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Applied Kinesiology > Week 4 > Flashcards

Week 4 Flashcards

1
Q

What are the 4 joints of the shoulder complex?

A
  • sternoclavicular joint
  • acromioclavicular joint
  • glenohumeral joint
  • scapulothoracic
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2
Q

What are the characteristics (articulation and what joint type) of the sternoclavicular joint?

A
  • medial clavicle with notch of manubrium and 1st costal cartilage
  • saddle joint - convex on concave
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3
Q

Describe the orientation of the saddle joint of the SC joint in the superior to inferior direction and in the anterior to posterior direction.

A
  • superior/inferior - convex on concave (elevation/depression)
  • medial/lateral - concave on convex (protraction/retraction)
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4
Q

What is the function of the sternoclavicular fibrocartilage?

A
  • promotes stability
  • increase joint congruence
  • absorbs forces
  • helps limit medial movement of clavicle
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5
Q

What are the osteokinematics of the SC joint?

A
  • elevation/depression
  • protraction/retraction
  • anterior/ posterior rotation
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6
Q

What are arthrokinematics of elevation/depression of SC joint?

A

Convex on concave

Elevation
- superior roll, inferior glide

Depression
- inferior roll, superior glide

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7
Q

What are arthrokinematics of protraction/retraction of SC joint?

A

concave on convex

Protraction
- anterior roll and glide

Retraction
- posterior roll and glide

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8
Q

What are arthokinetmatics of anterior/posterior rotation of SC joint?

A

Spin

Posterior Rotation
- Inferior surface turns anteriorly (backward rotation)

Anterior Rotation
- Inferior surface returns to inferior position - only occurs after posterior rotation

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9
Q

What is the closed packed position for the SC joint?

A

full posterior rotation

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10
Q

What is the function of the AC joint and what osteokinematic motions are associated with the AC joint?

A
  • allow the scapula to rotate during arm movement
  • internal/external rotation
  • anterior/posterior tilting
  • upward/downward rotation
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11
Q

Describe the plane of the scapula.

A
  • around 35 degrees off the frontal plane

- plane where scapula is best in contact with the rib cage

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12
Q

What is the purpose of internal/external rotation of AC joint?

A

important for maintaining contact of scapula on curved thorax during protraction and retraction of clavicle

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13
Q

What is the purpose of anterior/posterior tilting of AC joint?

A

Important for maintaining contact of scapula on curved thorax during elevation and depression of clavicle

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14
Q

What is the purpose of upward/downward rotation of AC joint?

A

Important for positioning glenoid fossa in optimal position in order to maintain contact with humerus

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15
Q

What shoulder motions move the scapula in an upward rotation?

A

flexion and abduction

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16
Q

What shoulder motions move the scapula in a downward rotation?

A

adduction and extension

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17
Q

What is closed packed position of the AC joint?

A

full upward rotation - full shoulder abduction and/or flexion

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18
Q

What are the primary and secondary osteokinematic motions associated with the scapulothoracic joint?

A

Primary

  • elevation/depression
  • protraction/retraction
  • upward/downward rotation

Secondary

  • Anterior/posterior tilting
  • internal/external rotation
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19
Q

Elevation/depression of scapulothoracic joint is a combination of what 2 joint movements?

A

Elevation
- SC joint elevation and AC joint downward rotation

Depression
- SC joint depression and AC joint upward rotation

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20
Q

Protraction/retraction of scapulothoracic joint is a combination of what 2 joint movements?

A

Protraction
- SC joint protraction and slight AC joint IR

Retraction
- SC joint retraction and slight AC joint ER

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21
Q

Upward rotation/downward rotation of scapulothoracic joint is a combination of what 2 movements?

A

Upward Rotation

  • SC joint elevation and AC joint upward rotation
  • observed during shoulder flexion/abduction

Downward Rotation
- SC joint depression and AC joint downward rotation

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22
Q

Describe and define the angle of inclination and the angle of torsion at the GH joint.

A

Angle of Inclination - 130-150 degrees in frontal plane

Angle of torsion
- orientation of humeral head w/ the condyles - 30 degrees posterior in traverse plane

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23
Q

Define retroversion of the GH joint. What function does normal retroversion serve?

A
  • posterior orientation of humeral head w/ regard to the condyles
  • keeps humeral head in contact with glenoid during movement
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24
Q

Describe the characteristics and functions of the glenoid labrum and joint capsule.

