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NPTE Study Practice > MSK Anatomy/Biomechanics > Flashcards

MSK Anatomy/Biomechanics Flashcards

1
Q

Which direction does the bone glide when it is concave moving on convex and convex moving on concave surfaces

A
  • Concave on convex = same direction
  • Convex on concave = opposite direction
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2
Q

What is the convex/concave rule in the spine

A
  • Alanto-occipital joint follows the convex rule
  • All joints below the 2nd vertebrae follow the concave rule
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3
Q

List the normal physiological end-feels

A
  • Soft: soft tissue approximation
  • Firm: capsular & ligamentous stretching
  • Hard: when bone and/or cartilage meet
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4
Q

List the pathological end-feels

A
  • Boggy: edema, joint swelling
  • Firm with decreased elasticity: fibrosis of soft tissues
  • Rubbery: muscle spasm
  • Empty: loose then very hard, associated with muscle spasm/painful
  • Hypermobility: end-feel at a later time than on opposite side
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5
Q

Close/open-packed position for vertebral

A
  • Open: midway bw flexion/extension
  • Close: max extension
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6
Q

Close/open-packed position TMJ

A
  • Open: jaw slightly open
  • Close: clenched jaw or max opening
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7
Q

Close/open-packed position GHJ

A
  • Open: scapular plane; 40-55º ABD and 30º horizontal ABD
  • Close: max ABD and ER
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8
Q

Close/open-packed position humeroulnar joint

A
  • Open: 70º flexion & 10º supination
  • Close: full extension and supination
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9
Q

Close/open-packed position humeroradial joint

A
  • Open: full extension and supination
  • Close: 90º flexion and 5º supination
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10
Q

Close-packed position radioulnar joint

A
  • 5º supination
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11
Q

Close/open-packed position MCP

A
  • Open: slight flexion
  • Close: full flexion; full opposition (thumb)
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12
Q

Close/open-packed position IP

A
  • Open: slight flexion
  • Close: full extension
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13
Q

Close/open-packed position hip

A
  • Open: 30º flexion, 30º ABD, slight lateral rotation (ER)
  • Close: full extension, ABD, and IR
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14
Q

Close/open-packed position knee

A
  • Open: 25º flexion
  • Close: full extension and ER
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15
Q

Close-packed position toes

A
  • Full extension
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16
Q

Close/open-packed position talocrual

A
  • Open: midway bw INV/EVR and 10º PF
  • Close: full DF
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17
Q

Close/open-packed position subtalar

A
  • Open: midway bw ROM
  • Close: full inversion
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18
Q

Close/open-packed position midtarsal

A
  • Open: midway bw ROM
  • Close: full supination
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19
Q

Close/open-packed position tarsometatarsal

A
  • Open: midway bw supination and pronation
  • Close: full supination
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20
Q

Capsular restriction patterns for OA joint

A
  • Flexion limited more than extension (flexion > extension)
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21
Q

Capsular restriction patterns for AA joint

A
  • limited rotation
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22
Q

Capsular restriction patterns for lower cervical spine

A
  • SBing and rotation > extension
  • Flexion is in tact
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23
Q

Capsular restriction patterns for GHJ

A
  • ER > ABD > IR
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24
Q

Capsular restriction patterns for elbow

A
  • Flexion more limited than extension
  • Pronation = supination limitations
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25
Q

Capsular restriction patterns for wrist

A
  • Flexion is equally limited as extension
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26
Q

Capsular restriction patterns for fingers

A
  • Flexion > extension
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27
Q

Capsular restriction patterns for thoracic spine

A
  • SBing and rotation > extension > flexion
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28
Q

Capsular restriction patterns for lumbar spine

A
  • SBing and rotation > extension > flexion
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29
Q

Capsular restriction patterns for hip

A
  • Flexion & IR > ABD
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30
Q

Capsular restriction patterns for knee

A
  • Flexion > extension
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31
Q

Capsular restriction patterns for foot

A
  • PF > DF
  • IVR > EVR
  • Supination > pronation
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32
Q

