Chapter 1: kinesology online class
Anatomical Position vs Fundamental Position
Anatomical position is the reference starting position for the course and movement analysis.
Posture: upright, feet parallel or touching, head upright.
Palms face forward.
This position is used as the starting reference for every movement phase.
Fundamental position is similar to anatomical position but with palms facing the sides (thumbs pointing away from the body).
Commonly used during walking, object manipulation, or pronated palm positions.
Key difference:
Anatomical position: palms forward.
Fundamental position: palms facing the body sides (anterior surface of the body not exposed to the front).
Practical note: the body is treated as a cheat sheet for locating and palpating landmarks; positions help highlight bony landmarks.
Other reference body positions (overview used in demonstrations)
Fetal position: curled up.
Hook line position (recumbent, supine with knees bent): lying on the back with hips and knees flexed so feet are on the table.
Lateral recumbent (lateral decubitus): lying on one side; common in ultrasonography for heart conditions.
Long sitting: legs straight out in front on the table/plinth.
Short sitting: knees bent and hanging off the edge of the table.
Prone: lying face down.
Supine: lying face up.
Right lateral decubitus: lying on the right side; description requires specifying the side (e.g., right lateral recumbent) for clarity.
Important note: leg/tendon tension (e.g., hamstrings) varies with position and can affect pelvic movement; long sitting vs short sitting changes hamstring tension.
Descriptive language matters when describing recumbent positions to other clinicians.
Anatomic terminology: directional terms and orientation
Anterior (ventral): toward the front of the body.
Posterior (dorsal): toward the back of the body.
Superior (cephalic, cranial): toward the head.
Inferior (caudal): toward the feet/tail.
Antero- vs postero- prefixes describe front/bac k positions relative to other structures; e.g., antero-inferior = front and below.
Antero- superior = front and above.
Lateral vs medial:
Lateral: toward the outside, away from the midline.
Medial: toward the midline.
Examples: antero-lateral, antero-medial, postero-lateral, postero-medial, etc.
Contralateral: on the opposite side of the body.
Ipsilateral: on the same side of the body.
Bilateral: on both sides.
Inferior/ superior can combine with medial/lateral to describe movement directions (e.g., moving inferior and medial).
Median: near the midline; often used in relation to midsagittal plane concepts.
Right vs left terms: dextor (right), sinister (left).
Foot and hand specifics:
Dorsum of the foot: the top of the foot.
Plantar surface (plantar flexion): bottom/sole of the foot; plantar flexion = pointing toes downward toward the plantar surface.
Dorsal surface of the hand: the back of the hand; palmar (volar) aspect = palm.
Palmar vs volar are commonly used for the hand; dorsal for the back of the hand.
Radial side: thumb side (lateral in the upper limb); Ulnar side: medial side.
Limbs relative to midline:
Proximal: closer to the trunk.
Distal: farther from the trunk.
Proprioceptive and directional cues: orientation terms help describe rotations and positions in rehabilitation and movement analysis.
Special directional terms for spine and head: rostral (toward the face/front of head); cephalic (head region); sagittal references often tie to anterior-posterior orientation.
Planes and axes of movement
Cardinal planes (movement occurs within these imaginary planes):
Sagittal plane (anterior-posterior plane): divides body into left and right halves. Movement within this plane includes flexion and extension.
Frontal plane (coronal plane, lateral plane): divides body into anterior and posterior halves. Movement includes abduction/adduction.
Transverse plane (horizontal plane, axial plane): divides body into superior and inferior halves. Movement includes internal/external rotation.
Diagonal planes: combinations of the traditional planes allowing multi-planar movement (e.g., high diagonal, low diagonal actions).
Axes of motion (perpendicular to planes): terminology varies; common practice in the lecture uses various labels (some call axes X, Y, Z; others use mediolateral, anteroposterior, vertical).
A plane and its axis form a pair: movement occurs about an axis perpendicular to the plane.
Important caveat: multiple naming conventions exist; pick one and stay consistent; you may annotate with alternate names on a cue card for exams.
