musculoskeletal biomechanics

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    KNEE BIOMECHANICS

    Andrew Crosby

    The Musculoskeletal Sy

    stemThe Musculoskeletal System

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    11. Anatomy:. Anatomy:The science or study of bodyThe science or study of body

    structurestructure

    22. Physiology:. Physiology:The study of functionThe study of function

    33. Functional Human Anatomy. Functional Human Anatomy

    UNDERSTANDING THEUNDERSTANDING THE

    STRUCTURESTRUCTURE

    AS IT RELATES TO FUNCTIONAS IT RELATES TO FUNCTION

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    Origin

    Insertion

    Musculoskeletal BiomechanicsMusculoskeletal Biomechanics

    Modeling of the MSK systemwith the objective of identifyingforces exerted/acting on the

    Bones, Joints, Muscles andother soft tissues;

    Application to Trauma,

    Prosthetics and OrthopedicImplant Design

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    The Skeletal SystemThe Skeletal System

    The human skeleton isThe human skeleton is

    composed ofcomposed of 208208 toto 212212

    1717%% of the total weightof the total weight

    1. (bone)

    2. (cartilage)

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    Cartilage

    chondrocytes matrix matrix 2 fiber collagen fiber

    elasticfiber ground substance glycosaminoglycans chondrocyte matrix

    fiber matrix 3

    1. Hyaline cartilage

    2. Elastic cartilage 3. Fibro cartilage

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    1.Hyaline cartilage

    , (larynx), (trachea),bronchus,costal cartilage articularcartilage

    Hyaline cartilage perichondrium articularcartilage

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    2.Elastic cartilage

    hyaline cartilagematrixcollagenfiber elasticfiber

    Eustatiantube (epiglottis)

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    3.Fibrocartilage dense connective

    tissue hyaline cartilage perichondrium pubic symphysis

    (intervertrebral disk)(ligament) (tendon)

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    Bones

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    Function ofBones

    Store Minerals Bones store calcium, phosphorus and otherminerals used by your body.

    ProtectsProtects Bones help protect the body from injury. The spine andskull protect the CNS (Central Nervous System).

    MovementMovement Bones provide form and structure for muscles to workagainst. Muscles can contract, but not extend. Using bones as leversone muscle can contract to extend another.

    Blood CellsBlood Cells Red blood cells and some white blood cells are formedin the epiphysis of long bones. Red blood cells carry oxygenthroughout the body. White blood cells help fight off infections.

    Structure and SupportStructure and Support The skeletal system provides a framework ofsupport for the body to be built upon. The bones of the legs andback support the body's entire weight

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    (Microscopic structure)

    1. (Osteoblast)-

    (osteoprogenitorcells)

    - (osteoid)

    -

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    2. (Osteocyte)

    (lacuna)

    (canaliculi)

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    3. (Osteoclast)

    (monocytestem cells)

    (bone remodeling)

    (acidphosphatase)

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    (Gross structure of bone)

    2

    1.Cancellous (spongy) bone (trabeculae) trabeculae (bone marrow)

    )

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    DiaphysisDiaphysis compactbonecompactbone spongybonespongybonediaphysisdiaphysismarrowmarrow cavitycavity ((medullarymedullary cavitycavity))

    EpiphysesEpiphyses spongyspongy bonebone compactcompactbonebone

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    (periosteum)

    2 fibrous layer osteogenic

    layerfibroblastosteoblast

    articularsurface

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    (Haversian canal)

    (bone cells)

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    33

    1.Growth epiphyseal plate

    peak bone mass 20-30 2.Bone modeling

    growth

    3.Bone remodeling

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    2 1.Axial skeleton

    29 26 (

    24 (12 11 12 )

    1

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    2.Appendicular skeleton cortical compact trabecularcortical 126

    - 30

    - 30 - 1 -1

    - 1

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    Types of BonesTypes of Bones

    11.Long Bones.Long Bones

    The classification body which is longer than itis wide, with growth plates (epiphysis) at either

    end,

    Both ends ofthe bone are covered in hyalinehyaline

    cartilagecartilage to help protect the bone and aid shock

    absorption

    The femurs, tibias, fibulas, humeri, radii,

    ulnas, metacarpals, metatarsals, phalanges, and

    clavicles

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    2.Short Bones

    defined as being approximately as wide as they are long

    primary function ofproviding support and stability with little movement

    .the Carpals and Tarsals in the wrist and foot.

