Exam 1 Flashcards
1
Q
Identify three planes of motions and their respective axis.
A
Sagittal - Medial / Lateral
Frontal - Anterior / Posterior
Transverse - Vertical
2
Q
What is an osteokinematic motion? List all osteokinematic motions
A
Flexion, extension…
3
Q
What is an arthrokinematic motion? List all arthrokinematic motions.
A
Roll, Glide, Spin
4
Q
What is the difference between a rotation and a translation
A
Rotation - rigid body moves in a circular path around a pivot point
Translation - All points on a rigid body move parallel and in the same direction as all others
5
Q
Differentiate between an open chain motion and a closed chain motion
A
Closed chain - Distal segment fixed
Open chain - Distal segment not fixed
6
Q
Define the convex-concave rule.
A
cave on vex - same direction
Vex on cave - opposite direction
7
Q
What are the differences between the loose-pack and close- pack position of a joint
A
Close-pack position - position of maximal congruency (normally at end ranges)
loose-pack position - position of minimal congruence (all other positions than close-pack)
8
Q
Identify the contractile and noncontractile proteins in skeletal muscle
A
Contractile - Actin and myosin
Noncontractile - cytoskeleton, structural proteins (titin, desmin)
9
Q
Differentiate between fusiform, pennate, and strap muscle morphology
A
Fusiform
parallel fibers and central tendon
Pennate
fibers approach central tendon obliquely
more fibers per area
Larger force
10
Q
Define isometric, concentric, and eccentric contraction.
A
Isometric - no change in length
Concentric - shortening
Eccentric - lengthening
11
Q
Identify between the parallel elastic components and series elastic components
A
Series
Tendons, titin
Parallel
extracellular connective tissues
epimysium, perimysium, and endomysium.
12
Q
Define passive and active length-tension.
A
Passive
spring like tension when stretching a muscle
Active
Activated muscle fiber
13
Q
How does velocity of contraction impact force production for a concentric versus eccentric contraction
A
Concentric - velocity up = force down
Eccentric = velocity up = force up
14
Q
Define a motor unit
A
single alpha motor neuron and all the muscle fibers it innervates
15
Q
Differentiate between fast fatigable, fast fatigue-resistant, and slow motor unit type
A
Fast fatigable
Fast glycolytic
Fast fatigue resistant
Fast oxidative
slow motor unit type
Slow oxidative
16
Q
What are the two types of electrodes used for EMG analysis? Compare and contrast them
A
Linear array
cover large recording area
smaller electrodes aligned proximal to one another in columbs
Fine Wire
inserted directly into the muscle
useful for deeper muscles
17
Q
Define a band-pass filter for surface EMG
A
Combination of high pass filter and low pass filter
Signals of 10-500 Hz
Used for eliminating artifact
18
Q
Why would EMG signal need to be normalized? What is one common method to do this
A
to make data comparable
Timing and amplitude of signal is used
full wave rectification
19
Q
Explain why EMG magnitude may not always be used to reliably compare the relative forces produced between two muscles
A
because EMG magnitude measures electrical activation which does not always mean force
20
Q
Define maximal voluntary isometric contraction
A
normalization tool to used to establish a theoretical maximum of muscle contraction activity
21
Q
Name five factors that may affect the magnitude of EMG signal
A
Electrode configuration and size
Range and type of filtering of the frequency content of the signal
magnitude of cross talk from nearby muscles
location of electrodes relative to the motor unit endplates
orientation of the electrodes relative to the muscle fibers
22
Q
Define strength and hypertrophy
A
Maximal force
increased muscle size
23
Q
What adaptations in the nervous system occur with resistance training?
A
an increased area of activity within the cortex of the brain during a motor task (as shown by functional magnetic resonance imaging), increased supraspinal motor drive, increased motor neuron excitability, and greater discharge frequency of motor units coupled with a decrease in neural inhibition at both spinal and supraspinal levels
24
Q
What are the effects of immobilization on muscle?
