final review Flashcards
1
Q
When the body is in motion, it can be broken down into what two dynamics?
A
Kinematics and Kinetics
2
Q
What is an axis?
A
the pivot point for angular motion of the whole body or body segments (the motion of the rotating body is zero at this point)
3
Q
typically referred to as “the rotation of a joint”
A
angular motion
4
Q
What is a series of articulated segmented links?
A
Kinematic chain
5
Q
Two perspectives of movement at a joint:
A
- Proximal segment rotating on fixed distal segment
- Distal segment rotating on fixed proximal segment
6
Q
What are arthrokinematics?
A
motion between the articular joints
7
Q
What is the difference between a roll, slide, and spin?
A
Roll:
- Multiple points along one rotating surface contact multiple points on another articular surface
Slide:
- A single point on one articular surface contacts multiple points on another articular surface
Glide:
- A single point on one articular surface rotates on one single point on another articular surface
8
Q
What is the effect of forces on the body?
A
Kinetics
9
Q
A force can be described as…
A
A push or pull that can produce/arrest/ modify movement.
10
Q
What is the standard unit of force on the body?
A
Newtons (N)
11
Q
Name the common loads or forces applied on the body?
(Hint 7)
A
- Unloaded
- Tension
- Compression
- Bending
- Shear
- Torsion
- Combined loading
12
Q
What is the most common force on the body due to a MVA?
A
Shearing
13
Q
The ability of the periarticular connective tissues to accept and disperse loads can be impacted by…
A
- aging
- trauma
- prolonged immobilization
- disease
14
Q
What is an indication of increasing de-formation under constant load?
A
Creep
15
Q
What is an internal force and internal moment arm?
A
Internal torque
16
Q
What is an external force (gravity) and external moment arm?
A
External torque
17
Q
What is the moment arm length possessed by a particular force; changes throughout the ROM
A
Leverage
18
Q
When internal and external torque are equal, what occurs?
A
static rotatory equilibrium
19
Q
What type of muscle activation maintains a constant length; internal = external torque?
A
Isometric
20
Q
What type of muscle activation makes the muscle shortens; internal torque > external; rotation in direction of activated muscle?
A
Concentric
21
Q
What type of muscle activation makes the muscle lengthens (still a pulling force) external torque > internal; joint rotation is dictated by external torque?
A
Eccentric
22
Q
What muscle/muscle group initiates or executes the particular movement?
A
Agonist
23
Q
What muscle group does the opposite action of a particular agonist?
A
Antagonist
24
Q
What muscle group involves cooperating muscles for execution of a particular movement?
A
Synergist
25
2 or more muscles produce forces in different linear directions – resulting torques act in same rotatory direction
Force Couple
26
What is the evolute?
the path of serial locations for the IAR (Instantaneous axis of rotation)
27
What are the two basic elements of cells and extra-cellular matrix?
- Fibrous components
- Ground substance
(glue that holds us together)
28
What is ground substance composed of?
-water saturated matrix or gel
- GAGs (Glycoaminoglycans)
29
What is the role of ground substance and what is it determined by?
Transmits loads
The composition/role of the matrix: determined by the stress that impacts the cells
30
What are GAGs and their role?
Glycoaminoglycans (GAGs) – give physical resilience
31
Are Glycosaminoglycans (GAGs), also known as mucopolysaccharides, negatively or positively charged polysaccharide compounds?
negatively-charged
32
What can form as a result of increased spinal stresses (discal or instability)?
Bony spurs
33
Bone is constantly altering its shape/strength/density in response to external forces because of what law?
Wolf's Law: tension and compression cycle creates a small electrical potential that stimulates bone deposition and increased density at points of stress
34
What is the difference in osteoclasts and osteoblasts?
Osteoblasts- constantly synthesizing ground substance/collagen; deposition of salts
Osteoclasts – remove bone
(refer to image review ppt 29)
35
Bone is laid down in areas of _____ stress and reabsorbed in areas of ____ stress
High; low
36
Immobilization can result in...
- Marked changes in the structure and function of its connective tissues – loss of mass, volume and strength
- Mechanical strength is reduced – due to level of forces on musculoskeletal system reduced
37
What are some impacts of aging on periarticular connective tissue and bone? (3)
A slowing of the rate of fibrous proteins and proteoglycan replacement and repair in all periarticular tissues and bone.
Loss of ability to restrain and disperse forces…microtrauma
Physical activity and resistance training mitigates some of these issues!
38
What are the three layers of extracellular connective tissues (deep to superficial)?
