Lecture #1: Anatomical Direction & Movement of Bones

Question 1

Describe neutral anatomic position.

Answer 1

This refers to when the body is standing in a neutral position: straight standing, feet together, palms forward.

Question 2

Define articulate (articulation)

Answer 2

Where two surfaces or structures come into contact with each other (i.e where two bones come together to form a joint)

Question 3

Define palpate

Answer 3

This means to examine by touch. This helps introduce your touch to the client as well as observe things you cannot from the other senses (i.e feel temperature and texture)

Question 4

Define flexion

Answer 4

The bending of a joint, decreases the angle of the bones in a joint (i.e to flex your bicep you will bend the elbow and bring your hand or fist closer to your shoulder)

Question 5

Define extension

Answer 5

Straightening out the joint, bringing it out of flexion back into neautral position, increasing the angle of the joint ( i.e straightening your elbow)

Question 6

Define abduction

Answer 6

Movement of a body part away from the midline (i.e if I move my arm away from my body I am abducting it away from the midline of my body)

Question 7

Define adduction

Answer 7

This is a movement of the body towards the midline.

Question 8

Define opposition

Answer 8

This is in reference to the thumb. It is the movement or action of touching your thumb to your pinky finger. This is the only part of the body where we are cabable of performing oppositiion.

Question 9

Define reposition

Answer 9

Returning the body to neutral position.

Question 10

Define supinate

Answer 10

Rotation of the forearm away from the midline resulting in palms facing upward.

Question 11

Define pronate

Answer 11

Rotating the forearm towards the midline resulting in palms down.

Question 12

Define circumduction

Answer 12

The act of moving a structure through its entire axis. Not a “pure” movement. (I.e when swimming or throwing a ball you move your arm around an axis to omplete the movement, your arm does not go all the way around, complete a “windmill” motion or circulatory motion).

Question 13

Define plantar

Answer 13

Sole of the foot, bottom of the foot. The parts of the foot that touh the floor when walking.

Question 14

Define dorsal

Answer 14

Refers to the top of the foot (or hand). It is where your shoe laces sit.

Question 15

Define inversion

Answer 15

Describes how you rotate your ankles with the big toes pointing toward the midline (pigeon toe) (how you slow down or stop when skiing)

Question 16

Describe eversion

Answer 16

Standing with your ankles rotated outward, big toes pointing away from the midline (duck feet)

Question 17

Define superficial

Answer 17

This refers to something that is nearer to the surface. (I.e your skin is superficial to your muscle and bone, your muscle is superficial to your bone)

Question 18

Define intermediate

Answer 18

This means in between (i.e your muscles are intermediate to your skin and bone)

Question 19

Define deep

Answer 19

This refers to structures further away from the surface. (I.e your bone is the deepest part, and your muscle is deep in relation to your skin)

Question 20

Define medial

Answer 20

Refers to something or moving something nearer to the midline/ median plane

Question 21

Define proximal

Answer 21

Refers to something that is nearer to the trunk of the body or point if origin. (Your trunk is your ribcage, core, hips and pelvis) (i.e your shoulders are proximal to your trunk)

Question 22

Define distal

Answer 22

This means further away from your trunk or point if origin. (I.e your fingertips are distal to your trunk, your toes are the most distal to your trunk)

Question 23

Define lateral

Answer 23

Movement or placement farther away from the midline.

Question 24

Define posterior

Answer 24

Refers to the back or nearer to the back

Question 25

Define anterior

Answer 25

Refers to the front or nearer to the front

Question 26

Define inferior

Answer 26

Refers to something situated below (direction: towards toes)

Question 27

Define superior

Answer 27

Refers to something situated above (direction: towards the head)

Question 28

Define prone

Answer 28

Laying face down on the table or surface

Question 29

Define supine

Answer 29

Laying face up on the table or surface

Question 30

Define elevation

Answer 30

Raising a structure (i.e raise my shoulders or eyebrows)

Question 31

Define depression

Answer 31

To lower a structure (i.e lowering my shoulders or eyebrows)

Question 32

Describe hypertension (hyperextension)

Answer 32

Movement beyond its normal range (i.e double jointed people)

Question 33

Describe ulnar deviation

Answer 33

The movement of the hand and wrist medially

Question 34

Describe radial deviation

Answer 34

Movement of the hand or wrist laterally

Question 35

What is the palmar surface?