A
atrophy
3-6% loss of strength per day in first week
After 10 days 40% decrease in 1RM
protein synthesis reduced especially in slow twitch fibers
25
What are the effects of age on muscle
reduced strength, power and speed
26
Define sarcopenia.
loss of muscle tissue with advanced age
27
Define the term kinematics
branch of mechanics that describes motion of the body without regard for the forces or torques produced by the body
Qualitative and quantitative description of motion
28
What is the difference between linear/translation and angular/rotatory movement
Translation - strait line, all points move in the same direction
Angular - rotate around axis
29
What is the importance of having a frame of reference
allows position and direction of motion to be defined relative to a known location
30
What is the difference between relative angle and the global/absolute angle
relative - angle of joints relative to other joints
| Global - limb position relative to external structure
31
Please get familiar with terms such as linear and angular displacement, linear and angular velocity, and linear and angular acceleration.
linear displacement - a^2 + b^2 = c^2
Angular displacement -
linear velocity - v = (Pf-Pi)/(Ti-Ti)
angular velocity - w = angled-anglei / deltaT
linear acceleration - a= (Vf-Pi)/(Vi-Ti)
angular acceleration - a = deltaV / delta T
32
Understand the use of trigonometric and inverse trigonometric functions from the VOPP
Sohcahtoa
sin - opp/hyp
cos - adj/hyp
tan - opp/adj
33
Define axis of rotation.
the line about which one rigid body rotates around another
34
Differentiate between spin, slide, and roll
spin - occurs around fixed mechanical axis , bone moves but axis remains stationary
slide - translation
roll - different points on a surface come in contact with different points on another surface
35
Define the term kinematics.
motion relative to position, angle, velocity and acceleration
36
Define the term kinetics
the study of the relationship between the motions of a body and the forces acting upon them
37
Explain Newton’s 1st, 2nd, and 3rd Law
an object in motion will stay in motion until acted upon by another force
acceleration of an object is directly proportional to the magnitude of the resultant forces acting upon it F=MA
every action has an equal and opposite reaction
38
Define force per unit area and identify the consequences of increasing versus decreasing values.
pressure = force per area
P=N/cm^2
N up = P up
cm up = P down
39
Compare and contrast the three types of levers
```
1st class
fulcrum between the load and force
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```
2nd class
load between the fulcrum and force
```
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3rd class
effort between fulcrum and load - mechanical disadvantage
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40
Name five components of a lever
```
Fulcrum
weight Force
input force
weight arm
Force arm
```
41
Give an example of each type of lever in the human body.
1st - erector spinae acting on lumbar and thoracic spines
2nd - ankle plantar flexors acting at the MTP joints
3rd - bicep pulling on the radius
42
Define torque and moment arm.
toque - the strength of a rotational force acting around an object = force x distance to fulcrum
moment arm - distance from rotational axis and line of action
43
Why are Type II levers at a mechanical advantage
the force moment arm is longer than resistance moment arm
44
Why are Type III levers at a mechanical disadvantage
the force moment arm is shorter than the resistance moment arm
45
What is Mechanical work and mechanical power
work - F x distance object moves
power - rate at which force does work
power = work/time
46
Define center of mass and center of gravity.