- Endomysium
- Perimysium
- Epimysium
39
What extracellular connective tissue is a thin layer of connective tissue that surrounds an individual muscle cell/fiber; immediately external to the sarcolemma (cell membrane); collagen fibers?
Endomysium: partly connected to perimysium – help transfer the contractile force inside it from the actin/myosin to the tendon
40
What extracellular connective tissue is a sheath of fibrous elastic tissue surrounding a muscle belly.
Epimysium: separates it from other muscles; tough tightly woven collagen fibers resistant to stretch.
41
What extracellular connective tissue is the sheath of connective tissue surrounding a bundle of muscle fibers (fascicle)?
Perimysium: provides a conduit for blood vessels and nerves; tough and resistant to stretch.
42
Muscle contains what two contractile (actin) proteins?
Actin and myosin
43
What stabilizes the alignment of adjacent sarcomeres?
Desmin
44
What provides passive tension within a muscle fiber (cell)?
Titin
45
Non-contractile 'structural' proteins are made of what components?
- Cytoskeleton within muscle fibers (cells); supportive structure between fibers (internal and external support/structure)
46
What fibers run parallel to one another and to a central tendon?
Fusiform; designed for mobility, low force over long range
47
What fibers approach their central tendon obliquely?
Pennate; Contain a larger # of fibers per area. Generate relatively larger forces. Most muscles in this group
Unipennate, bipennate, multipennate
48
What impacts the amount of force transmitted from muscle to tendon to bone?
Muscle architecture
49
Most muscles have pennation angles between __ and ___ .
0 and 30
50
What is the difference between series and parallel?
Series: aligned in (In a series circuit, all components are connected end-to-end) forming a single path
Parallel: all components are connected across each other
(Refer to ppt 37 picture)
51
What are structural proteins
and extracellular connective tissues (epi/peri/endomysiums) considered?
Noncontractile elements
52
What tissues attached end to end with the active proteins: tendon, titan?
Series elastic components
53
What tissues lies parallel with active proteins: epi/peri/endomysium
Parallel elastic components
54
What two properties of muscle are components of plyometric exercise?
elasticity and viscoelasticity
55
Who is the ultimate force generator in a muscle?
Sarcomeres
56
Dark band = A band =______
Light bands = I bands = _____
thick myosin
thin actin
57
The myosin head attaches to an adjacent actin filament to form what structure?
crossbridge; the amount of force in a given sarcomere depends on the simultaneously formed crossbridges
refer to ppt 46-48
58
Do the active proteins themselves shorten?
No
59
What action occurs during each contraction?
- Concentric
- Eccentric
- Isometric
- shortens
- lengthens
- nearly constant
60
How does the body alter the contractions/forces it needs? (3)
Through the recruitment of motor units, action potentials, rate coding.
(refer to ppt 53)
61
What operates in the rise of muscle force and are highly specific to demand?
Rate coding and recruitment
62
What is muscle fatigue?
- exercise-induced decline in max voluntary muscle force despite max effort
It is the basis of neuromuscular overload and adaptation necessary for training.
63
What are some causes of muscle fatigue in healthy people? (5)
-Rate of fatigue is specific to the task and rest-work cycle
-High intensity – short duration
-Low intensity - low duration
-Women less fatigable than men for concentric/isometric when intensity the same (more type I slow twitch)
-Older – less fatigable than young in isometrics; more with concentric at fast velocities
64
What can cause reduced use in muscles?
Immobility, Disuse, injury
65
When muscle experience reduces use, when does atrophy occur?
Atrophy within first few weeks – 3-6% within first week.
66
What type of resistive exercises can reverse or mitigate these changes to reverse muscle atrophy?
- Eccentric activation >est gains in strength and fiber size
- Low intensity and long duration due to smaller motor units more prone to atrophy
67
What two muscles are deep to the trachea and esophagus and assist in all vertical stability?
Longus Colli and Longus Capitis
68
What muscle is anterior T1-3, all cervical vertebrae (only one) bodies, TPs and anterior arch of the atlas, and can flex/reduce cervical lordosis?
Longus Colli
69
What muscle is located in the mid/lower TPs into basilar part of occiput, it flexes and stabilizes the upper craniocervical spine?
Longus capitis
70
When stabilizing the crainocervical region, musculature needs to be __________ to contract before_______.
trained; loading
71
What structures are the cervical muscles anchored to be stabilized? (5)
sternum
clavicle
ribs
scapula
vertebral column
72
What are the arthokinematics of the mandibular condyle and disc?