Describe a Tenodesis grip

A
  • Passive finger flexion by contraction of wrist extensors when fingers are weak
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33
Q

Osteology of humeral head

A
  • Articular surface covered in hyaline cartilage
  • Head is retroverted 20-30º
  • Longitudinal axis of head is 135º from axis of neck
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34
Q

Orientation of glenoid fossa places true abduction at

A
  • 30º anterior to frontal plane
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35
Q

Archeology of sternoclavicular joint

A
  • Convex superior/inferior and concave anterior/posterior articulates with reciprocal shape of sternum
  • Both articulations covered with fibrocartilage
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36
Q

Function of the coracohumeral ligament

A
  • Reinforces biceps tendon, superior capsule & prevent caudal (tail/bottom) dislocation of humerus
  • Taut with ER
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37
Q

Function of coracoacrominal ligament

A
  • Not a “true” ligament
  • Connects two points of same bone
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38
Q

Function of the transverse humeral ligament

A
  • Passes over bicipital groove
  • Acts as retinaculum for long biceps tendon
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39
Q

Function of glenohumeral ligaments and what motions they limit

A
  • Reinforce GHJ capsule anteriorly and inferiorly
  • Superior GH lig.: limits ER and inferior translation
  • Middle GH lig.: limits ER and anterior translation
  • Inferior GH lig.: Anterior band limits ER & anterior/superior translation; Posterior band limits IR & anterior translation
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40
Q

At ~_____ of elevation, ER (conjunction rotation) occurs, preventing compression of greater tubercle against the acromion

A
  • ~75º of shoulder elevation
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41
Q

Purpose of ulnar collateral ligament

A
  • Reinforces humeroulnar joint medially
  • Triangular shape
42
Q

Purpose of radial collateral ligament

A
  • Reinforces humeroradial joint laterally
  • Fan shaped and runs from lateral epicondyle of humerus to annular ligament
43
Q

Purpose of annular ligament

A
  • Attaches to anterior/posterior surfaces of ulna near radial notch
  • Protects radial head especially in semi-flexion
  • Taut in extremes of pronation/supination
44
Q

Purpose of quadrate ligament

A
  • Reinforces inferior joint capsule
  • Maintains radial head in opposition to ulna
  • Limits amount of spin in supination/pronation
45
Q

Purpose of the anterior and posterior radioulnar ligaments

A
  • Strengthens capsule
46
Q

What arteries does the elbow recieve its blood supply from

A
  • Brachial artery
  • Anterior ulnar recurrent artery
  • Posterior ulnar recurrent artery
  • Radial recurrent artery
  • Middle collateral branch of deep brachial artery
47
Q

Why is the radial collateral ligament not as strong as the ulnar collateral ligament

A
  • It is not as strong due to its attachment to another soft tissue structure, the annular ligament, and it experiences more lateral compressive forces rather than tensile forces
48
Q

Biomechanics of the ulnar during elbow flexion/extension

A
  • Ulna supinates with flexion and pronates with extension
  • Proximal ulna glides medially during extension and laterally during flexion
49
Q

Is capitate convex or concave in relation to its articulates with scaphoid, trapezoid, and hamate

50
Q

What motion does the dorsal radiocarpal ligament limit

A
  • Limits flexion, pronation, & possibly radial deviation of wrist
51
Q

What motion does the radiate ligament limit

A
  • Stabilizes hand for impact
52
Q

What motion does the palmar ulnocarpal ligament limit

A
  • Limits extension and supination of wrist
53
Q

What motion does the palmar radoiocarpal ligament limit

A
  • Limits extension & supination through knuckles
54
Q

What is the extensor hood and its purpose

A
  • Fibrous mechanism on the dorsum of each finger that is a fibrous expansion of the extensor digitorum tendon
  • Purpose is to assist with extension of the PIP and DIP joints
55
Q

What are the volar plates

A
  • Present on palmar aspect of the MCP, PIP, and DIP joints
  • Thickening of capsule
  • Functions to increase articular surface during extension & protect joint volarly
  • More mobile at MCP than IP
56
Q

