MSK Anatomy Flashcards
Passive Insufficiency
Inability of a 2-joint muscle to
passively extend across full ROM
of both joints (while stretching).
Typically will use the hamstrings
Active insufficiency
Inability of a 2-joint muscle to
actively contract across full
ROM of both joints (Active = movement)
Can’t make a fist as well when in wrist flexion
Convex on concave rule
Convex surface on fixed concave surface = opposite directions roll and slide
Concave surface on fixed convex surface = same direction roll and slide
All fingers and metacarpal phalangeal arthrokinematics
Concave on convex (same as the toes)
so they move in the same direction
Wrist arthrokinematics
Convex on concave
with exception of trapezoid which is concave on convex
Arthrokinematics of pronation/supination of radioulnar joint proximal
convex on concave
Arthrokinematics of pronation/supination of radioulnar joint distal
concave on convex
(so roll and glide in the same direction)
Arthrokinematics of flexion and extension of humeroradial joint
concave on convex
Arthrokinematics of flexion and extension of humeroulnar joint
Concave on convex
Glenohumeral joint arthrokinematics
All are convex on cave (if in OKC this reverses in CKC kinda)
Sternoclavicular arthrokinematics with elevation/depression and protraction/retraction
Elevation/depression = Convex on concave (chicken wing motion)
Protraction/retraction = Concave on convex
A/C joint arthrokinematics
All movement on concave on convex
Toes flexion/extension and abduction/adduction arthrokinematics
concave on convex (same as the fingers)
Ankle arthrokinematics
Tibiofibular arthrokinematics
All motions are concave on convex
Knee arthrokinematics
Concave on Convex
Hip arthrokinematics
Convex on concave
TMJ arthrokinematics
Convex on concave
Open packed position; closed pack position; capsular pattern of restriction of vertebrae
OPP: Midway between flexion and ext
CPP: Maximal extension
Cap pattern:
Upper c-spine: OA - forward flexion limited > ext; AA - limited rotation
Lower c-spine and thoracic spine: limitations in ALL MOTIONS EXCEPT FLEXION (SB and rotation equally limited > extension)
Open packed position; closed pack position; capsular pattern of restriction of TMJ
OPP: Jaw slightly open
CPP: Maximal retrusion or anterior position mouth open fully
Cap pattern: limited opening
Open packed position; closed pack position; capsular pattern of restriction of Sternoclavicular
OPP: arm resting by side
CPP: Arm maximally elevated
Cap pattern: full elevated limited; pain at extreme motions
Open packed position; closed pack position; capsular pattern of restriction of Acromioclavicular
OPP: Arm resting by side
CPP: arm abduction to 90 deg
Cap pattern: full elevated limited; pain at extreme motions
Open packed position; closed pack position; capsular pattern of restriction of Glenohumeral
OPP: 40-50 deg of abduction, 30 deg of horiz. adduction (scapular plane)
CPP: Max abduction and ER
Cap pattern: ER>abduction>IR (most to least)
Open packed position; closed pack position; capsular pattern of restriction of Humeroulnar
OPP: 70 deg of flexion and 10 deg of supination
CPP: full extension and supination
Cap pattern: Flexion > extension (limited)
Open packed position; closed pack position; capsular pattern of restriction of Humeroradial
OPP; full extension and supination
CPP: 90 deg flexion and 5 deg of supination
Cap pattern: flexion> extension (limited)
Open packed position; closed pack position; capsular pattern of restriction of Proximal radioulnar
OPP: 70 deg of flexion and 35 deg of supination
CPP: 5 deg of supination
Cap pattern: pronation=supination (equal limitation)
Open packed position; closed pack position; capsular pattern of restriction of distal radioulnar
OPP: 10 deg of supination
CPP: 5 deg of supination
Cap pattern: pronation=supination (equal limitation)
Open packed position; closed pack position; capsular pattern of restriction of Radio/ulnar carpal
OPP: netural with slight ulnar deviation
CPP: full extension with radial deviation
Cap pattern: flexion=extension (limitation)
Open packed position; closed pack position; capsular pattern of restriction of midcarpals
OPP: Neutral or slight flexion with slight ulnar deviation
CPP: extension with ulnar deviation
Cap pattern: equal all directions
Open packed position; closed pack position; capsular pattern of restriction of carpometacarpal (2-5)
OPP: midway between abduction/adduction and flexion extension (for thumb); midway b/n flexion and extension (fingers)
CPP: full opposition (thumb); full flexion (fingers)
Cap pattern: thumb restricted equal in all directions; fingers flexion > extension
Open packed position; closed pack position; capsular pattern of restriction of Metacarpophalangeal (MCP)
OPP: slight flexion
CPP: full opposition (thumb); full flexion (fingers)
Cap pattern: ?
