the knee from full extension?

Popliteus

122

If thigh is fixed (open chain), popliteus _____ rotates the leg to unlock the knee

medially

123

If leg is fixed (closed chain), popliteus _____ rotates the thigh to unlock the knee

laterally

124

Purpose of the patella?

Act as anatomic pulley - increasing leverage and force that quads exert on tibia

Reduces friction between quads tendon and femoral condyles

125

How much quad strength is lost if there is no patella?

20%

126

Why does the articular surface of the patella have the thickest cartilage of any joint?

Quad contraction force creates compression of patella against femur

127

What causes patellofemoral syndrome (chondromalacia patella)?

Compressive forces of the patella on the femur plus improper tracking causes cartilage to damage and break down

128

When the knee is in full extension, the patella sits where?

Proximal to the intercondylar groove (freely moveable)

129

When the knee is flexed, the patella sits where?

Within the intercondylar groove (not much mobility)

130

When is patella most stable?

When knee is flexed (despite full extension being the closed-pack position of the knee)

131

What is genu valgum?

Abduction of tibia relative to femur

132

What is genu varum?

Adduction of tibia relative to femur

133

What is the normal value for genu valgum angle?

5-10 degrees (normal since femur is not vertical)

134

What is the value of excessive genu valgum (knock-knees)?

Greater than 10 degrees

135

What are factors contributing to increased genu valgum?

Overpronation of foot (lost arch)
Lax MCL
Excessive femoral medial rotation/adduction

136

What is genu varum called?

Bowleg

137

Where are the tensile/compression forces of excessive genu valgum?

Tensile: medial
Compression: lateral

138

Where are the tensile/compression forces of excessive genu varum?

Tensile: lateral
Compression: medial

139

What is the Q-angle?

Intersection of 2 lines:
1. From tibial tuberosity to center of patella
2. Center of patella to ASIS

Angle (lateral) of pull of quads on patella

140

What is the implication of an increased Q-angle?

Pulls patella laterally and causes it to ride against lateral side of intercondylar groove - patellofemoral syndrome

141

What is the normal Q-angle measurement?

10-15 degrees

142

Why do women have a greater Q-angle?

Pelvis is wider

143

Does increased genu valgum or varum increase the Q-angle?

Valgum

144

If a client has an increased Q-angle, what exercises are recommended?

Those aimed at strengthening the vastus medialis (counteract lateral pull)

145

What is genu recurvatum?

When knee joint hyperextends beyond 10 degrees

146

How does genu recurvatum occur?

Shape of tibial plateau slopes slightly posteriorly

Center of person's weight falls anterior to knee joint when standing

147

What type of joint is proximal tibiofibular?

Plane synovial

148

Functionally, the proximal tib-fib joint is related to what other joint?

Ankle (not knee)

149

What type of joint is the middle tib-fib joint?

Fibrous syndesmosis

150

Purposes of the middle tib-fib joint?

Interosseous membrane holdes bones together so they can hold talus between them at ankle (talocrural joint)

Allows force of all muscle attachments that pull of fibula to be transferred to the tibia to move the leg at the knee joint

151

What type of joint is the distal tib-fib?

Fibrous syndesmosis

152

Why is stability of distal tib-fib most important for ankle function?

securely holds talus between the two bones

153

What direction is tibial torsion? Implication of movement at ankle joint?

lateral

Distal tibia faces somewhat laterally - dorsiflexion/plantarflexion occur in an oblique plane

154

The 2 bones of the leg articulate with the foot at what joint?

Talocrural

155

What is the hind foot?

Talus and calcaneus

156

What is the mid foot?

Navicular, cuboid, 3 cuneiforms

157

What is the forefoot?

Metatarsals and phalanges

158

What is the first ray?

first metatarsal and 2 phalanges of the big toe

159

Functions of the foot

Stable to support weight-bearing
Absorb shock from landing
Propel through space

160

Is the foot stable or flexible?

Rigid enough to absorb force (dorsi/plantarflexion) and flexible enough to navigate uneven surfaces (pro/supination)

161

Where is the subtalar joint?

