Midterm Flashcards
1
Q
Define open kinematic chain
A
Distal part of extremity is moving through space (e.g. bicep curl)
2
Q
Define eccentric contraction
A
Muscle contraction in which the muscle lengthens as its joint moves through its ROM; muscle controls the descent of a weight or resistance against gravity; bones move away from each other as contraction occurs (e.g. setting down a glass of water)
3
Q
Passive insufficiency
A
when a multijoint muscle is lengthened over the joints it crosses, it is too long to allow for its full ROM and its contraction ability is compromised; e.g. when the wrist is flexed, the fingers extend; when the wrist is passively extended, fingers are pulled into flexion
4
Q
Shunt muscle
A
allows for stability; a muscle’s proximal attachment is near the joint, distal attachment further from the joint (e.g. gastrocnemius a SHUNT muscle at the knee)
5
Q
Spurt muscle
A
designed for mobility at a joint (rotary component); typically has its origin further away from joint surface, while distal attachment is very close to the
joint that its acting at (or performing its movement); example: gastrocnemius a SPURT at the ankle
6
Q
Type I muscle fiber type: red or white?
A
Red: presence of myoglobin for beta oxygenation
7
Q
Type I muscle fiber: produces high or low tension? Contraction speed slow or fast?
A
Low tension, slow contraction speed
8
Q
Type I fiber type: fatigues easily or not?
A
Type I muscle fibers are fatigue resistant
9
Q
Type I muscle fibers: fiber diameter?
A
Small fiber diameter
10
Q
Example of a muscle with a large presence of Type I “Slow Oxidative” muscle fibers?
A
Soleus
11
Q
Which muscle fiber type relies on glycogen for its metabolic needs?
A
Type IIB (“fast glycolytic”)
12
Q
Type IIB muscle fibers: red or white?
A
White (low myoglobin)
13
Q
Type IIB muscle fibers: contraction speed, fatigue rate
A
Fast contraction speed, fatigues quickly
14
Q
Type IIA fibers: what are its energy sources?
A
Relies on both oxygen and glycogen, has adequate myoglobin for some beta oxidation, but still contracts quickly. Fatigues at an intermediate rate compared to Type IIB and Type I fibers (best of both worlds)
15
Q
What type of connective tissue is injured in a sprain?
A
Ligament
16
Q
What type of tissue is injured in a strain?
A
Tendon
17
Q
Describe the rotary and translatory motion in a joint when a concave surface moves on a convex surface
A
Rotary and translatory motions occur in the same direction
18
Q
Describe the rotary and translatory motion in a joint when a convex surface moves on a concave surface
A
Rotary and translatory motion occurs in opposite directions
19
Q
Give an example of a triaxial joint
A
Glenohumeral joint: can do flexion/extension, abduction/adduction, internal/external rotation
20
Q
Give an example of a biaxial joint
A
MCPs: can do flexion/extension and abduction/adduction
21
Q
Uniaxial joint: give an example
A
elbow: hinge, only does flexion and extension
22
Q
what is a complex joint?
A
a simple or compound joint that contains a disc or a meniscus (TMJ, knee)
23
Q
what is a compound joint?
A
joint with more than 2 bones involved (e.g. elbow, wrist
24
Q
simple joint
A
only 2 bones involved; e.g. glenohumeral (also complex!), MCPs
25
Diarthrodial joint
freely moveable, synovial joint
26
Amphiarthrodial joint
Small amount of joint play, e.g. pubic symphysis, sternocostal
27
Motion along the x-axis occurs on which plane?
sagittal
28
AC joint motions
Internal (medial)/external (lateral) rotation; A/P tipping (tilting); upward/downward rotation
29
AC joint upward/downward rotation: what is the reference point on the scapula? What plane/axis?
Glenoid fossa: tilts up during upward rotation, down on downward rotation; motion limited by coracoclavicular ligaments; Occurs along z axis, frontal plane
30
AC A/P tipping: function; occurs during what motion of the scapulothoracic joint?
