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CALU - Kinesiology > Module 3 Quiz > Flashcards

Module 3 Quiz Flashcards

1
Q

What are the bones of the pelvis?

A

Sacrum, Coccyx, 2 Pelvic Bones

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2
Q

What are the three components of a pelvic bone that fused together?

A

Ilium
Ischium
Pubis

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3
Q

Why is the bony pelvis called the pelvic girdle?

A

It encircles the body and provides a firm, stable base of attachment for the femurs.

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4
Q

What are the 2 types of pelvic motion?

A 
Intrapelvic (SIJ or pubic symphysis)
Entire pelvis (relative to trunk or thigh)
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5
Q

What is the major ligament of the pubic symphysis?

A

Arcuate pubic ligament

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6
Q

What type of joint is the SI joint?

A

Nonaxial plane

Mixed synovial/fibrous
Mixed diarth/amphiarthrotic

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7
Q

Why does the SI joint transition from a synovial joint to a fibrous joint as we age?

A

Weight-bearing forces from above, wedging the sacrum into pelvic bones, and forces transmitted up from the LEs

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8
Q

Aside from non axial gliding, what major motion can the SI joints do?

A

Nutation/counternutation (axial movements in the sagittal plane)

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9
Q

What is nutation and counternutation?

A

Sagittal plane

Nutation - sacral base move anterior and inferior (but pelvis posterior tilts)

Counternutation - sacral base move posterior and superior (but pelvis anterior tilts)

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10
Q

Major ligaments of the SIJ (4)

A

Sacroiliac ligaments (ant, post, interosseus)
Sacrotuberous ligament
Sacrospinous ligament
Iliolumbar ligament

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11
Q

What is the dividing point between the greater and lesser sciatic notch?

A

Ischial spine

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12
Q

The sciatic nerve exits the pelvis through the…?

A

Greater sciatic foramen (created by greater sciatic notch and sacrotuberous ligament)

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13
Q

What is the weight transfer occurring at the SIJ?

A

Weight of axial body to pelvic bones of lower extremities

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14
Q

What is reverse action of the lumbosacral joint?

A

When the pelvis moves relative to the lumbar spine at the LS

Also when lower lumbar spine moves relative to upper spine

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15
Q

Plane movements of the spine

A

Anterior/posterior tilt in sagittal plane

Depress/elevate in frontal plane (one side up one side down)

Rotation in transverse plane

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16
Q

Depression of the pelvis on one side is also called…

A

lateral tilt

Ex: right side depressed = right lateral tilt

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17
Q

What is reverse action at the hips?

A

When pelvis moves on fixed thighs

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18
Q

ROM of pelvis

A

Anterior Tilt: 30
Posterior Tilt: 15
R/L Depression: 30
R/L Rotation: 15

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19
Q

Posterior tilt of the pelvis at the lumbosacral joint is analogous to _____ of the trunk at lumbosacral joint

A

flexion

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20
Q

Muscles that perform flexion of the trunk also perform ________ of the pelvis at the lumbosacral joint

A

posterior tilt

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21
Q

Examples of muscles that would perform anterior tilt of the pelvis (extension of the trunk)

A

Erector spine group
Transversospinalis group
Quadratus lumborum
Latissimus dorsi

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22
Q

Examples of muscles that would perform posterior tilt of the pelvis (flexion of the trunk)

A

Rectus abdominis
External oblique
Internal oblique

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23
Q

Elevation of the right pelvis (depression of the left pelvis) at the LS is analogous to _________ of the trunk at the LS

A

right lateral flexion

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24
Q

Right rotation of the pelvis at the LS is analogous to _______ of the trunk at the LS

A

left rotation

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25
Q

Examples of muscles that would perform right rotation of the pelvis (left rotation of the trunk)

A

Left-sided ipsilateral rotators (left erector spinae, letter internal oblique) and right contralateral rotators (right transversospinalis group, right external oblique)

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26
Q

Anterior tilt of the pelvis at the hip joint is analogous to ______ of the thigh

A

flexion

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27
Q

Muscles that perform flexion of the thigh also perform ______ of the pelvis

A

anterior tilt

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28
Q

Muscles that perform extension of the thigh also perform ______ of the pelvis

A

posterior tilt

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29
Q

Muscles that perform depression of the right pelvis also perform _______ of the right thigh

A

abduction

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30
Q

Muscles that depress the pelvis on one side of the body also _______ on the opposite side of the body

A

elevate the pelvis

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31
Q

Hiking the left hip means what is happening at the right hip?

A

Elevation

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32
Q

Muscles that perform right rotation of the pelvis also perform ______ of the right thigh and _______ of the left thigh

A

medial rotation; lateral rotation

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33
Q

Which side of the pelvis is closer to midline anteriorly when rotating to the right?

A

Left side

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34
Q

Lateral rotators of the thigh at the hip joint can also perform ______ of the pelvis

A

Contralateral rotation

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35
Q

Sacral base angle is a measure of the degree of _____ tilt of the sacrum

A

anterior

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36
Q

Any change in the sacral base angle affects _______ of the spine

A

posture

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37
Q

Relationship between the posture and movement of the pelvis and spine is referred to as

A

lumbopelvic rhythm

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38
Q

What is a normal sacral base angle

A

30 degrees

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39
Q

A sacral base angle greater than 30 degrees results in _____ spinal curvature

A

increased

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40
Q

The desire of the body to bring the head to a level posture is known as

A

righting reflex

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41
Q

Why do we want the head level?

