Joint structure and function : a comprehensive analysis

SECTION 1 Joint Structure and Function: Foundational Concepts 2 Chapter 1 Biomechanical Applications to Joint Structure and Function 3 Pamela K. Levangie, PT, DSc Introduction 4 Patient Case 4 Part 1: Kinematics and Introduction to Kinetics 5 Descriptions of Motion 5 Types of Displacement 5 Location of Displacement in Space 7 Direction of Displacement 9 Magnitude of Displacement 9 Rate of Displacement 10 Introduction to Forces 10 Definition of Forces 10 Force Vectors 12 Force of Gravity 15 Introduction to Statics and Dynamics 19 Newton’s Law of Inertia 19 Newton’s Law of Acceleration 20 Translatory Motion in Linear and Concurrent Force Systems 20 Linear Force System 21 Determining Resultant Forces in a Linear Force System 21 Concurrent Force System 22 Newton’s Law of Reaction 24 Additional Linear Force Considerations 25 Tensile Forces 26 Joint Distraction 28 Revisting Newton’s Law of Inertia 31 Shear and Friction Forces 32 Part 2: Kinetics – Considering Rotatory and Translatory Forces and Motion 35 Torque, or Moment of Force 35 Angular Acceleration and Angular Equilibrium 37 Parallel Force Systems 38 Meeting the Three Conditions for Equilibrium 41 Muscle Forces 42 Total Muscle Force Vector 42 Torque Revisited 44 Changes to Moment Arm of a Force 45 Angular Acceleration with Changing Torques 46 Moment Arm and Angle of Application of a Force 46 Lever Systems, or Classes of Levers 48 Muscles in Third-Class Lever Systems 50 Muscles in Second-Class Lever Systems 50 Muscles in First-Class Lever Systems 51 Mechanical Advantage 51 Trade-Offs of Mechanical Advantage 52 Limitations to Analysis of Forces by Lever Systems 53 Force Components 53 Resolving Forces into Perpendicular and Parallel Components 54 Perpendicular and Parallel Force Effects 54 Translatory Effects of Force Components 60 Rotatory Effects of Force Components 61 Total Rotation Produced by a Force 62 Multisegment (Closed-Chain) Force Analysis 63 Summary 66 Chapter 2 Joint Structure and Function 69 Sandra Curwin, PT, PhD Introduction 70 Joint Design 70 Materials Used in Human Joints 71 Structure of Connective Tissue 72 Specific Connective Tissue Structures 77 General Properties of Connective Tissue 83 Mechanical Behavior 83 Viscoelasticity 87 Time-Dependent and Rate-Dependent Properties 87 Properties of Specific Tissues 89 Complexities of Human Joint Design 91 Synarthroses 91 Diarthroses 93 Joint Function 98 Kinematic Chains 98 Joint Motion 99 General Changes with Disease, Injury, Immobilization, Exercise, and Overuse 102 Disease 102 Injury 102 Immobilization (Stress Deprivation) 103 Exercise 104 Overuse 106 Summary 107 Chapter 3 Muscle Structure and Function 113 Gary Chleboun, PT, PhD Introduction 113 Patient Case 114 Elements of Muscle Structure 114 Composition of a Muscle Fiber 114 The Contractile Unit 115 The Motor Unit 117 Muscle Structure 119 Muscular Connective Tissue 121 Muscle Function 123 Muscle Tension 123 Classification of Muscles 129 Factors Affecting Muscle Function 132 Effects of Immobilization, Injury, and Aging 135 Immobilization 135 Injury 135 Aging 136 Summary 136 SECTION 2 Axial Skeletal Joint Complexes 140 Chapter 4 The Vertebral Column 141 Diane Dalton, PT, MS, OCS Introduction 142 Patient Case 142 General Structure and Function 142 Structure 142 Function 150 Regional Structure and Function 156 Structure of the Cervical Region 156 Function of the Cervical Region 161 Structure of the Thoracic Region 164 Function of the Thoracic Region 165 Structure of the Lumbar Region 166 Function of the Lumbar Region 170 Structure of the Sacral Region 173 Function of the Sacral Region 174 Muscles of the Vertebral Column 176 The Craniocervical / Upper Thoracic Regions 176 Lower Thoracic / Lumbopelvic Regions 180 Muscles of the Pelvic Floor 186 Effects of Aging 187 Summary 188 Chapter 5 The Thorax and Chest Wall 193 Julie Starr, PT, MS, CCS