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Terms in this set (57)
death or degeneration of bone resulting from lack of blood supply to the affected bones
the posterior aspect of the wrist or hand
the anterior aspect of the wrist and the hand
a degenerative joint disease resulting from deterioration of the bones and cartilage that compose affected joints
wrist is extended when fingers are passively flexed; wrist is flexed when fingers are passively extended
The transverse carpal ligament bridges the palmar side of the carpal bones, helping to form the carpal tunnel.
Houses the median nerve and tendons of the extrinsic flexor muscles
Carpal tunnel syndrome
characterized by pain/paresthesia (tingling),over the sensory distribution of the median nerve.
extreme cases: muscular weakness and atrophy in the intrinsic muscles around the thumb.
The "Position of Function" of the Wrist
common daily activities require about 45 degrees of sagittal plane motion: from 5 to 10 degrees of flexion to 30 to 35 degrees of extension.
same daily activities also require about 25 degrees of frontal plane motion: from 15 degrees of ulnar deviation to 10 degrees of radial deviation.
Radial & Ulnar Deviators' Functions in Grasping...
activities that involve the grasp and control of objects held within the hand.
Ex. using a tennis racquet, casting a fishing rod, pushing oneself in a wheelchair, hammering a nail into a piece of wood.
Basilar joint osteoarthritis
functional demand placed on the CMC joint of the thumb results in a painful condition.
Typically pain, but also with functional limitations, ligamentous laxity (looseness), and instability of the joint.
advanced arthritis of the base of the thumb -severe pain (made worse by pinching actions), weakness, swelling, dislocation, and crepitation (abnormal popping or clicking sounds that occur with movement).
Occurs more in women.
Position of Tension: Placing Useful Tension...
Flexion of the metacarpophalangeal joints places a stretch within the collateral ligaments. Increased tension in collateral ligaments useful because it lends natural stability to the base of the fingers, which is especially useful during flexion movements such as a holding playing cards
Zigzag Deformity of the Thumb
Results from advance rheumatoid arthritis. Relatively common deformity involves the CMC joint flexion and adduction, MCP joint hyperextension, and IP joint flexion.
Passive Finger Flexion via Tenodesis Action...
Extrinsic flexors of the digits (FDP, FDS, and FPL) cross over the anterior side of the wrist. Position of the wrist alters the amount of stretch on these muscles. Extend wrist → passive flexion of fingers and thumb.
Deformity at the MCP joint → excessive ulnar deviation and ulnar translation (slide) of the proximal phalanx relative to the head of the metacarpal.
Treatment align the MCP joint and minimize mechanics that cause instability and deformity (splints and joint protection strategies).
Anterior Pelvic Tilt
tilting the superior aspect of the pelvis anteriorly while holding the trunk upright.
motion creates a short arc, pelvic-on-femoral (hip) flexion motion that is naturally accompanied by an increasing lumbar lordosis.
Posterior Pelvic Tilt
tilting the superior aspect of the pelvis posteriorly while holding the trunk upright.
motion creates a short arc, pelvic-on-femoral (hip) extension movement that is naturally accompanied by a decreasing lumbar lordosis.
normal sagittal curvature of the vertebral column; convex posteriorly and concave anteriorly. The thoracic and sacral regions of a normal spine display kyphotic curves.
a normal sagittal plane curvature of the spine; concave posteriorly and convex anteriorly. The cervical and lumbar regions of a normal spine display lordotic curves.
abnormal frontal and horizontal plane curvature within the vertebral column.
a narrowing; typically refers to the vertebral canal or the intervertebral foramen.
Normal Curvature of Vertebral Column
not fixed natural and flexible
Thoracic= kyphosis - kyphosis of the vertebral column allows for more room for vital organs
Sacrococcygeal kyphosis - look above
Flexion of the trunk → decreases lordosis and increases kyphosis
Extension of the trunk → increases lordosis and decreases kyphosis
Herniated Nucleus Pulposus
Nucleus pulposus is the center of the intervertebral disc.
w/ excessive force, middle portion can bulge outward into the annulus fibrosus (outer part of the disc), causing a slipped disc.
Usually a posterior-lateral or posterior migration. Can hit a spinal nerve root or the spinal cord and be very painful or asymptomatic.
4 Categories of Herniated Nucleus Pulposus
4 Categories of Herniated Nucleus Pulposus: Protrusion
displaced nucleus propulsus remains within the annulus fibrosus; may create a pressure bulge of the neural tissues (baddish)
4 Categories of Herniated Nucleus Pulposus: Prolapse
displaced nucleus propulsus reaches the posterior edge of the disc, but remains confined within the annulus propulsus (bad)
4 Categories of Herniated Nucleus Pulposus: Extrusion
annulus fibrosus ruptures, allowing the nucleus propulsus to escape the disc and into the epidural space (badder)
4 Categories of Herniated Nucleus Pulposus: Sequestration
parts of the nucleus propoulss and fragments of the annulus fibrosus become lodged within the epidural space (worst)
anterior displacement on the one vertebra over the other.
