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Arthrokinesiology
This quiz concerns arthrokinesiology. References are a little difficult to come by. Grays Anatomy from the 36th Edition on has a section on this subject. Those of you who have taken courses in manual therapy should be able to consult your course notes and handouts. And for those of you who have just recently graduated or taken an interest in manual therapy; bug your colleagues, it will do them good.
Define the following terms and discuss their clinical significance.
1. Osteokinematics are the movements of bones without reference to the joint or the forces producing that movement. It is the part of the physiological motion that is observed by the therapist during active or passive motion. The ROM is gauged from this. Myofascial (musculotendonous) inextensibility results in restriction of this component and not (usually) the arthrokinematic. 2. Arthrokinematics are the movements of joint surfaces without reference to the motion of bones or the forces producing them. It is the part of the physiological motion that cannot be observed and is the gliding and spinning the occurs at the joint surfaces (also called accessory movements). Articular involvement in hypomobility is evaluated by the degree of restriction of the arthrokinematic (glide). 3. The mechanical axis is a theoretical line that runs perpendicular to the average plane of the joint and replaces the bone when modeling osteokinematics. It is a stratagem to make picturing the bone movement easier. The mechanical axis tends to run down the shaft of the bone in those bones without a neck and along the neck in those bones that do possess one. 4. Conjunct rotation is the non-volitional movement that occurs as part (conjoined) of another main movement and is produced by the shape of the joint surfaces and ligaments. This motion tends to spin the bone as it moves near its ends of range and so is important for close packing, nutrition and stability. When mobilizing near the end of range, the therapist must apply the rotation to ensure that full range can be obtained. In joints with two degrees of freedom or less, the conjunct rotation is obligatory (that is it cannot be avoided or undone). In joints with three degrees of freedom the conjunct rotation is avoidable and can be undone. 5. The number of degrees of freedom a bone possesses is the number of independent axes it can be rotated around. The maximum number is of course three (there are only three planes) and while combined movements can be mobilized, the therapist must ensure that each of the degrees of freedom is included in the total program of mobilization for a joint.
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