center of mass - point at center of objects mass
| center of gravity - same as center of mass when considering weight
47
What are the 3 ligaments of the SC joint
Anterior and posterior sternoclavicular ligaments
Interclavicular ligament
costoclavicular ligament
48
What is the role of the articular disk of the SC joint
strengthen the articulation and act as a shock absorber
49
What are the Osteokinematic motions of the SC joint
Rotation in all three planes
elevation, depression - 35-45 / 10
protraction, retraction 15-30
rotation around longitudinal axis 20-30
50
What are the arthrokinematic motions of the SC joint
elevation - superior roll inferior glide
depression - inferior roll superior glide
protection - anterior roll anterior glide
retraction - posterior roll posterior glide
posterior rotation - spin
51
What ligaments provide stability to the acromioclavicular (AC) joint
superior and inferior acromioclavicular ligaments
coracoclavicular ligament
(trapezoid and conoid)
52
List 6 motions that occur at the AC joint
upward rotation, 30, ABD flexon
downward rotation, ADD, extension
internal rotation - direction of rotation at glenoid
external rotation - direction of rotation at glenoid
anterior tilting - direction of rotation at glenoid
posterior tilting - direction of rotation at glenoid
53
List 6 motions that occur at the scapulothoracic (ST) joint
```
Elevation
Depression
protraction
retraction
upward rotation, 60 degrees. ⅓ ST GH ratio
downward rotation
```
54
What motions occur at the SC, AC, and ST joints during Elevation
SC elevation
| AC slight downward rotation
55
What motions occur at the SC, AC, and ST joints during depression
SC depression
| AC upward slight rotation
56
What motions occur at the SC, AC, and ST joints during Protraction
AC protraction
57
What motions occur at the SC, AC, and ST joints during retraction
AC Retraction
58
What motions occur at the SC, AC, and ST joints during upward rotation
SC elevation
| AC upward rotation
59
What motions occur at the SC, AC, and ST joints during downward rotation
SC depression
| AC downward rotation
60
Describe the mechanism of support of the Superior glenohumeral ligament
attaches to anatomic neck
| supports ER, inferior and anterior translations
61
Describe the mechanism of support of the Middle glenohumeral ligament
attaches to anterior aspect off anatomical neck
| supports anterior translation especially 45-90, ER
62
Describe the mechanism of support of the Inferior glenohumeral ligament
attaches to inferior and posterior margins of neck
axillary band - supports 90 degrees of ABD, with anterior posterior and inferior translations
anterior band - supports90 degrees of ABD, full ER, anterior translation
posterior band - supports 90 degrees of ABD, full internal rotation
63
Describe the mechanism of support of the Coracohumeral ligament
anterior greater tubercle
| inferior translation, ER
64
Describe how the rotator cuff muscles and the long head of biceps brachii provide GH joint stability.
The rotator cuff muscles actively stabilizes the GH joint, especially during dynamic movements, also tendons of these muscles blend into the capsule
The long head of the biceps restricts anterior translation of the humeral head, also superior translation
65
What structures are responsible for the static versus dynamic stability to the GH joint when the arm is hanging by the side?
static stability - superior capsular ligament, coracohumeral ligament, tendon of supraspinatus
dynamic stability - isometric activation of the rotator cuff muscles
66
What are the osteokinematic motions of the GH joint
```
flexion
extension
abduction - 120 with 60 scapular upward rotation
adduction
internal rotation
external rotation
horizontal abduction
horizontal adduction
```
67
What are the arthrokinematic motions during abduction, adduction, flexion, extension, internal rotation, and external rotation of the GH joint?
Abduction - superior roll, inferior glide
Adduction - inferior roll, superior glide
flexion/extension - spinning of humerus in glenoid fossa
Internal rotation - posterior roll, anterior glide
External rotation - anterior roll, posterior glide
68
What ligament is responsible for creating posterior rotation of the clavicle during arm elevation?
coracoclavicular ligament
| Conoid and trapezoid
69
Explain scapulohumeral rhythm.
for every 3 degrees of GH abduction 2 comes from GH, 1 comes from ST
70
Compare and contrast GH joint abduction in the frontal versus scapular plane.
clavicle retracts a greater distance in the frontal plane than in the scapular plane
71
Describe all 6 the kinematic principles associated with full shoulder abduction
2:1 ratio for GH and ST joint
60 degrees at ST is result of elevation at SC and upward rotation at AC
the clavicle retracts at the SC during abduction, 15-20
during abduction the upwardly rotating scapula posteriorly tilts and externally rotates
clavicle rotates around its longitudinal axis during abduction
GH joint externally rotates during shoulder abduction
72
What muscles are responsible for the following motion of the shoulder: Elevation
upper traps
Levator Scapulae
Rhomboids
73
What muscles are responsible for the following motion of the shoulder: depression
Lower Traps
Lats
Pec Minor
Subclavius
74
What muscles are responsible for the following motion of the shoulder: Protraction
Serratus anterior
75
What muscles are responsible for the following motion of the shoulder: Retraction
middle traps
rhomboids
lower traps
76
What muscles are responsible for the following motion of the shoulder: upward rotators
Serratus
| upper and lower traps
77
What muscles are responsible for the following motion of the shoulder: downward rotation
rhomboids
| pec minor
78
What muscles are responsible for the following motion of the shoulder: abduction
deltoids
| supraspinatus
79
What muscles are responsible for the following motion of the shoulder: adduction
pecs
| lats
80
What muscles are responsible for the following motion of the shoulder: flexion
anterior delt
biceps
coracobrachialis
81
What muscles are responsible for the following motion of the shoulder: extension
triceps
lats
posterior delt
82
What muscles are responsible for the following motion of the shoulder: internal rotation
pecs
teres major
subscap
83
What muscles are responsible for the following motion of the shoulder: external rotation
teres minor
infraspinatus
supraspinatus
84
List the muscles that are primarily responsible for elevation of the arm at the GH and ST joints and describe the role of the rotator cuff during elevation of the arm.