AC anterior/posterior tipping: of the scapula in relation to the clavicle; keeps the scapula contoured to the thorax; occurs during scapular elevation (anterior tipping) and depression (posterior tipping)
31
AC joint medial/lateral rotation: which axis? What does this motion do in the glenoid fossa and along the thorax? What occurs in relation to the clavicle?
Y-axis; transverse plane; brings glenoid fossa anteromedially, posterolaterally; maintains contact of scapula with horizontal curvature of thorax as clavicle protracts and retracts
32
Motion along the Z-axis occurs on which plane?
Frontal plane
33
Motion along the Y-axis occurs on which plane?
Transverse plane
34
Define/describe active insufficiency
Occurs when full ROM is attempted simultaneously at all joints crossed by a multijoint muscle, producing a decrease in torque available; muscle is shortened the joints it crosses (e.g. wrist flexed, fingers less able to make a strong fist)
35
Rotary motion
Direction of whole bone/segment
36
Translatory motion
Motion directly at joint surface
37
2 types of cartilage commonly found in joints
Fibrocartilage (discs, symphyses); hyaline (covering humeral head, etc)
38
Role of retinaculum
Binds down tendons
39
Cortical bone
Compact, outer layer; dense, stores and releases Ca2+
40
Cancellous bone
Spongy bone/trabecular; site of hematopoiesis, contains red bone marrow
41
Trabelculae
Calcified collagen, main component of cancellous bone
42
osteoblasts
Build up bone
43
osteoclasts
break down bone
44
epimysium
Connective tissue that covers an entire muscle, continuous with deep fascia
45
endomysium
surrounds individual muscle fibers
46
perimysium
surrounds fascicles
47
Fascicles
Bundles of muscle fibers surrounded by perimysium
48
Fusiform muscle
Long fibers running parallel to the line of pull and parallel to the long axis of the muscle; aka longitudinal muscle; e.g. sartorius, rectus abdominus
49
Pennate muscle fibers
Run obliquely to longitudinal axis of muscle
50
Fusiform vs. pennate muscles: which fiber arrangement allows for more muscle fibers? What does this mean for tension production?
Pennate muscles contain more fibers, can therefore produce greater tension
51
which muscle fiber arrangement is better for joint excursion/ROM?
Longitudinal/fusiform muscle fibers
52
Define torque
Torque= force x distance
| -tendency of a force to create rotation or motion around an axis
53
Center of mass (COM)
balance point around which the effects of gravity are concentrated
54
Class I lever, example
Seesaw; axis is between the internal force and the external force. Example: AO joint
55
Class II lever, example
Wheel barrow; axis, external load, internal force; example: MTP joint, standing up on tip toes. Least common lever type in the body
56
Class III lever, example
Bicep curl; axis, internal force, external load; very common in the body
57
External torque definition
Text= (Weight of limb X COM) + (Weight of external load X Distance of load from axis)
Text = (R X ra) + (W X Wa)
58
Internal torque definition
Tint=Rotary force X Distance of insertion from axis
Tint= Fr X fa
Tint=Text
59
Name 4 joints of the shoulder girdle
Scapulothoracic, sternoclavicular, acromioclavicular, glenohumeral
60
Motions of the scapulothoracic joint plus reference point:
abduction/adduction (protraction/retraction), elevation/depression, upward/downward rotation (glenoid fossa reference)
61
Motions of the SC joint (use clavicle as reference)
elevation/depression, protraction/retraction, A/P rotation of the clavicle
62
What type of joint is the SC joint?
Saddle shaped, plane synovial joint; complex (contains a disk), triaxial
63
SC joint: elevation/depression of clavicle. what axis/plane?
Z axis, frontal plane
64
SC/clavicular elevation and depression: normal ROM?
~45 deg. elevation; ~15 deg. depression
65
SC j. clavicular elevation/depression: clavicle and manubrium surface convex or concave?
Clavicle surface convex, moves on concave manubrium
66
SC j. protraction/retraction: plane and axis?
y axis; transverse plane
67
SC j. protraction/retraction: joint surface concave/convex?
