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Protrusion, Retrusion, and Excursion Anatomy

In this anatomy lesson, I’m going to demonstrate protrusion, retrusion, and excursion , which are special body movement terms in anatomy that refer to forward (anterior), backward (posterior), or side to side movements.

Protrusion in Anatomy

Protrusion refers to the movement of a structure in an anterior (forward) direction. In fact, the word protrude means “projecting something forward.”

I call protrusion the kissing movement because it occurs when you pucker your lips like you’re going to give someone a kiss or stick out your tongue. Moving the mandible (lower jaw) forward is also an example of protrusion.

Retrusion in Anatomy

Retrusion is the opposite of protrusion. It refers to the movement of a structure in a posterior, or backward, direction. Putting your tongue back in your mouth, moving the lips back, or moving the mandible back are all examples of retrusion in anatomy.

Excursion in Anatomy

Finally, we have excursion , which refers to the side-to-side movement of the lower jaw (mandible). If you’ve ever heard of a character named Ernest P. Worrell, then you’ve definitely seen the excursion movement. He’s the character in those movies such as Ernest Goes to Camp, Ernest Goes to Jail, etc. When Ernest saw something nasty, he’d move his jaw back and forth and say, “Ewwww.”

Excursion can occur in either direction, and anatomists use directional terms to specify the type of excursion. When the mandible moves to either the left or right, it’s moving away from the body’s midline, so it’s called lateral excursion . When the mandible moves closer to the midline of the body, it’s called medial excursion .

Protrusion and Retrusion vs Protraction and Retraction

What about protraction and retraction ? Some anatomy textbooks will refer to the forward movement of the mandible, lips, or tongue as protraction (instead of protrusion), and the backward (posterior) movement will be called retraction (instead of retrusion). The terms are sometimes used interchangeably, so use whatever method your anatomy professor suggests (they give you the grade, not me!).

However, some anatomists today use protraction and retraction to refer almost exclusively to the scapulae, as it is a combined movement (protraction is anterolateral, and retraction is posteromedial). In contrast, protrusion and retrusion are more of an anterior/posterior movement. Then again, some anatomists prefer not to use protraction and retraction at all, even when describing shoulder blade movement.

Protrusion, Retrusion, and Excursion in Healthcare

Healthcare professionals use protrusion, retrusion, and excursion when documenting, performing assessments on patients, or treating disorders.  For example, in her head-to-toe assessment , Nurse Sarah asked me to stick out my tongue (an example of protrusion), to assess cranial nerve twelve .

In addition, something called a mandibular protrusion test (MPT) is sometimes used by anesthesiologists to predict difficult airways in patients.

Free Quiz and More Anatomy Videos

Take a free protrusion vs retrusion quiz to test your knowledge, or review our protrusion vs retrusion video . In addition, you might want to watch our anatomy and physiology lectures on YouTube, or check our anatomy and physiology notes .

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ex·cur·sion

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9.5 Types of Body Movements

Learning objectives.

By the end of this section, you will be able to:

Define and identify the different body movements

• Demonstrate the different types of body movements
• Identify the joints that allow for these motions

Synovial joints allow the body a tremendous range of movements. Each movement at a synovial joint results from the contraction or relaxation of the muscles that are attached to the bones on either side of the articulation. The degree and type of movement that can be produced at a synovial joint is determined by its structural type. While the ball-and-socket joint gives the greatest range of movement at an individual joint, in other regions of the body, several joints may work together to produce a particular movement. Overall, each type of synovial joint is necessary to provide the body with its great flexibility and mobility. There are many types of movement that can occur at synovial joints ( Table 9.1 ). Movement types are generally paired, with one directly opposing the other. Body movements are always described in relation to the anatomical position of the body: upright stance, with upper limbs to the side of body and palms facing forward. Refer to Figure 9.5.1 as you go through this section.

External Website

Watch this video to learn about anatomical motions. What motions involve increasing or decreasing the angle of the foot at the ankle?

Flexion and Extension

Flexion and extension are movements that take place within the sagittal plane and involve anterior or posterior movements of the body or limbs. For the vertebral column, flexion (anterior flexion) is an anterior (forward) bending of the neck or body, while extension involves a posterior-directed motion, such as straightening from a flexed position or bending backward. Lateral flexion is the bending of the neck or body toward the right or left side. These movements of the vertebral column involve both the symphysis joint formed by each intervertebral disc, as well as the plane type of synovial joint formed between the inferior articular processes of one vertebra and the superior articular processes of the next lower vertebra.

In the limbs, flexion decreases the angle between the bones (bending of the joint), while extension increases the angle and straightens the joint. For the upper limb, all anterior motions are flexion and all posterior motions are extension. These include anterior-posterior movements of the arm at the shoulder, the forearm at the elbow, the hand at the wrist, and the fingers at the metacarpophalangeal and interphalangeal joints. For the thumb, extension moves the thumb away from the palm of the hand, within the same plane as the palm, while flexion brings the thumb back against the index finger or into the palm. These motions take place at the first carpometacarpal joint. In the lower limb, bringing the thigh forward and upward is flexion at the hip joint, while any posterior-going motion of the thigh is extension. Note that extension of the thigh beyond the anatomical (standing) position is greatly limited by the ligaments that support the hip joint. Knee flexion is the bending of the knee to bring the foot toward the posterior thigh, and extension is the straightening of the knee. Flexion and extension movements are seen at the hinge, condyloid, saddle, and ball-and-socket joints of the limbs (see Figure 9.5.1 a-d ).

Hyperextension is the abnormal or excessive extension of a joint beyond its normal range of motion, thus resulting in injury. Similarly, hyperflexion is excessive flexion at a joint. Hyperextension injuries are common at hinge joints such as the knee or elbow. In cases of “whiplash” in which the head is suddenly moved backward and then forward, a patient may experience both hyperextension and hyperflexion of the cervical region.

Abduction and Adduction

Abduction and adduction motions occur within the coronal plane and involve medial-lateral motions of the limbs, fingers, toes, or thumb. Abduction moves the limb laterally away from the midline of the body, while adduction is the opposing movement that brings the limb toward the body or across the midline. For example, abduction is raising the arm at the shoulder joint, moving it laterally away from the body, while adduction brings the arm down to the side of the body. Similarly, abduction and adduction at the wrist moves the hand away from or toward the midline of the body. Spreading the fingers or toes apart is also abduction, while bringing the fingers or toes together is adduction. For the thumb, abduction is the anterior movement that brings the thumb to a 90° perpendicular position, pointing straight out from the palm. Adduction moves the thumb back to the anatomical position, next to the index finger. Abduction and adduction movements are seen at condyloid, saddle, and ball-and-socket joints (see Figure 9.5.1 e ).

Circumduction

Circumduction is the movement of a body region in a circular manner, in which one end of the body region being moved stays relatively stationary while the other end describes a circle. It involves the sequential combination of flexion, adduction, extension, and abduction at a joint. This type of motion is found at biaxial condyloid and saddle joints, and at multiaxial ball-and-sockets joints (see Figure 9.5.1 e ).

Rotation can occur within the vertebral column, at a pivot joint, or at a ball-and-socket joint. Rotation of the neck or body is the twisting movement produced by the summation of the small rotational movements available between adjacent vertebrae. At a pivot joint, one bone rotates in relation to another bone. This is a uniaxial joint, and thus rotation is the only motion allowed at a pivot joint. For example, at the atlantoaxial joint, the first cervical (C1) vertebra (atlas) rotates around the dens, the upward projection from the second cervical (C2) vertebra (axis). This allows the head to rotate from side to side as when shaking the head “no.” The proximal radioulnar joint is a pivot joint formed by the head of the radius and its articulation with the ulna. This joint allows for the radius to rotate along its length during pronation and supination movements of the forearm.

Rotation can also occur at the ball-and-socket joints of the shoulder and hip. Here, the humerus and femur rotate around their long axis, which moves the anterior surface of the arm or thigh either toward or away from the midline of the body. Movement that brings the anterior surface of the limb toward the midline of the body is called medial (internal) rotation . Conversely, rotation of the limb so that the anterior surface moves away from the midline is lateral (external) rotation (see Figure 9.5.1 f ). Be sure to distinguish medial and lateral rotation, which can only occur at the multiaxial shoulder and hip joints, from circumduction, which can occur at either biaxial or multiaxial joints.

Supination and Pronation

Supination and pronation are movements of the forearm. In the anatomical position, the upper limb is held next to the body with the palm facing forward. This is the supinated position of the forearm. In this position, the radius and ulna are parallel to each other. When the palm of the hand faces backward, the forearm is in the pronated position , and the radius and ulna form an X-shape.

Supination and pronation are the movements of the forearm that go between these two positions. Pronation is the motion that moves the forearm from the supinated (anatomical) position to the pronated (palm backward) position. This motion is produced by rotation of the radius at the proximal radioulnar joint, accompanied by movement of the radius at the distal radioulnar joint. The proximal radioulnar joint is a pivot joint that allows for rotation of the head of the radius. Because of the slight curvature of the shaft of the radius, this rotation causes the distal end of the radius to cross over the distal ulna at the distal radioulnar joint. This crossing over brings the radius and ulna into an X-shape position. Supination is the opposite motion, in which rotation of the radius returns the bones to their parallel positions and moves the palm to the anterior facing (supinated) position. It helps to remember that supination is the motion you use when scooping up soup with a spoon (see Figure 9.5.2 g ).

Dorsiflexion and Plantar Flexion

Dorsiflexion and plantar flexion are movements at the ankle joint, which is a hinge joint. Lifting the front of the foot, so that the top of the foot moves toward the anterior leg is dorsiflexion, while lifting the heel of the foot from the ground or pointing the toes downward is plantar flexion. These are the only movements available at the ankle joint (see Figure 9.5.2 h ).

Inversion and Eversion

Inversion and eversion are complex movements that involve the multiple plane joints among the tarsal bones of the posterior foot (intertarsal joints) and thus are not motions that take place at the ankle joint. Inversion is the turning of the foot to angle the bottom of the foot toward the midline, while eversion turns the bottom of the foot away from the midline. The foot has a greater range of inversion than eversion motion. These are important motions that help to stabilize the foot when walking or running on an uneven surface and aid in the quick side-to-side changes in direction used during active sports such as basketball, racquetball, or soccer (see Figure 9.5.2 i ).