Between talus and calcaneus

162

Where is the transverse tarsal joint?

Between talus/calcaneus and navicular/cuboid

163

What are the 3 arches of the foot?

Medial longitudinal
Lateral longitudinal
Transverse

164

What is the medial longitudinal arch?

Largest; length of foot on medial side

165

What is the lateral longitudinal arch?

Runs length of foot on lateral side (not as high as medial)

166

How do you evaluate the arches?

Observing in weight-bearing position

Anterior - height of arch
Posterior - bowing of Achilles tendon

Foot imprints

167

What is pes cavus? Planus?

Cavus: excessive arch
Planus: decreased arch (flatfoot)

168

Implications of dropped arch?

Difference in leg height --> pelvis depressed or tilted to one side --> spinal curve

Structural stress on plantar fascia, knee joint, hip joint

169

What is the plantar fascia?

Dense fibrous tissue on plantar foot

170

What can cause a heel spur?

Plantar fasciitis due to tension placed on calcaneal attachment

171

Plantar fasciitis is caused most often by...

overly pronated foot

172

Purpose of the plantar fascia?

Maintain and stabilize longitudinal arches

173

Implication of walking in shoes?

Requires less work by intrinsic muscles leading to weakness of the muscles and plantar fascia --> loss of arch

174

What is the windlass mechanism?

During toe-off, metatarsals extend at MTP joints, which pulls plantar fascia taut (connected to MTP flexors) and makes foot more rigid to push the body forward

175

What is a retinaculum?

Acts to hold down tendons (important in wrist and ankle)

176

Why is retinaculum important in the ankle?

When leg muscles contract to move the foot or toes, retinaculum holds the tendons down, preventing them from bowstringing away from the body (which would weaken the muscle)

177

What is a mortise joint?

1 piece of wood with a notch and other piece carved to fit in the notch

Talocrural joint is similar to this (most congruent in body)

178

What kind of joint is the talocrural?

Synovial hinge (uniaxial diarthrotic)

179

What is the shape of the dome of the talus and how is this important?

Anterior aspect is wider than posterior

When foot dorsiflexes, wider aspect moves between tib-fib and pushes them apart - good for force absorption and stability

180

If the foot is fixed, the leg moves at what joint?

talocrural

181

ROM of talocrural

Dorsi: 20
Plantar: 50

182

What is the medial collateral ligament of the ankle also called?

Deltoid ligament

183

Attachments of the deltoid ligament (MCL)?

Tibia
Calcaneus, talus, navicular

184

The deltoid (MCL) limits...

eversion of the foot at the talocrural joint

pronation of foot at subtalar joint

185

Why are eversion sprains relatively uncommon?

Lateral malleolus extends down farther distally than medial malleolus (limits motion)

Deltoid (MCL) is very taut and strong

186

What are the 3 ligaments of the lateral collateral ligament of the ankle?

Anterior talofibular
Posterior talofibular
Calcaneofibular

(all attach to distal fibula)

187

The LCL of the ankle limits...

inversion of the foot at the talocrural joint

supination of foot at subtalar joint

188

What is the most commonly sprained ligament in the body? Why?

Anterior talofibular (1/3 of LCL)

Usually occur when person is moving forward (plantar flexion + inversion) - places particular stress on ligament

189

Closed packed position of the talocrural joint

Dorsiflexion

190

What protects tendons of the ankle from friction

Tendon sheaths

191

What supports the talus on the medial side of the foot?

Sustentaculum tali (of calcaneus)

192

What is the sinus tarsus?

Large cavity on lateral side between talus and calcaneus

193

Type of joint: subtalar?

Synovial

Uniaxial (triplanar), diarthrotic

194

ROM of subtalar (non-weight-bearing)

Ev: 10
Inv: 20
Dors: 2.5
Plant: 5
ER: 10
IR: 20

195

Major motions of the subtalar joint?

