Anatomy

Question 1

Define biomechanics and anisotropic?

Answer 1

Biomechanics evaluates the motion of living organisms using Newtonian physics.

Anisotropic-not constant direction. This can apply to joints with multiple degrees of freedom (planes of motion)

Question 2

The following terms relate to which field of study?
flexion, extension, abduction, adduction.

A) osteokinematics
B) Arthrokinematics
C) Anisotropic
D) Biomechanics

Answer 2

A is correct. The study of osteokinematics describes the relationships of bones relative to each other.

B describes the relationship of bone surfaces and uses terms such as glide, roll, or spin.

Question 3

What are some of the determinants of joint arthrokinematics?

Answer 3

geometry of the joint surfaces-concave or convex
congruence of the surfaces-fit
radius of the curvature of the surfaces
Type of motion occurring-glides roll or spin
Relationship of muscle to joint and restraining structures

Question 4

How would you describe the movements of roll glide and spin? Are they necessary for full range of motion?

Answer 4

accessory movements that are essential to normal full ROM

Question 5

What’s unique about sellar joints and what other name do they go by?

Answer 5

both concave and convex, also called saddle joints

example-elbow olecranon process articulating with the olecranon fossa of the humerus

Question 6

What three types of motion can occur at a joint? Describe each and identify which is the least common in human anatomy.

Answer 6

Rock and Roll-each pt on one surface makes contact with a new pt of the other surface. i.e. ball rolling on a table

Sliding and gliding- same point on one surface makes contact with a new point of other surface.

Spin- (least common) pure rotation around the mechanical axis. ***If it’s NOT pure it’s called swing.

Location- It can only occur at the head of the femur, the head of the humerus, and the radius at the proximal radio-ulnar joint.

Question 7

Differentiate between cardinal and Arcuate swing

Answer 7

Cardinal swing occurs parallel to a cardinal plane. Examples include: AB and AD duction, extension and flexion, as well as, internal and external rotation.

Arcuate swing is more common and is motion that moves out of the plane and then re-enters it.

Question 8

In a joint where the concave surface is fixed and the convex is not how would you describe the roll and glide of this type of joint? What if the opposite surface were fixed? Also, provide examples of these types of joints in the body.

Answer 8

In the first example the convex joint would roll and glide in opposite directions. Ex. concave distal radius and the carpals (convex)

In the second example the concave joint would roll and glide in the same direction. Ex. Femur and tibia.

Question 9

What’s the difference between the closed-packed position and the open and which would be best used during casting of injured bone.

Answer 9

closed-packed position is the pt of congruency between two joint surfaces: max surface contact, ligaments are farthest apart and under tension, joint is mechanically compressed and difficult to separate.

Loose-packed position joints do not fit perfectly: lig and capsular structures slacked, joint may be distracted, allows for accessory motion, decrease friction.

This is best for casting so that nutrient flow is not impeded in any way at this point.

Question 10

What’s the difference between adjunct and conjunct rotation?

Answer 10

Adjunct- volunatary rotation around joints with more than three degrees of freedom

a limb is voluntarily and simultaneously rotated through 180 degrees

shoulder AB duction example

Conjunct-Involuntary and automatic movement around longitudinal axis

ex- flex shoulder 90 degrees then horizontally abduct 90 deg then Aduct 90 deg

what did you get? rotation, occurs at shoulder and hip joint

Clinical application- this maybe useful when beginning therapy post op.

Question 11

What type of fracture of the radius affects the function of the extensor pollicis longus by impairing the pulley that allows for this tendon to pull on the distal phalanx of the thumb?

What is the name of the bone that serves as this tendons pulley? What percentage of the force generated by the EPL tendon is transferred to this pulley?

Answer 11

Colle’s fracture

Listers tubercle

about 75%

Question 12

You have a patient experiencing post operative hip pain after having had her right hip replacement 4wks prior. She’s starting to walk again but needs a cane. On which hand would you recommend that she holds her cane; why?

She comes back to the clinic about 3 wks later explaining that she just started back to work in her law office downtown. She wanted your recommendation about which hand she should use to carry her heavy briefcase What do you recommend and why?

About how much weight does the hip joint accept from the body as we walk?

Answer 12

Left side as the force on the hip will be dramatically reduced as compared to the same side

Right side for carrying weight, as the force will be less on the hip

approximately 2.5x our body weight

Question 13

An x-ray from your patient indicates a fracture at the distal humerus. Which nerve are you concerned might be damaged?

