Learning Objectives and Kahoot Flashcards
At what level in the cervical spine does rotation mostly occur?
C1/C2
What are the atypical vertebrae of each region of the spine (Cervical, Thoracic, Lumbar)? What makes them atypical?
Cervical:
C1 = Has a posterior tubercle instead of a spinous process.
C2 = Has the dens
C7 = Elongated and non-bifid spinous process
Thoracic:
T1 = Superior costal facets are ‘whole’ as C7 does not have an inferior costal demifacet.
T9 = Has no inferior demifacet so does not connect to 10th rib.
T11-12 = Single costal facets
T10 = Sometimes has same feature as T11-12
Lumbar:
L5 = Large vertebral body and TP
What are the common ligaments of the spine? What is the function of each one?
Anterior Longitudinal Ligament:
- Limits spinal extension.
Posterior Longitudinal Ligament:
- Limits spinal flexion.
Ligamentum Flavum:
- Maintains posture and prevents vertebral separation.
Interspinous Ligament:
- Limits flexion by restricting spinous process separation.
Ligamentum Nuchae:
- Supports the head.
Intertransverse Ligament:
- Provides lateral stability, especially in the neck
What are the various descriptions of rib movement at various levels?
- Pump Handle (Ribs 1–5): Moves front-to-back.
- Bucket Handle (Ribs 6–10): Moves side-to-side.
- Caliper (Ribs 11 & 12): Moves in-and-out laterally.
What are the muscles of the erector spinae?
- Illiocastalis
- Longissimus
- Spinalis
What are some of the differences in the pelvis between males and females?
Female differences:
- Wider and broader yet lighter
- Oval-shaped inlet versus heart shaped
- Less prominent ischial spines = greater
bispinous diameter
- Greater sub-pubic arch angle
- Shorter, more curved sacrum
What is the facet orientation throughout the spine?
Cervical:
- Facet joints are oriented in the coronal plane,
and face 45 degrees to the transverse plane.
Thoracic:
- Facet joints are oriented in the coronal plane,
and lie almost vertically in the sagittal plane.
Lumbar:
- Facet joints are oriented in the sagittal plane, and are at right angles to the transverse plane.
Name the joints and muscles involved in pronation of the forearm
Joints:
- Proximal Radioulnar Joint
- Distal Radioulnar Joint
Muscles:
- Pronator Teres
- Pronator Quadratus
- Flexor Carpi Radialis
Name the only joint that joins the upper limb to the axial skeleton
Sternoclavicular Joint
Explain scapulohumeral rhythm – the various joints, their ranges of motion and the interplay in creating shoulder abduction
Scapulohumeral rhythm in shoulder abduction:
- Glenohumeral Joint: Provides 120° of movement.
- Scapulothoracic Joint: Contributes 60° through scapular rotation.
These joints work in a 2:1 ratio, with the GH joint moving more initially, followed by both joints together to complete abduction
List muscles involved with each range of motion of the Humeroulnar Joint
Flexion:
- Biceps brachii
- Brachialis
- Brachioradialis
Extension:
- Triceps brachii
List muscles involved with each range of motion of the Glenohumeral Joint
Flexion:
- Pectoralis major
- Deltoid (anterior fibers)
- Coracobrachialis
- Biceps brachii (long head)
Extension:
- Latissimus dorsi
- Teres major
- Deltoid (posterior fibers)
- Triceps brachii (long head)
Abduction:
- Deltoid
- Supraspinatus
Adduction:
- Pectoralis major
- Latissimus dorsi
- Teres major
- Coracobrachialis
Internal Rotation:
- Subscapularis
- Teres major
- Latissimus dorsi
- Pectoralis major
- Deltoid (anterior fibers)
External Rotation:
- Infraspinatus
- Teres minor
- Deltoid (posterior fibers)
List muscles involved with each range of motion of the Radioulnar Joints (forearm)
Pronation:
- Pronator teres
- Pronator quadratus
Supination:
- Supinator
- Biceps brachii
List muscles involved with each range of motion of the Radiocarpal Joint - Wrist
Flexion:
- Flexor carpi radialis
- Flexor carpi ulnaris
- Palmaris longus
- Flexor digitorium superficialis
- Flexor digitorium profundus
Extension:
- Extensor carpi radialis longus
- Extensor carpi radialis brevis,
- Extensor carpi ulnaris
- Extensor digitorium
Radial Deviation (Abduction):
- Flexor carpi radialis
- Extensor carpi radialis longus and brevis
- Abductor pollicis longus
Ulnar Deviation (Adduction):
- Flexor carpi ulnaris
- Extensor carpi ulnaris
List muscles involved with each range of motion of the Iliofemoral Joint - Hip
Flexion:
- Psoas
- Illiacus
- Rectus femoris
Extension:
- Gluteus maximus
- Hamstrings (Biceps femoris, Semitendinosus, Semimembranosus)
- Adductor magnus
Abduction:
- Gluteus medius
- Gluteus minimus
- Tensor fasciae latae
Adduction:
- Adductor magnus
- Adductor longus
- Adductor brevis
- Gracilis
- Pectineus
Internal Rotation:
- Gluteus medius
- Gluteus minimus
External Rotation:
- Gluteus maximus
- Piriformis
- Obturator internus
- Gemelli superior & inferior
- Quadratus femoris
List muscles involved with each range of motion of the tibiofemoral joint - Knee
Flexion:
- Hamstrings (Biceps femoris, Semitendinosus, Semimembranosus)
Extension:
- Quadriceps (Rectus femoris, Vastus lateralis, Vastus medialis, Vastus intermedius)
Medial/lateral rotation:
- Popliteus
- Semimembranosus
- Semitendinosus
What is the role of the meniscus of the knee?
