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Intro to Anatomy Lumbar
Anatomy Lower spine
58
Anatomy
Graduate
06/02/2013

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Term
Anatomical Position
Definition
Reference pt. for describing posture, joint motion, and location of structures

Refers to body position as if the person were standing upright

Body Position:
-head facing anteriorly & in midline
-arms adjacent to sides with palms facing anteriorly
-lower extremities close together with feet parallel & toes anteriorly
Term
Sagittal (Median) Plane
Definition
Vertical plane that divides the body into left and right halves
Term
Frontal (Coronal) Plane
Definition
Vertical plane that is perpendicular to sagittal plane that divides the body into anterior and posterior parts
Term
Transverse (Horizontal) Plane
Definition
Plane that divides the body into superior and inferior parts
Term
Superior
Definition
higher or above or toward the upper part of the body (head)
Term
Inferior
Definition
Lower or below or toward the lower part of the body (sole of the foot)
Term
Cranial (cephalad)
Definition
Closer to the head than another structure toward the head
Term
Caudal
Definition
closer to the tailbone than another structure;

usually refers to structures on the trunk**
Term
Anterior (ventral)
Definition
Toward the front surface of the body
Term
Posterior (dorsal, dorsum)
Definition
Toward the back of the body
Term
Medial
Definition
Toward the midline
Term
Lateral
Definition
Away form the midline
Term
Proximal
Definition
Closer to the point of attachment or reference pt
Term
Distal
Definition
further away from the origin or reference pt
Term
Unilateral
Definition
One side of the body
Term
Bilateral
Definition
Occurs on both sides of the body
Term
Ipsilateral
Definition
something occurring on the same side of the body as another structure
Term
Contralateral
Definition
something occurring on the opposite side of the body as another structure
Term
What are the 2 major classification of joints?
Definition
1.Synarthroses (non-synovial)
2.diarthroses (synovial)
Term
Synarthroses
Definition
defined as "non-synovial" and "barely movable"

the two joint surfaces are connected by connective tissue
Term
Syndesmosis or fibrous joint
Definition
type of joint held together by strong ligamentous structures
allow min. movement between bones
ex - coracoclavicular joint & inferior tibiofibular joint
Term
synchondrosis
Definition
type of joint separated by hyaline or fibrocartilage
-permits slight to moderate movement while providing stability/mobility
ex - chondrosternal, pubic symphasis, intervertebral joints
Term
Diarthroses (synovial)
Definition
Freely movable
5 components:
1. fibrous joint capsule
2. joint cavity
3. synovial membrane
4. synovial fluid
5. articular (hyaline) cartilage
Term
Joint capsule
Definition
Sleevelike covering of ligamentous tissue that surrounds the bony ends forming the joints composed of fibrous capsule & synovial membrane
Term
How are diarthroses (synovial joints) classified?
2 ways
Definition
1. Shape of articulating surface

2. movements permitted
Term
Hinge (ginglymus)
Definition
Permits a wide range of movement only in 1 plane
- ex: ankle, elbow (humeroulnar)
Term
Ball and socket (spheroidal)
Definition
type of joint that permits movement in ALL planes

-ex: glenohumeral and hip joints
Term
Bicondylar (modified hinge)
Definition
same characteristics as hinge, except there is slight rotation when knee is flexed

by shape:
2 convex condyles on one surface and 2 concave condyles on the other > "bi" condylar
Term
Trochoid (Pivot)
Definition
this type of joint has a rotational movement around a long axis
-ex:rotation of the radius @ the radioulnar joint
Term
Saddle (Sellar)
Definition
this type of reciprocal reception is found only in the thumb at the carpometacarpal joint

by shape:
-trapezium has concave & convex parts to it > reason it acts as a "saddle"
Term
Planar
Definition
this type of joint has 2 flat surfaces that are against each other
-limited to gliding movement
-ex: carpal bones of the wrist & tarsometatarsal joint of foot

by shape:
-formed by 2 "flat" surfaces
Term
Ellipsoidal (condyloid)
Definition
type of joint in which the bones permit movement in 2 planes without rotation
-ex: 2-5th metacarpophalangeal joints