A

Glenoid labrum

  • Enhances concavity and increases articular surface
  • Resists humeral head translations, dissipates forces, protects bony edges
  • Attachment of glenohumeral ligaments and tendon of biceps long head

Joint Capsule

  • Significant laxity, minimal stability provided
  • Potential volume size is 2x size of humeral head
  • Reinforced by thicker external ligaments
  • Inferior portion is slack in adducted position creating axillary pouch
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25
Q

What are the ligaments of the glenohumeral joint?

A
  • superior glenohumeral ligament
  • middle glenohumeral ligament
  • inferior glenohumeral ligament
  • coracohumeral ligament
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26
Q

What is the function of the superior glenohumeral ligament?

A
  • Limits external rotation and anterior & inferior translation at 0° abduction
  • Slackens when abducted beyond 35-45 degrees
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27
Q

What is the function of the middle glenohumeral ligament?

A
  • limits anterior translation from 45-90 degrees abduction and extremes of external rotation
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28
Q

What are the components and what is the function of the inferior glenohumeral ligament?

A

3 components
- anterior band, posterior band, and axillary pouch

  • primary stabilizer beyond 45 degrees of abduction or with combined abduction and rotation
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29
Q

With abduction, the axillary pouch of the inferior glenohumeral ligament resists _____ & ______ translation

A

inferior and anterior-posterior

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30
Q

With abduction and lateral rotation, the anterior band of the inferior glenohumeral ligament resists _______ translation.

A

anterior

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31
Q

With abduction and medial rotation, the posterior band of the inferior glenohumeral ligament resist _______ translation

A

posterior

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32
Q

What is the function of the coracohumeral ligament?

A

limits inferior translation and external rotation of the humeral head w/ the arm in the dependent position

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33
Q

Describe the function of the rotator cuff.

A
  • reinforce the GH joint capsule

- stabilize GH joint w/ dynamic activities

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34
Q

Where does the rotator cuff not reinforce the GH joint?

A

inferiorly and region between subscapularis and supraspinatus

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35
Q

What are the osteokinematics and arthrokinematics of the GH joint?

A

Osteokinematics

  • flexion/extension
  • adduction/abduction
  • external/internal rotation

Arthrokinematics

  • spin
  • superior/inferior glide
  • anterior/posterior glide
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36
Q

What are arthrokinematics during flexion/extension of GH joint?

A

convex on concave

Flexion
- superior roll, inferior slide

Extension
- inferior roll, superior glide

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37
Q

What are arthrokinematics during adduction/abduction of GH joint?

A

Convex on concave

Adduction
- inferior roll, superior glide

Abduction
- superior roll, inferior glide

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38
Q

What movement accompanies full abduction of GH joint?

A

external rotation

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39
Q

What are the arthokinematics of external/internal rotation of GH joint?

A

convex on concave

External rotation: posterior roll, anterior glide

Internal rotation
- anterior roll, posterior glide

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40
Q

What is closed packed position of the GH joint?

A

90 degrees and full external rotation or full abduction and external rotation

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41
Q

What is the capsular pattern of the GH joint?

A

external rotation > abduction > internal rotation

42
Q

Describe scapulohumeral rhythm.

A

Ratio of 2 degrees of glenohumeral to 1 degree of scapular motion during arm elevation/abduction
- 2:1

43
Q

Discuss the 6 principles associated with full abduction of the shoulder.

A

1) 2: scapulohumeral rhythm - active shoulder abduction of about 180 degrees occurs as a result of simultaneous 120 degrees of GH joint abduction and 60 degrees of scapulothoracic upward rotation
2) The 60 degrees of upward rotation of the scapula during full shoulder abduction is the result of a simultaneous elevation at the SC joint combined with upward rotation at the AC joint
3) The clavicle retracts at the SC joint during shoulder abduction
4) The upwardly rotating scapula posteriorly tilts and, less consistently, externally rotates slightly during full shoulder abduction
5) The clavicle posteriorly rotates around its own axis during shoulder abduction
6) The GH joint ER during shoulder abduction

44
Q

What is the ideal position for shoulder girdle posture?

A
  • Slightly elevated and relatively retracted scapula

- Results in glenoid fossa facing slightly upward

45
Q

Describe the position of the shoulder girdle in rounded shoulders posture. What could this posture predispose an individual to?

A
  • Slight depression, downward rotation and protraction of scapula
  • predisposes to individual to impingement
46
Q

What muscles act as a force couple to produce upward rotation at the GH joint?

A

serratus anterior, upper trapezius, and lower trapezius

47
Q

What joints comprise the elbow complex?

