K and B unit 01

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K and B unit 01
2011-09-30 00:04:32
Kinesiology Biomechanics

Unit 1
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  1. Define: Kinesiology
    The study of movement & the active & passive structures involved
  2. Define: Biomechanics
    Biomechanics – evaluates the motion of a living organism and the effects of force, internal or external, on the organism
  3. Define: Kinetics
    Kinetics – Describes the effect of forces
  4. Define: Kinematics
    Kinematics – describes motion without respect to forces
  5. What are the Applications of Kinesiology to PT
    • Manual muscle testing
    • Evaluation of mechanics of injury
    • Therapeutic exercise prescription
    • Joint mobilization
    • Assessment of gait and posture
  6. Name and define the Two pure types of Kinematics motion?
    • Translatory - Movement along a straight pathway (unconstrained segment)
    • Each point on the segment moves through the same distance at the same time
    • Doesn’t occur in a pure sense in the body

    • Rotary Motion - occurs around a fixed axis.
    • Each point moves through the same angle at the same time.
    • The human body rarely has a fixed axis and so an instantaneous axis of rotation is used to determine where the axis is during the range of motion of a joint
  7. What is the name for the type of kinematic motion which includes both rotation & translation
  8. Name, and describe the two positions commonly used in anatomy texts?
    Anatomic position - serves as our reference position

    Fundamental - Same as Anatomic but hands face medially
  9. What is Osteokinematics?
    Osteokinematics describes the motion of bones; typically around an axis or along an axis.

    These motions occur in one of 3 Planes of motion

    Axes of rotation with regard to planes of motion
  10. Name all 3 planes of motion in Osteokinematics and list the axes of rotation for each plane?
    • Mediolateral axis – Sagittal plane
    • Anteroposterior axis – Frontal plane
    • Vertical Axis – Horizontal plane
  11. Name the Factors influencing Osteokinematics?
    • Joint surface
    • Tissue bulk
    • Connective tissue
    • Bony limitation
  12. Name some of the most common Osteokinematic Movements?
    • Flexion/Extension
    • Abduction/Adduction
    • Rotation
  13. Name the Osteokinematics: for the Scapula?
    • Protraction /Retraction of scapula
    • Elevation /Depression of scapula
    • Upward rotation / Downward rotation of scapula
  14. Name the Typical Osteokinematic motions that occur in Multiplanes?
    • Circumduction
    • Pronation / Supination (at ankle and subtalar joint)
  15. Name and define the 3 Types of Arthrokinematic Motions?
    • Roll - Movement in which points, at equal intervals, on a moving joint surface contact points on the opposing surface.
    • Example: Ball rolling on the ground

    • Glide - Movement in which a single contact point on the moving surface contacts numerous points on the opposing surface
    • Example:Tires sliding on an icy road

    • Spin - Rotation around a stationary mechanical axis
    • Example:A top spinning or the stationary axel of a car
  16. In what Atherokinematic motions does spin occur?
    • Where spin occurs
    • Forearm pronation/supination
    • Shoulder flexion/extension
    • Hip flexion/extension
    • SC joint rotation
  17. T/F - Glide can occur alone but Roll and glide occur together?

    Because if only roll took placethe moving bone wouldtend to dislocate, and If only glide took place, the moving bone would tend to impinge and prevent full ROM.
  18. What are the Two Rules to Determine Arthrokinematic Motions for a Particular Osteokinematic?
    • 1. Decide which direction the shaft of the bone is traveling
    • -Roll is always in the direction of bone movement (distal aspect of shaft -

    Example: If the tibia moves anterior then roll will also be anterior

    2. Determine which joint surface is relatively fixed (stable) -

    If the convex segment is fixed and the concave segment is movingRoll and Glide occur in SAME direction

    -If the concave segment is fixed and the convex segment is movingRoll and Glide occur in the OPPOSITE direction
  19. Shoulder Abduction What direction is the upper arm traveling?

    What bone is relatively fixed?

    The fixed bone has what type of joint surface?
    • Shoulder Abduction What direction is the upper arm traveling?
    • Superior
    • What bone is relatively fixed?
    • Scapula

    The fixed bone has what type of joint surface?

    ConcaveWhat are the resulting arthrokinematics?Superior Roll and Inferior Glide (Roll / Glide Opposite)
  20. Elbow Flexion What direction is the forearm traveling?

    What bone is relatively fixed?

    The fixed bone has what type of joint surface?

    What are the resulting arthrokinematics?
    Elbow Flexion What direction is the forearm traveling? Anterior

    • What bone is relatively fixed? HumerusThe fixed bone has what type of joint surface?
    • Convex
    • What are the resulting arthrokinematics?

