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Foundations in Sports Therapy
1 Functional anatomy
Check your understanding answers
1. Describe the axial and appendicular skeleton, making reference to the names, types of bones
and their function.
Axial
The axial skeleton forms the upright axis of the body and consists of the following:
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Cranium – which consists of the parietal, temporal, frontal, occipital, ethmoid and sphenoid bones (flat
bones).
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Facial bones – which consist of the maxilla, zygomatic, mandible, nasal, palatine, inferior nasal
concha, lacrimal and vomer bones (irregular/flat bones).
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Hyoid bone – which is a U-shaped bone located in the neck.
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Vertebral column – which consists of the cervical, thoracic and lumbar vertebrae, as well as the
sacrum and coccyx (irregular bones).
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Thoracic cage – which consists of the sternum and ribs (flat bones).
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Auditory ossicles – which consist of the malleus, incus and stapes found in the inner ear.
Appendicular
The appendicular skeleton consists of all the bones which attach to the axial skeleton, and can be divided
into six regions:
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Each arm and forearm consists of humerus, ulna, and radius (long bones).
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Each hand consists of eight carpals, five metacarpals, five proximal phalanges, four middle
phalanges, five distal phalanges and two sesamoid (short bones).
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Each pectoral girdle consists of two clavicle and two scapulae (flat bones).
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The pelvis consists of left and right os coxae, which are formed by the fusion of the ilium, ischium and
pubis (irregular bones).
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Each leg consists of a femur, tibia, patella and fibula (long bones).
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Each foot contains seven tarsals, five metatarsals, five proximal phalanges, four middle phalanges,
five distal phalanges and two sesamoid bones (short bones).
Functions of the skeletal system
The skeletal system has a number of physiological and mechanical functions:
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Protection – the skeletal framework protects the vital tissues and organs in your body. The cranium
protects the brain, the thoracic cage protects the heart and lungs, the vertebral column protects the
spinal cord and the pelvis protects the abdominal and reproductive organs.
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Attachment for skeletal muscles – the skeleton provides a framework for attachment of the skeletal
muscles, via tendons as well as the attachment of ligaments. The skeletal system provides a lever
system in order to create joint motion and movement.
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Support – the skeletal frame provides a structural framework, giving the body a supportive framework
for soft tissue, and providing shape.
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Source of red blood cell production – red bone marrow found within the bone produces red blood
cells, white blood cells and platelets.
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Foundations in Sports Therapy
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Store of minerals – bone stores minerals such as calcium, phosphate (stored form of phosphorus)
and magnesium, which are essential for growth and bone health. Minerals are released into the
bloodstream as the body requires them. The yellow bone marrow stores fat.
2. Palpate the following bony prominences on a client.
When you are palpating these areas you should make reference to Field, D. and Hutchinson, J. (2006),
Anatomy palpation and surface marking, London: Elsevier, to ensure you are palpating the correct
structures.
3. Briefly describe the three classifications of joints.
Refer to Figure 1.8, Foundations in Sports Therapy, page 11.
Synarthrosis/fibrous/fixed
The bones which articulate at fibrous joints are connected via fibrous connective tissue and they allow
very limited movement. The three sub-categories are:
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suture(s) – for example, found between the cranial bones
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gomphosis (-es) – for example, a tooth in its socket
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syndesmosis (-es) – for example, an inferior tibiofibular joint.
Amphiarthrosis/cartilaginous/slightly moveable
The bones which articulate at cartilaginous joints are connected by either hyaline (articular) cartilage
forming a primary joint such as first sternoclavicular joint, or fibrocartilage forming a secondary joint such
as intervertebral disc, which may contain an internal cavity or nucleus. Movement permitted is greater
than at fibrous joints.
