The Joints

Description:	(CN) The Joints - Anatomy, ROM, Ortho
Category:	Physical Therapy
Created by:	PT Board Exam on 2006-05-22

Front	Back
What are the four articulations of the shoulder joint?	Sternoclavicular, Acromioclavicular, Glenohumeral and Scapulothoracic
What type of joint is the elbow?	Hinge
What ligaments reinforce the elbow?	Ulnar collateral and radial collateral
What structures provide stability of the hip joint?	Acetabulum, and the Iliofemoral Pubofemoral and Ischiofemoral ligaments.
What type of joint is the knee?	Hinge
What are the stabilizing ligaments of the knee?	ACL, PCL, MCL, LCL, Deep medial capsular ligament
What type of joint is the ankle?	Hinge
What are the medial ligaments of the ankle?	Deltoid ligaments (Anterior Tibiotalar, Tibionavicular, Tibiocalcaneal)
What ligaments make up the Deltoid Ligament?	Anterior Tibiotalar, Tibionavicular, Tibiocalcaneal
What are the lateral ligaments of the ankle? (5)	Anterior Tibiofibular, Anterior Talofibular, Calcaneofibular, Lateral talocalcaneal and Posterior Talofibular
What is the most commonly sprained ligament in the ankle?	The Anterior Talofibular, (inversion sprain)
What are the free nerve endings found in joints sensitive to?	There are 2 types. One type is sensitive to non-noxious mechanical stress, and the other is sensitive to noxious mechanical or biochemical stimuli.
What do golgi ligament endings do?	They sense tension or stretch on ligaments.
What do Golgi-Mazzoni Corpuscles sense?	Compression of the joint capsule.
What do Pacinian Corpuscles sense? Where are they located?	High frequency vibration, acceleration and high velocity changes in joint position. They are found in the fibrous layer of joint capsule in all joints.
What do Ruffini Endings sense, and where are they located?	They sense stretching of the capsule, and amplitude and velocity of joint position. They are located in the fibrous layer of the joint capsule, with greatest density in the proximal joints.
What are the open and close pack positions of the facet joints?	Open: Midway between flexion and extension. Closed: Extension
What are the open and close pack positions of the tmj?	Open: mouth slightly open. Closed: clenched teeth.
What are the open and close pack positions of the Glenohumeral joint?	Open: 55 Abduction, 30 Horizontal adduction Closed: Abduction and Lateral Rotation
What are the open and close pack positions of the A/C joint?	Open: Arm resting by side in normal position Closed: 90 Abduction
What are the open and close pack positions of the Ulnohumeral joint?	Open: 70 Flexion, 10 Supination Closed: Extension
What are the open and close pack positions of the radiohumeral joint?	Open: Full extension, full supination Closed: 90 flexion, 5 supination
What are the open and close pack positions of the proximal radiolulnar joint?	Open: 70 Flexion, 35 Supination Closed: 5 Supination
What are the open and close pack positions of the distal radioulnar joint?	Open: 10 Supination Closed: 5 Supination
What are the open and close pack positions of the carpometacarpal joints?	Open: Midway between abduction/adduction and flexion/extension Closed: None listed
What are the open and close pack positions of the metacarpophalangeal joints?	Open: Slight flexion Closed: Full flexion (fingers) Full opposition (thumb)
What are the open and close pack positions of the IP joints?	Open: Slight flexion. Closed: Full extensions.
What are the open and close pack positions of the Hip joint?	Open: 30 Flexion, 30 Abduction, Slight lateral rotation. Closed: Full extension, medial rotation
What are the open and close pack positions of the Knee?	Open: 25 flexion. Closed: Full extension, lateral rotation of tibia.
What are the open and close pack positions of the Talocrural joint?	Open: 10 PF, midway between max inversion and eversion. Closed: Maximum dorsiflexion.
What are the open and close pack positions of the Subtalar joint?	Open: Midway between extremes of ROM. Closed: Supination.
What are the open and close pack positions of the Midtarsal joints?	Open: Midway between extremes of ROM. Closed: Supination.
What are the open and close pack positions of the Tarsometatarsal joints?	Open: Midway between extremes of ROM. Closed: Supination.
What are the open and close pack positions of the metatarsophalangeal, and IP (toe) joints?	Open: Neutral. Closed: Full Extensions
What is the capsular pattern for the AC joint?	Pain at extreme of ROM
What is the capsular pattern for the humeroulnar joint?	Flexion > extension (FE)
What is the capsular pattern for the proximal radioulnar joint?	Flexion > Extension > Supination > Pronation (FESP)
What is the capsular pattern for the distal radioulnar joint?	Full ROM, with pain at extremes of rotation
What is the capsular pattern for the wrist?	Flexion = Extension limitation.
What is the capsular pattern for the MC and IP joints?	Flexion > Extension (FE)
What is the capsular pattern for the TSpine & LSpine?	Side flexion = Rotation limitation > Extension
What is the capsular pattern for the Knee?	Flexion > Extension (FE)
What is the capsular pattern for the SI, symphysis pubis and sacrococcygeal joints?	Pain w/ joint stress
What is the capsular pattern for the hip?	Flexion > Abduction > Medial rotation (sometimes MR is most limited) (FAbM)
What is the capsular pattern for the talocrural joint?	PF > DF
What is the capsular pattern for the subtalar joint?	Limitation of varus ROM
What is the capsular pattern for the midtarsal joints?	DF > PF > Add > Medial rotation
What is the capsular pattern for the first metatarsophalangeal joint?	Extension > Flexion (EF)
What are the normal ROM Requirements for normal gait? (Hip flex/ext, Knee flex, Ankle DF/PF)	Hip flex: 30, Hip ext: 15, Knee flex: 60, DF:10, PF: 20.
Describe the four grades of joint mobilizations.	Grade I: Small amplitude movement @ beginning of range. Grade 2: Large amplitude movement within the range, but not reaching limits. Grade 3: Large amplitude movement performed to the limit of range. Grade 4: Small amplitude movement @ end range.
What is the convex/concave rule?	When convex moves on concave, roll and glid are opposite. Concave on convex, Roll and glide are the same.
What are the contraindications to joint mobilization? (8)	Active disease, Infection, Advanced osteoporosis, Hypermobility, Fracture, Acute inflammation, Muscle guarding, Joint replacement.