Kinesiology Exam 1

  1. Foot/Ankle Complex: Main Functions (2)
    -stable base of support

    -shock absorption
  2. composition of ankle

    held together by...
    • -distal tibia
    • -distal fibula
    • -talus

    -interosseous membrane
  3. mortise of ankle composed of...

    malleoli composed of...
    -fibula and tibia

    -ends of tibia and fibula
  4. sections of foot (3)
    • -hindfoot (talus and calcaneus)
    • -midfoot (3 cuneiforms,navicular,cuboid)
    • -forefoot (metatarsals and phalanges)
  5. 4 main joints
    • -ankle
    • -subtalar
    • -tarsometatarsal
    • -metatarsalphalangeal
  6. Motions of ankle (2)
    • plantarflexion-50*
    • dorsiflexion-20*
  7. ankle talus/mortise
    • mortise allows talus to pass through
    • talus is wider anteriorly 
    • talus is narrower posteriorly
    • tight at end range in dorsiflexion
    • loose at end range in plantarflexion (sprains)
  8. Talus (injury)
    • often fractured in dislocations of ankle
    • has upward arterial supply(against gravity, hard to heal)
    • prone to necrosis w/sever injury
    • Snowboarder's fracture(compression)
  9. Subtalar joint
    • "below the ankle"
    • formed between talus and calcaneus
    • calcaneus =heel
  10. subtalar joint movement
    • inversion-30*
    • eversion-15*
  11. subtalar neutral
    • in the middle
    • "optimally aligned foot"
    • best stress distribution 
  12. tarsometatarsal joint
    • 3 cuneiforms and cuboid with metatarsals
    • helps regulate positions of the foot
    •      -springs,shocks
  13. metatarsophalangeal joint
    • "MTP"
    • 5 joints
    • primarily flexion an extension
    • hinge to allow heel to rise while toes stabilize
    •      -gait
  14. 6 main movements of foot/ankle complex
    • plantarflexion
    • dorsiflexion
    • inversion
    • eversion
    • pronation (eversion and dorsiflexion)
    • supination (inversion and plantarflexion)
  15. ankle/foot complex ligaments (4)
    • interosseous membrane (force distribution and shock attenuation)
    • Deltoid ligament (connects tibia to talus,calcaneus, and navicular) 
    •      *strong(bone(tibia) often fails before ligament ruptures)
    • Antierior talofibular ligament (fibula to talus)
    •      *most often sprained
    • Plantar calcaneonavicular ligament (aka spring ligament)
    •      *helps support medial longitudinal arch
    •      *helps prevent over pronation
  16. Arches 
    • longitudinal
    •      *medial
    •      *lateral