Diarthrosis/synovial/freely moveable
See Figure 1.9, Foundations in Sports Therapy, page 12. Synovial joints are unique and allow a greater
degree of movement than fibrous and cartilaginous. Articular cartilage encases the end of bones that
articulate at the joint, allowing freedom of movement and reduction of friction. The joint is surrounded by a
strong fibrous capsule, which is lined with a synovial membrane (synovium) providing lubrication and
nourishment to the articular cartilage. The ligaments attach bone to bone and further strengthen the
fibrous capsule. Ligaments are located internal and external to the capsule, and are further supported by
the surrounding muscles and strong tendons. Ligament function is to provide joint stability and thus
prevent dislocation. If excessive movement occurs ligaments may become damaged.
4. Describe the gross and micro-structure of a muscle.
Gross muscle structure
A skeletal muscle consists of thousands of individual muscle fibres, encased by connective tissue called
the endomysium. Individual muscle fibres are made up of muscle cells. Muscle fibres are bundled together
into fascicles, around 10–100 in any bundle, further encased by connective tissue called the perimysium.
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Foundations in Sports Therapy
All the fascicles are collated together and encased by connective tissue called the epimysium, which
surrounds the whole muscle. The endomysium, perimysium and epimysium all extend from the deep
fascia.
The endomysium, perimysium and epimysium are continuous connective tissue that may extend beyond
the muscle tissue and form the tendon. The tendon is, therefore, a dense regular connective tissue.
Micro muscle structure
In order to understand muscle contraction, you must understand the micro-structure of a muscle fibre. The
cell membrane of the muscle fibre is known as the sarcolemma. A muscle fibre consists of long myofibrils
(the length of the fibre) between which organelles such as mitochondria, glycogen granules and
myoglobic are suspended in the sarcoplasm.
Myofibrils are the contractile elements, consisting of thin and thick myofilaments known respectively as
actin and myosin. The myofilaments do not run the length of the myofibril, they are organised into units
called sarcomeres. Sarcomere units are repeated along the length of the myofibril, where actin and
myosin are present in an overlapping formation.
Sliding filament theory
The sliding filament model of muscle contraction is a complex process. When a muscle receives a nerve
impulse (stimulus) the lengths of actin and myosin do not change, but are drawn closer together by sliding
across each other forming cross bridges; thus the sarcomere shortens. The resultant factor of the
sarcomeres shortening is the contraction of the myofibril. The myofibril becomes shorter and thicker.
The relaxation phase is a passive process, where the cross bridges relax, actin and myosin return to their
original position, thus the sarcomere, and myofilament lengthen to their original position.
The nerve impulse is based on the ‘all or nothing law’. Each fibre is capable of either contracting or not
contracting; there is no in between. As the athlete begins to fatigue it is the strength of the contraction
which may decrease.
5. Differentiate between the functions of a ligament and a tendon.
Ligament – connects bone to bone and provides joint stabilisation.
Tendon – connects muscle to bone. The tendon is a dense regular connective tissue due to the
continuation of endomysium, perimysium and epimysium.
6. Describe lordosis and its effect on the muscular system.
Lordosis is caused through an exaggeration of the lumbar curve, resulting in an increased anterior tilt of
the pelvis.
Lengthened weak muscles include the hamstrings group and the abdominals. To correct the imbalance (if
appropriate) lengthened weak muscles need to be strengthened with the use of strengthening exercises.
Shortened strong muscles include the erector spinae and iliopsoas, rectus femoris, sartorius and tensor
fascia latae. To correct the imbalance (if appropriate) shortened strong muscles should be lengthened
through stretching or exercises such as yoga.
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Foundations in Sports Therapy
7. Describe kyphosis and explain which sports may predispose an athlete to this condition.
Kyphosis is caused through an exaggerated curve in the thoracic vertebrae. The scapulae are protracted,
putting the scapulae and clavicles (shoulder girdle) under constant pull of gravity.
Lengthened weak muscles include the muscles responsible for scapular retraction and on the posterior
aspect of the thoracic region such as trapezius and rhomboids.
Shortened strong muscles include anterior muscles of the thoracic region such as pectoralis major and
minor.
8. Observe a rugby player performing a squat and complete the following table for the up and
down phase.
