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Reference Lines & Planes of motion (definition and palpation)
1. Cardinal planes – know also their alternate names
a. Sagittal
b. Frontal
c. Transverse
d. Diagonal
e. Scapular
2. Axis of Rotation
a. Frontal
b. Sagittal
c. Vertical
d. Diagonal
Bone Shapes
1. Be able to identify what shape a bone is by picture.
a. Long
b. Short
c. Flat
d. Irregular
e. Sesamoid –pay special attention to this term as it may be new to you.

Key anatomical terminology should be studied for definition
1. Anterior
2. Anteroinferior
3. Anerolateral
4. Anteromedial
5. Anteroposterior
6. Anterosuperior
7. Bilateral
8. Caudal
9. Cephalic
10. Contralateral
11. Deep
12. Dexter
13. Distal
14. Dorsal
15. Inferior
16. Inferolateral
17. Inferomedial
18. Ipsilateral
19. Lateral
20. Medial
21. Median
22. Palmar
23. Plantar
24. Posterior
25. Posteroinferior
26. Posterolateral
27. Posteromedial
28. Posterosuperior
29. Prone
30. Proximal
31. Sinister
32. Superficial
33. Superior
34. Superolateral
35. Superomedial
36. Supine
37. Ventral
38. Volar

Kinesiological Terminology by joint (and know what plane of motion these movements
fall under)
1. Abduction
2. Adduction
3. Flexion
4. Extension
5. Circumduction
6. Diagonal abduction
7. Diagonal adduction
8. External Rotation
9. Internal Rotation
Foot
10. Eversion
11. Inversion
12. Dorsi flexion
13. Plantar flexion
Radio-ulnar joint
14. Pronation
15. Supination
Scapulothoracic
16. Depression
17. Elevation
18. Protraction
19. Retraction
20. Downward rotation
21. Upward rotation
Gleno-humeral
1. Scaption
Gleno-humeral and hip
1. Horizontal abduction
2. Horizontal adduction
Spine
1. Lateral Flexion

2. Reduction
Wrist and Hand
1. Dorasal flexion
2. Palmar flexion
3. Radial flexion / deviation
4. Ulnar flexion/ deviation
5. Opposition (thumb)
6. Reposition (thumb)
3 types of motions at a joint- terms used specifically to describe what is occurring between the
bones of a given joint. – be able to tell what type of motion is occurring if you are shown a
motion between two bones.
1. Spin
2. Roll
3. Glide

Joint Motions by plane:
A. Sagittal Plane
1. flexion
2. extension
3. plantar flexion
4. dorsi flexion
5. hyperextension
6. protraction
7. retraction
B. Frontal Plane
1. lateral flexion
2. lateral extension
3. abduction
4. adduction
5. inversion / supination (foot)
6. eversion / Pronation (foot)
7. elevation
8. depression
9. Upward Rotation
10. Downward Rotation
9. protraction
10. retraction
11. abduction/adduction of the wrist ulnar deviation and radial deviation
C. Transverse Plane
1. spinal rotation
2. medial rotation /internal rotation
3. lateral rotation /external rotation
4. supination (hand)
5. pronation (hand)
6. horizontal abduction
7. horizontal adduction

D. Scapular Plane
1. Upward Rotation
2. Downward rotation
E. Multi-Planar
1. circumduction

Synovial Joints
1. The 6 types of Synovial Joints
-the alternative name to each joint and where they are located in the body
Key Terminology:
1. Properties of Muscles
a. Excitability
b. Contractility
c. Extensibility
d. Elasticity
2. Muscle nomenclature and fiber arrangement
a. Parallel vs pennate
3. Gaster (belly)
4. Origin
5. Insertion
6. Innervation
7. Action
8. Fascia

Key Outlines & Lists:
1. Types of muscle Contraction:
a. Static (isometric)
b. Dynamic (moving)
i. Concentric
ii. Eccentric
iii. Iso-kinetic
2. Roles of Muscles
a. Agonist
b. Prime mover
c. Synergist
d. Antagonist
e. Stabilizer
f. Neutralizers
3. The Neuromuscular Concepts we will focus a lot on this chapter
a. Motor Unit
b. Size principle
c. All or none
d. Fig. 2.15 Stages a muscle contraction
i. Stimulus
ii. Latent period
iii. Contraction
iv. Relaxation
v. Summation
vi. Tetanus
e. Active and Passive Tension and the length-tension relationship
f. Force-Velocity relationship
g. Reciprocal Inhibition
h. Active and Passive Insufficiency

Terminology
- Biomechanics
- Statics and Dynamics in relation to Biomechanics
- Kinetics
- Kinematics vs. Kinetics
- Levers
- Pulleys
- Wheels and axels
- The Kinetic Chain
- Open Kinetic Chain
- Closed Kinetic Chain
- Parts of a lever (and the alternative names for them)
--Axis of rotation (Fulcrum)
--Force (Effort)
--Resistance (Load)
Know the different classifications of levers be able to identify the different parts of a lever
- 1st class
- 2nd class
- 3rd class
You need to know how the length of the resistance arms and force arms changes how much force is
needed to overcome a resistance
Be able to identify what class a lever is from a picture, which arm is longer, and how changing the
position of the load, effort or fulcrum changes the amount of overall force needed