Cardinal planes and typical movements:
Sagittal (AP) plane: flexion/extension; axis = mediolateral (left-right) in standard biomechanics; some lectures discuss axes as anterior-posterior or frontal depending on convention.
Frontal (coronal) plane: abduction/adduction; axis = anterior-posterior (front-to-back) in standard biomechanics; other conventions exist.
Transverse (axial) plane: internal/external rotation; axis = vertical/longitudinal (head-to-toe direction).
Memorization aids (three core sentences):
ext{Flexion and extension take place in the sagittal plane (anteroposterior plane) about a lateral/coronal/frontal axis.}
ext{Abduction and adduction take place in the frontal/coronal plane about an axis that runs anterior to posterior.}
ext{Internal and external rotation take place in the transverse/horizontal plane about an axis that runs up and down.}
The instructor notes that you should choose a language family (names for planes/axes) you’re comfortable with and stick to it, possibly marking alternatives on a small note for exams.
Practical tip: combine planes and axes language when studying and practicing movement analysis.
Body regions and the skeletal system (overview of regions)
Body regions are named by key features (e.g., cervical region = neck; lumbar region = low back).
Axial skeleton: head, neck, trunk (midline structures).
Appendicular skeleton: upper and lower limbs (arms and legs).
Head and trunk details:
Cephalic region (cranium and facial structures).
Cervical spine (neck) has distinct handling but is part of the spine; trunk includes thoracic and lumbar regions and pelvis.
Upper and lower extremities: divisions within each limb (e.g., shoulder, elbow, forearm, hand; hip, knee, ankle, foot).
Pedal region: foot region terminology.
The skeletal system is studied through a region-based approach to movement and function.
The bone: osteology and structure
Approximate adult bone count: ~206 bones (variation exists with some extra/separate sesamoid bones).
Major roles of the skeleton:
Protection of vital organs (heart, lungs, brain, etc.).
Support and upright posture.
Lever system for muscles and ligaments via attachments (tendons and ligaments connect to specific bone sites).
Mineral storage (calcium and phosphorus) and hormonal/electrolyte roles.
Hematopoiesis: red blood cell production in red marrow within certain bones.
Bone types (structural categories): long, short, flat, irregular, sesamoid.
Long bones: longer than wide; hollow central cavity; sites of hematopoiesis; examples: radius, ulna, humerus, femur, metacarpals, metatarsals, etc.
Short bones: small with large articular surfaces; examples: carpals, tarsals (mosaic-like; many joints within the hand/foot).
Flat bones: thin, curved with protective/attachment surfaces; examples: scapula, sternum, some skull bones.
Irregular bones: irregular shapes; examples: sphenoid, jawbone, vertebrae, ischium.
Sesamoid bones: embedded in tendons to form pulley systems (e.g., patella, sesamoids at tendon insertions).
Bipartite or tripartite bones: one bone that appears as two or three pieces attached (e.g., bipartite patella).
Endochondral bone growth: bones start as cartilage and ossify over time; growth plates (epiphyseal plates) are cartilaginous regions that allow lengthwise growth; once closed, length growth ceases.
Growth plates and apophyses:
Epiphyseal plates: thin cartilage plates between diaphysis and epiphysis; responsible for longitudinal growth.
Apophyses: tendon/ligament attachment sites near growth plates; prone to apophysitis in adolescents (e.g., Osgood-Schlatter, Sever’s disease).
Osgood-Schlatter (tibial tuberosity apophysitis) and Sever’s disease (calcaneal apophysitis) are common adolescent conditions.
Cartilage and joint surfaces:
Articular cartilage: hyaline cartilage covering ends of bones at joints; provides cushioning and friction reduction; relatively avascular and rely on synovial fluid and loading cycles for nutrition.
When cartilage wears, bone-on-bone contact can occur, contributing to osteoarthritis symptoms.
Joints may also involve articular discs (menisci in the knee) and labra (shoulder/hip) to enhance stability and congruence.
Bone biology basics:
Bone matrix: ~70% minerals (calcium phosphate/calcium carbonate) with water and a small collagen component; collagen provides structural integrity with limited elasticity.
Osteoblasts/build bone and osteoclasts/resorb bone; balance maintains bone density.
