kines exam 3

Question Answer
What does the distal Radius articulate with Scaphoid and Lunate
Lister's Tubercle is a pulley for what Extensor pollicis longus
where is the TFCC located medial edge of the radius
What does a Colle's fracture Result in? the ulnar being longer than the radius… Ulnar positive variance
what does the distal ulna articulate with not the carpals
what are the proximal row carpals scaphoid lunate triquetrum pisiform
what are the distal row carpals Trapezius Trapezoid Capitate Hammate
Is the scaphoid concave of convex convex
most frequently fracture hand bone scaphoid
midline of the wrist scaphoid
where do all of the fingers angulate towards scaphoid
is the lunate concave or convex both, convex proximally and concave distally
what is the central bone in the proximal row of the hand lunate
what is keinbock's disease Associated with the lunate; it is an avascular necroses due to trauma
most frequently dislocated hand bone lunate
what bone is the attachment site for the UCL triquetrum
which bone is distal to the ulnar styloid process triquetrum
what bone is formed with the Flexor carpi ulnaris tendon pisiform
which bone is the medial border of guyons canal pisiform
the trapezium shape proximally and medially concave, distally saddle shaped
what bone does the trapezium articulate with trapezoid
what is the lateral attachment for the RCL trapezium
what two carpals sandwich the trapexoid capitate and trapezium
what is the lateral border of Guyons tunnel hook of hammate
central bone of the distal hand bones capitate
What type of joint is the thumb joint diarthrodial Saddle, articulation of 1st metacarpal and trapezium
what bones do the 2nd metacarpal articulate with trapezoid, trapezium, and capitate
what bones do that 3rd metacarpal articulate with capitate
what bones to the 4th metacarpal articulate with capitate and hammate
what bones do the 5th metacarpal articulate with hammate
radoiocarpal joint arthrokinimatics convex scaphoid, lunate and triquetrum on concave radial facet and TFCC disc
how many degrees of flexion and extension are at the radoiocarpal joint flexion: 35 extension: 45
what type of joint is the mid carpal joint synovial condyloid joint
arthrokinimatics of mid carpal joint convex distal row on concave proximal row
AKM of ulnar deviation at the mid carpal joint Capitate and hammate roll ulnar/ glide radial, trapezium and trapezoid glide palmarly
AKM of radial deviation at the mid carpal joint capitate and hammate roll radial/ glide ulnar, trapezium and trapezoid glide dorsally
most common joint location for OA in the hand 1st CMC joint (thumb)
flexion of thumb AKM concave MC rolls and glides ulnar
extension of thumb AKM concave MC tolls and glides radial
abduction of thumb AKM convex MC rolls palmarly and glides dorsally on concave trapezium
adduction of thumb AKM convex MC rolls dorsally and glides palmarly on concave trapezium
what type of joint is the radiocarpal, mid carpal and MCP joint s synovial condyloid
what type of joint is the distal radioulnar pivot
distal radio-ulnar joint AKM concave ulnar notch (on radius) and convex ulnar head (articular disc (TFCC))
what actions occur at the distal radio-ulnar joint pronation and supination (1 DF)
what type of joints are the cmc joints 2-4 plane synovial (1DF)
MCP joint AKM concave base of proximal phalanx on convex MC head
PIP joint AKM concave base of middle phalanx on convex head of proximal phalanx
DIP joint AKM concave base of distal phalanx on convex head of middle phalynx
what type of joints are the PIP and DIP joints hinge
purpose of radioulnar joint stabilize the forearm during pronation/ supination
common fracture site of the wrist distal radio-ulnar joint, radius displaced palmarly
distal radioulnar joint supination AKM concave ulnar notch on radius glides dorsal, ulnar head moves proximal and medial (anterior)
distal radio-ulnar joint pronation AKM concave ulnar notch glides anteriorly on ulnar head, ulnar head moves distally and dorsally
what causes the fingers to angulate toward the scaphoid IP, PIP and DIP joints
which digit has the tightest grip 5th
which has greater ROM, PIP or DIP PIP
when do IP joints have the greatest force ulnar deviation
when to IP joints have the least force wrist flexion
which muscles do not pass under the flexor retinaculum palmaris longus and flexor carpi ulnaris
primary flexor of the wrist Flexor carpi radialis
which muscle flexes the wrist as well as the PIP joints Flexor digitorum superficialis
which muscle the wrist and the DIP joints flexor digitorum profundus
which wrist flexor is likely to become actively insufficient flexor digitorum profundus
which muscles make up the largest part of the dorsal wrist extensor mass extensor carpi radialis longus and brevis
where does the Extensor carpi ulnaris connect to prevent bowstringing TFCC
which muscle exchanges intertendinous connections with Ext indicus extensor digitorum communis
which muscle lies between the ECRL and braves and extends the wrist and digits 2-5 extensor digitorum communis
