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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
Examples of muscles that would perform right rotation of the pelvis (left rotation of the trunk)
Left-sided ipsilateral rotators (left erector spinae, letter internal oblique) and right contralateral rotators (right transversospinalis group, right external oblique)
26
Anterior tilt of the pelvis at the hip joint is analogous to ______ of the thigh
flexion
27
Muscles that perform flexion of the thigh also perform ______ of the pelvis
anterior tilt
28
Muscles that perform extension of the thigh also perform ______ of the pelvis
posterior tilt
29
Muscles that perform depression of the right pelvis also perform _______ of the right thigh
abduction
30
Muscles that depress the pelvis on one side of the body also _______ on the opposite side of the body
elevate the pelvis
31
Hiking the left hip means what is happening at the right hip?
Elevation
32
Muscles that perform right rotation of the pelvis also perform ______ of the right thigh and _______ of the left thigh
medial rotation; lateral rotation
33
Which side of the pelvis is closer to midline anteriorly when rotating to the right?
Left side
34
Lateral rotators of the thigh at the hip joint can also perform ______ of the pelvis
Contralateral rotation
35
Sacral base angle is a measure of the degree of _____ tilt of the sacrum
anterior
36
Any change in the sacral base angle affects _______ of the spine
posture
37
Relationship between the posture and movement of the pelvis and spine is referred to as
lumbopelvic rhythm
38
What is a normal sacral base angle
30 degrees
39
A sacral base angle greater than 30 degrees results in _____ spinal curvature
increased
40
The desire of the body to bring the head to a level posture is known as
righting reflex
41
Why do we want the head level?
Inner ear function for proprioception | Vision
42
ROM of hip joint
``` Flex: 90 Ext: 20 Abd: 40 Add: 20 IR: 40 ER: 50 ```
43
Ligaments of the hip joint (7)
``` Fibrous joint capsule Iliofemoral ligament Ischiofemoral ligament Pubofemoral ligament Zona orbicularis Transverse acetabular ligament Ligamentum teres ```
44
What is the zone orbicularis?
Strong circular deep fibers of the hip joint capsule that surround the neck of the femur
45
The fibrous capsule of the hip joint is reinforced by which 3 capsular ligaments?
Iliofemoral ligament Ischiofemoral ligament Pubofemoral ligament
46
Location of the iliofemoral ligament?
Anterior-superior Anterior inferior iliac spine --> intertrochanteric line
47
Function of the iliofemoral ligament?
Limits extension of the thigh at hip Limits posterior tilt of pelvis at hip
48
What is the Y ligament?
The iliofemoral ligament (shaped like an upside down Y)
49
If someone stands with extension of the hip joint (extended thigh or posterior pelvic tilt), which ligament holds the body weight?
Y ligament (iliofemoral ligament) - super strong!
50
Location of the pubofemoral ligament?
Anterior-inferior Pubis --> femur
51
Function of the pubofemoral ligament?
Limits abduction of thigh Limits extreme extension of thigh Limits ipsilateral depression of pelvis
52
Location of the ischiofemoral ligament?
Posterior ischium --> femur
53
Function of the ischiofemoral ligament?
Limits medial rotation of thigh Limits extension of thigh Limits ipsilateral rotation of pelvis
54
What ligament runs from internal surface of acetabulum to head of the femur? Purpose?
Ligamentum teres Conduit for blood vessels and nerves to femoral head
55
Closed-packed position of hip joint?
Full extension
56
Articular cartilage of the acetabulum is also called...
lunate cartilage (crescent-shaped)
57
What is the labrum made of?
fibrocartilage
58
Purpose of labrum?
Increase depth of socket --> increasing stability
59
At the inferior margin of the acetabulum, the two ends of the labrum are connected by the...
transverse acetabular ligament
60
What is the concern with abnormal femoral angles of inclination and torsion?
Bone alignment / muscle compensations Decreased shock absorption Increased degenerative changes
61
What is the femoral angle of inclination?
Head/neck relative to shaft in frontal plane
62
Normal femoral angle of inclination?