Open packed position; closed pack position; capsular pattern of restriction of Interphalangeal (IP)
OPP: slight flexion
CPP: full extension
Cap pattern: tend toward extension restrictions
Open packed position; closed pack position; capsular pattern of restriction of Hip
OPP: 30 deg flexion, 30 deg abduction, and slight lateral rotation
CPP: full extension, abduction, IR
Cap pattern: limited flexion/IR; some limitation of abduction; no or little limitation of adduction and ER
Open packed position; closed pack position; capsular pattern of restriction of Knee
OPP: 25 deg flexion
CPP: full extension and ER
Cap pattern: flexion grossly limited; slight limitation of extension
Open packed position; closed pack position; capsular pattern of restriction of Ankle/Foot (Talocrural)
OPP: Mid inversion/eversion and 10 deg PF
CPP: full DF
Cap pattern: Loss of PF>DF
Open packed position; closed pack position; capsular pattern of restriction of Ankle/Foot (Subtalar)
OPP: midway between ROM
CPP: full inversion
Cap pattern: Increasing limitations of varus; joint fixed in valgus (inversion>eversion)
Open packed position; closed pack position; capsular pattern of restriction of Ankle/Foot (Midtarsal)
OPP: midway between ROM
CPP: Full supination
Cap pattern: supination>pronation (limited DF, PF, add, and medial rotation)
Open packed position; closed pack position; capsular pattern of restriction of Ankle/Foot (Tarsometatarsal)
OPP: midway between supination and pronation
CPP: Full supination
Cap pattern: ?
Open packed position; closed pack position; capsular pattern of restriction of Toes (metatarsophalangeal)
OPP: neutral - extension 10 deg
CPP: full extension
Cap pattern: variable; tend toward flexion restrictions
Open packed position; closed pack position; capsular pattern of restriction of Toes
(interphalangeal)
OPP: Slight flexion
CPP: Full extension
Cap pattern: Tend towards extension restrictions.
What is the SCM innervated by?
C1-4 cord segment
C3-4 posterior rami; spinal accessory (CN XI)
What muscles does medial/lateral pectoral nerve innervate and what is the muscle action?
Pec major/minor
shld horizontal adduction
What muscles does the long thoracic nerve innervate, muscle action of the muscle, and the nerve root?
Serratus Anterior
Shoulder protraction, scapular upward rotation
C5-7
What muscles does the Dorsal scapular nerve innervate, muscle action of the muscles, and the nerve roots?
Levator scapula (scapular elevation, downward rotation) - C5
Rhomboids (scapular adduction, elevation, downward rotation) - C4-5
What muscles does the Suprascapular nerve innervate, muscle action of the muscle, and the nerve root?
Supraspinatus (shld abduction) - C4-6
Infraspinatus (shld lateral rotation) - C4-6
What muscles does the Thoracodorsal, upper/lower subscapular, and medial/lateral pectoral nerves innervate, muscle action of the muscles, and the nerve root?
C5-T1
Shoulder medial rotation, adduction
Latissimus dorsi, teres major, subscapularis, and pectoralis major.
Lats (Thoracodorsal C6-8) - IR, adduction, ext
Teres Major (Lower subscapular n C5-7) - IR, adduction, and extension
Subscapularis (subscapular C5-6) - IR
Pectoralis Major (medial and lateral pectoral n C5-T1) - adduction and IR
What muscles does the axillary nerve innervate, muscle action of the muscle, and the nerve root?
Deltoid ( shld abduction, flexion, extension)
Teres minor (shld lateral rotation)
C5
C5-6
What muscles does the musculocutaneous nerve innervate, muscle action of the muscle, and the nerve root?
Biceps Brachii (elbow flexion, forearm supination) - C5-6
Coracobrachialis (shld flexion, adduction) - C6-7
Brachialis, biceps brachii (elbow flexion) - C5-6
What muscles does the Ulnar nerve innervate and nerve roots?