A
  • humeroulnar and humeroradial

- proximal and distal radioulnar

48
Q

Describe the characteristics of the joint capsule of the elbow complex.

A
  • Large, loose and weak anteriorly and posteriorly
  • Contains folds that are able to expand to allow for a full range of elbow motion
  • Fat pads located between the capsule to decrease friction
  • Reinforced laterally by collateral ligaments
49
Q

What is the carrying angle and why is it significant?

A
  • valgus angulation of forearm
  • allows for a person to carry object away from side of the thigh
  • 8-15 degrees
50
Q

What are the ligaments of the elbow joint?

A
  • Medial collateral ligament - anterior, posterior, and transverse
  • Lateral collateral ligament complex - lateral (radial) collateral ligament, lateral ulnar collateral ligament, and annular ligament
51
Q

What are the functions of the medial and lateral collateral ligaments of the elbow?

A

medial - prevent valgus

lateral - prevent varus

52
Q

Describe what happens at the elbow as a result of an extreme valgus-producing force?

A

May result in rupture of medial collateral ligament and/or compression force within the humeroradial joint

53
Q

What are arthrokinematics of flexion/extension of elbow joint?

A

concave on convex

flexion - roll anterior, slide anterior

extension - roll posterior, slide posterior

54
Q

What is closed packed position of the elbow joint?

A
  • Humeroulnar: Full extension and supination

- Humeroradial: 90° elbow flexion and 5° supination

55
Q

What is open packed position of the elbow joint?

A
  • Humeroulnar: Flexed 70°, supinated 10°

- Humeroradial: Full extension and supination

56
Q

What is the capsular pattern of the elbow joint?

A

flexion > extension

57
Q

What are the osteokinematics and arthokinematics at proximal radioulnar joint?

A
  • supination - lateral rotation

- pronation - medial rotation

58
Q

What are the osteokinematics and arthokinematics at distal radioulnar joint?

A

concave on convex

  • supination - roll and slide laterally
  • pronation - roll and slide medially
59
Q

What compensatory shoulder motion could help someone who is lacking in forearm pronation and/or supination to increase this forearm ROM in OKC?

A
  • supination - external rotation of shoulder

- pronation - internal rotation of shoulder rotation

60
Q

Describe what happens in closed chain supination and pronation.

A
  • humerus and ulna rotate relative to a fixed radius/hand
  • pronation is a result of shoulder external rotation
  • supination is a result of internal rotation
61
Q

What is the closed packed position of the proximal and distal radioulnar joints?

A

Proximal
- 5° of supination

Distal
- 5° of supination

62
Q

What is the open packed position of the proximal and distal radioulnar joints?

A

Proximal
- 70° of flexion, 35° of supination

Distal
- 10° of supination

63
Q

What is the capsular pattern of the proximal and distal radioulnar joints at the elbow?

A

supination = pronation

64
Q

Describe the relationship of flexion torque with the elbow in a supinated position compared to a pronated position.

A
  • 20-25% more force in supinated position

- this is because biceps is stretched during pronation - passive insufficiency

65
Q

Describe the relationship of elbow pronation and supination with shoulder IR and ER

A
  • pronation - associated with shoulder IR
  • supination - associated with shoulder ER
  • Important to keep in mind when testing forearm pronation and supination - hold elbow at 90 and pressed to side to block humerus torque
66
Q

Describe what happens when a task requires high-power supination torque

A
  • biceps is recruited
  • triceps must co-contract to prevent biceps from flexing elbow and shoulder
  • ex: turning a screwdriver
67
Q

What is the law of parsimony? Give some examples of parsimony at work in the musculoskeletal system.

A
  • nervous system tends to activate the fewest muscles or muscle fibers possible for the control of a given joint action
  • ex: Lower powered activities utilize pronator quadratus while higher powered activities also recruit pronator teres
68
Q

Name the joints of the wrist and hand complex.

A
  • distal radioulnar
  • radiocarpal and midcarpal
  • carpometacarpal
  • metacarpophalangeal
  • interphalangeal
69
Q

Describe the benefit of the wrist joint being compromised of the radiocarpal and midcarpal joints

A
  • Permits large ROM with less exposed articular surface and tighter joint capsules
  • Less tendency for structural pinch at extremes of motion
  • Allows for flatter multi-joint surfaces that are more capable of withstanding imposed pressures
70
Q

Describe the function of the extensor retinaculum and palmar carpal ligament

A
  • prevent bowstringing during wrist movements
71
Q

What bones are in the 1st row (proximal) of carpals?