which extensor muscle of the hand passes through a a separate synovial compartment extensor digitorum minimi
extends IP joint of the thumb extensor pollicis longus
which are the extrinsic thumb muscles Flexor pollicis longus, extensor pollicis brevis, abductor pollicis longus
which are the intrinsic thumb muscles opponens pollicis, abductor pollicis brevis, flexor pollicis brevis, adductor pollicis
which muscle sits between the sesamoid bones in the hand flexor pollicis longues
which muscles arise from the FDP in the palm lumbricals
which muscles pass anterior and dorsally to the transverse metacarpal ligament interossei: dorsal, lumbricals: anterior
where do the lumbricals attach lateral band of extensor hood
lumbrical action IP extensors and flexion at MCP joint
TFCC blood supply very poor, only about 20 % is vascularized
ulnar negative variance TFCC is thicker, short ulnar, causes kneinbocks disease
ulnar positive variance TFCC is thinner, long ulna, causes impingement
loading of TFCC 80% from scaphoid lunate and radius 20% TFCC and ulna
carpal tunnel 4 tendons of FDS, 4 tendons of FDP, 1 tendon of FPL, median N, flexor retinaculum, transverse carpal ligament
does radoiocarpal joint have more extension or flexion extension
which works harder, wrist flexors or extensors flexors X2
A1 pulley head of MC
A2 pulley volar side of proximal phalanx
A3 pulley distal portion of proximal phalanx
A4 pulley central on middle phalanx
A5 pulley if present….. base of distal phalanx
C1 pulley between A2 and A3
C2 pulley between A3 and A4
C3 pulley Between A4 and A5
thumb includes which ligaments 2 annular and 1 oblique
types of power grip cylindrical, spherical, hook, lateral
types of precision handling two jaw chuck, three jaw chuck, pad to pad, tip to tip, pad to side
cylindrical grin involves mainly which muscle FDP
spherical grip involves mainly which muscles interossei
hook grip involves mainly which muscles FDS and FDP
two jaw chuck thumb and index finger
pad to pad is… 80% of all precision handling
tip to tip is… most precise form of grip, needs FDP FPLand interossei to function
pad to side is… known as the "key grip" and is least precise
mechanical Axis vs. Anatomical Axis M: through head of femur, A: through shaft of femur
longitudinal axes form angle medially @ knee joint of… 185 degrees
Screw Home mechanism when locking into extension, Medial condyle with cause ER of the tibia because it is longer than the lateral condyle
knee flexion to extension closed chain Femur IR
knee flexion to extension open chain Tibia ER
knee extension to flexion closed chain Femur ER
Knee extension to flexion open chain Tibia IR, unlocked by politieus, before flexion
3 factor's guiding "screw home" 1. shape of medial femoral condyle. 2. tension of ACL. 3. Lateral pull of quads
semitendinoses OIA O: ischial tub I: Pes anseurin A: Extend thigh, IR @ knee when flexed
Semimembranoses OIA O: ischial tub I: medial meniscus A: Extend thigh, IR @ knee when flexed
Biceps Femoris OIA O: ischial tub and lateral supracondylar line I: head of fib A: extend thigh flex knee, Knee ER when flexed
Popliteus OIA O: lat meniscus/ condyle I:post tibia A: unlock knee by IR tibia
Sartorius OIA O: ASIS I: pes ansuerine A: *cross legs
Gracilis OIA O: Inf pubic ramus I: pes ansuerine A: adduct IR
Knee extensors MA is greatest at…. degrees 45 degrees of flexion
all of the knee extensors insert where? patella and tibial tuberosity
Rectus femoris Origin AIIS
Vastus medialis Origin Linea aspera and trochanteric line
Vastus lateralis Origin intertrochanteric line
Vastus intermedius Origin Anterior lateral femur
if the patella was removed the MA of the quads would be decreased by what % 49%
what is patella alta a long tendon… which makes the patella sit higher on the knee
what is patella baja short tendon, can caused tight compression problems and OA
when the knee is fully extended how much patellar contact is made with the femur little
when is the the patella at full contact with the femur at 90 degrees
when does the patella equal the patella tendon knee extension
the extensor retinaculum of the knee joint has two layers: deep and superficial.. what does the deep consist of? longitudinal fibers, connecting capsule to the menisci by the coronary ligaments
the extensor retinaculum of the knee joint has two layers: deep and superficial.. what does the superfical consist of? has transverse fibers which blend with vests medalis and laterails
where does the synovial lining of the knee joint capsule adhere to? the inner wall of fibrous layer (but not posterior) and ACL/ PCL
what is synovial septa (plicae) tissue on the inside of joint along the synovium, little synovial capsular tissue that regresses
transverse meniscal ligament anterior horn of medial to lateral meniscus
coronary meniscal ligament attaches meniscus to tibial plateau, highly innervated
meniscopatellar ligaments attach meniscus to femur, pull menisci anterior during extension
lateral meniscus O shaped, attaches to PCL and Popliteus, very mobile!