    They consist ofonly a thin layerthin layer ofcompactofcompact, hard bone with cancellous

    bone on the inside along with relatively large amounts of bone marrow.

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    3.Flat Bones

    the main function of providing protection to the bodies vital

    organs and being a base for muscular attachment the Scapula (shoulder blade). The Sternum (breast bone), Cranium

    (skull), Pelvis and Ribs

    Anterior and posterior surfaces are formed ofcompact bone to

    provide strengthfor protection with the centre consisting of

    cancellous (spongy) bone and varying amounts of bone marrow. In adults, the highest number ofred blood cells are formed in flat

    bones.

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    44.Irregular Bones.Irregular Bones

    non-uniform shape. Good

    examples ofthese are the Vertebrae,Sacrum and Mandible (lower jaw).

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    5.Sesamoid Bones

    short or irregular bones, imbedded in a tendon.The most obvious example ofthis is the Patella (knee

    cap) which sits within the Patella or Quadriceps tendon.

    Other Pisiform (smallest ofthe Carpals) and the two small

    bones at the base ofthe 1st Metatarsal.

    Sesamoid bones are usually present in a tendon where

    it passes over a joint which serves to protect the tendon.

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    Bones as Components of JointsBones as Components of JointsClassification of Joints

    By Structure

    1.Fibrous jointfibrous tissue

    2.Cartilagenous joint

    3.Synovial jointsynovial membrane synovial fluid

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    (Fibrous joints=) (dense

    connective tissue)

    joint capsule

    (Sutures) =Skull

    (Syndesmosis) =Ulnars , Radius

    densefibrous tissue

    distal tibiofibularjoint

    (Gomphosis) =(maxilla,mandible)

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    (Cartilaginous joint)

    (Synchondrosis) (hyaline cartilage)

    (Symphysis) (Fibrocartilage) (intervertebral discs)(intervertebral discs)

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    (Synovial joint)(Synovial joint)

    jointcapsule ligament

    (articular capsule)

    (synovial fluid)

    articular discmeniscus

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    By functionBy function

    degree of movement 31. Synarthrosis

    2. Amphiarthrosis

    3. Diarthrosis

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    ((DiarthrosisDiarthrosis))Joint Type Movement at joint Examples Structure

    HingeHinge

    Flexion/Extension Elbow/Knee Hinge joint

    Pivot

    Rotation of one bone

    around another

    Top of the neck

    (atlas and axis bones)

    Pivot Joint

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    Joint TypeJoint Type Movement at jointMovement at joint ExamplesExamples StructureStructure

    Socket

    ---

    Flexion/Extension/Ad

    duc

    tion/Abduction/Internal &

    External Rotation

    Shoulder/Hip Ball and socket joint

    Saddle

    Flexion/Extension/Ad

    duction/

    Abduction/Circumduc

    tion

    CMC joint ofthe

    thumb

    Saddle joint

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    Joint TypeJoint Type Movement at jointMovement at joint ExamplesExamples StructureStructure

    Condyloid

    Flexion/Extension/Adduction

    /Abduction/Circumduction

    Wrist/MCP & MTP

    joints

    Condyloid joint

    GlidingGliding

    Gliding movements Intercarpal joints Gliding joint

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    (tendon) VS (ligament)

    (ligament)

    (tendon)

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    Biomechanics of the SpineBiomechanics of the Spine (Biomechanics of

    the cervical spine)

    1.Occipitoatlanto axial complex

    -(occiput)1 (cup-shaped)

    -(rotation) -(flexion/extension)

