Final Frontier MSK Basics

Biomechanics and Kinematic Chain

Define osteokinematic joint motion.

the gross movement that happens between two bones

Osteokinematic joint motion is described or expressed using what parameters?

range of motion

What are the different descriptors used to describe osteokinematic motion?

hypermobility and hypomobility

Explain the relationship between hypomobility and hypermobility in osteokinematic motion.

Hypomobility at one joint can lead to hypermobility at another joint

Give an example of how hypomobility and hypermobility are related in osteokinematics.

Excessive plantarflexion causes knee hyperextension

Define arthrokinematic joint motion.

the movement of joint surfaces

What are the types of arthrokinematic motion?

Rolling

Sliding/gliding

spinning

Describe how the convex-concave rule applies to joint motion.

describes movement of articular surface and shaft

Explain how a convex joint surfaces moves according to the convex-concave rule.

movement in the opposite direction

Explain how a concave joint surface moves according to the convex-concave rule.

movement in the same direction

Explain the movement of the shoulder joint according to the convex-concave rule.

convex on concave

opposite (roll anterior, slide posterior)

Explain the movement of the elbow joint according to the convex-concave rule.

concave on convex

same (roll anterior, slide anterior)

Explain the movement of the proximal radioulnar joint according to the convex-concave rule.

convex on concave

opposite (roll anterior, slide posterior)

Explain the movement of the distal radioulnar joint according to the convex-concave rule.

concave on convex

same (roll anterior, slide anterior)

Explain the movement of the wrist joint according to the convex-concave rule.

convex on concave

opposite (roll anterior, slide posterior)

Explain the movement of the fingers according to the convex-concave rule.

concave on convex

same (roll anterior, slide anterior)

Explain the movement of the hip joint according to the concave-convex rule.

convex on concave

opposite (roll anterior, slide posterior)

Explain the movement of the knee joint according to the convex-concave rule.

concave on convex

same (roll anterior, slide anterior)

Explain the movement of the ankle joint according to the convex-concave rule.

convex on concave

opposite (roll anterior, slide posterior)

Explain the movement of the toes according to the convex-concave rule.

concave on convex

same (roll anterior, slide anterior)

Explain the movement of the thumb according to the convex-concave rule.

flexion/extension: same

Abduction/adduction: opposite

A patient presents with limited ankle inversion. What would be an appropriate intervention to address this restriction?

lateral glide of the calcaneus on the talus

A patient presents with limited ankle eversion. What would be an appropriate intervention to address this restriction?

medial glide of the calcaneus on the talus

A patient presents with limited ankle dorsiflexion. What would be an appropriate intervention to address this restriction?

posterior glide of the talus on the tibia

A patient presents with limited ankle plantarflexion. What would be an appropriate intervention to address this restriction?

anterior glide of the talus on the tibia

Describe the motions involved in open kinetic chain pronation.

eversion

dorsiflexion

abduction

Describe the motions involved in open kinetic chain supination.

inversion

plantarflexion

adduction

Describe the motions involved in closed kinetic chain pronation.

eversion

plantarflexion

adduction

Describe the motions involved in closed kinetic chain supination.

inversion

dorsiflexion

abduction

During medial rotation of the shoulder (glenohumeral) joint, in which direction does the humeral head glide?

posterior

During external rotation of the shoulder (glenohumeral) joint, in which direction does the humeral head glide?

anterior

During abduction of the shoulder (glenohumeral) joint, in which direction does the humeral head glide?

superior

During adduction of the shoulder (glenohumeral) joint, in which direction does the humeral head glide?

inferior

Which functional activities involve shoulder medial rotation?

turning head over shoulder when driving

combing hair

Using the convex-concave rule, describe how shoulder joint movement is affected in a patient with adhesive capsulitis treatment.

posterior inferior glide

Describe the characteristics of a grade 1 joint mobilization.

small amplitude of movement performed at the beginning of the range

Describe the characteristics of a grade 2 joint mobilization.

large amplitude movement performed within the range, but not reaching the limit

Describe the characteristics of a grade 3 joint mobilization.

large amplitude rhythmic oscillations are performed up to the limit of the available motion and are stressed into the tissue resistance

Describe the characteristics of a grade 4 joint mobilization.

small amplitude rhythmic oscillations are performed at the limit of the available motion and stressed into the tissue resistance

Describe the characteristics of a grade 5 joint mobilization.

small amplitude high velocity thrust technique performed to snap adhesions at the limit of range

Describe the muscle imbalances associated with Janda’s Upper Crossed Syndrome.

inhibited: deep cervical flexors, lower trapezius, serratus anterior

facilitated: SCM, pectoralis, upper trapezius, levator scapula

Describe the muscle imbalances associated with Janda’s Lower Crossed Syndrome.

inhibited: abdominals, glute med, glute max, glute min

facilitated: rectus femoris, iliopsoas, thoraco-lumbar extensors

What is the purpose of the long sitting (supine to sit) test?

identifies sacroiliac joint dysfunction which may be the cause of leg length discrepancy

During the long sitting (supine-to-sit) test, what does it indicate if one leg appears longer?

anteriorly rotated innominate

During the long sitting (supine-to-sit) test, what does it indicate if one leg appears shorter?

posteriorly rotated innominate

While examining the patient, the physical therapist notices a drop of the left hip during right midstance. Injury to which nerve is MOST LIKELY the cause of this impairment?

right superior gluteal nerve

Which muscle is innervated by the right inferior gluteal nerve?

glute max

What mobilization technique is MOST APPROPRIATE to improve limited hip external rotation range of motion?

anterior glide to femur

Which mobilization technique is MOST APPROPRIATE to improve hip flexion range of motion?

posterior glide to femur

Which mobilization technique is MOST APPROPRIATE to improve limited hip adduction range of motion?

superior glide to femur

Which mobilization technique is MOST APPROPIRATE to improve limited hip abduction range of motion?

inferior glide to femur

Describe the characteristics of an isometric muscle contraction.

muscle torque = load torque

Describe the characteristics of a concentric muscle contraction.

muscle torque is greater than load torque

Describe the characteristics of an eccentric muscle contraction.

muscle torque is less than load torque

A physical therapist is evaluating muscle function during gait. During which phase of the gait cycle do the hamstring muscles contract eccentrically?

terminal swing