A

Inner ear function for proprioception

Vision

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42
Q

ROM of hip joint

A 
Flex: 90
Ext: 20
Abd: 40
Add: 20
IR: 40
ER: 50
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43
Q

Ligaments of the hip joint (7)

A 
Fibrous joint capsule
Iliofemoral ligament
Ischiofemoral ligament
Pubofemoral ligament
Zona orbicularis
Transverse acetabular ligament
Ligamentum teres
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44
Q

What is the zone orbicularis?

A

Strong circular deep fibers of the hip joint capsule that surround the neck of the femur

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45
Q

The fibrous capsule of the hip joint is reinforced by which 3 capsular ligaments?

A

Iliofemoral ligament
Ischiofemoral ligament
Pubofemoral ligament

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46
Q

Location of the iliofemoral ligament?

A

Anterior-superior

Anterior inferior iliac spine –> intertrochanteric line

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47
Q

Function of the iliofemoral ligament?

A

Limits extension of the thigh at hip

Limits posterior tilt of pelvis at hip

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48
Q

What is the Y ligament?

A

The iliofemoral ligament (shaped like an upside down Y)

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49
Q

If someone stands with extension of the hip joint (extended thigh or posterior pelvic tilt), which ligament holds the body weight?

A

Y ligament (iliofemoral ligament) - super strong!

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50
Q

Location of the pubofemoral ligament?

A

Anterior-inferior

Pubis –> femur

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51
Q

Function of the pubofemoral ligament?

A

Limits abduction of thigh

Limits extreme extension of thigh

Limits ipsilateral depression of pelvis

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52
Q

Location of the ischiofemoral ligament?

A

Posterior

ischium –> femur

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53
Q

Function of the ischiofemoral ligament?

A

Limits medial rotation of thigh

Limits extension of thigh

Limits ipsilateral rotation of pelvis

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54
Q

What ligament runs from internal surface of acetabulum to head of the femur? Purpose?

A

Ligamentum teres

Conduit for blood vessels and nerves to femoral head

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55
Q

Closed-packed position of hip joint?

A

Full extension

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56
Q

Articular cartilage of the acetabulum is also called…

A

lunate cartilage (crescent-shaped)

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57
Q

What is the labrum made of?

A

fibrocartilage

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58
Q

Purpose of labrum?

A

Increase depth of socket –> increasing stability

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59
Q

At the inferior margin of the acetabulum, the two ends of the labrum are connected by the…

A

transverse acetabular ligament

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60
Q

What is the concern with abnormal femoral angles of inclination and torsion?

A

Bone alignment / muscle compensations

Decreased shock absorption

Increased degenerative changes

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61
Q

What is the femoral angle of inclination?

A

Head/neck relative to shaft in frontal plane

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62
Q

Normal femoral angle of inclination?

A

125 degrees

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63
Q

Femoral angle of inclination <125 degrees is called…

A

coxa vara

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64
Q

Femoral angle of inclination >125 degrees is called…

A

coxa valga

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65
Q

Which leads to a longer lower extremity? Coxa vara or valga?

A

Valga

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66
Q

What is the femoral torsion angle?

A

Head/neck relative to shaft in transverse plane (shaft twisted medially relative to head and neck)

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67
Q

Normal femoral torsion angle?

A

Head/neck 15 degrees away from the frontal plane (anteversion)

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68
Q

Femoral torsion angle less than 15 degrees is called…

A

retroversion (more medially rotated when foot straight)

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69
Q

Femoral torsion angle greater than 15 degrees is called…

A

excessive anteversion (more laterally rotated when foot straight)

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70
Q

Which results in toe-in posture: retroversion or excessive anteversion

A

excessive anteversion (need to compensate by medially rotating thigh to get proper alignment)

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71
Q

Why does toe-in or toe-out posture occur?

A

Compensation to optimally line up the articular surfaces of the femur and acetabulum

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72
Q

Why is flexion posterior from the knee but anterior from the elbow?

A

Upper limb buds laterally rotate (ventral surface anterior) and lower limb buds medially rotate (ventral surface posterior) during embryo development

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73
Q

Why are children prone to toe-in posture?

A

Femoral torsion angle starts at about 30-40 degrees and decreases to 15 at about age 6.

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74
Q

What is a coupled action?

A

Two different joint actions tend to be coupled together (if one occurs, the other also tends to occur)

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75
Q

What is the coupled action to when a person flexes the right thigh at the hip to kick a ball?

A

Pelvis is posteriorly tilted at left thigh to increase range of motion of the kick

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76
Q

Thigh extension of the right hip is coupled with…

A

left pelvic anterior tilt

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77
Q

Thigh abduction of the right hip is coupled with…

A

Left pelvic depression

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78
Q

Thigh adduction of the right hip is coupled with…

A

Left pelvic elevation

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79
Q

Thigh lateral rotation of the right hip is coupled with…

A

Left pelvic rotation

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80
Q

What are the articulations of the tibiofemoral joint?

A

Medial/lateral condyles of femur

Plateau of tibia

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81
Q

What are the articulations of the patellofemoral joint?

A

Posterior surface of patella

Intercondylar groove of femur

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82
Q

What is the synovial subtype of the knee joint?