The Ulnar Nerve is the MAFIA (C8-T1)
M = medial lumbricals (3rd&4th lumbrical of the 4th and 5th fingers)
A = Adductor pollicis (tested with froment sign)
F = flexor group
I = dorsal interossei (help with finger abduction)
A = abductor digit minimi
Flexor digitorum profundus - C7-T1
Flexor carpi ulnaris - C7-T1
Abductor digiti minimi (deep ulnar) - C8-T1
Opponens digiti minimi (deep ulnar) - C8-T1
Flexor digit minimi brevis (deep ulnar) - C8-T1
Interossei of the hand (deep ulnar) - C8-T1
What muscles doe the Median nerve innervate and nerve roots?
The Median Nerve is a 1/2 LOAF
1st and 2nd lumbricals, opponens pollicis, abductor pollicis brevis, flexor group (also the pronators)
Pronator teres, pronator quadratus (anterior interosseous) - C6-7
flexor carpi radialis - C6-7
palmaris longus - C7-T1
flexor digitorum superficialis - C7-T1
flexor pollicis longus (anterior interosseous) - C7-T1
Flexor digitorum profundus (radial part)(anterior interosseous) - C7-T1
abductor pollicis brevis - C8-T1
opponens pollicis - C8-T1
Which muscles are innervated by both ulnar and median nerves?
Flexor pollicis brevis - C8-T1
Lumbricals - C8-T1
Also flexor digitorum profundus
What is the difference between the flexor digitorum profundus and the flexor digitorum superficialis
profundus - means “top of”….so this is the top part of the finger….so the DIP
superficialis - the PIP joint
Which muscles are innervated by radial nerve?
BEAST (brachioradialis, extensors, anconeus/abductor pollicis longus, supinator, triceps) - C6-T1
Brachioradialis - (elbow flexion in neutral) - C5-6
Triceps brachii - C6-8
extensor carpi radialis longus - C6-C7
extensor digitorum - (2-5th MCP, IP extension) - C7-C8
Extensor carpi ulnaris - C7 -C8
Supinator - C7-8
Abductor pollicis longus (thumb MCP abduction) - C7-8
Extensor pollicis longus/brevis (thumb extension) - C7-8
Extensor indicis - C7-8
Sensory region of the median nerve?
lateral hand and thumb, index and middle finger
What is innervated by the Anterior Interosseous Nerve (AIN)?
A branch of the median nerve
Flexor digitorum profundus of first finger
Flexor pollicis longus
Pronator quadratus
How to test the anterior interosseous nerve?
Test tip to tip pinch (median nerve, AIN). If they can’t do it they will resort to pad to pad pinch grip (innervated by ulnar nerve)
Which muscle(s) are innervated by the anterior rami and what is their function and nerve roots?
Iliopsoas (hip flexion) - L1-3
Which muscle(s) are innervated by the femoral nerve and what is their function and nerve roots?
Sartorius (hip flexion, abduction, lateral rotation) - L2-3
Quadriceps femoris (knee extension)- L2-4
Also includes the iliopsoas and pectineus (what the atlas says)
Which muscle(s) are innervated by the obturator nerve and what is their function and nerve roots?
Pectineus, adductor longus (hip adduction) - L2-3
Adductor brevis (hip adduction) - L2-4
Adductor magnus (hip adduction)
Gracilis (hip adduction (with slight hip flexion), also knee flexion/IR) - L2-4
Which muscle(s) are innervated by the superior gluteal nerve and what is their function and nerve roots?
Gluteus medius, minimus (hip abduction, flexion, medial rotation…FADIR) - L4-S1
Tensor fascia lata (hip flexion, abduction, medial rotation) - L4-L5
Which nerves are innervated by the sacral plexus nerve and what is their function and nerve roots?
Superior gluteal nerve (L4-S1) - Glut med, min, TFL
Inferior gluteal nerve (L5-S2) - Glut max
Sciatic n (branches to common fibular and tibial n)
Pudenal n. (S2-S4)
Direct branches too - piriformis, obturator internus (and gemelli), quadriceps femoris
From atlas book
Which muscle(s) are innervated by the inferior gluteal nerve and what is their function and nerve roots?
Gluteus maximus (hip extension, lateral rotation) - L4-S2
Which muscle(s) are innervated by the tibial nerve and what is their function and nerve roots?