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    2.Lower cervical spine (C3-C7)

    intervetebral disc facet joints

    (Facet joint)

    Facet

    Facet

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    flexion, extension, lateralbending rotation

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    (Biomechanics of the lumbar spine)

    lumbar spine thoraciccervical spine

    facet joints Sagittalplane

    (flexion/extension) thoracic spine

    12

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    0o 60o lumbar spine

    60o

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    (bendingmoment) lumbar spine (W)lever arm(Lw) lumbar spine

    (compression) (tension)

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    L3 disc

    L3 disc

    100%

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    Biomechanics of Shoulder, elbow, and wristBiomechanics of Shoulder, elbow, and wrist

    Shoulder, elbow, and wrist

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    ShoulderShoulder

    Shoulder forward flexion = zero to 180 degrees.

    Shoulder abduction = zero to 180 degrees.

    Shoulder external rotation = zero to 90 degrees.

    Shoulder internal rotation = zero to 90 degrees

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    Shoulder dislocation () 90%

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    Rotatorcuff

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    Elbow Anatomy

    Elbow flexion = zeroto 145 degrees.

    Forearmsupination = zeroto 85 degrees.

    Forearmpronation = zeroto 80 degrees

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    Medial Elbow Injuries The Ulnar Collateral

    Ligament

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    Medial Elbow Injuries The Ulnar

    Collateral Ligament

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    the ulnar collateral ligamentor"UCL - pulls the forearmforward with the rotating upper armWhen improper mechanics are used or arm muscles becomefatigued, the load placed on the UCL may be increased to morethan it can withstand, causing small "micro"-tears in the UCL.

    Microtears in muscles or ligaments can heal when given enough

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    Golferselbow

    Golferselbow

    ()(medialepicondyle) tenniselbow

    (lateralepicondyle)

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    1. Superficial extensor muscles forearms back-hand 2. lateral epicondyle

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    Wrist Biomechanics

    Wrist dorsi flexion (extension) = zero to 70degrees.

    Wrist plantar flexion = zero to 80 degrees.

    Wrist radial deviation = zero to 20 degrees Wrist ulnar deviation = zero to 45 degrees

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    TennisWrist injuryTennisWrist injury

    Overuseinjuriesofthewristaretendinitis, nerveconditions

    carpaltunnelsyndrome

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    These symptoms can be

    evident when driving, holding

    newspapersCarpal tunnel is defined by

    compression of the median

    nerve at the level of the

    wrist(help you bend yourfingers)

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    DeQuervain's Syndrome: Also

    known as "washerwoman's

    sprain

    this syndrome can be a

    product of overuse

    rapid, repetitive movementsof the thumb and wrist

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    Fractures

    Common types of hand and wrist fractures

    include Distal Radial Fracture, Smith'sFracture, and Scaphoid Fracture

    an outstretched hand or on to the back of the

    hand

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    HipHip --BiomechanicsBiomechanicsForces across hip joint combination of:

    Body weight

    Ground rea

    ction

    forces

    Abductor muscle forces

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    ACTIVITYACTIVITY

    Hi f ti

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    Hip range of motion:

    (Movement offemur as it rotates in the acetabulum.)

    Flexion = 0 to 125 degrees

    Extension = 0 to 30 degrees.

    Adduction = 0 to 25 degrees.

    Abduction = 0 to 45 degrees.

    External rotation = 0 to 60 degrees.

    Internal rotation = 0 to 40 degrees

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    Knee joint

    Flexion = 0 to 140 degrees.

    Extension - zero degrees =full extension.

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    Knee (Femur) (Tibia)

    (Patella)

    3 (Articular cartilage)(Synovial membrane)

    C

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    (Knee Stabilizer)

    1. (Lateral collateral ligament)2. (Medial collateral ligament)3. (Anterior cruciate ligament)4. (Posterior cruciate ligament)

    Themedial

    collateralligament (MCL)andlateral

    Themedial

    collateralligament (MCL)andlateral

    collateralligament (LCL)arethemostoftencollateralligament (LCL)arethemostofteninjuredingolfinjuredingolf

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    ,,

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    St t d F ti l

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    StructureandFunctionalAnatomyoftheAnkle

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    Ankle range of motion

    Pronation

    Abduction, dorsiflexion, eversion

    SupinationAdduction, plantarflexion, inversion

    dorsiflexion is 0 to 20 degrees; plantar flexion is0 to 45 degrees.