A

Modified hinge joint

biaxial diarthrotic

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83
Q

How much knee flexion is required to allow rotation?

A

30 degrees

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84
Q

Medial rotation of the leg at the tibiofemoral joint is equivalent to ______ of the thigh at the tibiofemoral joint.

A

lateral rotation

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85
Q

ROM of leg at tibiofemoral joint

A

F: 140
E: -5
IR: 15
ER: 30

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86
Q

Why are ligaments of tibiofemoral joint often injured?

A

Large forces transmitted to joint, weight-bearing, lack of bony stability - requires ligaments to work very hard at stability

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87
Q

Is the proximal tibiofibular joint in the knee joint capsule?

A

No

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88
Q

What is the anterior capsule of the tibiofemoral joint reinforced by?

A

Distal quadriceps femoris tendon
Patella
Infrapatellar ligament
Retinacular fibers (expansions of quads)

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89
Q

What is the lateral capsule of the tibiofemoral joint reinforced by?

A

Lateral collateral ligament
Iliotibial band
Lateral retinacular fibers

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90
Q

What is the medial capsule of the tibiofemoral joint reinforced by?

A

Medial collateral ligament
3 pes anserine muscle tendons
Medial retinacular fibers

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91
Q

What is the posterior capsule of the tibiofemoral joint reinforced by?

A

Oblique popliteal ligament
Arcuate popliteal ligament
Fibrous expansions of popliteus, gastrocnemius, and hamstrings

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92
Q

What does the medial collateral ligament limit?

A

Abduction of the leg at the tib-fem joint in frontal plane

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93
Q

What are the attachments of the MCL?

A

Medial epicondyle of femur

Medial proximal tibia

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94
Q

What are the attachments of the LCL?

A

Lateral epicondyle of femur

Head of fibula

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95
Q

What does the LCL limit?

A

Adduction of leg at tib-fem joint in frontal plane

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96
Q

Are the cruciate ligaments of the knee intra-articular? Intra-synovial?

A

Intra-articular

Extra-synovial

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97
Q

What are the attachments of the ACL?

A

Anterior tibia

Posteriolateral femur

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98
Q

What does the ACL limit?

A

Anterior translation of leg when thigh is fixed

Posterior translation of thigh when leg is fixed

Hyperextension of tibiofemoral joint

Rotation

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99
Q

What are the attachments of the PCL?

A

Posterior tibia

Anteromedial femur

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100
Q

What does the PCL limit?

A

Posterior translation of leg when thigh is fixed (anterior translation when leg is fixed)

End range flexion of tib-fem

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101
Q

If an impact from the lateral side causes abduction of the leg (genu valgum), what ligament will be torn?

A

MCL

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102
Q

Why is the LCL less injured than the MCL?

A

Would need a force from the medial side causing adduction of leg (genu varum) and this is less common

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103
Q

What is the test of translation of the knee joint?

A

Anterior/posterior drawer test

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104
Q

What is the most commonly injured ligament of the knee? How?

A

ACL

Anterior translation force of tibia on fixed thigh (posterior translation force of tibia on fixed leg); Hyperextension; rotation forces; “cutting” - forceful extension and rotation with planted foot

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105
Q

What does the oblique popliteal ligament limit?

A

Full extension of tib-fem

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106
Q

What does the arcuate popliteal ligament limit?

A

Full extension of tib-fem

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107
Q

Where is the patellar ligament?

A

Between patella and tibial tuberosity (part of distal tendon of quad fem)

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108
Q

What is the closed-packed position of the tib-fem joint?

A

Full extension

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109
Q

What are the 3 pes anserine muscles?

A

Sartorius
Gracilis
Semitendinosus

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110
Q

How do the pes anserine muscles stabilize the knee joint?

A

Stabilize medial side

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111
Q

What are the menisci made of?

A

fibrocartilage

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112
Q

What are the open ends of the menisci called?

A

Horns

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113
Q

Where are menisci thickest/thinnest?

A

Thick: peripheral
Thin: central

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114
Q

What is the function of the menisci?

A

Increase congruency of tib-fem joint and therefore stability (make sockets for the femoral condyles)

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115
Q

How much weight-bearing force do the menisci absorb

A

Half force through tib-fem joint

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116
Q

Why is the medial meniscus more frequently injured than lateral?

A

More firmly attached and therefore has decreased mobility

Also attached to the MCL and forces that stress the MCL also transfer to the medial meniscus

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117
Q

Why is healing difficult for menisci?

A

Blood supply is limited

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118
Q

What is the screw-home mechanism of the knee?

A

During last 30 degrees of tib-fem joint extension, concomitant rotation occurs

Lateral rotation of leg if thigh is fixed, medial rotation of thigh if leg is fixed

Locks joint and increases stability; decreases work of quads when in full extension

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119
Q

How much quad contraction is needed to maintain standing when knee joints are fully extended?

A

None (due to screw-home mechanism)

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120
Q

Mechanics of the screw-home mechanism?

A

Passive pull of ACL
Pull of vastus laterals

Larger lateral condyle keeps extending when medial condyle stops; lateral pivots around fixed medial condyle (medial rotation)

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121
Q

What is the most important muscle for unlocking the knee from full extension?

A

Popliteus

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122
Q

If thigh is fixed (open chain), popliteus _____ rotates the leg to unlock the knee

A

medially

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123
Q

If leg is fixed (closed chain), popliteus _____ rotates the thigh to unlock the knee

A

laterally

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124
Q

Purpose of the patella?

