other Flashcards

1
Q

typical joint elements – synovial joints

A
  • proximal and distal bone
  • articular/hyaline cartilage
  • capsule
  • ligaments
  • synomivial membrane synovial fluid
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

hilton’s law

A
  • john hilton, british surgeon
  • joint innervation
    • a nerve that innervates a joint also tends to innervate the muscles that move the joint and the skin that covers the distal attachments of the muscle
  • example
    • elbow: radial, median, musculocutaneous, ulnar nn.
    • knee: femoral, sciatic (fibular and tibial), obturator nn.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

fibrocatilage in synovial joints

A
  • meniscus, articular disc, laburm
  • present in tibiofemoral, glenohumeral, acromioclavicular, sternoclavicular, termporomandibular, femoroacetabular
  • purpose: to distibute compressive forces, provide additional joint stability/congruency
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

types of synovial joints

A
  • plane (gliding)
    • acromioclavicular
  • hinge (ginglymus)
    • humeroulnar, tibiofemoral
  • sellar (saddle)
    • sternoclavicular
  • ellipsoidal (condyloid)
    • 2nd MCP
  • ball and socket
    • glenohumeral
  • trochoid (pivot)
    • proximal radioulnar (supination/pronation)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

planar joint

A
  • lack of convexity/concavity along surfaces
  • primary motion is gliding of two surfaces on one another
  • examples
    • AC joint
    • SI joint
    • most spinal facet joints
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

hinge joint

A
  • ginglymus
  • stable
  • examples
    • humeroulnar
    • tibiofemoral
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

sellar (saddle) joint

A
  • examples
    • sternoclavicular joint
      • 1st carpometacarpal joint (thumb)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

ellipsoidal jiont

A
  • CC and CV in all planes
    • ligaments provide stability
  • example
    • metacarpal phalangeal joints
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

pivot (trochoid) joint

A
  • examples
    • atlantoaxial
    • proximal radioulnar
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

convex on concave rule

A

roll and slide/glide opposite

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

concave of convex rule

A

roll and slide/glide same diraction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

joints of the shoulder girdle

A
  • sternoclavicular: only attachment of shoulder to body
  • acromioclavicular: link to skeleton
  • glenohumeral
  • scapulothoracic: pseudojoint, only muscular attachments
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

importance of scapular positioning

A
  • glenoid moves like a seal’s nose to remain in right spot to control ball/head of humerus
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

scapulohumeral rhythm

A
  • consists of integrated movements of GH, ST, AC, and SC joints
  • occurs in sequential fashion to allow full functional motion of shoulder complex
  • serves three purposes
    • allows for greater overall shoulder ROM
    • maintains optimal contact between humeral head and glenoid fossa
    • assists with maintaining optimal length-tension relationship of glenohumeral muscles
      • for stability
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

evidence summary on arm elevation

A
  • scapular upward rotation may be greater on non-dominant side
  • scapulohumeral rhythm between 1:3 and 1:5 depending on plane of humeral motion, side of dominance and age of patient
  • unilateral or bilateral movement alters scapular and thoracic movement patterns
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

role of thoracic spine

A
  • bilateral shoulder motion: 10-30 degrees of thoracic extension (primarily lower) with full shoulder elevation
  • unilateral shoulder motion: 10-30 degrees of thoracic rotation and/or side bending
  • clinical relevance: assess thoracic motion in patients with shoulder symptoms
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

restraints to external rotation at shoulder

A
  • 0 degrees abduction
    • subscapularis
    • SGHL
  • 45
    • SGHL
    • MGHL
  • 90
    • anterior band IGHLC
18
Q

restraints to internal rotation

A
  • 0
    • posterior band IGHLC
  • 45
    • anterior and posterior band IGHLC
  • 90
    • anterior and posterior band IGHLC
19
Q

restraints to inferior translation

A
  • 0
    • SGHL
    • coracohumeral ligament
  • 90
    • IGHLC
20
Q

GH joint accessory motion

A
  • loose/open packed position
    • 55 deg abd, 30 deg horiz add
  • closed packed position
    • end range abduction and ER
21
Q

CV-CC rule in shoulder

A
  • ER always rolls posterior and glide anterior
  • IR always roll anterior and glide posterior
  • flexion always roll superior and glide inferior

NOT ALWAYS in GH joint

humeral head will glide away from the tightest portion of the capsule

22
Q

primary restraint against GH ER with arm at 45 degrees abduction

A
  • middle glenohumeral ligament
23
Q

in protraction of shoulder girdle, what glide occurs at the sternoclavicular joint

A
  • anterior
24
Q

distal attachment of subscapularis muscle

A
  • lesser tubercle of humerus
25
Q

ligaments that restrict superior migration of the clavicle

A
  • costoclavicular ligament
  • conoid ligament
  • acromioclavicular ligament
26
Q

primary stabilizer of GH joint at 90 degrees abduction

A
  • inferior glenohumeral ligament complex
27
Q

carrying angle of elbow

A
  • angle between axis of humerus and axis of forearm
  • female: 12-16
  • male: 10-14
28
Q

pronation and supination

A
  • occurs simultaneously at both proximal and distal radioulnar joints
  • also requires rotation of radius (spin) at humeroradial joint in anular ligament
29
Q

wrist axis of rotation

A
  • flexion/extension: coronal axis between lunate and capitate
  • rad/ulnar deviation: sagittal between unate and capitate
  • circumduction: polyaxial
  • center of rotation is variable dependent upon wrist position and motion
30
Q

radiocarpal kinematics

A
  • gliding of proximal row on radius and TFCC
  • gliding movement opposite from hand (convex on concave)
31
Q

midcarpal biomechanics

A
  • joint: functional rather than anatomic convex on concave configuration (tongue and groove)
  • motion: favors extension over flexion, opposite RC joint
    • small amount of RD/UD
32
Q

ligamentous stability “ring” system

A
  • lichtman describes the carpus as “ring” system”
    • bones within each row tethered together by interosseous ligaments
    • ring is only complete by addition of midcarpal ligaments
    • carpal bones move together as a unit
33
Q

during wrist flexion, both rows flex and vice versa in extension

A
  • 50% at MC and 50% at RC joints, but amount varies
34
Q

configuration of SI joints

A
  • extremely variable from person to person in terms of morphology and mobility
  • differences are not pathological, but are normal adaptations and anatomical variation
35
Q

primary function of SIJ

A
  • distribute forces through pelvic ring
36
Q

stresses on knee ligaments

A
  • valgus F stresses MCL
  • varus stresses LCL
  • anterior tensions ACL
  • posterior tensions PCL
37
Q

menisci and weight bearing

A
  • designed to distribute forces – hoop stress
    • WB restrictions after surgery
38
Q

meniscal blood supply

A
  • blood flow is greatest in the peripheral 1/3 and is least in central 1/3
  • healing capacity is vascularity and age dependent
    • also repeated injury
39
Q

medial meniscus repair considerations

A
  • femoral condyle imparts sheer force to meniscus in weightbearing beyond 115-120 degrees of knee flexion
  • hamstring contraction indirectly “tugs” on posterior horn of mensicus
40
Q

patellofemoral joint – compressive forces

A
  • increase with degree of flexion angle at knee
  • increase with quadriceps muscle force production
  • surface area of contact increases with flexion
    • increased surface area results in reduced focal areas of pressure
41
Q

rearfoot-midfoot function

A
  • supination
    • perpendicular axes –> rigid lever to push off
    • good for propelling forward (toe off)
  • pronation
    • parallel axes –> “loose bag of bones”
    • attentuate forces for heel strike
42
Q

ground up or hip down for supination and pronation

A
  • both