Protraction and Retraction

Protraction and retraction are anterior-posterior movements of the scapula or mandible. Protraction of the scapula occurs when the shoulder is moved forward, as when pushing against something or throwing a ball. Retraction is the opposite motion, with the scapula being pulled posteriorly and medially, toward the vertebral column. For the mandible, protraction occurs when the lower jaw is pushed forward, to stick out the chin, while retraction pulls the lower jaw backward. (See Figure 9.5.2 j .)

Depression and Elevation

Depression and elevation are downward and upward movements of the scapula or mandible. The upward movement of the scapula and shoulder is elevation, while a downward movement is depression. These movements are used to shrug your shoulders. Similarly, elevation of the mandible is the upward movement of the lower jaw used to close the mouth or bite on something, and depression is the downward movement that produces opening of the mouth (see Figure 9.5.2 k ).

Excursion is the side to side movement of the mandible. Lateral excursion moves the mandible away from the midline, toward either the right or left side. Medial excursion returns the mandible to its resting position at the midline.

Superior Rotation and Inferior Rotation

Superior and inferior rotation are movements of the scapula and are defined by the direction of movement of the glenoid cavity. These motions involve rotation of the scapula around a point inferior to the scapular spine and are produced by combinations of muscles acting on the scapula. During superior rotation , the glenoid cavity moves upward as the medial end of the scapular spine moves downward. This is a very important motion that contributes to upper limb abduction. Without superior rotation of the scapula, the greater tubercle of the humerus would hit the acromion of the scapula, thus preventing any abduction of the arm above shoulder height. Superior rotation of the scapula is thus required for full abduction of the upper limb. Superior rotation is also used without arm abduction when carrying a heavy load with your hand or on your shoulder. You can feel this rotation when you pick up a load, such as a heavy book bag and carry it on only one shoulder. To increase its weight-bearing support for the bag, the shoulder lifts as the scapula superiorly rotates. Inferior rotation occurs during limb adduction and involves the downward motion of the glenoid cavity with upward movement of the medial end of the scapular spine.

Opposition and Reposition

Opposition is the thumb movement that brings the tip of the thumb in contact with the tip of a finger. This movement is produced at the first carpometacarpal joint, which is a saddle joint formed between the trapezium carpal bone and the first metacarpal bone. Thumb opposition is produced by a combination of flexion and abduction of the thumb at this joint. Returning the thumb to its anatomical position next to the index finger is called reposition (see Figure 9.5.2 l ).

Chapter Review

The variety of movements provided by the different types of synovial joints allows for a large range of body motions and gives you tremendous mobility. These movements allow you to flex or extend your body or limbs, medially rotate and adduct your arms and flex your elbows to hold a heavy object against your chest, raise your arms above your head, rotate or shake your head, and bend to touch the toes (with or without bending your knees).

Each of the different structural types of synovial joints also allow for specific motions. The atlantoaxial pivot joint provides side-to-side rotation of the head, while the proximal radioulnar articulation allows for rotation of the radius during pronation and supination of the forearm. Hinge joints, such as at the knee and elbow, allow only for flexion and extension. Similarly, the hinge joint of the ankle only allows for dorsiflexion and plantar flexion of the foot.

Condyloid and saddle joints are biaxial. These allow for flexion and extension, and abduction and adduction. The sequential combination of flexion, adduction, extension, and abduction produces circumduction. Multiaxial plane joints provide for only small motions, but these can add together over several adjacent joints to produce body movement, such as inversion and eversion of the foot. Similarly, plane joints allow for flexion, extension, and lateral flexion movements of the vertebral column. The multiaxial ball and socket joints allow for flexion-extension, abduction-adduction, and circumduction. In addition, these also allow for medial (internal) and lateral (external) rotation. Ball-and-socket joints have the greatest range of motion of all synovial joints.

Interactive Link Questions

Dorsiflexion of the foot at the ankle decreases the angle of the ankle joint, while plantar flexion increases the angle of the ankle joint.

Review Questions

1. Briefly define the types of joint movements available at a ball-and-socket joint.

2. Discuss the joints involved and movements required for you to cross your arms together in front of your chest.

Answers for Critical Thinking Questions

• Ball-and-socket joints are multiaxial joints that allow for flexion and extension, abduction and adduction, circumduction, and medial and lateral rotation.
• To cross your arms, you need to use both your shoulder and elbow joints. At the shoulder, the arm would need to flex and medially rotate. At the elbow, the forearm would need to be flexed.

This work, Anatomy & Physiology, is adapted from Anatomy & Physiology by OpenStax , licensed under CC BY . This edition, with revised content and artwork, is licensed under CC BY-SA except where otherwise noted.

Images, from Anatomy & Physiology by OpenStax , are licensed under CC BY except where otherwise noted.

Access the original for free at https://openstax.org/books/anatomy-and-physiology/pages/1-introduction .

Anatomy & Physiology Copyright © 2019 by Lindsay M. Biga, Staci Bronson, Sierra Dawson, Amy Harwell, Robin Hopkins, Joel Kaufmann, Mike LeMaster, Philip Matern, Katie Morrison-Graham, Kristen Oja, Devon Quick, Jon Runyeon, OSU OERU, and OpenStax is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License , except where otherwise noted.

9.5 Types of Body Movements

Learning objectives.

By the end of this section, you will be able to:

• Define the different types of body movements
• Identify the joints that allow for these motions

Synovial joints allow the body a tremendous range of movements. Each movement at a synovial joint results from the contraction or relaxation of the muscles that are attached to the bones on either side of the articulation. The type of movement that can be produced at a synovial joint is determined by its structural type. While the ball-and-socket joint gives the greatest range of movement at an individual joint, in other regions of the body, several joints may work together to produce a particular movement. Overall, each type of synovial joint is necessary to provide the body with its great flexibility and mobility. There are many types of movement that can occur at synovial joints ( Table 9.1 ). Movement types are generally paired, with one being the opposite of the other. Body movements are always described in relation to the anatomical position of the body: upright stance, with upper limbs to the side of body and palms facing forward. Refer to Figure 9.12 as you go through this section.

Interactive Link

Watch this video to learn about anatomical motions. What motions involve increasing or decreasing the angle of the foot at the ankle?

Flexion and Extension

Flexion and extension are typically movements that take place within the sagittal plane and involve anterior or posterior movements of the neck, trunk, or limbs. For the vertebral column, flexion (anterior flexion) is an anterior (forward) bending of the neck or trunk, while extension involves a posterior-directed motion, such as straightening from a flexed position or bending backward. Lateral flexion of the vertebral column occurs in the coronal plane and is defined as the bending of the neck or trunk toward the right or left side. These movements of the vertebral column involve both the symphysis joint formed by each intervertebral disc, as well as the plane type of synovial joint formed between the inferior articular processes of one vertebra and the superior articular processes of the next lower vertebra.

In the limbs, flexion decreases the angle between the bones (bending of the joint), while extension increases the angle and straightens the joint. For the upper limb, all anterior-going motions are flexion and all posterior-going motions are extension. These include anterior-posterior movements of the arm at the shoulder, the forearm at the elbow, the hand at the wrist, and the fingers at the metacarpophalangeal and interphalangeal joints. For the thumb, extension moves the thumb away from the palm of the hand, within the same plane as the palm, while flexion brings the thumb back against the index finger or into the palm. These motions take place at the first carpometacarpal joint. In the lower limb, bringing the thigh forward and upward is flexion at the hip joint, while any posterior-going motion of the thigh is extension. Note that extension of the thigh beyond the anatomical (standing) position is greatly limited by the ligaments that support the hip joint. Knee flexion is the bending of the knee to bring the foot toward the posterior thigh, and extension is the straightening of the knee. Flexion and extension movements are seen at the hinge, condyloid, saddle, and ball-and-socket joints of the limbs (see Figure 9.12 a-d ).

Hyperextension is the abnormal or excessive extension of a joint beyond its normal range of motion, thus resulting in injury. Similarly, hyperflexion is excessive flexion at a joint. Hyperextension injuries are common at hinge joints such as the knee or elbow. In cases of “whiplash” in which the head is suddenly moved backward and then forward, a patient may experience both hyperextension and hyperflexion of the cervical region.

Abduction and Adduction

Abduction and adduction motions occur within the coronal plane and involve medial-lateral motions of the limbs, fingers, toes, or thumb. Abduction moves the limb laterally away from the midline of the body, while adduction is the opposing movement that brings the limb toward the body or across the midline. For example, abduction is raising the arm at the shoulder joint, moving it laterally away from the body, while adduction brings the arm down to the side of the body. Similarly, abduction and adduction at the wrist moves the hand away from or toward the midline of the body. Spreading the fingers or toes apart is also abduction, while bringing the fingers or toes together is adduction. For the thumb, abduction is the anterior movement that brings the thumb to a 90° perpendicular position, pointing straight out from the palm. Adduction moves the thumb back to the anatomical position, next to the index finger. Abduction and adduction movements are seen at condyloid, saddle, and ball-and-socket joints (see Figure 9.12 e ).

Circumduction

Circumduction is the movement of a body region in a circular manner, in which one end of the body region being moved stays relatively stationary while the other end describes a circle. It involves the sequential combination of flexion, adduction, extension, and abduction at a joint. This type of motion is found at biaxial condyloid and saddle joints, and at multiaxial ball-and-sockets joints (see Figure 9.12 e ).

Rotation can occur within the vertebral column, at a pivot joint, or at a ball-and-socket joint. Rotation of the neck or body is the twisting movement produced by the summation of the small rotational movements available between adjacent vertebrae. At a pivot joint, one bone rotates in relation to another bone. This is a uniaxial joint, and thus rotation is the only motion allowed at a pivot joint. For example, at the atlantoaxial joint, the first cervical (C1) vertebra (atlas) rotates around the dens, the upward projection from the second cervical (C2) vertebra (axis). This allows the head to rotate from side to side as when shaking the head “no.” The proximal radioulnar joint is a pivot joint formed by the head of the radius and its articulation with the ulna. This joint allows for the radius to rotate along its length during pronation and supination movements of the forearm.

Rotation can also occur at the ball-and-socket joints of the shoulder and hip. Here, the humerus and femur rotate around their long axis, which moves the anterior surface of the arm or thigh either toward or away from the midline of the body. Movement that brings the anterior surface of the limb toward the midline of the body is called medial (internal) rotation . Conversely, rotation of the limb so that the anterior surface moves away from the midline is lateral (external) rotation (see Figure 9.12 f ). Be sure to distinguish medial and lateral rotation, which can only occur at the multiaxial shoulder and hip joints, from circumduction, which can occur at either biaxial or multiaxial joints.

