Tools and Settings
Content
Questions and Tasks
Students will be able to:
The human body is constantly moving and capable of numerous movements wherein the relationship between various body segments change. To accurately describe these movements a specific body position was selected to serve as a starting point from which all movement could be referenced. This is known as anatomical position
Figure 1
Fundamental (Physiological) Position
Figure 2
Reference Positions – Starting Points
Reference Segment: The Distal Segment, in relation to the joint where the “problem” is occurring
Reference Curve: The convex side of the curve or rotation of the vertebral body, as compared to the concave side
Anatomical Directional Terminology
Specific terms are used to describe the location of a structure and its position relative to other structures.
Anterior - In front. Toward the front (Anteroinferior, Anterosuperior, Anterolateral, Anteromedial)
Posterior - In back. Toward the back (Posteroinferior, Posterosuperior, Posterolateral, Posteromedial)
Superior - Above in relation to another structure (Superolateral, Superomedial)
Inferior Below in relation to another structure (Inferolateral, Inferomedial)
Medial - Nearer to the midline. Toward the middle
Lateral – Farther from the midline. Toward the outside
Dorsal – Relating to the back. Upper surface (prone position)
Ventral – Relating to the abdomen. Lower surface (prone position)
Proximal – Nearest the point of origin (extremity)
Distal – Farther from point of origin (extremity)
Palmar – Relating to the palm or volar aspect of the hand
Plantar – Relating to the sole or volar aspect of the foot
Ulnar – closer to or toward the ulna
Radial – closer to or toward the radius
Tibial – closer to or toward the tibia
Fibular – closer to or toward the fibula
Cephalic – Above in relation to another structure. Toward the head
Caudal – Below in relation to another structure. Toward the tail
Volar – Relating to palm of hand or sole of foot
Dorsum – Superior surface of an anterior projecting structure
Prone – Face down position
Supine – Face up position
Ipsilateral – Pertaining to the same side
Contralateral – Pertaining to the opposite side
Unilateral – Pertaining to one side
Bilateral – Pertaining to both sides
Superficial – Near the surface (describes depth)
Deep – Below the surface (describes depth)
Cubitus – elbow
Coxa – hip
Genu – knee
Pes – foot
Pollux – thumb
Hallux – big toe
Talipes – congenital club foot problem
Equino/Equinus – extreme plantarflexion
Calcaneo/Calcaneus – extreme dorsiflexion
Recurvatum – backward or reverse curve
Varum/Varus/Vara – distal segment nearer midline
Valgum/Valgus/Valga – distal segment farther from midline
Cavus – cave like (high arch)
Acquired – not present at birth
Congenital – present at birth
Etiology – the cause of
Idiopathic – the cause is unknown
Contracture – the abnormal and relatively permanent shortening of a tissue/muscle
Elongation – the relatively permanent lengthening of a tissue/muscle
Hypertrophy – increased growth
Atrophy – diminished growth
As stated, kinesiology is the analysis of motion. Motion is fundamental to physical activities, rehabilitation, etc. Specific to the body, motion is generally produced, or at least started, by muscular action. Basically there are two types of motion: linear motion and angular motion.
Linear Motion (also known as translatory motion) is motion that takes place along a line from one location to another. All parts of the object move the same distance, in the same direction, and at the same time.
Angular Motion (also known as rotary motion) is motion that takes place around a fixed point or axis. All parts of the object move through the same angle, in the same direction, and at the same time – but they do not move the same distance.
When you consider physical activities in which a person might engage, both types of motion are involved. The angular motion of joints working together produces the linear motion of walking, running or jumping, or the linear motion of a thrown or struck object.
To describe motion of the human body, we need to describe or map the space through which motion occurs. Because space is three-dimensional we need to describe the three dimensions of space. We describe them with a plane.
A plane, or plane of motion, is an imaginary flat surface that cuts through space. The human body, or a part of the body, may move in each of these three dimensions. The three types of planes are sagittal, frontal, and transverse.
Figure 11
Plqnes of Motion
A. Sagittal Plane: divides the body into left and right portions, running in an anteroposterior (or posterior to anterior) direction.
B. Frontal Plane (also called coronal): divides the body into anterior and posterior portions, running in a left to right (or right to left) direction. It can also be described as running in a medial to lateral (or lateral to medial) direction.
C. Transverse Plane (also called horizontal): divides the body into superior and inferior portions, where the body part stays in place and spins.
Oblique Plane: is a combination of the sagittal and frontal planes.
Note: these three cardinal planes are defined relative to anatomical position. Whenever a plane passes through the midline of a body, whether it is the sagittal, frontal, or transverse plane, it is referred to as a cardinal plane, because it divides the body into equal parts. The point where the three cardinal planes intersect is the center of gravity.