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    1.lateral ankle sprain

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    lateral ankle ligaments : lateral angleligaments ligament 31. Anterior talofibular ligaments

    2. Caleaneofibular ligaments3. Posterior talofibular ligament anterior talofibular ligament anterior subluxation talus

    planter flexion ligament inversion

    A hili t d

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    Achilis tendon(Achilles tendon ruptures)

    - Overuse injuries

    Achilles tendon gastrochemiussoleuscomplex

    2 ten ion

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    Planes

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    Planes

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    SagittalPlane Movements (bilateral axis)1. Flexion joint angle increases*.

    2. Extension joint angle decreases*

    3. Hyperextension continued extension beyond starting position.

    Frontal Plane Movements (anteroposterior axis)1. Abduction movement away from midline ofthe body

    2. Adduction movement toward midline ofthe body

    3. Lateral Flexion lateral bending oftrunk or head

    Transverse Plane Movements (vertical axis)1. Rotation# anterior aspect turns left or right.

    2. Supination outward rotation offorearm

    3. Pronation inward rotation offorearm

    #the shoulder can rotate in all three planes

    Fundamental movements:

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    Axis of Rotation

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    Standard Reference Terminology

    Anatomical Reference Axes

    An imaginary axis ofrotation that passes

    through a joint to which it is attached

    Mediolateral or frontal axis

    Anterioposterior or sagittal axis

    Longitudinal axis

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    2-5

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    Joint Movement Terminology

    In anatomical position, all body segments are

    considered to be positioned at zero degrees.

    Sagittal Plane Movements

    Frontal Plane Movements

    Transverse Plane Movements

    Other Movements

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    2-6

    Sagittal plane movements

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    2-8

    Frontal Plane Movements

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    2-13

    Transverse Plane Movements

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    2-16

    Other Movements

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    2-19

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    Spatial Reference Systems

    Used to standardize the measurements taken

    Cartesian Coordinate system

    Movements primarily in a single direction, or

    planar, can be analyzed using a two-

    dimensional Cartesian

    X (horizontal) direction

    Y (vertical) direction

    3-dimensional by adding a z-axis

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    Cartesian Coordinate System

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    Dimensions ofMovement

    0 Dimensions - point.

    1Dimension - line.

    2 Dimensions - plane.

    3 Dimensions - cube, sphere, etc.

    4 Dimensions - 3 Dimensions + time.

    Movement occ

    urs in all 4 dimensions (time andspace).

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    Positional Reference Systems

    These are designed to identify location

    or position

    1. Anatomical2. Linear

    3. Angular (rotational or radial)

    Directional Terms Used in

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    Directional Terms Used in

    Describing Anatomy

    SUPERIOR Directed upwards or towards the

    head

    INFERIOR Directed downwards or towards

    the feet

    ANTERIOR Directed towards the front ofthe

    body

    POSTERIOR Directed towards the back ofthebody

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    Serratus Anterior

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    Serratus Anterior

    Serratus Posterior

    Superior

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    Serratus Anterior

    Serratus Posterior

    Superior

    Serratus Posterior

    Inferior

    Directional Terms Used in

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    Directional Terms Used in

    Describing Anatomy MEDIAL Nearer the midline ofthe body

    LATERAL Farther from the midline ofthe body

    PROXIMAL Nearer to the attachment ofa limb to

    the trunk DISTAL Farther from the attachment ofthe limb to

    the trunk

    SUPERFICIAL Located on or near the surface ofthe

    body

    DEEP Away from the surface ofthe body

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    The Anatomical Position

    The position ofreference for

    all movements.

