Flexion Extension

Instruct the patient regarding nonpharmacologic strategies including elevation of the affected extremity and anti-embolic exercises such as flexion/extension of the ankle (for lower extremity VTE) or hand squeezing/relaxation (for upper extremity VTE). 

To monitor efficacy, the patient s baseline pain can be assessed with a visual analog scale, and range of motion for affected joints can be assessed with flexion, extension, abduction, or adduction. 

Musculoskeletal Assess extremities for deformities, swelling, lacerations, or other injuries. Palpate distal pulses for equality, rate, and rhythm compare with central pulses. Ask child to wiggle toes and fingers evaluate strength through hand grips and foot flexion/extension. 

The Morrison load cycles were applied to selected prostheses in the simulator shown in Figure 1. Cyclic loading patterns were applied in the Tibial Axis and A-P directions, the hydraulic mechanisms being controlled by a waveform synthesiser supplied with some 200 bits of information. The primary joint motion in flexion-extension was achieved by means of a cam driven rack-and-pinion system, while a low-friction self-aligning bearing arrangement on the upper, femoral, specimen holder allowed rotation about the A-P axis. 

Trank Bend forward Bend backwards Bend sideways Rotate about the Long axis Flexion Extension Lateral flexion Axial rotation... 

Shoulder and hip joints Raise arm or thigh forward Raise arm or thigh to side Rotate arm or leg along its long axis Flexion (extension") Abduction (adduction") Lateral or outward rotation (medial or inward rotation")... 

Elbow and knee joints Bend from the fully straightened position Flexion (extension") ... 

Wrist joint (combined with carpal joints) Bend palm upwards Move hand away from trunk to the side of radius Flexion (extension") Adduction or radial deviation (adduction or ulnar deviation") ... 

The bony structures of the elbow are the distal end of the humerus and the proximal ends of the radius and ulna. The elbow joint complex allows two degrees of freedom in motion flexion/extension and pronation/supination. The elbow joint complex is three separate synovial articulations. The humeral-ulnar joint is the articulation between the trochlea of the distal radius and the trochlear fossa of the proximal ulna. The humero-radial joint is formed by the articulation between the capitulum of the distal humerus and the head of the radius. The proximal radioulnar joint is formed by the head of the radius and the radial notch of the proximal ulna. 

Medial trochlear groove radius Distal location of flexion/extension 13.2 1.4... 

FIGURE 49.27 The nonlinear relation between the contact area and the load at the proximal wrist joint. The contact area was normalized as a percentage of the available joint surface. The load of 11, 23, 46, and 92 lbs was applied at the position of neutral pronation/supination, neutral radioulnar deviation, and neutral flexion/extension. (From Viegas S.F., Patterson R.M., Peterson P.D., Roefs J., Tencer A., and Choi S. 1989. /. Hand Surg. 14A 458. With... 

Wrist motion (+) Pronation ( —) Supination (+) Flexion ( -) Extension ( —) Radial deviation ... 

The axes of rotation of the CMC joint have been described as being fixed [Hollister et al., 1992], but others beUeve that a polycentric center of rotation exists [Imaeda et al., 1994]. Holhster et al. [1992] found that axes of the CMC joint are fixed and are not perpendicular to each other, or to the bones, and do not intersect. The flexion/extension axis is located in the trapezium, and the abduc-tion/adduction axis is on the first metacarpal. In contrast, Imaeda et al. [1994] found that there was no single center of rotation, but rather the instantaneous motion occurred reciprocally between centers of rotations within the trapezium and the metacarpal base of the normal thumb. In flexion/extension. 

Note The coordinate system is defined with the x-axis corresponding to intemal/external rotation, the /-axis corresponding to abduction/adduction, and the z-axis corresponding to flexion/ extension. The x-axis is positive in the distal direction, the /-axis is positive in the dorsal direction for the left hand and in the palmar direction for the right hand, and the z-axis is positive in the radial direction. The origin of the coordinate system was at the intersection of a line connecting the radial and ulnar prominences and a hne connecting the volar and dorsal tubercles. 

Interphalangeal joint flexion-extension axis (Figure 49.33a) t/T 44 17%... 

The angle of the abduction-adduction axis with respect to the flexion-extension axis is 84.8 12.2°. The location and angulation of the T -wires of the axes with respect to the bones were measured, a, f ) directly with a goniometer. The positions of the pins in the bones were measured T,L) with a Vernier caliper. 

Youm Y, McMurty R.Y, Flatt A.E. et al. 1978. Kinematics of the wrist an experimental study of radioulnar deviation and flexion/extension. /. Bone Joint Surg 60A 423. 

Patrick, L.M. and Chou, C. 1976. Response of the human neck in flexion, extension, and lateral flexion. Vehicle Research Institute Report No. VRl-7-3. Warrendale, PA, Society of Automotive Engineers. 

Visual upper extremity information processing speed Upper extremity random reach movement speed Index finger (proximal intercarpal phalangeal joint), flexion extension speed... 

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