125 degrees
63
Femoral angle of inclination <125 degrees is called...
coxa vara
64
Femoral angle of inclination >125 degrees is called...
coxa valga
65
Which leads to a longer lower extremity? Coxa vara or valga?
Valga
66
What is the femoral torsion angle?
Head/neck relative to shaft in transverse plane (shaft twisted medially relative to head and neck)
67
Normal femoral torsion angle?
Head/neck 15 degrees away from the frontal plane (anteversion)
68
Femoral torsion angle less than 15 degrees is called...
retroversion (more medially rotated when foot straight)
69
Femoral torsion angle greater than 15 degrees is called...
excessive anteversion (more laterally rotated when foot straight)
70
Which results in toe-in posture: retroversion or excessive anteversion
excessive anteversion (need to compensate by medially rotating thigh to get proper alignment)
71
Why does toe-in or toe-out posture occur?
Compensation to optimally line up the articular surfaces of the femur and acetabulum
72
Why is flexion posterior from the knee but anterior from the elbow?
Upper limb buds laterally rotate (ventral surface anterior) and lower limb buds medially rotate (ventral surface posterior) during embryo development
73
Why are children prone to toe-in posture?
Femoral torsion angle starts at about 30-40 degrees and decreases to 15 at about age 6.
74
What is a coupled action?
Two different joint actions tend to be coupled together (if one occurs, the other also tends to occur)
75
What is the coupled action to when a person flexes the right thigh at the hip to kick a ball?
Pelvis is posteriorly tilted at left thigh to increase range of motion of the kick
76
Thigh extension of the right hip is coupled with...
left pelvic anterior tilt
77
Thigh abduction of the right hip is coupled with...
Left pelvic depression
78
Thigh adduction of the right hip is coupled with...
Left pelvic elevation
79
Thigh lateral rotation of the right hip is coupled with...
Left pelvic rotation
80
What are the articulations of the tibiofemoral joint?
Medial/lateral condyles of femur | Plateau of tibia
81
What are the articulations of the patellofemoral joint?
Posterior surface of patella | Intercondylar groove of femur
82
What is the synovial subtype of the knee joint?
Modified hinge joint | biaxial diarthrotic
83
How much knee flexion is required to allow rotation?
30 degrees
84
Medial rotation of the leg at the tibiofemoral joint is equivalent to ______ of the thigh at the tibiofemoral joint.
lateral rotation
85
ROM of leg at tibiofemoral joint
F: 140 E: -5 IR: 15 ER: 30
86
Why are ligaments of tibiofemoral joint often injured?
Large forces transmitted to joint, weight-bearing, lack of bony stability - requires ligaments to work very hard at stability
87
Is the proximal tibiofibular joint in the knee joint capsule?
No
88
What is the anterior capsule of the tibiofemoral joint reinforced by?
Distal quadriceps femoris tendon Patella Infrapatellar ligament Retinacular fibers (expansions of quads)
89
What is the lateral capsule of the tibiofemoral joint reinforced by?
Lateral collateral ligament Iliotibial band Lateral retinacular fibers
90
What is the medial capsule of the tibiofemoral joint reinforced by?
Medial collateral ligament 3 pes anserine muscle tendons Medial retinacular fibers
91
What is the posterior capsule of the tibiofemoral joint reinforced by?
Oblique popliteal ligament Arcuate popliteal ligament Fibrous expansions of popliteus, gastrocnemius, and hamstrings
92
What does the medial collateral ligament limit?
Abduction of the leg at the tib-fem joint in frontal plane
93
What are the attachments of the MCL?
Medial epicondyle of femur | Medial proximal tibia
94
What are the attachments of the LCL?
Lateral epicondyle of femur | Head of fibula
95
What does the LCL limit?
Adduction of leg at tib-fem joint in frontal plane
96
Are the cruciate ligaments of the knee intra-articular? Intra-synovial?
Intra-articular | Extra-synovial
97
What are the attachments of the ACL?
Anterior tibia | Posteriolateral femur
98
What does the ACL limit?