    Anterior Roll and Anterior Glide (Roll / Glide Same)
  21. What is Joint Congruency, name the two types of it?
    The fit of the joint Can be

    • Close-packed
    • Open-packed
  22. What happens to a joint in a close-packed postion?
    • Joints become maximally congruent
    • Most ligaments and capsule are pulled taught
    • Provides stability
    • Arthrokinematic motions are very limited
  23. What happens to a joint in a open-packed postion?
    • All other positions from close-packed position
    • Ligaments and capsule
    • slacken Allows for mobility
  24. Define Force?
    Force – a push or pull exerted by one object or substance on another
  25. Name the two types of forces?
    Internal and external
  26. What is COM or COG?
    Point of application – Center of Mass (COM) or gravity (COG)

    in the overall human body this point occurs around (COM) at S2 (2nd sacral vertebra)
  27. T/F Does every body have it's own COM?
  28. What is LOG and how is it magnitude determined?
    Direction – line of gravity (LOG) is the direction of the force of gravity

    Magnitude – determined by the distance from the center of the earth
  29. Define BOS?
    Base of support (BOS) is the contact that the body has with the ground
  30. What determines the stabilit of the over all human body?
    Stability is determined by where the LOG falls in relationship to the BOS

    hence a wider base of support or a lower center of gravity makes you more stable.
  31. Name 4 external forces and two internal forces?
    • External
    • Gravity
    • Bouyancy
    • Air resistance
    • Friction

    • Internal
    • Elasticity
    • Muscle contraction
  32. What is newtons law of inertia?
    Inertia is the property of an object that resists both initiation and change in motion

    Is proportional to its mass

    Application – Walkers
  33. What is Newton’s Law of Acceleration?
    Acceleration is proportional to the net unbalanced forces and inversely proportional to its mass

    Acceleration is in the direction of the unbalanced force

    Is related to the Law of Inertia based on mass
  34. What is newtons law of reactions?
    All forces come in pairs that are applied to contacting objects, are equal in magnitude and opposite in direction

    Impact on PT is in things like Ground reaction force
  35. Explain what a linear forces system is?
    When two or more forces act:on the joint of interest in the same plane and in the same line (if tails were extended would overlap)
  36. What types of force are created on joints do to a linaer force system?
    Results of linear force systems

    Traction/Distraction: net force moves a bony segment away from its adjacent bony segment

    Compression: two segments are pushed together

    Shear: a force that moves or attempts to move one object on another
  37. What is a Concurrent force system?
    Concurrent Force System

    When two forces are applied to the same object are not collinear but intersect

    Most forces acting on the body are concurrent

    Graphically you can understand how forces interact with each other by using the parallelogram method
  38. What is the parallelogram method?
    It is a graphical way to determine a resultant force vecotor. From two other forces.
  39. Muscle contractions create internal force vectors. Since most muscles attach at an angle the force vector created can be resolved into components. These components have different effects on the joint depending on their direction, what are these effects?
    Normal force – forces perpendicular to the bone shaft where the muscle attaches

    May cause translation or rotation

    Tangential force – forces acting parallel to the bone shaft where the muscle attaches

    May occur as a compression or distraction within the joint
  40. Force through the COM will cause what type of effect on a joint?
    Force through the COM will cause translation
  41. Force away from the COM with a fixed axis will cause what type of motion?
    Force away from the COM with a fixed axis will cause rotation
  42. Strength of rotation is known as? What is the equation for this force?

    Torque = Force x moment arm
  43. Explain what Musculoskeletal Levers are and what componets make them up?
    Definition – A rigid segment that rotates around an axis, which produces torque

    What’s NeededTwo forces – Load (L) and Effort (acts to move the lever in the opposite direction of the Load)

    Two moment arms are associated with levers, may have different lengths

  44. Explaine: Type 1 lever?
    1st Class levers: Axis is in between the effort and load forces

    Common Example: teeter totter

    Uncommon in the human bodyExample – Atlanto-Occipital jt
  45. Explain a second class lever?
    Second Class Levers: load force is between the axis and the effort force

    Common Example: Wheel barrow

    Unusual in human bodyExample – Raising heels off of ground
  46. Explain: what a 3rd class lever is?
    Third class levers: effort force is between the axis and the load force

    Examples: Shovel

    • Most musculoskeletal levers in body are 3rd class
    • Example – bicep curls
  47. Define the two types of kinamatic chains?
    Open Chain – distal segment is free to move while the proximal segment is fixed

    Closed Chain – proximal segment is free to move while the distal segment is fixed

