Musculoskeletal Anatomy and Movement: Key Terms and Tests

Flexion

Bending a limb at a joint

Extension

Straightening a limb at a joint

Abduction

Moving a limb AWAY from the midline

Adduction

Moving a limb TOWARD the midline

Pronation

Palm facing down

Supination

Palm facing up

TMJ Location

Anterior to the tragus of the ear

TMJ Movements

Hinge and Gliding

Spine Counts

7 Cervical 12 Thoracic 5 Lumbar 5 Sacral 3-4 Coccygeal

Epiphyses

Growth plates at ends of bones

Epiphyses Closure

Occurs around age 20

Genu Varum

Bowlegs

Genu Valgum

Knock-knees

Scoliosis

Lateral curvature of spine

Lordosis

Inward curve of lower spine (pregnancy)

Kyphosis

Outward curve of thoracic spine (aging)

Bone Remodeling

Process of resorption and deposition

Osteoporosis

Resorption exceeds deposition

Height Loss

Thinning and water loss of discs

Get Up and Go Test

>12 seconds is high fall risk

BMD

Best predictor for hip and vertebral fractures

DXA Screening Females

Age 65 and older

DXA Screening Males

Age 70 and older

DXA Screening High Risk

Age 50 and older

ADLs

Activities of Daily Living

Subjective Joints

Pain stiffness swelling heat redness

Subjective Muscles

Pain or weakness

Dislocation

Complete loss of contact between bones

Subluxation

Partial misalignment

Contracture

Shortening of a muscle

Ankylosis

Stiffness or fixation of a joint

Crepitus

Grating or crunching sound

Boggy Joint

Doughy feel (inflammation)

Muscle Grade 5

Full ROM vs Max Resistance

Muscle Grade 4

Full ROM vs Moderate Resistance

Muscle Grade 3

Full ROM vs Gravity ONLY

Muscle Grade 2

Full ROM with Gravity Eliminated

Muscle Grade 1

Slight contraction no movement

Muscle Grade 0

No contraction

TMJ Nerve Test

Tests Cranial Nerve V (Trigeminal)

Rotator Cuff Tear Sign

Limited ROM during abduction

Phalen Test

Backs of hands together (Carpal Tunnel)

Tinel Sign

Tapping median nerve (Carpal Tunnel)

Plantar Flexion

Toes pointing down

Dorsiflexion

Toes pointing up

Hallux Valgus

Bunion (great toe points inward)

RA

Autoimmune bilateral morning stiffness >1hr

OA

Wear and tear unilateral worse at night

Gout

Uric acid sudden red swollen big toe

Ortolani Maneuver

Infant hip abduction click is positive

Allis Test

Comparing infant knee height

Polydactyly

Extra digits

Syndactyly

Webbed digits

Infant Spine Shape

C-shaped at birth

Cervical Curve

Develops at 3-4 months

Lumbar Curve

Develops at 1 year to 18 months

CNS

Brain and Spinal Cord (integration center)

nPNS

12 Cranial Nerves and 31 Spinal Nerves (connections)

nAfferent

Sensory signals traveling TO the brain

nEfferent

Motor signals traveling AWAY from the brain (Exit)

nSomatic System

Controls voluntary skeletal muscles

nAutonomic System

Controls involuntary functions (heart/glands)

nSympathetic Division

Fight or Flight response

nParasympathetic Division

Rest and Digest response

nInfant Neuro Development

Not fully myelinated; controlled by primitive reflexes

nAging Neuro Changes

Neuron loss; slower response time; decreased sensation

nNormal Aging

Cognitive decline/dementia is NOT a normal part of aging

nCN I Olfactory

Sensory - Smell

nCN II Optic

Sensory - Vision (Snellen chart)

nCN III Oculomotor

Motor - Eye movement and pupil constriction (PERRLA)

nCN IV Trochlear

Motor - Downward and inward eye movement

nCN V Trigeminal

Both - Facial sensation and chewing

nCN VI Abducens

Motor - Lateral (side to side) eye movement

nCN VII Facial

Both - Facial expressions (smile/puff cheeks) and taste

nCN VIII Acoustic

Sensory - Hearing and balance (Whisper test)

nCN IX Glossopharyngeal

Both - Swallowing and gag reflex

nCN X Vagus

Both - Speech and swallowing (Uvula rise midline)

nCN XI Accessory

Motor - Shoulder shrug and neck rotation

nCN XII Hypoglossal

Motor - Tongue movement (no deviation)

nAtrophy

Wasting away of muscle size

nFlaccidity

Decreased muscle tone; limp like a rag doll (Hypotonia)

nSpasticity

Increased resistance to passive stretch (CNS damage)

nTics

Sudden brief repetitive movements (blinking)

nTremors

Rhythmic back and forth shaking (Parkinson's)

nFasciculations

Small muscle twitches visible under the skin

nChorea

Irregular jerky dance-like movements

nPronator Drift

Arm turns inward and drifts down when eyes closed (stroke sign)

nGait

Manner of walking; should be smooth and rhythmic

nTandem Walking

Heel-to-toe walking in a straight line

nRomberg Test

Standing feet together eyes closed; Positive = loss of balance

nCerebellum

Part of brain for balance and coordination

nStereognosis

Identifying an object in hand by touch only

nGraphesthesia

Identifying a number/letter traced on the palm

nPeripheral Neuropathy

Loss of vibration/position sense in feet (Diabetes)

nDTR Grade 2+

Average or normal reflex response

nDTR Grade 4+

Very brisk or hyperactive with clonus (disease)

nDTR Grade 0

No reflex response

nBiceps Reflex

C5 to C6

nTriceps Reflex

C7 to C8

nQuadriceps Reflex

L2 to L4 (Knee jerk)