As a body segment moves through a plane of motion it rotates around an axis. An axis is an imaginary line around which motion occurs. This is often referred to as axial movement, or rotary movement. Therefore, for each one of the planes of the body, a corresponding axis exists. This axis is always perpendicular to the plane of motion or has a 90º relationship with the plane.
Figure 12
Cardinal Axes
A. Frontal Axis (mediolateral axis): a line that runs from medial to lateral. Movements that occur in the sagittal plane move around a frontal or mediolateral axis.
B. Sagittal Axis (anteroposterior axis): a line that runs from anterior to posterior. Movements that occur in the frontal plane move around a sagittal or anteroposterior axis.
C. Vertical or Longitudinal Axis (superoinferior axis): a line that runs superior to inferior. Movements that occur in a transverse plane moves around a vertical/longitudinal or superoinferior axis.
Simply defined a joint is the union between two or more bones. The primary function of a joint is to allow movement. The movement at a joint is created by muscle contraction acting on the bone or bones forming the joint. Ligaments and joint capsules function to limit excessive or undesired movement at a joint. Therefore, joints allow movement; muscles create movement, and ligaments and joint capsules limit movement at the joint. In addition to allowing movement, joints have three other functions:
Joints are classified according to structure or function.
Amphiarthrodial (slightly moveable)
Figure 13
Syndesmosis
Figure 14
Symphysis
Figure 15
Synchondrosis
Figure 16
Components of a Diarthrodial (Synovial) Joint
Note: The joint surface shape affects the type of motion that can occur at the joint. All joint surfaces are either: 1. Ovoid – convex-concave relationship
2. Seller – convex in one direction and concave in the other direction
There are six classifications of diarthrodial joints, each having motion in one or more planes. If a joint has motion in only one plane it is often referred to as having one degree of freedom, whereas joints having motion in two or three planes are described as having two or three degrees of freedom, respectively.
ClassificationName
General Name
HumeroulnarTibiotarsalTibiofemoral
(dual) InterphalangealMetacarpophalangeal
of the thumb
MetacarpophalangealRadiocarpal
Atlantooccipital Metatarsophalangeal
Radioulnar (proximal & distal)
AtlantoaxialTibiofemoral (dual)
AcetabulofemoralGlenohumeralHumeroradial
(Atypical Ball & Socket - biaxial)
Carpometacarpal of thumb
Sternoclavicular (Complex Saddle)
Upper BodyVertebral FacetsCostovertebral
CostotransverseSternocostalAcromioclavicular
IntercarpalIntermetacarpalCaropmetacarpal
Osteokinematic Motion - motion that takes place by the bones moving through a plane of motion about an axis. Said another way, movement is the change in relationship between segments. Movement Terminology are the terms used to describe the actual change in position of the bones relative to each other. The specific amount of movement in a joint can be measured using an instrument called a goniometer.
Figure 22
Example #1
Figure 23
Exampe #2
Fill in the following table for practice:
Figure 24
Plane of Motion:Axis if Rotation
a. Elevation – superior movement of shoulder
girdle (scapula).
b. Protraction (Scapular Abduction) – lateral movement of shoulder girdle away from spine.
c. Depression – inferior movement of shoulder
d. Retraction (Scapular Adduction) – medial movement of shoulder girdle toward spine.
e. Upward Rotation – upward rotary movement of Scapula (acromion process = superomedial).
f. Downward Rotation – downward rotary movement of Scapula (acromion process = inferolateral).
Figure 25
a. Flexion – movement resulting in a decrease of the
joint angle. Humerus moves anterior.
b. Extension – movement resulting in an increase of the
joint angle. Humerus moves posterior.
Plane of Motion: ___________________________
Axis of Rotation: ___________________________
c. Abduction – lateral movement away from body midline. Humerus moves lateral.
d. Adduction – medial movement toward body Midline. Humerus moves medial.
e. Horizontal Abduction – shoulder movement of
humerus (90° abd.) away from body midline.
f. Horizontal Adduction - shoulder movement of humerus (90° abd.) toward body midline.
g. External Rotation – shoulder rotary movement around longitudinal axis of bone away from midline.
h. Internal Rotation – shoulder rotary movement around the longitudinal axis of bone toward body midline.
Figure 26
Anatomical (Osteokinematic) Movement Terms Specific to the Elbow Joint & Radiounlar Joint
a. Extension – elbow movement resulting in an increase of the joint angle, forearm moves back to anatomical position.
b. Flexion – elbow movement resulting in a decrease of the joint angle, forearm moves away from anatomical position.
c. Supination – external rotation of radius/forearm. Palm turns up.
d. Pronation – internal rotation of radius/forearm. Palm turns down.
Ulnar Deviation – wrist movement with little finger side of hand moving toward medial forearm.
Radial Deviation – wrist movement with thumb side of
hand moving toward lateral forearm.
Flexion – wrist movement with palmer aspect of hand
moving toward anterior forearm.
Extension – wrist movement with dorsal aspect of hand
moving toward posterior forearm.