Anterior translation of leg when thigh is fixed Posterior translation of thigh when leg is fixed Hyperextension of tibiofemoral joint Rotation
99
What are the attachments of the PCL?
Posterior tibia | Anteromedial femur
100
What does the PCL limit?
Posterior translation of leg when thigh is fixed (anterior translation when leg is fixed) End range flexion of tib-fem
101
If an impact from the lateral side causes abduction of the leg (genu valgum), what ligament will be torn?
MCL
102
Why is the LCL less injured than the MCL?
Would need a force from the medial side causing adduction of leg (genu varum) and this is less common
103
What is the test of translation of the knee joint?
Anterior/posterior drawer test
104
What is the most commonly injured ligament of the knee? How?
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
105
What does the oblique popliteal ligament limit?
Full extension of tib-fem
106
What does the arcuate popliteal ligament limit?
Full extension of tib-fem
107
Where is the patellar ligament?
Between patella and tibial tuberosity (part of distal tendon of quad fem)
108
What is the closed-packed position of the tib-fem joint?
Full extension
109
What are the 3 pes anserine muscles?
Sartorius Gracilis Semitendinosus
110
How do the pes anserine muscles stabilize the knee joint?
Stabilize medial side
111
What are the menisci made of?
fibrocartilage
112
What are the open ends of the menisci called?
Horns
113
Where are menisci thickest/thinnest?
Thick: peripheral Thin: central
114
What is the function of the menisci?
Increase congruency of tib-fem joint and therefore stability (make sockets for the femoral condyles)
115
How much weight-bearing force do the menisci absorb
Half force through tib-fem joint
116
Why is the medial meniscus more frequently injured than lateral?
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
117
Why is healing difficult for menisci?
Blood supply is limited
118
What is the screw-home mechanism of the knee?
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
119
How much quad contraction is needed to maintain standing when knee joints are fully extended?
None (due to screw-home mechanism)
120
Mechanics of the screw-home mechanism?
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)
121
What is the most important muscle for unlocking the knee from full extension?
Popliteus
122
If thigh is fixed (open chain), popliteus _____ rotates the leg to unlock the knee
medially
123
If leg is fixed (closed chain), popliteus _____ rotates the thigh to unlock the knee
laterally
124
Purpose of the patella?
Act as anatomic pulley - increasing leverage and force that quads exert on tibia Reduces friction between quads tendon and femoral condyles
125
How much quad strength is lost if there is no patella?
20%
126
Why does the articular surface of the patella have the thickest cartilage of any joint?
Quad contraction force creates compression of patella against femur
127
What causes patellofemoral syndrome (chondromalacia patella)?
Compressive forces of the patella on the femur plus improper tracking causes cartilage to damage and break down
128
When the knee is in full extension, the patella sits where?
Proximal to the intercondylar groove (freely moveable)
129
When the knee is flexed, the patella sits where?
Within the intercondylar groove (not much mobility)
130
When is patella most stable?
When knee is flexed (despite full extension being the closed-pack position of the knee)
131
What is genu valgum?
Abduction of tibia relative to femur
132
What is genu varum?
Adduction of tibia relative to femur
133
What is the normal value for genu valgum angle?
5-10 degrees (normal since femur is not vertical)
134
What is the value of excessive genu valgum (knock-knees)?
Greater than 10 degrees
135
What are factors contributing to increased genu valgum?
Overpronation of foot (lost arch) Lax MCL Excessive femoral medial rotation/adduction
136
What is genu varum called?
Bowleg
137
Where are the tensile/compression forces of excessive genu valgum?
Tensile: medial Compression: lateral
138
Where are the tensile/compression forces of excessive genu varum?
Tensile: lateral Compression: medial
139
What is the Q-angle?
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
What is the implication of an increased Q-angle?
Pulls patella laterally and causes it to ride against lateral side of intercondylar groove - patellofemoral syndrome
141
What is the normal Q-angle measurement?
10-15 degrees
142
Why do women have a greater Q-angle?
Pelvis is wider
143
Does increased genu valgum or varum increase the Q-angle?