Pronation and supination in an oblique plane around an oblique axis

196

Pronation of foot =

Eversion, dorsiflexion, lateral rotation

197

Supination of foot =

Inversion, plantarflexion, medial rotation

198

What happens when the weight-bearing foot pronates and the talus medially rotates relative to the fixed calcaneus? Implication of overpronation?

Talocrural joint does not rotate, so leg must medially rotate with the talus

Overpronation subjects knee to medial rotation stress; knee doesn't allow rotation in extension so this medial rotation force is then transmitted to the hip joint

199

If a client has excessive pronation, the patella rotates in what direction?

Medially

200

Solutions to overpronated foot?

Orthotics

Strengthen supination muscles

Strengthen lateral rotation muscles of hip

201

What does the interosseous talocalcaneal ligament (in the sinus tarsus) limit?

Eversion (pronation) of subtalar joint

202

What does the cervical ligament (in the sinus tarsus) limit?

Inversion (supination) of the subtalar joint

203

Where is the spring ligament?

Spans subtalar joint on plantar side (calcaneus to navicular)

204

Spring ligament limits

Eversion (pronation) of subtalar joint

205

Closed packed position of subtalar joint?

Supination

206

Subtalar motion is intimately tied to which joints?

Transverse tarsal joint and talocrural joint

207

What are the 2 joints of the transverse tarsal joint?

Talonavicular joint
Calcaneocuboid joint

208

Transverse tarsal joint is also known as

Chopart's joint

209

What are the motions of the transverse tarsal joint?

Pronation/supination (move with the subtalar joint)

210

The talus shares a joint capsule with which bones?

Calcaneus and navicular

211

Spring ligament forms the floor of which joint

Talonavicular

212

Where is the long plantar ligament?

Length of foot on plantar side

213

Where is the short plantar ligament?

Deep to long plantar ligament on plantar side between calcaneus and cuboid

214

What is the bifurcate ligament?

Y-shaped ligament on dorsal side of foot (medial: calcaneus to navicular; lateral: calcaneus to cuboid)

215

Closed packed position of the transverse tarsal joint?

Supination

216

Type of joints: tarsometatarsals?

Plane synovial

217

What is the central stable pillar of the foot?

2nd ray of foot (2nd TMT joint) - base is wedged between 1st and 3rd cuneiform joints

Reference line for abduction/adduction of toes

218

Major motions of TMT joints

Dorsi/plantarflexion
Inversion/eversion

Conform to surfaces

219

Proximal intermetatarsal joints are stabilized by

Joint capsules and inter metatarsal ligaments

220

Distal intermetatarsal joints are stabilized by

Joint capsules and deep transverse metatarsal ligaments

221

Why is the big toe unable to oppose?

Deep transverse metatarsal ligaments connect all of the distal metatarsals together, including the big toe (does not happen in hand)

222

Type of joint: metatarsophalangeal?

Condyloid synovial

Biaxial, diarthrotic

223

Major motion of the MTP joint

Flexion/extension (sagittal)
Abduction/adduction (transverse plane)

224

ROM of toes at MTP joints

Toes #2-5
Ext: 60
Flex: 40

Big Toe
E: 80
F: 40

225

Capsule of MTP joint stabilized by

collateral ligaments and plantar plate

226

What is the plantar plate?

Thick, dense, fibrous tissue structure on plantar side of MTP joint

227

Function of plantar plate

Protect head of MT when walking

228

Closed-packed position of MTP

Extension

229

What is hallux valgus?

Deformity of big toe in which big toe deviates laterally at MTP joint

Also medial deviation of 1st MT

230

How does hallux valgus occur?

Genetic predisposition or

Overpronation and incorrect footwear that pushes big toe laterally (heels, triangle front)

231

Implications of hallux valgus?

Exposes head of 1st MT to greater stress --> inflammation of bursa --> fibrosis and excessive bone growth on medial/dorsal MT (bunion)

232

Type of joint: interphalangeal joints

Synovial hinge

Uniaxial, diarthrotic

233

ROM of PIP joints

F: 90 (less laterally)
E: 0

(from neutral)

234

ROM of DIP joints

F: 45 (less laterally)
E: small hypertext

(from neutral)

235

Interphalangeal joints are stabilized by

Fibrous capsule
MCL
LCL
Plantar plate

236

Closed packed position of IP joints of foot

Extension

237

What is the shoulder girdle made up of?