Supination and Pronation

Supination and pronation are movements of the forearm. In the anatomical position, the upper limb is held next to the body with the palm facing forward. This is the supinated position of the forearm. In this position, the radius and ulna are parallel to each other. When the palm of the hand faces backward, the forearm is in the pronated position , and the radius and ulna form an X-shape.

Supination and pronation are the movements of the forearm that go between these two positions. Pronation is the motion that moves the forearm from the supinated (anatomical) position to the pronated (palm backward) position. This motion is produced by rotation of the radius at the proximal radioulnar joint, accompanied by movement of the radius at the distal radioulnar joint. The proximal radioulnar joint is a pivot joint that allows for rotation of the head of the radius. Because of the slight curvature of the shaft of the radius, this rotation causes the distal end of the radius to cross over the distal ulna at the distal radioulnar joint. This crossing over brings the radius and ulna into an X-shape position. Supination is the opposite motion, in which rotation of the radius returns the bones to their parallel positions and moves the palm to the anterior facing (supinated) position. It helps to remember that supination is the motion you use when scooping up soup with a spoon (see Figure 9.13 g ).

Dorsiflexion and Plantar Flexion

Dorsiflexion and plantar flexion are movements at the ankle joint, which is a hinge joint. Lifting the front of the foot, so that the top of the foot moves toward the anterior leg is dorsiflexion, while lifting the heel of the foot from the ground or pointing the toes downward is plantar flexion. These are the only movements available at the ankle joint (see Figure 9.13 h ).

Inversion and Eversion

Inversion and eversion are complex movements that involve the multiple plane joints among the tarsal bones of the posterior foot (intertarsal joints) and thus are not motions that take place at the ankle joint. Inversion is the turning of the foot to angle the bottom of the foot toward the midline, while eversion turns the bottom of the foot away from the midline. The foot has a greater range of inversion than eversion motion. These are important motions that help to stabilize the foot when walking or running on an uneven surface and aid in the quick side-to-side changes in direction used during active sports such as basketball, racquetball, or soccer (see Figure 9.13 i ).

Protraction and Retraction

Protraction and retraction are anterior-posterior movements of the scapula or mandible. Protraction of the scapula occurs when the shoulder is moved forward, as when pushing against something or throwing a ball. Retraction is the opposite motion, with the scapula being pulled posteriorly and medially, toward the vertebral column. For the mandible, protraction occurs when the lower jaw is pushed forward, to stick out the chin, while retraction pulls the lower jaw backward. (See Figure 9.13 j .)

Depression and Elevation

Depression and elevation are downward and upward movements of the scapula or mandible. The upward movement of the scapula and shoulder is elevation, while a downward movement is depression. These movements are used to shrug your shoulders. Similarly, elevation of the mandible is the upward movement of the lower jaw used to close the mouth or bite on something, and depression is the downward movement that produces opening of the mouth (see Figure 9.13 k ).

Excursion is the side to side movement of the mandible. Lateral excursion moves the mandible away from the midline, toward either the right or left side. Medial excursion returns the mandible to its resting position at the midline.

Superior Rotation and Inferior Rotation

Superior and inferior rotation are movements of the scapula and are defined by the direction of movement of the glenoid cavity. These motions involve rotation of the scapula around a point inferior to the scapular spine and are produced by combinations of muscles acting on the scapula. During superior rotation , the glenoid cavity moves upward as the medial end of the scapular spine moves downward. This is a very important motion that contributes to upper limb abduction. Without superior rotation of the scapula, the greater tubercle of the humerus would hit the acromion of the scapula, thus preventing any abduction of the arm above shoulder height. Superior rotation of the scapula is thus required for full abduction of the upper limb. Superior rotation is also used without arm abduction when carrying a heavy load with your hand or on your shoulder. You can feel this rotation when you pick up a load, such as a heavy book bag and carry it on only one shoulder. To increase its weight-bearing support for the bag, the shoulder lifts as the scapula superiorly rotates. Inferior rotation occurs during limb adduction and involves the downward motion of the glenoid cavity with upward movement of the medial end of the scapular spine.

Opposition and Reposition

Opposition is the thumb movement that brings the tip of the thumb in contact with the tip of a finger. This movement is produced at the first carpometacarpal joint, which is a saddle joint formed between the trapezium carpal bone and the first metacarpal bone. Thumb opposition is produced by a combination of flexion and abduction of the thumb at this joint. Returning the thumb to its anatomical position next to the index finger is called reposition (see Figure 9.13 l ).

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Definition of excursion

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In Latin, the prefix ex- means "out of" and the verb currere means "to run." When the two are put together, they form the verb excurrere , literally "to run out" or "to extend." Excurrere gave rise not only to excursion but also to excurrent (an adjective for things having channels or currents that run outward) and excursus (meaning "an appendix or digression that contains further exposition of some point or topic"). Other words deriving from currere include corridor , curriculum , and among newer words, parkour .

Examples of excursion in a Sentence

These examples are programmatically compiled from various online sources to illustrate current usage of the word 'excursion.' Any opinions expressed in the examples do not represent those of Merriam-Webster or its editors. Send us feedback about these examples.

Word History

Latin excursion-, excursio , from excurrere

circa 1587, in the meaning defined at sense 1a

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Dictionary Entries Near excursion

excursional

Cite this Entry

“Excursion.” Merriam-Webster.com Dictionary , Merriam-Webster, https://www.merriam-webster.com/dictionary/excursion. Accessed 11 May. 2024.

Kids Definition

Kids definition of excursion.

from Latin excursio, excursion- "a going out," from excurrere "to run out, make an excursion, extend," from ex- "out, forth" and currere "to run" — related to current

Medical Definition

Medical definition of excursion, more from merriam-webster on excursion.