Semiteninosus (hip ext, knee flexion) - L5-S2
Semimembranosus (leg medial rotation) - L5-S2
Popliteus (leg medial rotation) - L4-S1
Tibialis posterior (Foot inversion) - L5-S2
Gastroc/soleus (ankle PF) - L5-S2
Flexor digitorum longus (2nd-5th digit DIP flexion) - L5-S2
Flexor hallucis longus (great toe MTP flexion) - L5-S2
Which muscle(s) are innervated by the deep fibular nerve and what is their function and nerve roots?
tibialis anterior (ankle DF) - L4-5
extensor digitorum longus (2nd-5th digit MTP extension) - L4-S1
extensor hallucis longus (great toe MTP extension) - L4-S1
Which muscle(s) are innervated by the medial plantar nerve and what is their function and nerve roots?
Flexor digitorum brevis (2nd-5th PIP flexion) - L5-S1
Flexor hallucis brevis (great toe flexion) - L5-S2
Which muscle(s) are innervated by the lateral plantar nerve and what is their function and nerve roots?
Dorsal/plantar interossei (toe adduction/abduction) - S1-S2
Which muscle(s) are innervated by the tibial and common fibular nerves and what is their function and nerve roots?
Biceps femoris (hip extension, knee flexion, leg lateral rotation) - L5-S2
Which of the following muscles works in opposition to the deltoid to prevent scapular winging?
rhomboid major; rhomboid minor; trapezius; serratus anterior
Serratus Anterior
The serratus anterior originates on the 1st through 8th ribs on the lateral chest wall and inserts along the medial border of the scapula. This muscle acts to stabilize the scapula against the chest wall.
What is the primary action of the dorsal interossei on the metacarpophalangeal joints of the index, middle, and ring fingers?
Abduction
There are four dorsal interossei whose primary action is abduction of the metacarpophalangeal (MCP) joints of the index, middle, and ring fingers. The secondary action is flexion of the MCP joints for the index, middle, and ring fingers and extension of the proximal and distal interphalangeal joints for the index, middle, and ring fingers.
Which bone is most susceptible to necrosis following a fracture?
Scaphoid
The scaphoid, identified by line C, is supplied by the palmar branch of the radial artery and the dorsal carpal branch of the radial artery. If the scaphoid is fractured, the disrupted blood supply can significantly inhibit the ability of the bone to heal which can result in necrosis.
Which of the following muscles share a common insertion site?
- coracobrachialis and pectoralis minor
- brachioradialis and brachialis
- tibialis anterior and peroneus longus
- sartorius and rectus femoris
Tibialis Anterior and Peroneus Longus
The tibialis anterior and peroneus longus both insert at the base of the first metatarsal and medial cuneiform. The coracobrachialis and pectoralis minor have a common origin or insertion, however, the coracobrachialis originates at the coracoid process while the pectoralis minor inserts at the same structure. The remaining muscles do not share common origins or insertions.
The elbow ligament that allows the head of the radius to rotate and retain contact with the radial notch of the ulna is known as:
Annular Ligament
The annular ligament consists of a band of fibers that surrounds the head of the radius. It allows the head of the radius to rotate and maintain contact with the radial notch of the ulna.
The elbow ligament that allows the head of the radius to rotate and retain contact with the radial notch of the ulna is known as:
Annular Ligament
The annular ligament consists of a band of fibers that surrounds the head of the radius. It allows the head of the radius to rotate and maintain contact with the radial notch of the ulna
Which muscle plays a significant role in depressing the mandible during mouth opening?
- medial pterygoid
- temporalis
- lateral pterygoid
- masseter
Lateral pterygoid
The lateral pterygoid is made up of two heads. It is one of the few muscles of mastication that opens the mouth.
The others are the suprahyoid and infrahyoid
What is the lateral articular surface of the distal humerus called?
Capitulum
What creates the anatomical snuffbox?
extensor pollicis brevis
extensor pollicis longus
abductor pollicis longus
can feel scaphoid when ulnarly deviated.
What creates the femoral triangle?
The femoral triangle is comprised of the inguinal ligament, adductor longus, and sartorius.
Within the femoral triangle is the femoral nerve, femoral artery, and femoral vein.
What type lever permits large movements at rapid speeds?
