Exam 2 Review - Joint Arthrokinematics Flashcards
What osteokinematic motions can the atlanto-occipital (AO) joint of the spine do?
flexion
extension
side bending
During flexion of the AO joint, the occiput rolls into flexion and ________ on the superior facet of the atlas (c1)
glides posterior
During extension of the AO joint, the occiput rolls into extension and _______ on the superior facet of the atlas
glides anterior
During side bending to the right of the AO joint, the occiput rolls into right side bending and _________ on the superior face of the atlas
glides left
What are the osteokinematic motions of the atlanto-axial (AA) joint?
flexion
extension
axial rotation
During flexion at the AA joint, the inferior facet of the atlas ______ into flexion on the superior face of c2
tilts
During extension at the AA joint, the inferior facet of the atlas ______ into extension on the superior facet of the axis
tilts
During rotation to the right the _____ inferior facet of the atlas ________ on the right superior facet of c2; the _______ inferior facet of the atlas _________ on the left superior facet of the axis
right, glides posterior
left, glides anterior
What are the osteokinematic motions of C3-7?
flexion
extension
rotation
side bending
During flexion of C3-7, the inferior facets of the superior vertebra glide _______ & ________ on the superior facets of the inferior vertebra
anterior and superior
During extension of C3-7, the inferior facets of the superior vertebra glide _____ & _____ on the superior facets of the inferior vertebra
posterior and inferior
During rotation of C3-7 to the right, the _______ inferior facet of the superior vertebra glides _______ & _______ on the right superior facet of the inferior vertebra. The _______ inferior facet of the superior vertebra glides ______ & _____ on the left superior facet of the inferior vertebra
right, posterior and slightly inferior
left, anterior and slightly superior
During side bending of C3-7 to the right, the ______ inferior facet of the superior vertebra glides ____ & ____ on the right superior facet of the inferior vertebra. The ____ inferior facet of the superior vertebra glides _____ & _____ on the left superior facet of the inferior vertebra
right, inferior and slightly posterior
left, superior and slightly anterior
What is the orientation of the facets of C3-7?
- angled 45 deg
- superior facet: face superior and posterior
- inferior facet: face inferior and anterior
What is the orientation of the facets of the thoracic vertebrae?
- slightly tipped forward
- superior facet: face posterior and slightly superior
- inferior facet: face anterior and slight inferior
What are the osteokinematic motions of the thoracic vertebrae?
flexion
extension
rotation
side bending
During flexion of the thoracic vertebrae, the inferior facet of the superior vertebra glides _____ & ______ on the superior facets of the inferior vertebra
superior and slightly anterior
During extension of the thoracic vertebrae, the inferior facet of the superior vertebrae glides _____ & _____ on the superior facets of the inferior vertebra
inferior and slightly posterior
During rotation of the thoracic vertebrae to the right, the inferior facet of the superior vertebra glide _____ on the superior facet of the inferior vertebra
left
What is the orientation of facets in the lumbar region of the spine?
- 90 deg
- superior facets: face medial to posterior-medial
- inferior facets: face lateral to anterior-lateral
During side bending of the thoracic vertebrae to the right, the inferior facets of the superior vertebra glide ______ on the superior facets of the inferior vertebra
right
What are the osteokinematic motions of the lumbar region?
flexion
extension
rotation
side bending
During flexion in the lumbar region, the inferior facets of the superior vertebra glide ______ & _____ on the superior facets of the inferior vertebra
superior and anterior
During extension in the lumbar region, the inferior facets of the superior vertebra glide ______ & _____ on the superior facets of the inferior vertebra
inferior and posterior
During rotation to the right in the lumbar region, the _______ inferior facets of the superior vertebra ________ against the left superior facet of the inferior vertebra. The _____ inferior face too the superior vertebra ______ slightly from the right superior facet of the inferior vertebra
left, approximates (compresses)
right, distracts (gaps)
During side bending to the right in the lumbar region, the ____ inferior facet of the superior vertebra slides ______ on the left superior facet of the inferior vertebra. The ______ inferior facet of the superior vertebra glides _______ on the right superior facet of the inferior vertebra
left, superior
right, inferior
What is the bilateral action of SCM?
cervical flexion
What is the unilateral action of SCM?
contralateral rotation, ipsilateral side bending
What is the bilateral action of semispinalis cervicis?
cervical extension
What is the unilateral action of semispinalis cervicis?
contralateral rotation, ipsilateral side bending
What is the bilateral action of splenius capitis?
cervical extension
What is the unilateral action of splenius capitis?
ipsilateral rotation and side bending
What is the bilateral action of obliquus internus?
trunk flexion
What is the unilateral action of obliquus internus?
ipsilateral rotation and side bending
What is the bilateral action of obliquus externus?
trunk flexion
What is the unilateral action of obliquus externus?
contralateral rotation, ipsilateral side bending
What is the bilateral action of lumbar multifidus?
lumber extension
What is the unilateral action of lumbar multifidus?
contralateral rotation, ipsilateral side bending
What are the four ways to reduce the amount of force required by the back extensor muscles during lifting?