The shoulder Girdle
Joints:
1. Sternoclavicular joint
a. Arthrodial joint- allows limited rotary gliding movement
b. Primary ligaments: anterior sternoclavicular ligament covering the joint, and the costoclavicular
ligament holding the clavicle preventing upward dislocation.
c.
2. Acromio-clavicular joint (AC joint)
a. Arthrodial joint - 20-30 degrees of gliding movement
b. Primary ligaments
i. Coracoclavicluar ligament
1. two components the trapezoid ligament and the Conoid ligament
2. Both run from the coracoid process of the scapula to the inferior surface of the
distal clavicle. Each has a tubercle on the scapula named for the ligaments
respectively.
3. Unique in that this ligament is not directly at the joint.
ii. Acromioclavicular ligaments- weaker
3. Scapulo-thoracic Interaction- NOT A JOINT. The scapula slides along the thoracic surface. Muscles of
the rib cage and muscles on the anterior surface of the scapula prevent most bone/bone contact

a. Common Injuries-
i. Separated shoulder- Acromioclavicular and/or coracoclavicular ligament tear/sprain
(the clavicle pops up above the scapula. (See x-ray above)
ii. SC Sprain
iii. ‘FOOSH’ mechanism of injury- Fall on outstretched hand
iv. Arthritis of the AC joint
v. Arthritis of the sternoclavicular joint.
vi. Winging Scapula muscle imbalance
Motions:
1. Elevation/Depression
2. Protraction / Retraction (adduction/ abduction)
3. Upward rotation/ downward rotation
4. Lateral tilt (outward tilt) ‘winging’ /Medial-tilt Inward tilt
5. Anterior Tilt (upward tilt) / Posterior tilt (inferior tilt)
Key Concepts:
1. Why it is vital to strengthen scapular stabilizers and improve posture
2. The scapula as a movable base for gleno-humeral movement
3. The scapula cannot move without rotary movement from the AC or SC joints (They move together as a
unit

The Shoulder Joint, Glenohumeral joint
Joints:
1. Glenohumeral Joint
a. Multi-axial ball and socket joint with joint capsule
b. Glenoid Labrum- cartilaginous ring adding stability and support to the joint
c. Four key trans glenohumeral ligaments that add strength and stability primarily to the anerior, superior, and inferior surfaces of the joint
capsule.
i. Inferior glenohumeral ligament
ii. Middle glenohumeral ligament
iii. Superior glennohumeral ligament
iv. Coracohumeral ligament
d. Transverse ligament holds the bicep tendon in the bicipital groove. This ligament does not cross the joint. It only crosses the biciptal
groove.
e. Bursa- slippery fluid filled sacks that help reduce impact and friction forces around the shoulder joint.

f. Common Glenohumeral Injuries-
i. Labral tear
ii. rotator cuff tear
iii. dislocated shoulder
iv. shoulder impingement syndrome
v. shoulder bursitis
vi. Arthritis of the shoulder
vii. ‘FOOSH’ is a common mechanism of injury- Fall on outstretched
hand

g. The Rotator Cuff Muscles
i. Important muscles for support of the joint
1. Subscapularis, teres minor, supraspinatus, infraspinatus.
Motions:
1. Flexion /Extension
2. Adduction/ Abduction
3. Horizontal Abduction/ Horizontal Addcution
4. Internal rotation / External Rotation
5. Circumduction
Key Concepts:
1. Glennohumeral joint has mobility, but not stability. Trade-off for increased range
of motion is a reduction in body structure. The joint is largely supported by muscles and ligaments not bone.
2. The shoulder gridle and the Glenohuemral joint work/move in unison. Do not confuse them with each other or use the language of the joint
carelessly.

Joints:
1. Elbow-
a. Humeral-ulna Joint
b. Radio-ulna joint
2. Ligaments and other soft tissue structures:
a. Ligaments
b. Interosseous membrane (syndesmosis between the radius and ulna)
c. Bursa- slippery fluid filled sacks that help reduce impact and friction near the
olecranon process. .

d. Common Glenohumeral Injuries-
i. Fractures
ii. dislocated elbow
iii. bursitis
iv. ‘FOOSH’ is a common mechanism of injury- Fall on outstretched injury.
Motions:
1. Elbow: Flexion /Extension (the radius and ulna on the trochlea and capitulum)
2. Radio-ulnar joint (also) supination/ pronation
Key Concepts:
1. The ulna is the primary force bearing bone at the elbow, but at the wrist the radius is a larger,
stronger, bone. The force must be transmitted from one bone to the other in the kinetic chain of
the forearm. This is one of the reasons that the forearm is so frequently broken. Compare this to
the tibia & fibula. Tibia is thicker top and bottom, fibula is thinner top and bottom.

Muscles that move the Humerus at the Glenohumeral Joint
Muscle Origin Insertion Action(s) Innervation
Biceps Brachii
(Long Head)
Biceps Brachii
(Short Head)
Brachialis

Muscle Origin Insertion Action(s) Innervation
Brachioradialis
Pronator
Teres
Pronator
Quadratus
Triceps Brachii
Long Head

Muscle Origin Insertion Action(s) Innervation
Triceps
Brachii
Lateral Head
Tricpes
Brachii
Medial Head

Wrist and Hand Study Guide
• Bones
- Radial styloid process
- Ulna styloid process
( what ligaments attach to these bones)
- 8 Carpal Bone: Scaphoid, Lunate, Triquetrum, Pisiform, Trapezium, Trapezoid, Capitate,
Hamate
(which 4 bones are more proximal and articulate to the radius and ulna)
- Most commonly fractured carpal bone: Scaphoid
- Most commonly dislocated carpal bone: lunate
- 5 Metacarpal bones
- 14 Phalange bones
- Saddle joint: articulation between the trapezium and 1st metacarpal bone
• Medial Epicondyle: attachment site for wrist flexors
• Lateral Epicondyle: attachment site for wrist extensors
• What type of joint is the wrist joint?
• What type of joints are the MCP joints?
• What type of joints are the PIP and DIP joints?
• Wrist movements: Flexion, extension, abduction (radial deviation), adduction (ulnar deviation)
• Origin, Insertion, Action of the following muscles
- Flexor carpi radialis
- Palmaris longus
- Flexor carpi ulnaris
- Extensor carpi ulnaris
- Extensor carpi radialis brevis
- Extensor carpi radialis longus
- Flexor digitorum superficialis
- Flexor digitorum profundus
- Extensor digitorum
• Pollicis: in regards to the thumb
• Innervation: which of the 3 nerves (radial, median, ulnar) coincide to parts of the hand