Biomechanics of the 1st CMC

A
  • Flexion/extension is concave moving on convex
  • Abduction/adduction is convex moving on concave
  • Flexion/abduction the 1st MC rotates ulnarly
  • Extension/adduction the 1st MC rotates radially
57
Q

Normal angle of inclination for the femur, coxa valga, and coxa vara

A
  • Normal: 115-125º
  • Coxa valga: >125º
  • Coxa vara: <115º
58
Q

Normal femoral neck angle anteriorly, ante version, and retroversion

A
  • Normal: 10-15º anterior rotation
  • Anteversion: >25-30º
  • Retroversion: <10º
59
Q

Which direction does the acetabulum face

A
  • It faces laterally, inferiorly, and anteriorly
60
Q

Function of the “Y” illiofemoral ligament

A
  • Both bands taut during extension and ER
  • Superior band taut with adduction
  • Inferior band taut with abduction
61
Q

When is the pubofemoral ligament taut

A
  • Taut with extension, ER, and abduction
62
Q

When is the ischiofemoral ligament taut

A
  • Taut with medial rotation, abduction, & extension
63
Q

Purpose of the Zona orbicularis

A
  • Runs in a circular pattern around femoral neck
  • Has no bony attachments, but helps to hold head of femur in acetabulum
64
Q

Where does the inguinal ligament run

A
  • 12-14cm long, running from ASIS medially and inferiorly, attaching to pubic tubercle
65
Q

Describe the blood supply of the hip

A
  • Proximal femur is supplied by the medial and lateral femoral circumflex
  • Femoral head supplied by a small branch off obturator artery
  • Acetabulum supplied by branches from superior and inferior gluteal arteries
66
Q

How much of which hip joint ROM are required for normal gait over level ground

A
  • 30º flexion
  • 10º extension
  • 5º abduction/adduction
  • 5º IR/ER
67
Q

Which side of the patella has a larger surface area

A
  • Lateral aspect is larger
68
Q

When is the medial collateral ligament of the knee lax versus taut

A
  • Taut in extension
  • Lax in flexion
  • Prevents ER & provides stability against valgus forces
69
Q

When is the lateral collateral ligament of the knee lax versus taut

A
  • Taut in extension
  • Lax in flexion
  • Prevents ER and provides stability against varus forces
70
Q

Where does the ACL attach to and its purpose

A
  • Runs from anterior tibia to medial aspect of lateral condyle of the femur
  • Limits anterior translation of the tibia on the femur & provides rotational stability
71
Q

Where does the PCL attach to and its purpose

A
  • Runs from posterior tibia to lateral surface of medial condyle of femur
  • Checks posterior displacement of tibia on femur
72
Q

Where does the meniscofemoral ligament run

A
  • Runs with the PCL
  • Attaches below the posterior horn of lateral meniscus
  • Common insertion into lateral aspect of medial condyle
73
Q

What does the arcuate popliteal and oblique popliteal ligaments strengthen

A
  • Arcuate is Y-shaped attaching to the fibular head and strengthens the posterolateral capsule
  • Oblique inserts into expansion from tendon of semimembranosus and strengthens posteromedial capsule
74
Q

What does the transverse ligament in the knee attach

A
  • Attaches lateral and medial meniscus anteriorly
75
Q

Purpose of the meniscopatellar ligament

A
  • Pulls menisci forward with extension
76
Q

Purpose of the Alar fold in the knee

A
  • Keeps patella in contact with femur
77
Q

Purpose of infra patellar fold

A
  • Acts as stop gap as it is compressed by patella tendon in full flexion
78
Q

What attaches to the medial meniscus and what does it look like

A
  • Large, C-shaped
  • Semimembranosus muscle and medial meniscopatellar ligament attach
79
Q

What attaches to the lateral meniscus and what does it look like

A
  • Smaller than medial and more circular
  • Popliteus muscle, lateral meniscopatellar ligament, & meniscofemoral ligament attach
80
Q

Describe the movements of the menisci

A
  • Follow tibia with flexion/extenion & femoral condyles with IR/ER
  • Medial moves 6 mm and lateral moves 12mm
  • Isolated tibial IR medial meniscus moves anteriorly while lateral meniscus moves posteriorly
81
Q