by shape:
formed by oval convex surface that articulates with an elliptical concave surface
Term
Types of diarthrosis (synovial joints)
Definition
1. Hinge (ginglymus)
2. Ball and Socket (spheroidal)
3. Bicondylar (modified hinge)
4. Trochoid (pivot)
5. Saddle (Sellar)
6. Planar
7. ellipsoidal (condyloid)
Term
Movements within different planes?
Definition
rotation about an axis produces motion in a plane that is PERPENDICULAR to that axis
- ex: tire and axis
Term
Diarthrodial Joints classified by movement
Definition
1. Uniaxial - motion occurs in 1 plane around 1 axis
2. Biaxial - motion occurs in 2 planes around 2 axes
3. multiaxial - free to move around 3 planes & 3 axes
Term
Accessory structures to a joint
Definition
-Meniscus/fibrocartilaginous discs
-Bursa = fluid filled sac that is near bone to reduce friction & provide cushion
-Labrum = fibrous tissue around periphery of fossa; helps deepen the joint
-Fat pad = located around joints & often within joint capsule
-Ligaments = connect bone to bone
-Tendons = muscle to bone
Term
Osteokinematics
Definition
gross motion controlled through active muscle contraction
Term
Examples of osteokinematics
Definition
Flexion
Extension
Rotation
Adduction
Abduction
Term
Arthrokinematics
Definition
-Movement that occurs at the joint surface during the osteokinematic motion that is controlled by internal forces

-Usually one joint surface is more stable, and serves as basis of motion to occur

-Small movements that occur within the joints themselves
Term
Arthrokinematic Motion - Kaltenborn's Rule
Definition
Concave on convex
-When the convex surface is fixed and the concave surface is moving on it, roll & glide occur in the SAME direction

Convex on concave
-When the concave surface is fixed and the convex surface is moving on it, roll & glide occur in OPPOSITE directions
Term
Goniometry
Definition
-Derived from greek words "gonia" = angle and "metron" = measure
-It is the "measurement of angles created at human joints by the bones of the body"
Term
Common uses of goiniometry
Definition
-Diagnostic implications
-Assists in assessment of condition
-Objective measurement of treatment goals
-Treatment modifications
-Motivation
-Research
-Fabricate orthoses/equipment
Term
Goniometer Instrumentation:
Definition
-Universal goniometer
-Bubble Inclinometer
Term
AROM
Definition
AROM is the unrestricted ROM that is produced by active contraction of the muscles crossing that joint
Term
Information obtained from AROM?
Definition
-Estimate of AROM
-Movements that increase or decrease pain
-Patient's willingness to move
-Coordination
-Level of consciousness
-Attention span
-Muscle strength
-Ability to perform functional tasks
Term
Qualities of normal AROM
Definition
-Smooth, regardless of speed
-Full range
-Pain free
Term
Limitations of AROM
Definition
-Restricted joint mobility
-Weakness
-Decreased muscle length
-Pain
-Injury to area
-Unwillingness to move
-Inability to follow instructions
Term
Assessment of AROM
Definition
Important:
-Quality of movement
-Compensations/substitution
-Amount of movement
-Patient reaction
Term
What should examiner ask during AROM
Definition
-Do symptoms occur?
-Do symptoms change during motion?
-Where do symptoms occur?
-Are the symptoms the same as the chief complaint?
Term
PROM
Definition
PROM = movement that occurs within unrestricted range of the joint and is produced entirely by an external force

-normally more than AROM
Term
Information obtained through PROM assessment includes:
Definition
-Amt of movement available at joint
-Quality of motion
-End feel
-Presence/absence of capsular pattern
-Pain
Term
End feel (Cyriax)
Definition
Quality of resistance to movement that an examiner feels at the end of a passive movement performed by the examiner
Term
Normal End Feels?
Definition
-Bony approximation
-Tissue stretch - normal feel of mm & capsule at end of ROM
-Soft tissue approximation
Term
Abnormal End Feels?
Definition
1. Empty - painful and patient doesn't want to go further or muscle guarding/resisting
2. Bony - end feel is bony when normally in this joint it wouldn't be
3. Capsular (early in ROM) - tissue stretch before normal
4. Springy block - lose body in the joint (ex-meniscal tears)
5. Spasm/hard - muscle spasm, no bone in area to cause hard end feel; normal then feels really hard
Term
PROM Contraindications
Definition
-Fx or dislocation
-Immediately following surgical repair of tendons, ligaments, muscle, joints (condition specific, so not ALWAYS a contraindication!!!!)
-Presence of myositis ossificans - soft tissue injured and bleeds causing a hematoma, this hardens and bone forms
Term
PROM Precautions
Definition
-Inflammatory process
-Assessing hypermobile joints
-Marked osteoporosis
-Patient on pain meds or muscle relaxants
-Pain during ROM
-Regions of hematoma
-Assessing joints that are ankylosed - tight/stiff
-Immediately following injury where soft tissue disruption has occured
Term
ROM Considerations
Definition
-Position of athlete
-Position of ATC
-Stabilization
-Alignment of goniometer
-Handling of goniometer
-Interpreting & reading goniometer
-Recording data
Term
Athlete Position when Assessing ROM
Definition
-Position depends on joint to be measured
-AROM measured against gravity
-Place joint @ zero degrees (if able)
-Stabilize proximal to joint being measured
-Min. patient movement between ROM measures
-Maintain patient decency

*Be sure to make note of positions because you may get different measurements depending on the athlete's position
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