Foundational Terms and Concepts

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Foundational Terms and Concepts

• Anatomy and Physiology of Human Movement
• 420050

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Outline

• Introduction
• Terminology
• Planes and Axes
• Movements
• Osteology
• Arthrology

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Introduction

• Road Map
• Terminology
• Critical concepts
• Planes and axes
• Joint movements
• Arthrology (osteology)
• Muscle structure and function
• Basic biomechanics
• Joint systems
• Upper body shoulder girdle, shoulder joint,
  elbow complex, wrist and hand joints
• Lower body pelvic girlde, hip joint, knee
  joint, ankle and foot joints
• Trunk

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Outline

• Introduction
• Terminology
• Planes and Axes
• Movements
• Osteology
• Arthrology

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Reference positions

• Basis from which to describe joint movements
• Anatomical position
• Fundamental position
• Anatomical position
• Standing in an upright posture, feet parallel and
  close, palms forward
• Fundamental position
• Same with palms facing the body

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Anatomical Directional Terminology

• Anterior
• In front in relation to another structure
• Posterior
• In back in relation to another structure
• Inferior (infra)
• Below in relation to another structure
• Superior (supra)
• Above in relation to another structure
• Distal
• Situated away from the center or midline of the
  body
• Proximal
• Nearest the trunk or the point of origin
• Lateral
• On or to the side
• Medial
• Relating to the middle or center

From Van De Graaff KM Human anatomy, ed 6, New
York, 2002, McGraw-Hill
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Anatomical Directional Terminology

• Contralateral
• Pertaining to the opposite side
• Ipsilateral
• On the same side
• Bilateral
• Relating to the right and left sides of the body
• Deep
• Beneath or below the surface
• Superficial
• Near the surface
• Prone
• stomach lying
• Supine
• lying on the back

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Body Regions

• Axial
• Cephalic (Head)
• Cervical (Neck)
• Trunk (Thoracic and Lumbar)
• Appendicular
• Upper limbs
• Lower limbs

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Outline

• Introduction
• Terminology
• Planes and Axes
• Osteology
• Arthrology
• Movements

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Planes of Motion

• Imaginary two-dimensional surface through which a
  limb or body segment is moved
• Motion through a plane revolves around an axis
• There is a ninety-degree relationship between a
  plane of motion its axis

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Cardinal Planes of Motion

• Sagittal Plane
• Frontal Plane
• Transverse Plane

Modified from Booher JM, Thibodeau GA Athletic
injury assessment, ed 4, New York, 2000,
McGraw-Hill
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Cardinal Planes of Motion

• Sagittal Plane
• Divides body into equal, bilateral segments
• Bisects body into 2 equal symmetrical halves or a
  right left half
• Movements?

Modified from Booher JM, Thibodeau GA Athletic
injury assessment, ed 4, New York, 2000,
McGraw-Hill
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Cardinal Planes of Motion

• Frontal Plane
• Divides the body into (front) anterior (back)
  posterior halves
• Movements?

Modified from Booher JM, Thibodeau GA Athletic
injury assessment, ed 4, New York, 2000,
McGraw-Hill
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Cardinal Planes of Motion

• Transverse Plane
• Divides body into (top) superior (bottom)
  inferior halves when the individual is in
  anatomic position
• Movements?

Modified from Booher JM, Thibodeau GA Athletic
injury assessment, ed 4, New York, 2000,
McGraw-Hill
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Diagonal Planes of Motion
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Axes of Rotation

• Two basic types of movement
• Linear
• Angular
• For angular movement to occur in a plane, it must
  turn or rotate about an axis as referred to
  previously
• The axes are named in relation to their
  orientation

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Axes of Rotation

• Mediolateral (ML) Axis
• Has same orientation as frontal plane of motion
  runs from side to side at a right angle to
  sagittal plane of motion
• Runs medial / lateral
• Also known as
• Frontal, Lateral or Coronal Axis

Modified from Booher JM, Thibodeau GA Athletic
injury assessment, ed 4, New York, 2000,
McGraw-Hill
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Axes of Rotation

• Anteroposterior (AP) Axis
• Has same orientation as sagittal plane of motion
  runs from front to back at a right angle to
  frontal plane of motion
• Runs anterior / posterior
• Also known as
• Sagittal Axis

Modified from Booher JM, Thibodeau GA Athletic
injury assessment, ed 4, New York, 2000,
McGraw-Hill
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Axes of Rotation