Often at L5-S1 junction.
Can injure the nerves in cauda equina as they pass through the lumbosacral junction.
Contraindications - exercises that promote full extension or hyperlordosis of the lumbar spine. Do not perform extreme anterior pelvic tilt.
gait deviation in which one side of the pelvis inadvertently lowers during the swing phase of gait.
a gait compensation in which one side of the pelvis is elevated (hiked) to help clear the swing leg from the ground.
Common Mechanisms of Injury to the ACL
most frequently totally ruptured ligament of the knee.
70% actually occur during non-contact or minimal contact situations, such as landing from a jump or quickly decelerates during a change of direction
describes a sagittal plane motion of the ankle or foot in which the dorsum of the foot is drawn upward toward the tibia (shin)
the sagittal plane of motion in which the foot moves downward, as when stepping on the accelerator pedal of a car.
frontal plane motion of the foot in which a point on its plantar aspect rotates laterally.
a frontal plane motion of the foot in which a point on its plantar aspect rotates medially.
a gait deviation, typically due to weakness of the dorsiflexors, that results in unwanted "dropping" of the foot during the swing phase of gait.
phase of gait when the leg is in contact with the ground; occupies the first 60% of the entire gait cycle.
phase of gait when the leg is not in contact with the ground but is advancing forward; occupies the last 40% of the gait cycle.
The gait cycle describes the events that occur (while walking) within two successive heel contacts of the same leg. Each gait cycle is divided into a stance phase and a swing phase.
refers to the events that occur when the foot is in contact with the ground
describes the events that occur when the foot is swinging through the air, advancing the lower extremity to the next step
The stance phase and is subdivided into five events:
1. heel contact (0% of the gait cycle) (definitions of each below)
2. foot flat (8% of the gait cycle)
3. mid stance (30% of the gait cycle)
4. heel off (40% of the gait cycle), and
5. toe off (60% of the gait cycle).
push off phase in gait
the combined events of heel off and toe off, when the stance foot is literally "pushing off" towards the next step, typically spanning 40-60% of the gait cycle. In the last 40% of the cycle the limb is off the ground in the swing phase:
The swing phase is typically subdivided into
1. early swing (60-75% of the gait cycle)
2. mid swing (75-85% of the gait cycle), and
3. late swing/terminal swing (85%-100% of the gait cycle)
"flat foot" due to a poorly supported/weakened longitudinal arch
(the longitudinal arch = arch of the foot, it is also known as the medial-longitudinal arch and is the primary shock absorber of the foot).
Pes Planus can be caused by
- muscle weakness of the tibialis posterior
- abnormal bony anatomy
- general looseness in connective tissues, and
- over elongation of the plantar fascia
is a painful condition of inflammation of the plantar fascia of the foot, due to repetitive stress on the plantar fascia from recreational activities like running or jumping.
( runners/athletes w/pes planus are at risk for getting plantar fasciitis).
a subdivision of the stance phase of the gait cycle, when the heel makes contact with the ground.
The instant the lower limb contacts the ground (0% of the gait cycle).
a subdivision of the stance phase of the gait cycle, when the plantar aspect of the foot is completely in contact with the ground.
The period that the entire plantar aspect of the foot is on the ground (8% of the gait cycle).
a subdivision of the stance phase of the gait cycle, when the leg is in a vertical position. Mid-stance phase on one limb normally corresponds with mid-swing phase on the other limb.
The point where the body weight passes directly over the supporting lower extremity (30% of the gait cycle); coincides with a vertically oriented lower leg.
a subdivision of the stance phase of the gait cycle, when the heel breaks contact with the ground.
The instant the heel leaves the ground (40% of the gait cycle).
a subdivision of the stance phase of the gait cycle, when the toes break contact with the ground.
The instant the toe leaves the ground (60% of the gait cycle).
a generic term that describes the final subdivisions of the stance phase of the gait cycle related to propulsion (toe off and heel off).
the part of the gait cycle at which the leg is in the beginning period of its forward (swinging) motion.
The period from toe off to mid swing (60% to 75% of the gait cycle).
a subdivision of the swing phase, when the left is in the middle period of its forward (swinging) motion.
The period when the foot of the swing leg passes next to the foot of the stance leg (75% to 85% of the gait cycle). This corresponds to the mid stance phase of the opposite lower extremity.
a subdivision of the swing phase during which the leg is in the end period of its forward (swinging) motion (just before heel-contact phase).
The period ranging from mid swing until heel contact (85% to 100% of the gait cycle).
biomechanical factors that, when combined, put the ACL at high risk for injury:
Strong activation of the quads over a slightly flexed or fully extended knee
Marked "valgus collapse" of the knee
Excessive ER of the knee (excessive IR of the femur relative to a fixed tibia)
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