  17. Function of arches
    • add stability and shock absorption
    • supported by ligaments, shapes of bones, tendons, muscles
  18. Plantar flexors (5 main muscles)
    • gastrocnemius
    • plantaris
    • soleus
    • flexor hallucis longus
    • flexor digitorum longus
  19. gastrocnemuis
    • Proximal Attachment : posterior condyles of femur
    • Distal Attachment: common insertion via achilles tendon
    • Action: plantarflexes foot (helps bend knee)
  20. soleus
    • proximal attachment: proximal posterior tibia along soleal line
    • Distal attachment: common insertion via achilles tendon
    • Attachment: plantar flexes foot (does NOT help bend knee, does not cross)
  21. plantaris
    • proximal attachment: distal posterior femur
    • distal attachment: posterior calcaneus
    • Action: plantarflexes the foot
  22. flexor hallicus longus
    • proximal attachment: distal 2/3 of posterior fibula
    • distal attachment: base pf the distal phalanx of the great toe, plantar surface
    • action: plantarflexes foot and big toe
  23. flexor digititorum longus
    • proximal attachment: distal 1/2 of the posterior tibia
    • distal attachment: base of distal phalanges of digits 2-5 on plantar surface
    • action: plantar flexes foot
  24. dorsiflexors (3 muscles)
    • tibialis anterior
    • extensor digitorum longus
    • extensor hallicus longus
  25. tibialis anterior
    • proximal attachment: superior 2/3 of anterolatal tibia
    • distal attachment: base of 1st metatarsal f the 1st digit, also 1st cuneiform
    • action: dorsiflexes foot AND inverts foot
  26. extensor digitorum longus
    • Proximal attacment: superior 3/4 of the fibula, anterior surface
    • Distal attachment: via common tendon along the dorsal surfaces of phalanges 2-5
    • Action: dorsiflexes foot
  27. extensor hallicus longus
    • Proximal attachment: middle anterior surface of the fibula
    • Distal attachment: dorsal surface of the great toe 
    • Action dorsiflexes foot
  28. Everters (3 muscles)
    • peroneus longus
    • peroneus brevis
    • preoneus tertius
  29. peroneous longus
    • proximal attachment: head and proximal 1/2 of fibula, lateral side
    • distal attachment: dorsal surface of the great toe
    • Action: everts foot
  30. peroneus brevis
    • proximal attachment: distal 1/2 of the lateral side of the fibula
    • distal attachment: tuberosity of the lateral side of the 5th matatarsal
    • Action: everts foot
  31. peroneus tertius
    • proximal attachment: distal 1/3 of the anterior surface of fibula
    • Distal attachment: dorsal surface of the base of the 5th metatarsal
    • Action: everts foot
  32. Inverters (2 muscles)
    • tibialis anterior
    • tibialis posterior
  33. tibialis posterior
    • proximal attachment: lateral side of the posterior tibia proximally
    • distal attachment: navicular tuberosity, three cuneiforms, cuboid, metatarsal 2-4
    • Action: inverts foot
  34. muscles of the foot are mostly....
  35. ankle sprain
    • inversion w/plantarflexion
    •      *tear to ATF
    •      *severe inversion may fracture distal fibula
    • Eversion (rare)
    •      *tear to deltoid ligament
  36. plantar fascitis
    • inflammation of plantar fascia
    • fascia usually tears near its calcaneus calcaneus attachment
    • cardinal sign symptom: pain worst with first few steps in morning
    • MOI: repetitive overuse,over pronation, poor shoe support
    • Calf stretching good for remodleing scar tissue
  37. fibular fracture (2 types)
    • low energy: ground level falls and athletic injuries
    • high energy injuries: motor vehicle injuries, pedestrians struck by vehicle and gunshot wounds
  38. Fibular fracture
    • ambulation is often still possible:fibula 10%-15% of weight and tibia 85%-90% of weight
    • Surgical options: open reduction and internal fixation
  39. achilles tendonitis
    • 1-2" above attachment to calcaneus
    • "critical zone of avascularity"
    • pronation increases LENGTH of achilles tendon
  40. achilles tendon rupture
    • violent start or stop
    • over age 30
    • audible pop or snap
    • needs to be repaired right away
    • **strengthen hip to decrease pain
  41. shin splints
    • repetitive microtrauma to tibia and its muscular attachments
    • microtears to the tibialis posterior muscle or soleus muscled (medial tibial pain)
  42. shin splits (causes)
    • torsion on the tibia bone 
    • excess pronation
    • poor shock absoprtion
    • poor foot alignment
    • sudden increase in activity levels
    • muscle imbalances
    • poor warmup
    • poor conditioning
    • tight achiles tendon
    • toe running
