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combined terms, hyperextension is the most
commonly used.
Terms describing general
movements
Abduction: Lateral movement away from the mid-
line of the trunk in the frontal plane. An example
is raising the arms or legs to the side horizontally.
Adduction: Movement medially toward the midline
of the trunk in the frontal plane. An example is
lowering the arm to the side or the thigh back to
the anatomical position.
Flexion: Bending movement that results in a decrease
of the angle in a joint by bringing bones together,
usually in the sagittal plane. An example is the
elbow joint when the hand is drawn to the shoulder.
Extension: Straightening movement that results in an
increase of the angle in a joint by moving bones
apart, usually in the sagittal plane. Using the elbow,
an example is when the hand moves away from
the shoulder.
Circumduction: Circular movement of a limb that
delineates an arc or describes a cone. It is a combi-
nation of fexion, extension, abduction, and adduc-
tion. Sometimes referred to as circumfexion. An
example is when the shoulder joint or the hip joint
moves in a circular fashion around a fxed point,
either clockwise or counterclockwise.
Diagonal abduction: Movement by a limb through a
diagonal plane away from the midline of the body,
such as in the hip or glenohumeral joint.
Diagonal adduction: Movement by a limb through
a diagonal plane toward and across the midline of
the body, such as in the hip or glenohumeral joint.
External rotation: Rotary movement around the lon-
gitudinal axis of a bone away from the midline of
the body. Occurs in the transverse plane and is also
FIG. 1.19

Joint movements. A, Examples of sagittal plane movements: extension of left toes, ankle (plantar
fexion), knee, hip, shoulder, elbow, wrist, fngers, lumbar and cervical spine; fexion of right toes, ankle
(dorsifexion), knee, hip, shoulder, elbow, wrist, and fngers. B, Examples of frontal plane movements:
abduction of left transverse tarsal/subtalar joints (eversion), shoulder, wrist, fngers, and shoulder girdle
(upward rotation), lumbar (lateral fexion to right) and cervical spine (lateral fexion to left), and right
hip; adduction of right transverse tarsal/subtalar joints (inversion), shoulder, wrist, fngers, and shoulder
girdle (downward rotation). C, Examples of transverse plane movements: internal rotation of right hip, left
shoulder, radioulnar joints (pronation); external rotation of left knee, hip, right shoulder, radioulnar joints
(supination), and lumbar (right rotation) and cervical spine (right rotation).
A
B C
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known as rotation laterally, outward rotation, and
lateral rotation.
Internal rotation: Rotary movement around the lon-
gitudinal axis of a bone toward the midline of the
body. Occurs in the transverse plane and is also
known as rotation medially, inward rotation, and
medial rotation.
Terms describing ankle
and foot movements
Eversion: Turning the sole of the foot outward or lat-
erally in the frontal plane; abduction. An example is
standing with the weight on the inner edge of the foot.
Inversion: Turning the sole of the foot inward or me-
dially in the frontal plane; adduction. An example
is standing with the weight on the outer edge of
the foot.
Dorsal fexion (dorsifexion): Flexion movement of
the ankle that results in the top of the foot moving
toward the anterior tibia in the sagittal plane.
Plantar fexion: Extension movement of the ankle
that results in the foot and/or toes moving away
from the body in the sagittal plane.
Pronation: A position of the foot and ankle resulting
from a combination of ankle dorsifexion, subtalar
eversion, and forefoot abduction (toe-out).
Supination: A position of the foot and ankle result-
ing from a combination of ankle plantar fexion,
subtalar inversion, and forefoot adduction (toe-in).
Terms describing radioulnar
joint movements
Pronation: Internally rotating the radius in the trans-
verse plane so that it lies diagonally across the ulna,
resulting in the palm-down position of the forearm.
Supination: Externally rotating the radius in the
transverse plane so that it lies parallel to the ulna,
resulting in the palm-up position of the forearm.
Terms describing shoulder girdle
(scapulothoracic) movements
Depression: Inferior movement of the shoulder gir-
dle in the frontal plane. An example is returning to
the normal position from a shoulder shrug.