Scapula, clavicle, sternum

238

Function of the shoulder girdle?

Stable base for upper extremity to move

239

What ties the shoulder girdle together in the back?

Rhomboids and middle trapezius attach medial borders of the scapulae (like the lacing of a corset)

240

The net result of the sternoclavicular and acromioclavicular joints is to...

orient the scapula to the desired position

241

Position of the scapula is important to facilitate _____ motion at the _____ joint

humeral
glenohumeral

242

The coupling of shoulder girdle movement with arm movement is called

scapulohumeral rhythm (or scapuloclaviculohumeral rhythm)

243

ROM of entire shoulder joint complex

F: 180
E: 150
Abd: 180
Add: 0
ER: 90
IR: 90

244

Why is abduction of the glenohumeral joint restricted when arm is in neutral or IR?

Greater tubercle of head of humerus will connect with acromion process

245

ROM of GHJ (anatomic position)

F: 100
E: 40
Abd: 120
Add: 0
ER: 50
IR: 90

246

Major reverse actions of the scapula at the GHJ?

Upward/downward rotation (when arm is fixed)

247

The capsule of the GHJ is so lax that if the muscles are completely relaxed, the head of the humerus can be moved how far from the glenoid fossa?

1-2 inches

248

What are the 3 glenohumeral ligaments?

Superior GH
Middle GH
Inferior GH

249

Function of GH ligaments

Prevent dislocation of humeral head anteriorly and inferiorly

250

Where do the majority of shoulder dislocations occur?

Foramen of Weitbrecht - small region of anterior GH capsule between superior and middle GH ligaments

251

Where is the coracohumeral ligament?

Between coracoid process (scapula) and greater tubercle (humerus)

252

Function of coracohumeral ligament

Prevents dislocation of humeral head anteriorly and inferiorly

Limits extremes of flexion, extension, and lateral rotation

253

Closed-packed position of GHJ

Lateral rotation and abduction

254

Abductor muscles of GHJ

Deltoid
Supraspinatus

255

Adductor muscles of GHJ

Pectoralis major
Latissimus dorsi
Teres major

256

Lateral rotators of the GHJ?

Posterior deltoid
Infraspinatus
Teres minor

257

Medial rotators of the GHJ

Anterior deltoid
Latissimus dorsi
Teres major
Subscapularis

258

Flexors of GHJ

Anterior deltoid
Pectoralis major
Coracobrachialis
Biceps brachii

259

Extensors of GHJ

Posterior deltoid
Latissimus dorsi
Teres major
Long head of triceps brachii

260

Where is the subacromial bursa

Between acromion process and rotator cuff tendon

261

Irritation and injury of the rotator cuff tendon will also cause the same in the...

subacromial bursa

262

What is the coracoacromial arch? Function?

Formed by acromion process and coracoacromial ligament

Roof of GHJ; protects superior structures of GHJ

263

Why is the coracoacromial ligament unique?

Connects the same bone (coracoid profess and acromion process)

264

What are the superior structures of the GHJ that can become impinged between the head of the humerus and the coracoacromial arch during abduction/flexion?

Supraspinatus muscle/tendon
Subacromial bursa
Long head of biceps
Superior joint capsule

265

Where does the long head of the biceps go within the GHJ capsule?

Bicipital groove of humerus to supraglenoid tubercle of scapula

266

Why is the GHJ so mobile and less stable?

Shallow glenoid fossa and joint capsule laxity

267

Where is the majority of the shoulder stability coming from?

Rotator cuff

268

What ribs articulate in the scapula costal joint?

2-7

269

What kind of joint is scapulocostal?

Functional joint

270

Major motions of scapulocostal joint

Elevation
Depression
Protraction
Retraction
Upward/downward rotation

271

What joints also need to move for motion of scapula at scapulocostal joint?