- reduce acceleration
- reduce magnitude of external load
- reduce the length of external moment arm
- increase length of internal moment arm
How does the squat lift compare to the stoop lift?
squat lift reduces the torque demand about the lumbar spine but increases the total work required to lift a load
How does the vasalva maneuver impact the spine during lifting?
- creates rigidity in spine by increasing intra-abdominal pressure and decreasing volume by activating core muscles to decrease the demand on lumbar spine muscles = more stability and stiffness in lumbar region
What are the osteokinematic motions of the sternoclavicular joint?
elevation
depression
protraction
retraction
rotation
During elevation of the SC joint, the convex surface of the clavicle rolls into elevation as it __________ on the concave sternum
slides inferiorly
During depression of the SC joint, the convex surface of the clavicle rolls into depression as it _______ on the concave surface of the sternum
slides superior
During protraction of the SC joint, the concave surface of the clavicle rolls into protraction as it __________ on the convex surface of the sternum
slides anterior
During retraction go the SC joint, the concave surface of the clavicle rolls into retraction as it ________ on the convo surface of the sternum
slides posterior
What plane of motion does rotation of the SC joint occur and when does it happen?
- sagittal plane
- rotates posteriorly during shoulder abduction or flexion
What are the osteokinematic motions of the AC joint?
upward rotation and downward rotation (frontal)
rotational adjustment positions
Does the AC joint have arthrokinematic motion?
no
What are the osteokinematic motions of the GH joint?
flex/ext
ext/int rotation
abd/adduction
horizontal abd/add
During extension of the GH joint, the humeral head ____ into extension on the glenoid fossa
spins
During flexion of the GH joint, the humeral head _____ into flexion on the glenoid fossa
spins
During ext rotation of the GH joint, the humeral head rolls into external rotation and ______ on the glenoid fossa
glides anterior
During int rotation of the GH joint, the humeral head rolls into internal rotation and ______ on the glenoid fossa
glides posterior
During abduction of the GH joint, the humeral head rolls into abduction as it _____ on the glenoid fossa
glides inferior
During adduction of the GH joint, the humeral head rolls into adduction as it ______ on the glenoid fossa?
glides superior
During horizontal abduction the humeral head rolls posterior as it ________ on the glenoid fossa
glides anterior
During horizontal adduction the humeral head rolls anterior as it _______ on the glenoid fossa
glides posterior
What are the osteokinematics of the scapulothoracic joint?
upward/downward rotation
elevation
depression
protraction
retraction
anterior tilt/posterior tilt
What are the associated osteokinematics at the SC and AC joint during upward rotation of the ST joint?
SC elevation, AC upward rotation
What are the associated osteokinematics at the SC and AC joint during downward rotation of the ST joint?
SC depression, AC downward rotation
What are the associated osteokinematics at the SC and AC joint during elevation of the ST joint?
SC elevation, AC downward rotation
What are the associated osteokinematics at the SC and AC joint during depression of the ST joint?
SC depression, AC upward rotation
What are the associated osteokinematics at the SC and AC joint during protraction of the ST joint?
SC protraction, AC int rotation
What are the associated osteokinematics at the SC and AC joint during retraction of the ST joint?
SC retraction, AC ext rotation
What muscles contribute to upward rotation of the scapula?
- traps (upper, middle, lower)
- serratus anterior
What muscles contribute to downward rotation of the scapula?
- latissimus
- levator scapulae
- rhomboids
What are the degrees of movement at the SC joint during shoulder abduction?
- 20 deg elevation
- 20 deg retraction
- 30 deg posterior rotation
What is the degree movement at the AC joint during shoulder abduction?
30 deg upward rotation
How much of shoulder abduction comes from the ST joint and GH joint?
ST: 60 deg
GH: 120 deg
How must the scapula move for full shoulder abduction?