Class 3
Lateral flexion of the cervical spine (Below C2) is coupled with rotation to the _____ side
Ipsilateral
Rotation of the lumbar spine is coupled with ____________
lateral flexion to the contralateral side
Which arthrokinematic motion is coupled with cervical rotation?
lateral flexion
due to the shape of the articulating facet joints. Lateral flexion is not always couple din the same direction as rotation…depending of the level of the c-spine
What is considered normal protrusion?
10 mm
Arthorokinematics of the carpometacarpal joint?
The saddle joint of the first carpometacarpal joint causes a:
convex on concave – abduction/adduction
concave on convex – extension/flexion.
What arthrokinematic motion is involved in hip internal rotation?
The femoral head rolls anteriorly and slides posteriorly on the acetabulum
The hip is a ball and socket joint with three degrees of freedom. The convex head of the femur glides posteriorly and rolls anteriorly in hip internal rotation.
Which joints make up the transverse tarsal joint?
talonavicular and calcaneocuboid joints
The transverse tarsal joint, also known as the midtarsal joint, consists of the talonavicular and calcaneocuboid joints. These joints connect the rearfoot with the midfoot.
Which motions occur at the talocrural joint?
DF & PF
What is the capsular pattern of the cervical spine?
lateral flexion = rotation limited > extension.
The close packed position is full extension. The loose packed position is midway between flexion and extension.
Which condition would be most likely to contribute to a capsular pattern?
- ligamentous adhesions
- fracture
- internal derangement
- extra-articular limitations
ligamentous adhesions
After an injury, adhesions can form that impact specific ligaments. Motions that require extensibility from the affected ligaments tend to be painful and restricted resulting in limited motion in a capsular pattern.
True/False:
IF a joint is swollen, the CPP cannot be achieved
True
The close packed position should be utilized as much as possible during an assessment.
False (the loose packed position)
The CPP should generally be avoided except ______________________
to stabilize an adjacent joint
The CPP of the hip is especially important for nourishment of the articular cartilage to help prevent?
Osteoarthritis
The CPP of the hip forces synovial fluid into the articular cartilage which nourishes the cartilage and helps to prevent the degradation commonly seen in OA. The CPP of the hip is full extension and IR.
Proximal radioulnar supination mobilization
Convex radius moving on a concave ulna
Radius rolls posterior and glides anterior
So to mobilize to improve supination mobilize anterior
Proximal radioulnar pronation mobilization
Convex radius moving on a concave ulna
Radius rolls anterior and glides posterior
So to mobilize to improve pronation mobilize posterior
Distal radioulnar supination mobilization
Concave radius (ulnar notch) on convex ulna
Radius rolls posteriorly and glides posterior
So to mobilize to improve supination mobilize posterior
Distal radioulnar pronation mobilization
Concave ulnar notch on radius on convex ulna
Radius rolls anteriorly and glides anteriorly
So to mobilize to improve pronation mobilize anteriorly.
Radiocarpal flexion mobilization
convex carpals on concave radius
Flexion the carpals roll anteriorly and glide posteriorly (dorsal).
So to mobilize to improve wrist flexion mobilize posteriorly.
Radiocarpal extension mobilization
convex carpals on concave radius
extension of the carpals roll posteriorly and glide anteriorly.
So to mobilize to improve wrist extension mobilize anteriorly.
What direction should joint distraction be applied in relation to the glenoid fossa of the scapula when treating the glenohumeral joint?
Perpendicular
The glenohumeral joint is formed by the convex head of the humerus and the concave glenoid fossa of the scapula. Distraction (i.e., separation or pulling apart of joint surfaces) requires the force to be applied in a perpendicular direction in relation to the glenoid fossa.
What term best describes a mobilization force applied parallel to the treatment plane in the concave joint surface?
Glide
Gliding techniques are applied parallel to the treatment plane of the concave joint surface.
The articulating facets of the lumbar vertebrae are oriented:
90 deg to the transverse plane
The articular facets of the lumbar vertebrae are oriented nearly vertical (i.e., 90 degrees) to the transverse plane. The majority of facets (C3-C7) in the cervical spine are oriented at 45 degrees to the transverse plane and 60 degrees to the transverse plane in the thoracic spine.
What grade is a non-thrust oscillatory technique that uses a large amplitude rhythmic oscillation that is performed within the available joint range of motion and does not reach the anatomic limit of the joint?