A

Act as anatomic pulley - increasing leverage and force that quads exert on tibia

Reduces friction between quads tendon and femoral condyles

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125
Q

How much quad strength is lost if there is no patella?

A

20%

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126
Q

Why does the articular surface of the patella have the thickest cartilage of any joint?

A

Quad contraction force creates compression of patella against femur

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127
Q

What causes patellofemoral syndrome (chondromalacia patella)?

A

Compressive forces of the patella on the femur plus improper tracking causes cartilage to damage and break down

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128
Q

When the knee is in full extension, the patella sits where?

A

Proximal to the intercondylar groove (freely moveable)

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129
Q

When the knee is flexed, the patella sits where?

A

Within the intercondylar groove (not much mobility)

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130
Q

When is patella most stable?

A

When knee is flexed (despite full extension being the closed-pack position of the knee)

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131
Q

What is genu valgum?

A

Abduction of tibia relative to femur

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132
Q

What is genu varum?

A

Adduction of tibia relative to femur

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133
Q

What is the normal value for genu valgum angle?

A

5-10 degrees (normal since femur is not vertical)

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134
Q

What is the value of excessive genu valgum (knock-knees)?

A

Greater than 10 degrees

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135
Q

What are factors contributing to increased genu valgum?

A

Overpronation of foot (lost arch)
Lax MCL
Excessive femoral medial rotation/adduction

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136
Q

What is genu varum called?

A

Bowleg

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137
Q

Where are the tensile/compression forces of excessive genu valgum?

A

Tensile: medial
Compression: lateral

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138
Q

Where are the tensile/compression forces of excessive genu varum?

A

Tensile: lateral
Compression: medial

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139
Q

What is the Q-angle?

A

Intersection of 2 lines:

  1. From tibial tuberosity to center of patella
  2. Center of patella to ASIS

Angle (lateral) of pull of quads on patella

140
Q

What is the implication of an increased Q-angle?

A

Pulls patella laterally and causes it to ride against lateral side of intercondylar groove - patellofemoral syndrome

141
Q

What is the normal Q-angle measurement?

A

10-15 degrees

142
Q

Why do women have a greater Q-angle?

A

Pelvis is wider

143
Q

Does increased genu valgum or varum increase the Q-angle?

A

Valgum

144
Q

If a client has an increased Q-angle, what exercises are recommended?

A

Those aimed at strengthening the vastus medialis (counteract lateral pull)

145
Q

What is genu recurvatum?

A

When knee joint hyperextends beyond 10 degrees

146
Q

How does genu recurvatum occur?

A

Shape of tibial plateau slopes slightly posteriorly

Center of person’s weight falls anterior to knee joint when standing

147
Q

What type of joint is proximal tibiofibular?

A

Plane synovial

148
Q

Functionally, the proximal tib-fib joint is related to what other joint?

A

Ankle (not knee)

149
Q

What type of joint is the middle tib-fib joint?

A

Fibrous syndesmosis

150
Q

Purposes of the middle tib-fib joint?

A

Interosseous membrane holdes bones together so they can hold talus between them at ankle (talocrural joint)

Allows force of all muscle attachments that pull of fibula to be transferred to the tibia to move the leg at the knee joint

151
Q

What type of joint is the distal tib-fib?

A

Fibrous syndesmosis

152
Q

Why is stability of distal tib-fib most important for ankle function?

A

securely holds talus between the two bones

153
Q

What direction is tibial torsion? Implication of movement at ankle joint?

A

lateral

Distal tibia faces somewhat laterally - dorsiflexion/plantarflexion occur in an oblique plane

154
Q

The 2 bones of the leg articulate with the foot at what joint?

A

Talocrural

155
Q

What is the hind foot?

A

Talus and calcaneus

156
Q

What is the mid foot?

A

Navicular, cuboid, 3 cuneiforms

157
Q

What is the forefoot?

A

Metatarsals and phalanges

158
Q

What is the first ray?

A

first metatarsal and 2 phalanges of the big toe

159
Q

Functions of the foot

A

Stable to support weight-bearing
Absorb shock from landing
Propel through space

160
Q

Is the foot stable or flexible?

A

Rigid enough to absorb force (dorsi/plantarflexion) and flexible enough to navigate uneven surfaces (pro/supination)

161
Q

Where is the subtalar joint?

A

Between talus and calcaneus

162
Q

Where is the transverse tarsal joint?

A

Between talus/calcaneus and navicular/cuboid

163
Q

What are the 3 arches of the foot?

A

Medial longitudinal
Lateral longitudinal
Transverse

164
Q

What is the medial longitudinal arch?

A

Largest; length of foot on medial side

165
Q

What is the lateral longitudinal arch?

A

Runs length of foot on lateral side (not as high as medial)

166
Q

How do you evaluate the arches?

A

Observing in weight-bearing position

Anterior - height of arch
Posterior - bowing of Achilles tendon

Foot imprints

167
Q

What is pes cavus? Planus?

A

Cavus: excessive arch
Planus: decreased arch (flatfoot)

168
Q

Implications of dropped arch?

A

Difference in leg height –> pelvis depressed or tilted to one side –> spinal curve

Structural stress on plantar fascia, knee joint, hip joint

169
Q

What is the plantar fascia?