    Whenever the foot or hand is contacting an object, certain joints may NOT be in closed chain position
  48. What are the three classifications of Joints by anatomical structure?
    • Three types:
    • Synarthrosis
    • Amphiarthrosis
    • Diarthrosis
  49. What Ct makes up a Synarthrosis joint, how much motion is it capable off and list an example?
    Joint Material – Dense, irregular connective tissue

    Available Motion – negligible

    Examples – Interosseous membrane
  50. What CT makes up a Amphiarthrosis joint, how much motion is it capable off and list an example?
    Joint Material – hyaline cartilage or fibrocartilage

    Available Motion – minimal

    Examples – Intervertebral disk, pubic symphysis
  51. What CT makes up a Diarthrosis joint, how much motion is it capable off and list an example?
    Joint Material – true joint space filled with synovial fluid, surrounded by a capsule

    Available Motion – extensive

    Examples – will be listed on a different slide
  52. Name the Elements of Diarthrodial Joints? Specify which are required and which aren't required?
    RequiredSynovial fluid – provides nutrition to articular surface

    Articular cartilage – allows for near frictionless movement

    Articular capsuleCapsular ligaments

    Not RequiredMenisci & Labra – increase stability (increase congruence), provide shock absorption, & facilitate motion
  53. Classify of synovial joints based on planes of motion?
    • Uniaxial – movement in one plane
    • Hinge
    • Pivot

    • Biaxial – movement in two planes
    • Condyloid
    • Saddle

    • Triaxial – movement in three planes Ball and socket
    • Random - Plane
  54. Give an example of each type of Synovial joint?
    • Hinge: Humeroulnar joint
    • Pivot: Proximal radioulnar
    • Condyloid: Metacarpophalangeal
    • Saddle: 1st Carpometacarpal joint
    • Ball and socket: Glenohumeral
    • Plane: Intercarpal joints
  55. Name some of the CT marterials that make up joints?
    • Bone
    • Compact
    • Trabecular

    • Dense
    • Regular
    • Irregular

    • Cartilage
    • Hyaline
    • Fibrocartilage
  56. Name the cells that form CT?
    • Cells
    • Chondroblast - Found in cartilage
    • Creates mostly Type II collagen

    • Fibroblast - Found in tendon, ligament, and bone
    • Creates mostly Type I collagen

    • Osteoblast - Found in bone
    • Creates mostly Type I collagen and hydroxyappatite
  57. What is the EMC and what two layers make it up?
    Extracellular Matrix (ECM) – Function of connective tissue is primarily determined by the ECM

    • Two parts
    • Interfibrillar
    • Fibrillar
  58. list and define the cells that make up the ECM – specificly the Interfibrillar part?
    Glycoprotein – carbohydrate covalently bound to protein. They Fasten various components of the ECM together

    Proteoglycans – similar to glycoproteins; differ in the number of carbohydrates attached. Distinguished by their protein core and their attached Glycosaminoglycans (GAG)

    • Glycosaminoglycans (GAG) - Attract water through their GAGs.
    • Proportion of GAGs determine how much water is contained in connective tissue

    Regulate collagen fibril size

    Are increased in tissues subjected to alternating cycles of compression
  59. Name and define the fibers that make up the Fibrillar part of the ECM?

    Type I Collagen - Most common, it has a high tensile strength. Found in ligaments, tendons, fascia, and fibrous capsules.

    Type II Collagen - Possess less tensile strength as type I. Helps maintain the general shape and consistency of structures. Found mainly hyaline cartilage and center of intervertebral disk

    • ElastinHave more give when stretched. Readily return to their original shape after being deformed.
    • Found in small quantities in load bearing tissues
  60. Define: Load and deformation?
    Load: external force(s) applied to a structure

    Deformation: caused by a force that acts upon a structure
  61. Name and define the types of load?
    • Tensile – pull apart
    • Compressive – push together
    • Torsional – twisting
    • Shear – surfaces try to slide past each other
    • Combination – bending; tensile and compression on opposite sides
  62. Define stress and strain?
    Stress is a measure of load that is in an object

    Equal to force / cross sectional area

    Strain is a relative deformation (change in length, width, or shape) of a structure
  63. What is the stress strain curve?
    Plotting the stress against the strain – gives information about the properties of the material.
  64. There are five regions or points/regions on the stress-strain curve define them?
    Toe region - Slack of tissues is taken up

    Elastic region - Slope of elastic region is referred to as Young’s Modulus or Modulus of Elasticity. Is a measure of the material’s stiffness. In the elastic region - Fibers are elongated and resist the force – influenced by the type of collagen, fibril size, and cross-linking between fibrils

    Yield point - Marks the end of the elastic region and the start of the plastic region.