Nglish: Translation of excursion for Spanish Speakers

Britannica English: Translation of excursion for Arabic Speakers

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Functional Anatomy

2 Functional Anatomy Sharon R. Flinn and Lori DeMott Introduction Anatomy is the study of the physical structures within the human body. The skeleton provides the foundation for the body; muscles attach by way of bony origins and insertions. Knowledge of the nervous system provides us with a practical understanding of muscle action, tendon excursion, and joint motion. Therefore, the assessment of key postural markers throughout the upper extremity provides an understanding of proper skeletal alignment and balance in the neuromusculoskeletal system as well as a basis for comparing the normal default of body conformation to that of abnormal alignment. As hand therapy professionals, we rely on the functional anatomy of the upper extremity as the main determinant in grading the success of our client’s task performance. We can correlate abnormal postures to a client’s functional complaints. Fundamentally and simplistically, the observation and assessment of the body’s alignment is a measure of how the neuromusculoskeletal system is performing. The concept of balance and movement can provide a greater understanding of human anatomy and direct us to the contributions of soft tissue impairment. The important issue for us is that a postural assessment gives us the ability to evaluate the overall muscle balance and the response of the body as a whole to disease and trauma. During purposeful activity, a client thinks more about what they want to do and less about how they do it. Frequently, unguarded movements lead to stressing joints and overloading muscles without knowing the consequences of their effects on healing tissues. When symptoms and functional limitations appear, pain is the body’s response to injury. As the first line of defense, movement is altered unconsciously to reduce pain. Whether the complaints are global and diffuse or pinpoint and local, we cannot be fooled into narrowly interpreting the origin of their symptoms as the source of pathology to a specific body structure. Altered body movements and imbalances in resting neuro-muscular-skeletal alignment can cause mechanical pathology and can be the secondary complications that result in the client’s chief complaint that is it “hurts.” Due to a fixed time period allotted for our evaluation, it is imperative that we observe our client’s static body postures and movement patterns to understand the etiology of their physical impairment. Our efficiency and skill in evaluation is imperative to control health care dollars and, above all, to direct treatments to the best outcomes for each of our clients. During the initial interview of chief complaints and general medical history, you can simultaneously perform an assessment of posture. Observations can be done in static, resting positions while the client is sitting, standing, and lying down as well as during spontaneous, dynamic movements when the client first shakes your hand, takes off his/her coat, walks, sits down, or completes paperwork. These observations are the first quick functional anatomy screen of how the body is aligned, possible altered responses proximally and distally, and observations of the sites related to the client’s physical complaints. Resting and dynamic postural assessments assist us in developing a plan of care that provides a clear relationship between the desired improvements of the neuro-muscular-skeletal balances and functional tasks. Self-reports are obtained every visit on the client’s satisfaction and ease of performance in doing purposeful daily activities. For example, the ability to wash hair will improve more efficiently and safely when scapular muscle stabilizers are strengthened and able to support free movement at the glenohumeral joint. Balanced scapulo-thoracic rhythm occurs at the normal starting position of retracted, downward rotation. This allows normal gliding of the rotator cuff tendons without impingement at the acromioclavicular joint and reduces subsequent pain. A systematic approach to screening the functional anatomy of the core and distal joints of the body combines the knowledge of kinematic chains, tissue imbalances, and compensatory movements in the recovery of the upper extremity from disease and trauma. To enhance your clinical reasoning skills, this chapter will review anatomy and neurophysiology principles beyond the rote memorization of origins, insertions, nerves, and actions. Instead, the reader will be introduced to normal postural mechanics and the characteristics associated with healthy bones, joints, ligaments, muscles, tendons, and the neurovascular system of the upper extremity. Then, common clinical scenarios will illustrate abnormal deviations or faults in postural mechanics resulting from tissue imbalance and will provide suggestions for quick screens of the functional anatomy. An extensive review of anatomic features such as joint function, the lymphatic system, dermatome levels, sensory distributions, and pulleys for flexor tendons, are provided in other chapters of the book. Normal Postural Mechanics There are observable muscle behaviors that influence our posture and purposeful movements, also termed as our functional anatomy. Important distinctions should be made between anatomic characteristic of body positions, both at the initial static position of a kinematic event and then the return to our neuro-muscular-skeletal equilibrium of balance. 1 Static posture is the stationary position held against gravity, whereas dynamic posture refers to a series of positions that constantly change during movement and function. Both postures require equilibrium of the muscle system and are observed during relaxation, standing, sitting, or lying down. 1 The neutral resting balance of our anatomy is the state of default or the zero position of the body. 2 The zero position is different from the anatomical position of the body. It represents the normal resting balance position where the upper extremities align themselves in space against gravity and where movement ceases and loads are removed. In zero position, the upper extremities are positioned in the midrange of glenohumeral and forearm rotation, the wrist is positioned in approximately ten degrees of extension, and the finger joints are positioned in approximately 45 degrees of flexion. Abnormal changes in functional anatomy cannot be understood without knowledge of the normal resting balance position. Fig. 2-1 illustrates zero position. FIGURE 2-1 The zero position of the body from the sagittal and coronal planes. A, Anterior view. B, Posterior view. C, Lateral view. (Modified from Cameron MH, Monroe LG: Physical rehabilitation: evidence-based examination, evaluation, and intervention, St Louis, 2007, Saunders Elsevier.) The upper extremities return to this default resting position, or zero position, in most static body postures. It is an assumed position of joint alignment where the tone of muscle activity is minimal, where the origins and insertions are in a “resting” tone, and where the tension of the joint is in a relaxed, balanced position. Tone is defined as the continuous and passive-partial contraction of the muscle or the muscle’s resistance to passive stretch during the resting state. 3 Clinical Pearl If the starting position of the body differs from the zero position of balance, the altered anatomy will create a disrupted kinematic chain of movement that adds stress to areas, such as the acromioclavicular joint or to the muscles that originate on lateral epicondyles. Functional anatomy, defined by postural kinematic expressions, is fundamentally based on a predictable design. Skeletal conformation is observed and analyzed by envisioning the underlying bone positions. By knowing the preset configuration, or default design, you can visually construct the muscle anatomy and its contribution to posture. The gross structure, knowledge of fiber alignment, location, and the origins and insertions from your human anatomy references will assist you in understanding the natural tone and potential force of a specific muscle. The angles and lines that are produced as well as the conformation of our body are indications as to how synergistic muscles and peripheral nerves are performing. Typically, the points of reference are anatomical landmarks and are observed in two body planes. The coronal plane is vertical and divides the body into anterior and posterior halves. 2 From the coronal plane, we draw a linear line, or plumb line, that forms an axis of reference. From the lateral view of the client, the alignment of the ear, shoulder, lateral elbow, posterior hip, anterior knee, and lateral malleolus are body landmarks that are located close to, if not directly within, the axis of reference. From the axis, you can observe the flexion, extension, anterior, and posterior adaptations of the body. Similarly, the sagittal plane is vertical and divides the body into right and left right halves. 2 Postures viewed from all sides include obvious body markers, such as head position, shoulder height and glenoid orientation, clavicle angle, scapular position, antecubital fossa (carry angle), hand orientation, and hip height. Fig. 2-1 , A and B, illustrates the body in the sagittal plane and provides the anterior and posterior views of the body. Fig. 2-1 , C, illustrates the body in the coronal plane and provides a lateral view of the body with a clear view of the arm position. A functional anatomy screen is performed by envisioning the points at the joints, the anatomic landmarks, and the bone segments as they create altered angles in contrast to those described in the zero position. The differences in these angles or projections are used to hypothesize the influence of the associated muscle function. To understand postural forces of human anatomy and to utilize these concepts in practice, we need to apply the normal orientation of the ideal balance for the skeleton and muscles at rest and during movement throughout the entire kinematic chain. These “normal” default postures can then be compared to the patient who has compensatory adaptation and restrictions in his/her anatomical structures. Mapping is a technique of drawing using the design and angles of the body that create a picture of alignment. Positions of mapping are in movement planes. The body’s coronal and sagittal planes produce the lines of reference in static and dynamic body postures. The front and back views of the body allow the best view of symmetry. Landmarks are structures that identify a feature other than a joint. Examples of landmarks are the ear, forehead creases, palm and nail positions, the carry angle space, web spaces, and skin folds in the back and digital creases. Once the position of the joint articulation and landmarks are identified, the segments are drawn. The design is then analyzed using the expected functional anatomy as the reference point for identifying imbalances that can contribute to pain, weakness, and restrictions in movement. The use of the two anatomic planes, axes of reference, and mapping techniques serve as a functional anatomy screening tool that allows the hand therapy professional to compare the ideal postural alignment to that of the assumed posture of the client. The deviation from the ideal can range from slight to severe and will guide the evaluator in understanding the problems associated with joint and muscle functions. Next, a review of the anatomical systems will be discussed in further detail including the characteristics associated with bones, joints, ligaments, muscles, tendons, and the neurovascular systems of the upper extremity and their the contribution to normal postural mechanics. Bones, Ligaments, and Joints Bones are responsible for the rigidity and structure of the entire foundation. The joint anatomy is designed to allow transmission of muscle force, at rest and during motion. Understanding the joint structure contributes to the overall whole of functional anatomy and posture configuration. The bone-to-bone connection meets to create the joint. The bone segments within the joint move in relation to each other. The configuration of the bony surfaces dictates the degree of freedom of a joint and creates a type of movement hinge. The joint allows freedom of movement from one to three planes. Two bony segments move in relationship to each other. Usually one segment is stable while the other moves in relation to the base. At the joint there can be more than one articulation. For example, the glenohumeral joint has scapulo-humeral, sterno-humeral, and clavico-humeral articulations. 2 The control and stability of the joint’s axis of rotation directly relates to the articular orientation of the bones. Without rules of engagement for the joint, the simplest movement can become weakened by loss of mechanical advantage. This is seen in joint dislocation and a segmental bone fracture, whereby the movement is not guided and irregular angulations are observed. Conversely, if the segments of bone are not congruent and there is altered space that changes the axis of movement, the normal extrinsic muscle pull can be offset and the movement will present with distorted mechanics that are less than desired. Throughout the body, there are many axes of rotation. In the upper extremity there are flexion-extension, abduction-adduction, internal-external, radial-ulnar, and pronation-supination axes. The wrist has two, the elbow joint has one at the ulnohumeral joint axis, and the glenohumeral joint is a ball and socket joint with three axes of rotation. The relationships of joint axes have a normal presentation of balance that is predictable and can be assessed at rest and during movement. The normal skeletal system of the upper extremity can be mapped to determine the normal default state of zero position. An imaginary overlay of the skeleton on the conformation of the body creates the approximate location of the joints and bone segments. These structures assist you in recognizing important landmarks. An example of important landmarks from Fig. 2-1 is the space between the arm and body. Fig. 2-2 identifies the mapping specific to the hand. Important landmarks for the hand are nail positions, the space between the index and thumb, the cascading flexion of the fingers, the mass of the thenar eminence, and the prominence of the ulnar head. FIGURE 2-2 Mapping of the hand at rest in a pronated (A), supinated (B), and neutral forearm position. (From Donatelli RA: Orthopaedic physical therapy , ed 4, St Louis, 2010, Churchill Livingstone Elsevier.) Clinical Pearl An understanding of normal anatomy and the ideal positions of balance is essential to recognize the imbalances in your client’s neuromusculoskeletal anatomy. Altered configuration of the joint’s soft tissue matrix or bony constructs lead to the joint’s failure to glide and can result in various types of joint collapses and deformities. 3 With joint laxity, the axis shifts into the direction of the weakened, degraded tissue integrity. Frequently, this is seen with attritional changes of the glenohumeral joint where the anterior capsulo-ligaments are weakened and attenuated. A shift in the joint axis results in changes in the anterior and posterior capsule and in the formation of adhesions. Another example is seen with metacarpophalangeal (MP) joint subluxation and swan neck deformities in the hands of persons with rheumatoid arthritis. A common joint change is when the proximal phalanx segment shifts palmary toward the volar plate, descending and subluxing. What is observed at rest is the prominent head of the metacarpal. The forces from muscle contractions are transmitted through the altered axis and with changes in the moment arm of the tendon, the extensor becomes a flexor of the finger MP joint. The change in the axis of rotation alters not only the forces applied to the MP joint but also the kinematic chain of all joints that the muscle tendon unit controls. The shortening or lengthening of the long tendon, in conjunction with significant joint changes, presents with a zigzag of the fingers in proximal interphalangeal (PIP) hyperextension and distal interphalangeal (DIP) flexion joint postures. Similar attritional changes often are observed with joint dysfunction to the carpometacarpal (CMC) joint of the thumb. Synovitis of the joint causes bone surface erosions and ligament laxity. Laxity of the stabilizing deep anterior oblique ligament (DAOL), called the beak ligament, causes the joint to sublux in a radial and palmar direction. Over time, the degenerative thumb CMC joint exhibits changes in appearance as seen with a prominent ledge that extends from the radial side of the base of the thumb. The loss of joint stability changes the characteristic of the surrounding muscular anatomy. The abductor pollicis brevis weakens and the adductor pollicis muscle contracts, unopposed. The thumb CMC joint is drawn into adduction and rotational supination. The imbalance of the thumb intrinsics change the axis of rotation, decrease the transmission of flexion forces across the metacarpal joint, and move the resting position of the MP joint from a flexed posture to extension. Over time, the metacarpal joint hyperextends as the mechanical advantage from the extensor pollicis brevis (EPB) muscle further aggravates the adductor pull on the CMC joint and the increasing severity of the contracture. The interphalangeal (IP) joint compensates for loss of metacarpal joint flexion and overly flexes to produce a functional tip pinch. The cascading events are self-perpetuating as the normal joint forces become pathologic. The anatomy of the arthritic thumb presents with imbalances, principally at the CMC joint level, with bone erosions and capsular instability that contribute to the distal joint changes at rest and during dynamic loads. Fig. 2-3 illustrates mapping of a normal and pathological CMC joint. The dots estimate the joint location, the stars are the landmarks, and the dashes are the bone segments. The disparities between the two thumbs are clear. Compared to the normal thumb, imbalances in the pathological thumb are identified by three visible landmarks; increased nail rotation, MP joint hyperextension, and a protuberance at the CMC joint caused by the subluxing metacarpal. FIGURE 2-3 Mapping of a normal and pathological carpometacarpal (CMC) joint of the thumb. (Photo by Lori DeMott.) Clinical Pearl The kinematic chain of mobility is controlled and primarily influenced proximally. Mapping the skeletal alignment within the body conformation is a screening tool that you can utilize to assist with evaluation of the functional anatomy. The technique can be drawn on the client and, with practice, will be visualized as part of your observations during the functional anatomy screen. Muscles and Tendons Muscles work in groups and patterns of movement. Individual muscles have lengthening, contractile, excitable, and recoil characteristics. Contractility allows a muscle to shorten with force, to lengthen passively, and to move. Excitability allows a muscle to respond to a stimulus and to maintain chemical potentials across its cell membranes. Extensibility allows a muscle to be stretched, repeatedly and considerably, as needed, without being damaged. Elasticity allows a muscle to return to its normal length after being stretched or shortened. The end result is a force application. For example, a coordinated neuromuscular event occurs during the conscious decision to make a fist. The wrist extensors stabilize the wrist in approximately 35 degrees of extension, the extrinsic extensor digitorum communis (EDC) elongates into a full extensible position as the antagonist muscle, and simultaneously the extrinsic flexor digitorum profundus (FDP) and flexor digitorum superficialis (FDS) contract in their role as agonist muscles. The coordinated muscle contractions differentiate the glide that allows terminal distal joint flexion. Simultaneously, contraction of the intrinsic lumbrical and interossei muscles increase metacarpal joint flexion, stabilize and control the joint, and allow the digits to converge into a tucked position within the palm. The characteristics of the musculotendinous structures that contribute to muscle balance are located in Box 2-1 . 3 BOX 2-1     Musculotendinous Characteristics that Contribute to Balance 1.  The resting length of a muscle is the relationship and proportional stretch to the fully contracted muscle fiber. 2.  At rest and even during sleep, there is a tendency of the muscle to contract and resist lengthening. This principle is influenced by the central nervous system and the intrinsic muscle structure and by definition is our muscle tone. 3.  Ordinary normal range of motion at rest or during movement is influenced by the variability of length and pull of all of our contributing anatomy due to antagonist lengthening as well as synergistic coordination. 4.  Gravity and the need for skeletal stability will change the resting muscle tone and therefore change distal joint position. 5.  Length and cross-section of a muscle leads to predictable excursion and levels of muscle elasticity. 6.  A muscle crossing multiple joints will provide a composite excursion; a proximal joint stability is necessary for increased distal joint mobility. 7.  Passive joint mobility is without influence of soft tissue elastic characteristics. 8.  Muscle balance is involuntary, and over time the resting length can change or be changed by an altered axis. As the joint moves, these altered forces create imbalances and lead to deformity. Nervous System The peripheral, central, and autonomic nervous systems all combine to form one internal communication system for sensing and responding to internal and external stimuli. 4 The motor and sensory functions for the forearm, wrist, and hand are provided by the peripheral nervous system; consisting of the median, ulnar, and radial nerves. Each nerve has efferent motor and afferent sensory fibers arranged in bundles of axons. The axons are protected by layers of dense connective tissues called the epineurium, perineurium, and endoneurium. Each layer has a unique role to support the innermost structures of the nerve, modulate compressive and tensile forces, and allow gliding between nerve fascicles and the surrounding anatomical structures. 5 Electrical impulses are rapidly conducted via the nodes of Ranvier along a neural pathway, which originates at the spinal cord and brainstem and terminates in the fingers and toes. Due to the continuous nature and physiology of the peripheral nervous system, motions at a distal site, such as the wrist joint, increase the strain at the cord level of the brachial plexus. Similarly, contralateral flexion of the cervical spine increases the strain in the cords of the brachial plexus and three major nerves in the arm. 4 Under tension, the neural tissue may have difficulty conducting electrical impulses, assuring adequate blood supply, and providing adequate axonal transport especially during movement. 5 Several biomechanical properties are necessary to protect the nerve from tensile, shear, and compressive forces that occur across multiple joints in various postures and dynamic movements of the upper extremity during everyday activities. 5 The properties of the nerve protect it from the forces generated from whole body movements resulting from everyday activities. These protections are due to the nerve’s capacity to change its length during movement, slide or glide relative to the surrounding interfacing tissue during movement, and tolerate increases in pressure or compression from the surrounding interfacing tissue. 5 When the nerve does not tolerate normal stresses, a “sensitized” protective state may result as the upper extremity joints usually adjust by flexion or extension to limit the nerve excursion. Symptoms can include increased pain or aberrant movements in the absence of altered nerve conduction. 4 , 5 Observations of static and dynamic postures are essential to evaluate the neurodynamics of the peripheral nervous system in its entirety and the changes which can result from limited excursion or traumatized segment(s) of the nerve. 4 As simply observed in an acute nerve injury, the upper arm is held tightly in shoulder adduction, internal rotation, and elbow flexion. In the presence of long-standing trauma to the nerve, imbalances in motor function can be observed. For example, hyperextension of the thumb MP joint during resistive lateral pinch can be observed in persons with ulnar nerve palsy. A zigzag deformity is observed as a result of absent function of the adductor pollicis muscle and imbalances created from a weakened intrinsic extensor mechanism and overpowering extrinsic long flexor. A neuromusculoskeletal screen of the upper extremity is critical to understanding the changes that impact functional anatomy. Several observations of normal postures can be made. At rest, clients with neural tension postures will limit movement that places the nerve in full excursion. The elbow joint has a high degree of contribution to nerve glide. In resting postures the elbow will flex, and the head will laterally tilt to the affected side. During movement, the head may increase the degree of tilt or the elbow joint increase its flexed position to offset the increased demand at adjacent joints. Now that you have a better understanding of normal postural mechanics and the neuromusculoskeletal systems, common clinical scenarios are provided to illustrate abnormal deviations, or defaults, in the postural mechanics that result from tissue imbalances. Quick screens will also be provided in each scenario to assist you in applying the principles of balance. Scenario 1 How does proper cervical alignment facilitate normal functioning of blood vessels and nerve roots? Proper cervical alignment is necessary for sound neurological and vascular function in the shoulder, arm, and hand. The normal relationships of bone, ligaments, disks, vasculature, and nerves provide the cervical spine with valuable mobility that other segments of the spinal column do not possess. The cervical spine supports motions of the head which consist of rotation from side-to-side, flexion and extension, lateral flexion to each side, and all the motions in between. While the locations of the structures are designed to provide increased mobility at the cervical level, they are also vulnerable to injuries as a result of these anatomical relationships. Proper cervical alignment of vertebrae, muscle, and soft tissue facilitates normal conduction and excursion of nervous tissue in nerves C1 to C8. In addition, alignment of these structures also provides for normal blood flow within the vertebral artery and the vertebral and deep cervical veins, insuring adequate blood flow and drainage for the cervical structures related to upper extremity function. Fig. 2-4 illustrates the anterior rami of nerves C5 to T1, which form the brachial plexus and innervate the entire upper extremity. FIGURE 2-4 Diagram of the brachial plexus. (From Neuman D: Kinesiology of the musculoskeletal system: foundations for rehabilitation, ed 2, St Louis, 2010, Mosby.)