A

Dense fibrous tissue on plantar foot

170
Q

What can cause a heel spur?

A

Plantar fasciitis due to tension placed on calcaneal attachment

171
Q

Plantar fasciitis is caused most often by…

A

overly pronated foot

172
Q

Purpose of the plantar fascia?

A

Maintain and stabilize longitudinal arches

173
Q

Implication of walking in shoes?

A

Requires less work by intrinsic muscles leading to weakness of the muscles and plantar fascia –> loss of arch

174
Q

What is the windlass mechanism?

A

During toe-off, metatarsals extend at MTP joints, which pulls plantar fascia taut (connected to MTP flexors) and makes foot more rigid to push the body forward

175
Q

What is a retinaculum?

A

Acts to hold down tendons (important in wrist and ankle)

176
Q

Why is retinaculum important in the ankle?

A

When leg muscles contract to move the foot or toes, retinaculum holds the tendons down, preventing them from bowstringing away from the body (which would weaken the muscle)

177
Q

What is a mortise joint?

A

1 piece of wood with a notch and other piece carved to fit in the notch

Talocrural joint is similar to this (most congruent in body)

178
Q

What kind of joint is the talocrural?

A

Synovial hinge (uniaxial diarthrotic)

179
Q

What is the shape of the dome of the talus and how is this important?

A

Anterior aspect is wider than posterior

When foot dorsiflexes, wider aspect moves between tib-fib and pushes them apart - good for force absorption and stability

180
Q

If the foot is fixed, the leg moves at what joint?

A

talocrural

181
Q

ROM of talocrural

A

Dorsi: 20
Plantar: 50

182
Q

What is the medial collateral ligament of the ankle also called?

A

Deltoid ligament

183
Q

Attachments of the deltoid ligament (MCL)?

A

Tibia

Calcaneus, talus, navicular

184
Q

The deltoid (MCL) limits…

A

eversion of the foot at the talocrural joint

pronation of foot at subtalar joint

185
Q

Why are eversion sprains relatively uncommon?

A

Lateral malleolus extends down farther distally than medial malleolus (limits motion)

Deltoid (MCL) is very taut and strong

186
Q

What are the 3 ligaments of the lateral collateral ligament of the ankle?

A

Anterior talofibular
Posterior talofibular
Calcaneofibular

(all attach to distal fibula)

187
Q

The LCL of the ankle limits…

A

inversion of the foot at the talocrural joint

supination of foot at subtalar joint

188
Q

What is the most commonly sprained ligament in the body? Why?

A

Anterior talofibular (1/3 of LCL)

Usually occur when person is moving forward (plantar flexion + inversion) - places particular stress on ligament

189
Q

Closed packed position of the talocrural joint

A

Dorsiflexion

190
Q

What protects tendons of the ankle from friction

A

Tendon sheaths

191
Q

What supports the talus on the medial side of the foot?

A

Sustentaculum tali (of calcaneus)

192
Q

What is the sinus tarsus?

A

Large cavity on lateral side between talus and calcaneus

193
Q

Type of joint: subtalar?

A

Synovial

Uniaxial (triplanar), diarthrotic

194
Q

ROM of subtalar (non-weight-bearing)

A 
Ev: 10
Inv: 20
Dors: 2.5
Plant: 5
ER: 10
IR: 20
195
Q

Major motions of the subtalar joint?

A

Pronation and supination in an oblique plane around an oblique axis

196
Q

Pronation of foot =

A

Eversion, dorsiflexion, lateral rotation

197
Q

Supination of foot =

A

Inversion, plantarflexion, medial rotation

198
Q

What happens when the weight-bearing foot pronates and the talus medially rotates relative to the fixed calcaneus? Implication of overpronation?

A

Talocrural joint does not rotate, so leg must medially rotate with the talus

Overpronation subjects knee to medial rotation stress; knee doesn’t allow rotation in extension so this medial rotation force is then transmitted to the hip joint

199
Q

If a client has excessive pronation, the patella rotates in what direction?

A

Medially

200
Q

Solutions to overpronated foot?

A

Orthotics

Strengthen supination muscles

Strengthen lateral rotation muscles of hip

201
Q

What does the interosseous talocalcaneal ligament (in the sinus tarsus) limit?

A

Eversion (pronation) of subtalar joint

202
Q

What does the cervical ligament (in the sinus tarsus) limit?

A

Inversion (supination) of the subtalar joint

203
Q

Where is the spring ligament?

A

Spans subtalar joint on plantar side (calcaneus to navicular)

204
Q

Spring ligament limits

A

Eversion (pronation) of subtalar joint

205
Q

Closed packed position of subtalar joint?

A

Supination

206
Q

Subtalar motion is intimately tied to which joints?

A

Transverse tarsal joint and talocrural joint

207
Q

What are the 2 joints of the transverse tarsal joint?

A

Talonavicular joint

Calcaneocuboid joint

208
Q

Transverse tarsal joint is also known as

A

Chopart’s joint

209
Q

What are the motions of the transverse tarsal joint?

A

Pronation/supination (move with the subtalar joint)

210
Q

The talus shares a joint capsule with which bones?

A

Calcaneus and navicular

211
Q

Spring ligament forms the floor of which joint

A

Talonavicular

212
Q

Where is the long plantar ligament?

A

Length of foot on plantar side

213
Q

Where is the short plantar ligament?