• Suprainferior (SI) Axis
• Runs straight down through top of head is at a
  right angle to transverse plane of motion
• Runs superior/ inferior
• Also known as
• Long or Vertical Axis

Modified from Booher JM, Thibodeau GA Athletic
injury assessment, ed 4, New York, 2000,
McGraw-Hill
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Axes of Rotation

• Diagonal or Oblique Axis
• Also known as the oblique axis
• Right angle to the diagonal plane

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Outline

• Introduction
• Terminology
• Planes and Axes
• Movements
• Osteology
• Arthrology

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Movements

• General
• Flexion/Extension
• Abduction/Adduction
• Circumduction
• Internal/External Rotation
• Specific
• Ankle
• Radioulnar
• Shoulder girdle
• Spine and pelvic girdle

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GENERAL

• Flexion
• Bending movement that results in a decrease of
  angle
• Extension
• Straightening movement that results in an
  increase of angle
• Joints
• Spine, shoulder, elbow, wrist, fingers, hip,
  knee, ankle, toes
• Plane and axis?

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GENERAL

• Abduction
• Lateral movement away from midline of trunk
• Adduction
• Movement medially toward midline
• Joints
• Spine, shoulder, wrist, fingers, hip, ankle,
  toes
• Plane and axis?

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GENERAL

• Horizontal Abduction
• Movement away from the midline while parallel to
  the ground
• Horizontal Adduction
• Movement towards the midline while parallel to
  the ground
• Joints
• Shoulder and hip
• Plane and axis?

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GENERAL

• Circumduction
• Circular movement of a limb that delineates an
  arc or describes a cone
• Combination of flexion, extension, abduction,
  adduction
• Joints
• Spine, shoulder, wrist, fingers, hip, ankle, toes
• Planes and axes?

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GENERAL

• Internal rotation
• Rotary movement around longitudinal axis of a
  bone toward midline of body
• External rotation
• Rotary movement around longitudinal axis of a
  bone away from midline of body
• Joints
• Spine, shoulder and hip
• Plane and axis?

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SPECIFIC ANKLE FOOT

• Inversion
• Turning sole of foot inward or medially
• Eversion
• Turning sole of foot outward or laterally

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SPECIFIC ANKLE FOOT

• Plantar flexion
• Extension movement of ankle that results in foot
  moving away from body
• Dorsal flexion (dorsiflexion)
• Flexion movement of ankle that results in top of
  foot moving toward anterior tibia bone

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SPECIFIC RADIOULNAR JOINT

• Pronation
• Internally rotating radius where it lies
  diagonally across ulna, resulting in palm-down
  position of forearm
• Supination
• Externally rotating radius where it lies parallel
  to ulna, resulting in palm-up position of forearm

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SPECIFIC SHOULDER GIRDLE

• Elevation
• Superior movement of shoulder girdle
• Depression
• Inferior movement of shoulder girdle

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SPECIFIC SHOULDER GIRDLE

• Protraction
• Forward movement of shoulder girdle away from
  spine
• Abduction of the scapula
• Retraction
• Backward movement of shoulder girdle toward spine
• Adduction of the scapula

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SPECIFIC SHOULDER GIRDLE

• Rotation upward
• Rotary movement of scapula with inferior angle of
  scapula moving laterally upward
• Rotation downward
• Rotary movement of scapula with inferior angle of
  scapula moving medially downward

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SPECIFIC SPINE AND PELVIS

• Lateral flexion (side bending)
• Movement of head and / or trunk laterally away
  from midline
• Abduction of spine
• Reduction
• Return of spinal column to anatomic position from
  lateral flexion
• Adduction of spine

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SPECIFIC SPINE AND PELVIS

• Anterior pelvic tilt
• Iliac crest forward
• Posterior pelvic tilt
• Iliac crest backward
• Plane and axis?

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SPECIFIC WRIST HAND

• Radial flexion (radial deviation)
• Abduction movement at wrist of thumb side of hand
  toward forearm
• Ulnar flexion (ulnar deviation)
• Adduction movement at wrist of little finger side
  of hand toward forearm

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SPECIFIC WRIST HAND

• Opposition of the thumb
• Diagonal movement of thumb across palmar surface
  of hand to make contact with the hand and/or
  fingers

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Outline

• Introduction
• Terminology
• Planes and Axes
• Movements
• Osteology
• Arthrology

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Skeletal System
Modified from Van De Graaff KM Human anatomy, ed
6, New York, 2002, McGraw-Hill
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Osteology Interesting Facts