Elevation: Superior movement of the shoulder girdle
in the frontal plane. An example is shrugging the
shoulders.
Protraction (abduction): Forward movement of the
shoulder girdle in the horizontal plane away from
the spine. Abduction of the scapula.
Retraction (adduction): Backward movement of the
shoulder girdle in the horizontal plane toward the
spine. Adduction of the scapula.
Rotation downward: Rotary movement of the scapula
in the frontal plane with the inferior angle of the
scapula moving medially and downward. Occurs pri-
marily in the return from upward rotation. The infe-
rior angle may actually move upward slightly as the
scapula continues in extreme downward rotation.
Rotation upward: Rotary movement of the scapula
in the frontal plane with the inferior angle of the
scapula moving laterally and upward.
Terms describing shoulder joint
(glenohumeral) movements
Horizontal abduction: Movement of the humerus
or femur in the horizontal plane away from the
midline of the body. Also known as horizontal ex-
tension or transverse abduction.
Horizontal adduction: Movement of the humerus
or femur in the horizontal plane toward the midline
of the body. Also known as horizontal fexion or
transverse adduction.
Scaption: Movement of the humerus away from the
body in the scapular plane. Glenohumeral abduc-
tion in a plane 30 to 45 degrees between the sagit-
tal and frontal planes.
Terms describing spine movements
Lateral fexion (side bending): Movement of the
head and/or trunk in the frontal plane laterally
away from the midline. Abduction of the spine.
Reduction: Return of the spinal column in the frontal
plane to the anatomic position from lateral fexion.
Adduction of the spine.
Terms describing wrist
and hand movements
Dorsal fexion (dorsifexion): Extension movement
of the wrist in the sagittal plane with the dorsal or
posterior side of the hand moving toward the pos-
terior side of the forearm.
Palmar fexion: Flexion movement of the wrist in the
sagittal plane with the volar or anterior side of the
hand moving toward the anterior side of the forearm.
Radial fexion (radial deviation): Abduction move-
ment at the wrist in the frontal plane of the thumb
side of the hand toward the lateral forearm.
Ulnar fexion (ulnar deviation): Adduction move-
ment at the wrist in the frontal plane of the little
fnger side of the hand toward the medial forearm.
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Opposition of the thumb: Diagonal movement of
the thumb across the palmar surface of the hand to
make contact with the fngers.
Reposition of the thumb: Diagonal movement of
the thumb as it returns to the anatomical position
from opposition with the hand and/or fngers.
These movements are considered in detail in
the chapters that follow as they apply to the indi-
vidual joints.
Combinations of movements can occur. Flex-
ion or extension can occur with abduction, ad-
duction, or rotation.
Movement icons (pedagogical feature)
Throughout this text a series of movement icons
will be utilized to represent different joint move-
ments. These icons will be displayed in the page
margins to indicate the joint actions of the muscles
displayed on that page. As further explained in
Chapter 2, the actions displayed represent the
movements that occur when the muscle contracts
concentrically. Table 1.7 provides a complete list
of the icons. Refer to them as needed when read-
ing Chapters 4, 5, 6, 7, 9, 10, 11, and 12.