- Joint stability
- Shock absorption
- Weight distribution/load transmission
- Proprioception (position awareness)
What is the role of the ACL, PCL and collateral ligaments of the knee?
ACL:
Limits:
- Anterior displacement of tibia under a fixed
femur
- Hyperextension
- Internal femoral rotation on a fixed tibia
PCL:
Limits:
- Posterior displacement of tibia under a fixed
femur
- Hyperflexion
- External femoral rotation on a fixed tibia
MCL:
Limits:
- Medial and Lateral translation of tibia under
fixed femur
- Valgus stress
What is the angle of inclination and it’s ranges for classification?
Angle taken between the long axis of the femoral neck and the long axis of the femoral shaft
Coxa Vara – angle less than 110-120 degrees
Coxa Valga – angle more than 130 - 135 degrees
What is the angle of torsion and it’s ranges for classification? What type of posture is created by increased and decreased torsion?
Angle between the long axis of the femoral neck and a line touching the posterior borders of the femoral condyles
- Varies between 10-15°
Femoral anteversion – pathological increase in angle of torsion
- “Pigeon-toed”
Femoral retroversion – pathological decrease in angle of torsion
Explain the normal carrying angle of the elbow
The carrying angle is the angle between the forearm and upper arm when the arm is extended and the palm faces forward.
- Normal 5-15 degrees
What factors may have an impact on posture?
Ligament integrity, vertebrae structure, muscle strength, and flexibility. Other contributing factors include age, injury, ergonomic conditions, and daily habits affecting muscular tension and spine alignment.
What are the most common causes of workplace injuries?
- Repetitive motion = 63%
- Placing, grasping or moving objects = 20%
- Repetitive use of tools = 8%
- Typing/key entry = 9%
What are the three pillars of ergonomics?
Physical, cognitive, and organizational
What are the most common types of workplace injuries?
- Soft tissue = 28.6%
- Trauma to muscle and tendon = 20.6%
- Trauma to joints and ligaments = 14.1%
- Trauma to muscle = 6.9%
- Dislocation = 2.6%
What lifting techniques can be used with manual handling?
- Carry close to your body
- Use thigh muscles
- Pushing is better then pulling
- Use mechanical aids
- take frequent breaks
- Warm up and cool down
What is the average loss of height after 40 years of age? What are some of the causes?
- 1cm every 10 years
Pathological causes:
- Spondyloarthropathies
- Osteoporosis
Structural causes:
- Disc pathologies
- Kyphosis
What are the risk factors for decreased skeletal composition in aging adults?
- Inactive lifestyle
- Hormonal changes
- Loss of calcium and other minerals in bone
What are the different classifications of physical function according to Spirduso?
- Physically dependent (debilitated)
- Physically frail (Activities of daily living [ADL]
affected) - Physically independent (Free from disease,
however, don’t exercise regularly) - Physically fit (Physically active)
- Physically elite (Masters athletes)
What is the daily amount of moderate exercise recommended in the elderly?
30 minutes of moderate intensity
What is the rate of loss of VO2 max in active elderly adults versus inactive elderly adults?
VO2 max decreases at a rate of approximately 3% per decade, whereas in inactive elderly adults, it declines at a rate of 6% per decade.
What type of hip fracture has worse outcomes in elderly adults?
Femoral neck fracture
Reasons for decreases in exercise capacity during ageing
- 40% of muscle size lost between 20 – 80 yrs
- Strength related to mass and/or cross-
sectional area - Decreased number of fast twitch fibres
- Slow twitch fibres preserved due to their
activity during ADL such as postural control
and walking
Describe the various grades of a ligament sprain injury
Grade 1 (Mild):
- Microtear to ligament
- Mild tenderness and swelling around ankle
Grade 2 (Moderate):
- Partial tearing of ligament (some but not all
of fibers torn)
- Moderate tenderness and swelling
- Moderate instability
Grade 3 (Severe)
- Complete tear/rupture
- Significant tenderness
- Significant instability
Describe the various grades of a muscle strain injury (use the histology)
Grade 1:
- Tear with a maximum diameter less than a muscle fascicle
Grade 2:
- Tear with a diameter greater than a fascicle
Grade 3:
- Tear involving the subtotal/complete muscle diameter/tendinous injury involving the enthesis (where tendon or ligament inserts into bone)