Figure 27
Anatomical (Osteokinematic) Movement Terms Specific to the Wrist
Figure 28
Anatomical (Osteokinematic) Movement Terms Specific to the Pelvis
a. Anterior Pelvic Tilt/Rotation – anterior part of pelvis tilts downward.
b. Posterior Pelvic Tilt/Rotation – posterior part of pelvis tilts downward.
c. Lateral Pelvic Tilt/Rotation (right or left) – indicated side tilts downward, opposite side elevates.
d. Transverse Pelvic Tilt/Rotation (right or left) – trunk turns toward indicated direction, with movement taking place primarily at the hip joints (internal and external respectively)
Figure 29
Anatomical (Osteokinematic) Movement Terms Specific to the Hip
Figure 30
Anatomical (Osteokinematic) Movement Terms Specific to the Knee
a. Flexion – knee movement resulting in a decrease of the joint angle. Tibia move posterior.
b. Extension – knee movement resulting in an increase of the joint angle. Tibia moves anterior.
c. Internal Rotation – knee rotary movement around the longitudinal axis of bone toward body midline.
d. External Rotation – knee rotary movement around
longitudinal axis of bone away from midline.
Figure 31
Anatomical (Osteokinematic) Movement Terms Specific to the Ankle and Foot
a. Plantarflexion – extension movement of ankle. Toes
move away from body.
b. Dorsiflexion – flexion movement of ankle. Top of foot moves toward anterior tibia.
c. Inversion – foot movement turning sole of foot inward.
d. Eversion – foot movement turning sole of foot outward.
Figure 32
Anatomical (Osteokinematic) Movement Terms Specific to the Spine
a. Flexion – forward movement of neck or trunk.
b. Extension – backward movement of the neck or trunk.
Plane of Motion: _________________
Axis of Rotation: _________________
c. Lateral Flexion – movement of neck and/or trunk to side away from midline (side bending).
Reduction - return of the spinal column to the anatomical Position.
d. Rotation – right or left spinal rotation
Figure 33
Anatomical (Osteokinematic) Movement Terms Specific to the Caropmetacarpal Joint of the Thumb
a. Adduction: CMC movement from abducted position back to anatomical position in the sagittal plane.
b. Abduction (Short Abduction) – CMC movement with thumb moving away from palm in the sagittal plane.
c. Extension (Long Abduction) – CMC movement of thumb moving away from hand in frontal plane.
d. Flexion: CMC movement across the palm in the frontal plane.
e. Thumb Opposition – CMC movement of the thumb across the palm to make contact with fingers. This movement is the combination of CMC abduction, flexion, and internal rotation.
f. Thumb Reposition – CMC movement of the thumb back to the anatomical position from opposition. This movement is the combination of CMC adduction, extension, and external rotation.
Anatomical (Osteokinematic) Movement Terms Specific to the Mandible
Protrusion – forward thrusting of jaw.
Plane:
Retrusion – movement of jaw back to anatomical
position from protrusion.
Figure 34
Arthrokinematic Motion
In order for osteokinematic movements to occur there must be movement at the actual articular surfaces of the joint. This is known as arthrokinematic motion. The three types of arthrokinematic motion are:
Spin – A single point on one
articular surface rotates about a
single point on another articular
surface.
Example: A top spinning on a surface.
Roll – a series of points on one
articular surface contacts with a
series of points on another articular
Example: A tire rolling across a surface.
Glide/Slide– a specific point on one
articulating surface comes in
contact with a series of points on
another surface.
Example: A block sliding across a surface.
Figure 35
Figure 36
Figure 37
Is this a concave on convex, or a convex on concave movement?
Is the roll anterior, posterior, medial, or lateral?
How would you describe the glide/slide
Figure 38
At the knee joint is this a concave-convex or a convex-concave movement?
How would you describe the roll?
Figure 39
Is this a concave-convex or a convex-concave movement?
Is the roll medial, lateral, anterior, or inferior?
Figure 40
How would you describe the glide/slide?
Figure 41
Figure 42
How well a joint’s surfaces fit together, match or lineup is referred to as joint congruency. As a joint moves through a plane of motion, the degree of alignment or matching can change.
1. The joint surfaces that make up the joint are in maximum contact with each other (well matched or lined up). This is referred to as congruency.
2. The joint is compressed together tightly via tension, allowing very little joint play or movement.
3. The joint capsule and ligaments that stabilize the joint are taut.
Note: It is in the closed-pack position that a joint is usually tested for its stability and integrity. It is also in this position that a joint is vulnerable to injury.
1. The joint surfaces are in minimal contact with each other. This is referred to as incongruence.
2. The joint is loose as parts of the joint capsule and associated ligaments are lax.
3. Arthrokinematic motions of roll, glide, and spin can best occur.
Note: It is in the open pack position that joint mobilization techniques are best applied.