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• Anatomical Position
• Body Planes
• Terms of Movement
• Terms of Location
• Embryology Terms
• Classification
• Synovial Joint
• Joint Stability
• Skeletal Muscle
• Blood Vessels
• Head and Neck
• Cardiovascular System
• Respiratory System
• Urinary System
• Reproductive System
• Central Nervous System
• Cranial Fossae
• Pterygopalatine Fossa
• Infratemporal Fossa
• Mastoid Fossa
• Frontal Bone
• Sphenoid Bone
• Ethmoid Bone
• Temporal Bone
• Occipital Bone
• Nasal Skeleton
• Cranial Foramina
• Facial Expression
• Extraocular
• Mastication
• Sympathetic Innervation
• Parasympathetic Innervation
• Ophthalmic Nerve
• Maxillary Nerve
• Mandibular Nerve
• Nose and Sinuses
• Salivary Glands
• Oral Cavity
• Arterial Supply
• Venous Drainage
• Lacrimal Gland
• Basal Ganglia
• Pineal Gland
• Pituitary Gland
• Spinal Cord (Grey Matter)
• Medulla Oblongata
• Ascending Tracts
• Descending Tracts
• Visual Pathway
• Auditory Pathway
• Olfactory Nerve (CN I)
• Optic Nerve (CN II)
• Oculomotor Nerve (CN III)
• Trochlear Nerve (CN IV)
• Trigeminal Nerve (CN V)
• Abducens Nerve (CN VI)
• Facial Nerve (CN VII)
• Vestibulocochlear Nerve (CN VIII)
• Glossopharyngeal Nerve (CN IX)
• Vagus Nerve (CN X)
• Accessory Nerve (CN XI)
• Hypoglossal Nerve (CN XII)
• Dural Venous Sinuses
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Anatomical Terms of Movement

Original Author(s): Oliver Jones Last updated: May 30, 2020 Revisions: 27

• 1 Flexion and Extension
• 2 Abduction and Adduction
• 3 Medial and Lateral Rotation
• 4 Elevation and Depression
• 5 Pronation and Supination
• 6 Dorsiflexion and Plantarflexion
• 7 Inversion and Eversion
• 8 Opposition and Reposition
• 9 Circumduction
• 10 Protraction and Retraction

Anatomical terms of movement are used to describe the actions of muscles upon the skeleton. Muscles contract to produce movement at joints, and the subsequent movements can be precisely described using this terminology.

The terms used assume that the body begins in the anatomical position . Most movements have an opposite movement – also known as an antagonistic movement. We have described the terms in antagonistic pairs for ease of understanding.

Flexion and Extension

Flexion and extension are movements that occur in the sagittal plane. They refer to increasing and decreasing the angle between two body parts:

Flexion refers to a movement that decreases the angle between two body parts. Flexion at the elbow is decreasing the angle between the ulna and the humerus. When the knee flexes, the ankle moves closer to the buttock, and the angle between the femur and tibia gets smaller.

Extension refers to a movement that increases the angle between two body parts. Extension at the elbow is increasing the angle between the ulna and the humerus. Extension of the knee straightens the lower limb.

Fig 1 – Flexion and extension.

Abduction and Adduction

Abduction and adduction are two terms that are used to describe movements towards or away from the midline of the body.

Abduction is a movement away from the midline – just as abducting someone is to take them away. For example, abduction of the shoulder raises the arms out to the sides of the body.

Adduction is a movement towards the midline. Adduction of the hip squeezes the legs together.

In fingers and toes, the midline used is not the midline of the body, but of the hand and foot respectively. Therefore, abducting the fingers spreads them out.