  43. talar avascular necrosis
    • following fracture or dislocation
    • inverted arterial supply
  44. Planes of motion (3)
    • sagittal plane
    • frontal plane
    • transverse plane
  45. sagittal plane
    • bisects body in left and right halves
    • motion: flexion and extension (bicep curl)
  46. frontal plane
    • divides body front to back
    • motion: adduction and abduction
  47. transverse plane
    • divides body horizontally into superior and inferior halves
    • motion: rotational, pronation, supination and spinal rotation
  48. Axes of rotation
    • sagittal plane: lateral
    • frontal plane: anteroposterior
    • transverse plane:vertical
  49. anterior
  50. anteroinferior
    front and down
  51. anterolateral
    front and away from midline
  52. anteromedial
    front and towards midline
  53. anteroposterior
    front and back
  54. anterosuperior
    front and up
  55. caudal
    to tail
  56. cephalic
    to head
  57. contralateral
    opposite sides
  58. deep
    inside body
  59. distal
    farther from
  60. dorsal
  61. ipsilateral
    same side
  62. lateral
    away from midline
  63. medial
    closer to midline
  64. posterios
  65. posterioinferior
    back and down
  66. posterolateral
    back and away
  67. posteromedial
    back and to midline
  68. posterosuperior
    back and above
  69. prone
    face down
  70. proximal
    closer to midline
  71. superficial
    closer to surface
  72. superior
  73. supine
    face up
  74. ventral
  75. volar
    palms and bottoms of feet
  76. types of bones (5)
    • long bones
    • short bones
    • flat bones
    • irregular bones
    • sesamoid bones
  77. long bones
    • long cylindrical shaft
    • wide protruding ends
    • function: serve as lever
    • femur, tibia, fibula
  78. short bones
    • small, cube shaped, solid bones
    • function: shock abosrption
    • wrist and ankle
  79. flat bones
    • curved surface
    • can be thick or thin
    • function: protection
    • cranial, ribs, pelvis
  80. irregular bones
    • serve a variety of purpose
    • bones of entire spine, ischium, pubis and maxilla
  81. sesamoid bones
    • small bones embedded within the musculoskeletal tendon that provide protection
    • free floating: do not attach to other bones
    • also serve to improve mechanical advantage o muskulotendious unit
    • hyoid, patella, thumb and big toe
  82. Joint
    • articulation of 2 or more bones
    • enable movement to occur
  83. join classification
    • structure/function
    • fibrous/synarthrodial (no movement)
    • cartilaginous/amphiarthrodial(some movement)
    • synovial/diarthrodial (a lot of movement)
  84. fibrous joints
    • joined together by connective tissue
    • general IMMOVABLE
    • examples: sacroiliac joint, sternoclavicular
  85. cartilaginous
    • joined together by hyaline cartilage or fibrocartilage
    • examples: costochondral joints of ribs, intervertebral discs
  86. synovial joints
    • freely moveable 
    • contain a joint capusle
    • contain synovial fluid
    • generally DIARHTROIDAL
    • examples: knee, shoulder
  87. amphiarthrodial
    • slightly movable
    • three types
  88. syndemosis
    • held together by strong ligament structures
    • amphiarthrodial joint
  89. symphisis
    • joint separated by a fibrocartilage pad
    • amphiarthrodial
  90. synchrosis
    joint separated by hyaline cartilage
  91. diarthrodial joints
    • freely movable 
    • contains a joint capsule (sleeve-like covering)
    • joint capsule surrounds bony ends
    • contain synovial fluid: lubricates joint cavity
    • examples: knee, shoulder
  92. motion in one plane
    • 1 degree of freedom
    • knee and elbow
  93. motion in two planes
    • 2 degrees of freedom
    • wrist
  94. motion in three planes
    • 3 degrees of freedom
    • shoulder, lumbar spine,neck, hips
  95. arthrodial joint (gliding joint)
    • two flat bony surfaces
    • butt against each other
    • permits limited gliding motion
    • 1 degree of motion
    • example: carpal bones of wrist
  96. condyloidal joint (biaxial ball and socket joint)
    • bones permit movement in two planes without rotation(2 degrees of freedom)
    • example: wrist between the radius and proximal row of the carpal bones
  97. enarthrodial joint (multiaxial ball and socket joint)
    • permits movement in all three planes (3 degrees of freedom)
    • examples: hip and shoulder
  98. ginglymus joint (hinge joint)
    • one plane of motion
    • wide range of motion in that plane
    • examples: elbow (≃150°) and knee
  99. sellar joint (saddle joint)
    found only in thumb