Deltoids and supraspinatus - ABD
Anterior deltoid, coracobrachialis, biceps - flexion
supra activated at onset on abduction, max activation 60-90
85
What are the 10 direct and indirect causes of shoulder impingement syndrome?
- abnormal kinematics at GH joint
- scapular dyskinesis
- slouched posture that affect SC joint
- impairments of GH or SC joints
- swelling in and around subacromial space
- wear and degeneration of the rotator cuff and biceps tendons
- GH instability
- adhesions or stiffness within inferior GH capsule
- tightness in the posterior capsule of the GH joint
- osteophytes forming around AC joint
- abnormal shape of acromion or coracoacromial arch
86
Define carrying angle of the elbow and identify the normal range of orientation
Normal cubitus valgus
The medial lip of the trochlea laterally deviates the ulna laterally
13 degrees in men 15 in women
increases with age
87
What are the 5 ligaments at the elbow complex and what motions cause increased tension in each ligament
Medial collateral anterior - extension, flexion
Medial collateral posterior - valgus, flexion
Radial - Varus
lateral collateral - Varus, ER of elbow, flexion
annular ligament - distraction of the radius
88
Describe a common mechanism of injury to the MCL
FOOSH with excessive valgus force
| repetitive valgus strains placed on the elbow, baseball or tennis elbow
89
What are the osteokinematic motions at the elbow complex
flexion 0 -150
extension 150-0-5
functional arc 30-130
90
What are the arthrokinematic motions at the elbow and superior radioulnar joints
flexion - anterior roll anterior glide
| extension - posterior roll, posterior glide
91
List the muscles that perform the following motions: elbow flexion, elbow extension, forearm supination, and forearm pronation
flexion - brachialis, biceps brachii, brachioradialis, pronator teres
extension - triceps, anconeus
supination - biceps, supinator
pronation - pronator quadratus, pronator teres
92
Define synergistic relationship. With what muscle do the elbow flexors have a synergistic relationship with
assist in an agonist movement, and act at different but neighboring joints
flexors - posterior deltoid
93
With what muscle do the elbow extensors have a synergistic relationship with
?
94
At what angle(s) is the highest torque produced by the elbow flexors? Extensors? Why
85-95 flexion with supinated grip
80-90 flexion
this due to the muscles maximal force potential and internal moment arm length
95
At what angle(s) is the longest lever arm for the elbow flexors? Extensors
flexors - 100
| extensors - close to full extension
96
Describe how loading occurs across the radiocarpal joint? Through which structures does the majority of forces travel?
20% passes through the articular disk of the ulna
| 80% passes through the scaphoid and lunate to the radius
97
What are the osteokinematic motions at the wrist complex? What ROM is required for most ADLs
Flexion (75-85) extension (60-75)
Ulnar (35-40) and radial deviation (15-20)
ADLs - 40 FLEX, 40 EXT, 10 RD, 30 UD
98
What are the arthrokinematic motions at the wrist complex during wrist extension and flexion? Ulnar and radial deviation? Pronation and supination?
Flexion Extension - Vex on cave
| UD RD - vex on cave
99
dentify two common forms of carpal instability.