Physiological movements versus
accessory motions
Movements such as fexion, extension, abduction,
adduction, and rotation occur by the bones mov-
ing through planes of motion about an axis of
rotation at the joint. These movements may be re-
ferred to as physiological movements. The motion
of the bones relative to the three cardinal planes
resulting from these physiological movements is
referred to as osteokinematic motion. In order
TABLE 1.7 Movement icons representing joint actions
Shoulder girdle
Scapula
elevation
Scapula
depression
Scapula
abduction
Scapula
adduction
Scapula upward
rotation
Scapula
downward
rotation
Gleno humeral
Shoulder
fexion
Shoulder
extension
Shoulder
abduction
Shoulder
adduction
Shoulder
external
rotation
Shoulder
internal
rotation
Shoulder
horizontal
abduction
Shoulder
horizontal
adduction
Elbow Radioulnar joints
Elbow fexion Elbow extension Radioulnar supination Radioulnar pronation
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Knee
Knee fexion Knee extension Knee external rotation Knee internal rotation
TABLE 1.7 (continued) Movement icons representing joint actions
Hip
Hip fexion Hip extension Hip abduction Hip adduction
Hip external
rotation
Hip internal
rotation
Wrist
Wrist extension Wrist fexion Wrist abduction Wrist adduction
Thumb carpometacarpal joint
Thumb metacarpophalangeal
joint
Thumb interphalangeal joint
Thumb CMC
fexion
Thumb CMC
extension
Thumb CMC
abduction
Thumb MCP
fexion
Thumb MCP
extension
Thumb IP
fexion
Thumb IP
extension
2nd, 3rd, 4th, and 5th MCP, PIP,
and DIP joints
2nd, 3rd, 4th,
and 5th MCP
and PIP joints
2nd, 3rd, 4th, and 5th
metacarpophalangeal joints
2nd, 3rd, 4th,
and 5th PIP
joints
2nd, 3rd, 4th,
and 5th DIP
joints
2nd5th MCP,
PIP, and DIP
fexion
2nd5th MCP,
PIP, and DIP
extension
2nd5th
MCP and PIP
fexion
2nd5th
MCP fexion
2nd
5th MCP
extension
2nd5th PIP
fexion
2nd5th DIP
fexion
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Ankle Transverse tarsal and subtalar joints
Ankle plantar fexion Ankle dorsal fexion
Transverse tarsal and
subtalar inversion
Transverse tarsal and
subtalar eversion
Great toe metatarsophalangeal and
inter phalangeal joints
2nd5th metatarsophalangeal, proximal inter phalangeal,
and distal interphalangeal joints
Great toe MTP and IP
fexion
Great toe MTP and IP
extension
2nd5th MTP, PIP, and DIP
fexion
2nd5th MTP, PIP, and DIP
extension
TABLE 1.7 (continued) Movement icons representing joint actions
Cervical spine
Cervical fexion Cervical extension Cervical

lateral f lexion
Cervical rotation
unilaterally
Lumbar spine
Lumbar fexion Lumbar extension Lumbar lateral fexion
Lumbar rotation
unilaterally
for these osteokinematic motions to occur, there
must be movement between the actual articular
surfaces of the joint. This motion between the
articular surfaces is known as arthrokinematics,
and it includes three specifc types of accessory
motions. These accessory motions, named specif-
ically to describe the actual change in relationship
between the articular surface of one bone relative
to another, are spin, roll, and glide (Fig. 1.20).
Roll is sometimes referred to as rock or rock-
ing, whereas glide is sometimes referred to as
slide or translation. If accessory motion is pre-
vented from occurring, then physiological motion
cannot occur to any substantial degree other than
by joint compression or distraction. Because most
diarthrodial joints in the body are composed of
a concave surface articulating with a convex sur-
face, roll and glide must occur together to some
degree. For example, as illustrated in Fig. 1.21,
as a person stands from a squatting position, in
order for the knee to extend, the femur must roll
forward and simultaneously slide backward on
the tibia. If not for the slide, the femur would roll
off the front of the tibia, and if not for the roll, the
femur would slide off the back of the tibia.
Spin may occur in isolation or in combination
with roll and glide, depending upon the joint
structure. To some degree, spin occurs at the
knee as it fexes and extends. In the squatting to
standing example, the femur spins medially or in-
ternally rotates as the knee reaches full extension.
Table 1.8 provides examples of accessory motion.
Roll (rock): A series of points on one articular sur-
face contacts a series of points on another articular
surface.
Glide (slide, translation): A specifc point on one
articulating surface comes in contact with a series
of points on another surface.
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Spin: A single point on one articular surface rotates
about a single point on another articular surface.
Motion occurs around some stationary longitudinal
mechanical axis in either a clockwise or a counter-
clockwise direction.
Websites
BBC Science & Nature
www.bbc.co.uk/science/humanbody/body/interactives/3djigsaw_02/
index.shtml?skeleton
Allows interactive placement of bone and joint structures.