A

Deep to long plantar ligament on plantar side between calcaneus and cuboid

214
Q

What is the bifurcate ligament?

A

Y-shaped ligament on dorsal side of foot (medial: calcaneus to navicular; lateral: calcaneus to cuboid)

215
Q

Closed packed position of the transverse tarsal joint?

A

Supination

216
Q

Type of joints: tarsometatarsals?

A

Plane synovial

217
Q

What is the central stable pillar of the foot?

A

2nd ray of foot (2nd TMT joint) - base is wedged between 1st and 3rd cuneiform joints

Reference line for abduction/adduction of toes

218
Q

Major motions of TMT joints

A

Dorsi/plantarflexion
Inversion/eversion

Conform to surfaces

219
Q

Proximal intermetatarsal joints are stabilized by

A

Joint capsules and inter metatarsal ligaments

220
Q

Distal intermetatarsal joints are stabilized by

A

Joint capsules and deep transverse metatarsal ligaments

221
Q

Why is the big toe unable to oppose?

A

Deep transverse metatarsal ligaments connect all of the distal metatarsals together, including the big toe (does not happen in hand)

222
Q

Type of joint: metatarsophalangeal?

A

Condyloid synovial

Biaxial, diarthrotic

223
Q

Major motion of the MTP joint

A

Flexion/extension (sagittal)

Abduction/adduction (transverse plane)

224
Q

ROM of toes at MTP joints

A

Toes #2-5
Ext: 60
Flex: 40

Big Toe
E: 80
F: 40

225
Q

Capsule of MTP joint stabilized by

A

collateral ligaments and plantar plate

226
Q

What is the plantar plate?

A

Thick, dense, fibrous tissue structure on plantar side of MTP joint

227
Q

Function of plantar plate

A

Protect head of MT when walking

228
Q

Closed-packed position of MTP

A

Extension

229
Q

What is hallux valgus?

A

Deformity of big toe in which big toe deviates laterally at MTP joint

Also medial deviation of 1st MT

230
Q

How does hallux valgus occur?

A

Genetic predisposition or

Overpronation and incorrect footwear that pushes big toe laterally (heels, triangle front)

231
Q

Implications of hallux valgus?

A

Exposes head of 1st MT to greater stress –> inflammation of bursa –> fibrosis and excessive bone growth on medial/dorsal MT (bunion)

232
Q

Type of joint: interphalangeal joints

A

Synovial hinge

Uniaxial, diarthrotic

233
Q

ROM of PIP joints

A

F: 90 (less laterally)
E: 0

(from neutral)

234
Q

ROM of DIP joints

A

F: 45 (less laterally)
E: small hypertext

(from neutral)

235
Q

Interphalangeal joints are stabilized by

A

Fibrous capsule
MCL
LCL
Plantar plate

236
Q

Closed packed position of IP joints of foot

A

Extension

237
Q

What is the shoulder girdle made up of?

A

Scapula, clavicle, sternum

238
Q

Function of the shoulder girdle?

A

Stable base for upper extremity to move

239
Q

What ties the shoulder girdle together in the back?

A

Rhomboids and middle trapezius attach medial borders of the scapulae (like the lacing of a corset)

240
Q

The net result of the sternoclavicular and acromioclavicular joints is to…

A

orient the scapula to the desired position

241
Q

Position of the scapula is important to facilitate _____ motion at the _____ joint

A

humeral

glenohumeral

242
Q

The coupling of shoulder girdle movement with arm movement is called

A

scapulohumeral rhythm (or scapuloclaviculohumeral rhythm)

243
Q

ROM of entire shoulder joint complex

A 
F: 180
E: 150
Abd: 180
Add: 0
ER: 90
IR: 90
244
Q

Why is abduction of the glenohumeral joint restricted when arm is in neutral or IR?

A

Greater tubercle of head of humerus will connect with acromion process

245
Q

ROM of GHJ (anatomic position)

A 
F: 100
E: 40
Abd: 120
Add: 0
ER: 50
IR: 90
246
Q

Major reverse actions of the scapula at the GHJ?

A

Upward/downward rotation (when arm is fixed)

247
Q

The capsule of the GHJ is so lax that if the muscles are completely relaxed, the head of the humerus can be moved how far from the glenoid fossa?

A

1-2 inches

248
Q

What are the 3 glenohumeral ligaments?

A

Superior GH
Middle GH
Inferior GH

249
Q

Function of GH ligaments

A

Prevent dislocation of humeral head anteriorly and inferiorly

250
Q

Where do the majority of shoulder dislocations occur?

A

Foramen of Weitbrecht - small region of anterior GH capsule between superior and middle GH ligaments

251
Q

Where is the coracohumeral ligament?

A

Between coracoid process (scapula) and greater tubercle (humerus)

252
Q

Function of coracohumeral ligament

A

Prevents dislocation of humeral head anteriorly and inferiorly

Limits extremes of flexion, extension, and lateral rotation

253
Q

Closed-packed position of GHJ

A

Lateral rotation and abduction

254
Q

Abductor muscles of GHJ

A

Deltoid

Supraspinatus

255
Q

Adductor muscles of GHJ

A

Pectoralis major
Latissimus dorsi
Teres major

256
Q

Lateral rotators of the GHJ?

