Neumann: Kinesiology of the Musculoskeletal System, 2nd Edition

Chapter 01: Getting Started

Study Questions and Answers

1. Contrast the fundamental difference between kinematics andkinetics.

Kinematics describes the motion of a body without regard to the forces or torques that may
have produced the motion. Examples include walking velocity and angular displacement
(range of motion) of a joint. Kinetics describes the forces (or torques) that act on a body.
Examples include compression of an articular disc or tension within a stretched ligament.

2. Describe a particular movement of the body or body segment that incorporates both
translation and rotation kinematics.
The arthrokinematics of glenohumeral abduction include a roll (rotation) and a slide
(translation). Also, walking includes a linear displacement (translation) of the center of mass
of the body as a whole, as well as a concurrent rotation of the joints within the limbs.

3. Note the accessory movements at the metacarpophalangeal joint of your index finger
in full flexion and in full extension. Which joint position has the greater amount of
accessory movements? Which position (flexion or extension) would you assume is the
joint’s close-packed position?
Passive accessory motions at the metacarpophalangeal joint, such as distraction or side-to-
side translation, are greater in or near full extension. The close-packed (and most stable)
position of this joint is near full flexion. At the metacarpophalangeal joint, the close-packed
position is associated with elongation and increased tension in the joint’s collateral
ligaments.

4. Figure 1-8 depicts the three fundamental movements between joint surfaces for both
convex-on-concave and concave-on-convex arthrokinematics. Using a skeleton or an
image of a skeleton, cite an example of a specific movement at a joint that matches each
of these six situations. Examples may include combinations of roll and slide.
Convex-on-concave arthrokinematics:

Roll: During femoral-on-tibial flexion of the knee (as in descending into a squat position),
the distal femur rolls posteriorly on the proximal tibia.

Slide: During extension of the wrist, the proximal end of the (proximal row) of carpal bones
slides palmarly (anteriorly) relative to the distal end of the radius.

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Spin: During flexion of the hip, a point on the center of head of the femur spins within the
acetabulum of the pelvis.
Concave-on-convex arthrokinematics:

Roll: During flexion of the metacarpophalangeal joint, the proximal end of the proximal
phalanx slides palmarly relative to the head of the metacarpal.
Slide: During flexion of the knee, the proximal end of the tibia slides posteriorly relative to
the distal end of the femur.

Spin: While pronating and supinating the forearm, the head of the radius spins relative to the
capitulum of the humerus.

5. Provide examples of how the six forces depicted in Figure 1-12 could naturally occur
at either the disc or spinal cord associated with the junction of the fifth and sixth
cervical vertebrae.
The posterior side of the intervertebral disc experiences tension with increased neck flexion.
 The anterior side of the intervertebral disc is compressed with greater neck flexion.
 The position of full flexion of the neck places an anterior bend through the disc–vertebral
body interface.
 Being struck from behind during a car accident can cause excessive and damaging
anterior-posterior shear on the spinal cord and intervertebral disc.
 Excessive rotation of the head to the right or left can create excessive torsion within the
annulus fibrosus of the intervertebral disc.
 “Spear” tackling in American football can cause a combined load on the intervertebral
disc, consisting of compression and torsion.

6. Contrast the fundamental differences between force and torque. Use each term to
describe a particular aspect of a muscle’s contraction relative to a joint.
A force is a push or pull applied against a mass. A contraction force produced by the elbow
flexor muscles can create significant compression within the elbow joint.
A torque is the rotary equivalent of a force, with its magnitude equal to the product of a
muscle force and its moment arm. The torque produced by the elbow flexor muscles can
produce rapid angular acceleration of the elbow, quickly bringing the hand to the mouth.

7. Define and contrast internal torque and external torque .

Internal torque is a torque produced around a joint driven by an internal force, such as a
muscle contraction. External torque is a torque produced around a joint caused by an external
force, such as gravity or manual resistance applied by a therapist. When opposing internal
and external torques about a joint (within a given plane) are equal, the joint is often described
as being in “static rotary equilibrium.” If the internal and torques were not equal, the joint
would accelerate in the direction of the larger torque.

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8. The elbow model in Figure 1-17 is assumed to be in static equilibrium. While

maintaining this equilibrium how would a change in the variables EF, D1, or D
independently affect the required amount of internal force (IF)? How can a change in
these variables “ protect ” an arthritic joint from unnecessarily large joint reaction
forces?
Assuming the elbow joint model remains in static and rotary equilibrium:
 Increasing EF would increase internal force (IF).
 Decreasing EF would decrease IF.
 Increasing D1 would increase IF.
 Decreasing D1 would decrease IF.
 Increasing D would decrease IF.
 Decreasing D would increase IF.
Reducing internal (muscle) force decreases joint reaction force on the elbow. This situation
may offer joint “protection” to an unstable or painful elbow.