    Plastic region - Permanent deformation after load is removed. Progressive failure as stress continues

    Ultimate failure point
  65. Where on the stress-strain curve will you find a grade I ligament sprain? (injury to a few ligament fibers)
    Early part of plastic range
  66. Where on the stress-strain curve will you find a grade III ligament sprain? (complete rupture of lig)
    At failure point
  67. Define Viscoelasticity?
    Materials where the stress-strain curve changes as a function of time
  68. T/F Rate of loading - Slope is greater if load is applied quickly. Slope is less if same load is applied slowly.
    This Helps protect underlying structures.
  69. Define Creep and explain how CT tissue demonstrate creep?
    Creep - is a progressive strain of a material under a constant load over time.

    Tendons or ligaments demonstrate creep through tensile loads.

    Bone or cartilage demonstrate creep through compressive loads.
  70. What is Viscoelasticity –Stress Relaxation?
    If the strain is held constant, the stress decreases with time.
  71. Name the different names for the two Types of Bone.
    Compact, Cortical or Lamellar

    Trabecular, Spongy or Cancellous
  72. Explaine the microstructure of compact bone?
    Central Canal- runs parallel to bone, and contain nerves, veins, and arteries, around this is are the Lamella- Concentric layers of bone that surround central canal, each layer contains collagen fibers at a 45 degree angle and each layer runs opposite to the one beneath.

    Within this is the Lacunae- small cavities between adjacent lamella. They are connected by canaliculi, which allow nutrients to pass through them.
  73. Explain the Microstructure of Trabecular Bone?
    Lamellae not arranged in concentric layers. Arranged in lines corresponding to where max stress is applied in the body
  74. What are the implications if compact bone is stiffer than trabecular bone?
    Can have more force applied before failure
  75. What are the implications if trabecular bone can withstand greater strain than compact bone?
    Can elongate further before failure
  76. What cause microfractures in Trabecular bone?
    • Compressive loading will cause hyptertrophy in trabecular bone
    • Dependent on rate, frequency, duration, and magnitude microfractures can occur do to
    • High repetitions with a low load
    • Low repetitions with a high load
  77. What are the properties of tendons?
    Collagen fibers are nearly parallel; when straightened not all fibers will be affected the same due to the nearly parallel arrangement.

    Cross-sectional area, composition of the tendon, and the length of the tendon determine the amount of force that can be resisted.

    Transition regions (muscle to tendon; tendon to bone) render tendons more susceptible to injury due to changes in composition.

    In response to a tensile force, tendons have a moderate ↑ in thickness & strength
  78. What are the properties of ligaments?
    Are similar to tendons mechanically. The more variable collagen orientation make ligaments more able to function in a range of load directions without being damaged.

    Handle tensile forces from multiple directions

    Intermittent tension will cause an increase in thickness and strength to ligaments
  79. What are the properties of Cartilage?
    In order for cartilage to withstand compressive forces it must have an intact collagen network and proteoglycan/GAG matrix.

    The compressive load is supported by both the fluid components and solid components of cartilage Upon being loaded in compression, fluid will be “squeezed” out of the solid component region and with the removal of the load the fluid will enter via an osmotic gradient

    Behavior to tensile stresses is similar to tendons and ligaments.

    Resistance to shear stresses is dependent on the collagen present
  80. Is loading excercise good for cartilage?
    Some level of loading or exercise is appears to be beneficial for cartilage – The magnitude or frequency is yet to be determined
  81. What are the General Changes that occur do to Immobilization?
    Immobilization can be due to a inflammation, cast, bed rest, weightlessness, or denervation If immobilization is due to inflammation, a loose pack joint position will be assumed. Capsule, ligaments, tendon, and muscle will adapt to this position in as short as just a few weeks. Muscles develop contractures; ligaments and capsules will have one side lengthen and one side shorten
  82. Effects of immobilization on ligaments and tendons?
    Effects on Ligaments and Tendon

    Have a decrease in their collagen content and cross-linking, i.e. weaken

    Can loose 50% of tensile strength in 8 weeks

    Recovery may take over a year to regain strength

    Graded reloading is necessary to restore tendon and ligament strength
  83. Effects of immobilization on Articular Surfaces and Bone?
    Effects on Articular Surfaces and Bone