    permits ball and socket movement, except rotation
  100. general joint motions
    • abdution
    • adduction
    • circumduction
    • diagonal abduction
    • diagonal adduction
    • flexion
    • extension
    • external rotation
    • internal rotation
  101. abduction
    • lateral movement away from the body
    • frontal plane motion
  102. adduction
    • movement medially toward the midline of the trunk
    • frontal plane motion
  103. circumduction
    • circular movement of a limb that delineates an arc
    • combination of flexion, extension, abduction and adduction
  104. diagonal abduction
    • movement by a limb through a diagonal plane
    • away from midline of body
    • drawing a sword
  105. diagonal adduction
    • movement by a limb through a diagonal plane
    • toward and across midline
    • sheathing a sword
  106. flexion
    • bending movement of a limb
    • results in a decreased joint angle by moving bones together
    • usually occurs in the sagittal plane
  107. extension
    • straightening movement of a limb 
    • results in an increased joint able by moving bones apart
    • usually occurs in the sagittal plane
  108. external rotation
    • rotary movementaround a longitudinal axis of a bone
    • movement is away from the body 
    • transverse plane motion
  109. internal rotation
    • rotary movement around the longitudinal axis of a bone
    • movement is towards the midline of the body
    • transverse plane motion
  110. muscles
    • 600+ 
    • 40-50% of body weight
    • responsible for movement of body and joints
    • provide protection, posture and support
    • provide major portion of body heat
    • many different shapes and sizes
    • different fiber types and arrangements
  111. intrinsic muscle
    • pertaining to muscles within or belonging solely to the body part on which they act
    • example: small intrinsic muscles of the hand
  112. extrinsic muscles
    • pertaining usually to muscles that arise or originate outside the body part in which they act
    • example: forearm muscles that attach to distal end of humerus and insert on the fingers
  113. action
    • the specific movement of the joint resulting from a concentric (shortening) contraction of a muscle which crosses the joint
    • usually action is caused by a group of muscles working together
    • a particular muscle may cause more than one action, either at the same joint or a different joint.
    • example: bicps brachii has the action of flexion at the elbow
  114. proximal insertion (origin)
    • generally considered the least moveable part
    • usually the part that attaches closes to midline of the body
  115. distal insertion (insertion)
    • generally considered the most moevable part
    • usually the part that attaches farthest from the midline
  116. innervation
    • the segment of the nervous system defines as being responsible for providing a stimulus to muscle fibers within a specific muscle or portion of the muscle
    • a particular muscle may be innervated by more than one nerve
    • a particular nerve may innervate more than one muscle
  117. types of muscle contraction
    • isometric
    • isotonic
    • concentric
    • eccentric
  118. isometric
    • no movement (pusing against the wall)
    • tension is developed within the muscle but the joint angle remains constant
    • static contractions
  119. isotonic
    • involve the muscle developing tension to either cause or control joint movement 
    • Dynamic contraction: causes the joint angle to change
  120. concentric
    involves the muscle developing tension as is shortens

