kin exam

• Anatomical positions

  • Elevation - lifting the shoulders (scapula)
  • Depression - lowering the shoulders (scapula)
  • Supine - lying face-up
  • Prone - lying face-down
  • Superior - nearer to the head
  • Inferior - nearer to the feet
  • Anterior - nearer to the front
  • Posterior - nearer to the back
  • Superficial - nearer to the surface of the body
  • Deep - farther from the surface of the body
  • Medial - nearer to the median plane
  • Lateral - furthest from the median plane
  • Distal - farther from the trunk
  • Proximal - nearer to the trunk
• Planes


  • Sagittal plane - running in a straight line
  • Frontal plane - moving side to side
  • Transverse plane - hula hoop
• Movements


  • Flexion - reduces the angle between two bones at a joint
  • Extension - increases the angle between two bones at a joint
  • Dorsiflexion - motion bringing the top of the foot toward the lower leg or shin
  • Plantar flexion - "Planting" the foot
  • Abduction - movement away from the midline of the body
  • Adduction - movement toward the midline of the body in the frontal plane
  • Circumduction - movement of a body region in a circular motion
  • Internal (medial) rotation - movement toward the median plane
  • External (lateral) rotation - movement out laterally
  • Pronation - when the palm is moved to face posteriorly
  • Supination - when the palm is moved to face anteriorly
  • Inversion - when the sole is turned inward
  • Eversion - when the sole is turned outward or away from the median plane of the body
• Functions of skeletal system

  • Bones support tissues and provide a framework for the body
  • Bones protect organs
  • Bone marrow is the site of blood cell production
• Bone types


  • Long - femur, tibia, fibula, humerus, radius, metacarpals, metatarsals, phalanges (tubular, with bone marrow)
  • Short - carpals, tarsals (no bone marrow)
  • Flat - scapula, clavicle, ribs, sternum, mandible, cranial bones
  • Irregular - facial bones, vertebrae, pelvis
  • Sesamoid - patella ('floating bones')
  • Wormion - small jigsaw fragments found along the sutures of the skull
• Major bones of the upper/lower body, spine, pelvis, skull


  • Upper body (axial skeleton) - skull, vertebral column, sternum, thorax/rib cage
  • Lower body (appendicular system) - pectoral girdle, upper limb, pelvic girdle, lower limb
  • Spine - cervical, thoracic, lumbar, sacrum, coccyx
  • Skull
• True ribs


  7 pairs of ribs directly attached to the sternum by a strip of costal cartilage
• False ribs


  3 pairs of ribs (8th, 9th, 10th) that indirectly attach to the sternum
• Floating ribs


  2 pairs of ribs that attach to the muscles of the abdominal wall and are not tied to the sternum
• Scapula


  Capable of so much movement because they are held to the chest wall by many muscles instead of being directly attached to other bones
• Patella


  A sesamoid bone in the tendon of the quadriceps muscles (thigh)
• Spinal abnormalities


  • Kyphosis (hunchback) - exaggerated thoracic curvature
  • Scoliosis - abnormal lateral curvature
  • Lordosis (sway back) - exaggerated lumbar curvature
• Joint classifications


  • Ball and socket - allows greatest range of motion
  • Hinge - allows movement in only two directions (flexion and extension)
  • Gliding - connects flat or slightly curved surfaces, enables slight movement in one plane
  • Pivot - limited to rotation
  • Condyloid - reduced ball-and-socket, allows quite a bit of movement but not as much as ball-and-socket
  • Saddle - allows movement in 2 planes (flexion-extension, abduction-adduction) but not rotation
• Connective tissues


  • Cartilage - rubbery tissue made of collagen, forms cushions and protects bones
  • Ligaments - tough bands of fibre that join bone to bone and stabilize movement
  • Tendons - strong, flexible tissue that attaches muscles to bones
  • Bursa - small fluid-filled sacs that provide cushion and reduce friction
• Muscle types


  • Cardiac - weblike and branching, allows for coordinated contraction of the heart
  • Smooth - found in walls of hollow organs, contractions are involuntary
  • Skeletal - appear 'striated' under a microscope, have contractile units called sarcomeres
• Agonist


  The prime mover - performs a desired action
• Antagonist


  Performs the opposite movement to the agonist, may act to control an agonist movement
• Fixator


  Stabilizes one attachment of a muscle so the contraction moves the other end
• Synergist


  Acts to prevent unwanted secondary joint movement in order to maximize the desired joint movement
• Types of muscle contraction

  • Isometric - no visible change in muscle length, muscle undergoes contraction
  • Isotonic - muscle changes length but not tension
  • Isokinetic - neuromuscular system works at constant speed despite changing leverage
  • Auxotonic - neither force nor length remains constant
  • Plyocentric - hybrid contraction from a stretched position
  • Concentric - muscle shortens during movement
  • Eccentric - muscle lengthens during movement
• Fast twitch (FT) muscle fibres

  More aerobic, larger, fatigue faster, have faster contraction speed than slow twitch fibres
• Slow twitch (ST) muscle fibres

  Rely on oxygen, smaller, slower contracting, fatigue resistant
• Types of stretching


  • Static - holding a fully stretched position
  • Dynamic - rapidly moving a joint through its full range of motion
  • PNF (proprioceptive neuromuscular facilitation) - active stretching, pre-tension, passive stretching
• Major sports trauma


  • Bone trauma - fractures
  • Joint trauma - sprains, dislocations
  • Muscle trauma - contusions, strains, cramps, spasms
• Types of fractures


  • Stress fractures - occur over long period of time
  • Acute fractures - sudden onset, varied patterns
  • Avulsion fractures - piece of bone breaks off at tendon/ligament insertion
  • Simple fractures - bone does not break skin
  • Compound (open) fractures - bone breaks through skin
• RICE


  Rest, ice, compress, elevate (but no taping)
• Arteries


  Carry blood away from the heart, have elastic fibres and thick muscle to stretch and contract
• Veins


  Carry blood towards the heart, have valves to stop blood going the wrong way, have thin muscles and elastic fibres
• Cardiac output (Q)


  The amount of blood pumped out by the heart in one minute (a product of heart rate x stroke volume)
• Heart rate (HR)


  The number of times the heart beats in one minute
• Blood pressure (BP)


  Measurement of the force of blood outward on the artery walls
• Exercise increases heart rate and increases systolic BP


  Diastolic BP is not increased because of sweat which causes blood to lose water, leading to less blood volume, and arteries dilate to allow more blood flow
• Long-term effects of exercise on CV system

  Lower resting heart rate, cardiac output remains the same but heart rate and stroke volume are altered, increase in size and number of capillaries, increase in size and elasticity of arteries, increase in hemoglobin in RBCs, increase in collateral circulation
• External respiration


  The exchange of O2 and CO2 between the alveoli (in the lungs) and the blood
• Internal respiration


  The exchange of O2 and CO2 between the blood and the body's cells
• What happens in the alveoli

  1. O2 diffuses through the one-cell-thick walls of the alveoli into the interstitial space, then through the one-cell-thick capillary walls into the bloodstream

  2. CO2 does the opposite, to be exhaled from the lungs
• What happens in the blood

  1. O2 binds to hemoglobin (Hgb) in red blood cells, when the Hgb reaches an oxygen-depleted area the O2 is released

  2. CO2 is picked up by the blood and transported back to the lungs to be exhaled
• Elasticity of arteries


  • Provides greater blood flow with less resistance
  • Decreases blood pressure
• Increases hemoglobin in RBCs

  • Improves oxygen-carrying capacity
• Increase collateral circulation


  • Important in re-establishing circulation when a main vessel is closed off, as in a blood clot