What is the “Screw home” mechanism of the knee joint

A
  • 5º of tibial ER during extension in open-chain
  • 5º of femoral IR during extension in closed-chain
  • Unlocked by the action of popliteus muscle
82
Q

What is the “Windlass” effect

A
  • Tightening of the plantar fascia with DF/extension of the MTP joints which occurs during push off
  • Tightening of the fascia causes supination of the calcaneus and inversion of subtalar joint creating a rigid lever for push off
83
Q

What is the rule of 3 for thoracic spinous processes

A
  • T1-T3 spinous processes are even with transverse process of same level vertebra
  • T4-T6 are found one-half level below transverse processes of same level
  • T7-T9 are one full level below transverse process of same level
  • T10 is full level below
  • T11 is one-half level below
  • T12 is level
84
Q

How do the shapes of vertebral bodies differ between cervical, thoracic, and lumbar

A
  • Cervical: rectangular shaped
  • Thoracic: heart shaped
  • Lumbar: kidney shaped
85
Q

Describe the make up of the annulus fibrosis

A
  • Concentric layers composed of collagen (Type I predominates outer layers to withstand shear and type II in inner layers for weight bearing)
  • Outer 1/3 of annulus is innervated by branches from sinovertebral nerve
86
Q

What is the function of the vertebral endplates

A
  • Functions to provide passive diffusion of nutrients
  • Made of fibrocartilage (on side closest to disc) and hyaline cartilage (on side closest to vertebral body)
87
Q

Purpose of the alar ligament

A
  • Attaches dens to occipital condyles
  • Limits flexion, contralateral SBing, and contralateral rotation
88
Q

Purpose of the anterior longitudinal ligament

A
  • Courses on anterior and lateral surfaces of vertebral bodies
  • Reinforces the anterolateral portion of the intervertebral discs
89
Q

Purpose of the posterior longitudinal ligament

A
  • Courses the posterior aspect on the vertebral bodies
  • Limits flexion and reinforces the posterior aspect of the intervertebral discs
90
Q

Purpose of the tectorial membrane

A
  • Superior extension of the posterior longitudinal ligament
  • Limits flexion
91
Q

Purpose of the ligamentum flavum

A
  • Connects laminae of one vertebra to the laminae above
  • Limits flexion particularly in lumbar
92
Q

Purpose of interspinous ligament

A
  • Courses b/w spinous processes
  • Limits flexion & rotation
93
Q

Purpose of the supraspinous ligaments

A
  • Limit flexion
  • Found in lumbar and thoracic regions
94
Q

Function of iliolumbar ligaments

A
  • Very strong and functions to limit motion between L5 and S1
95
Q

Function of the sacrotuberous ligament

A
  • Limits anterior rotation and superior translation of the sacrum
96
Q

At what level do spinal nerves exit from the spinal cord/vertebrae

A
  • Cervical: spinal nerves come out at the level above its associated vertebra
  • Thoracic/lumbar: spinal nerves come out at the level below its associated vertebra
97
Q

At what level does the spinal cord terminate in adults

A
  • Approximately at level of L1-L2 disc (conus medullaris)
98
Q

What are the coupled motions of the spine

A
  • Cervical: SBing and rotation occur in the same direction for C2-C7; for C1 it is opposite
  • Thoracic/lumbar: in extension SBing and rotation are in opposite directions; in flexion SBing and rotation is in the same direction
99
Q

How much lumbar flexion occurs before the pelvis begins to rotate anteriorly

A
  • 60-70º of lumbar flexion followed by pelvis anterior rotation and eventually hip flexion
  • During extension the order is reversed
100
Q

Define nutation

A
  • Movement that involves flexion of sacrum and posterior rotation of ilium
101
Q

Define counternutation

A
  • Describes a movement that involves extension of sacrum and anterior rotation oof ilium
102
Q

What is the functional range of opening for the TMJ

A
  • Functional range oof opening is 40mm, with 25mm of rotation, and 15mm of translator glide

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