Up phase
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Agonist muscle
Action
Origin
Insertion
Gluteus maximus
Hip extension
Posterior aspect of dorsal ilium posterior
to posterior gluteal line, posterior
superior iliac crest, posterior inferior
aspect of sacrum and coccyx, and
sacrotuberous ligament
Primarily in fascia lata at the
iliotibial band; also into the
gluteal tuberosity on posterior
femoral surface
Rectus femoris
Knee
extension
Straight head from anterior inferior iliac
spine; reflected head from groove just
above acetabulum
Base of patella to form the
more central portion of the
quadriceps femoris tendon
Vastus intermedius
Knee
extension
Superior 2/3 of anterior and lateral
surfaces of femur; also from lateral
intermuscular septum of thigh
Lateral border of patella; also
forms the deep portion of the
quadriceps tendon
Vastus medialis
Knee
extension
Inferior portion of intertrochanteric line,
spiral line, medial lip of linea aspera,
superior part of medial supracondylar
ridge of femur, and medial
intermuscular septum
Medial base and border of
patella; also forms the medial
patellar retinaculum and medial
side of quadriceps femoris
tendon
Vastus lateralis
Knee
extension
Superior portion of intertrochanteric line,
anterior and inferior borders of greater
trochanter, superior portion of lateral lip
of linea aspera, and lateral portion of
gluteal tuberosity of femur
Lateral base and border of
patella; also forms the lateral
patellar retinaculum and lateral
side of quadriceps femoris
tendon
Gastrocnemius
Ankle
plantarflexion
Medial head from posterior nonarticular
surface of medial femoral condyle;
lateral head from lateral surface of
femoral lateral condyle
The two heads unite into a
broad aponeurosis which
eventually unites with the deep
tendon of the soleus to form the
Achilles tendon, inserting on
the middle 1/3 of the posterior
calcaneal surface
Soleus
Ankle
plantarflexion
Posterior aspect of fibular head, upper
1/4 – 1/3 of posterior surface of fibula,
middle 1/3 of medial border of tibial
shaft, and from posterior surface of a
tendinous arch spanning the two sites of
bone origin
Eventually unites with the
gastrocnemius aponeurosis to
form the Achilles tendon,
inserting on the middle 1/3 of
the posterior calcaneal surface
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Foundations in Sports Therapy
Down phase
Agonist muscle
Action
Origin
Insertion
Iliacus
Hip flexion
Upper 2/3 of iliac fossa of ilium, internal
lip of iliac crest, lateral aspect of
sacrum, ventral sacroiliac ligament, and
lower portion of iliolumbar ligament
Lesser trochanter
Psoas major
Hip flexion
Anterior surfaces and lower borders of
transverse processes of L1 – L5 and
bodies and discs of T12 – L5
Lesser trochanter
Semimembranosis
Knee flexion
Superior lateral quadrant of the ischial
tuberosity
Posterior surface of the medial
tibial condyle
Semitendinosis
Knee flexion
From common tendon with long head of
biceps femoris from superior medial
quadrant of the posterior portion of the
ischial tuberosity
Superior aspect of medial
portion of tibial shaft
Biceps femoris –
long head
Knee flexion
Common tendon with semitendinosus
from superior medial quadrant of the
posterior portion of the ischial tuberosity
Primarily on fibular head; also
on lateral collateral ligament
and lateral tibial condyle
Biceps femoris –
short head
Knee flexion
Lateral lip of linea aspera, lateral
supracondylar ridge of femur, and
lateral intermuscular septum of thigh
Primarily on fibular head; also
on lateral collateral ligament
and lateral tibial condyle
Tibialis anterior
Ankle
dorsiflexion
Lateral condyle of tibia, proximal 1/2 –
2/3 or lateral surface of tibial shaft,
interosseous membrane, and the deep
surface of the fascia cruris
Medial and plantar surfaces of
1st cuneiform and on base of
first metatarsal
(Information on muscle origins and insertions from the University of Washington Department of Radiology
Muscle Atlas)
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