- 60 deg upward rotation
- 20 deg posterior tilt
- 5 deg external rotation
In order get full shoulder ROM what must the humerus do?
externally rotate 35 deg
What are the osteokinematic motions of the humeroulnar joint?
flexion
extension
During flexion of the humeroulnar joint, the trochlear notch of the ulna rolls into flexion and _________ on the trochlea of the humerus
glides anterior
During extension of the humeroulnar joint, the trochlear notch of the ulna rolls into extension and __________ on the trochlea of the humerus
glides posterior
What are the osteokinematic motions of the humeroradial joint?
flexion
extension
pronation
supination
During flexion of the humeroradial joint, the head of he radius rolls into flexion and ________ on the capitulum of the humerus
glides anterior
During extension of the humeroradial joint, the head of he radius rolls into extension and ________ on the capitulum of the humerus
glide posterior
During pronation of the humeroradial joint, the head of the radius ________ into pronation on the capitulum of the humerus
spins
During supination of the humeroradial joint, the head of the radius ________ into supination on the capitulum of the humerus
spins
What are the osteokinematic motions of the PRUJ?
pronation
supination
During pronation of the PRUJ the head of the radius rolls into pronation and ________ on the radial notch of the ulna
glides posterior
During supination of the PRUJ the head of the radius rolls into supination and ________ on the radial notch of the ulna
glides anterior
What are the osteokinematic motions of the DRUJ?
pronation
supination
During pronation of the DRUJ the ulnar notch of the radius rolls into pronation and ________ on the head of the ulna
glides anterior
What are the osteokinematic motions of the radiocarpal joint?
flexion
extension
radial deviation
ulnar deviation
During supination of the DRUJ the ulnar notch of the radius rolls into supination and ________ on the head of the ulna
glides posterior
During flexion of the radial carpal joint, the proximal carpals roll into flexion as they _________ on the distal radius
glide posterior (dorsal)
During extension of the radial carpal joint, the proximal carpals roll into extension as they _________ on the distal radius
glide anterior (palmar)
During radial deviation of the radial carpal joint, the proximal carpals roll into radial deviation as they _________ on the distal radius
glide ulnarly
During ulnar deviation of the radial carpal joint, the proximal carpals roll into ulnar deviation as they _________ on the distal radius
glide radially
What needs to happen into order to have a strong grip with your hand?
flexors must activate to grip object but extensors must also activate to keep a neutral wrist
What is the optimal length for dinger flexors?
30 deg of wrist extension
What happens to grip strength if the wrist is flexed?
decreases because finger flexors experiencing active insufficiency and finger extensors are over lengthened which causes an extension torque at the PIP, reducing strength
What are the osteokinematic motions of the hip?
extension
flexion
ext/int rotation
abd/adduction
During open chain extension of the hip, the head of the femur _______ into extension on the acetabulum
spins
During closed chain extension of the hip, the acetabulum _______ into extension on the head of the femur
spins
During open chain flexion of the hip, the head of the femur _______ into flexion on the acetabulum
spins
During closed chain flexion of the hip, the acetabulum ______ into flexion on the head of the femur
spins
During open chain external rotation of the hip, the head of the femur rolls into ext rotation and _______ on the acetabulum
glides anterior
During closed chain external rotation of the hip, the acetabulum rolls into external rotation and ________ on the head of the femur
glides posterior
During open chain internal rotation of the hip, the head of the femur rolls into int rotation and _______ on the acetabulum
glides posterior
During closed chain internal rotation of the hip, the acetabulum rolls into internal rotation and ________ on the head of the femur
glides anterior
During open chain abduction of the hip, the head of the femur rolls into abduction and _______ on the acetabulum
glides inferior
During closed chain abduction of the hip, the acetabulum rolls into abduction and ______ on the head of the femur
glides superior
During open chain adduction of the hip, the head of the femur rolls into adduction and _______ on the acetabulum
glides superior
During closed chain adduction of the hip, the acetabulum rolls into adduction and ______ on the head of the femur
glides inferior
What is the muscle action of piriformis in neutral?
external rotation
What is the muscle action of piriformis in 120 deg of hip flexion?
internal rotation
What is the muscle action of adductor longus in neutral?
adduction and extension
What is the muscle action of adductor longus in 120 deg of hip flexion?
adduction and flexion
What is closed chain hip flexion associated with in the pelvis and lumbar spine?
anterior pelvic tilt
lumbar lordosis (extension)
What is closed chain hip extension associated with in the pelvis and lumbar spine?
