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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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