    Cartilage will atrophy

    Proteoglycan synthesis is decreased

    Greater deformation when subjected to compressive loads

    Bone can have a regional osteoporosis

    Due to less collagen formed and an increase in bone resorption
  84. Effects of agingon CT tissues?
    • Decreased number and size of GAG molecules
    • Fibers don’t align themselves as readily to imposed tensile forces
    • Adhesions are more likely to form between connective tissue
  85. name the gernal components of a muscle fiber/cell?
    • Sarcolemma: cell membrane
    • Sarcoplasm: – contains myofilaments, which are composed of actin and myosin
    • Non-contractile proteins:
    • Contractile proteins: - Myosin, Actin
  86. What are the characteristics of myosin?
    • Contractile proteins
    • Contains a rod-like tail and two globular heads
    • Hinge joints occur between the myosin head and tail
    • ATPase activity: found on Myosin – referred to as the thick filament myosin heads
  87. What are the componets of the myofilament , actin?
    • The actin filament is made up of three separate protein molecules:
    • Actin molecules (G-actin) form a twisted pearl strand, referred to as F-actin
    • Tropomyosin hides the actin-myosin binding site Troponin has 3 isoforms
  88. What are the structural proteins inside a muscle cell and what do they do?
    Structural proteinsC-protein – holds the myosin tails in correct spatial arrangement

    Titin – links myosin (M-line) to Z-line

    α-Actinin – attaches actin to Z-line
  89. Name and define the lines and bands that make up a sarcomere?
    Z-line to Z-line; composed of two bands

    BandsA-band: composed of myosin filaments and areas of overlap with actin fibers; lies at the center of the sarcomere

    H-zone: lies in the middle of the A-band; contains only myosin tails

    I-band: composed of actin filaments; part of two adjacent sarcomeres, bisected by Z-line
  90. Explain the interaction of the actin/myosin cross bridges?
    Action potential (AP) enters cell

    Ca+2 is released in response to AP, which binds to troponin

    Troponin moves tropomyosin to uncover the binding site for myosin

    Binding of myosin to actin is referred to as a cross-bridge and is what is required for tension to develop in muscles
  91. Name the layers of CT that suround each structutral level of a muscle?
    Endomysium – surrounds the muscle fiber

    Perimysium – surrounds bundles of muscle fibers called a fascicle

    Epimysium – surrounds the whole muscle
  92. What Factors Influence a Muscle’s Ability to Produce Movement?
    Two factors

    Length of the muscle fibers

    Size of the muscle’s moment arm
  93. What determines joint ROM?
    Joint range of motion (ROM) is determined by two properties.

    • Sarcomeres in series.
    • Muscle architecture
  94. Discuss muscle shortening?
    Muscle shortening is proportional to the length of the muscle fibers

    Typically muscles can shorten to ~50% of its length

    • There is a wide variety of muscle lengths in the human body
    • Sartorius vs. Bicep brachii

    Length of the muscle fibers is a function of the muscle architecture
  95. Name and define the two classification of fiber architecture?
    • Fiber architecture can be divided into two main classifications
    • Parallel
    • Pennate

    Parallel – muscle fibers are approximately parallel to the length of the whole muscle

    Pennate – muscle fibers are oriented obliquely to the long axis of the muscle
  96. What effect does the moment arm have on ROM?
    Muscles with greater moment arms have to shorten more than muscles with smaller moment arms to achieve the same ROM for the same joint angle
  97. What factors effect muscle strenght?
    • Muscle size
    • Muscle moment arm
    • Stretch
    • Contraction velocity
    • Muscle recruitment
    • Fiber types
  98. What two methods are used to determine muscle size?
    Anatomic cross-sectional area is a cross-section of the muscle at the widest part

    Physiologic Cross- Sectional Area (PCSA) is the cross-sectional area of the muscle that is perpendicular to the orientation of the muscle fibers
  99. How does a muscles moment arm effects it ability to generate torque?
    A muscle with a greater moment arm will be able to produce greater torque around a joint than a muscle with a smaller moment arm if they contract with the same force
  100. After 90 degrees what effect does the tangential componet of muscle force have on a joint?
    After 90°, the tangential component of the total muscle force produces a distraction force
  101. What is resting length of a muscle?
    There is a sarcomere length at which actin and myosin are optimally overlapped for cross-bridge formation, this is the resting length of the muscle
  102. What effect does changing a muscles length from it optimal length to a greater or lesser length have on cross bridge formation?
    Changing the sarcomere width beyond the optimal length decreases the number of cross-bridges Active tension may still be developed, however, it is less due to fewer cross-bridges between actin and myosin
  103. Tension in a muscle is also developed in a muscle when it is lengthened (i.e. put on stretch), the resistance is due to?
    • CE = contractile elements
    • PE = parallel elements
    • SE = series elements
  104. Define passive and active tensions?
    Passive Tension – tension developed in the parallel & series elastic components

    Active Tension – the tension developed by cross-bridge formation
  105. What is passive insuficancy?
    Passive Insufficiency - A muscle can’t stretch enough to achieve full range of motion at all joints it crosses