• 206 bones
• Axial skeleton 80 bones
• Appendicular 126 bones
• Composed of calcium carbonate, calcium phosphate,
  collagen, water
• 60-70 of bone weight - calcium carbonate
  calcium phosphate
• 25-30 of bone weight water
• 1/5th of the skeleton replaces itself in one
  year in young adults

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Skeletal Functions

• Protection of inner organs, brain, spinal cord
  etc.
• Support to maintain posture
• Movement by serving as points of attachment for
  muscles and acting as levers
• Mineral storage such as calcium phosphorus
• Hemopoiesis in vertebral bodies, femur,
  humerus, ribs, sternum
• process of blood cell formation in the red bone
  marrow

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Types of bones

• Long bones - humerus, fibula
• Short bones - carpals, tarsals
• Flat bones - skull, scapula
• Irregular bones - pelvis, ear ossicles
• Sesamoid bones - patella

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Types of Bones

• Long bones
• Composed of a long cylindrical shaft with
  relatively wide, protruding ends
• Shaft contains the medullary canal
• Ex. Phalanges, metatarsals, metacarpals, tibia,
  fibula, femur, radius, ulna, humerus
• Function Levers

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Types of Bones

• Short bones
• Small, cubical shaped, solid bones that usually
  have a proportionally large articular surface in
  order to articulate with more than one bone
• Ex. Carpals tarsals
• Function Shock absorption

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Types of Bones

• Flat bones
• Usually have a curved surface vary from thick
  where tendons attach to very thin
• Ex. ilium, ribs, sternum, clavicle, scapula
• Function Protection, large surface area for
  muscle/tendon attachment

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Types of Bones

• Irregular bones
• Include bones throughout entire spine ischium,
  pubis, maxilla
• Function Varies
• Sesamoid bones
• Patella, flexor tendon of thumb and big toe
• Function Improvement of mechanical advantage

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Typical Bony Features

• Diaphysis long cylindrical shaft
• Cortex - hard, dense compact bone forming walls
  of diaphysis
• Periosteum - dense, fibrous membrane covering
  outer surface of diaphysis
• Endosteum - fibrous membrane that lines the
  inside of the cortex
• Medullary (marrow) cavity between walls of
  diaphysis, containing yellow or fatty marrow

From Shier D, Butler J, Lewis R Holes human
anatomy physiology, ed 9, New York, 2002,
McGraw-Hill.
48
Typical Bony Features

• Epiphysis ends of long bones formed from
  cancelleous (spongy or trabecular) bone
• Epiphyseal plate - (growth plate) thin cartilage
  plate separates diaphysis epiphyses
• Articular (hyaline) cartilage covering the
  epiphysis to provide cushioning effect reduce
  friction

Modified from Van De Graaff KM Human anatomy, ed
6, New York, 2002, McGraw-Hill.
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Bone Growth

• Grow rapidly into structures shaped similar to
  the bones which they will eventually become
• Growth continues and gradually undergoes
  significant change to develop into long bone
• Longitudinal growth continues as long as
  epiphyseal plates are open
• Shortly after adolescence, plates disappear
  close
• Most close by age 18, but some may be present
  until 25
• Growth in diameter continues throughout life

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Bone Properties

• Bone size shape are influenced by the direction
  magnitude of forces that are habitually applied
  to them
• Bones reshape themselves based upon the stresses
  placed upon them (remodeling)
• Bone mass increases over time with increased
  stress

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Bone Markings

• Processes (including elevations projections)
• Processes that form joints
• Condyle Large, smooth, rounded projection
• Facet Small flat surface
• Head Rounded projection of epiphysis separated
  by a neck

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Bone Markings

• Processes (elevations projections)
• Processes to which ligaments, muscles or tendons
  attach
• Crest Narrow and ridgelike process
• Epicondyle Projection above condyle
• Line Ridge of bone (less prominent than crest)
• Process Any projection
• Spine (spinous process) Sharp, slender
  projection
• Suture Line of union between bones
• Trochanter Large roughened projection
• Tubercle Small rounded projection
• Tuberosity Small roughened projection

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Bone Markings

• Cavities (depressions) - including opening
  grooves
• Foramen Rounded hole or opening for blood
  vessels or nerves
• Fossa Shallow depression or flattened surface
• Sulcus (groove) Narrow furrow or groove-like
  depression
• Notch Depression in the margin of a bone

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Outline

• Introduction
• Terminology
• Planes and Axes
• Movements
• Osteology
• Arthrology

