Course Objectives. HUMAN MOTION -- Osteokinematics. Classification of Joints - based on anatomic structure and movement potential

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Course Objectives Kinesiology 2017#2: Huei-Ming Chai, Ph.D., PT School of Physical Therapy National Taiwan University To review components of synovial joint To identify planes of motions and its relative axes To describe human motions using kinesiological terms To identify types of motions experienced by the human body To explain the interrelationship between displacement, velocity, and acceleration, and use the knowledge of this interrelationship to describe and analyze motion To distinguish the angular kinematics from linear kinematics and describe their relationship 2 Synovial joint Orientation of human body Description of human motion Motions occurring in body plane Types of human motion Description of osteokinematics Wrist joint 3 Classification of Joints - based on anatomic structure and movement potential diarthrosis: an articulation that contains a articular cavity between two bones synarthrosis: an articulation between bones that is held together by dense irregular connective tissues amphiarthrosis: an articulation between bones that is formed primarily by fibrocartilage and/or hyaline cartilage intervertebral disc 4 diarthrosis synarthrosis amphiarthrosis prefix di = double syn = together amphi = both articular cavity, capsule, synovial membrane articular surfaces to connect bones to transmit forces to allow motions exapmples Comparisons of Joint Types presence no no hyaline cartilage or fibrocartilage + + maximum extremity joints linked by fibrocartilage, fibrous tissues, or ligaments + + no or little cranial suture linked by fibrocartilage and/or hyaline cartilage IVD + + some Bone Synovial Joint Articular cartilage (hyaline cartilage) Connective tissue ligament capsule Meniscus or Disc: fibrocartilage Synovial membrane Bursa joint capsule Synovial fluid bone bone cartilage ligament synovial joint 5 6 1

Intra-Articular Components articular cartilage (hyaline cartilage) joint capsule and capsular ligament synovial membrane synovial cavity rheumatoid arthritis synovial fluid: to provide nutrition and lubrication for the articular cartilage 7 Extra-Articular Components ligament exception: anterior/ posterior cruciate ligament of the knee muscle tendon meniscus or disc bursa labrum fat pads synovial plica 8 Functions of Synovial Joints Osteokinematic Movements Joint Mobility Osteokinematic movements physiological movements movements between 2 bony segments Arthrokinematic movements accessory movements movements between 2 articular surfaces Joint Stability 9 Swing: rotary movement around an axis Spin: rotation around longitudinal axis of distal segment 10 Orientation of human body Description of human motion Motions occurring in body planes Types of human motion Description of osteokinematics Wrist joint 11 Reference Plane the plane of human motion in the context of a person standing in the anatomic position anatomic position a standard position of the body standing erect, facing directly forward, feet pointed forward and slightly apart, and arms hanging down at the sides with palms facing forward cardinal plane the plane where the center of mass (COM) passes through when an individual stands in the anatomic position 12 2

Axis 是哪兩個平面的交集? Three Cardinal Planes sagittal plane Cardinal Planes location bisecting body into transverse axis sagittal plane (median plane) vertically from front to back right/ left transverse plane frontal plane frontal plane (coronal plane) vertically from side to side anterior/ posterior transverse plane (horizontal plane) horizontal upper/ lower sagittal axis vertical axis 13 14 sagittal axis (anteroposterior axis) Axis of Motion direction horizontally from front to back perpendicular to frontal plane Migration of Axis of Rotaiton Although the three orthogonal axes are depicted as stationary, in reality, each axis of all joints in human body migrates throughout the range of motion because the articular surfaces of the joint are not reciprocally shaped as a perfect sphere frontal axis (transverse axis) horizontally from side to side sagittal plane vertical axis perpendicular to the ground transverse plane 15 16 Longitudinal Axis axis that extends within and parallel to a long bone or body segment Orientation of human body Description of human motion Motions occurring in body planes Types of human motion 17 Description of osteokinematics Wrist joint 18 3