Pelvis and Hip
Osteological Overview
1. The Pelvic Girdle consists of the Right & Left Pelvic bones (also call innominate bones)and
the sacrum & coccyx.
2. Familiarize yourself with all the bony landmarks on the powerpoint because they will
become the origins and insertions for the hip and pelvis muscles.
Joints

1. The ileum, ischium & Pubis are fused into the ‘os coxae’, coxal bone, or innominate bone (three names for same thing) over many years (4-18yrs).
Fusion starts at the ischiopubic ramus and ends with the illium fusing at the acetabulum. In adults there is NO motion at these joints. Thus the
coxal bone is considered as a single fused unit.
2. The Saccro-illiac joint (or SI joint) is movable, but held tightly together with ligaments. You have one on each side of the sacrum.
a. Even thought the amount of movement at this joint is small, the SI joint can be a source of pain if it is not functioning properly because
this joint carries all the weight of the upper body connecting it to the pelvis/legs.
3. Pubic Syphilis is the location where the pubic bones meet and is the most anterior portion of the pelvic girdle. There is a cartilaginous disk
between the two pubis bones. There is limited motion in this joint, and it also loosens in late pregnancy to prepare for delivery.
4. Hip Joint- a ball and socket joint.

Motions:
Pelvis Motions - ‘tilt’ in three planes
1. Saggittal- Anterior or posterior pelvic Tilt
2. Frontal Plane- Right or Left Lateral pelvic rotation
3. Transverse Plane – Right or Left Transverse pelvic rotation
The steering wheel analogy from the book is very very helpful. Notice that you cant move
just once side of a steering wheel, if one side of the pelvis lifts, the other must drop, etc.
Hip Motions
1. Flexion /Extension
2. Adduction/ Abduction
3. Horizontal Abduction/ Horizontal Addcution
4. Internal rotation / External Rotation
5. Circumduction
Ligaments
Anterior hip ligaments
- Iliofemoral ligament (Y ligament)
- Pubofemoral ligament
Posterior hip ligament
- Ischiofemoral ligament

Muscle Origin Insertion Actions
Iliopsoas
Pectineus
Rectus Femoris
Sartorius
Adductor Brevis
Adductor Longus
Adductor Magnus
Gracilis
Gluteus Maximus
Gluteus Medius
Gluteus Minimus
Biceps Femoris
Semitendinosus
Semimembranosus
Tensor Fascia Latae
Piriformis

Knee

Foot and Ankle

Muscles of the Torso

Key Concepts in Human Anatomy

1. Cardinal Planes of Motion:

   • Sagittal: Divides body into left and right.

   • Frontal: Divides body into front and back.

   • Transverse: Divides body into top and bottom.

   • Diagonal & Scapular: Movements in a combined pattern.

2. Bone Shapes:

   • Long, Short, Flat, Irregular, Sesamoid.

3. Key Anatomical Terminology:

   • Understand terms like Anterior, Posterior, Medial, Lateral, Proximal, Distal, etc., that describe locations and orientations in the body.

4. Kinesiological Terminology:

   • Movements by joint, including Flexion, Extension, Abduction, Adduction, Internal and External Rotation, etc.

5. Types of Joint Motions:

   • Spin, Roll, Glide.

6. Muscular Anatomy:

   • Properties: Excitability, Contractility, Extensibility, Elasticity.

   • Roles of muscles: Agonist, Antagonist, Synergist.

7. Synovial Joints:

   • Characteristics of different types including ball and socket, hinge, and others, with examples from the human body.

8. Biomechanics:

   • Relationship between forces and movements; lever systems and their classifications (1st, 2nd, 3rd class).

9. Pelvic and Hip Anatomy:

   • Structure and function of the pelvic girdle and hip joint; common injuries and motions.

Reference Lines & Planes of Motion

1. Cardinal Planes (Alternate Names):

   • Sagittal (Median Plane): Divides the body into left and right halves.

   • Frontal (Coronal Plane): Divides the body into front and back halves.

   • Transverse (Horizontal Plane): Divides the body into top and bottom halves.

   • Diagonal (Oblique Plane): Combination of movements across planes.

   • Scapular Plane: Refers to the natural movement of the scapula.

2. Axis of Rotation:

   • Frontal (Medial-Lateral Axis): Movement along the sagittal plane.

   • Sagittal (Anteroposterior Axis): Movement along the frontal plane.

   • Vertical (Longitudinal Axis): Movement along the transverse plane.

   • Diagonal Axis: Movement in diagonal planes.

Bone Shapes

1. Types of Bones:

   • Long Bones: E.g., femur, humerus.

   • Short Bones: E.g., carpals, tarsals.

   • Flat Bones: E.g., skull, scapula.

   • Irregular Bones: E.g., vertebrae.

   • Sesamoid Bones: Embedded within tendons, e.g., patella.

Key Anatomical Terminology

• Directional Terms: Anterior, Posterior, Lateral, Medial, Proximal, Distal, etc.

• Positional Terms: Supine (lying face-up), Prone (lying face-down).

• Movements: Ipsilateral (same side), Contralateral (opposite side).

Kinesiological Terminology by Joint

1. Movements:

   • Abduction/Adduction (Frontal Plane)

   • Flexion/Extension (Sagittal Plane)

   • Circumduction: Multi-planar movement.

   • Rotation: Internal and external (Transverse Plane).

2. Specific Joints:

   • Foot: Eversion, Inversion, Dorsiflexion, Plantar Flexion.