posterior pelvic tilt and decreased lumbar lordosis (flexion)
What are the impacts of limited hip extension?
slower gait and smaller steps
anterior pelvic tilt and increased lumbar lordosis
What are the impacts of limited hip flexion on patients after hip surgery?
patients sit with posterior pelvic tilt and lumbar flexion
What are the osteokinematics of the tibiofemoral joint?
flexion
extension
external/internal rotation
During flexion of the tibiofemorial joint, the tibia rolls into flexion and ________ on the femur
glides posterior
During extension of the tibiofemoral joint, the tibia rolls into extension and ________ on the femur
glides anterior
During external rotation of the tibiofemoral joint, the tibia _____ into external rotation on the femur
spins
During internal rotation of the tibiofemoral joint, the tibia _____ into internal rotation on the femur
spins
What are the osteokinematics of the patellofemoral joint?
flexion and extension in frontal plane
During flexion of the patellofemoral joint, the patella ________ on the femur
glides inferior
During extension of the patellofemoral joint, the patella ______ on the femur
glides superior
In what direction does the patella experience the most pull?
lateral
What is the determinant of lateral pull on the patella and how does its size affect the amount of pull?
Q angle, the larger the q angle, the greater the lateral pull
What structures contribute to the lateral pull on the patella?
- quads
- IT Band
- later retinacular fibers
What structures contribute to the medial pull on the patella?
- vastus medialis
- raised trochlear groove
- patellofemoral ligament
What is the screw home mechanism?
in last 30 deg of knee extension, there is a external rotation of 10 deg, to make joint stable
What causes the screw home mechanism?
shape of medial femoral condyle
passive tension of ACL
slight lateral pull of quads
popliteus must unlock knee to internal rotate
What motion is limited by the ACL?
extension
tibial anterior translation
extreme varus or valgus
rotation
What motion is limited by the PCL?
flexion
tibial posterior translation
extreme varus or valgus
rotation at 90 deg of flexion
What motion is limited by the MCL?
valgus
extension
external tibial rotation
What motion is limited by the LCL?
varus
extension
extreme axial rotation
What are the osteokinematics of the talocrural joint?
plantar flexion
dorsiflexion
What is the axis of rotation for the talocrural joint?
inferior/posterior/lateral to superior/anterior/medial
During plantar flexion of the talocrural joint, the trochlea of the talus rolls into PF and _________ on the ankle mortise
glides anterior
During dorsiflexion of the talocrural joint, the trochlea of the talus rolls into DF and _______ on the ankle mortise
glides posterior
What are the osteokinematics of the subtalar joint?
pronation and supination
What bones make up the subtalar joint?
talus and calcaneus
What motions are involved in pronation of the subtalar joint?
eversion + abduction + DF
What motions are involved in supination of the subtalar joint?
inversion + adduction + PF
During pronation of the subtalar joint, the calcaneus rolls into eversion and _________ on the talus
glides medially
During supination of the subtalar joint, the calcaneus rolls into inversion and _________ on the talus
glides laterally
What axis is the subtalar joint on?
oblique axis = inferior posterior lateral to superior anterior medial
What axis is the mid tarsal joint on?
oblique axis
What makes up the mid tarsal joint?
talanavicular and calcaneocuboid joint
What are the osteokinematics of the mid tarsal joint?
pronation and supination
What axis is inversion/eversion of the ankle/foot on?
A-P axis
What axis is abd/adduction of the ankle/foot on?
vertical axis
What axis is DF/PF of the ankle/foot on?
M-L axis
What is the muscle action of tibialis posterior?
inversion and PF
What is muscle action of tibialis anterior?
DF, inversion, adduction
What are the muscle actions of fibularis longus and brevis?
eversion and PF
What are the muscle actions of extensor digitorum brevis and longus?
toe ext and DF
How does rear foot pronation/supination affect mid foot stability?
supination of the calcaneus increases mid foot stability
pronated calcaneus leads to flexible midfoot
What are the effects of pronation and supination up the kinematic chain?
closed chain subtalar pronation is couples with tibial and femoral internal rotation, increasing valgus stress at knee
at hip, internal rotation flexion and adduction
What are the 3 rockers in the sagittal plane gait?
heel rocker: heel strike and subsequent PF
ankle rocker: tibial advancement over foot by ankle DF
forefoot rocker: during heel rise, ankle PF, and MTP joint extension
What is the order of the 3 rockers of gait?
heel > ankle > forefoot