Medial and Lateral Rotation

Medial and lateral rotation describe movement of the limbs around their long axis:

Medial rotation is a rotational movement towards the midline. It is sometimes referred to as internal rotation. To understand this, we have two scenarios to imagine. Firstly, with a straight leg, rotate it to point the toes inward. This is medial rotation of the hip. Secondly, imagine you are carrying a tea tray in front of you, with elbow at 90 degrees. Now rotate the arm, bringing your hand towards your opposite hip (elbow still at 90 degrees). This is internal rotation of the shoulder.

Lateral rotation is a rotating movement away from the midline. This is in the opposite direction to the movements described above.

Fig 2 – Adduction, abduction and rotation.

Elevation and Depression

Elevation refers to movement in a superior direction (e.g. shoulder shrug), depression refers to movement in an inferior direction.

Pronation and Supination

This is easily confused with medial and lateral rotation, but the difference is subtle. With your hand resting on a table in front of you, and keeping your shoulder and elbow still, turn your hand onto its back, palm up. This is the supine position, and so this movement is supination .

Again, keeping the elbow and shoulder still, flip your hand onto its front, palm down. This is the prone position, and so this movement is named pronation .

These terms also apply to the whole body – when lying flat on the back, the body is supine. When lying flat on the front, the body is prone.

Dorsiflexion and Plantarflexion

Dorsiflexion and plantarflexion are terms used to describe movements at the ankle. They refer to the two surfaces of the foot; the dorsum (superior surface) and the plantar surface (the sole).

Dorsiflexion refers to flexion at the ankle, so that the foot points more superiorly. Dorsiflexion of the hand is a confusing term, and so is rarely used. The dorsum of the hand is the posterior surface, and so movement in that direction is extension . Therefore we can say that dorsiflexion of the wrist is the same as extension.

Plantarflexion refers extension at the ankle, so that the foot points inferiorly. Similarly there is a term for the hand, which is palmarflexion.

Fig 3 – Dorsiflexion and plantar flexion

Inversion and Eversion

Inversion  and  eversion are movements which occur at the ankle joint, referring to the rotation of the foot around its long axis.

Inversion involves the movement of the sole towards the median plane – so that the sole faces in a medial direction.

Eversion involves the movement of the sole away from the median plane – so that the sole faces in a lateral direction.

Opposition and Reposition

A pair of movements that are limited to humans and some great apes, these terms apply to the additional movements that the hand and thumb can perform in these species.

Opposition brings the thumb and little finger together.

Reposition is a movement that moves the thumb and the little finger away from each other, effectively reversing opposition.

Circumduction

Circumduction can be defined as a conical movement of a limb extending from the joint at which the movement is controlled.

It is sometimes talked about as a circular motion, but is more accurately conical due to the ‘cone’ formed by the moving limb.

Protraction and Retraction

Protraction describes the anterolateral movement of the scapula on the thoracic wall that allows the shoulder to move anteriorly. In practice, this is the movement of ‘reaching out’ to something.

Retraction  refers to the posteromedial movement of the scapula on the thoracic wall, which causes the shoulder region to move posteriorly i.e. picking something up.

The terms used assume that the body begins in the anatomical position . Most movements have an opposite movement - also known as an antagonistic movement. We have described the terms in antagonistic pairs for ease of understanding.

Abduction is a movement away from the midline - just as abducting someone is to take them away. For example, abduction of the shoulder raises the arms out to the sides of the body.

These terms also apply to the whole body - when lying flat on the back, the body is supine. When lying flat on the front, the body is prone.

Inversion involves the movement of the sole towards the median plane - so that the sole faces in a medial direction.

Eversion involves the movement of the sole away from the median plane - so that the sole faces in a lateral direction.

It is sometimes talked about as a circular motion, but is more accurately conical due to the 'cone' formed by the moving limb.

Protraction describes the anterolateral movement of the scapula on the thoracic wall that allows the shoulder to move anteriorly. In practice, this is the movement of 'reaching out' to something.

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Module 10: Joints

Types of body movements, learning objectives.

• Define the different types of body movements
• Identify the joints that allow for these motions

Synovial joints allow the body a tremendous range of movements. Each movement at a synovial joint results from the contraction or relaxation of the muscles that are attached to the bones on either side of the articulation. The type of movement that can be produced at a synovial joint is determined by its structural type. While the ball-and-socket joint gives the greatest range of movement at an individual joint, in other regions of the body, several joints may work together to produce a particular movement. Overall, each type of synovial joint is necessary to provide the body with its great flexibility and mobility. There are many types of movement that can occur at synovial joints (Table 1). Movement types are generally paired, with one being the opposite of the other. Body movements are always described in relation to the anatomical position of the body: upright stance, with upper limbs to the side of body and palms facing forward.

Watch this video to learn about anatomical motions. What motions involve increasing or decreasing the angle of the foot at the ankle?

Flexion and Extension

Flexion  and  extension  are movements that take place within the sagittal plane and involve anterior or posterior movements of the body or limbs. For the vertebral column, flexion (anterior flexion) is an anterior (forward) bending of the neck or body, while extension involves a posterior-directed motion, such as straightening from a flexed position or bending backward.  Lateral flexion  is the bending of the neck or body toward the right or left side. These movements of the vertebral column involve both the symphysis joint formed by each intervertebral disc, as well as the plane type of synovial joint formed between the inferior articular processes of one vertebra and the superior articular processes of the next lower vertebra.

In the limbs, flexion decreases the angle between the bones (bending of the joint), while extension increases the angle and straightens the joint. For the upper limb, all anterior-going motions are flexion and all posterior-going motions are extension. These include anterior-posterior movements of the arm at the shoulder, the forearm at the elbow, the hand at the wrist, and the fingers at the metacarpophalangeal and interphalangeal joints. For the thumb, extension moves the thumb away from the palm of the hand, within the same plane as the palm, while flexion brings the thumb back against the index finger or into the palm. These motions take place at the first carpometacarpal joint. In the lower limb, bringing the thigh forward and upward is flexion at the hip joint, while any posterior-going motion of the thigh is extension. Note that extension of the thigh beyond the anatomical (standing) position is greatly limited by the ligaments that support the hip joint. Knee flexion is the bending of the knee to bring the foot toward the posterior thigh, and extension is the straightening of the knee. Flexion and extension movements are seen at the hinge, condyloid, saddle, and ball-and-socket joints of the limbs (see Figure 1).

Figure 1. Flexion and extension. (a)–(b) Flexion and extension motions are in the sagittal (anterior–posterior) plane of motion. These movements take place at the shoulder, hip, elbow, knee, wrist, metacarpophalangeal, metatarsophalangeal, and interphalangeal joints. (c)–(d) Anterior bending of the head or vertebral column is flexion, while any posterior-going movement is extension.

Hyperextension  is the abnormal or excessive extension of a joint beyond its normal range of motion, thus resulting in injury. Similarly,  hyperflexion  is excessive flexion at a joint. Hyperextension injuries are common at hinge joints such as the knee or elbow. In cases of “whiplash” in which the head is suddenly moved backward and then forward, a patient may experience both hyperextension and hyperflexion of the cervical region.

Abduction, Adduction,  and Circumduction

Figure 2. Abduction, adduction, and circumduction.

Abduction and adduction are motions of the limbs, hand, fingers, or toes in the coronal (medial–lateral) plane of movement. Moving the limb or hand laterally away from the body, or spreading the fingers or toes, is abduction. Adduction brings the limb or hand toward or across the midline of the body, or brings the fingers or toes together. Circumduction is the movement of the limb, hand, or fingers in a circular pattern, using the sequential combination of flexion, adduction, extension, and abduction motions.

Adduction, abduction, and circumduction take place at the shoulder, hip, wrist, metacarpophalangeal, and metatarsophalangeal joints.

Abduction and Adduction

Abduction  and  adduction  motions occur within the coronal plane and involve medial-lateral motions of the limbs, fingers, toes, or thumb. Abduction moves the limb laterally away from the midline of the body, while adduction is the opposing movement that brings the limb toward the body or across the midline. For example, abduction is raising the arm at the shoulder joint, moving it laterally away from the body, while adduction brings the arm down to the side of the body. Similarly, abduction and adduction at the wrist moves the hand away from or toward the midline of the body. Spreading the fingers or toes apart is also abduction, while bringing the fingers or toes together is adduction. For the thumb, abduction is the anterior movement that brings the thumb to a 90° perpendicular position, pointing straight out from the palm. Adduction moves the thumb back to the anatomical position, next to the index finger. Abduction and adduction movements are seen at condyloid, saddle, and ball-and-socket joints (see Figure 2).

Circumduction

Circumduction  is the movement of a body region in a circular manner, in which one end of the body region being moved stays relatively stationary while the other end describes a circle. It involves the sequential combination of flexion, adduction, extension, and abduction at a joint. This type of motion is found at biaxial condyloid and saddle joints, and at multiaxial ball-and-sockets joints (see Figure 2).

Figure 3. Rotation.

Rotation  can occur within the vertebral column, at a pivot joint, or at a ball-and-socket joint. Rotation of the neck or body is the twisting movement produced by the summation of the small rotational movements available between adjacent vertebrae. At a pivot joint, one bone rotates in relation to another bone. This is a uniaxial joint, and thus rotation is the only motion allowed at a pivot joint. For example, at the atlantoaxial joint, the first cervical (C1) vertebra (atlas) rotates around the dens, the upward projection from the second cervical (C2) vertebra (axis). This allows the head to rotate from side to side as when shaking the head “no.” The proximal radioulnar joint is a pivot joint formed by the head of the radius and its articulation with the ulna. This joint allows for the radius to rotate along its length during pronation and supination movements of the forearm.

Rotation can also occur at the ball-and-socket joints of the shoulder and hip. Here, the humerus and femur rotate around their long axis, which moves the anterior surface of the arm or thigh either toward or away from the midline of the body. Movement that brings the anterior surface of the limb toward the midline of the body is called  medial (internal) rotation . Conversely, rotation of the limb so that the anterior surface moves away from the midline is  lateral (external) rotation  (see Figure 3). Be sure to distinguish medial and lateral rotation, which can only occur at the multiaxial shoulder and hip joints, from circumduction, which can occur at either biaxial or multiaxial joints.

Turning of the head side to side or twisting of the body is rotation. Medial and lateral rotation of the upper limb at the shoulder or lower limb at the hip involves turning the anterior surface of the limb toward the midline of the body (medial or internal rotation) or away from the midline (lateral or external rotation).