Periosteum: dense fibrous outer covering; attachment site for tendons/ligaments; supports bone protection and repair.
Endosteum: inner lining of bone cavity; plays role in remodeling.
Medullary (marrow) cavity: contains yellow (fatty) marrow in adults; red marrow in some regions for hematopoiesis.
Bone remodeling and aging:
Wolf's Law: bone adapts to the stresses placed on it; higher stress leads to increased bone density (mineral deposition) and modeling to strengthen bone against expected loads.
Davis's Law: soft tissues (ligaments, joint capsules, muscles, tendons) adapt to stresses (shorten/lengthen); prolonged changes in length lead to lasting adaptations.
Examples: apophysitis, osteoarthritis risk reduction with appropriate loading; aging reduces collagen synthesis and bone density, leading to osteopenia/osteoporosis risks.
Joints: structure, classification, and function
Joints (arthro-): where movement occurs; three major classifications:
Synarthrodial (fibrous joints): immovable joints (e.g., skull sutures, gomphosis teeth in sockets).
Amphiarthrodial (cartilaginous joints): limited, slight movement (e.g., pubic symphysis, intervertebral discs).
Diarthrodial (synovial joints): freely movable joints with a joint capsule and synovial fluid; main focus of this course.
Synovial joint components:
Joint capsule (fibrous), reinforced by ligaments.
Synovial fluid bathes articulating surfaces; articular cartilage covers ends of bones.
Labrum, menisci, and articular cartilage contribute to stability and congruence.
Types of diarthrodial (synovial) joints (six main types):
Arthrodial (gliding) joints: two flat surfaces glide; examples include carpal joints and vertebral facets.
Hinge joints: uniaxial, move in one plane (flexion/extension); examples include elbow and interphalangeal joints.
Pivot (trochoid) joints: uniaxial rotation around a single axis; examples include atlantoaxial joint and proximal radioulnar joint.
Condyloid (ellipsoidal) joints: biaxial; convex on one side, concave on the other; examples include radiocarpal joint (wrist).
Ball-and-socket joints: multiaxial, three degrees of freedom; examples include shoulder and hip.
Saddle (sellar) joints: triaxial with unique concave-convex geometry; thumb carpometacarpal joint is the classic example.
Joint stability vs mobility (trade-off): more mobility often means less static stability; more static stability often means less mobility.
Static stabilizers: bone architecture, labrums, menisci, joint capsules, ligaments; some cannot be changed with training.
Dynamic stabilizers: muscles, tendons, proprioception, motor control, and neuromuscular coordination.
Proprioception and motor control contribute to joint stability during movement.
Three laws of tissue adaptation applied to joints:
Wolf's Law (bone adaptation to load).
Davis's Law (soft tissue adaptation to load).
Clinical implications: proper loading can strengthen joints; excessive loading or immobilization can cause stiffness or instability.
Practical rehabilitation concepts:
Joint mobilizations used by clinicians to stretch connective tissues when necessary.
Proprioception/motor control training improves stability during movement.
Open vs closed kinetic chain concepts affect how joint surfaces move and how roll/glide occur.
Movement terminology recap (coupled with examples):
Flexion/extension: sagittal plane; decrease/increase of joint angle.
Abduction/adduction: frontal plane; movement away from/toward midline.
Internal (medial) and external (lateral) rotation: transverse plane; rotation about a vertical axis.
Circumduction: combined movement in multiple planes (flexion + extension + abduction + adduction).
Diagonal movements: high/low diagonals combining planes (e.g., diagonal abduction/adduction).
Pronation/supination: forearm movements (palm orientation in the transverse plane).
Dorsiflexion/plantar flexion: foot movements; dorsum toward shin vs plantar toward sole.
Inversion/eversion: foot movements around a longitudinal axis.
Radial/ulnar deviation: hand/wrist movements toward radial (thumb) or ulnar (pinky) sides.
Elevation/depression, protraction/retraction, and scapular rotations for the shoulder girdle.
Lateral flexion: side bending of the spine.
Reduction: returning to neutral after lateral flexion.