medial meniscus C shaped, attaches MCL ACL and semimembranoses, not mobile, injured more than Lateral meniscus
peripheral 1/3 of meniscus anatomy RED, vascularized, aneural
Middle 1/3 of meniscus anatomy RED/WHITE semi vascularized, aneural
Inner 1/3 of meniscus anatomy WHITE, avascular, anueral
what happens with the meniscus and patella during knee extension meniscus pulled anterior by meniscopatellar ligaments, patella moves superiorly
what happens with the meniscus during knee flexion medial meniscus is puled posteriorly by semimembranoses and lateral meniscus is pulled posteriorly by popliteus
when the meniscus is removed, what % of the contact area is decreased 40%
what is the knee closed packed position full extension
passive and active insuficiency passive= cannot lengthen anymore active= cannot shorten anymore
what type of joint is the knee joint double condyloid , 2 DF
which femoral condyle is longer? medial
which tibial plateau is larger medial
what is the shape of the lateral tibial plateua it is a little convex, but with the lateral meniscus it become concave
where is the patellofemoral joint located interface between the articular side of the patella and the intercondylar groove on the femur
what is the motion of the patella during tibial on femoral flexion the patella slides against the femur
what is the motion of the patella during femoral on tibial flexion the femur slides against the patella
what is the patellofemoral joint considered anatomic pulley and reduces friction
during extension and flexion where does the patella slide on the femur ext= ant surface of distal femur, flex= between femoral condyles
what are some external features on the patella medial and lateral facets, groove or sucks, concave side to side, convex top and bottom
what is the patellofemoral joint congruence (extending the knee) patella equals the patellar tendon
what happens with increase patellofemoral flexion increased compression with increased flexion
what does the patella contribute to for the quads from full flexion to full extension length of lever arm for quads muscle force
what happens to the patella in full flexion patella is in the intercondylar groove, producing anterior displacement of quads
what happens to the patella as the knee extends patella rises from the intercondylar groove producing significant anterior displacement of tendon
when does the length of the patellar tendon diminish extension beyond 45 degrees
when does the patella contact the femur near its superior pole at 135 degrees
at the superior pole, where does the patella rest? below the intercondylar groove bridging the intercondylar notch of femur
what happens at 90 degrees to the patella in flexion contact region on the patella starts to migrate down
what haps to the patella femoral joint between 90-60 degrees greatest contact area of the patella
angle of inclination between femoral neck and medial femoral shaft normally 125 degrees…. coxa vara < 125 and coxa alga is > 125
femoral torsion rotation between the fromoral shaft and neck, normally anteverted 15 degrees
excessive ante version can lead to > 15 degrees = IR (pigeon toed)
Retrovesion torsion < 15 degrees that cause excessive ER (toes point out)
what way is the femoral head typically oriented medially, superiorly and anteriorly
center edge angle (angle of Wilberg) how much the acetabulum covers the top of the femoral head… normally 35 degrees,
excessive center edge angle leads to… > 40 degrees (coxa profunda) and leads to impingement (PENSOR)
insuffienct center edge angle leads to… < 20 degrees(congenital dysplasia) leads to dislocation of joint
coxa vara less than 125 degrees AOI
coxa valga more than 125 degrees AOI
retroversion any torsion degree less than 0
acetabular labrum deepens the acetabulum socket by…. % 30
iliofemoral ligament (Y ligament) attaches from the ilium to the intertrochanteric line of the femur taut in hip extension and ER, strongest hip ligament
pubofemoral ligament superior pubic ramus to the femur, taut in hip abduction and extension, thin fibers
ischiofemoral ligament attaches from the ischium to the femur,taut in full hip extension, IR, and adduction
closed packed position of the hip (soccer player) extension, IR and abduction
innominate pelvis– having no name, union of 3 bones (ilium, ischium and pubis) connected anteriorly by pubic symphysis and posteriorly by the sacrum.