Answer 35

This is the palm of the hand

Question 36

What is the dorsal surface?

Answer 36

This is the top/ back/ posterior side of the hand ( you also have dorsal surface on foot)

Question 37

Describe the “support” we get from our skeletal system

Answer 37

Bones form our internal frame that supports and anchors the rest of our body including soft tissues and organs (i.e the skull holds brain in place, skeleton holds our body together so we do not fall apart).

Question 38

Describe how our skeletal system provides “protection” for our body.

Answer 38

Bones not only hold us together but they protect those organs and soft tissues from any injury or damage they may incur (i.e skull protects the brain, vertebrae protects spinal cord, ribcage protects organs and thorax)

Question 39

Describe how our skeletal system provides “movement” (allows us to move)

Answer 39

Skeletal muscles which are attatched to the bones by tendons, use the bones as levers to move the body anad its different parts (mechanics of the body)

Question 40

Describe the “storage” function of the skeletal system

Answer 40

Fat is stored in the internal cavities of our bones. Bone serves as a “storehouse” for the minerals (most importantly calcium and phosphorus).

Question 41

Describe how the skeletal system aids in blood cell formation

Answer 41

Blood cell formation (hematopoiesis) occurs within the marrow cavities of certian bones (in the long bones of the body i.e femur bone)

Question 42

What is a joint and what is its function?

Answer 42

The connection between two or more bones of the skeleton, providing the body with certain movements (i.e make bending the elbow possible)

Question 43

What are the two types of bone tissue?

Answer 43

1. compact bone- dense, smooth and homogeneous
2. Spongy bone- composed of small pin like holes/ spaces and pieces of bone with a lot of open space. Looks like the holes in a sponge.

Question 44

Describe the 4 types of bone shapes

Answer 44

1. Long- longer than they are wide ( all bones of the limbs except wrist and ankles)
2. Short- generally cub shaped/ spongy bone (wrist and ankle)
3. Flat- thin, flattened and unusually curved (most bones of the skull, ribs and sternum)
4. Irregular- dont fit into other three categories, different shaped bones ( vertebrae, patella, hip, pelvis)

Question 45

Describe the 2 types of bone joints

Answer 45

1. Moveable- All joints you can move: elbows, knees, hips, wrists, ankles (hinge joints)
2. Immovable- These are considered joints but allow little to no movement: pelvis or skull

Question 46

What are bones of the axial skeleton?

Answer 46

These are bones of the skull (pg 3-8 in the Bowden textbook). The human skull contains 22 bones divided into 2 groups: the cranium (top of skull/ head) and the facial bones (bones that make up the face).

Question 47

What is the FRONTAL BONE (axial skeleton)

Answer 47

Forms the forehead

Question 48

What is the TEMPORAL BONES ( axial skeleton)

Answer 48

• mastoid process

- covers from behind, around and above the ear

Question 49

What are the PARIETAL BONES (axial skeleton)

Answer 49

These form the sides and crown of the cranium (the main portion of the skull)

Question 50

What is the OCCIPITAL BONE (axial skeleton)

Answer 50

This is the hindmost bone in the skull (forms the back of the skull above the nape)

Question 51

What is the MAXILLA BONE (axial skeleton)

Answer 51

This bone forms the upoer jaw (above the front teeth)

Question 52

What is the ZYGOMATIC BONE (axial skeleton)

Answer 52

This bone forms the cheekbone of the face

Question 53

What is the MANDIBLE BONE (axial skeleton)

Answer 53

This bone forms your lower jawline (chin). It is the largest and strongest of the facial bones. It also consists of the temporamandibular joint which connects your jaw to your face and allows jaw movement.

Question 54

What is the main bone of the neck?

Answer 54

This is called the hyoid bone. It is a “U” shaped bone at the base of the tongue that supports tongue muscles.