Diane Dalton, PT, MS, OCS Introduction 193 Patient Case 193 General Structure and Function 193 Rib Cage 193 Muscles Associated With the Rib Cage 200 Coordination and Integration of Ventilatory Motions 208 Developmental Aspects of Structure and Function 209 Differences Associated with the Neonate 209 Differences Associated with the Elderly 210 Pathological Changes in Structure and Function 210 Chronic Obstructive Pulmonary Disease 210 Summary 212 Chapter 6 The Temporomandibular Joint 215 Don Hoover, PT, PhD Pamela Ritzline, PT, EdD Patient Case 215 Introduction 215 Structure 216 Articular Surfaces 216 xvi ■ Contents Articular Disk 217 Capsule and Ligaments 218 Upper and Lower Temporomandibular Joints 219 Function 219 Mandibular Motions 219 Muscular Control of the Temporomandibular Joint 222 Relationship with the Cervical Spine 223 Dentition 225 Age-Related Changes in the Temporomandibular Joint 225 Dysfunctions 226 Inflammatory Conditions 226 Capsular Fibrosis 226 Osseous Mobility Conditions 226 Articular Disk Displacement 227 Degenerative Conditions 227 Summary 228 SECTION 3 Upper Extremity Joint Complexes 232 Chapter 7 The Shoulder Complex 233 Paula M. Ludewig, PT, PhD John D. Borstead, PT, PhD Introduction 233 Patient Case 234 Components of the Shoulder Complex 234 Sternoclavicular Joint 234 Acromioclavicular Joint 237 Scapulothoracic Joint 242 Glenohumeral Joint 246 Integrated Function of the Shoulder Complex 259 Scapulothoracic and Glenohumeral Contributions 259 Sternoclavicular and Acromioclavicular Contributions 260 Structural Dysfunction 262 Muscles of Elevation 263 Deltoid Muscle Function 263 Supraspinatus Muscle Function 264 Infraspinatus, Teres Minor, and Subscapularis Muscle Function 264 Upper and Lower Trapezius and Serratus Anterior Muscle Function 264 Rhomboid Muscle Function 266 Muscles of Depression 266 Latissimus Dorsi and Pectoral Muscle Function 266 Teres Major and Rhomboid Muscle Function 266 Summary 267 Chapter 8 The Elbow Complex 273 Cynthia C. Norkin, PT, EdD Introduction 273 Patient Case 274 Structure: Elbow Joint (Humeroulnar and Humeroradial Articulations) 274 Articulating Surfaces on the Humerus 274 Articulating Surfaces on the Radius and Ulna 275 Articulation 276 Joint Capsule 276 Ligaments 278 Muscles 280 Function: Elbow Joint (Humeroulnar and Humeroradial Articulations) 282 Axis of Motion 282 Range of Motion 284 Muscle Action 286 Structure: Superior and Inferior Articulations 289 Superior Radioulnar Joint 289 Inferior Radioulnar Joint 289 Radioulnar Articulation 290 Ligaments 290 Muscles 292 Function: Radioulnar Joints 292 Axis of Motion 292 Range of Motion 293 Muscle Action 293 Stability 294 Mobility and Stability: Elbow Complex 295 Functional Activities 295 Relationship to the Hand and Wrist 295 Effects of Age and Injury 296 Age 296 Injury 297 Summary 300 Chapter 9 The Wrist and Hand Complex 305 Noelle M. Austin, PT, MS, CHT Introduction 305 The Wrist Complex 305 Radiocarpal Joint Structure 306 Midcarpal Joint Structure 310 Function of the Wrist Complex 311 The Hand Complex 319 Carpometacarpal Joints of the Fingers 319 Metacarpophalangeal Joints of the Fingers 321 Interphalangeal Joints of the Fingers 324 Extrinsic Finger Flexors 325 Contents ■ xvii Extrinsic Finger Extensors 328 Extensor Mechanism 329 Intrinsic Finger Musculature 333 Structure of the Thumb 337 Thumb Musculature 339 Prehension 340 Power Grip 341 Precision Handling 344 Functional Position of the Wrist and Hand 346 Summary 346 SECTION 4 Hip Joint 354 Chapter 10 The Hip Complex 355 Pamela K. Levangie, PT, DSc Introduction 355 Patient Case 356 Structure of the Hip Joint 356 Proximal Articular Surface 356 Distal Articular Surface 358 Articular Congruence 361 Hip Joint Capsule and Ligaments 362 Structural Adaptations to Weight-Bearing 365 Function of the Hip Joint 366 Motion of the Femur on the Acetabulum 366 Motion of the Pelvis on the Femur 368 