   • Radio-Ulnar Joint: Pronation, Supination.

   • Scapulothoracic: Elevation, Depression, Protraction, Retraction, Rotation.

   • Glenohumeral & Hip: Horizontal Abduction/Adduction.

Joint Motions by Plane

• Sagittal Plane: Flexion, Extension, Hyperextension.

• Frontal Plane: Abduction, Adduction, Elevation.

• Transverse Plane: Rotation, Horizontal movements.

• Scapular Plane: Specialized motions (e.g., upward/downward rotation).

• Multi-Planar: Circumduction.

Synovial Joints

1. Types & Alternate Names:

   • Plane, Hinge, Pivot, Condyloid, Saddle, Ball-and-Socket.

2. Key Locations: Knee, Shoulder, Elbow, Hip.

Muscle Properties and Terminology

1. Properties:

   • Excitability, Contractility, Extensibility, Elasticity.

2. Contraction Types:

   • Static (Isometric).

   • Dynamic: Concentric, Eccentric, Iso-kinetic.

3. Roles:

   • Agonist, Antagonist, Synergist, Stabilizer, Neutralizer.

Neuromuscular Concepts

1. Principles:

   • Motor Unit, All-or-None, Size Principle.

   • Force-Velocity Relationship.

   • Reciprocal Inhibition.

2. Muscle Tension:

   • Active and Passive Tension.

   • Length-Tension Relationship.

3. Stages of Contraction: Stimulus, Latent, Contraction, Relaxation.

Biomechanics and Kinetics

1. Key Terms:

   • Biomechanics, Kinetics (force), Kinematics (motion).

   • Open/Closed Kinetic Chain.

2. Levers:

   • Classes: 1st, 2nd, 3rd.

   • Key Factors: Length of resistance and force arms.

   • Adjustments in load, fulcrum, and effort.

Specific Joint Details

1. Shoulder Girdle:

   • Includes sternoclavicular and acromioclavicular joints.

   • Key injuries: Separated shoulder, FOOSH (Fall on Outstretched Hand).

   • Motions: Elevation, Depression, Protraction, Retraction.

2. Glenohumeral Joint:

   • Multi-axial ball-and-socket.

   • Common Injuries: Labral tears, Rotator cuff injuries, Dislocations.

   • Rotator Cuff Muscles: Supraspinatus, Infraspinatus, Teres Minor, Subscapularis.

3. Elbow & Radio-Ulnar Joint:

   • Humeral-ulna and radio-ulna joints.

   • Motions: Flexion, Extension, Supination, Pronation.

   • Common injuries: Bursitis, Dislocations.

4. Wrist and Hand:

   • Bones: Radial/Ulna Styloid, 8 Carpal Bones.

   • Motions: Flexion, Extension, Radial/Ulnar Deviation, Opposition/Reposition.

Muscles and Movements

• Be familiar with origins, insertions, actions, and innervations of muscles like biceps brachii, triceps brachii, pronators, and supinators.

• Anterior: Front side of the body or toward the front.

• Anteroinferior: In front and below.

• Anterolateral: In front and to the side, especially the outside.

• Anteromedial: In front and toward the middle.

• Anteroposterior: Relating to both front and back.

• Anterosuperior: In front and above.

• Bilateral: Relating to both sides of the body.

• Caudal: Toward the tail or lower part of the body.

• Cephalic: Toward the head or upper part of the body.

• Contralateral: Opposite side of the body.

• Deep: Farther from the surface of the body.

• Dexter: Right side of the body.

• Distal: Farther from the trunk or point of origin.

• Dorsal: Toward the back or posterior side.

• Inferior: Below or lower.

• Inferolateral: Below and to the outside.

• Inferomedial: Below and toward the midline.

• Ipsilateral: Same side of the body.

• Lateral: Away from the midline of the body.

• Medial: Toward the midline of the body.

• Median: In the midline or middle.

• Palmar: Referring to the palm side of the hand.

• Plantar: Referring to the sole of the foot.

• Posterior: Back side of the body or toward the back.

• Posteroinferior: Behind and below.

• Posterolateral: Behind and to the outside.

• Posteromedial: Behind and toward the middle.

• Posterosuperior: Behind and above.

• Prone: Lying face down.

• Proximal: Closer to the trunk or point of origin.

• Sinister: Left side of the body.

• Superficial: Closer to the surface of the body.

• Superior: Above or higher.

• Superolateral: Above and to the outside.

• Superomedial: Above and toward the midline.

• Supine: Lying face up.

• Ventral: Toward the front or anterior side.

• Volar: Refers to the palm of the hand or sole of the foot.

• Properties of Muscles

• Excitability (Irritability): The ability of muscle tissue to respond to stimuli (such as nerve impulses).

• Contractility: The ability of muscle fibers to contract or shorten forcefully when stimulated.

• Extensibility: The ability of muscle fibers to stretch or lengthen beyond their resting length.

• Elasticity: The ability of muscle fibers to return to their original length after being stretched or contracted.

• Muscle Nomenclature and Fiber Arrangement

• Parallel vs. Pennate:

• Parallel: Muscle fibers run parallel to the length of the muscle. Examples include the biceps brachii (fusiform) and rectus abdominis (strap).

• Subtypes: Fusiform, strap, flat, circular, triangular.

• Pennate: Muscle fibers are arranged obliquely (at an angle) to the tendon, resembling a feather.

• Subtypes: Unipennate (fibers on one side of the tendon), bipennate (fibers on both sides of the tendon), and multipennate (fibers branching off multiple tendons).

• Other Key Terms

• Gaster (Belly): The central, fleshy portion of the muscle, where most of the muscle's fibers are located. It is the part that increases in diameter during contraction.

• Origin: The attachment site of a muscle to a stationary bone, typically located proximally and less movable.