pubic symphysis anatomy immobile synarthrosis joint, lined with hyaline cartilage, interpubic disc and ligaments, provides stress relief during walking
resting position of the hip (shaq) 30 deg flexion, 30 deg abduction, ER
bony closed packed position 90 deg flexion, abduction, ER
ligamentous closed packed position (kicking soccer ball)
average pelvic on femoral motion 30 degrees of anterior pelvic tilt or 15 degrees of posterior pelvic tilt while sitting
if someone is standing on the left leg, and the pelvis laterally tilts up on the right.. then the left hip is…. abducted (pelvic hike)
if someone is standing on the left leg, dropping the pelvis on the right results in… adduction of the left hip joint (pelvic drop)
the cane should be used on the…. side of the injured leg contralateral
the briefcase should be carried on the….. side of the injured leg ipsilateral (side of injury)
what are the primary hip internal rotators none
which finger does not have a dorsal interossei 5th
which fingers have proximal and distal interossei attachments middle and ring
where does the TFCC transmit force too hand to forearm
ape hand median N
claw hand ulnar n, intrinsic minus position because of no interrossei or lumbricals
dypuytrens contracture 4th and 5th flexor contracture and palmar aponeurosis scarring
mallet finger extensor digitorum at distal phalanx and flexion of DIP
intrinsic plus flexion @ MCP extension @ PIP and DIP
extrinsic plus MCP joint hyperextension IP flexion (claw hand)
extensor hood serves as a cable system for extension of MCP and IP joints, extensor muscles pull extensor hood and pull MCP joint
intrinsic muscles of the hand extend DIP and PIP
extrinsic muscles of the hand create tension in the central tendon and lateral bands pulling those structures proximally (towards wrist)
flexor mechanism relaxation of central tendon, lateral band relaxes , FDS and FDP flex pip and dip
muscles responsible for flexion of PIP and DIP PIP= FDS, DIP= FDP
lateral collateral ligament of knee prevents… varus and IR of tibia
MCL of knee prevents… valgus, extension, ER of tibia,
ACL of knee prevents… ant displacement of tibia on femur (tested in flexion)
PCL of knee prevents post displacement of tibia on femur
which muscle tendon reinforces the anterior region of the petellofemoral joint capsule quads
which muscle tendons reinforce the lateral region of the petellofemoral joint capsule LCL, biceps femoris, popliteal tendon, gastroc
which muscle tendons reinforce the posterior region of the petellofemoral joint capsule popliteus, gastroc, hamstrings
which muscle tendons reinforce the posterolateral region of the petellofemoral joint capsule popliteal tendon
which muscle tendons reinforce the medial region of the petellofemoral joint capsule semimembranoses, sartorial, gracilis, semitendinoses
pelvic on femoral abduction 30 degrees
pelvic on femoral adduction 25 degrees
femoral on pelvic flexion 120 degrees
femoral on pelvic extension 20 degrees
femoral on pelvic abduction 40 degrees
femoral on pelvic adduction 25 degrees
femoral on pelvic IR and ER IR- 35 degrees, and ER-45 degrees
piriformis action ER until 90 degrees of hip flexion then it does IR
anterior fibers of the Gluteus Maximus action ER until 90 degrees of hip flexion then it does IR
adductor longus action aids hip extension when the hip is flexed, in a position to flex the hip when the hip is extended
what do the gracilis, adductor longs, adductor braves and pectinous have in common greater contribution to hip flexion once it is flexed 40 to 50 degrees
hip adductors are____________ in neutral and.____________when hip is flexed hip flexors, hip extensors
primary hip flexors iliopsoas, sartorius, TFL, RF, adductor longus, pectineus
secondary hip flexors adductor brevis, gracilis, glut max
primary hip extensors glut max, BF LH, semitendinoses, membranoses,
secondary hip extensors glut med
primary hip ER's glut max, piriformis, obturator interns, gemellus's
secondary hip ER's glut med, min, obturator externes, sartorius, BF LH
hip IR's glut min, med, TFL adductor longus, adductor braves, pectineus
primary hip adductors pectinous, adductor longs, gracilis, adductor brevis, adductor Magnus
secondary hip adductors biceps femoris LH, glut max, quadrates femoris
primary hip abductors glut med and min, TFL
secondary hip abductors piriformis, satorius