-Protrusion and retrusion (translate ant/post)
- Lateral Excursion
(side to side)
- Depression and Elevation
(Combo rotation and translation)
73
In depression and elevation
what phase has 35-50% primarily rotation?
the early phase
74
In depression and elevation what phase has the final 50-65% primarily translation?
the late phase
75
What are the primary muscles in mastication?
- masseter
- temporalis
- lateral pterygoid
- medial pterygoid
76
What is the loss of intervertebral stiffness that can lead to abnormal and increased intervertebral motion?
Spinal instability
77
What is the amount of intervertebral movement that occurs with the least passive resistance form the surrounding tissues?
Neutral zone
78
What are the kinematics in the sagittal plane?
Osteokinematics flexion/extension:
- 120-130 degrees combined
- 80 ext
- 45-50 flexion: 20-25% total @ OA/AA – rest C2-C7
79
In the arthrokinematics of cervical flexion/extension which segment has overall 90-100 degrees of motion?
C2-C7; flexion and extension
80
Protraction and retraction creates what type of movement in the sagittal plane?
Translation in the sagittal plane
81
What are the arthokinematics in the horizontal plane at the AA joint?
35-40 degrees of rotation
82
What are the arthokinematics in the horizontal plane at C2-C7?
- Guided by facets at 45 deg; 30-35 deg whole of segments
Inferior glides posteriorly/inferiorly same side; opposite anterior and superior
83
What are the osteokinematics of depression and elevation?
35-45 degrees of elevation
10 degrees of depression
84
What are the arthrokinematics of elevation?
Elevation of clavicle: convex surface rolls superiorly and slides inferiorly; CC ligament stretches – limits motion
85
What are the arthrokinematics of depression?
Depression of clavicle: convex surface rolls inferiorly and slides superiorly; interclavicular igament/superior portion of capsule stretches
86
What are the arthrokinematics and osteokinematics in abduction and adduction?
- Rotation of the humerus frontal plane, axis A-P
- Convex head of humerus rolling superiorly, sliding inferiorly along longitudinal diameter of fossa
87
How many degrees of upward rotation occur in abduction and adduction?
60 degrees
88
What plays an active role in preventing the pinching of the humeral head and the undersurface acromion?
Dynamic stability
89
In scapulohumeral rhythm, the natural rhythm between GH _________ and scapulothoracic (ST) __________________ .
adbuction; upward rotation
(after 30 degrees of abduction)
90
How many degrees of elevation occurs at the SC joint during full abduction?
30 degrees
91
What happens to the clavicle at full abduction?
The clavicle retracts at the SC joint.
92
As full abduction occurs – the scapula tilts ________ and slightly rotates _________.
posteriorly; outward
93
What does the humerus naturally rotate during abduction?
Externally; this allows the greater tubercle on the humerus to pass posterior to the acromion
94
What three retractors muscles?
Middle Trapezius
Rhomboids
Lower Trapezius
95
What muscle is essential for elevation of UE at the ST joint?
Serratus anterior
96
What muscle rolls the humeral head superiorly toward abduction while also compressing the joint for added stability?
Supraspinatus
97
What muscles internally rotate the shoulder? (5)
Subscapularis
Pectoralis major
Latissimus dorsi
Teres major
Anterior deltoid
98
What muscles externally rotate the shoulder? (3)
Infraspinatus
Teres minor
Posterior deltoid
99
Which variable is most responsible for the magnitude and direction of the joint reaction force at the elbow?
Muscle force is most responsible for elbow joint reaction force.
100
What joint contributes to the stability of the elbow and contributes to the flexion and extension of the forearm?
Humero-ulnar joint
101
Where is the axis for flexion/extension in the elbow?
Lateral epicondyle through the convex members, near med-lateral (review ppt 108)
102
In the periarticular connective tissue of the elbow, what four ligaments are responsible multiplanar stability?
MCL- medial collateral ligament
RCL- radial collateral ligament
LCL- lateral collateral ligament
Annular ligament
103
What structures can be injured to the MCL when extended and valgus force weight-bearing?
ulnar nerve, anterior capsule, medial musculature at epicondyle
104
What type of injury can occur at repetitive valgus stress producing a strain, overhead athletes?
(especially baseball pitchers)
NWB (non-weight bearing) MCL injury
105
What type of surgery is for the repair of the anterior fibers through a tendon graft from palmaris longus, gracilis, or plantaris?
Tommy John surgery
106
What is the mechanism of injury in the terrible triad injury?
FOOSH, fall outstretched and supinated
107
What structures are injured in the terrible triad injury? (3)
Elbow joint dislocation (lig injury)
Fx radial head
Fx coronoid process
108
What are the arthokinematics of the humeroradial joint?
