kinesiology oral exam joint movements (gait + spine)

loading response: hip in sagittal

extending

isometric extensors early, C extensors

accept weight, extend hip, prevent jackknifing (stabilize trunk)

mid stance: hip in sagittal

extending

C extensors + hamstrings

finish hip extension

terminal stance: hip in sagittal

extending

E flexors

decelerate hip extension

pre-swing: hip in sagittal

flexing

C flexors

initiate hip flexion

initial swing: hip in sagittal

flexing

C flexors

generate hip flexion torque

mid-swing: hip in sagittal

flexing

C flexors: finish hip flexion

E extensors: decelerate hip flexion

terminal swing: hip in sagittal

extending

C extensors

begin hip extension + prepare limb for initial contact

loading response: knee in sagittal

flexing

E extensors: shock absorption, control flexion (quads)

mid stance: knee in sagittal

extending

C extensors: finish extending limb

E flexors: prevent hyperextension

terminal stance: knee in sagittal

extending till foot off ground, then flexing

slight C flexor (late): initiate knee flexion

pre-swing: knee in sagittal

flexing

E extensors

limit knee flexion rate

initial swing: knee in sagittal

flexing

min extensor/flexor activity

movement from inertia as hip flexes, shank left behind

mid-swing: knee in sagittal

extending

min. flexor/extensor activity

terminal-swing: knee in sagittal

extending until 97%, then flexing

extensors: coavtication prep of contact

E flexors: decelerate knee extension, prevent hyperextension, + prepare for ground contact

loading response: ankle in sagittal

plantar flexing until neutral then dorsiflexing

E dorsiflexors

control plantarflexion + prevent foot slap

mid stance: ankle in sagittal

dorsiflexing

E plantarflexors

control tibia advancing over foot

terminal stance: ankle in sagittal

dorsiflexing until heel off then plantarflexing

E PF: control tibia advancement over foot

C PF: push off (primary propulsion contributor)

pre-swing: ankle in sagittal

plantarflexing

C plantarflexors

push off (primary forward propulsion contributor)

initial swing: ankle in sagittal

dorsiflexing

C dorsiflexors

bring ankle to neutral

mid-swing: ankle in sagittal

dorsiflexing to neutral

C / isometric dorsiflexors

bring/hold ankle in neutral

terminal swing: ankle in sagittal

minimal dorsiflexing

C/isometric dorsiflexors

hold in neutral + prepare for ground contact

loading response: ankle in frontal

everting

C evertors

initiate eversion response

mid stance: ankle in frontal

everting

E invertors

decelerate eversion

terminal stance: ankle in frontal

inverting

C invertors

create rigid foot

pre-swing: ankle in frontal

inverting

C invertors: stabilize foot at toe off

E evertors: limit inversion at toe off

loading response: pelvic obliquity in frontal

small contralateral pelvis drop

E abductors

slow opposite hip drop

mid stance: pelvic obliquity in frontal

small contralateral pelvis raise

C abductors

raise opposite hip

loading response: hip in frontal

adducting

E abductors

slow opposite hip drop

mid stance: hip in frontal

abducting

C abductors

raise opposite hip

20% into initial swing: hip in frontal

C abductors

Abductor torque to elevate contralateral iliac crest

swing: hip in frontal

minimal frontal plane hip torque

C adductors: after toe off helps initiate hip flexion

E abductors: at terminal swing to prepare for heel contact

occiput - C1 flexion

anterior roll of occiput, posterior glide

(convex occipital condyles moving on concave superior facets of atlas)

occiput - C1 extension

posterior roll of occiput, anterior glide

(convex occipital condyles moving on concave superior facets of atlas)

occiput - C1 right side bend

ipsilateral roll of occiput, contralateral glide

(convex occipital condyles moving on concave superior facets of atlas)

occiput - C1 right rotation

condyles: minimal movement

(convex occipital condyles moving on concave superior facets of atlas)

C1-C2 flexion

atlas tilts forward

C1-C2 extension

atlas tilts backward

C1-C2 right side bend

limited

C1-C2 right rotation

L facet of C1 glides anterior

R facet of C1 glides posterior

C2-C7 flexion of inferior facets of superior vertebrae

glide superiorly and anteriorly

C2-C7 extension of inferior facets of superior vertebrae

glides inferiorly and posteriorly

C2-C7 right side bend of inferior facets of superior vertebrae

right side facet: posterior and inferior glide

left side facet: anterior and superior glide

C2-C7 right side rotation of inferior facets of superior vertebrae

right side facet: posterior and slight inferior glide

left side facet: anterior and slight superior glide

thoracic flexion of inferior facets of superior vertebrae

superior + anterior glide

opening

anterior roll of body

thoracic extension of inferior facets of superior vertebrae

inferior + posterior glide

closing

posterior roll of body

thoracic right side rotation of inferior facets of superior vertebrae

right facet: posterior

left facet: anterior

both facets glide left

thoracic right side bend of inferior facets of superior vertebrae

right side facet: posterior + inferior glide (close)

left side facet: anterior + superior glide (open)

