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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
Capsular restriction patterns for wrist
- Flexion is equally limited as extension
26
Capsular restriction patterns for fingers
- Flexion > extension
27
Capsular restriction patterns for thoracic spine
- SBing and rotation > extension > flexion
28
Capsular restriction patterns for lumbar spine
- SBing and rotation > extension > flexion
29
Capsular restriction patterns for hip
- Flexion & IR > ABD
30
Capsular restriction patterns for knee
- Flexion > extension
31
Capsular restriction patterns for foot
- PF > DF - IVR > EVR - Supination > pronation
32
Describe a Tenodesis grip
- Passive finger flexion by contraction of wrist extensors when fingers are weak
33
Osteology of humeral head
- Articular surface covered in hyaline cartilage - Head is retroverted 20-30º - Longitudinal axis of head is 135º from axis of neck
34
Orientation of glenoid fossa places true abduction at
- 30º anterior to frontal plane
35
Archeology of sternoclavicular joint
- Convex superior/inferior and concave anterior/posterior articulates with reciprocal shape of sternum - Both articulations covered with fibrocartilage
36
Function of the coracohumeral ligament
- Reinforces biceps tendon, superior capsule & prevent caudal (tail/bottom) dislocation of humerus - Taut with ER
37
Function of coracoacrominal ligament
- Not a "true" ligament - Connects two points of same bone
38
Function of the transverse humeral ligament
- Passes over bicipital groove - Acts as retinaculum for long biceps tendon
39
Function of glenohumeral ligaments and what motions they limit
- 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
40
At ~_____ of elevation, ER (conjunction rotation) occurs, preventing compression of greater tubercle against the acromion
- ~75º of shoulder elevation
41
Purpose of ulnar collateral ligament
- Reinforces humeroulnar joint medially - Triangular shape
42
Purpose of radial collateral ligament
- Reinforces humeroradial joint laterally - Fan shaped and runs from lateral epicondyle of humerus to annular ligament
43
Purpose of annular ligament
- Attaches to anterior/posterior surfaces of ulna near radial notch - Protects radial head especially in semi-flexion - Taut in extremes of pronation/supination
44
Purpose of quadrate ligament
- Reinforces inferior joint capsule - Maintains radial head in opposition to ulna - Limits amount of spin in supination/pronation
45
Purpose of the anterior and posterior radioulnar ligaments
- Strengthens capsule
46
What arteries does the elbow recieve its blood supply from
- Brachial artery - Anterior ulnar recurrent artery - Posterior ulnar recurrent artery - Radial recurrent artery - Middle collateral branch of deep brachial artery
47
Why is the radial collateral ligament not as strong as the ulnar collateral ligament
- 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
Biomechanics of the ulnar during elbow flexion/extension
- Ulna supinates with flexion and pronates with extension - Proximal ulna glides medially during extension and laterally during flexion
49
Is capitate convex or concave in relation to its articulates with scaphoid, trapezoid, and hamate
- Convex
50
What motion does the dorsal radiocarpal ligament limit
- Limits flexion, pronation, & possibly radial deviation of wrist
51
What motion does the radiate ligament limit
- Stabilizes hand for impact
52
What motion does the palmar ulnocarpal ligament limit
- Limits extension and supination of wrist
53
What motion does the palmar radoiocarpal ligament limit
- Limits extension & supination through knuckles
54
What is the extensor hood and its purpose
- 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
What are the volar plates
- 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
Biomechanics of the 1st CMC
- 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
Normal angle of inclination for the femur, coxa valga, and coxa vara
- Normal: 115-125º - Coxa valga: >125º - Coxa vara: <115º
58
Normal femoral neck angle anteriorly, ante version, and retroversion
- Normal: 10-15º anterior rotation - Anteversion: >25-30º - Retroversion: <10º
59
Which direction does the acetabulum face
- It faces laterally, inferiorly, and anteriorly
60
Function of the "Y" illiofemoral ligament
- Both bands taut during extension and ER - Superior band taut with adduction - Inferior band taut with abduction
61
When is the pubofemoral ligament taut
- Taut with extension, ER, and abduction
62
When is the ischiofemoral ligament taut
- Taut with medial rotation, abduction, & extension
63
Purpose of the Zona orbicularis
- Runs in a circular pattern around femoral neck - Has no bony attachments, but helps to hold head of femur in acetabulum
64
Where does the inguinal ligament run
- 12-14cm long, running from ASIS medially and inferiorly, attaching to pubic tubercle