    Occurs with multiarticulate muscles

    Muscle is being moved by someone (i.e. therapist) or something else (i.e. antagonist muscle) – it takes a passive role in being lengthened
  106. What is active insuficancy?
    Active insufficiency – a muscle can’t develop full force due to the actin-myosin overlap, which decreases ROM for the distal joints the muscle crosses

    Occurs with multiarticulate muscles

    Muscle is causing the change in length or change in ROM – taking an active role

    • Causes
    • Decrease in cross-bridge formation
    • Change in moment arm at different joints
    • Passive tension of antagonist muscle
  107. Name and define the three types of muscle contractions?
    Types of Muscle Contraction

    Isometric – tension is generated by myosin and actin binding but no movement occurs

    Concentric – tension is generated; actin is pulled into the H-zone; shortening of the muscle occurs

    Eccentric – tension is generated; actin is pulled away from the H-zone; lengthening of the muscle occurs
  108. Explain the Force velocity relationship?
    This is the relationship between velocity of contraction and force produced

    When shortening contraction speed increases, force that can be produced decreases

    When lengthening contraction speed increases, force that can be developed is able to increase to a certain point

    In a dynamic contraction you have to consider both the velocity and the length of the muscle in order to determine force production

    We don’t move with constant velocity so force changes with a change in velocity & change in length
  109. Explain alpha motor units?
    A motor unit consists of an alpha motor neuron and all of the muscle fibers associated with that neuron

    Size of a motor unit can vary from a few muscle fibers to 1000s of fibers

    Fine control is provided by small motor units

    Gross movement is provided by large motor units

    Smaller motor units are recruited first

    If additional force is required, larger motor units will be recruited

    Partly due to energy conservationWhat does that mean?

    More energy is expended when a large motor unit is recruited since is activates 1000s of muscle fibers
  110. Name the 3 types of muscle fibers and there characteristics?
    Type I - Don’t fatigue easily; often referred to as stability or postural muscles; force production is limited

    Type IIa - Characteristics are between those of Type I and Type IIb

    Type IIb - Fatigue easily; can generate tremendous amounts of force
  111. List the roles a muscle can play in movements?
    Prime mover (agonist) – the muscle whose role is to produce a desired motion

    Antagonist – opposes the movement of the agonist

    Co-Contraction: provides stability

    Synergist – assist the agonist to perform the desired motion. Can help produce the desired motionor. Can stabilize a segment to allow the agonist to produce the motion
  112. Name the syngerists involved in wrist flexion?
    • Flexor carpi radialis and ulnaris are agonists for wrist flexion;
    • extensor digitorum is the antagonist;
    • flexor digitorum is a synergist by helping produce wrist flexion
  113. Name the syngerists for Finger flexion?
    • Flexor digitorum profundus will cause wrist flexion
    • so the extensor digitorum will act as a synergist and eliminate wrist flexion
    • so the profundus can produce finger flexion
  114. Name and explain the role of the seonsroy receptors involved with muscles?
    Muscle Spindle – within muscles; is sensitive to stretch and will contract the muscle in order to avoid injury

    Golgi Tendon Organ – within tendons, is sensitive to tension, will cause relaxation of muscle in order to prevent injury
  115. What are the effect of immobilization on Muscles?
    In shortened position -

    • Decrease in number of sarcomeres
    • Increase in connective tissue
    • Muscle atrophy
    • Prevention of the above effects need only ~30 minutes of daily ROM activities

    In lengthened position

    • Increase in the number of sarcomeres
    • May have a decrease in strength
  116. Effects of aging on muscles?
    • Fiber number and fiber type changes
    • Loss of muscle fibers
    • Decrease in type II fibers Increase in type I fibers
    • Connective tissue changes
    • Increased connective tissue
  117. What are the arthrokinematics of closed-chain knee flexion from standing to sitting?
    A. Roll Posterior, Glide Posterior
    B. Roll Posterior, Glide Anterior
    C. Roll Anterior, Glide Posterior
    D. Roll Anterior, Glide Anterior
  118. Which of the following answers is an aspect of Newton’s 2nd law and defines shear force?

