Welcome to anatomical yoga. We'll start at the top of our mats in anatomic
position -- gently elevate and retract your scapula with ever-so-slight
cervical circumduction.
Now flex your dominant hip and knee while an
externally rotated contralateral hip and flex knee allow you to rest your foot on
your thigh. Next we'll move on to my favorite the downward Vesalius
If none
of that made sense then keep watching this video because today we're talking
about movement terms
What's up y'all my name is Pat Kelly I got another anatomy lesson for you
Today we're talking movement terms. These are all the motions as they apply to the
body so we're going to go over what those movements are what joints they
apply to and give you a few memory devices so hopefully you can remember
them easier. I made this video to accompany my anatomical regions and
directional terms videos so if you haven't seen those and recommend
clicking that link right there to get a little bit of background.
So here's the
big picture: we have multiple joints that all move in incredibly unique ways so
simple terms like up-down in sideways don't apply here.
We need unique terms to describe unique motions and when we're talking about
anatomical motion we reference an imaginary body in something called the
anatomic position. That's standing upright with feet forward arms by your
side with palms forward and head neutral looking forward. I've said it before and
I'll say it again always refer to the anatomic position whenever you're
talking about direction or motion. This is forever and always your starting
point in anatomy. Why?
Well it's tempting to say something like "move the patient's
leg up" to refer to hip flexion when someone is in the anatomic position but
that's a completely different motion than if they're lying on their side.
So in order to standardize language we always refer to the anatomic position
The second thing to keep in mind is that there are different planes of motion and
different axes of motion with which these limbs and joints move around.
Obviously your body exists and moves in three dimensions so while some motions
seem like they happen in a very straightforward, linear way, most
day-to-day motions are a combination of those. Let's start with abduction which
is movement of a joint away from the midline of the body and adduction,
movement towards the midline of the body.
Specifically this midline on the
sagittal plane. Now clearly these words sound very similar and some folks will
painstakingly spell it out A-B-duction to make it super clear but the
difference is actually way easier to remember.
I picture an alien abduction
taking my arm away from me whereas with adduction I'm adding to the size of my
body. You'll see these motions all the time with shoulders and hips but you can
also apply them to fingers and wrists. In those cases abduction doesn't
necessarily mean going away from the body's midline but from the midline
of the hand. So really finger abduction is the same thing as spreading your
fingers while adduction is closing them.
One little note though, some clinicians
will call this motion wrist abduction or adduction but some will say radial
deviation meaning the hand is moving towards the radius or ulnar deviation
toward the ulna. They're the exact same thing but since the hand and wrist are
so often not in anatomic position they're easier to remember this way. Next
up is bending and straightening more technically flexion which is a decrease
in the angle between two joints and extension and increase in that angle
It's pretty intuitive for joints like the knee, elbow or even spine but some
joints are a little trickier. Like this is shoulder flexion, and to me it just
looks like my arm is going away from my body so I had to come up with a separate
way to remember flexion versus extension. I remember that flexion is like the
fetal position which clearly both start with F -- check it out: the hips and knees
are in flexion the shoulders elbows and wrists are in flexion and the neck and
all parts of the spine are in flexion.
That's right flexion and fetal the two
best F words for any memory device.
Extension is the opposite, you're
increasing the angle between two joints which usually results in straightening
the limb or extending it past that frontal plane midline. But be careful
because flexion and flexing are two very different things. When we say flex a
muscle what we're actually saying is to put tension on it, to contract it and
yeah when you're flexing your bicep you're also doing elbow flexion but you
can flex your quadriceps while you're extending your knee
Got it? Rad. Moving on.
Next up is medial and lateral rotation sometimes called internal and external
rotation and just like picturing rotation from physics we first need to
figure out what our axis is.
So for both the shoulder and the hip joints our axis
is going to be an imaginary line running through the long bone of those joints
You can do this with me. If you stand up and lock out your elbow and rotate your
shoulder so that your thumb starts pointing towards your midline you
medially or internally rotated the shoulder now on the flip side the thumb
is heading back out so we're doing lateral or external rotation. Same thing
with the hip joint. If you stand up and lock out your knee when the
foot goes towards the midline that's medial rotation if it goes out
lateral rotation. But remember, movement terms use the anatomic position as a
reference so if we're in standing we can get away with using our hands and feed
as little guides but that might completely disappear if we have our
person change position.
Like imagine for whatever reason you wanted to assess a
patient's internal shoulder rotation in a seated position. It's gonna be really
difficult to work with a straight arm so you have your patient bend their elbow
Now in this case internal and external rotation still make intuitive sense. My
arm is going towards the midline or away from the midline which agrees with the
long axis rotation we defined earlier. That's awesome unfortunately that
doesn't translate to the hip joints.
Right here I'm actually doing medial hip
rotation: the long axis of the femur is rotating towards the midline. But my
lower leg is all out to the side vice versa when I do lateral rotation or when
you test this in the supine position.
Okay lesson learned, if you look at the
long axis of the bone and anatomic position you'll never trip up.
So those
are our major multi-joint movements but there are some exceptions and from here
on out it gets pretty specific
Like the radius has the ability to flip around
the ulna due to a cool little pivot joint between the radius and ulna that's
totally separate from shoulder rotation.
This is called supination and pronation.
Supination everyone remembers because you flip your hand up like you're asking
for soup... it gets dumber.
On the other hand I remember pronation because it's
like a bunch of pro national football players all putting their hands in on
the pile.
Also can I get credit for putting literally the other hand in?
But it gets even weirder and more specific like the ankle joint -- specifically
between the talus and the lower leg -- do something called dorsiflexion and
plantarflexion
I remember these because when you point
your toes down you're planting your toes on the ground then when you point them
back towards you, you're pointing them towards your dorsal aspect, your back where
we'd keep our dorsal fin.
But the ankle can still wiggle a little more that same
talocrural joint rotates around the long axis of the METATARSALS to do
inversion and eversion.
Easy way to remember those, if you invert your feet
your body will trip over and your body will end up inverted
- but you could forever comfortably stand an eversion.
We're getting to the end
but lastly we need to look at the scapula.
They can elevate or depress
protract or retract, all of which are pretty intuitive to remember.
Finally we
have circumduction which is this big silly looking circular motion that
happens at a few joints including the neck shoulders and hips.
Now those are
all the major motions but there are a couple things to keep in mind.
As a clinician you're probably gonna care about these movement terms because
they're gonna help you document things like range of motion and functional
movements
Usually we care about three types of movements: active motion which
means the patient is moving the joint through their own effort passive motion
which means the motion is being done to them either by your hands or by a
machine and resisted motion which is self-explanatory some kind of resistance
is being placed on that motion.
And those are important distinctions to make
because that might help you with your assessment
For instance if somebody had
painful shoulder flexion but they were fine on passive shoulder flexion you can
use that information
Now all Anatomy students are gonna need to know these
movement terms but if you're more interested in movement itself I'm gonna
recommend this playlist up here it's my musculoskeletal biomechanics and
kinesiology playlist specifically I'm gonna recommend this video about origins
and insertions I think it'll be really helpful to you and a big thank you to
David who's my newest patron on patreon if you want to join them you can click
that link there or you can support the channel for free by subscribing at that
link there have fun be good I'll see you next time