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CHAPTER 2:MUSCULOSKELETAL SYSTEM:

FRAMEWORK AND MOVEMENTS

KINESIOLOGYScientific Basis of Human Motion, 12th edition

Hamilton, Weimar & LuttgensPresentation Created by

TK Koesterer, Ph.D., ATCHumboldt State University

Revised by Hamilton & Weimar

Copyright © 2012 by The McGraw-Hill Companies, Inc. All rights reserved.McGraw-Hill/Irwin

2-2

MUSCULOSKELETAL FRAMEWORK

 An arrangement of bones, joints, and muscles.

 Acts as a lever system allowing for a great number of coordinated movements.

 An anatomical lever is a bone that engages in movement when force is applied to it.

 The force is from a muscle attached to the bone or an external force (gravity or weight).

 Muscles can produce motion only by shortening.

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THE BONES

 Skeleton: provides support, muscle attachment, & protection

 Axial: skull, spinal column, sternum, and ribs

 Appendicular: upper and lower extremities

Fig 2.1

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THE BONES: SKELETAL CHANGES

 Growth Osteogenesis Initial matrix Osteoblasts form bone on matrix. Bone forms in response to loading stress.

 Degeneration Osteoclasts reabsorb bone in the absence of stress. Bones become more porous and brittle; osteoporosis.

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THE BONES:

 Bone typesTwo types allow bone to

be strong, yet light.Compact: dense outer

boneCancellous: open,

spongy looking inner bone

Fig. 2.2

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TYPES OF BONES

 Long: shaft or body with a medullary canal, and relatively broad, knobby ends Femur, tibia, humerus, ulna, radius, etc.

 Short: relatively small, chunky, solid Carpals and tarsals

 Flat: flat & plate like  Sternum, scapulae, ribs, pelvis

 Irregular: bones of spinal column Vertebrae, sacrum, & coccyx

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MECHANICAL AXIS OF A BONE

 A straight line that connects the midpoint of the joint at one end of a bone with the midpoint of the joint at the other end.

 The axis may lie outside the shaft.

Fig 2.3

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SKELETAL CHANGES

 Epiphysis is a part of a bone separated from the main bone by a layer of cartilage.

 Epiphyseal cartilage is where growth occurs. When this cartilage ossifies and closure is

complete, no more growth can occur. Tables 2.1 & 2.2: ages of ossification  Need to be aware of epiphyseal injuries in children

& adolescents.

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ARTICULATIONS

 Structure and function of joints are so interrelated that it is difficult to discuss them separately.

 The configuration of the bones that form an articulation, together with the reinforcing ligaments, determine and limit the movements of the joint.

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STRUCTURAL CLASSIFICATION

 Based on presence or absence of a joint cavity:Diarthrosis or Synarthrosis

 Further classified either by shape or nature of the tissues that connect the bones.

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DIARTHROSIS: CHARACTERISTICS

 Articular cavity Ligamentous

capsule Synovial membrane Surfaces are

smooth Surfaces covered

with cartilage Fig 2.5

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DIARTHROSIS: CLASSIFICATION Irregular joint: irregular surfaces, flat or slightly curved,

permits gliding movement. Hinge joint: convex/concave surfaces, uniaxial, permits

flexion/extension. Pivot joint: a peg-like pivot, permits rotation. Condyloid joint: oval or egg-shape convex surface fits into a

reciprocal concave surface, biaxial, permits flexion/extension, ab & adduction, and circumduction.

 Saddle: modification of condyloid, both surfaces are convex and concave, biaxial, permits flexion/extension, ab & adduction, and circumduction.

 Ball-and-socket: head of one bone fits into the cup of the other bone.

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TYPE OF JOINTS

Plane Hinge Pivot CondyloidIntercarpal Elbow Atlantoaxial Radiocarpal

Condyloid Saddle Ball & Socket Ball & SocketMCP joint Thumb Shoulder Hip

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SYNARTHROSIS: CHARACTERISTICS

 No articular cavity, no capsule, synovial membrane or synovial fluid.

 In two types, bones are united by cartilage or fibrous tissue.

 Third type, not a true joint, but is a ligamentous connection between bones.

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SYNARTHROSIS: CLASSIFICATION

 Cartilaginous joint: united by fibrocartilage permits bending & twisting motions.

 Fibrous joint: edges of bone are united by a thin layer of fibrous tissue, no movement permitted.

 Ligamentous joints: two bodies are tied together by ligaments, permits limited movement of no specific type.

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JOINT STABILITY Function of joints is to provide a means of moving or, rather, of being

moved. Secondary functions is to provide stability without interfering with the

desired motions. All joints do not have the same degree of stability.

 Emerson’s law: “For everything that is given, something is taken”. Movement is gained at the expense of stability.

 Resistance to displacement Factors responsible for stability

 Bony structure Ligamentous arrangement Muscle tension Fascia Atmospheric pressure

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SHAPE OF BONY STRUCTURE

 May refer to kind of joint:Hinge, condyloid, pivot, or ball-and-socket

 Or specific characteristics of a joint:Depth of socket

More stable, less mobile

More mobile, less stable

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LIGAMENTOUS ARRANGEMENTS

 Ligaments are strong, flexible, stress-resistant, somewhat elastic, fibrous tissues that form bands or cords.

 Join bone to bone. Help maintain relationship of bones. Check movement at normal limits of joint. Resist movements for which joint is not

constructed.  Will stretch when subject to prolonged

stress. Once stretched, their function is affected.