    A. Is proportional to its mass; net forces move a bony segment away from its adjacent bony segment

    B. All forces come in pairs that are applied to contacting objects; a force that moves one object on another

    C. Is inversely proportional to its force; net forces moves a bony segment away from its adjacent bony segment

    D. Is in the direction of the unbalanced forces; a force that moves one object on another
  119. What are the four articulations for the shoulder complex?
    • Sternoclavicular joint (SC jt)
    • Acromioclavicular joint (AC jt)
    • Scapulothoracic joint not a true physiologic joint
    • Glenohumeral joint (GH jt)
  120. What are the charcteristics of the SC joint?
    • The SC joint has incongruent joint surfaces
    • Joint Type: Saddle (2 physiologic DOF; 1 non-physiologic: rotation)

    • Joint DiskShock Absorber
    • Improves joint surface contact
  121. What are the motions of the SC joint and what are the arthokinematics for each of these motions?
    • MotionElevation/Depression
    • Arthrokinematics: Roll/Glide opposite

    • Protraction/Retraction
    • Arthrokinematics: Roll/Glide same

    • Rotation
    • Arthrokinematics: Spin
  122. Name and define all of the stabilizing tissues of the SC joint?
    • Articular disc
    • Anterior SC ligament Restricts retraction
    • Posterior SC ligament Restricts protraction
    • Interclavicular ligament Restricts depression

    • Costoclavicular ligament
    • Restricts: ElevationProtraction, Retraction

    Muscle: Sternocleidomastoid, sternohyoid, sternothyroid – stretched in depression

    Depression can cause a pinching of nerves & arteries
  123. What type of joint is the AC joint? What does it do?
    Joint Type: Plane: has 3 DOF

    Joint Disk: May only be partial disk

    Degeneration is common

    Motion: Helps fine tune the position of the scapula after motions have occurred at the SC joint
  124. Motions of the AC joint and what planes do they occur in?
    • Motion: Upward Rotation/Downward Rotation
    • Plane: Frontal

    Winging - Plane: Horizontal

    Tipping - Plane: Sagittal
  125. What are the stabilizing tissues of the AC joint?
    Stabilizing tissues

    Articular disc

    Superior AC ligament - Restricts downward rotation

    Inferior AC ligament - Restricts upward rotation

    Coracoclavicular ligament - Restricts upward rotation

    Muscles: Deltoid & Trapezius – surround the joint
  126. What is the Scapulothoracic Joint, and explain were it is?
    Interface between scapula and thorax

    • Position
    • Superior angle = rib 2, inferior angle = rib 7

    Medial border = ~2 inches from spinous processes

    Bony connections: SC and AC joints
  127. Which of the following is correct for the SC joint?

    A. A tight posterior SC ligament would restrict protraction while anterior glides would help restore protraction

    B. A tight costoclavicular ligament would restrict retraction while anterior glides would help restore retraction

    C. A tight anterior SC ligament would restrict elevation while superior glides would help restore elevation

    D. A tight interclavicular ligament would restrict depression while inferior glides would help restore depression
  128. What are the motions of the scapulothoracic joint?
    • Elevation/Depression
    • Protraction/Retraction
    • Upward / Downward Rotation
  129. What is the type anf position of the GH joint?
    • Joint type – Ball and Socket
    • Position
    • Glenoid fossa: Lateral
    • Slightly anteriorSuperior

    • Humeral head:
    • Medial
    • Posterior
    • superior
  130. What is the stabilizing tissues of the GH joint?
    Stabilizing tissue

    Glenoid labrum – increases the joint congruency

    Rotator cuff muscles – dynamic stabilizers, attach to the capsule

    Biceps brachii – long head – blends with the superior capsule

    Capsular ligaments:

    Superior restricts: Adduction, External rotation

    Middle restricts: external rotation horizontal abduction

    • Inferior – has three bands
    • Anterior restricts: Abduction, External rotation
    • Axillary pouch restricts: abduction
    • Posterior restricts: Abduction, Internal rotation
  131. Name the factors that effect GH joint stability?
    • Adequate size of the glenoid fossa
    • Humeral head retroversion
    • Intact capsule and labrum
    • Shoulder girdle muscle control
  132. What what causes Static Stability of the GH?
    • Gravity
    • Superior capsule
    • Coracohumeral ligament
    • Passive tension of supraspinatus

    Resultant force pulls the head of the humerus into the glenoid fossa

    Deltoid contracts creates rotation and superior translation

    Supraspinatus Produces a compressive force

    Infraspinatus, Teres Minor, Subscapularis - Produce an inferior translation to counteract the superior translation of the deltoid contraction
  133. What are the GH joint motions?
    • Flexion / Extension
    • Arthrokinematics: Spin (both open & closed chain)
    • Inferior / Posterior glide

    • Abduction / Adduction
    • Arthrokinematics: Roll / Glide Opposite (open chain)

    • External / Internal rotation
    • Arthrokinematics: Roll / Glide Opposite (open chain)

    • Horizontal Adduction / Horizontal Abduction
    • Arthrokinematics: Roll / Glide Opposite (open chain)
  134. Explain Scapulohumeral rhythme?
    Combination of GH and STJ for abduction and flexion

    Is a 2:1 ratio of movement between GH and STJ

    Scapula has 60° upward rotation

    GH contributes 120° of elevation, even if scapula is fixed

    Total ROM is 180°
  135. What is the purpose of the scapulohumeral rythme?
    Assists in maintaining proper length tension relationships

    Distributes motion between two joints

    Maintains glenoid fossa in an optimal position
  136. Explain the phases of the scapulohumeral rythme?

