Arthrokinematics & Osteokinematics Flashcards

1
Q

Joint motion is dependent on:

A
Integrity of joint surfaces
Mobility and pliability of S.T.
Degree of S.T. approximation
Degree of fibrosis (scarring)
Age
Gender
Co-morbidities
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2
Q

AROM is dependent on:

A
Quantity
Willingness
Integrity of contractile & non-contractile tissues
Symptom reproduction
Pattern of motion restriction

Reduced vs. Normal vs. Excessive

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3
Q

PROM is…

A

Info regarding the integrity of the inert tissues (non-contractile elements)
Allows for assessment of end-feel

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4
Q

Kinematics is…

A

the study of motion

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5
Q

Osteokinematics is…

A

bone on bone

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6
Q

Arthrokinematics is…

A

joint movements

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7
Q

What is “bone movement”?

A

When any object forms the radius of an imaginary circle about a fixed point.
Whole bone moving around a joint axis.

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8
Q

What is “joint movement”?

A

Motion occurring at the joint surfaces

  • Concave (tibia)
  • Convex (femur)

aka “Joint Play” or “Accessory Motion”

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9
Q

Restricted arthrokinematic motion will result in…

A

Decrease osteokinematic

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10
Q

Do osteo and arthro motions occur simultaneously?

A

YES, directly proportional

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11
Q

Does normal arthro motion must occur for full ROM onset motion?

A

YES

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12
Q

Arthrokinemation motion has 3 motions:

A

Roll
Glide
Spine

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13
Q

What is roll?

A

constantly changing surface on contact

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14
Q

What is glide?

A

2 fixed surfaces that still translate

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15
Q

What is spin?

A

rotation around, surface spinning on surface

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16
Q

Which artho motion do we access?

A

Glide!

Linear motion of bone on another joint surface

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17
Q

A glide is always accompanied by a roll. T/F?

A

TRUE

18
Q

Which is easier to treat? Roll or Glide?

A

Glide, you can feel the joint glide

19
Q

Roll occurs in the ___ direction as the bone movement.

A

SAME

20
Q

Glide depends on…

A

the SHAPE

Convex-Concave RULE!

21
Q

If the moving joint surface is Concave, the glide occurs…

A

in the SAME direction as osteokinematic

22
Q

If the moving joint surface is Convex, the glide occurs…

A

in the OPPOSITE direction as osteokinematic

23
Q

What does a loss of joint accessory motion tell us?

A

Testing the ability of a joint surface to glide on another

24
Q

Limited joint surface glide (artho) there will be…

A

Less ROM (osteo)

25
Q

Closed pack:

A
Max tautness of major lig.
Max surface congruity
Min joint volume
Max stability of the joint
Movements toward close-packed involved an element of compression
26
Q

Open pack:

A

All positions away from close-pack!

27
Q

How many resting positions are there?

A

ONE

28
Q

Open pack, resting position:

A
Slackening of major lig.
Min surface congruity
Min joint surface contact
Max joint volume
Min stability of the joint
Movements toward open-packed involve an element of distraction
Only one resting position
29
Q

Which position will there be the most glide of a joint?

A

Resting position, it can move…

30
Q

Resting position of the knee

A

25 - 45 flexion

31
Q

Close position of the knee

A

full extension, ER tibia

32
Q

What are we feeling?

A
Quantity of motion
- Hypo/Hyper/Normal
Quality
- Crepitis
End-feel
- Normal, Boney, Firm (Capsular/Muscular), Soft
Abnormal
- Spring, Boggy, Spasm, Empty, Pain
33
Q

ACL: MOI

A
Valgus knee position
Hyperextension, rotation
70% non-contact
Deceleration phase
Cutting, landing
"Pop"
Swelling, laxity, pain
Chronic presentation - unstable joint, LOF (pain is gone)
34
Q

MCL: MOI

A

Valgus Force, knee collapsing inward
Football, soccer, slip, direct blow to lateral knee
Often injured concurrently w/ meniscus or ACL
Medial Knee Pain
Tender to palpate specifically at MCL
Valgus Stress Test
w/ delayed endfeel, w/ pain, w/o firm

35
Q

PCL: MOI

A
Hyperflexion
Football, fall onto knees, dashboard
Excessive tibial post translation
C/O weakness, instability
HS test will aggravate PCL
36
Q

Patellofemoral Pain Syndrome

A
Commonly overuse
Running related
Malalignment between patella & femur
Reduces contact area w/ increased mechanical stress
IR/ADD
37
Q

Patellofemoral Pain Syndrome: Impaired Hip Control

A

Femur moves independently during squatting

Quads contraction during WB anchors patella to stable tibia, allowing femur to move under extensor mechanism of knee jt

38
Q

Patellofemoral Pain Syndrome: Physical Exam

A

Tenderness along facets of patella
Crepitis
Passive patella compression w/ w/o QS LAQ elicits CC
Squatting, kneeling, or stretch to the quads/ITB May reproduce sx

39
Q

ITBS

A

Tightness elicits increased rubbing, particularly in athletes performing repeated knee flexion/extension
Runners, Triathletes, bikers, weight lifters, cross-fit participants
Bursa, compressive forces
Palpation is KEY!
TIght ITB
Hip muscle strength imbalances

40
Q

What are the most common fractures?

A

Patellar & Tibial Plateau
Easy to Dx
Geared back to baseline, pre-morbid