Supination and Pronation

Supination and pronation are movements of the forearm. In the anatomical position, the upper limb is held next to the body with the palm facing forward. This is the  supinated position  of the forearm. In this position, the radius and ulna are parallel to each other. When the palm of the hand faces backward, the forearm is in the  pronated position , and the radius and ulna form an X-shape.

Supination and pronation are the movements of the forearm that go between these two positions.  Pronation  is the motion that moves the forearm from the supinated (anatomical) position to the pronated (palm backward) position. This motion is produced by rotation of the radius at the proximal radioulnar joint, accompanied by movement of the radius at the distal radioulnar joint. The proximal radioulnar joint is a pivot joint that allows for rotation of the head of the radius. Because of the slight curvature of the shaft of the radius, this rotation causes the distal end of the radius to cross over the distal ulna at the distal radioulnar joint. This crossing over brings the radius and ulna into an X-shape position.  Supination  is the opposite motion, in which rotation of the radius returns the bones to their parallel positions and moves the palm to the anterior facing (supinated) position. It helps to remember that supination is the motion you use when scooping up soup with a spoon (see Figure 4).

Dorsiflexion and Plantar Flexion

Dorsiflexion  and  plantar flexion  are movements at the ankle joint, which is a hinge joint. Lifting the front of the foot, so that the top of the foot moves toward the anterior leg is dorsiflexion, while lifting the heel of the foot from the ground or pointing the toes downward is plantar flexion. These are the only movements available at the ankle joint (see Figure 4).

Figure 4. Supination and pronation. (a) Supination of the forearm turns the hand to the palm forward position in which the radius and ulna are parallel, while forearm pronation turns the hand to the palm backward position in which the radius crosses over the ulna to form an “X.” (b) Dorsiflexion of the foot at the ankle joint moves the top of the foot toward the leg, while plantar flexion lifts the heel and points the toes.

Inversion and Eversion

Inversion and eversion are complex movements that involve the multiple plane joints among the tarsal bones of the posterior foot (intertarsal joints) and thus are not motions that take place at the ankle joint.  Inversion  is the turning of the foot to angle the bottom of the foot toward the midline, while  eversion  turns the bottom of the foot away from the midline. The foot has a greater range of inversion than eversion motion. These are important motions that help to stabilize the foot when walking or running on an uneven surface and aid in the quick side-to-side changes in direction used during active sports such as basketball, racquetball, or soccer (see Figure 5).

Protraction and Retraction

Protraction  and  retraction  are anterior-posterior movements of the scapula or mandible. Protraction of the scapula occurs when the shoulder is moved forward, as when pushing against something or throwing a ball. Retraction is the opposite motion, with the scapula being pulled posteriorly and medially, toward the vertebral column. For the mandible, protraction occurs when the lower jaw is pushed forward, to stick out the chin, while retraction pulls the lower jaw backward. (See Figure 5.)

Figure 5. Inversion, eversion, protraction, and retraction. (a) Eversion of the foot moves the bottom (sole) of the foot away from the midline of the body, while foot inversion faces the sole toward the midline. (b) Protraction of the mandible pushes the chin forward, and retraction pulls the chin back.

Depression and Elevation

Depression  and  elevation  are downward and upward movements of the scapula or mandible. The upward movement of the scapula and shoulder is elevation, while a downward movement is depression. These movements are used to shrug your shoulders. Similarly, elevation of the mandible is the upward movement of the lower jaw used to close the mouth or bite on something, and depression is the downward movement that produces opening of the mouth (see Figure 6).

Figure 6. Depression, elevation, and opposition. (a) Depression of the mandible opens the mouth, while elevation closes it. (b) Opposition of the thumb brings the tip of the thumb into contact with the tip of the fingers of the same hand and reposition brings the thumb back next to the index finger.

Excursion is the side to side movement of the mandible.  Lateral excursion  moves the mandible away from the midline, toward either the right or left side.  Medial excursion  returns the mandible to its resting position at the midline.

Superior Rotation and Inferior Rotation

Superior and inferior rotation are movements of the scapula and are defined by the direction of movement of the glenoid cavity. These motions involve rotation of the scapula around a point inferior to the scapular spine and are produced by combinations of muscles acting on the scapula. During  superior rotation , the glenoid cavity moves upward as the medial end of the scapular spine moves downward. This is a very important motion that contributes to upper limb abduction. Without superior rotation of the scapula, the greater tubercle of the humerus would hit the acromion of the scapula, thus preventing any abduction of the arm above shoulder height. Superior rotation of the scapula is thus required for full abduction of the upper limb. Superior rotation is also used without arm abduction when carrying a heavy load with your hand or on your shoulder. You can feel this rotation when you pick up a load, such as a heavy book bag and carry it on only one shoulder. To increase its weight-bearing support for the bag, the shoulder lifts as the scapula superiorly rotates.  Inferior rotation  occurs during limb adduction and involves the downward motion of the glenoid cavity with upward movement of the medial end of the scapular spine.

Opposition and Reposition

Opposition  is the thumb movement that brings the tip of the thumb in contact with the tip of a finger. This movement is produced at the first carpometacarpal joint, which is a saddle joint formed between the trapezium carpal bone and the first metacarpal bone. Thumb opposition is produced by a combination of flexion and abduction of the thumb at this joint. Returning the thumb to its anatomical position next to the index finger is called  reposition  (see Figure 6).

• Chapter 9. Authored by : OpenStax College. Provided by : Rice University. Located at : http://cnx.org/contents/[email protected]@7.1. . Project : Anatomy & Physiology. License : CC BY: Attribution . License Terms : Download for free at http://cnx.org/content/col11496/latest/

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• Dynamic occlusion: lateral excursion

The dynamic occlusion is the contact that teeth make during movements of the mandible - when the jaw moves side to side, forward, backward or at an angle. In dynamic occlusion, the contacts of the teeth are not points as in static occlusion, but they are described with lines. 

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9.5: Types of Body Movements

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Learning Objectives

• Define the different types of body movements
• Identify the joints that allow for these motions

Synovial joints allow the body a tremendous range of movements. Each movement at a synovial joint results from the contraction or relaxation of the muscles that are attached to the bones on either side of the articulation. The type of movement that can be produced at a synovial joint is determined by its structural type. While the ball-and-socket joint gives the greatest range of movement at an individual joint, in other regions of the body, several joints may work together to produce a particular movement. Overall, each type of synovial joint is necessary to provide the body with its great flexibility and mobility. There are many types of movement that can occur at synovial joints (Table). Movement types are generally paired, with one being the opposite of the other. Body movements are always described in relation to the anatomical position of the body: upright stance, with upper limbs to the side of body and palms facing forward. Refer to Figure \(\PageIndex{1}\) as you go through this section.

Watch this video to learn about anatomical motions. What motions involve increasing or decreasing the angle of the foot at the ankle?

Figure \(\PageIndex{1}\): Movements of the Body, Part 1. Synovial joints give the body many ways in which to move. (a)–(b) Flexion and extension motions are in the sagittal (anterior–posterior) plane of motion. These movements take place at the shoulder, hip, elbow, knee, wrist, metacarpophalangeal, metatarsophalangeal, and interphalangeal joints. (c)–(d) Anterior bending of the head or vertebral column is flexion, while any posterior-going movement is extension. (e) Abduction and adduction are motions of the limbs, hand, fingers, or toes in the coronal (medial–lateral) plane of movement. Moving the limb or hand laterally away from the body, or spreading the fingers or toes, is abduction. Adduction brings the limb or hand toward or across the midline of the body, or brings the fingers or toes together. Circumduction is the movement of the limb, hand, or fingers in a circular pattern, using the sequential combination of flexion, adduction, extension, and abduction motions. Adduction/abduction and circumduction take place at the shoulder, hip, wrist, metacarpophalangeal, and metatarsophalangeal joints. (f) Turning of the head side to side or twisting of the body is rotation. Medial and lateral rotation of the upper limb at the shoulder or lower limb at the hip involves turning the anterior surface of the limb toward the midline of the body (medial or internal rotation) or away from the midline (lateral or external rotation).

Figure \(\PageIndex{2}\): Movements of the Body, Part 2. (g) Supination of the forearm turns the hand to the palm forward position in which the radius and ulna are parallel, while forearm pronation turns the hand to the palm backward position in which the radius crosses over the ulna to form an "X." (h) Dorsiflexion of the foot at the ankle joint moves the top of the foot toward the leg, while plantar flexion lifts the heel and points the toes. (i) Eversion of the foot moves the bottom (sole) of the foot away from the midline of the body, while foot inversion faces the sole toward the midline. (j) Protraction of the mandible pushes the chin forward, and retraction pulls the chin back. (k) Depression of the mandible opens the mouth, while elevation closes it. (l) Opposition of the thumb brings the tip of the thumb into contact with the tip of the fingers of the same hand and reposition brings the thumb back next to the index finger.

Flexion and Extension

Flexion and extension are movements that take place within the sagittal plane and involve anterior or posterior movements of the body or limbs. For the vertebral column, flexion (anterior flexion) is an anterior (forward) bending of the neck or body, while extension involves a posterior-directed motion, such as straightening from a flexed position or bending backward. Lateral flexion is the bending of the neck or body toward the right or left side. These movements of the vertebral column involve both the symphysis joint formed by each intervertebral disc, as well as the plane type of synovial joint formed between the inferior articular processes of one vertebra and the superior articular processes of the next lower vertebra.

In the limbs, flexion decreases the angle between the bones (bending of the joint), while extension increases the angle and straightens the joint. For the upper limb, all anterior-going motions are flexion and all posterior-going motions are extension. These include anterior-posterior movements of the arm at the shoulder, the forearm at the elbow, the hand at the wrist, and the fingers at the metacarpophalangeal and interphalangeal joints. For the thumb, extension moves the thumb away from the palm of the hand, within the same plane as the palm, while flexion brings the thumb back against the index finger or into the palm. These motions take place at the first carpometacarpal joint. In the lower limb, bringing the thigh forward and upward is flexion at the hip joint, while any posterior-going motion of the thigh is extension. Note that extension of the thigh beyond the anatomical (standing) position is greatly limited by the ligaments that support the hip joint. Knee flexion is the bending of the knee to bring the foot toward the posterior thigh, and extension is the straightening of the knee. Flexion and extension movements are seen at the hinge, condyloid, saddle, and ball-and-socket joints of the limbs (see Figure \(\PageIndex{1}\).a-d).