Body Segment Direction of Motion upper extremity (arm) upper arm, forearm, and hand lower extremity (leg) thigh, low leg, and foot trunk chest and upper back abdomen and low back head and neck 19 anterior vs. posterior front vs. back forward vs. backward medial vs. lateral left vs. right toward vs. away inward vs. outward superior vs. inferior upper vs. lower cranial vs. caudal top vs. bottom proximal vs. distal posterior superior inferior anterior 20 Description of Motion -- Example 1 Motion -- Example 2 frontal axis Kicking: The leg moves forward in the sagittal plane about a frontal axis Turning the head The head moves around a vertical axis in the horizontal plane vertical axis side view superior view 21 22 Orientation of human body Description of human motion Motions occurring in body planes Types of human motion Osteokinematics synonym: physiological movement human movements movements in sagittal plane movements in frontal plane movements in transverse plane non-axial movement movement in a combination of plane 23 24 4

Movements in Sagittal Plane flexion: increase joint angle extension: decrease joint angle hyperextension extension beyond anatomical plane dorsiflexion/ plantarflexion ankle only forward/ backward bending trunk movements nutation/ counternutation sacroiliac joint movements Nutation/ Counternutation Sacroiliac joint motion 25 26 Movements in Frontal Plane Movements in Transverse Plane abduction: away from midline adduction: toward midline fingers/ toes movements midline indicates 3 rd finger or toe lateral flexion: neck/ trunk only radial/ ulnar deviation: wrist only inversion/ eversion: foot only ulnar deviation radial deviation 27 external rotation: anterior surface of distal segment moves outwards internal rotation: anterior surface of distal segment moves inwards pronation/ supination forearm only abduction/ adduction foot only axial rotation (spin) neck movements 28 Non-Axial Movements Movements in A Combination of Planes translatory movement motions at a plane joint e.g. facet joint of spine C5 C6 vertebral body spinal cord Circumduction distal segment follows surface of a cone tips of distal segment trace a circular path thumb opposition flexion + adduction + rotation facet joint intervertebral disc 29 30 5

Diagonal Movement the movement occurs in a plane which is not parallel to any cardinal planes Thumb Movements flexion/extension in the palmar plane abduction/ adduction in a plane perpendicular to the palm e.g. triplanar motion foot pronation/ supination 31 32 Orientation of human body Description of human motion Motions occurring in body planes Definition of motion Types of human motion Motion the act or process of changing place or position of a body with respect to some reference point reference point Description of osteokinematics Wrist joint 33 34 Rest vs. Motion Absolute vs. Relative Motion reference point 1 reference point 2 absolute motion using the global reference system the trunk during standing up foot trunk relative motion using the local reference system a sleeping passenger in a smoothly moving bus bus ground a parked car ground sun depending on reference point 35 36 6

Relative: Knee Flexion depending on reference system same terminology is required!! Newton s Law Law of Inertia Law of Acceleration: F = ma Law of Reaction Absolute: downward Absolute: upward 37 38 Newton s First Law law of inertia A particle remains at rest or in a uniform state of motion if it is not acted upon by any net external force If F = 0 then v = constant Newton s Second Law law of acceleration Acceleration of a particle is proportional to the unbalanced force acting on it and inversely proportional to the mass of the particle F = ma 1 N 1 kg 1 m/s acceleration 39 40 Newton s Third Law law of action and reaction For every action, there is an equal and opposite reaction F action = F reaction action reaction 41 Orientation of human body Description of human motion Motions occurring in body plane Types of human motion Description of osteokinematics Wrist joint 42 7