Opposition/reposition: thumb contact with fingers and return to neutral.
Movement notation: think in terms of joint movements (bone positions), not muscles themselves; a muscular contraction produces joint movement, not the action label by itself.
Normal ranges of motion (ROM): assessed with a goniometer (360-degree device) or inclinometer; concept of 0–180 degrees used for simplicity; actual normal ranges vary by joint and region; emphasis is understanding relative angles rather than exact numeric normal values.
The physiology of the musculoskeletal system: integration into movement
The body as a lever system: bones act as levers, joints as fulcrums, muscles as drivers; ligaments and tendons provide force transmission and guidance.
Open vs closed kinetic chain examples:
Open chain: distal segment moves freely (e.g., knee extension machine); movement of a single joint with the other segments free.
Closed chain: distal segment fixed (e.g., squat); multiple joints move in a coordinated fashion with proximal stabilization.
Practical take-home: for rehabilitation, understanding which bone is fixed vs moving changes the direction of accessory movements (roll vs glide) and how to approach training safely.
Measurements and practical assessment tools
Goniometer: primary tool for measuring joint ROM in degrees (0–180 typically used as reference).
Inclinometer: used in some contexts (e.g., spine ROM) for more precise angle measurement.
Concept: use ROM measures to track changes due to rehabilitation, training, or pathology; ROM improvements reflect adaptation of bones, cartilage, and soft tissues (per Wolf’s and Davis’s laws).
Important practical notion: normal ROM is region-specific and not universally fixed; focus on relative movement quality and functional ability rather than a single universal number.
Putting it all together: chapter wrap-up ideas
Movement is a joint effort between bone (structure) and soft tissues (muscles, ligaments, tendons, cartilage).
Proper movement relies on matching stability with mobility (the C-principle): too much stability may impede movement; too much mobility can risk injury.
The body’s tissues adapt with loading: bones undergo remodeling (Wolf’s Law) and soft tissues adapt (Davis’s Law).
Mastery comes from building a consistent language set (planes, axes, and movement terminology) and using tools like goniometers to quantify progress.
Final note: nomenclature in this course includes multiple naming conventions for planes/axes; focus on consistency within your own notes and be able to translate between common synonyms when needed.
Quick reference terms (condensed definitions)
Epiphysis: end of a long bone separated from the shaft by the growth plate; site for joint articulation.
Diaphysis: shaft of a long bone; contains the medullary cavity; cortical (compact) bone forms the hard outer shell.
Periosteum: outer fibrous membrane covering bone; attachment site for tendons/ligaments.
Endosteum: inner lining of bone's medullary cavity.
Medullary cavity: central cavity of bone containing yellow (fatty) marrow in adults; red marrow in some regions.
Articular cartilage: hyaline cartilage covering joint ends; reduces friction and absorbs load.
Labrum/menisci: fibrocartilaginous structures that improve joint congruence and stability.
Growth plate (epiphyseal plate): cartilage zone for longitudinal bone growth in children.
Apophysis: tendon/ligament attachment site near growth plates; prone to apophysitis in adolescence.
Osteoblasts/osteoclasts: bone-forming vs bone-resorbing cells; balance governs bone density.
Wolff's Law: bone adapts to the loads it experiences.
Davis's Law: soft tissues adapt to the stresses placed on them.
Synarthrodial: immovable joints (e.g., skull sutures).
Amphiarthrodial: slightly movable joints (e.g., pubic symphysis).
Diarthrodial: freely movable joints with a synovial capsule.
Six diarthrodial types: gliding (arthrodial), hinge, pivot, condyloid, ball-and-socket, saddle.
Degrees of freedom: how many planes a joint can move in (1, 2, or 3).
Accessory joint motions (arthrokinematics): roll, glide, spin; depend on concave-convex relationships.
Open kinetic chain vs closed kinetic chain: distal segment moves freely vs fixed.
ROM measurement: use goniometer; degrees of freedom give a practical sense of joint flexibility.
Common clinical conditions mentioned: Osgood-Schlatter disease, Sever’s disease, apophysitis, avulsion fractures, osteopenia/osteoporosis (context of aging bones).