• Insertion: The attachment site of a muscle to a movable bone, usually located distally and more movable.

• Innervation: The supply of nerves to a muscle, enabling it to receive signals from the central nervous system to control movement.

• Action: The specific movement(s) a muscle produces when it contracts (e.g., flexion, extension, abduction).

• Fascia: A band or sheet of connective tissue that surrounds, supports, and separates muscles and other internal organs. It helps transmit force and reduce friction.

Types of Muscle Contraction

1. Static (Isometric):

   • The muscle contracts without changing its length, and there is no visible movement at the joint.

   • Example: Holding a plank position.

2. Dynamic (Moving):

   • The muscle changes length while contracting, leading to visible joint movement. Subtypes include:

   • Concentric: The muscle shortens as it contracts to produce movement.

     • Example: Lifting a weight during a bicep curl.

   • Eccentric: The muscle lengthens as it contracts, typically controlling movement against resistance or gravity.

     • Example: Lowering a weight during a bicep curl.

   • Iso-kinetic: The muscle contracts at a constant speed throughout the range of motion. Requires specialized equipment (e.g., isokinetic dynamometers).

Roles of Muscles

1. Agonist:

   • The primary muscle responsible for producing a specific movement.

   • Example: The biceps brachii during elbow flexion.

2. Prime Mover:

   • Often used interchangeably with "agonist," it refers to the main muscle driving a movement.

3. Synergist:

   • Assists the agonist in producing the movement by providing additional force or reducing unnecessary motion.

   • Example: The brachialis assists the biceps brachii during elbow flexion.

4. Antagonist:

   • The muscle that opposes the action of the agonist. It relaxes or lengthens to allow the movement.

   • Example: The triceps brachii during elbow flexion.

5. Stabilizer:

   • Maintains a stable base or fixes a body part to allow the agonist to work effectively.

   • Example: The core muscles stabilize the torso during a push-up.

6. Neutralizer:

   • Prevents unwanted motion by canceling out extra movement generated by the agonist.

   • Example: The pronator teres prevents supination of the forearm during bicep curls.

Neuromuscular Concepts

1. Motor Unit:

   • Consists of a single motor neuron and all the muscle fibers it innervates.

   • A motor unit’s size determines the precision of movement (e.g., small motor units for fine control like in the eyes).

2. Size Principle:

   • Motor units are recruited from smallest to largest based on the force required.

   • Small units (slow-twitch fibers) activate first, followed by larger units (fast-twitch fibers) as force demands increase.

3. All-or-None Principle:

   • A motor unit's fibers contract fully or not at all when stimulated above the threshold.

4. Stages of Muscle Contraction (Fig. 2.15):

   • Stimulus: Initiation of a neural impulse.

   • Latent Period: Time between the stimulus and the onset of contraction.

   • Contraction: Muscle fibers actively shorten and generate tension.

   • Relaxation: Tension decreases as fibers return to resting length.

   • Summation: Increased frequency of stimuli results in greater tension.

   • Tetanus: A sustained contraction with no relaxation between stimuli.

5. Active and Passive Tension & Length-Tension Relationship:

   • Active Tension: Tension produced by muscle contraction.

   • Passive Tension: Tension generated when a muscle is stretched.

   • Optimal length exists where maximum force can be generated due to ideal overlap of actin and myosin.

6. Force-Velocity Relationship:

   • Inverse relationship: As contraction velocity increases, force decreases, and vice versa.

7. Reciprocal Inhibition:

   • The agonist contracts while the antagonist relaxes to allow movement.

8. Active and Passive Insufficiency:

   • Active Insufficiency: A muscle cannot shorten enough to produce full range of motion at all joints it crosses.

   • Passive Insufficiency: A muscle cannot stretch enough to allow full range of motion at all joints it crosses.

Biomechanics and Related Terminology

1. Biomechanics:

   • The study of mechanical principles applied to biological systems.

2. Statics vs. Dynamics:

   • Statics: Study of systems at rest or moving at a constant velocity.

   • Dynamics: Study of systems in motion with acceleration.

3. Kinetics vs. Kinematics:

   • Kinetics: Study of forces causing motion.

   • Kinematics: Study of motion itself (e.g., velocity, acceleration).

4. Levers, Pulleys, Wheels & Axles:

   • Understand how these mechanical systems affect force and motion in the body.

5. The Kinetic Chain:

   • Linked body segments working together during movement.

   • Open Kinetic Chain: Distal segment moves freely (e.g., leg extension).

   • Closed Kinetic Chain: Distal segment is fixed (e.g., squats).

Parts of a Lever

• Axis of Rotation (Fulcrum): The pivot point.

• Force (Effort): The force applied to move the resistance.

• Resistance (Load): The weight or resistance being moved.

Classifications of Levers

1. 1st Class Lever:

   • Axis is between force and resistance (e.g., seesaw, head nodding).

2. 2nd Class Lever:

   • Resistance is between axis and force (e.g., wheelbarrow, standing on toes).

3. 3rd Class Lever:

   • Force is between axis and resistance (e.g., bicep curl, most body movements).

1. Why It Is Vital to Strengthen Scapular Stabilizers and Improve Posture

Strengthening scapular stabilizers and improving posture are essential for the following reasons:

1. Improved Shoulder Function:

   • Scapular stabilizers (like the serratus anterior, trapezius, and rhomboids) maintain the correct position of the scapula, which is critical for proper shoulder mechanics.

2. Injury Prevention:

   • Weak scapular stabilizers can lead to compensatory movements and overuse injuries, such as impingement or rotator cuff issues.

3. Enhanced Athletic Performance:

   • Strong scapular stabilizers provide a stable foundation for powerful and controlled upper limb movements, crucial in sports and functional activities.