Radius rolls and slides;
Active flexion – radial fovea pulled firmly against capitulum by contracting muscles
109
During pronation and supination, the ______ and __________ rotate around the fixed humerus and ulna.
radius and carpal bones
110
What muscle pronates the forearm and pulls the radius proximally against the capitulum?
Pronator Teres
111
What are the primary muscles in supination?
Biceps brachii and supinatior
112
Define the kinematics of the “dart throwing” motion at the wrist.
The “dart throwing” motion naturally combines wrist extension with radial deviation and flexion with ulnar deviation.
113
Which muscle is the most direct antagonist to the flexor carpi ulnaris?
Either the extensor pollicis longus or the extensor carpi radialis brevis.
114
List all muscles that have a full or partial proximal attachment to the lateral epicondyle of the humerus. Which nerve innervates all these muscles? (7)
Brachioradialis
Extensor carpi radialis longus
Extensor carpi radialis brevis
Extensor carpi ulnaris
Extensor digitorum
Anconeus
Supinator
All the above muscles are innervated by the radial nerve.
115
What muscle is the most direct antagonist to the brachialis muscle?
The medial head of the triceps, based on its action and relative attachment site on the humerus.
116
What is the kinesiologic role of the anterior deltoid during a “pushing” motion that combines elbow extension and shoulder flexion?
The anterior deltoid has two roles in this action. First, the muscle flexes the shoulder to thrust the hand forward against the door. Second, the muscle produces a shoulder flexion torque that neutralizes the shoulder extension torque potential of the long head of the triceps.
117
Describe the arthrokinematics at the humeroradial joint during a combined motion of elbow flexion and supination of the forearm.
Arthrokinematics include a combined spin and a roll-and-slide in similar directions.
118
How many nerves innervate the primary muscles that flex the elbow (against gravity)?
Three: The musculocutaneous nerve innervates the brachialis, the radial nerve innervates the brachioradialis (and part of the brachialis), and the median nerve innervates the pronator teres.
119
What percentage in reduction of max grip effort would occur, if there was injury to the ulnar nerve?
38%
120
What intervention would encourage extension of the fingers with an ulnar nerve lesion?
Manually holding the metacarpophalangeal joints into flexion.
121
In finger extension that phase is extending primarily the metacarpophalangeal joint?
Early Phase
122
In finger extension, what phase do the intrinsic muscles assist the extensor digitorum w/ extension of the proximal and distal interphalangeal joints?
Middle Phase
123
In finger extension, what phase does the activation in the flexor carpi radialis slightly flex the wrist.
Late Phase
124
What muscle flexes the MCP and extends IP? (8)
-4 Palmar interossei adduct (unipennate)
-4 Dorsal interossei abduct (bipennate)
125
What muscles attach to the lateral band of the extensor mechanism and extend the PIP and DIP?
Lumbricals:
- 2 lateral ones, median
- 2 medial ones, ulnar
126
In an open chain position, what does the pronator do to produce a pronation torque?
Pronator rotates the radius relative to a fixed ulna.
127
In an closed chain position, what does the pronator do to produce a pronation torque?
Pronator rotates the radius relative to a fixed radius.
128
In an closed chain position, what muscle rotates the humerus relative to a fixed scapula?
Infraspinatus
129
What disease is the softening of the lunate AVN?
Kienbocks disease
130
In the carpal bones, what bone is the most inherently unstable?
Lunate
131
What bone does the axis go through in the wrist?
Capitate
132
What carpal bones are in the proximal row?
scaphoid, lunate, triquetrum and pisiform
133
What carpal bones are in the distal row?
trapezium, trapezoid, capitate and hamate
134
What joint has a concave radius and disc and convex scaphoid and lunate?
Radiocarpal joint
135
What joint is between proximal and distal rows, continuous capsule?
Midcarpal joint
136
What complex fills the space that looks empty on radiograph (ulnocarpal space) at the ulnocarpal space?
Triangular fibrocartilage complex (TFCC)
137
What are the osteokinematics of the wrist (2 degrees of freedom)?
flexion/extension & ulnar-radial deviation
138
What motion occurs when a dart a being thrown?
10-15 deg of ext, 10 deg ulnar dev
139
What is the excessive mobility between carpals, usually laxity/rupture ligaments?
Carpal instability
140
What is mechanically proximal carpals are a row of mobile bones between two?
Rotational Collapse of the Wrist
141
How many degrees of extension are need for maximal grip force?
30 degrees