Clavicle concave, manubrium convex (opposite of elevation/depression--SADDLE joint)
68
SC protraction/retraction ROM:
~15-20 deg. protraction; ~20-30 deg retraction
69
SC Anterior/Posterior rotation: axis/plane?
x axis, sagittal plane
70
SC A/P rotation: ROM
Posterior rotation (aka upward rotation, backward rotation): up to 50 deg; Anterior rotation: >10 deg (return to neutral from posterior rotation)
71
Ligaments supporting the SC joint:
Interclavicular, anterior sternoclavicular, costoclavicular ligs (A/P); ***also subclavian muslce provides stability
72
What ligaments stabilize the AC joint?
Superior/inferior AC ligament; Coracoclavicular ligament (includes conoid and trapezoid)
73
Raising the arm produces passive tension on which AC ligament?
Conoid
74
Upward/downward rotation of the scapula: which shoulder joint(s) involved?
SC joint (clavicular elevation/dep, upward/downward rotation), AC joint upward/downward rotation, up/down rotation of the scapulothoracic
75
Elevation/depression of scapula: which joint(s) involved?
SC joint elev/dep, AC joint A/P tipping, AC joint rotation
76
Protraction/retraction of scapula: joint(s) involved?
scapulothoracic abd/add, SC joint protraction/retraction, AC joint rotation (med/lat)
77
Glenohumeral joint: type of joint
Triaxial, ball and socket synovial, complex (simple) joint
78
Normal ROM glenohumeral flexion/extension
~180 deg flex, ~40-60 deg extension (sagittal plane x axis)
79
Motions of the GH joint
Flexion/extension, abduction/adduction, int/ext rotation, horizontal abd/add
80
Ligaments supporting the GH joint
sup, middle, inf GH ligaments, coracohumeral lig, plus supraspinatus tendon
81
GH horizontal abd/add: normal ROM
Horizontal abd ~45 deg; add ~130 deg
82
in full abduction at the shoulder, how much ROM is attributed to the GH joint, how much to other shoulder girdle (i.e. scapular) joints?
120 degree GH, 60 degrees scapular
83
in the first 90 degrees of abduction at the shoulder, how many degrees are done by the GH joint, how much is done by the SC joint, how much by AC j?
60 degrees GH joint, 25 degrees by SC joint, 5 degrees AC joint
84
from 90-180 of abduction at the shoulder, what is the distribution of ROM for GH j, SC and AC jj?
60 degrees GH, 25 degrees AC, 5 degrees SC
85
Arm abduction/elevation: accessory motions
scapular abduction, upward rotation, medial rotation (winging), posterior tipping IS THIS RIGHT???
86
What structures make up the coracoacromial arch?
Coracoid process, acromion, coracoacromial ligament, arches over humeral head; contains subacromial bursa, supraspinatus-leads to RC tendons, can be impinged, worn down
87
How to test upper traps
Shoulder shrug against resistance
88
Overall function of traps for shoulder girdle
Holds up shoulder girdle against gravity, assists in some scapular movements (upward rotation)
89
Testing the middle traps
squeeze shoulder blades together
90
Testing lower traps
Abduct arm 140 degrees, extend shoulder
91
What muscles are involved in the synergy that allows scapular upward rotation?
Upper traps (lifts acromion+clavicle), lower traps (lowers root of scapular spine), serratus anterior (protracts scapula along thorax wall)
92
testing the rhomboids
place hand behind back, retract shoulder blade (adduct)
93
rhomboids-action
adducts, downward rotation of scap
94
levator scapula-action
elevation, downward rotation
95
pec minor-action at scapula
depression, downward rotation
96
coracobrachialis-actions
flexion, adduction
97
supraspinatus-actions
primary abductor, stabilizes GH, steers hum head in fl fossa as arm raises (convex on concave)
98
which part of the deltoid does external rotation?
posterior delt
99
Infraspinatus actions
Good external rotator of arm, pulls humeral head down during arm elevation
100
In full arm abduction, which direction of humeral rotation is important for full ROM?