Valgum
144
If a client has an increased Q-angle, what exercises are recommended?
Those aimed at strengthening the vastus medialis (counteract lateral pull)
145
What is genu recurvatum?
When knee joint hyperextends beyond 10 degrees
146
How does genu recurvatum occur?
Shape of tibial plateau slopes slightly posteriorly Center of person's weight falls anterior to knee joint when standing
147
What type of joint is proximal tibiofibular?
Plane synovial
148
Functionally, the proximal tib-fib joint is related to what other joint?
Ankle (not knee)
149
What type of joint is the middle tib-fib joint?
Fibrous syndesmosis
150
Purposes of the middle tib-fib joint?
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
What type of joint is the distal tib-fib?
Fibrous syndesmosis
152
Why is stability of distal tib-fib most important for ankle function?
securely holds talus between the two bones
153
What direction is tibial torsion? Implication of movement at ankle joint?
lateral Distal tibia faces somewhat laterally - dorsiflexion/plantarflexion occur in an oblique plane
154
The 2 bones of the leg articulate with the foot at what joint?
Talocrural
155
What is the hind foot?
Talus and calcaneus
156
What is the mid foot?
Navicular, cuboid, 3 cuneiforms
157
What is the forefoot?
Metatarsals and phalanges
158
What is the first ray?
first metatarsal and 2 phalanges of the big toe
159
Functions of the foot
Stable to support weight-bearing Absorb shock from landing Propel through space
160
Is the foot stable or flexible?
Rigid enough to absorb force (dorsi/plantarflexion) and flexible enough to navigate uneven surfaces (pro/supination)
161
Where is the subtalar joint?
Between talus and calcaneus
162
Where is the transverse tarsal joint?
Between talus/calcaneus and navicular/cuboid
163
What are the 3 arches of the foot?
Medial longitudinal Lateral longitudinal Transverse
164
What is the medial longitudinal arch?
Largest; length of foot on medial side
165
What is the lateral longitudinal arch?
Runs length of foot on lateral side (not as high as medial)
166
How do you evaluate the arches?
Observing in weight-bearing position Anterior - height of arch Posterior - bowing of Achilles tendon Foot imprints
167
What is pes cavus? Planus?
Cavus: excessive arch Planus: decreased arch (flatfoot)
168
Implications of dropped arch?
Difference in leg height --> pelvis depressed or tilted to one side --> spinal curve Structural stress on plantar fascia, knee joint, hip joint
169
What is the plantar fascia?
Dense fibrous tissue on plantar foot
170
What can cause a heel spur?
Plantar fasciitis due to tension placed on calcaneal attachment
171
Plantar fasciitis is caused most often by...
overly pronated foot
172
Purpose of the plantar fascia?
Maintain and stabilize longitudinal arches
173
Implication of walking in shoes?
Requires less work by intrinsic muscles leading to weakness of the muscles and plantar fascia --> loss of arch
174
What is the windlass mechanism?
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
What is a retinaculum?
Acts to hold down tendons (important in wrist and ankle)
176
Why is retinaculum important in the ankle?
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
What is a mortise joint?
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
What kind of joint is the talocrural?
Synovial hinge (uniaxial diarthrotic)
179
What is the shape of the dome of the talus and how is this important?
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
If the foot is fixed, the leg moves at what joint?
talocrural
181
ROM of talocrural
Dorsi: 20 Plantar: 50
182
What is the medial collateral ligament of the ankle also called?
Deltoid ligament
183
Attachments of the deltoid ligament (MCL)?
Tibia | Calcaneus, talus, navicular
184
The deltoid (MCL) limits...
eversion of the foot at the talocrural joint pronation of foot at subtalar joint
185
Why are eversion sprains relatively uncommon?
Lateral malleolus extends down farther distally than medial malleolus (limits motion) Deltoid (MCL) is very taut and strong
186
What are the 3 ligaments of the lateral collateral ligament of the ankle?
Anterior talofibular Posterior talofibular Calcaneofibular (all attach to distal fibula)
187
The LCL of the ankle limits...
inversion of the foot at the talocrural joint supination of foot at subtalar joint
188
What is the most commonly sprained ligament in the body? Why?
