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 Reviewing basic joint structure and muscle action and their normal and pathologic functions


 Exploring the science behind muscle function and movement


 Understanding how groups of muscle together can contribute to function or dysfunction


 Developing foundational knowledge and critical-thinking skills


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4 PART I Basic Clinical Kinesiology and Anatomy CHAPTER 1 Basic Information 5


patella is located and what the structures are around it, you can accurately describe its location using your own words. You do not need to memorize someone else’s words to be correct. By keeping in mind some of the basic principles


affecting muscles, understanding individual muscle function need not be so mind-boggling. If you know (1) what motions a particular joint allows, (2) that a muscle must span a particular side of a joint surface to cause a certain motion, and (3) what that muscle’s line of pull is, then you will know the particular action(s) of a specific muscle. For example, (1) the elbow allows only flexion and extension, (2) a muscle must span the elbow joint anteriorly to flex and posteriorly to extend, and (3) the biceps brachii is a vertical muscle on the anteri- or surface of the arm; (conclusion) therefore, the biceps muscle flexes the elbow. Yes, kinesiology can be understood by mere mortals. Its study can even be enjoyable. However, a word of cau- tion should be given: Like exercising, it is better to study in small amounts several times a week than to study for a long period in one session before an exam.


Segments of the Body


The body is divided into segments according to bones (Fig. 1-1). In the upper extremity, the arm is the bone (humerus) between the shoulder and the elbow joint.


Head Neck


Thorax Trunk Abdomen Forearm Hand Thigh Arm


Upper extremities


Next, the forearm (radius and ulna) is between the elbow and the wrist. The hand is distal to the wrist. The lower extremity is made up of three similar seg- ments. The thigh (femur) is between the hip and knee joints. The leg (tibia and fibula) is between the knee and ankle joints, and the foot is distal to the ankle. The trunk has two segments: the thorax and the abdomen. The thorax, or chest, is made up primarily of the ribs, sternum, and thoracic vertebrae. The abdomen, or lower trunk, is made up primarily of the pelvis, stomach, and lumbar vertebrae. The neck (cervical vertebrae) and head (cranium) are separate segments.


Body segments are rarely used to describe joint


motion. For example, flexion occurs at the shoulder, not the arm. The motion occurs at the joint (shoulder), and the body segment (arm) just goes along for the ride! An exception to this concept is the forearm. It is a body segment but functions as a joint as well. Technically, joint motion occurs at the proximal and distal radioul- nar joints; however, common practice refers to this as forearm pronation and supination.


Descriptive Terminology Leg Foot


Anatomical position


Figure 1-1. Body segments.


Lower extremities


The human body is active and constantly moving; therefore, it is subject to frequent changes in position. The relationship of the various body parts to each other also changes. To be able to describe the organiza- tion of the human body, it is necessary to use some arbitrary position as a starting point from which move- ment or location of structures can be described. This is known as the anatomical position (Fig. 1-2) and is described as the human body standing in an upright position, eyes facing forward, feet parallel and close together, and arms at the sides of the body with the palms facing forward. Although the position of the forearm and hands is not a natural one, it does allow for accurate description. Specific terms are used to describe the location of a structure and its position relative to other structures (Fig. 1-3). Medial refers to a location or position toward the midline, and lateral refers to a location or position farther from the midline. For example, the ulna is on the medial side of the forearm, and the radius is lateral to the ulna. Anterior refers to the front of the body or to a posi- tion closer to the front. Posterior refers to the back of the body or to a position more toward the back. For example, the sternum is located anteriorly on the chest wall, and the scapula is located posteriorly. Ventral is a synonym (a word with the same meaning) of anterior,


Posterior Anterior


Superior Inferior


Lateral Medial


Proximal Distal


proximal means toward the trunk. For example, the humeral head is located on the proximal end of the humerus. The elbow is proximal to the wrist but distal to the shoulder. Superior is used to indicate the location of a body


Figure 1-2. Descriptive position. Anatomical


position


part that is above another or to refer to the upper sur- face of an organ or a structure. Inferior indicates that a body part is below another or refers to the lower surface of an organ or a structure. For example, the body of the sternum is superior to the xiphoid process but inferior to the manubrium. Sometimes people use cranial or cephalad (from the word root cephal, meaning “head”) to refer to a position or structure close to the head. Caudal (from the word root cauda, meaning “tail”) refers to a position or structure closer to the feet. For example, cauda equina, which means “horse’s tail,” is the bundle of spinal nerve roots descending from the infe- rior end of the spinal cord. Like dorsal and ventral, cranial and caudal are terms that are best used to describe posi- tions on a quadruped (a four-legged animal). Humans are bipeds, or two-legged animals. You can see that if the dog in Figure 1-4 were to stand on its hind legs, dor- sal would become posterior and cranial would become superior, and so on. A structure may be described as superficial or deep, depending on its relative depth. For example, in describ- ing the layers of the abdominal muscles, the external oblique is deep to the rectus abdominis but superficial to the internal oblique. Another example is the scalp being described as superficial to the skull. Supine and prone are terms that describe body posi- tion while lying flat. When supine, a person is lying straight, with the face, or anterior surface, pointed upward. A person in the prone position is horizontal,


Caudal Cranial


Dorsal


Figure 1-3. Descriptive terminology.


and dorsal is a synonym of posterior; anterior and posteri- or are more commonly used in kinesiology. Front and back also refer to the surfaces of the body, but these are considered lay terms and are not widely used by health- care professionals. Distal and proximal are used to describe locations on the extremities. Distal means away from the trunk, and


Ventral


Figure 1-4. Descriptive terminology for a quadruped.


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