External rotation rotates greater tuberosity out of the way to clear the acromial shelf
101
Teres minor: actions
external rotation, some adduction/abduction
102
Rotator cuff external rotators:
infraspinatus, teres minor, plus posterior delt
103
Rotator cuff internal rotators:
subscapularis plus anterior delt plus teres major plus lats
104
Lats-actions
adduction, internal rotation, extension, scapular depression and downward rotation
105
pec major-actions
internal rotation (biciptal groove attachment), weak flexor (clavicular head), horizontal adduction, scapular depression (sternal head), protraction (both heads, but steral moreso)
106
Synergy: levator scapula, rhomboids, pec minor
Create scapular downward rotation
levator scap: pulls root of scap spine upward
rhomboids: pull medial border of scapula upward, tilting GH joint down
pec minor: pulls coracoid down, which is lateral to axis, supports downward rotation
107
Which synergy assists in the translatory motion of the humeral head in the GH joint during arm abduction?
Deltoids+rotator cuff
108
Which muscles act synergistically to prevent the shoulder from being pulled DOWN during abduction and flexion (
Delts+upper traps
109
Rhomboid + teres major synergy
for teres major to act as an extensor and adductor of the distal humeral attachment, the proximal attachment at the scapula must be stabilized because it is lighter than the distal attachment; the rhomboids (downward scap rotators) thus fix the scapula (prevent it from rotating upward) as the teres major contracts in order to move the heavier humerus
110
elbow-joint type, movements
uniaxial, hinge, flexion/extension
111
elbow ROM
flexion ~140-150 deg; neutral 0 deg; hyperextension possible
112
Trochlear ridge of ulna articulates with the ______________ of the humerus
trochlear groove
113
the coronoid process of the ulna articulates with the ___________________ at the limit of elbow flexion
coronoid fossa
114
During elbow flexion, the head of the radius fits into the ________________, which is designed to receive the head of the radius during elbow flexion. This groove is just proximal to the capitulum.
radial fossa
115
What bony structure fits into the capitulotrochlear groove?
The rim of the radial head!
116
During elbow flexion, the radius gets (closer/further) away to the humerus
It gets closer: it slides around capitulum and articulates with the radial fossa
117
During full elbow extension, what does the olecranon process articulate with on the humerus?
Olecranon fossa
118
Medial (ulnar)collateral ligament resists what type of forces?
Valgus forces (medially directed)
119
The lateral collateral ligament resists what type of forces?
Varus forces (laterally directed)
120
What are the articulating surfaces of the proximal radial ulnar joint?
Radial head-radial notch (ulna)
121
What are the articulating surfaces of the distal radioulnar joint?
Ulnar head-sigmoid ulnar notch (radius)
122
During pronation/supination of the arm, which bone moves? Which bone doesn't?
Radius moves over the ulna, crossing over it during pronation. Ulna moves very little.
123
What bony structures in the elbow joint limit extreme flexion of the elbow?
approximation of the coronoid process with coronoid fossa; rim of radial head in radial fossa
124
Brachialis: shunt or spurt? Why?
Spurt: distal attachment lies close to the elbow joint (inserts on the ulna); proximal attachment lies further away, at mid humerus
125
Biceps brachii flex and __________ the arm
Supinate: distally attach at the radial tuberosity, can supinate and flex the arm.
126
Position of active insuffiency for biceps brachii?
Shoulder flexed, elbow flexed
127
Brachioradialis: shunt or spurt at the elbow?
Shunt muscle (stabilizing elbow joint): proximal attachment is close to the elbow joint (lateral supracondylar ridge), distal attachment all the way down at the radial styloid process.
128
Triceps passive insufficiency position:
Shoulder extended, elbow flexed (same as biceps brachii active insufficiency)
129
Which ligament encircles the rim of the radial head and stabilizes the proximal radioulnar joint?
Annular ligament
130
What is the primary pronator of the arm?
Pronator quadratus
131
How can the supinator be tested?
Fully extend the arm to inhibit the biceps from assisting in supination
132
Which action is stronger: pronation or supination of the arm?
Supination! Assistance from biceps
133
What muscle synergy helps prevent shoulder flexion during elbow flexion?
Posterior deltoid is active during elbow flexion to prevent shoulder flexion
134
Role of triceps in a pushup: when do they act concentrically, when do they act eccentrically?