AC and SC

272

Scapular upward rotation accompanies what motion?

Humeral abduction

273

Accessory movements of the scapula?

Lateral/medial tilt
Upward/downward tilt

274

What is a healthy tilt of the scapula?

Medially and downwardly

275

What is lateral tilt of the scapula called?

Winging of the scapula

276

Push-ups are an example of what action at the scapula?

Reverse action of scapulocostal joint. Trunk moves relative to scapula

277

Elevators of the scapula

Upper trapezius
Levator scapulae
Rhomboid

278

Depressors of scapula

Lower trapezius
Pectoral is minor

279

Protractors of scapula

Serrated anterior
Pectoralis minor

280

Retractors of the scapula

Middle trapezius
Rhomboidal

281

Upward rotators of the scapula

Serratus anterior
Upper/lower trapezius

282

Downward rotators of scapula

Pectoral is minor
Rhomboids
Levator scapulae

283

Type of joint: sternoclavicular

Synovial saddle

Biaxial, diarthrotic

284

Major motions of the SCJ

Protraction/retraction (transverse plane)
Elevation/depression (frontal)
Upward/downward rotation (sagittal)

285

ROM of clavicle at SCJ

Elevation: 45
Depression: 10
Protraction: 30
Retraction: 30
Upward rotation: 45
Downward rotation: 0

286

Why does the SCJ need to be well stabilized?

Only osseous joint that connects the upper extremity to the axial skeleton

287

Motion of the scapula at the scapulocostal joint is driven by motion of...

the clavicle at the SCJ

288

What muscles stabilize the SCJ?

Sternocleidomastoid
Sternohyoid
Sternothyroid

289

Which ligaments reinforce the SC joint capsule?

sternoclavicular ligaments (anterior and posterior)

290

What is the interclavicular ligament?

Spans from one clavicle to the other

291

What is the costoclavicular ligament?

Runs from first rib to clavicle

292

What is the closed-packed position of the SCJ?

Full upward rotation of the clavicle

293

Why is there an articular disc in the SCJ?

Improve congruence of joint surfaces and absorb shock

294

Type of joint: ACJ

Synovial plane

Nonaxial, diarthrotic

295

Motions of the ACJ?

Upward/downward rotation of scapula relative to the clavicle

296

Accessory actions of the ACJ

Lateral/medial tilt of scapula
Upward/downward tilt of scapula

297

Accessory tilt actions of the scapula at the acromioclavicular joint are necessary to maintain...

proper position of the scapula relative to the ribcage

298

Upward rotation of the scapula follows what part of the bone?

Inferior angle (moving laterally)

299

ROM of scapula at ACJ

Upward rotation: 30
Downward rotation: 0

300

Muscle stabilization of the ACJ

Trapezius
Deltoid

301

Ligament reinforcement of the ACJ capsule

Acromioclavicular ligament (superior and inferior)

302

What are the 2 parts of the coracoclavicular ligament?

Trapezoid ligament
Conoid ligament

303

Closed packed position of the ACJ

Full upward rotation of the scapula

304

Is there a fibrocartilaginous disc in both the SCJ and ACJ?

Yes

305

The ACJ is very susceptible to...

injury and degeneration

306

What is typical injury to ACJ?

Falling on outstretched arm

307

In full 180 degrees of abduction, how much is from GHJ?

120 degrees

308

Flexion of the arm at the GHJ couples with.... of the scapula at the ScC joint

protraction and upward rotation

309

Extension of the arm at the GHJ couples with.... of the scapula at the ScC joint

retraction and downward rotation

310

Extension of the arm at the GHJ beyond neutral couples with ______ of the scapula at the ScC joint

upward tilt

311

Abduction of the arm at the GHJ couples with _____ of the scapula at the ScC joint

upward rotation

312

Adduction of the arm at the GHJ couples with _____ of the scapula at the ScC joint

downward rotation

313

Medial rotation of the arm at the GHJ couples with _____ of the scapula at the ScC joint

protraction

314

Lateral rotation of the arm at the GHJ couples with _____ of the scapula at the ScC joint

retraction

315

When the arm abducts at the GHJ more than approximately 90 degrees, it also need to _____ at the GHJ

laterally rotate

316

Which muscles keep the head of the humerus down during arm elevation movements so there is no impingement?