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MUSCULAR ARRANGEMENT

 Muscles that span joints aid in stability.

 Especially when bony structure contributes little to stability.

Fig 5.13

Muscles acting to stabilize the shoulder

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FASCIA AND SKIN

 Fascia consists of fibrous connective tissue.  May form thin membranes or tough, fibrous

sheets. Intense or prolonged stress may cause

permanent stretch. Iliotibial tract and thick skin covering the knee

joint are examples.

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ATMOSPHERIC PRESSURE

 Negative pressure in joint capsule forms a vacuum.

 The suction created is an important factor in resisting dislocation of a joint.

 Key in hip and shoulder joints.

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FACTORS AFFECTING THE RANGE OF MOTION (ROM) Three factors that affect the stability of a joint are

also related to its ROM:1. Shape of articular surfaces.2. Restraining effect of ligaments.3. Muscles and tendons (single most important

factor). Flexibility should not exceed muscle’s ability to

maintain integrity of joint. Additional factors include: injury or disease,

gender, body build, heredity, occupation, exercise, and age.

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METHODS OF ASSESSING A JOINT’S RANGE OF MOTION

 Measure degrees from starting position to its maximal movement.

 Goniometer: axis placed directly over center of joint, one arm held stationary, other arm held to moving segment.

Fig 2.7

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METHODS OF ASSESSING A JOINT’S RANGE OF MOTION

 Videotape: joint centers are marked to be visible in projected image.

 Joint angles can be taken from images.

 Segment action must occur in picture plane.

Fig 2.8 85°

91°

2-25

AVERAGE RANGES OF JOINT MOTION

 Ranges vary and it is difficult to establish norms.

 Age, gender, body build, and level of activity may all be factors.

 Four sets of ranges are presented in table 2.4.

 Illustration of joint ROM for most fundamental movements are found in Appendix B.

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ORIENTATION OF THE BODY

Center of Gravity: imaginary point representing the weight center of an object

Line of Gravity: imaginary vertical line that passes through the center of gravity

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ORIENTATION OF THE BODYPLANES OF THE BODY

Fig2.8

Sagittal Frontal Transverse

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ORIENTATION OF THE BODYAXES OF MOTION

 Bilateral: axis passes horizontally from side to side; perpendicular to sagittal plane.

 Anteroposterior or AP: axis passes horizontally from front to back; perpendicular to frontal plane.

 Vertical: axis is perpendicular to the ground and transverse plane.

 Rotation occurs in a plane and around an axis. Axis of movement is always at right angles to the

plane in which it occurs.

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ORIENTATION OF THE BODYSTANDARD STARTING POSITIONS

Fig 2.10

Fundamental Standing Position

Anatomical Standing Position

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FUNDAMENTAL MOVEMENTS SAGITTAL PLANE ABOUT A BILATERAL AXISFlexion: reduction in joint angle. Examples:

 Tipping the head forward Lifting the foot & leg backward from knee Raising entire lower extremity forward-

upward as though kicking Raising forearm straight forward Elbow straight, raising entire upper extremity

forward-upward

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FUNDAMENTAL MOVEMENTS SAGITTAL PLANE ABOUT A BILATERAL AXIS

Extension: return movement from flexion.Hyperflexion: arm is flexed beyond vertical.Hyperextension: continuation of extension

beyond starting position.Reduction of Hyperextension: return

movement from hyperextension.

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JOINT MOTIONS IN THE SAGITTAL PLANE AROUND A BILATERAL AXIS.

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FUNDAMENTAL MOVEMENTS FRONTAL PLANE ABOUT AN AP AXIS

Abduction: movement away from the midline.Adduction: return movement from abduction.Lateral Flexion: lateral bending of head or trunk.Hyperabduction: arm abducted beyond vertical.Hyperadduction: move across in front of the body.Reduction of Hyperadduction: return movement.Reduction of Lateral Flexion: return movement.

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JOINT MOTIONS IN THE FRONTAL PLANE AROUND AN ANTERO-POSTERIOR AXIS.

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FUNDAMENTAL MOVEMENTS TRANSVERSE PLANE ABOUT A VERTICAL AXIS(Point of reference for the upper extremities is the

midpoint of the fundamental (not anatomic) position.)

Rotation Left & Right: rotation of head, neck, or pelvis.

Lateral & Medial Rotation: rotation of thigh and upper arm.

Supination & Pronation: rotation of forearm along long axis.

Reduction of Lateral Rotation, Medial Rotation, Supination, or Pronation: rotation of segment back to mid-position.

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TORSO MOTION IN THE TRANSVERSE PLANE AROUND A VERTICAL AXIS.

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FUNDAMENTAL MOVEMENTS COMBINATION OF PLANES

Circumduction: whole segment describes a cone. arm circling and trunk circling

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NAMING JOINT ACTION IN COMPLEX MOVEMENTS All joint actions are named as if they were

occurring in anatomical position. The plane and axis are identified as those

in which the movement actually occurs.Non-axial MovementsMovements in plane joints are non-axial

gliding movements between articular facets of spinal column.

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ANALYZING JOINT MOTIONS

 Alignment: optimum alignment should be based on efficiency, effectiveness, and safety.

 Range of Motion: ROM demands of an activity must be compatible to avoid injury.

 Flexibility: reduces internal resistance to motion.

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