Upon descent during a pushup, triceps act eccentrically to control elbow flexion; during the push UP, triceps act concentrically to extend the elbow
135
Stabilizing synergy: when biceps are acting as a supinator, what other muscles prevent flexion of the elbow?
Triceps
136
Anconeus: assists in elbow extension and stabilizes during what movements?
Pronation and supination
137
Wrist joint characteristics
Complex, compound; biaxial
138
2 components of the wrist joing
radiocarpal, midcarpal
139
Does the wrist joint have greater radial deviation or ulnar deviation capabilities?
Ulnar deviation ~30-35 deg (rad. dev up to 25 deg)
140
Does the wrist have greater flexion or extension?
Flexion ~80-90 degrees (extension ~70-80 degrees)
141
Which part of the wrist joint brings wrist from full flexion to neutral?
Midcarpal
142
What part of the wrist joint brings wrist from neutral to ~45 degrees of extension?
Distal carpal + scaphoid
143
Which component of the wrist joint brings the wrist from 45 degrees of extension to full extension?
Radiocarpal
144
What structures make up the radiocarpal joint?
Radius, radial ulnar disc, scaphoid, lunate, triquetrum, NOT ULNA
145
What structures make up the midcarpal joint?
proximal row of carpals-scaphoid, lunate, triquetrum; articulate with the distal row-trapezium, trapezoid, capitate, hamate
146
In the sagittal plane, what does the scaphoid do during radial deviation?
flexion
147
In the sagittal plane, what does the scaphoid do during ulnar deviation?
extension
148
In the frontal plane, what do the proximal and distal carpal rows do during ulnar deviation?
During ulnar deviation, the proximal row of carpal bones move radially, but the distal row moves ulnarly.
149
In the frontal plane, describe the movement of the proximal and distal row of carpals during radial deviation
During radial deviation, the proximal carpals move ulnarly and the distal row moves radially
150
What are the primary wrist flexors?
Flexor carpi ulnaris, flexor carpi radialis, palmaris longus
151
T/F: Flexor digitorum superficialis crosses the elbow joint and runs to the middle phalanges of 4 digits (no thumb)
TRUE! The humeral head originates at the medial epicondyle/common flexor origin). The radial head starts at the radius.
152
T/F The tendon of the flexor carpi radialis can be felt just laterally to the radial pulse.
False! The FCR tendon attaches to the base of the 2nd metacarpal, so it is palpable just medial (ulnarly) to the radial pulse.
153
FCR flexes and _______ ________ the wrist.
radially deviates
154
What are the actions of the FCU?
Wrist flexion, ulnar deviation (distally attaches to the pisiform, hook of hamate, 5th cetacarpal)
155
How can the flexor pollicus longus be palpated?
Flex thumb DIP against resistance, tendon palpable
156
What motions can occur with FPL activity?
Wrist flexion, radial deviation
157
Which muscle makes up the "basement" of the snuff box?
Abductor pollicus longus
158
What tendon comprises the "roof" of the snuff box?
Extensor pollicus longus
159
Which muscle makes up the "floor" of the snuff box?
Extensor pollicus brevis
160
What are the primary wrist extensors?
Extensor carpi radialis longus (also radial deviator), extensor carpi radialis brevis (weak rad. dev), extensor carpi ulnaris (also ulnar deviator)
161
T/F: the extensor carpi radialis longus crosses 2 joints.
TRUE! Crosses elbow and wrist (lateral supracondylar ridge to base of 2nd metacarpal)
162
T/F: the extensor carpi ulnaris crosses 2 joints
TRUE! Lateral epicondyle of humerus->posterior border of ulna->dorsal aspect of 5th metacarpal
163
What is the role of the wrist extensors with respect to finger flexion/wrist flexion?
The wrist extensors prevent wrist flexion during finger flexion; stabilize wrist for finger dexterity
164
What stabilizing synergy prevents excessive radial deviation during thumb muscle activation?
Extensor carpi ulnaris and flexor carpi ulnaris (the primary ulnar deviators!) stabilize and prevent radial deviation
165
T/F: all of the muscles that make up the snuff box are considered to be primary radial deviators
TRUE
166
What muscles contribute to "cupping" the carpometacarpal (CMC) joint?