65
Describe the blood supply of the hip
- 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
How much of which hip joint ROM are required for normal gait over level ground
- 30º flexion - 10º extension - 5º abduction/adduction - 5º IR/ER
67
Which side of the patella has a larger surface area
- Lateral aspect is larger
68
When is the medial collateral ligament of the knee lax versus taut
- Taut in extension - Lax in flexion - Prevents ER & provides stability against valgus forces
69
When is the lateral collateral ligament of the knee lax versus taut
- Taut in extension - Lax in flexion - Prevents ER and provides stability against varus forces
70
Where does the ACL attach to and its purpose
- 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
Where does the PCL attach to and its purpose
- Runs from posterior tibia to lateral surface of medial condyle of femur - Checks posterior displacement of tibia on femur
72
Where does the meniscofemoral ligament run
- Runs with the PCL - Attaches below the posterior horn of lateral meniscus - Common insertion into lateral aspect of medial condyle
73
What does the arcuate popliteal and oblique popliteal ligaments strengthen
- 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
What does the transverse ligament in the knee attach
- Attaches lateral and medial meniscus anteriorly
75
Purpose of the meniscopatellar ligament
- Pulls menisci forward with extension
76
Purpose of the Alar fold in the knee
- Keeps patella in contact with femur
77
Purpose of infra patellar fold
- Acts as stop gap as it is compressed by patella tendon in full flexion
78
What attaches to the medial meniscus and what does it look like
- Large, C-shaped - Semimembranosus muscle and medial meniscopatellar ligament attach
79
What attaches to the lateral meniscus and what does it look like
- Smaller than medial and more circular - Popliteus muscle, lateral meniscopatellar ligament, & meniscofemoral ligament attach
80
Describe the movements of the menisci
- 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
What is the "Screw home" mechanism of the knee joint
- 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
What is the "Windlass" effect
- 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
What is the rule of 3 for thoracic spinous processes
- 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
How do the shapes of vertebral bodies differ between cervical, thoracic, and lumbar
- Cervical: rectangular shaped - Thoracic: heart shaped - Lumbar: kidney shaped
85
Describe the make up of the annulus fibrosis
- 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
What is the function of the vertebral endplates
- 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
Purpose of the alar ligament
- Attaches dens to occipital condyles - Limits flexion, contralateral SBing, and contralateral rotation
88
Purpose of the anterior longitudinal ligament
- Courses on anterior and lateral surfaces of vertebral bodies - Reinforces the anterolateral portion of the intervertebral discs
89
Purpose of the posterior longitudinal ligament
- Courses the posterior aspect on the vertebral bodies - Limits flexion and reinforces the posterior aspect of the intervertebral discs
90
Purpose of the tectorial membrane
- Superior extension of the posterior longitudinal ligament - Limits flexion
91
Purpose of the ligamentum flavum
- Connects laminae of one vertebra to the laminae above - Limits flexion particularly in lumbar
92
Purpose of interspinous ligament
- Courses b/w spinous processes - Limits flexion & rotation
93
Purpose of the supraspinous ligaments
- Limit flexion - Found in lumbar and thoracic regions
94
Function of iliolumbar ligaments
- Very strong and functions to limit motion between L5 and S1
95
Function of the sacrotuberous ligament
- Limits anterior rotation and superior translation of the sacrum
96
At what level do spinal nerves exit from the spinal cord/vertebrae
- 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
At what level does the spinal cord terminate in adults
- Approximately at level of L1-L2 disc (conus medullaris)
98
What are the coupled motions of the spine
- 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
How much lumbar flexion occurs before the pelvis begins to rotate anteriorly
- 60-70º of lumbar flexion followed by pelvis anterior rotation and eventually hip flexion - During extension the order is reversed
100
Define nutation
- Movement that involves flexion of sacrum and posterior rotation of ilium
101
Define counternutation
- Describes a movement that involves extension of sacrum and anterior rotation oof ilium
102
What is the functional range of opening for the TMJ
- Functional range oof opening is 40mm, with 25mm of rotation, and 15mm of translator glide

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