Coordinated Motions of the Femur, Pelvis, and Lumbar Spine 371 Hip Joint Musculature 373 Hip Joint Forces and Muscle Function in Stance 378 Bilateral Stance 378 Unilateral Stance 379 Reduction of Muscle Forces in Unilateral Stance 381 Hip Joint Pathology 385 Arthrosis 386 Fracture 386 Bony Abnormalities of the Femur 387 Summary 388 Chapter 11 The Knee Lynn Snyder-Macker, PT, ScD, SCS, ATC, FAPTA Michael Lewek, PT, PhD Introduction 393 Patient Case 394 Structure of the Tibiofemoral Joint 394 Femur 394 Tibia 395 Tibiofemoral Alignment and Weight-Bearing Forces 395 Menisci 397 Joint Capsule 399 Ligaments 402 Iliotibial Band 407 Bursae 408 Tibiofemoral Joint Function 409 Joint Kinematics 409 Muscles 413 Stabilizers of the Knee 419 Patellofemoral Joint 420 Patellofemoral Articular Surfaces and Joint Congruence 421 Motions of the Patella 422 Patellofemoral Joint Stress 423 Frontal Plane Patellofemoral Joint Stability 425 Weight-Bearing vs. Non–Weight-Bearing Exercises with Patellofemoral Pain 428 Effects of Injury and Disease 429 Tibiofemoral Joint 429 Patellofemoral Joint 430 Summary 431 Chapter 12 The Ankle and Foot Complex 437 Michael J. Mueller, PT, PhD, FAPTA Introduction 437 Patient Case 438 Definitions of Motions 438 Ankle Joint 440 Ankle Joint Structure 440 Ankle Joint Function 443 The Subtalar Joint 445 Subtalar Joint Structure 445 Subtalar Joint Function 447 Transverse Tarsal Joint 452 Transverse Tarsal Joint Structure 452 Transverse Tarsal Joint Function 454 Tarsometatarsal Joints 458 Tarsometatarsal Joint Structure 458 Tarsometatarsal Joint Function 459 Metatarsophalangeal Joints 460 Metatarsophalangeal Joint Structure 460 Metatarsophalangeal Joint Function 461 Interphalangeal Joints 464 Plantar Arches 464 Structure of the Arches 464 Function of the Arches 465 Muscular Contribution to the Arches 468 xviii ■ Contents Muscles of the Ankle and Foot 468 Extrinsic Musculature 468 Intrinsic Musculature 472 Deviations from Normal Structure and Function 472 Summary 474 SECTION 5 Integrated Function 478 Chapter 13 Posture 479 Cynthia C. Norkin, PT, EdD Introduction 479 Patient Case 480 Static and Dynamic Postures 480 Postural Control 481 Major Goals and Basic Elements of Control 481 Kinetics and Kinematics of Posture 484 Inertial and Gravitational Forces 485 Ground Reaction Forces 485 Coincident Action Lines 485 Sagittal Plane 486 Optimal Posture 487 Analysis of Standing Posture 487 Sagittal Plane Alignment and Analysis 488 Deviations from Optimal Alignment in the Sagittal Plane 493 Frontal Plane Optimal Alignment and Analysis 498 Deviations from Optimal Alignment in the Frontal Plane 498 Analysis of Sitting Postures 503 Muscle Activity 504 Interdiskal Pressures and Compressive Loads on the Spine 505 Seat Interface Pressures 506 Analysis of Lying Postures 508 Interdiskal Pressures 508 Surface Interface Pressures 508 Effects of Age, Pregnancy, Occupation, and Recreation on Posture 509 Age 509 Pregnancy 511 Occupation and Recreation 511 Summary 512 Chapter 14 Gait 517 Sandra J. Olney, PT, OT, PhD Introduction 517 General Features 518 Patient Case 518 Kinematics 519 Phases of the Gait Cycle 519 Gait Terminology 522 Joint Motion 524 Saunders’ “Determinants” of Gait 527 Kinetics 527 Ground Reaction Force 527 Center of Pressure 528 Kinetic Analysis 528 Internal and External Forces, Moments, and Conventions 530 Energy Requirements 534 Mechanical Energy of Walking 534 Mechanical Energy: Kinematic Approach 534 Mechanical Power and Work 537 Muscle Activity 543 Ground Reaction Force: Sagittal Plane Analysis 547 Kinematics and Kinetics of the Trunk and Upper Extremities 551 Trunk 551 Upper Extremities 553 Stair and Running Gaits 553 Stair Gait 553 Running Gait 555 Summary 558 Effects of Age, Gender, Assistive Devices, and Orthoses 559 Age 559 Gender 560 Assistive Devices 561 Orthoses 561 Abnormal Gait 561 Structural Impairment 562 Functional Impairment 562 Summary 564