A

Posterior deltoid
Infraspinatus
Teres minor

257
Q

Medial rotators of the GHJ

A

Anterior deltoid
Latissimus dorsi
Teres major
Subscapularis

258
Q

Flexors of GHJ

A

Anterior deltoid
Pectoralis major
Coracobrachialis
Biceps brachii

259
Q

Extensors of GHJ

A

Posterior deltoid
Latissimus dorsi
Teres major
Long head of triceps brachii

260
Q

Where is the subacromial bursa

A

Between acromion process and rotator cuff tendon

261
Q

Irritation and injury of the rotator cuff tendon will also cause the same in the…

A

subacromial bursa

262
Q

What is the coracoacromial arch? Function?

A

Formed by acromion process and coracoacromial ligament

Roof of GHJ; protects superior structures of GHJ

263
Q

Why is the coracoacromial ligament unique?

A

Connects the same bone (coracoid profess and acromion process)

264
Q

What are the superior structures of the GHJ that can become impinged between the head of the humerus and the coracoacromial arch during abduction/flexion?

A

Supraspinatus muscle/tendon
Subacromial bursa
Long head of biceps
Superior joint capsule

265
Q

Where does the long head of the biceps go within the GHJ capsule?

A

Bicipital groove of humerus to supraglenoid tubercle of scapula

266
Q

Why is the GHJ so mobile and less stable?

A

Shallow glenoid fossa and joint capsule laxity

267
Q

Where is the majority of the shoulder stability coming from?

A

Rotator cuff

268
Q

What ribs articulate in the scapula costal joint?

A

2-7

269
Q

What kind of joint is scapulocostal?

A

Functional joint

270
Q

Major motions of scapulocostal joint

A 
Elevation
Depression
Protraction
Retraction
Upward/downward rotation
271
Q

What joints also need to move for motion of scapula at scapulocostal joint?

A

AC and SC

272
Q

Scapular upward rotation accompanies what motion?

A

Humeral abduction

273
Q

Accessory movements of the scapula?

A

Lateral/medial tilt

Upward/downward tilt

274
Q

What is a healthy tilt of the scapula?

A

Medially and downwardly

275
Q

What is lateral tilt of the scapula called?

A

Winging of the scapula

276
Q

Push-ups are an example of what action at the scapula?

A

Reverse action of scapulocostal joint. Trunk moves relative to scapula

277
Q

Elevators of the scapula

A

Upper trapezius
Levator scapulae
Rhomboid

278
Q

Depressors of scapula

A

Lower trapezius

Pectoral is minor

279
Q

Protractors of scapula

A

Serrated anterior

Pectoralis minor

280
Q

Retractors of the scapula

A

Middle trapezius

Rhomboidal

281
Q

Upward rotators of the scapula

A

Serratus anterior

Upper/lower trapezius

282
Q

Downward rotators of scapula

A

Pectoral is minor
Rhomboids
Levator scapulae

283
Q

Type of joint: sternoclavicular

A

Synovial saddle

Biaxial, diarthrotic

284
Q

Major motions of the SCJ

A

Protraction/retraction (transverse plane)
Elevation/depression (frontal)
Upward/downward rotation (sagittal)

285
Q

ROM of clavicle at SCJ

A 
Elevation: 45 
Depression: 10
Protraction: 30
Retraction: 30
Upward rotation: 45
Downward rotation: 0
286
Q

Why does the SCJ need to be well stabilized?

A

Only osseous joint that connects the upper extremity to the axial skeleton

287
Q

Motion of the scapula at the scapulocostal joint is driven by motion of…

A

the clavicle at the SCJ

288
Q

What muscles stabilize the SCJ?

A

Sternocleidomastoid
Sternohyoid
Sternothyroid

289
Q

Which ligaments reinforce the SC joint capsule?

A

sternoclavicular ligaments (anterior and posterior)

290
Q

What is the interclavicular ligament?

A

Spans from one clavicle to the other

291
Q

What is the costoclavicular ligament?

A

Runs from first rib to clavicle

292
Q

What is the closed-packed position of the SCJ?

A

Full upward rotation of the clavicle

293
Q

Why is there an articular disc in the SCJ?

A

Improve congruence of joint surfaces and absorb shock

294
Q

Type of joint: ACJ

A

Synovial plane

Nonaxial, diarthrotic

295
Q

Motions of the ACJ?

A

Upward/downward rotation of scapula relative to the clavicle

296
Q

Accessory actions of the ACJ

A

Lateral/medial tilt of scapula

Upward/downward tilt of scapula

297
Q

Accessory tilt actions of the scapula at the acromioclavicular joint are necessary to maintain…

A

proper position of the scapula relative to the ribcage

298
Q

Upward rotation of the scapula follows what part of the bone?

A

Inferior angle (moving laterally)

299
Q

ROM of scapula at ACJ

A

Upward rotation: 30

Downward rotation: 0

300
Q

Muscle stabilization of the ACJ

A

Trapezius

Deltoid

301
Q

Ligament reinforcement of the ACJ capsule

A

Acromioclavicular ligament (superior and inferior)

302
Q

What are the 2 parts of the coracoclavicular ligament?

A

Trapezoid ligament

Conoid ligament

303
Q

Closed packed position of the ACJ

A

Full upward rotation of the scapula

304
Q

Is there a fibrocartilaginous disc in both the SCJ and ACJ?

A

Yes

305
Q

The ACJ is very susceptible to…

A

injury and degeneration

306
Q

What is typical injury to ACJ?