9. Slowly lowering a book to the table uses an eccentric activation of the elbow flexor
muscles. Explain how changing the speed at which you lower the book can affect the
type of activation (e.g., eccentric, concentric) and choice of muscle.
Slowly lowering the book to the table occurs primarily through an interaction of gravity
acting on the book and eccentric activation of the elbow flexor muscles. The elbow flexor
muscles control the movement by decelerating the descent of the book. To accelerate the
book toward the table at a rate that exceeds the pull of gravity, the elbow extensor muscles
must contract (through e activation) to produce the rapid descent of the book.

10. Assume a surgeon performs tendon transfer surgery to increase the internal
moment arm of a particular muscle relative to a joint. Are there potential negative
biomechanical consequences of increasing the muscle ’ s moment arm (leverage) too
far? If so, please explain.
Increasing a muscle’s internal movement arm allows a given torque to be produced with less
muscle force. This may be desirable if a muscle is weak or if the joint is not able to tolerate
large forces. As a biomechanical trade-off, increasing the internal moment arm (i.e.,
increasing the muscle’s mechanical advantage) results in a proportional loss in speed and
displacement of the limb or body part. If the moment arm is increased too far, a full muscle
contraction may fail to move the limb through its full, natural range of motion.

11. Describe a possible pathologic situation in which the inferior-directed joint reaction
force (JRF) depicted in Figure 1-15, B is not able to be generated by the distal humerus.
A large inferior-directed joint reaction is normally required to match (balance) the large
internal (elbow flexor) force. A humerus severely weakened by osteoporosis (or other
disease) may fracture in response to the strong pull of the muscle. In this case the structure of

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the humerus is unable to generate an adequate reaction force, allowing the forearm to
accelerate upward through the fractured distal humerus. This pathologic situation tends to
occur with greater frequency in joints that are subjected to very large forces, such as the hip.

12. What is the difference between force and pressure? How could these differences
apply to protecting the skin of a patient with a spinal cord injury and reduced
sensation?
In the context of this question, a force is the magnitude of a push applied against the patient’s
skin. Pressure is the force divided by the contact area. A force applied to a small surface area
can create large and potentially damaging pressure, also called stress. A person with a spinal
cord injury often has impaired sensation and is unable to perceive a potentially damaging
level of contact pressure. Over time, high contact pressure can lead to ulceration of the skin
and underlying soft tissues. To reduce the pressure, it is important to maximize the contact
area between the skin and external object, such as the seat of a wheelchair. Ideally, for
example, a properly fitting wheelchair with correct-sized seat cushion maximizes the surface
area that contacts the ischial region. Even a wrinkle in clothing can create potentially
damaging high pressure against insensitive skin.

13. Describe the difference between mass and weight.

A mass describes the number of particles that exists in an object. A weight is a force that
describes the gravitational pull exerted on a mass. A person’s mass is known by dividing their
body weight (in newtons) by the acceleration caused by gravity (9.81 m/s2).

14. Most muscle and joint systems within the body function as third-class levers. Cite a
biomechanic or physiologic reason for this design.
By definition, a muscle and joint system that acts as a third-class lever functions with a
mechanical advantage of less than one; that is, the length of the internal moment arm is less
than the length of the external moment arm. This mechanical situation allows a contracting
muscle to displace a body segment a greater distance than the actual contraction. (This is
usually necessary because a muscle only contracts a relatively short distance, about one third
of its resting length.) This mechanical benefit requires that the muscle generate a force that
exceeds the weight of the displaced segment. Such a system is said to “favor” speed and
distance of the lever system at the “expense” of muscle force. The structure of the joint must
be able to absorb safely the large muscles forces, often expressed as a compression or shear.

15. Assume a patient developed adhesions with marked increased stiffness in the
posterior capsular ligaments of his knee. How would this change in tissue property
affect full passive range of motion at the joint?
Knee extension naturally stretches the posterior capsular ligaments of the knee. Increased
stiffness within these ligaments (indicated by the slope of a stress-strain curve) may limit full
knee extension. Because flexion of the knee naturally slackens (rather than tenses) the

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posterior capsular ligaments, its increased stiffness in this tissue would not limit the extremes
of flexion.

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