Rotational Collapse of wrist
| Ulnar translocation of the carpus
100
Describe the difference between VISI and DISI
DISI - dorsal intercalated segment instability
FOOSH can result in tearing of the scapholunate ligament resulting in scapholunate dislocation and malalignment of both bones, distal articular surface faces dorsally
VISI - volar intercalated segment instability
injury to the lunotriquetral ligament may alow the lonate to dislocate and show its distal articular surface volarly
101
Based on how forces are transferred during a FOOSH, what ligament is commonly injured
scapholunate ligament
102
How does ulnar translocation of the carpus occur in the presence of rheumatoid arthritis
Over time arthritis may erode the ligaments holding the carpus as as a result the carpals slide down the ramp of the radius towards the ulna
103
What are the 3 primary wrist extensors
ECRL, ECRB, Extensor Carpi ulnaris
104
What are the primary wrist flexors
Flexor carpi radialis, flexor carpi ulnaris, palmaris longus
105
What are the primary wrist radial deviators
ECRL, ECRB, extensor pollicis longus, extensor pollicis brevis, flexor carpi radialis, abductor pollicis longus, flexor pollicis longus
106
What are the primary wrist ulnar deviators
Extensor carpi ulnaris, flexor carpi ulnaris, flexor digitorum deep and superficial, extensor digitorum
107
Describe the activity of the wrist extensors while making a fist
the extensors stabilize the flexors and often contract synchronously with the flexors
108
In what position is grip strength maximized? What happens to grip strength as you increase wrist flexion?
30-35 extension
| 5-15 ulnar deviation
109
Define opposition
bringing the thumb and pinky together
110
What extrinsic muscles perform the following motions: flexion of the digits, extension of the digits, and extension of the thumb?
Flexor digitorum superficialis and digitorum, flexor pollicis longus
Extensor digitorum, extensor indicis, extensor digiti minimi
extensor pollicis longus, extensor pollicis brevis, abductor pollicis brevis
111
Name five flexor pulleys and identify their function
A1-A5
A2, A4 - attach to the shafts of the proximal and middle phalanges
A1, A3, A5 - attach directly to the palmar plate
112
Define tenodesis
The stretching of a polyarticular muscle across one joint, which generates a passive movement at other joints
113
Define four aspects of the extensor mechanism and their primary function.
Central Band - transmits force from ED across PIP
Lateral Bands - Transmit extensor force from extensor digitorum, lumbricals, and interossei across PIP and DIP
Oblique retinacular ligaments - transmit force from lumbricals and interossei to lateral bands, assists extension and PIP and DIP
Dorsal hood - stabilize extensor tendon to MCP
114
List all intrinsic muscles of the hand
```
Thenar
abductor pollicis brevis
flexor pollicis brevis
opponens pollicis
hypothenar
adductor pollicis
lumbricals and interossei
```
115
What are the actions of the lumbricals and interossei
Lumbricals
MCP flexion, PIP and DIP extension
interosseous
PAD, DAB
116
What are the implications of a median nerve injury
Median
paralyzes all three muscles of the thenar eminence
thenar region becomes flat
117
Describe the process of events that culminates in opening of the hand (finger extension)
Early phase - ED extends MCP
Middle phase - intrinsic muscles help extend PIP and DIP, intrinsic also produce flexion torque preventing hyperextension at MCP
Late phase - muscle action continues to full extension
Muscle activation shifts slightly from extrinsic dominant to intrinsic dominant as the hand opens
118
Describe the process of events that culminates in the closing of the hand (finger flexion)
Early Phase - FDP and FDS and interosseous flex, lumbrical essentially inactive
late phase - this muscle action is maintained, ECRB extends wrist as ED helps slightly to reach the optimal grip position
119
Name five types of grip and identify key differences and similarities between them.