Classification Based on Path of Motion translatory motion: linear motion, translation a motion in which all parts of the moving body move toward the same direction rotary motion angular motion, rotation a motion in which the object acts as a radius and all parts of the moving object rotate in the same angular direction and follow a circular path about a pivot point Translatory Motion linear motion the path follows a straight line curvilinear motion the path follows a curved line circular motion a special form of curvilinear motion, which is the motion when a body moves along a circumference of a circle 43 44 Rotary Motion angular motion: the rotary motion with one side of the moving object fixed spin: the rotary motion with the axis of rotation around the center of mass Classification Based on Repetition of Motion single motion: movement performed only once repeated motion: same movement pattern that is done many times in a given time 45 46 Classification Based on Degree of Freedom DOF: a minimum number of kinematic variables required to specified all positions and orientations of the segments in a body system the number of plane in which the segments move the number of primary axes that the segments possess examples humeroulnar joint (elbow) =1 glenohumeral joint (shoulder) = 3 Classification Based on Relative Segment Kinematics kinematic chain: a series of connected segment links open kinematic chain motion: the joint motion with the distal segment moves free in space, e.g. raising lower leg or throwing a ball closed kinematic chain motion: the joint motion with the distal segment is fixed, e.g. standing up or squatting down 47 Important!! Will be discussed later. 48 8

Classification Based on Presence of Muscle Contraction Classification Based on Presence of Joint Kinematics active motion: the motion that is caused by muscle contraction osteokinematic movement: movements between 2 bony segments passive motion: the motion that is created by sources other than muscle, such as from gravity arhtrokinematic movement: movements between 2 articular surfaces Important!! Will be discussed later. 49 Important!! Will be discussed later. 50 Kinematic Description of Motion Orientation of human body Description of human motion Motions occurring in body plane Types of human motions Kinematic description of motion linear kinematics linear displacement linear velocity linear acceleration angular kinematics angular displacement angular velocity angular acceleration Description of osteokinematics Wrist joint 51 52 Linear Displacement Displacement Vs. Distance displacement: a vector quantity the change of position that an object moves from the reference point amplitude distance direction a person walks north for 3 m and then east for 4 m traveling distance = 3 + 4 = 7 m amplitude of displacement = distance (scalar quantity) how far an object travels from one place to another (32 + 42) 0.5 = 5 m 53 54 9

Linear Velocity velocity (vector quantity) the rate of change in displacement v = dx / dt amplitude ¹ speed direction speed (scalar quantity) the distance an object travels in a given time average speed = (distance traveled)/ time Linear Acceleration acceleration (vector quantity) the rate of change in velocity a = dv / dt amplitude direction deceleration: the negative acceleration 55 56 Relationship Among Displacement, Velocity, and Acceleration x = v 0 t + (1/2)at 2 v = v 0 + at average velocity = (v 0 + v) / 2 Kinematic Variables linear angular. Position r(x, y, z) Displacement s= r = Velocity v=dr/dt = d /dt Acceleration a = dv/dt d /dt 57 58 Linear and Angular Conversions Example: OC > OB > OA different linear displacement even though the angular displacement is the same (= ) = d / r = v / r = a / r Orientation of the body Description of motion Motions occurring in body plane Types of motions Factors that modify motion 59 Description of osteokinematics Wrist joint 60 10

Factors That Modify Motion Extrinsic Factors gravity contact forces fluid forces Intrinsic Factors Factors That Modify Motion Extrinsic Factors Intrinsic Factors friction between articular surfaces tension of antagonistic muscles, ligaments, faciae, and capsules anomalies of bones or joints atmospheric pressure within joint capsule presence the interfering muscle bulk or adipose tissues 61 62 Water Resistance Different Surface Area Help or Hinder? view from the front A view from the side Whether these modifying factors are a help or a hindrance depends on the circumstances and the nature of motion. Skills indicates to learn how to take advantage of these modify factors when they influence the movement. A 63 64 Orientation of the body Description of motion Motions occurring in body plane Types of motions Description of osteokinematics Wrist joint 65 Description of Osteokinematic Motions joint(s) involved/ degree of freedom plane of motion axis of rotation range of motion functional range open vs. closed chain factors limited motion 66 11