    Also called the standing

    supine position

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    ardinal Planesof

    the Body

    1. Sagittal Divides

    thebody intoleft

    and righthalves.2. Frontal Divides

    thebody intofront

    and backhalves.

    3. Transverse

    Dividesthebody

    intotopand

    bottomhalves.

    Sagittal Plane Movements

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    Sagittal Plane Movements

    (Forward & Backward Movements)

    Whole Body Forward and backward

    movement such as front or back flips

    Segmental

    Flexion

    Extension

    Hyperextension

    Dorsiflexion

    Plantar flexionAnkle

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    Backflipsand

    frontflipsare

    wholebody

    sagittalplanemovements.

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    Fora

    cyclist, the

    legmovements

    occurinthe

    sagittal

    plane.

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    Forward and

    backwardmovementsat

    specificjoints

    suchasthe

    shoulderandanklearesagittal

    plane

    movements.

    F t l Pl M t

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    Frontal Plane Movements

    (Sideward & Vertical Movements)

    Whole Body Sideward movement as seen

    in sideward cartwheels

    Frontal Plane Movements

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    Frontal Plane Movements

    (Sideward & Vertic

    al Movements) Segmental Abduction

    Adduction

    Lateral flexion

    Elevation and depression ofthe shoulder girdle(or scapula)

    Upward and downward rotation oftheshoulder girdle (or scapula)

    Radial deviation

    Ulnar deviationWrist

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    Hipabductionandadduction.

    Ulnarand radial

    Deviation.

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    Elevationand depressionofthe

    shouldergirdle.

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    ateralflexionofthetrunk.

    T Pl M t

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    Transverse Plane Movements

    (Horizontal Movement) Whole Body

    Horizontal

    movement orrotation as in a

    skaters or dancer's

    pirouette.

    Trans erse Plane Mo ements

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    Transverse Plane Movements

    (Rotation Around a Vertical Axis) Segmental

    Medial (inward) rotation

    Lateral (outward) rotation

    Left / right rotation ofthe trunk, neck, or head

    Supination - forearm

    Pronation forearm

    Horizontal abduction (transverse flexion)

    Horizontal adduction (transverse extension) Pronation ofsubtalar joint abduction + eversion

    Supination ofsubtalar joint adduction + inversion

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    Horizontaladductionand

    abductionare

    segmentaltransverseplane

    movements.

    Cardinal Axes ofthe Body

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    y

    (Axes is plural for axis.)

    X-Axis (Transverse, Mediolateral, Frontal, orBreadth Axis)

    Y-Axis (Longitudinal, Vertical, or Length Axis) Z-Axis (Anteroposterior, Sagittal, or Depth Axis)

    Movement, both whole body and segmental, takes

    place in the cardinal planes and around thecardinal axes.

    Th lli t

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    Theellipserepresents

    thetransverseplaneand

    theblacklinerepresentsthe Y-axis. (Theplaneis

    likearecord turntable

    and theaxisislikethe

    spindlethatholdstherecord inplace.) The Y-

    axisisperpendicularto

    thetransverseplane.

    Thereforeapointwhichrotatesaround the Y-axis

    willmoveinthe

    transverseplane.

    Transverse

    Plane

    Y-axis

    X A i

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    X-Axis

    Passes from side to side.

    Rotation in the sagittal plane takes place

    around the x-axis.

    Y Axis

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    Y-Axis

    Passes from top to bottom.

    Rotation in the transverse plane takes place

    around the y-axis.

    Z Axis

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    Z-Axis

    Passes from front to back.

    Rotation in the frontal plane takes placearound the z-axis.

    Y AxisThe cardinal axes

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    ZAxis

    X Axis

    CenterofGravity

    Thecardinalaxes

    lieatthe

    intersectionofthecardinalplanes.

    Thecardinal

    planesand axes

    allintersectatthecenterof

    gravity (c-g).

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    119/120

  • 8/8/2019 Musculoskeletal Biomechanics

    120/120