    • occurs when the muscle develops enough force to overcome applied resistance
    • can be thought of as causing movement against gravity or resistance
    • described as positive contraction
    • results in the joint angle being changed in the direction of the applied muscular force
  121. eccentric
    • involves muscle lengthening under tension 
    • occurs when the muscle gradually lessens tension to control the descent of the resistance
    • control movement with gravity or resistance
    • called negative contractions
    • results in a change in the joint angle in the direction of the resistance or external force
  122. agonist
    • muscles that, when contracting concentrically cause joint motion through a specified plane of motion
    • known as prime movers
  123. antagonist
    • muscles that are usually located on the opposite side of the joint from the agonist
    • have the opposite concentric action
    • known as  contralateral muscles
    • work in cooperation with agonistic muscles bu relaxing and allowing movement
  124. synergist
    • muscles that surround the joint or body part
    • contract to fixate or stabilize the area to enable another limb or body to exert more force or move
    • proximal stability---->distal mobility
  125. synergist
    • muscles that assist in the action of agonists
    • not necessarily in the prime movers for the action
    • known as guiding muscles
    • assist in refining movement
  126. knee
    • largest joint in body
    • structural: synovial joint
    • functional: diarthroidal joing
    • Provides: stability, mobility, shock absorption
  127. knee bones
    • femur
    • tibia
    • fibula
    • patella
  128. joints
    • tibiofemoral (knee)
    • patellofemoral
  129. tibiofemoral joint
    • synovial
    • diarthroidal
    • functions as a hinge
    • flexion and extension
    • some internal and external rotaion
  130. patella
    • kneecap 
    • embedded in the quadriceps tendon
    • function: to increase force of quadriceps muscle
  131. knee ligaments
    • MCL
    • LCL
    • PCL
    • ACL
  132. MCL (medial collateral ligament)
    • medial knoww
    • femur to tibia
    • thick and wide
    • protects against lateral blows to the knee
  133. LCL (lateral collateral ligament
    • lateral
    • femur to fibula
    • thin and narrow
    • protects against medial forces to the knee
  134. ACL (anterior cruciate ligament)
    • femur to anterior tibia
    • protects excessive anterior tibial movement
    • goes through notch of femur
    • hands in pockets
  135. PCL (posterior cruciate liga)ment
    • femur  to posterior tibia
    • protects posterior tibial movement
    • opposite of hands in pockets
  136. knee movements
    • flexion (155°)
    • extension (0-20°)
    • internal rotation
    • external rotation
    • ***foot has slight external rotation in extension due to shape of meniscus and bones
  137. IT band syndrome
    • sharp or burning pain 2cm prox. to lateral joint line
    • symptoms develop after reproducible distance run
    • pain with walking or sitting in sever cases
    • tests: pain with palpation, positive noble's test, positive obers test
  138. knee musles
    • extensors: quadricepss (4 parts)
    • flexors: hamstrings (3 parts)
    • internal knee rotators: popliteus 
    • external knee rotators: none
  139. quadirceps
    • 4 distinct parts:
    • rectus femoris
    • vastus lateralis
    • vastus intermedius
    • vastus medialis
  140. rectus femoris
    • proximal attachment: iliac spine
    • distal attachment: tibial tuberosity
    • action: extends the knee
  141. vastus lateralis
    • proximal attachment: lateral femur
    • distal attachment: tibial tuberosity
    • action: knee extension
  142. vastus medialis
    • PA: medial femur
    • DA: tibial tuberossity
    • A: knee extension
  143. vastus intermedius
    • PA: femur
    • DA: tibial tuberosity
    • A: knee extension
  144. hamstrings (3 muscles)
    • biceps femoris
    • semimembranosis
    • semitendinosus
  145. biceps femoris
    • PA: ischial tuberosity
    • DA: lateral condyle of tibia and head of fibula
    • A: knee flexion
  146. semimebranosis
    • PA: ischial tuberosity
    • DA: proximal media tibia
    • A: knee flexion
  147. semitendinosis
    • PA: ischial tuberosity
    • DA: proximal medial tibia
    • A: knee flexion
  148. popliteus
    • PA: posterior lateral femur
    • DA: medial tibia
    • A: knee internal rotation and knee flexion
  149. external rotation
    • tibia externally rotates on the femur
    • happens when knee extends
    • due to shapes of bones and meniscus
    • called: Screw Home Mechanism
  150. Internal rotation
    • popliteus "unlocks" the knee
    • popliteus internally rotates the knee
  151. MCL Sprain
    • can be minor to major (grade I-gradeIII)
    • MOI: lateral stress/force t knee
    • Signs and Symptoms: pain on inner side ningof knee, feeling of knee giving way
    • may hear or feel pop
    • Tests and measures: medial ligamentous stress test
    • rehab: bracing. ROM and, strengthe
  152. "Terrible Triad"
    ACL, MCL and meniscus 
  153. Osteoarthritis (OA)
    • MOI: insidious onset caused by breakdown and eventual lloss of joint carilate
    • common sites: hands, feet, spine and large wt. bearing joints
    • cause: with age
    • signs and symptoms: pain and stiffness of joint, usually effects medial knee compartment
    • Rehab: ROM and strengthening
    • Surgery: TKA or hemi TKA (total or partial knee arthoplasty(replacement)
  154. Total Knee replacement
    • preferred surgery for end stage of OA
    • 300,000/year in US
    • may replace medial compartment only
    • Rehab: strengthening and ROM
    • 6 months to year for complete rehab
    • unable to squat or kneel
  155. patellofemoral pain
    • MOI: usually repetitive stressful knee maltracking of the patella
    • signs and syptoms: retropatella(under) or peripatella(around) pain
    • etiology: probably multifactorial, biomechanical, muscular overuse therories
    • rehab: quad strengthining hamstring, IT band calf stetching
    • hip etiology?
  156. Q angle
    • large Q angle may be predisposing factor for developing patellofemoral pain
    • increased incidence in females vs. males
  157. patellar tendinitis/osis
    • MOI: sports and activity involving frequent jumping
    • also called "jumper's knee"
    • signs and symptoms: pain usually below patella to insertion of patellar tendon
    • itis=inflammation
    • osis=degeneration
    • treatment: modification of avtivity, stretching/strengthening quadricep muscles, patellar strap
    • surgery: pain>6 months
    • 6-12 month recovery period
    • 25% no recovery
  158. osgood-schlatter disease
    • MOI: running jumping activity during rapid bone growth( soft tissue cant keep up with growth)
    • higher frequency in athletes: 20%
    • signs and symptoms: pain swelling and tenderness at tibial tuberosity
    • sever cases: patellar tendon may actually detach at its insertionh:  
    • Rehab: quad stretching, activity modification
    • usually resolves after growth spurt 11-12 females, 13-14 males
    • surgery" if patellar ligament ruptures
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Kinesiology Exam 1