Components of Wrist Complex Functions of Wrist Complex No muscle attaches onto proximal row. trapezoid trapezium scaphoid radiocarpal joint distal radioulnar joint capitate radius ulna hamate distal row proximal row midcarpal joint pisiform triquetrum lunate 67 To argument fine hand and finger function To control length/ tension of finger long flexors and extensors To provide stability for skilled or forceful hand movements Loss of wrist function does not seriously impede performance of daily activities!! 68 Osteokinematic Movements biconvex joint 2 degrees of freedom flexion/ extension radial/ ulnar deviation circumduction cone-like motion F-RD-E-UD F-UD-E-RD R L C sagittal view Wrist Flexion/ Extension joint involved radiocarpal joint midcarpal joint Intercarpal joints sagittal plane motion normal range 85-90º of flexion 75-80º of extension dorsal side flexion 40% 60% 34% anterior view 69 67% extension palmar side 70 Axis of Wrist Flexion/ Extension Wrist Radial/ Ulnar Deviation a frontal axis through capitate palpation both styloid processes axis styloid process capitate styloid process joint involved radiocarpal joint midcarpal joint Intercarpal joints frontal plane motion normal range 15-25º of radial deviation 30-45º of ulnar deviation radius ulna 71 72 12

Axis of Radial/ Ulnar Deviation a line between capitate and lunate perpendicular to the palm capitate palpation axis lunate Joints at Wrist Radiocarpal joint primary joint for wrist extension Midcarpal joint primary joint for wrist flexion Intercarpal joint Distal radioulnar joint primary for forearm pronation/supination radius ulna 73 74 Radiocarpal Joint Characteristics of RC Joint Proximal component -- radius biconcave distal radius triangular fibrocartilage complex (TFCC) Note: only articulate with radius Distal component -- proximal row biconvex scaphoid, lunate, and triquetrum Articular shape is important!! Will be discussed later. S R L U T articular disc (TFCC) 75 joint type: biconvex degree of freedom: 2 motions wrist flexion/ extension wrist radial/ ulnar deviation closed-packed position full wrist extension Closed-packed position is important!! Will be discussed later. 76 Articulations at Midcarpal Joint Characteristics of MC Joint trapezii on scaphoid capitate on lunate capitate on triquetrum hemate on triquetrum trapezoid trapezium scaphoid capitate hamate distal row proximal row midcarpal joint pisiform triquetrum joint type: irregular degree of freedom: 2 motions wrist flexion/ extension wrist radial/ ulnar deviation closed-packed position full wrist extension Closed-packed position is important!! Will be discussed later. lunate 77 78 13

Intercarpal Joints Examples of Osteokinematic Motions trapezoid on capitate hamate on capitate pisiform on triquetrum trapezoid trapezium scaphoid capitate hamate distal row proximal row midcarpal joint pisiform triquetrum Forearm pronation and supination Proximal radioulnar joint Distal radioulnar joint Elbow flexion/ extension Shoulder complex motion Flexion/ extension Abduction/ adduction Internal/ external rotation lunate 79 80 Forearm Pronation/ Supination joint involved proximal radioulnar joint distal radioulnar joint humeroradial joint 1 degree of freedom transverse plane motion axis of rotation: a line through radial and ulnar heads 81 Elbow Flexion/ Extension joint involved humeroulnar joint humeroradial joint plane of motion sagittal plane axis of rotation not a fixed point a line through centers of trochlea and capitullum palpation: both epicondyles not perpendicular to the longitudinal axis of the humerus (4-8º of valgus) Degree of freedom? 82 Shoulder Flexion/ Extension joint involved: GH joint (principal joint) SC joint AC joint ST articulation plane of motion: sagittal plane axis: transverse axis thru center of humeral head range of motion shoulder flexion: 0-90º shoulder extension: 0-45 or 60º Shoulder Abduction/ Adduction joint involved: GH joint (principal joint) SC joint AC joint ST articulation plane of motion: frontal plane axis of rotation GH joint: sagittal axis thru center of humeral head SC joint: sagittal axis thru center of medial end of clavicle 83 84 14

Shoulder External/ Internal Rotation transverse plane motions shoulder external rotation 90º as the arm at 90º of abduction shoulder internal rotation 70º as the arm at 90º of abduction vertical axis through humeral head 85 15