4. Better Posture:

   • Strengthened scapular muscles help counteract forward-shoulder posture caused by prolonged sitting or poor ergonomics. Good posture reduces neck and back strain.

5. Reduced Pain:

   • Proper scapular alignment and stability relieve stress on the cervical spine, thoracic spine, and shoulder joints.

2. The Scapula as a Movable Base for Gleno-Humeral Movement

The scapula functions as a dynamic base for the humerus, facilitating efficient movement of the gleno-humeral joint (shoulder joint):

1. Range of Motion:

   • Scapular motion increases the functional range of shoulder movements like flexion, abduction, and rotation.

2. Force Transfer:

   • The scapula acts as a stable platform for muscle attachment, transferring force generated by the muscles to the humerus.

3. Joint Protection:

   • A well-positioned scapula maintains the congruency of the gleno-humeral joint, reducing stress on the joint capsule and ligaments.

3. The Scapula Cannot Move Without Rotary Movement from the AC or SC Joints

The scapula works in coordination with the acromioclavicular (AC) joint and sternoclavicular (SC) joint to allow smooth movement:

1. Interdependent Movements:

   • The AC joint provides rotational adjustments to the scapula, while the SC joint acts as the only bony connection between the upper limb and the axial skeleton. Together, they ensure scapular mobility and stability.

2. Scapulothoracic Rhythm:

   • Movements of the scapula are synchronized with the AC and SC joints. For every 2 degrees of gleno-humeral motion, there is about 1 degree of scapular movement.

3. Complex Kinematics:

   • Movements like upward/downward rotation, anterior/posterior tilting, and internal/external rotation of the scapula rely on the AC and SC joints to provide the necessary adjustments.

4. Functional Impairment:

   • If the AC or SC joint is restricted, scapular movement is compromised, affecting the entire shoulder's functional range and increasing injury risk

1. Subscapularis

• Origin:

  • Subscapular fossa of the scapula (the anterior surface of the scapula).

• Insertion:

  • Lesser tubercle of the humerus.

• Action:

  • Medial (internal) rotation of the humerus.

  • Assists in stabilizing the head of the humerus in the glenoid cavity.

2. Teres Minor

• Origin:

  • Lateral border of the scapula (midpoint of the lateral border).

• Insertion:

  • Greater tubercle of the humerus (inferior facet).

• Action:

  • Lateral (external) rotation of the humerus.

  • Stabilizes the head of the humerus in the glenoid cavity.

3. Supraspinatus

• Origin:

  • Supraspinous fossa of the scapula.

• Insertion:

  • Greater tubercle of the humerus (superior facet).

• Action:

  • Abduction of the arm (initiates the first 15° of abduction).

  • Stabilizes the head of the humerus in the glenoid cavity.

4. Infraspinatus

• Origin:

  • Infraspinous fossa of the scapula.

• Insertion:

  • Greater tubercle of the humerus (middle facet).

• Action:

  • Lateral (external) rotation of the humerus.

  • Stabilizes the head of the humerus in the glenoid cavity

1. Biceps Brachii (Long Head)

• Origin:

  • Supraglenoid tubercle of the scapula.

• Insertion:

  • Radial tuberosity and bicipital aponeurosis.

• Action(s):

  • Flexion of the elbow.

  • Supination of the forearm.

  • Assists in shoulder flexion.

• Innervation:

  • Musculocutaneous nerve (C5-C6).

2. Biceps Brachii (Short Head)

• Origin:

  • Coracoid process of the scapula.

• Insertion:

  • Radial tuberosity and bicipital aponeurosis.

• Action(s):

  • Flexion of the elbow.

  • Supination of the forearm.

  • Assists in shoulder flexion.

• Innervation:

  • Musculocutaneous nerve (C5-C6).

3. Brachialis

• Origin:

  • Distal half of the anterior surface of the humerus.

• Insertion:

  • Ulnar tuberosity and coronoid process of the ulna.

• Action(s):

  • Primary flexor of the elbow.

• Innervation:

  • Musculocutaneous nerve (C5-C6) and radial nerve (small contribution from C7).

4. Brachioradialis

• Origin:

  • Lateral supracondylar ridge of the humerus.

• Insertion:

  • Styloid process of the radius.

• Action(s):

  • Flexion of the elbow (especially in neutral forearm position).

• Innervation:

  • Radial nerve (C5-C6).

5. Pronator Teres

• Origin:

  • Medial epicondyle of the humerus and coronoid process of the ulna.

• Insertion:

  • Middle of the lateral surface of the radius.

• Action(s):

  • Pronation of the forearm.

  • Assists in elbow flexion.

• Innervation:

  • Median nerve (C6-C7).

6. Pronator Quadratus

• Origin:

  • Distal anterior surface of the ulna.

• Insertion:

  • Distal anterior surface of the radius.

• Action(s):

  • Pronation of the forearm.

• Innervation:

  • Median nerve (anterior interosseous branch, C8-T1).

7. Triceps Brachii (Long Head)

• Origin:

  • Infraglenoid tubercle of the scapula.

• Insertion:

  • Olecranon process of the ulna.

• Action(s):

  • Extension of the elbow.

  • Assists in shoulder extension and adduction.

• Innervation:

  • Radial nerve (C6-C8).

8. Triceps Brachii (Lateral Head)

• Origin:

  • Posterior surface of the humerus (above the radial groove).

• Insertion:

  • Olecranon process of the ulna.

• Action(s):

  • Extension of the elbow.

• Innervation:

  • Radial nerve (C6-C8).

9. Triceps Brachii (Medial Head)

• Origin:

  • Posterior surface of the humerus (below the radial groove).

• Insertion:

  • Olecranon process of the ulna.

• Action(s):

  • Extension of the elbow.

• Innervation:

  • Radial nerve (C6-C8).