Anterior talofibular (1/3 of LCL) Usually occur when person is moving forward (plantar flexion + inversion) - places particular stress on ligament
189
Closed packed position of the talocrural joint
Dorsiflexion
190
What protects tendons of the ankle from friction
Tendon sheaths
191
What supports the talus on the medial side of the foot?
Sustentaculum tali (of calcaneus)
192
What is the sinus tarsus?
Large cavity on lateral side between talus and calcaneus
193
Type of joint: subtalar?
Synovial Uniaxial (triplanar), diarthrotic
194
ROM of subtalar (non-weight-bearing)
``` Ev: 10 Inv: 20 Dors: 2.5 Plant: 5 ER: 10 IR: 20 ```
195
Major motions of the subtalar joint?
Pronation and supination in an oblique plane around an oblique axis
196
Pronation of foot =
Eversion, dorsiflexion, lateral rotation
197
Supination of foot =
Inversion, plantarflexion, medial rotation
198
What happens when the weight-bearing foot pronates and the talus medially rotates relative to the fixed calcaneus? Implication of overpronation?
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
If a client has excessive pronation, the patella rotates in what direction?
Medially
200
Solutions to overpronated foot?
Orthotics Strengthen supination muscles Strengthen lateral rotation muscles of hip
201
What does the interosseous talocalcaneal ligament (in the sinus tarsus) limit?
Eversion (pronation) of subtalar joint
202
What does the cervical ligament (in the sinus tarsus) limit?
Inversion (supination) of the subtalar joint
203
Where is the spring ligament?
Spans subtalar joint on plantar side (calcaneus to navicular)
204
Spring ligament limits
Eversion (pronation) of subtalar joint
205
Closed packed position of subtalar joint?
Supination
206
Subtalar motion is intimately tied to which joints?
Transverse tarsal joint and talocrural joint
207
What are the 2 joints of the transverse tarsal joint?
Talonavicular joint | Calcaneocuboid joint
208
Transverse tarsal joint is also known as
Chopart's joint
209
What are the motions of the transverse tarsal joint?
Pronation/supination (move with the subtalar joint)
210
The talus shares a joint capsule with which bones?
Calcaneus and navicular
211
Spring ligament forms the floor of which joint
Talonavicular
212
Where is the long plantar ligament?
Length of foot on plantar side
213
Where is the short plantar ligament?
Deep to long plantar ligament on plantar side between calcaneus and cuboid
214
What is the bifurcate ligament?
Y-shaped ligament on dorsal side of foot (medial: calcaneus to navicular; lateral: calcaneus to cuboid)
215
Closed packed position of the transverse tarsal joint?
Supination
216
Type of joints: tarsometatarsals?
Plane synovial
217
What is the central stable pillar of the foot?
2nd ray of foot (2nd TMT joint) - base is wedged between 1st and 3rd cuneiform joints Reference line for abduction/adduction of toes
218
Major motions of TMT joints
Dorsi/plantarflexion Inversion/eversion Conform to surfaces
219
Proximal intermetatarsal joints are stabilized by
Joint capsules and inter metatarsal ligaments
220
Distal intermetatarsal joints are stabilized by
Joint capsules and deep transverse metatarsal ligaments
221
Why is the big toe unable to oppose?
Deep transverse metatarsal ligaments connect all of the distal metatarsals together, including the big toe (does not happen in hand)
222
Type of joint: metatarsophalangeal?
Condyloid synovial Biaxial, diarthrotic
223
Major motion of the MTP joint
Flexion/extension (sagittal) | Abduction/adduction (transverse plane)
224
ROM of toes at MTP joints
Toes #2-5 Ext: 60 Flex: 40 Big Toe E: 80 F: 40
225
Capsule of MTP joint stabilized by
collateral ligaments and plantar plate
226
What is the plantar plate?
Thick, dense, fibrous tissue structure on plantar side of MTP joint
227
Function of plantar plate
Protect head of MT when walking
228
Closed-packed position of MTP
Extension
229
What is hallux valgus?