Grade II
A grade II non-thrust oscillatory technique is characterized by using a large amplitude rhythmic oscillation that does not reach the anatomic limit of the joint. Generally, these oscillations are performed at 2-3 times per second for 1-2 minutes. A grade III non-thrust oscillatory technique would be performed up to the anatomical limit of the joint.
What mobilization technique would be most beneficial to increase hip flexion?
posterior glide
A posterior glide of the femur on the acetabulum would be used to increase hip flexion and internal rotation.
What mobilization technique would be most beneficial to increase shoulder flexion?
Posterior glide
The convex head of the humerus moves within the concave glenoid fossa. A posterior glide of the humerus on the glenoid fossa would be used to increase shoulder flexion and internal rotation
Which of the following joint mobilizations would be required if a patient has a loss of forearm pronation?
Both of these options listed below depending on whether mobilizing proximal or distal
Proximal: Dorsal glide of the proximal radius on the ulna
Distal: Volar glide of the distal radius on the ulna would both increase pronation range of motion.
Manual muscle testing procedure:
Have them do the AROM first (and perform first on uninvolved side)
Use “break testing” - applies resistance after the subject has reached the end range of the test position. Subject is asked to “hold” that position.
Resistance is applied gradually in a direction opposite to the line of pull of the muscle testing.
2 second build up of testing – 6 second hold of maximum contraction – 2 second diminishing of tension.
Repeat the test 3 times
Where should the pressure be applied when testing the flexor pollicis brevis
palmar surface of the proximal phalanx
How should manual resistance be applied when performing a manual muscle test on the adductor pollicis?
against the medial surface of the thumb toward abduction
Which muscle is tested as the examiner provides a force in the direction of plantar flexion of the ankle and eversion of the foot?
Tibialis anterior
Weakness in this muscle decreases the ability to dorsiflex the ankle, and allows a tendency toward eversion of the foot. This pattern of weakness and foot placement is commonly observed in patients following stroke with foot drop.
How should manual resistance be applied when performing a manual muscle test on the tensor fasciae latae?
against the leg in the direction of extension and adduction
Manual resistance should be placed against the leg in the direction of extension and adduction when testing the tensor fasciae latae. Application of force against the rotation component is not recommended.
What muscle would be strength tested by placing the elbow in maximal flexion and the forearm in maximal supination to minimize activation of the biceps brachii?
coracobrachialis
This coracobrachialis is tested with the elbow in flexion and the forearm in supination. This position is necessary since it dramatically reduces the ability of the biceps brachii to flex the shoulder.
What muscle would be strength tested in prone with the arm laying on the small of the back?
teres major
The teres major acts to adduct, extend, and medially rotate the shoulder. The muscle is innervated by the lower subscapular nerve.
Tarsal tunnel
- medial aspect of ankle
- formed by flexor retinaculum superior aspect of calcaneus, medial wall of talus, and medial distal aspect of the tibia.
- Tibial nerve, posterior tibial artery, and tendons of flexor hallucis longus, tibialis posterior, and flexor digitorum longus
Types of Grips
What is the power grip? What are the different types?
- hook grasp, cylinder grasp, fist grasp, and spherical grasp.
- A power grip is characterized by finger flexion with the wrist in ulnar deviation and slight extension.
What mechanism of injury is likely to injure the radial nerve
Crutch palsy (From axillary crutches)
Or humeral fracture (midshaft)
Results in wrist drop due to weakness of wrist extensors.
What does the inferior glenohumeral ligament restrict?
- support the humeral head above 90 degrees of abduction.
- Most important stabilizing structure of the shoulder for patients that engage in overhead activities.
- Has an anterior and posterior band.
- Anterior band tightens on ER
- Posterior band tightens on IR
What does the superior glenohumeral ligament restrict?
- Limit inferior translation when the shoulder is adducted.
- Limits ER when the shoulder is in 0-45 degrees of abduction.
What does the medial glenohumeral ligament restrict?
- Limit ER when the shoulder is in 45-90 degrees of abduction.
What physiological changes will be seen after both endurance and strength training?
- Increased tensile strength of tendons, ligaments, and connective tissue
*
What is compartment syndrome?
What nerve is most likely to be affected?
- increased tissue pressure in specific muscular compartment. Most specifically the anterior compartment
- S&S: pain with exertion, swelling, decreased sensation, diminished pulses
- The deep peroneal nerve is most likely to be affected. It is in the anterior compartment and innervates the tibialis anterior
- results in steppage gait due to loss of DF
- may require a fasciotomy.