Wrist and Hand Study Guide

Bones:

1. Radial Styloid Process

   • Description:

     • The radial styloid process is a bony prominence located at the distal end of the radius on the lateral side of the wrist. It can be palpated on the outer side of the wrist.

   • Ligaments attaching to the Radial Styloid Process:

     • Radial Collateral Ligament (Lateral Ligament):

       • This ligament connects the radial styloid process to the scaphoid and trapezium bones of the wrist. It helps stabilize the lateral side of the wrist.

     • Brachioradialis Tendon:

       • The tendon of the brachioradialis muscle inserts near the radial styloid process, though it is not directly a ligament, it plays a stabilizing role.

2. Ulna Styloid Process

   • Description:

     • The ulna styloid process is located at the distal end of the ulna, on the medial (inner) side of the wrist. It is the bony prominence that can be palpated on the side of the wrist near the pinky finger.

   • Ligaments attaching to the Ulna Styloid Process:

     • Ulnar Collateral Ligament (Medial Ligament):

       • This ligament attaches from the ulna styloid process to the triquetrum and pisiform bones of the wrist. It helps stabilize the medial side of the wrist.

     • TFCC (Triangular Fibrocartilage Complex):

       • The TFCC is a complex structure that includes ligaments, cartilage, and tendons. The ulnar styloid process is part of the attachment site for the TFCC, which provides stability to the distal radioulnar joint (DRUJ) and supports the ulnar side of the wrist.

  Wrist Joint (Radiocarpal Joint)

• Type: Condyloid (Ellipsoid) Joint

  • The wrist joint is a condyloid joint that allows movement in two planes: flexion/extension and abduction/adduction (radial/ulnar deviation). It does not allow significant rotation, which distinguishes it from a ball-and-socket joint. The joint is formed between the distal radius and the carpal bones (scaphoid, lunate, and triquetrum).

  MCP Joints (Metacarpophalangeal Joints)

• Type: Condyloid Joint

  • The MCP joints are the joints between the metacarpal bones of the hand and the proximal phalanges of the fingers. These are also condyloid joints, allowing for movement in two planes: flexion/extension and abduction/adduction, along with some degree of circumduction. The thumb's MCP joint is more limited in its motion compared to the other fingers.

  PIP and DIP Joints (Proximal Interphalangeal and Distal Interphalangeal Joints)

• Type: Hinge Joints

  • The PIP and DIP joints are hinge joints that allow movement primarily in one plane: flexion and extension. These joints are found in the fingers and toes and have a simple range of motion compared to the more complex joints like the wrist and MCP joints.

1. Flexor Carpi Radialis

• Origin: Medial epicondyle of the humerus

• Insertion: Base of the second and third metacarpals

• Action: Flexes and abducts the wrist (radial deviation)

• Innervation: Median nerve (C6, C7)

2. Palmaris Longus

• Origin: Medial epicondyle of the humerus

• Insertion: Flexor retinaculum and palmar aponeurosis

• Action: Flexes the wrist; tenses the palmar aponeurosis

• Innervation: Median nerve (C7, C8)

3. Flexor Carpi Ulnaris

• Origin: Medial epicondyle of the humerus and olecranon process of the ulna

• Insertion: Pisiform bone, hook of the hamate, and base of the fifth metacarpal

• Action: Flexes and adducts the wrist (ulnar deviation)

• Innervation: Ulnar nerve (C8, T1)

4. Extensor Carpi Ulnaris

• Origin: Lateral epicondyle of the humerus and posterior border of the ulna

• Insertion: Base of the fifth metacarpal

• Action: Extends and adducts the wrist (ulnar deviation)

• Innervation: Radial nerve (C6, C7)

5. Extensor Carpi Radialis Brevis

• Origin: Lateral epicondyle of the humerus

• Insertion: Base of the third metacarpal

• Action: Extends and abducts the wrist (radial deviation)

• Innervation: Radial nerve (C6, C7)

6. Extensor Carpi Radialis Longus

• Origin: Lateral supracondylar ridge of the humerus

• Insertion: Base of the second metacarpal

• Action: Extends and abducts the wrist (radial deviation)

• Innervation: Radial nerve (C5, C6)

7. Flexor Digitorum Superficialis

• Origin: Medial epicondyle of the humerus, coronoid process of the ulna, and the radius

• Insertion: Middle phalanges of digits 2-5

• Action: Flexes the middle phalanges of digits 2-5; assists in wrist flexion

• Innervation: Median nerve (C7, C8, T1)

8. Flexor Digitorum Profundus

• Origin: Proximal three-quarters of the anterior and medial surfaces of the ulna and interosseous membrane

• Insertion: Distal phalanges of digits 2-5

• Action: Flexes the distal phalanges of digits 2-5; assists in wrist flexion

• Innervation: Median nerve (for digits 2-3); Ulnar nerve (for digits 4-5) (C8, T1)

9. Extensor Digitorum

• Origin: Lateral epicondyle of the humerus

• Insertion: Extensor expansions of digits 2-5

• Action: Extends digits 2-5 and the wrist

• Innervation: Radial nerve (C6, C7, C8)

10. Pollicis Muscles (Thumb)

• Flexor Pollicis Longus:

  • Origin: Anterior surface of the radius and interosseous membrane

  • Insertion: Distal phalanx of the thumb

  • Action: Flexes the thumb

  • Innervation: Median nerve (C8, T1)

• Extensor Pollicis Longus:

  • Origin: Posterior surface of the ulna and interosseous membrane

  • Insertion: Distal phalanx of the thumb

  • Action: Extends the thumb

  • Innervation: Radial nerve (C7, C8)

• Extensor Pollicis Brevis:

  • Origin: Posterior surface of the radius and interosseous membrane

  • Insertion: Proximal phalanx of the thumb

  • Action: Extends the thumb at the MCP joint

  • Innervation: Radial nerve (C7, C8)

• Abductor Pollicis Longus:

  • Origin: Posterior surface of the ulna, radius, and interosseous membrane

  • Insertion: Base of the first metacarpal

  • Action: Abducts and extends the thumb at the carpometacarpal joint

  • Innervation: Radial nerve (C7, C8)

Innervation of the Hand:

• Median Nerve:

  • Innervates the flexor muscles in the forearm (except flexor carpi ulnaris and part of flexor digitorum profundus), thenar muscles (like flexor pollicis brevis, abductor pollicis brevis, and opponens pollicis), and the lateral two lumbricals.