    • 0 – 90° arm elevation
    • 60° GH abduction

    30° upward rotation

    • SC joint 20-25° elevation
    • AC joint 5-10° upward rotation

    • Late
    • 90 – 180° arm elevation
    • 60° GH abduction
    • GH external rotation 30° STJ upward rotation
    • SC joint 5° elevation
    • AC joint 20 - 25° upward rotation
    • Posterior clavicular rotation
  137. Name the muscles and division of muscles that make up the Axioscapular & Axioclavicular?
    • Trapezius
    • Upper - Elevation, Retraction, Upward rotation

    Tightness – elevation of shoulder girdle or asymmetrical head position

    • Middle - Retraction
    • Lower - Depression, Retraction

    Weakness – due to chronic scapular elevation or reciprocal inhibition

    Serratus Anterior- Protraction, Upward rotation

    Weakness – winging

    • Levator Scapula & Rhomboids
    • ElevationRetraction
    • Downward rotation

    Tightness: in the levator scapula may cause headaches

    • Pectoralis Minor
    • Protraction
    • Downward rotation
    • Depression
    • Anterior Tilt (Tip)

    • Deltoid - Anterior
    • Flexion
    • Internal rotation
    • Abduction
    • Horizontal adduction

    • Middle
    • Abduction
    • Posterior
    • Extension
    • External rotation
    • Abduction
    • Horizontal abduction

    • Pectoralis Major
    • Sternal head - Flexion, Extension (from 180 flexed position), Adduction, Internal rotation, Horizontal adduction

    Clavicular head - Flexion, Internal rotation

    Latissimus Dorsi - Extension, Adduction, Internal rotation, Shoulder depression

    Teres Major - Internal rotation, Extension, Adduction

    Coracobrachialis - Flexion, Adduction

    Biceps Brachii – Long head - Flexion

    Triceps Brachii – Long head - Extension, Adduction

    Supraspinatus - Abduction

    Weakness – significant abduction weakness and loss of endurance with abduction

    Teres Minor - External rotation

    Infraspinatus - External rotation

    Subscapularis - Internal rotation, Flexion, Adduction, Horizontal adduction

    Weakness – may contribute to anterior instability of the shoulder
  138. Explain the Synergy of Trapezius and Serratus Anterior?
    Trapezius and Serratus Anterior form a force couple for upward rotation - Serratus pulls from the bottom while the upper trapezius pulls from the topIf one of the muscles becomes paralyzed but the other muscle is intact; ROM is affected

    Flexion - With serratus anterior paralysis (trapezius intact): result is weak, partial ROM. Only 130°. With trapezius paralysis (serratus anterior intact): result is weak, full ROM. Unopposed retraction of trapezius only allows the scapula to upwardly rotate 1/3 of the normal motion.

    Abduction - With serratus anterior paralysis (trapezius intact): result is weak, full ROMWith trapezius paralysis (serratus anterior intact): result is weak, partial ROM. Only 75°. Without the trapezius the scapula rests in a downward rotated position
  139. What type of joint is the Humeroulnar Joint?
  140. What is the carrying angle and what two terms describe it?
    Carrying Angle - is the angle of the forearm in relation to the body.

    • Valgus = distal part is abducted
    • Varus = distal part is adducted
  141. If the elbow does Flexion / Extension, what are the Arthrokinematics of this motion? (open chain)

    What changes with the arthrokinematics when the elbow is performing a closed-chain movement?
    – Roll / Glide Same (open chain)

    Roll / glide opposite (closed chain)
  142. What are the stabilizing tissues of the elbow?
    Articular capsule covers humeroulnar, humeroradial, and proximal radioulnar joints

    Posterior-lateral = Varus force

    Anterior-medial = Valgus force

    • Annular ligament – surrounds radial head and
    • Prevents dislocation of radial head (Nursemaid’s elbow)

    Radiohumeral joint – will resist valgus forces

    • Medial collateral ligament
    • Anterior fibers
    • Resists Valgus
    • Resists Extension

    • Posterior fibers
    • Resists Valgus
    • Resists Flexion

    • Lateral collateral ligament
    • Ulnar component - resists -Varus and Flexion

    Radial component - resists - Varus