Deformity of big toe in which big toe deviates laterally at MTP joint Also medial deviation of 1st MT
230
How does hallux valgus occur?
Genetic predisposition or Overpronation and incorrect footwear that pushes big toe laterally (heels, triangle front)
231
Implications of hallux valgus?
Exposes head of 1st MT to greater stress --> inflammation of bursa --> fibrosis and excessive bone growth on medial/dorsal MT (bunion)
232
Type of joint: interphalangeal joints
Synovial hinge Uniaxial, diarthrotic
233
ROM of PIP joints
F: 90 (less laterally) E: 0 (from neutral)
234
ROM of DIP joints
F: 45 (less laterally) E: small hypertext (from neutral)
235
Interphalangeal joints are stabilized by
Fibrous capsule MCL LCL Plantar plate
236
Closed packed position of IP joints of foot
Extension
237
What is the shoulder girdle made up of?
Scapula, clavicle, sternum
238
Function of the shoulder girdle?
Stable base for upper extremity to move
239
What ties the shoulder girdle together in the back?
Rhomboids and middle trapezius attach medial borders of the scapulae (like the lacing of a corset)
240
The net result of the sternoclavicular and acromioclavicular joints is to...
orient the scapula to the desired position
241
Position of the scapula is important to facilitate _____ motion at the _____ joint
humeral | glenohumeral
242
The coupling of shoulder girdle movement with arm movement is called
scapulohumeral rhythm (or scapuloclaviculohumeral rhythm)
243
ROM of entire shoulder joint complex
``` F: 180 E: 150 Abd: 180 Add: 0 ER: 90 IR: 90 ```
244
Why is abduction of the glenohumeral joint restricted when arm is in neutral or IR?
Greater tubercle of head of humerus will connect with acromion process
245
ROM of GHJ (anatomic position)
``` F: 100 E: 40 Abd: 120 Add: 0 ER: 50 IR: 90 ```
246
Major reverse actions of the scapula at the GHJ?
Upward/downward rotation (when arm is fixed)
247
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?
1-2 inches
248
What are the 3 glenohumeral ligaments?
Superior GH Middle GH Inferior GH
249
Function of GH ligaments
Prevent dislocation of humeral head anteriorly and inferiorly
250
Where do the majority of shoulder dislocations occur?
Foramen of Weitbrecht - small region of anterior GH capsule between superior and middle GH ligaments
251
Where is the coracohumeral ligament?
Between coracoid process (scapula) and greater tubercle (humerus)
252
Function of coracohumeral ligament
Prevents dislocation of humeral head anteriorly and inferiorly Limits extremes of flexion, extension, and lateral rotation
253
Closed-packed position of GHJ
Lateral rotation and abduction
254
Abductor muscles of GHJ
Deltoid | Supraspinatus
255
Adductor muscles of GHJ
Pectoralis major Latissimus dorsi Teres major
256
Lateral rotators of the GHJ?
Posterior deltoid Infraspinatus Teres minor
257
Medial rotators of the GHJ
Anterior deltoid Latissimus dorsi Teres major Subscapularis
258
Flexors of GHJ
Anterior deltoid Pectoralis major Coracobrachialis Biceps brachii
259
Extensors of GHJ
Posterior deltoid Latissimus dorsi Teres major Long head of triceps brachii
260
Where is the subacromial bursa
Between acromion process and rotator cuff tendon
261
Irritation and injury of the rotator cuff tendon will also cause the same in the...
subacromial bursa
262
What is the coracoacromial arch? Function?
Formed by acromion process and coracoacromial ligament Roof of GHJ; protects superior structures of GHJ
263
Why is the coracoacromial ligament unique?
Connects the same bone (coracoid profess and acromion process)
264
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?
Supraspinatus muscle/tendon Subacromial bursa Long head of biceps Superior joint capsule
265
Where does the long head of the biceps go within the GHJ capsule?
Bicipital groove of humerus to supraglenoid tubercle of scapula
266
Why is the GHJ so mobile and less stable?