A

Falling on outstretched arm

307
Q

In full 180 degrees of abduction, how much is from GHJ?

A

120 degrees

308
Q

Flexion of the arm at the GHJ couples with…. of the scapula at the ScC joint

A

protraction and upward rotation

309
Q

Extension of the arm at the GHJ couples with…. of the scapula at the ScC joint

A

retraction and downward rotation

310
Q

Extension of the arm at the GHJ beyond neutral couples with ______ of the scapula at the ScC joint

A

upward tilt

311
Q

Abduction of the arm at the GHJ couples with _____ of the scapula at the ScC joint

A

upward rotation

312
Q

Adduction of the arm at the GHJ couples with _____ of the scapula at the ScC joint

A

downward rotation

313
Q

Medial rotation of the arm at the GHJ couples with _____ of the scapula at the ScC joint

A

protraction

314
Q

Lateral rotation of the arm at the GHJ couples with _____ of the scapula at the ScC joint

A

retraction

315
Q

When the arm abducts at the GHJ more than approximately 90 degrees, it also need to _____ at the GHJ

A

laterally rotate

316
Q

Which muscles keep the head of the humerus down during arm elevation movements so there is no impingement?

A

Rotator cuff isometrically contracts to keep proximal humerus fixed in place while distal end elevates

317
Q

What happens at early phase of arm abduction (first 90 degrees)

A

GHJ: 60 degrees

ScC upward rotation: 30 degrees

Clavicle elevates at SCJ (25 deg) and scapula upwardly rotates at ACJ (5 deg)

318
Q

What happens at the late phase of arm abduction (last 90 degrees)

A

GHJ: 60 degrees

ScC upward rotation: 30 degrees

Clavicle elevates at SCJ (5 deg) and scapula upwardly rotates at ACJ (25 deg)

319
Q

Implications of rounded shoulder posture on shoulder health?

A

Rounded posture = protracted scapula and medially rotated humerus

Abduction above 90 degrees will damage the rotator cuff and subacromial bursa due to greater tubercle impinging on acromion process

320
Q

What are the 3 articulations in the elbow joint capsule?

A

Humeroulnar joint
Humeroradial joint
Proximal radioulnar joint

321
Q

Type of joint: humeroulnar

A

Synovial hinge

Uniaxial, diarthrotic

322
Q

What part of the ulna connects to the distal humerus?

A

Trochlea

323
Q

Type of joint: humeroradial

A

Synovial atypical ball-and-socket

Biaxial, diarthrotic

324
Q

ROM of elbow

A

F: 145
E: 0

325
Q

3 parts of the MCL of the elbow

A

Anterior fibers
Posterior
Transverse

326
Q

Function of the MCL of the elbow

A

Stabilize medial side of joint

Prevent abduction of forearm at elbow

327
Q

2 parts of the LCL of the elbow

A

Annular fibers

Ulnar

328
Q

Function of the LCL of the elbow

A

Stabilize lateral side of joint

Prevent adduction of forearm at elbow

329
Q

Closed packed position of elbow

A

extension

330
Q

Flexors of the elbow

A

Brachialis
Biceps brachii
Brachioradialis
Pronator teres

331
Q

Extensors of the elbow

A

Triceps brachii
Anconeus
Extensor carpi ulnaris

332
Q

What is tennis elbow?

A

Lateral epicondylitis

Inflammation of the common extensor tendon

Related to hand and wrist use

333
Q

What is golfer’s elbow

A

Medial epicondylitis

Inflammation of the common flexor tendon

Related to hand and wrist use

334
Q

What is the carrying angle of the elbow?

A

Ulna deviates laterally in the frontal plane (relative to humerus)

Also called cubitus valgus

335
Q

What is normal carrying angle?

A

Men: 5-10 deg
Women: 10-15 deg

336
Q

Advantage of carrying angle?

A

objects carried in hand are naturally away from the body

337
Q

Where does pronation/supination occur in the elbow?

A

At radioulnar joints (proximal, middle, and distal)

338
Q

Type of joint: proximal radioulnar

A

Synovial pivot

Uniaxial, diarthrotic

339
Q

Type of joint: middle radioulnar

A

Fibrous syndesmosis

Uniaxial, amphiarthrotic

340
Q

Type of joint: distal radioulnar

A

Synovial pivot

Uniaxial, diarthrotic

341
Q

What are the movements of the proximal and distal radioulnar joints during pronation?

A

Proximal: head of radius medial rotates
Distal: radius swings around ulna

342
Q

What is the annular ligament of proximal radioulnar joint?

A

Wraps around head of radius - stabilizes proximal RU joint and creates a cavity within which the head of the radius can rotate

343
Q

Function of the interosseous membrane of the middle RU joint?

A

Stabilizes radius and ulna

Transfers compression forces from radius at wrist to ulna into the arm (and vice versa)

344
Q

Ligaments of the distal RU joint (2)

A

Dorsal and palmar radioulnar ligament

345
Q

What is the radioulnar disc?

A

Also known as triangular fibrocartilage

Blends into capsular/ligamentous structure of both distal RU joint and radio carpal joint and adds stability to both

346
Q

What should I know about joint capsules and proximal RUJ and distal RUJ?

A

Proximal shares capsule with elbow

Distal shares capsule with wrist

CALU - Kinesiology (8 decks)

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