Question 55

Describe the sternum and the parts of the sternum (bones of the trunk- pg 9 Bowdem textbook)

Answer 55

The sternum is the bone that is located in the middle /underneath the ribcage. It is what your ribs attatch to.

The three parts of the sternum include:

1. Manubrium- shaped like a mans tie at the top of the sternum
2. Body if the sternum (majority if the bone in between top and bottom)
3. Xiphoid process- is the bottom of the sternum and looks like a tail.

Question 56

Describe the different Ribs that make up our ribcage (bones of the trunk, pg 9 & 10 of Bowdem textbook)

Answer 56

Our ribcage (the thorasic cage) is made up of 12 different ribs.

Ribs 1-7 (referred to as true ribs) are directly attacthed to the sternum
Ribs 8-10 (refrered to as false ribs) are attached to one peice of cartilage that attaches them to the sternum
Ribs 11-12 (referred to as false ribs) are floating ribs that do not attatch to the sternum or cartilage

Question 57

Describe the vertebrael column and the different sections of the vertebrael column (bones if the trunk, pg 11 in Bowden textbook)

Answer 57

The vertebrael column extends from thr skull to the pelvis. It consists of 24 bones and 33 vertebrae.

The different sections of the vertebrael column include:

1. Cervical spine (neck)- contains 7 vertebrae
2. Thoracic Spine (where ribs are attatched)- contains 12 vertebrae
3. Lumbar spine (largest in the vertebral column, where movement ocurrs)- contains 5 vertebrae
4. Sacrum- originally had 5 different vertebrae but over time and evolution have become fused to make 1 large vertebrae
5. Coccyx- originally had 4 vertebrae but over time and evolution have become fused as well

** The sacrum and coccyx make up the tail bone

Question 58

Describe the Os Coxa (bones of the trunk, pg 19&20 in Bowdem textbook)

Answer 58

The os coxa is the pelvis. It is made up of the iliac crest, posterior/superior iliac spine, and the pubic symphysis.

• the spinal cord begins in the brain, travels through the vertebrae column, through the “trunk” (including os coxa) right down to the tail bone where they come out as nerves and innervate the lower body.

Question 59

What is the appendicular skeleton.

Answer 59

It is one of two major bone groups of the body (the other being the axial skeleton). It consists of the upper and lower extremities. Know the major landmarks of bones of the arm, shoulders, hand, leg and foot (covered in next section).

Question 60

Describe the 3 major bones of the upper extremities/ bones of the arm
(appendicular skeleton, pg 16-18 Bowdem textbook)

Answer 60

1. Humerus- single bone in the top of the arm.
   —>It is made up of the greater and lesser tubercle (close to the shoulders, has grooves to allow nerves to pass through)
   —>and the medial and lateral epicondyles (just above the elbow)
2. Radius & Ulna- The radius is larger and is located on the thumb side of the arm. The ulna is smaller and is located on the pinky side of the arm. They are also composed of/ with:
   —>Olecranon process (top of radius& ulna) makes up your elbow
   —>Styloid process (bottom of radius& ulna) two bones that stick out of your wrist that you can see and feel
3. Hand- bones to know in the hand are:
   —>Carpals (8 cubed bones that make up the wrist)
   —>Metacarpals (the 5 bones that run from your wrist to fingers, form the base of your knuckes)
   —>Phalanges (the bones of the fingers- 3 in each finger, 2 in each thumb- 14 total)

Question 61

Describe the major bones lower extremities (appendicular skeleton, pg 21-23, pg 27 of Bowdem textbook)

Answer 61

1. Femur: This is the thigh bone (heaviest and strongest bone in the body) It runs from the hip to the knee and consists of:
   —> Greater trochanter (upper femur)
   —> Lateral and medial epicondyle (lower femur)
2. Tibia & Fibula: 2 bones that make uo the lower leg below the knee and down to the ankle. They consist of:
   —> Tibia: the larger bone on the toe side
   —> Fibula: smaller bone on the pinky side (also referred to as shin bone)
   —> Head of fibula
   —> Lateral and medial meleolus
3. Foot & ankle- made up of:
   —> 7 tarsal bones that make up the ankle
   —> 5 metatarsals from ankle to toes
   —> 14 phalanges (proximal, medial, distal)
   ** one tarsal name you have to know is the Calcaneus- largest of the tarsal group that makes up the heel.
4. Patella: This is the bone that makes up the knee cap. It floats on the most distal aspect of the femur (front of knee) and is slightly egg shaped. It is a moveable bone.