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Classification of Joints

• Articulation - connection of bones at a joint
  usually to allow movement between surfaces of
  bones
• 3 major classifications according to structure
  movement characteristics
• Synarthrodial
• Amphiarthrodial
• Diarthrodial

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Classification of Joints
Structural classification Structural classification Structural classification
Fibrous Cartilagenous Synovial
Functional classification Synarthrodial Gomphosis Suture ----- -----
Functional classification Amphiarthrodial Syndesmosis Symphysis Synchondrosis -----
Functional classification Diarthrodial ----- ----- Arthrodial Condyloidal Enarthrodial Ginglymus Sellar Trochoidal
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Synarthrodial

• Immovable joints
• Suture
• Bony matrix/cement between bones
• Gomphosis such as teeth fitting into mandible or
  maxilla
• Conical peg and socket

Modified from Booher JM, Thibedeau GA Athletic
injury assessment, ed 4, New York, 2000,
McGraw-Hill.
63
Classification of Joints
Structural classification Structural classification Structural classification
Fibrous Cartilagenous Synovial
Functional classification Synarthrodial Gomphosis Suture ----- -----
Functional classification Amphiarthrodial Syndesmosis Symphysis Synchondrosis -----
Functional classification Diarthrodial ----- ----- Arthrodial Condyloidal Enarthrodial Ginglymus Sellar Trochoidal
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Amphiarthrodial

• Slightly movable joints
• Allow a slight amount of motion to occur
• Syndesmosis
• Synchondrosis
• Symphysis

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Amphiarthrodial

• Syndesmosis
• Two bones joined together by a strong ligament or
  an interosseus membrane that allows minimal
  movement between the bones
• Bones may or may not touch each other at the
  actual joint
• Ex. Coracoclavicular joint, distal tibiofibular
  jt.

Modified from Booher JM, Thibedeau GA Athletic
injury assessment, ed 4, New York, 2000,
McGraw-Hill.
66
Amphiarthrodial

• Synchondrosis
• Type of joint separated by hyaline cartilage that
  allows very slight movement between the bones
• Ex. costochondral joints of the ribs with the
  sternum 

Modified from Booher JM, Thibedeau GA Athletic
injury assessment, ed 4, New York, 2000,
McGraw-Hill.
67
Amphiarthrodial

• Symphysis
• Joint separated by a fibrocartilage pad that
  allows very slight movement between the bones
• Ex. Symphysis Pubis intervertebral discs

Modified from Booher JM, Thibedeau GA Athletic
injury assessment, ed 4, New York, 2000,
McGraw-Hill.
68
Classification of Joints
Structural classification Structural classification Structural classification
Fibrous Cartilagenous Synovial
Functional classification Synarthrodial Gomphosis Suture ----- -----
Functional classification Amphiarthrodial Syndesmosis Symphysis Synchondrosis -----
Functional classification Diarthrodial ----- ----- Arthrodial Condyloidal Enarthrodial Ginglymus Sellar Trochoidal
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Diarthrodial Joints

• Known as synovial joints
• Freely movable
• Composed of sleevelike joint capsule
• Secretes synovial fluid to lubricate joint cavity
• Capsule thickenings form tough, nonelastic
  ligaments that provide additional support against
  abnormal movement or joint opening
• Ligaments may also be located inside the joint

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Diarthrodial Joints

• Articular or hyaline cartilage covers the
  articular surface ends of the bones inside the
  joint cavity
• absorbs shock
• protect the bone
• Cartilage slowly absorbs synovial fluid during
  joint unloading or distraction
• Secretes synovial fluid during subsequent weight
  bearing compression
• Some diarthrodial joints have specialized
  fibrocartilage disks (menisci)

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From Seeley RR, Stephens TD, Tate P Anatomy
physiology, ed 7, New York, 2006, McGraw-Hill.
72
Diarthrodial Joints

• Diarthrodial joints have motion possible in one
  or more planes
• Degrees of freedom
• motion in 1 plane 1 degree of freedom
• motion in 2 planes 2 degrees of freedom
• motion in 3 planes 3 degrees of freedom

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Diarthrodial Joints

• Six types
• Each has a different type of bony arrangement
  between articulating surfaces
• Structure dictates function

Structural classification Structural classification Structural classification
Fibrous Cartilagenous Synovial
Functional classification Synarthrodial Gomphosis Suture ----- -----
Functional classification Amphiarthrodial Syndesmosis Symphysis Synchondrosis -----
Functional classification Diarthrodial ----- ----- Arthrodial Condyloidal Enarthrodial Ginglymus Sellar Trochoidal