lumbar disc movement during flexion

annulus: anterior compression, posterior stretch

nucleus: posterior movement

lumbar disc movement during extension

annulus: posterior compression, anterior stretch

nucleus: anterior movement

lumbar flexion of inferior facets of superior vertebrae

superior + anterior glide

vertebral body rolls anterior

facets open

lumbar extension of inferior facets of superior vertebrae

inferior + posterior glide

vertebral body rolls posterior

facets close

lumbar rotation of inferior facets of superior vertebrae

both inferior facets move to oppo side of rotation

ipsilateral: separation/opens

contralateral: compression/closes

vertebral body rotates to ipsilateral side

lumbar side bend of inferior facets of superior vertebrae

ipsilateral: inferior + posterior glide (closes)

contralateral: superior + anterior glide (opens)

pelvis tilts

nutation: anterior tilt (closed pack)

counternutation: posterior tilt (open pack)

sacral nutation

anterior + inferior

ischial tuberosities separate + iliac bones approximate

sacral counternutation

posterior + superior

iliac bones separate + asocial tuberosities approximate

facet joint movement with flexion

bilateral opening

facet joint movement with extension

bilateral closing

facet joint movement with right SB

right closes, left opens

facet joint movement with left SB

left closes, right opens

facet joint movement with cervical rotation

ipsilateral closes, contralateral opens

facet joint movement with lumbar rotation

ipsilateral opens, contralateral closes

objectives of initial contact

limb reaches for ground

impact deceleration

objectives of loading response

weight acceptance

objectives of mid stance

controlled tibial progression

limb + trunk stability

limb extends to allow easy passage of swing leg

objectives of terminal stance

COM progression moves ahead of forefoot

rigid foot and ankle

limb and trunk stability

objectives of pre swing

abrupt body weight transfer rapidly uploads limb

position limb for swing

accelerate progression of trailing limb w/ forward push

objectives of initial swing

foot clearance of floor (controlled mainly by knee flexion)

advancement of limb from trailing position

objectives of mid swing

limb advancement

foot clearance off ground

objectives of terminal swing

complete limb advancement

prepare limb for upcoming ground contact

peak hip flexion + extension

flex: 32 during mid swing (tibia vertical)

ext: 10 during pre-swing (end of terminal stance)

peak knee flexion and extension

flex: 60 at end of initial swing (feet adjacent)

ext: 5 just before initial contact/end of terminal swing

peak ankle dorsiflexion and plantarflexion

DF: 10 during 1st half of terminal stance

PF: 15-20 at toe off (end of pre-swing)

GRF moment during initial contact

H: flexion

K: extension

A: PF

GRF moment during loading response

H: flexion (min)

K: flexion
A: PF

GRF moment during mid-stance

H: extension

K: minimal

A: DF

GRF moment during terminal stance

H: extension

K: flexion

A: DF

GRF moment during pre-swing

H: extension

K: flexion

A: DF

GRF moment during swing phases

none bc no contact w/ floor

upper C spine protraction

extends upper C spine

flexes lower C spine

overactive post. upper cervical deep mm + passive anterior deep mm

upper C spine retraction

flexes upper C spine

extends lower C spine

overactive anterior deep mm + passive post. upper cervical deep mm

anterior deep muscles

sagittal plane upper C flexion

longus colli/capitus + rectus capitus lateralis/anterior

provide stability to C spine

posterior upper cerivcal deep muscles

extend head

rectus capitis post. major/minor + obliquus capitis inferior/superior

T10-T12 facet osteology

orientation similar to lumbar-sagittal plane (same side opens)

T11/12 lack costotransverse jt

thoracic facet orientation for which plane

coronal plane motion

rib plane directions during inspiration

AP + ML diameter

all ribs are a combo of motions

small rotation of rib at costotransverse + sternocostal jts

upper ribs motion during inspiration

pump handle motion (mostly AP)

TP angulated 25-35 in frontal plane

middle/lower ribs motion during inspiration

bucket handle motion (ML)

TP angulated 35-45 in lower ribs (frontal plane)

false ribs motion during inspiration

caliper motion

muscles for quiet inspiration

diaphragm

scalenes

intercostals

(all elevate ribs)

muscles added during forced inspiration

diaphragm, intercostals, scalenes

serratus post. inf + sup

levator costarum

SCM

lats (if arms fixed)

iliocostalis thoracis/cervices

pec major/minor (if scapulae + arm fixed)

quadrates lumborum

(to inc intrathoracic cavity further)

forced expiration

ab mm (rectus, obliques, TA)

internal intercostals

dec intrathoracic V by flexing trunk + depressing ribs (change length-tension relationship)

regional variations of spine osteokinematic motions

C: lots of flex/ext + rotation

T: less motion bc ribs (coronal plane)

L: most in sagittal plane (flex/ext)

why most herniations are posterior

greater flex ROM

PLL narrow in L region

dec ability to stop disc protruding

RA, ext + internal oblique bilateral + unilateral actions

BIL: trunk flexion

UNI: lateral trunk flexion + rotation (obliques)

TA mm action

ab compression, tighten thoracolumbar fascia

quadratus lumborum actions

BIL: lumbar extension

UNI: lumbar lateral flexion, hip hiking when trunk stable

iliopsoas action in L region

BIL: trunk/L flexion

UNI: lateral flexion (same side)

lumbar extensors

erector spinae: extension + lateral flexion

transversospinal mm: extension, lateral flexion, oppo side rotation

thoracolumbar fascia in stabilization (L)

ant/middle layer: insert on TP of vert. inferior to iliac crests

post layer: attach to SP on L + S, to ilium near PSIS

stability enhanced w/ glutes + lats