Power grip
stability and large forces
finger flexors, intrinsic muscles especially interossei, thumb adductor and flexor
Wrist extensors stabilize
Precision grip
control or delicate action
thumb and one or more digits
Power Pinch
large forces to stabilize object in between fingers
combines force of adductor pollicis and first dorsal interossei
Precision pinch
fine object control
tip to tip
pad to pad
Hook grip
PIP and DIP involvement
120
Describe the structure and function of the intervertebral disc
annulus fibrosus surrounds nucleus pulpulsus
70-90% water in the lumbar region
nucleus performs shock absorption
fibrosis is 15-25 layers of collagen
121
What is the relationship between the vertebral end plates and the IVD
end plates are thin cartilaginous caps that cover surfaces of vertebral bodies
binds to the annulus fibrosis
122
How does the IVD act as a hydrostatic pressure distributor
80% of load is supported by the interbody joint
| as the disk is compressed the fluid spreads out and distributes the load equally
123
Describe the reasons for the diurnal fluctuations in the water content within the IVD’s.
as the spine loads and unloads water is pushed in and out of the spine which accounts for 1% variation in weight across the day
124
What is spinal coupling and what are the reasons of spinal coupling
when movement in one plane of the spine produces movement in another
may involve muscle action, articular facet alignment, posture, attachment of ribs, stiffness of connective tissue, geometry of the spine itself
125
What are the arthrokinematics of the atlanto-occipital joint
C0 C1 - vex on cave
126
Describe the events that occur during flexion and extension of the spine
extension - inferior and posterior
| flexion - anterior superiro
127
Define lumbopelvic rhythm and describe variations of this rhythm during trunk flexion and when returning to standing from a flexed position
The kinematic relationship between the lumbar spine and hip joints during sagittal plane movements
flexion - 45 lumbar, 60 hip
extension - hip extensors first then lumbar extensors
128
How does pelvic tilt affect the osteokinematics of the lumbar spine
anterior - excess lordosis, increased anterior shear force across lower lumbar spineand lumbosacral area
posterior - decreased lordosis
129
Describe the effects of sitting posture on the alignment within the lumbar and cervical region
bad posture decreases lumbar lordosis and cervical extension
130
Describe the kinematics of the sacrum and the ilium
nutation - anterior sacral tilt
counternutation - posterior sacral tilt
3 degrees only
131
Describe the stabilizing effects of muscles and ligaments on the sacroiliac joint.
sacrotuberous, sacrospinous, interosseous ligaments
nutation torque increases stability
Erector spinae and lumbar multifidi, Diaphragm and pelvic floor muscles, Abdominal muscles, Rectus abdominis, Obliquus abdominis internus and externus, Transversus abdominis Hip extensor muscles (such as biceps femoris and gluteus maximus) Latissimus dorsi Iliacus and piriformis
132
What are the muscles of the posterior trunk
superficial - Trapezius, latissimus dorsi, rhomboids, levator scapula, serratus anterior
deep - erector spinae, transversospinal, interspinal muscles
133
What are the muscles of the anterior and lateral trunk
Rectus abdominis and obliques
134
What is the role of iliopsoas and quadratus lumborum on trunk stability
iliopsoas can drive lordosis, good vertical stabilizer
| QL can also provide excellent vertical stability
135
What is the role of intrinsic and extrinsic muscular stabilizers of the trunk
intrinsic - control alignment between spinal segments
| extrinsic - connect spine to other body regions for stability
136
Analyze the standard sit-up movement
trunk flexion and hip flexion phases
137
Discuss the role of the stabilizers in the craniocervical region
much of the stabilization is produced by the multifidi
scalenes, sternocleidomastoid, levator scapula, semispinalis capitis and cervicis, and trapezius provide vertical stability
138
Describe the magnitude of force imposed on the low back during lifting
MF + BW + EL
139
What are the ways to reduce force demands on the back during lifting
Reductions in muscle force have the most affect
| reduce external moment arm, reduce external load, reduce rate of lifting, increase internal moment arm
140
What is the role of intra-abdominal pressure during lifting
creates extension torque reducing demands on extensor muscles
also partially unloads vertebra
141
How does passive tension in ligaments aid with lifting
72Nm can be generated by allowing the passive elastic force to bounce back
spine must be maximally flexed
142
How does thoracolumbar fascia aids during lifting
provides extension torque in flexion and with activation of transverse abdominus, internal oblique, and lats
143
Describe the difference between stoop versus squat lift.
stoop - greater flexion of the back
| squat - true squat