Shallow glenoid fossa and joint capsule laxity
267
Where is the majority of the shoulder stability coming from?
Rotator cuff
268
What ribs articulate in the scapula costal joint?
2-7
269
What kind of joint is scapulocostal?
Functional joint
270
Major motions of scapulocostal joint
``` Elevation Depression Protraction Retraction Upward/downward rotation ```
271
What joints also need to move for motion of scapula at scapulocostal joint?
AC and SC
272
Scapular upward rotation accompanies what motion?
Humeral abduction
273
Accessory movements of the scapula?
Lateral/medial tilt | Upward/downward tilt
274
What is a healthy tilt of the scapula?
Medially and downwardly
275
What is lateral tilt of the scapula called?
Winging of the scapula
276
Push-ups are an example of what action at the scapula?
Reverse action of scapulocostal joint. Trunk moves relative to scapula
277
Elevators of the scapula
Upper trapezius Levator scapulae Rhomboid
278
Depressors of scapula
Lower trapezius | Pectoral is minor
279
Protractors of scapula
Serrated anterior | Pectoralis minor
280
Retractors of the scapula
Middle trapezius | Rhomboidal
281
Upward rotators of the scapula
Serratus anterior | Upper/lower trapezius
282
Downward rotators of scapula
Pectoral is minor Rhomboids Levator scapulae
283
Type of joint: sternoclavicular
Synovial saddle Biaxial, diarthrotic
284
Major motions of the SCJ
Protraction/retraction (transverse plane) Elevation/depression (frontal) Upward/downward rotation (sagittal)
285
ROM of clavicle at SCJ
``` Elevation: 45 Depression: 10 Protraction: 30 Retraction: 30 Upward rotation: 45 Downward rotation: 0 ```
286
Why does the SCJ need to be well stabilized?
Only osseous joint that connects the upper extremity to the axial skeleton
287
Motion of the scapula at the scapulocostal joint is driven by motion of...
the clavicle at the SCJ
288
What muscles stabilize the SCJ?
Sternocleidomastoid Sternohyoid Sternothyroid
289
Which ligaments reinforce the SC joint capsule?
sternoclavicular ligaments (anterior and posterior)
290
What is the interclavicular ligament?
Spans from one clavicle to the other
291
What is the costoclavicular ligament?
Runs from first rib to clavicle
292
What is the closed-packed position of the SCJ?
Full upward rotation of the clavicle
293
Why is there an articular disc in the SCJ?
Improve congruence of joint surfaces and absorb shock
294
Type of joint: ACJ
Synovial plane Nonaxial, diarthrotic
295
Motions of the ACJ?
Upward/downward rotation of scapula relative to the clavicle
296
Accessory actions of the ACJ
Lateral/medial tilt of scapula | Upward/downward tilt of scapula
297
Accessory tilt actions of the scapula at the acromioclavicular joint are necessary to maintain...
proper position of the scapula relative to the ribcage
298
Upward rotation of the scapula follows what part of the bone?
Inferior angle (moving laterally)
299
ROM of scapula at ACJ
Upward rotation: 30 | Downward rotation: 0
300
Muscle stabilization of the ACJ
Trapezius | Deltoid
301
Ligament reinforcement of the ACJ capsule
Acromioclavicular ligament (superior and inferior)
302
What are the 2 parts of the coracoclavicular ligament?
Trapezoid ligament | Conoid ligament
303
Closed packed position of the ACJ
Full upward rotation of the scapula
304
Is there a fibrocartilaginous disc in both the SCJ and ACJ?
Yes
305
The ACJ is very susceptible to...
injury and degeneration
306
What is typical injury to ACJ?
Falling on outstretched arm
307
In full 180 degrees of abduction, how much is from GHJ?