Hyperextension is the abnormal or excessive extension of a joint beyond its normal range of motion, thus resulting in injury. Similarly, hyperflexion is excessive flexion at a joint. Hyperextension injuries are common at hinge joints such as the knee or elbow. In cases of “whiplash” in which the head is suddenly moved backward and then forward, a patient may experience both hyperextension and hyperflexion of the cervical region.

Abduction and Adduction

Abduction and adduction motions occur within the coronal plane and involve medial-lateral motions of the limbs, fingers, toes, or thumb. Abduction moves the limb laterally away from the midline of the body, while adduction is the opposing movement that brings the limb toward the body or across the midline. For example, abduction is raising the arm at the shoulder joint, moving it laterally away from the body, while adduction brings the arm down to the side of the body. Similarly, abduction and adduction at the wrist moves the hand away from or toward the midline of the body. Spreading the fingers or toes apart is also abduction, while bringing the fingers or toes together is adduction. For the thumb, abduction is the anterior movement that brings the thumb to a 90° perpendicular position, pointing straight out from the palm. Adduction moves the thumb back to the anatomical position, next to the index finger. Abduction and adduction movements are seen at condyloid, saddle, and ball-and-socket joints (see Figure9.5.1.e).

Circumduction

Circumduction is the movement of a body region in a circular manner, in which one end of the body region being moved stays relatively stationary while the other end describes a circle. It involves the sequential combination of flexion, adduction, extension, and abduction at a joint. This type of motion is found at biaxial condyloid and saddle joints, and at multiaxial ball-and-sockets joints (see Figure9.5.1.e).

Rotation can occur within the vertebral column, at a pivot joint, or at a ball-and-socket joint. Rotation of the neck or body is the twisting movement produced by the summation of the small rotational movements available between adjacent vertebrae. At a pivot joint, one bone rotates in relation to another bone. This is a uniaxial joint, and thus rotation is the only motion allowed at a pivot joint. For example, at the atlantoaxial joint, the first cervical (C1) vertebra (atlas) rotates around the dens, the upward projection from the second cervical (C2) vertebra (axis). This allows the head to rotate from side to side as when shaking the head “no.” The proximal radioulnar joint is a pivot joint formed by the head of the radius and its articulation with the ulna. This joint allows for the radius to rotate along its length during pronation and supination movements of the forearm.

Rotation can also occur at the ball-and-socket joints of the shoulder and hip. Here, the humerus and femur rotate around their long axis, which moves the anterior surface of the arm or thigh either toward or away from the midline of the body. Movement that brings the anterior surface of the limb toward the midline of the body is called medial (internal) rotation . Conversely, rotation of the limb so that the anterior surface moves away from the midline is lateral (external) rotation (see Figure9.5.1.f). Be sure to distinguish medial and lateral rotation, which can only occur at the multiaxial shoulder and hip joints, from circumduction, which can occur at either biaxial or multiaxial joints.

Supination and Pronation

Supination and pronation are movements of the forearm. In the anatomical position, the upper limb is held next to the body with the palm facing forward. This is the supinated position of the forearm. In this position, the radius and ulna are parallel to each other. When the palm of the hand faces backward, the forearm is in the pronated position , and the radius and ulna form an X-shape.

Supination and pronation are the movements of the forearm that go between these two positions. Pronation is the motion that moves the forearm from the supinated (anatomical) position to the pronated (palm backward) position. This motion is produced by rotation of the radius at the proximal radioulnar joint, accompanied by movement of the radius at the distal radioulnar joint. The proximal radioulnar joint is a pivot joint that allows for rotation of the head of the radius. Because of the slight curvature of the shaft of the radius, this rotation causes the distal end of the radius to cross over the distal ulna at the distal radioulnar joint. This crossing over brings the radius and ulna into an X-shape position. Supination is the opposite motion, in which rotation of the radius returns the bones to their parallel positions and moves the palm to the anterior facing (supinated) position. It helps to remember that supination is the motion you use when scooping up soup with a spoon (see Figure \(\PageIndex{2}\).g).

Dorsiflexion and Plantar Flexion

Dorsiflexion and plantar flexion are movements at the ankle joint, which is a hinge joint. Lifting the front of the foot, so that the top of the foot moves toward the anterior leg is dorsiflexion, while lifting the heel of the foot from the ground or pointing the toes downward is plantar flexion. These are the only movements available at the ankle joint (see Figure \(\PageIndex{2}\).h).

Inversion and Eversion

Inversion and eversion are complex movements that involve the multiple plane joints among the tarsal bones of the posterior foot (intertarsal joints) and thus are not motions that take place at the ankle joint. Inversion is the turning of the foot to angle the bottom of the foot toward the midline, while eversion turns the bottom of the foot away from the midline. The foot has a greater range of inversion than eversion motion. These are important motions that help to stabilize the foot when walking or running on an uneven surface and aid in the quick side-to-side changes in direction used during active sports such as basketball, racquetball, or soccer (see Figure \(\PageIndex{2}\).i).

Protraction and Retraction

Protraction and retraction are anterior-posterior movements of the scapula or mandible. Protraction of the scapula occurs when the shoulder is moved forward, as when pushing against something or throwing a ball. Retraction is the opposite motion, with the scapula being pulled posteriorly and medially, toward the vertebral column. For the mandible, protraction occurs when the lower jaw is pushed forward, to stick out the chin, while retraction pulls the lower jaw backward. (See Figure \(\PageIndex{2}\).j).

Depression and Elevation

Depression and elevation are downward and upward movements of the scapula or mandible. The upward movement of the scapula and shoulder is elevation, while a downward movement is depression. These movements are used to shrug your shoulders. Similarly, elevation of the mandible is the upward movement of the lower jaw used to close the mouth or bite on something, and depression is the downward movement that produces opening of the mouth (see Figure \(\PageIndex{2}\).k).

Excursion is the side to side movement of the mandible. Lateral excursion moves the mandible away from the midline, toward either the right or left side. Medial excursion returns the mandible to its resting position at the midline.

Superior Rotation and Inferior Rotation

Superior and inferior rotation are movements of the scapula and are defined by the direction of movement of the glenoid cavity. These motions involve rotation of the scapula around a point inferior to the scapular spine and are produced by combinations of muscles acting on the scapula. During superior rotation , the glenoid cavity moves upward as the medial end of the scapular spine moves downward. This is a very important motion that contributes to upper limb abduction. Without superior rotation of the scapula, the greater tubercle of the humerus would hit the acromion of the scapula, thus preventing any abduction of the arm above shoulder height. Superior rotation of the scapula is thus required for full abduction of the upper limb. Superior rotation is also used without arm abduction when carrying a heavy load with your hand or on your shoulder. You can feel this rotation when you pick up a load, such as a heavy book bag and carry it on only one shoulder. To increase its weight-bearing support for the bag, the shoulder lifts as the scapula superiorly rotates. Inferior rotation occurs during limb adduction and involves the downward motion of the glenoid cavity with upward movement of the medial end of the scapular spine.

Opposition and Reposition

Opposition is the thumb movement that brings the tip of the thumb in contact with the tip of a finger. This movement is produced at the first carpometacarpal joint, which is a saddle joint formed between the trapezium carpal bone and the first metacarpal bone. Thumb opposition is produced by a combination of flexion and abduction of the thumb at this joint. Returning the thumb to its anatomical position next to the index finger is called reposition (see Figure \(\PageIndex{2}\).l).

Table \(\PageIndex{1}\)

Chapter Review

The variety of movements provided by the different types of synovial joints allows for a large range of body motions and gives you tremendous mobility. These movements allow you to flex or extend your body or limbs, medially rotate and adduct your arms and flex your elbows to hold a heavy object against your chest, raise your arms above your head, rotate or shake your head, and bend to touch the toes (with or without bending your knees).

Each of the different structural types of synovial joints also allow for specific motions. The atlantoaxial pivot joint provides side-to-side rotation of the head, while the proximal radioulnar articulation allows for rotation of the radius during pronation and supination of the forearm. Hinge joints, such as at the knee and elbow, allow only for flexion and extension. Similarly, the hinge joint of the ankle only allows for dorsiflexion and plantar flexion of the foot.

Condyloid and saddle joints are biaxial. These allow for flexion and extension, and abduction and adduction. The sequential combination of flexion, adduction, extension, and abduction produces circumduction. Multiaxial plane joints provide for only small motions, but these can add together over several adjacent joints to produce body movement, such as inversion and eversion of the foot. Similarly, plane joints allow for flexion, extension, and lateral flexion movements of the vertebral column. The multiaxial ball and socket joints allow for flexion-extension, abduction-adduction, and circumduction. In addition, these also allow for medial (internal) and lateral (external) rotation. Ball-and-socket joints have the greatest range of motion of all synovial joints.

Interactive Link Questions

Answer: Dorsiflexion of the foot at the ankle decreases the angle of the ankle joint, while plantar flexion increases the angle of the ankle joint.

Q. The joints between the articular processes of adjacent vertebrae can contribute to which movement?

A. lateral flexion

B. circumduction

C. dorsiflexion

D. abduction

Q. Which motion moves the bottom of the foot away from the midline of the body?

A. elevation

B. dorsiflexion

C. eversion

D. plantar flexion

Q. Movement of a body region in a circular movement at a condyloid joint is what type of motion?

A. rotation

B. elevation

C. abduction

D. circumduction

Q. Supination is the motion that moves the ________.

A. hand from the palm backward position to the palm forward position

B. foot so that the bottom of the foot faces the midline of the body

C. hand from the palm forward position to the palm backward position

D. scapula in an upward direction

Q. Movement at the shoulder joint that moves the upper limb laterally away from the body is called ________.

B. eversion

D. lateral rotation

Critical Thinking Questions

Q. Briefly define the types of joint movements available at a ball-and-socket joint.

A. Ball-and-socket joints are multiaxial joints that allow for flexion and extension, abduction and adduction, circumduction, and medial and lateral rotation.

Q. Discuss the joints involved and movements required for you to cross your arms together in front of your chest.

A. To cross your arms, you need to use both your shoulder and elbow joints. At the shoulder, the arm would need to flex and medially rotate. At the elbow, the forearm would need to be flexed.

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Definition of excursion – Learner’s Dictionary

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(Definition of excursion from the Cambridge Learner's Dictionary © Cambridge University Press)

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