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Terms of Movements by Prof. Dr. Muhammad Imran Qureshi Three systems of the body work in coordination to perform various movements of the body. These are: A System of Bones (Osteology), positive along the Y direction. In YZ planes (Frontal / Coronal), angles are measured from 0o in the Y direction and positive along the Z direction. A System of Muscles (Myology), and Flexion and Extension A system of Joints (Arthrology) The study of Analysis of various body movements is called “Kinesiology” Flexion and Extension are the movements that take place along the Xaxis (in sagittal plane). Movements in the body take place at joints where two or more bones meet. Some joints have no movements (sutures of skull), some have slight movements (superior tibiofibular joint) and some are freely movable joints (shoulder joint). These movements take place as a result of muscular contractions (Which act as levers for the bones. Terms of Movements Figure 2: Flexion, Extension & Hyperextension Flexion: It is a bending movement across a joint. The angle between the bones of the Figure 1: Axes of Movements These movements take place along THREE axis (X-axis, Y-axis, and Z-axis) or any combination of these axis) Angles in XY planes (Sagittal) are measured from 0o in the X direction and 1|Page Figure 3: Flexion & Extension at Elbow joint is reduced. As a result of this movement, the flexor surfaces approximate or tend to Figure 6: Flexion & Extension of Thumb Figure 4: Flexion & Extension at Shoulder approximate. Flexion and Extension are the movements that take place along the Xaxis (in sagittal plane). Extension: It is a straightening movement across a joint. The angle between the bones of the joint is increased. Figure 7: Flexion & Extension at Wrist As a result of this movement, the extensor surfaces tend to approximate. Flexion and Extension (In Hand) In hand dorsiflexion and palmar flexion occur at wrist joint. Dorsiflexion is in fact extension of the hand at wrist joint. Similarly, Palmar flexion is in fact flexion of hand at wrist joint. Figure 5: Flexion & Extension of Fingers 2|Page Figure 8: Flexion & Extension at Hip Figure 9: Flexion & Extension at Knee Flexion and Extension (In Foot) Dorsiflexion is flexion at the ankle joint. The angle between the dorsum of the foot and the anterior surface of leg is reduced. Such an injury is known as “whiplash” injury. Abduction and Adduction Abduction and Adduction are the movements that take place along the zaxis (in coronal plane). Abduction is the movement away from the median plane. The part of the body that moves away from the median plane is said to be abducted Figure 10: Dorsiflexion & Plantarflexion Adduction is the movement towards the median plane. The part of the body that moves towards the median plane is said to be adducted It is seen when we walk uphill or while putting the heel of advancing foot on the ground while walking. Plantarflexion is a movement at the ankle, which turns the foot or toes towards the sole (plantar surface) It is seen when we stand on our toes or lift the toes of the rear foot off the ground while walking. Figure 11: Flexion & Extension of Toes Figure 12: Abduction & Adduction at Shoulder Figure 13: Abduction & Adduction at Hip In the trunk straightening out from a forward bending position is “extension”. “Hyperextension” is extension of a limb or trunk beyond the normal limit. Such movements can sometimes cause injury. This is seen when an automobile is hit from behind and the neck rapidly hyperextends. 3|Page Figure 14: Abduction & Adduction at Wrist At the wrist, abduction is known as ‘radial deviation’, because the hand moves towards the thumb (radial) side; whereas adduction is known as ‘ulnar deviation’ because the hand moves towards the little finger (ulnar) side. In case of the hand, the axis for abduction and adduction for fingers passes through the MIDDLE FINGER. When the fingers move away from the middle finger, they are said to be This movement is used for precision acts like pinching, buttoning a shirt, holding a key, making fine strokes of a paint brush etc. Reposition: It is the reverse of opposition. The thumb is brought back to the anatomical position Circumduction It is the combination of the movements of Flexion, Abduction, Extension, and Adduction in that sequence. Figure 14: Abduction & Adduction of the Fingers abducted and vice versa. In case of the thumb, it is adducted when it lies by the side of the palm and abducted when it stands out at right angle to the surface of the palm. In other words, the plane along which, the fingers abduct and adduct is the same along which the thumb flexes and extends (coronal) and the plane along which, the fingers flex and extend is the same along which the thumb abducts and adducts (Sagittal). Figure 15: Circumduction at Shoulder Classically it takes place at shoulder and the first carpometacarpal joints. Rotation Rotation is the term applied to the movement of a part of the body around Opposition & Reposition Another set of movements of the thumb, unique in the human beings is Opposition and Reposition. Opposition: In this movement, the pulp / pad of the thumb is brought against the pulp / pad of another digit. 4|Page Figure 16: Rotation of the Head its longitudinal axis. For example, turning or revolving the head to the side. In the limbs, rotation involves a movement of the anterior surface. Medial rotation is the movement as a result of which the anterior surface of the part of the limb faces medially. This is also called internal rotation. The working position of the forearm is mid prone. Figure 19: Supination & Pronation Figure 17: Medial & Lateral Rotation of the arm Lateral rotation is the movement as a result of which the anterior surface of the part of the limb faces laterally. This (always at radioulnar joints) Elevation & Depression These movements take place along the Y-axis Elevation: The part of the body raises up or moves superiorly such as raising the shoulders while shrugging, closing of an open mouth by moving the mandible superiorly. Depression: The part of the body lowers down or moves inferiorly, e.g. lowering the shoulder downward or moving the mandible inferiorly while opening the mouth. Figure 18: Medial & Lateral Rotation of the leg Inversion is the movement of the foot. is also called external rotation. Supination & Pronation These terms are used in context with the Forearm. Supination of the forearm is the normal anatomical position of the forearm. In this position, both the bones of the forearm lie parallel to one another and the palm faces anteriorly Pronation is the movement in which the radius crosses the ulna diagonally, as a result of which, the palm faces posteriorly. 5|Page Figure 20: Inversion & Eversion of the Foot In this movement, the medial longitudinal arch is raised and the sole faces medially. a cavity. A fully inverted foot is also plantar flexed. Eversion is the opposite movement of the foot. In this movement, the lateral longitudinal arch is raised and the sole faces laterally. An everted foot is also dorsiflexed. The movements of inversion and eversion enable us to walk on uneven surfaces. Protraction & Retraction Protraction is a movement in the forward direction. For example, a forward movement of the shoulder seen when pushing against resistance (pushing an automobile) or punching an opponent during a boxing match. Protraction is also seen in mandible. The forward movement of mandible is also called protrusion. Retraction is a movement in the backward direction. For example, posterior movements of shoulder and mandible. Retraction of mandible is also called retrusion. These terms are used to describe the forward and backward movements of the jaw and shoulders at the temporomandibular and sternoclavicular joints respectively. Both these joints have articular discs in their synovial cavities. Invagination and Evagination: An inward or outward bulging of the wall of 6|Page Figure 21: Invagination & Evagination