‏هل تريد أن تنام وأنتَ مغفور لك؟

قال رسول الله ﷺ:
من قال حين يأوى إلى فراشه: لا إله إلا الله وحده لا شريك له ، له الملك وله الحمد وهو على كل شيء قدير ، لا حول ولا قوة إلا بالله العلي العظيم ، سبحان الله ، والحمد لله ، ولا إله إلا الله ، والله أكبر.
غُفرت له ذنوبه أو خطاياه وإن كانت مثل زبد البحر!

و قيام الليل❤️.

Lecture 7
( Gait analysis system )

#biomechanics1
Bu

أنا MUC😔
ابعتي عالبوت يبعتولك.

دي أسئلة د/الشريف لـ CNS والفايلات اللي قبلها شرح وأسئلة برضوه.

1- Sensory
2- Motor

#Neuro_physiology

ادعولنا❤️.

آمين.🤍

🖇️ Resistance direction 🖇️
هنجمع الresistance بتاعة كل الحركات علشان مهمين 🫶🏻
Resistance is givin in:
▫️grade 4 (Good ) >>>moderate resistance
▫️ grade 5 ( Normal )>>>
maximum resistance+ hold
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
1️⃣ Shoulder joint:
▫️ Flexion>>>down
▫️ Hyperextension>>> down
▫️Abduction>>> down
▫️Horizontal abduction>>> down
▫️Horizontal adduction ( pectoralis major)
- Clavicular head / upper fibers :
out and dowm
- sternal head / lower fibers :
out and up
▫️ lateral rotation>>> down
▫️ medial rotation>>>down
▫️ كلهم down ماعدا pectoralis نركز عليهاا مهممة 🫵🏻
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
2️⃣ Scapular movements:
▫️ Protraction (Ab) and upward rotation = serratus anterior>>> down
▫️ Elevation = upper trapizius or levator scapulae>>> down
▫️ Retraction (Ad) = middle trapizius>>> on the lateral border of scapula
▫️ Retraction (Ad) + depression =  lower trapizius>>> up and out, on the lateral border of scapula
▫️Retraction (Ad) + downward rotation = Rhomboideus muscles>>>  out and slightly down,on the medial border of the scapula
▫️الوحيدة اللى من ال medial border
Rhommmboids يبقى mmmedial border
حد يتلغبط بقى 😂🫶🏻
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
3️⃣ Elbow joint:
▫️elbow flexion>>> down
▫️ elbow extension>>> down
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
4️⃣ Wrist joint>>>
▫️ Wrist flexion:
- ( flexor Carpi ulnaris) :
In the direction of extension and toward radial side
- ( flexor Carpi radialis) :
In the direction of extension and
toward ulnar side

▫️ Wrist extension:
- ( extensor Carpi ulnaris) :
In the direction of flexion and toward radial side
- ( extensor radialis longus and brevis) :
In the direction of flexion and  toward ulnar side
مهميييين
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
5️⃣ Forearm:
▫️ Supination>>>
on the dorsal surface of distal end of radius with counterpressure against the ventral surface of the ulna
▫️ Pronation>>>
on the volar surface of distal end of  radius with counterpressure against the dorsal surface of the ulna
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
6️⃣ Thumb ab, ad:
▫️Thumb ab >>>
- (Abductor Pollicis Brevis) :
on the lateral border of the first/ proximal phalanx of the thumb
- (Abductor pollicis Longus) :
on the lateral border of the first Metacarpal bone

▫️ Thumb ad ( Adductor pollicis) >>>
on the medial border of the distal Phalanx of the thumb

🖇️ROM🖇️
👉🏻 Shoulder joint
▫️ flexion >>>0:90°
▫️ Hyperextension >>>0:50°
( Beyond mid line )
▫️ Ab/ Ad >>>0:90°
▫️ Horizontal ab/ ad>>>0:135°
▫️ Lateral/ medial rotation>>>0: 90°
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
👉🏻 Scapular movements
▫️ Protraction (Ab) and upward rotation>>> 3:4 fingers
▫️ Elevation >>> 3 fingers
▫️ Retraction (Ad) >>> 3:4 fingers
▫️ Retraction (Ad) + depression >>> 3:4 fingers
▫️Retraction (Ad) + downward rotation>>> 3:4 fingers
  _ _ _ _ _ _ _ _ _ _ _ _ _ _
👉🏻 Elbow joint:
▫️elbow flexion/extension>>>        0:145°-160°
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _
👉🏻 Wrist joint :
▫️ Wrist flexion>>>0:80°-90°
▫️ Wrist extension>>> 0:70°
▫️ Ulnar deviation>>> 0:30°-35°
▫️ Radial deviation>>> 0:20°-25°
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _
👉🏻 Forearm:
▫️ Supination/ pronation>>>
0:90° ( from the mid position)
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _
👉🏻 Thumb:
▫️Ab/Ad >>> 0:40°-50°
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _
👉🏻 Fingers:
▫️ MCPJ Flexion>>>0:90°
▫️ MCPJ extension>>>
0:20°-30° ( Beyond mid line )
▫️ Proximal IPJ>>>0:120°
▫️ Distal IPJ>>> 0:80°
▫️ Fingers ab/ ad >>>0:20°-25°

Limitation in movements...🤔

SHOULDER FLEXION
👉 limited by ankylosis of the shoulder joint.