Question 62

Describe osteoporosis/ symptoms and precautions the massage therapist should take (pathologies of bones)

Answer 62

Osteoporosis is the continuous loss of bone mass over time. There are often no symptoms until a fracture occurs. Affects women twice as much as men. It can also affect younger people who are extremely inactive due to accident or disease or on certain medications.

Symptoms- back pain, loss of height, fractures, dowagers hump.

Precautions- do not be heavy handed and avoid deep pressure. Check in with the client and ask how the pressure is more often.

Question 63

Describe what fractures are and what precautions a massage therapist should take (pathologies of bones, pg 29-30 in Bowden textbook)

Answer 63

Fractures are a break in the continuity of the bone due to trauma or injury.

Precautions- we do not massage a broken or fractured limb. Maintain the comfort of the client on the table by placing pillows under the broken area for even more support. When cast is removed massage very lightly with extra oil to maintain the integrity or the skin and healing bone.

Question 64

Describe 3 different postural conditions mentioned in the lecture and precautions you might use for each (pathologies of bones, pg 29-31 in Bowden textbook)

Answer 64

1. Scoliosis- the spine has an abnormal lateral curvature in either a “c” or “s” shape. Curves range from slight to extreme as well as pain level.
   —> structural scoliosis means the patient was born with it
   —> functional scoliosis means it was developed

Precautions- extra attention should be paid to “pillowing” with the clients feedback. If not comfortable, side lying should be used.

2. Hyperkyphosis: exaggerated kyphotic curvature of the spine (spine curves forward instead if side to side as in scoliosis) which is not caused by osteoporosis.

Precautions- client may complain about upper back pain and should be pillowed for comfort. A rolled towel may be placed under neck to support the spine in supine position and to support the anterior shoulders in prone position.

3. Hyperlordosis- exaggerated lumbar lordotic curve (forward curve of lower spine, hips come forward). Client may complain of lower back pain,

Precautions- should be pillowed with 1-2 pillows under abdomen in prone position and 2 pillows under knees in supine position.

** always encourage client feedback during massage for each of these conditions.

Question 65

Describe what a sprain is and necessary precautions the therapist should follow (pathologies of bones)

Answer 65

A sprain is where a ligament has been overstretched. Ligaments are the connective tissue structures that connect bone to bone.
—> Mild sprain: only a few tissure pulled or torn
—> Moderate sprain: many tissues are pulled and torn
—> Severe sprain: ligament has detatched from the bone.

** when the sprain is acute (recent) the area will be red, swollen, warm to touch, and very painful. When sprain is chronic it means it is in the process of healing but has not completely healed.

Precautions- client should be carefully supported with pillows under injury. They should be moved with care or move themselves with special attention to pain. Can be massaged very lightly if sprain is in chronic condition but always check in with client in regards to pressure first.

Question 66

Describe what dislocations are and the necessary precautions the therapist should be taking. (Pathologies of bones)

Answer 66

Dislocations are the complete disassociation at the articulating surfaces of the joint. Most commonly dislocated joints are the shoulder (gleno-humeral joint), fingers and toes. Joint must be “reduced” by a doctor to put joint back in place.

Considerations:
—> after reduction joint will be sore for a long time, tendons & ligaments will be overstratched for a while and are painful.
—> dislocation of a joint also results in a sprain of ligaments in that area
—> joint will remain unstable and prone to re-injury for months after dislocation

Precautions: Clients should be carefully positioned and pillowed to support the injured area. No passive movements should be performed in this area. Allow the clients to move the affected limb themselves as only they know how much pressure can be used and how far they can move it.