Rotator cuff isometrically contracts to keep proximal humerus fixed in place while distal end elevates

317

What happens at early phase of arm abduction (first 90 degrees)

GHJ: 60 degrees

ScC upward rotation: 30 degrees

Clavicle elevates at SCJ (25 deg) and scapula upwardly rotates at ACJ (5 deg)

318

What happens at the late phase of arm abduction (last 90 degrees)

GHJ: 60 degrees

ScC upward rotation: 30 degrees

Clavicle elevates at SCJ (5 deg) and scapula upwardly rotates at ACJ (25 deg)

319

Implications of rounded shoulder posture on shoulder health?

Rounded posture = protracted scapula and medially rotated humerus

Abduction above 90 degrees will damage the rotator cuff and subacromial bursa due to greater tubercle impinging on acromion process

320

What are the 3 articulations in the elbow joint capsule?

Humeroulnar joint
Humeroradial joint
Proximal radioulnar joint

321

Type of joint: humeroulnar

Synovial hinge

Uniaxial, diarthrotic

322

What part of the ulna connects to the distal humerus?

Trochlea

323

Type of joint: humeroradial

Synovial atypical ball-and-socket

Biaxial, diarthrotic

324

ROM of elbow

F: 145
E: 0

325

3 parts of the MCL of the elbow

Anterior fibers
Posterior
Transverse

326

Function of the MCL of the elbow

Stabilize medial side of joint
Prevent abduction of forearm at elbow

327

2 parts of the LCL of the elbow

Annular fibers
Ulnar

328

Function of the LCL of the elbow

Stabilize lateral side of joint
Prevent adduction of forearm at elbow

329

Closed packed position of elbow

extension

330

Flexors of the elbow

Brachialis
Biceps brachii
Brachioradialis
Pronator teres

331

Extensors of the elbow

Triceps brachii
Anconeus
Extensor carpi ulnaris

332

What is tennis elbow?

Lateral epicondylitis

Inflammation of the common extensor tendon

Related to hand and wrist use

333

What is golfer's elbow

Medial epicondylitis

Inflammation of the common flexor tendon

Related to hand and wrist use

334

What is the carrying angle of the elbow?

Ulna deviates laterally in the frontal plane (relative to humerus)

Also called cubitus valgus

335

What is normal carrying angle?

Men: 5-10 deg
Women: 10-15 deg

336

Advantage of carrying angle?

objects carried in hand are naturally away from the body

337

Where does pronation/supination occur in the elbow?

At radioulnar joints (proximal, middle, and distal)

338

Type of joint: proximal radioulnar

Synovial pivot

Uniaxial, diarthrotic

339

Type of joint: middle radioulnar

Fibrous syndesmosis

Uniaxial, amphiarthrotic

340

Type of joint: distal radioulnar

Synovial pivot

Uniaxial, diarthrotic

341

What are the movements of the proximal and distal radioulnar joints during pronation?

Proximal: head of radius medial rotates
Distal: radius swings around ulna

342

What is the annular ligament of proximal radioulnar joint?

Wraps around head of radius - stabilizes proximal RU joint and creates a cavity within which the head of the radius can rotate

343

Function of the interosseous membrane of the middle RU joint?

Stabilizes radius and ulna

Transfers compression forces from radius at wrist to ulna into the arm (and vice versa)

344

Ligaments of the distal RU joint (2)

Dorsal and palmar radioulnar ligament

345

What is the radioulnar disc?

Also known as triangular fibrocartilage

Blends into capsular/ligamentous structure of both distal RU joint and radio carpal joint and adds stability to both

346

What should I know about joint capsules and proximal RUJ and distal RUJ?

Proximal shares capsule with elbow
Distal shares capsule with wrist