Talocrural Joint
-TCJ
- articulation between tibia, fibular, and talus
- main motions: DF and PF
- motion during DF – abducts and everts
- motion during PF – adducts and inverts
- Normal ROM of TCJ:
15-20 of DF
50-56 deg of PF
Subtalar Joint
- articular between the calcaneous and talus (rearfoot)
- Motions: Supination and pronation
Supination in WB – DF and abduction of the talus with inversion of the calcaneus
Pronation in the WB – PF and adduction of the talus and eversion of the calcaneus
Midfoot
- Cuboid and Navicular bones
- Talonavicular and calcaneocuboid are the articulations between the midfoot and rearfoot.
- Stabilization by: plantar calcaneonavicular (spring) ligament, bifurcate ligament, short and long plantar ligaments
Forefoot
- all structures distal to the Navicular and cuboid bones
What supports the medial longitudinal Arch (MLA)
Plantar aponeurosis
Short and long plantar ligaments
Spring ligament
During WB the height of the arch is reduced as the supporting structures elongate.
What does the ATFL prevent (anterior talofibular ligament)
Resist anterior translation of the talus
What does the calcaneofibular ligament restrict?
Resists inversion of the talus
What does the deltoid ligament restrict?
Resists eversion of the talus
What does the posterior talofibular ligament restrict?
Resists posterior translation of the talus
Pes anserine
SGT Pepper
Sartorius
Gracilis
Semitendinosus
What muscles assists with TMJ depression
Lateral pterygoid
Suprahyoid
Infrahyoid
Elevation of TMJ
Masseter
Temporalis
Medial Pterygoid
Hip external rotation muscles
Gluteus Maximus
Obturator externus
Obturator internus
Pirifomis
Gemelli
Sartorius
Plantar Flexion muscles
Tibialis posterior
Gastrocs
Soleus
Peroneus longus
Peroneus brevis
Plantaris
Flexor hallicus
Downward rotation of the scapulae muscles
Rhomboids
Levator Scap
Pec minor
Hip abduction muscles
Gluteus medius
Gluteus minimus
Piriformis
Obturator internus
TFL
Finger abduction/adduction muscle
Abduction:
- Dorsal interossei
- Abductor digit minimi
Adduction:
- Palmar interossei
Hip IR muscles
TFL
Glut Med
Glut Min
Pectineus
Adductor longus
Shoulder lateral rotation muscles
Infraspinatus
Teres minor
Posterior deltoid
Scapular depression muscles
Lower traps
Pec major
Pec minor
Latissimus dorsi
Ankle inversion muscles
Tibialis posterior
Tibialis anterior
Flexor digitorum longus
Ankle DF muscles
Tibialis anterior
Extensor hallicus longus
Extensor digitorum longus
Peroneu tertius
Cervical flexion muscles
SCM
Scalenes
Longus colli
Scapula upward rotation muscles
Upper trap
Lower trap
Serratus anterior
Horizontal abduction muscles
Posterior deltoid
Infraspinatus
Teres minor
Anterior interosseous n. muscles
flexor policis longus, flexor didgitorum profundus, pronator quadratus,
Tested with OK sign
OKC supination of foot what occurs
Calcaneus inverts, adducts, and PF
OKC pronation of foot what occurs
Calcaneus everts, abducts, and DF
CKC supination of foot what occurs
Tibia = ER
Talus = DF and ABD
Calcaneus = Inversion
CKC supination of foot what occurs
Tibia = IR
Talus = PF and ADD
Calcaneus = Eversion
Where to palpate the
Dorsum of the wrist in line with the 3rd metacarpal
Where to palpate the extensor carpi radialis brevis
Dorsum of the wrist in line with the 3rd metacarpal
Where to palpate the extensor carpi radialis longus
Dorsum of the wrist in line with the 2nd metacarpal
Where to palpate the flexor carpi radialis
Palmar aspect of the wrist in line with either 2nd or 3rd metacarpal
What restricts horizontal motion at the AC joint
superior and inferior AC ligaments act as the primary restraint for a horizontal shear force
urther reinforced through the attachments from the deltoid and trapezius
What innervates the flexor digitorum superficialis
Median - AIN