Skeletal System
www.bio.psu.edu/faculty/strauss/anatomy/skel/skeletal.htm
Pictures of dissected bones and their anatomical landmarks.
ExRx Articulations
www.exrx.net/Lists/Articulations.html
Detailed common exercises demonstrating movements of each
joint and listing the muscles involved.
Human Anatomy Online
www.innerbody.com/image/skelfov.html
Interactive skeleton labeling.
FIG. 1.21

Knee joint arthrokinematics. A, Standing from squatting; B, Flexing from nonweight-bearing position.
FIG. 1.20

Joint arthrokinematics. A, Spin; B, Roll; C, Glide.

Roll
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Radiographic Anatomy of the Skeleton
www.uwmsk.org/RadAnatomy.html
X-rays with and without labels of bony landmarks.
Virtual Skeleton
www.uwyo.edu/RealLearning/4210qtvr.html
A 3-dimensional human osteology with Quicktime movies of
each bone.
Forensic Anthropology
www-personal.une.edu.au/~pbrown3/skeleton.pdf
A detailed discussion of skeletal anthropology with excellent
pictures of dissected bones.
Anatomy & Physiology Tutorials
www.gwc.maricopa.edu/class/bio201/index.htm
BBC Science & Nature
www.bbc.co.uk/science/humanbody/body/factfles/skeleton_
anatomy.shtml
Describes each bone and allows viewing of each from different
angles.
BBC Science & Nature
www.bbc.co.uk/science/humanbody/factfles/joints/ball_and_socket_
joint.shtml
Describes each type of joint and allows viewing of how the joint
moves within the body.
University of Michigan Learning Resource Center, Hypermuscle:
Muscles in Action
www.med.umich.edu/lrc/Hypermuscle/Hyper.html
Describes each motion and allows viewing of the motion
performed.
Foss Human Body
http://sv.berkeley.edu/showcase/pages/bones.html
An interactive site that allows assembly of the skeleton.
Functions of the Skeletal System
http://training.seer.cancer.gov/anatomy/skeletal
Several pages with information on bone tissue, bone develop-
ment and growth, and the joints.
Wireframe Skeleton
www.2fashgames.com/f/f-220.htm
Move around the skeletons limbs, arms, legs, body, and make it
do funny things.
eSkeletons Project
www.eskeletons.org
An interactive site with a bone viewer showing the morphology,
origins, insertions, and articulations of each bone.
Skeleton Shakedown
www.harcourtschool.com/activity/skel/skel.html
Help put a disarticulated skeleton back together.
Introductory Anatomy: Joints
www.leeds.ac.uk/chb/lectures/anatomy4.html
Notes on joint articulations.
Radiographic Anatomy of the Skeleton
www.szote.u-szeged.hu/Radiology/Anatomy/skeleton.htm
X-rays with and without labels of bony landmarks.
Skeleton: The Joints
www.zoology.ubc.ca/~biomania/tutorial/bonejt/outline.htm
Point and click to detailed joint illustrations.
TeachPE.com
www.teachpe.com/anatomy/skeleton.php
Interactive questions on bones, joints, and muscles.
REVIEW EXERCISES
1. Complete the blanks in the following paragraphs
using each word from the list below only once
except for the ones marked with two asterisks,**,
which are used twice. The number of dashes
indicates the number of letters of the word for
each blank.
TABLE 1.8 Accessory motion
Accessory motion Anatomical joint example Analogy
Roll (rocking)
Knee extension occurring from
femoral condyles rolling forward
on tibia as a person stands from
squatting position
Tire rolling across a road
surface, as in normal driving
with good traction
Combination of roll
and glide: Tire spinning
on slick ice (i.e., poor
traction) but still resulting
in movement across the
road surface
Glide (slide or
translation)
Knee extension occurring from
femoral condyles sliding backward
on tibia as a person stands from
squatting position
Tire skidding across a slick
surface with the brakes
locked
Spin
Radioulnar pronation/supination
occurring from spinning of radial head
against humeral capitulum
Point of a toy top spinning around in one spot on the
foor
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