SHOULDER EXTENSION
👉 limited by the tension of shoulder flexor muscles.

SHOULDER ABDUCTION
👉 limited by ankylose of the shoulder joint.

SHOULDER HORIZONTAL ABDUCTION
👉 limited by the following factors:
-Tension of anterior fibers of capsule of glenohumeral joint.
- Tension of pectoralis major and deltoid anterior fibers.

SHOULDER HORIZONTAL ADDUCTION
👉 limited by the following factors: 
-Tension of shoulder extensor muscles.
- Contact of arm with the chest.

SHOULDER EXTERNAL ROTATION
👉 limited by the following factors:
-Tension of superior portion of capsular ligament and coracohumeral ligament.
-Tension of medial rotator muscles of the shoulder.

SHOULDER INTERNAL ROTATION
👉 limited by the following factors:
-Tension of superior portion of capsular ligament
-Tension of lateral rotator muscles of the shoulder.

Scapular Abduction and Upward Rotation
👉 limited by the following factors:
1- Tension of trapezoid ligament (limits upward rotation of scapula upon clavicle).
2. Tension of Trapezius and Rhomboids major and minor.

Scapular Elevation
👉 limited by the following factors:
1-Tension of Costoclavicular ligament
2-  Tension of pectoralis minor, Subclavius and Trapezius (lower fibers).

Scapular Adduction
👉 limited by the following factors:
1- Tension of the conoid ligament (limits backward rotation of scapula upon clavicle).
2- Tension of Pectoralis major and minor and serratus anterior muscles.
3- Contact of vertebral border of scapula with spinal musculature.

SCAPULAR DEPRESSION AND ADDUCTION
👉 limited by the following factors: 
- Tension of interclavicular ligament and articular disc of sternoclavicular joint.
- Tension of trapezius (upper fibers)- levator scapulae and sternocleidomastoid (clavicular head) muscles.

SCAPULAR ADDUCTION AND DOWNWARD ROTATION
👉 limited by the following factors:
1- Tension of the conoid ligament .
2- Tension of Pectoralis major and minor and serratus anterior muscles.
3- Contact of vertebral border of scapula with spinal musculature.

THUMB ABDUCTION
👉 limited by the following factors:
- Tension of skin between thumb index finger.
- Tension of first Interosseus Dorsales Muscle.

THUMB ADDUCTION
👉 limited by contact of thumb with second metacarpal bone.

ELBOW FLEXION
👉 limited by the following factors:
- Contact of muscle masses on volar aspect of arm and forearm.
- Contact of coronoid process with coronoid fossa of humerus.

ELBOW EXTENSION
👉 limited by the following factors:
- Tension of radial and ulnar collateral ligaments of elbow joint.
- Tension of flexor muscles of forearm.
- Contact of olecranon process with olecranon fossa on posterior aspect of humerus.

FOREARM SUPINATION
👉 limited by the following factors:
- Tension of volar radioulnar ligament and ulnar collateral ligament of wrist joint.
●Tension of pronator muscles of forearm.
●Tension of lowest fibers of interosseous membrane.

FOREARM PRONATION
👉 limited by the following factors:
- Tension of dorsal radioulnar and dorsal radiocarpal ligaments.
- Tension of lowest fiber of interosseous membrane.
- Tension in supinator muscles.

WRIST FLEXION
👉 limited by tension of dorsal radiocarpal ligament.

WRIST EXTENSION
👉 limited by tension of the palmar radiocarpal ligament.

FLEXION OF MCP JOINTS
👉 limited by tension of expansions of extensor tendons of fingers.

EXTENSION OF MCP JOINTS
👉 limited by the following factors:
- Tension of palmar and collateral ligaments.
- Tension of flexor muscles of fingers

FLEXION OF PROXIMAL AND DISTAL IP JOINTS
👉 limited by tension of expansion of extensor digitorum communis tendons (dorsal ligament).

FINGER ABDUCTION
👉 limited by tension of fascia and skin between fingers.

FINGER ADDUCTION
👉 limited by the contact of each fingers.