• Ulnar Nerve:

  • Innervates the flexor carpi ulnaris, the medial part of the flexor digitorum profundus, the hypothenar muscles, adductor pollicis, and the medial two lumbricals.

• Radial Nerve:

  • Innervates the extensor muscles of the forearm, including extensor carpi radialis longus, extensor carpi radialis brevis, extensor carpi ulnaris, and extensor digitorum. It also innervates the abductor pollicis longus, extensor pollicis longus, and extensor pollicis brevis for thumb extension.

1. Iliopsoas

• Origin:

  • Iliacus: Iliac fossa of the pelvis

  • Psoas Major: Lumbar vertebrae (T12-L5)

• Insertion: Lesser trochanter of the femur

• Action: Flexes the hip joint, externally rotates the thigh

2. Pectineus

• Origin: Pectineal line of the pubis

• Insertion: Pectineal line of the femur

• Action: Adducts and flexes the hip, assists with medial rotation

3. Rectus Femoris

• Origin: Anterior inferior iliac spine (AIIS) and the superior acetabular rim

• Insertion: Tibial tuberosity via the patellar ligament

• Action: Extends the knee, flexes the hip

4. Sartorius

• Origin: Anterior superior iliac spine (ASIS)

• Insertion: Proximal medial surface of the tibia (pes anserinus)

• Action: Flexes, abducts, and externally rotates the hip; flexes the knee

5. Adductor Brevis

• Origin: Inferior ramus of the pubis

• Insertion: Pectineal line and proximal part of the linea aspera

• Action: Adducts and flexes the hip

6. Adductor Longus

• Origin: Pubic body just below the pubic crest

• Insertion: Middle third of the linea aspera

• Action: Adducts the hip, assists with hip flexion

7. Adductor Magnus

• Origin: Inferior ramus of the pubis, ramus of the ischium, and ischial tuberosity

• Insertion: Linea aspera and adductor tubercle of the femur

• Action: Adducts, extends, and assists in flexing the hip

8. Gracilis

• Origin: Inferior ramus of the pubis

• Insertion: Proximal medial surface of the tibia (pes anserinus)

• Action: Adducts the hip, flexes the knee, and assists with medial rotation of the tibia

9. Gluteus Maximus

• Origin: Posterior gluteal line of the ilium, sacrum, and coccyx

• Insertion: Gluteal tuberosity of the femur and iliotibial band

• Action: Extends and laterally rotates the hip; assists in abduction and adduction of the thigh

10. Gluteus Medius

• Origin: Outer surface of the ilium

• Insertion: Greater trochanter of the femur

• Action: Abducts the hip; stabilizes the pelvis during walking; medially rotates the hip

11. Gluteus Minimus

• Origin: Outer surface of the ilium, between the anterior and inferior gluteal lines

• Insertion: Greater trochanter of the femur

• Action: Abducts and medially rotates the hip

12. Biceps Femoris

• Origin:

  • Long head: Ischial tuberosity

  • Short head: Linea aspera of the femur

• Insertion: Head of the fibula

• Action: Flexes the knee; extends the hip (long head)

13. Semitendinosus

• Origin: Ischial tuberosity

• Insertion: Proximal medial surface of the tibia (pes anserinus)

• Action: Flexes the knee; extends the hip

14. Semimembranosus

• Origin: Ischial tuberosity

• Insertion: Medial condyle of the tibia

• Action: Flexes the knee; extends the hip; medially rotates the tibia when the knee is flexed

15. Tensor Fascia Latae

• Origin: Anterior iliac crest and anterior superior iliac spine (ASIS)

• Insertion: Iliotibial band (ITB)

• Action: Abducts, flexes, and medially rotates the hip; tenses the iliotibial band

16. Piriformis

• Origin: Anterior surface of the sacrum

• Insertion: Greater trochanter of the femur

• Action: Laterally rotates and abducts the hip (when the hip is flexed)

Key Concepts in Human Anatomy

1. Cardinal Planes of Motion:

   • Sagittal: Divides body into left and right.

   • Frontal: Divides body into front and back.

   • Transverse: Divides body into top and bottom.

   • Diagonal & Scapular: Movements in a combined pattern.

2. Bone Shapes:

   • Long, Short, Flat, Irregular, Sesamoid.

3. Anatomical Terminology:

   • Terms like Anterior, Posterior, Medial, Lateral, Proximal, Distal that describe body locations.

4. Kinesiological Terminology:

   • Movements by joints: Flexion, Extension, Abduction, Adduction, Internal & External Rotation.

5. Joint Motions:

   • Types include Spin, Roll, Glide.

6. Muscle Properties:

   • Excitability, Contractility, Extensibility, Elasticity.

   • Roles: Agonist, Antagonist, Synergist.

7. Synovial Joints:

   • Various types include ball-and-socket, hinge with specific examples in the body.

8. Biomechanics:

   • Study of forces and movements; lever systems classification (1st, 2nd, 3rd class).

9. Pelvic and Hip Anatomy:

   • Overview of the pelvic girdle and hip joint structure, function, common injuries, and motions.