FCU, FCR, FDP, FDS
167
What muscles contribute to "uncupping" at the carpometacarpal joint?
ECU, ECRL, ECRB, ED
168
Define carpometacarpal joint
Distal row of carpal bones articulating with the metacarpals
169
The 1st metacarpal articulates with which carpal bone?
trapezium
170
The trapezoid articulates with which metacarpal?
2nd
171
Which carpal bone articulates with the 3rd metacarpal?
capitate
172
The hamate articulates with which metacarpal(s)?
4th and 5th
173
Which CMC joint is the most mobile?
1st metacarpal/trapezium
174
Which CMC is the second most mobile?
4th/5th metacarpals/hamate
175
What type of joints are the 2nd-5th metacarpophalangeals?
condyloid! biaxial!
176
What type of joint is the 1st MCP?
Hinge, uniaxial (flexion/extension)
177
In the thumb, at what joint does abduction and adduction occur?
Carpometacarpal joint, NOT MCP!
178
In MCP joints, is the phalanx concave or convex? Is the metacarpal concave or convex? Describe the arthrokinematics of this joint relationship
Metacarpal head CONVEX; phalanx CONCAVE; rotary and translatory motions occur in the same direction
179
In finger abd/adduction, what is the point of reference?
3rd digit
180
How do you describe the abduction/adduction of the 3rd digit?
Radial abduction/ulnar abduction
181
Why is it nearly impossible to abd/add the fingers during MCP flexion?
the joint is in its close packed position, no room for abduction
182
Does the 2nd or 4th MCP exhibit greater flexion?
The 4th: ulnar side of the MCPs have more flexion than the radial side
183
PIP/DIP joint type
Hinge, uniaxial
184
PIP ROM:
~100-130 degrees flexion (digits 2+3 have less than 3+4)
185
DIP ROM
flexion ~80-90 degrees, can hyperextend ~10 degrees
186
Thumb IP ROM
~80 degrees flexion, 10 degrees extension
187
What is the route of the lumbricals?
Cross MCP jj. palmarly, pass obliquely to lateral side of extensor hood on proximal phalanges 2-5; allows MCP flexion, IP extension
188
Which intrinsic hand muscles abduct the fingers?
Dorsal interossei
189
Which intrinsic hand muscles adduct the fingers?
Palmar interossei
190
T/F: Extensor digitorum can extend both the wrist and the fingers without the help of the intrinsic hand muscles
FALSE! Extensor digitorum can only extend primarily the proximal phalanges. The intrinsics (lumbricals and dorsal interossei) complete the extension of the DIP
191
What movements are possible at the 1st CMC joint (thumb)?
Flexion/extension, abduction/adduction, axial rotation toward/away from palm
192
Define power grip
A forceful act resulting in flexion at all finger joints; thumb may act as a stabilizer to the object and the object is generally fixed against the palm.
193
Types of power grip:
Cylindrical grip (glass of water), spherical grip (ball), hook grip (holding a suitcase handle), lateral prehension (holding an index card between fingers)
194
Define precision handling
Palm generally not used; skillful placement of an object between the fingers or between the thumb and finger.
195
Types of precision handling
pad-to-pad (using tweezers), tip-to-tip (some styles of writing), pad-to-side (using a key)
196
MCP 2-5 heads are concave/convex?
Convex
197
Cylindrical grasp: what muscles are probably most active?
FDS, FDP (finger flexion); thumb abductors plus adductor pollicis to stabilize thumb
198
What muscles would be most active in a spherical grasp?
FDS, FDP; extrinsic thumb flexors (FPL, APL), interossei (both the abductors and adductors)
199
Hook grasp: what muscles most active?
no thumb, mostly FDS, FDP
200
What is a "jaw chuck" grasp?
A style of pad-to-pad precision grasp; ex)Holding a pencil: using thumb, pressing object against 1 or 2 other digits.
201
Muscles active in jaw chuck grasp?
Intrinsic thenar and hypothenars: OPB, FPB, AbdPB, lumbricals, interossei