120 degrees
308
Flexion of the arm at the GHJ couples with.... of the scapula at the ScC joint
protraction and upward rotation
309
Extension of the arm at the GHJ couples with.... of the scapula at the ScC joint
retraction and downward rotation
310
Extension of the arm at the GHJ beyond neutral couples with ______ of the scapula at the ScC joint
upward tilt
311
Abduction of the arm at the GHJ couples with _____ of the scapula at the ScC joint
upward rotation
312
Adduction of the arm at the GHJ couples with _____ of the scapula at the ScC joint
downward rotation
313
Medial rotation of the arm at the GHJ couples with _____ of the scapula at the ScC joint
protraction
314
Lateral rotation of the arm at the GHJ couples with _____ of the scapula at the ScC joint
retraction
315
When the arm abducts at the GHJ more than approximately 90 degrees, it also need to _____ at the GHJ
laterally rotate
316
Which muscles keep the head of the humerus down during arm elevation movements so there is no impingement?
Rotator cuff isometrically contracts to keep proximal humerus fixed in place while distal end elevates
317
What happens at early phase of arm abduction (first 90 degrees)
GHJ: 60 degrees ScC upward rotation: 30 degrees Clavicle elevates at SCJ (25 deg) and scapula upwardly rotates at ACJ (5 deg)
318
What happens at the late phase of arm abduction (last 90 degrees)
GHJ: 60 degrees ScC upward rotation: 30 degrees Clavicle elevates at SCJ (5 deg) and scapula upwardly rotates at ACJ (25 deg)
319
Implications of rounded shoulder posture on shoulder health?
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
What are the 3 articulations in the elbow joint capsule?
Humeroulnar joint Humeroradial joint Proximal radioulnar joint
321
Type of joint: humeroulnar
Synovial hinge Uniaxial, diarthrotic
322
What part of the ulna connects to the distal humerus?
Trochlea
323
Type of joint: humeroradial
Synovial atypical ball-and-socket Biaxial, diarthrotic
324
ROM of elbow
F: 145 E: 0
325
3 parts of the MCL of the elbow
Anterior fibers Posterior Transverse
326
Function of the MCL of the elbow
Stabilize medial side of joint | Prevent abduction of forearm at elbow
327
2 parts of the LCL of the elbow
Annular fibers | Ulnar
328
Function of the LCL of the elbow
Stabilize lateral side of joint | Prevent adduction of forearm at elbow
329
Closed packed position of elbow
extension
330
Flexors of the elbow
Brachialis Biceps brachii Brachioradialis Pronator teres
331
Extensors of the elbow
Triceps brachii Anconeus Extensor carpi ulnaris
332
What is tennis elbow?
Lateral epicondylitis Inflammation of the common extensor tendon Related to hand and wrist use
333
What is golfer's elbow
Medial epicondylitis Inflammation of the common flexor tendon Related to hand and wrist use
334
What is the carrying angle of the elbow?
Ulna deviates laterally in the frontal plane (relative to humerus) Also called cubitus valgus
335
What is normal carrying angle?
Men: 5-10 deg Women: 10-15 deg
336
Advantage of carrying angle?
objects carried in hand are naturally away from the body
337
Where does pronation/supination occur in the elbow?
At radioulnar joints (proximal, middle, and distal)
338
Type of joint: proximal radioulnar
Synovial pivot Uniaxial, diarthrotic
339
Type of joint: middle radioulnar
Fibrous syndesmosis Uniaxial, amphiarthrotic
340
Type of joint: distal radioulnar
Synovial pivot Uniaxial, diarthrotic
341
What are the movements of the proximal and distal radioulnar joints during pronation?
Proximal: head of radius medial rotates Distal: radius swings around ulna
342
What is the annular ligament of proximal radioulnar joint?
Wraps around head of radius - stabilizes proximal RU joint and creates a cavity within which the head of the radius can rotate
343
Function of the interosseous membrane of the middle RU joint?
Stabilizes radius and ulna Transfers compression forces from radius at wrist to ulna into the arm (and vice versa)
344
Ligaments of the distal RU joint (2)
Dorsal and palmar radioulnar ligament
345
What is the radioulnar disc?
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
What should I know about joint capsules and proximal RUJ and distal RUJ?
Proximal shares capsule with elbow | Distal shares capsule with wrist

CALU - Kinesiology (8 decks)

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