A
  • lunate, scaphoid, triquetrum
72
Q

What bones are in the 2nd row (distal) of carpals?

A
  • pisiform
  • hamate
  • capitate
  • trapezoid
  • trapezium
73
Q

What factors may result in carpal tunnel syndrome?

A
  • overcrowding
  • excessive mechanical stress
  • fibrotic changes of connective tissues
74
Q

What are the osteokinematcs at the wrist joint?

A
  • flexion/extension

- radial/ulnar deviation

75
Q

What are arthrokinematics at wrist joint during flexion/extension?

A

convex on concave

Flexion
- anterior roll, posterior glide

Extension
- posterior roll, anterior glide

76
Q

What are arthrokinematics at wrist joint during radial/ulnar deviation?

A

convex on concave

radial deviation
- lateral roll, medial glide

ulnar deviation
- medial roll, lateral glide

77
Q

What is the closed packed position of the wrist joint?

A

Full extension with radial deviation

78
Q

What is the open packed position of the wrist joint?

A

Neutral flexion/extension with slight ulnar deviation

79
Q

What is the capsular pattern at the wrist joint?

A

flexion = extension, slight radial and ulnar deviation

80
Q

Describe the length tension relationship of grip strength

A
  • Max grip at 30 degrees of extension

- as you move into more flexion and extension, you lose power - active insufficiency

81
Q

How do the FCU and the FCR act synergistically when performing active wrist flexion?

A

FCU and FCR act synergistically to oppose ulnar and radial deviation during active wrist flexion

82
Q

Describe the function of the ulnar collateral ligament and the radial collateral ligament in the 1st CMC joint.

A

ulnar collateral ligament
- prevent excessive ulnar deviation

radial collateral ligament
- prevent excessive radial deviation

83
Q

What are the osteokinematics of the 1st CMC joint?

A
  • flexion/extension
  • abduction/adduction
  • opposition/reposition
84
Q

What are arthrokinematics of flexion/extension at 1st CMC joint?

A

Concave on convex

Flexion
- medial roll and glide

Extension
- lateral roll and glide

85
Q

What are arthrokinematics of adduction/abduction of 1st CMC joint?

A

Convex on concave

Adduction
- anterior roll, posterior glide

Abduction
- posterior roll, anterior glide

86
Q

What motions happen during opposition and reposition at 1st CMC joint?

A

opposition
- abduction, flexion, and internal rotation

reposition
- adduction, extension, and external rotation

87
Q

What is the closed packed position of the carpometacarpal joints?

A

full oposition

88
Q

What is the open packed position of the carpometacarpal joints?

A

mid flexion/extension and mid abduction/adduction

89
Q

What is the capsular pattern at the 1st CMC joint?

A

abduction

90
Q

What are osteokinematics at MCP joints?

A
  • flexion/extension
  • abduction/adduction
  • circumduction
91
Q

What are arthrokinematics of flexion/extension at MCP joints?

A

concave on convex

Flexion
- anterior roll and glide

Extension
- posterior roll and glide

92
Q

What are arthrokinematics of abduction/adduction at MCP joints?

A

concave on convex

Abduction
- roll and glide away from 3rd digit

Adduction
- roll and glide toward 3rd digit

93
Q

What is closed and open packed position of MCP joints?

A

closed - full flexion

open - slight flexion

94
Q

What is capsular pattern of MCP joints?

A

flexion = extension

95
Q

What are the osteokinematics and arthrokinematics of IP joints?

A

concave on convex

Flexion - roll palmar/anterior, slide palmer/anterior

Extension - roll dorsal/posterior, slide dorsal/posterior

96
Q

What is closed and open packed position of IP joints?

A

closed - full extension

open - slight flexion

97
Q

What is capsular pattern at IP joints?

A

flexion = extension

98
Q

What is the function of the flexor mechanism?

A

Function to prevent bowstringing of the tendons with contraction of extrinsic finger flexors

99
Q

What is the position of function of the wrist, fingers and thumb.

A

Wrist
- 20-30 degrees of extension with slight ulnar deviation

Fingers
- 35-45 degrees of MCP flexion & 15-30 degrees of PIP and PIP joint flexion

Thumb
- 35-45 degre3es of CMC joint abduction

100
Q

What is the function of the extensor mechanism?

A
  • primary distal attachment for extensor digitorum, extensor indicis, and extensor digiti minimi

Applied Kinesiology (7 decks)

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