A) axillary
B) radial
C) median
D) ulnar

Answer 13

C is correct

A would be true of a surgical neck fracture

B would be true of a fracture near the radial groove (mid diaphysis)

D would be true of an elbow fall or a fracture near the medial epicondyle/ funny bone.

Question 14

What’s the function of the clavicle?

Answer 14

Supports anterior shoulder and prevents anterior displacement of scapula.

Question 15

What are the names of the scapular borders; including additional names?

Answer 15

superior border
medial border/vertebral border
lateral border/axillary border

Question 16

What is the clavipectoral triangle, and what passes through it ?

Answer 16

It is a space between the deltoid and the pectoralis major. The cephalic vein passes through it. The pectoralis minor passes inferior to the cephalic vein for attachment on the ribs.

Question 17

What anatomical landmarks for the borders of the antecubital fossa?

Answer 17

Superior border-line between the lateral and medial epicondyles
lateral border- Brachioradialis
Medial border- Pronator teres

Question 18

Which nerves innervate the anterior and posterior compartments of the brachial region of the arm? Which muscles do they innervate?

Answer 18

anterior-musculocutaneous: BBC: Bicepts brachii, Brachialis, and Coracobrachialis

posterior-radial: Tricepts brachii

Question 19

From lateral to medial name the veins of the antecubital fossa and then the important nerves, tendons, and arteries.

Answer 19

cephalic, median cubital, and basilic

Radial nerve, Bicepts tendon, Brachial artery, Median nerve.

Question 20

Where do the major veins of the arm originate and empty?

Answer 20

Originate from the dorsal venous arch (similar to the foot) . The cephalic vein empties into the subclavian vein (after passing though the clavipectoral triangle), and the basilic empties into the brachial vein/s.

Question 21

Which nerves innervate the anterior and posterior compartments of the forearm?

Answer 21

Anterior- Median and ulnar nerves

Posterior- Radial and interosseous nerve.

Question 22

Which muscles make up the superficial group in the anterior compartment of the forearm and what is their common origin?

Answer 22

Pronator teres
Flexor carpi radialis
Palmaris longus
Flexor carpi ulnaris

& deep to these -flexor digitorum superficialis (4 groups, whose tendons travel through the carpal tunnel)

originate on the common flexor tendon

Question 23

What’s another name for golfers elbow? Which muscles are affected by this? What about tennis elbow?

Answer 23

Medial epicondylitis

pronator teres and the intermediate group of flexor digitorum superficialis

Tennis elbow: lateral epicondylitis

Question 24

Which muscles make up the deep group of the anterior compartment of the forearm?

Answer 24

Flexor digitorum profundus
Flexor pollicis longus
Pronator quadratus

Question 25

What muscles make up the posterior compartments superficial group?

Answer 25

Originate just proximal to the common extensor tendon
Brachioradialis (on a horizontal section this muscle wraps around the radius and appears anterior)
Extensor carpi radialis longus

Originate from the common extensor tendon
Extensor carpi radialis brevis
Extensor digitorum
Extensor digiti minimi
Extensor carpi ulnaris
Anconeus

Question 26

What muscles make up the posterior compartments deep group?

Answer 26

Supinator

Outcropping muscles create the snuffbox
Abductor pollicis longus
Extensor pollicis brevis
Extensor pollicis longus

Extensor indicis

Question 27

You’re treating a patient for Occipital Neuralgia by placing a needle into the greater occipital nerve. Your anatomy is a bit rusty and you move a little bit laterally from the correct spot crossing along the sub-occipital triangle. The nerve you puncture innervates which three muscles? Had you hit a vessel rather than a nerve which would be most likely?

Answer 27

Obliquus capitus superior and inferior and the rectus capitus posterior major. These are the muscles of the sub-occipital triangle innervated by the sub-occipital nerve (motor innervation only)

vertebral artery within the sub-occipital triangle.

Question 28

You get into a bad car wreak which hyperflexed your head laterally pretty severely. After a PE your physician tells you that the good news is you don’t have a hangmans fracture, but you do have damage to some muscles. Which are most likely affected?

A) Levator scapula
B) scalenes
C) longus capitus
D) rectus capitus posterior minor

Answer 28

B) The scalenes help with lateral neck flexion and rib elevation

Question 29

A patient with osteoarthritis is having what appears to be some facet joint pain. What nerve branch innervates this area and from which rami does it originate?

Answer 29

Articular branch of the posterior rami