Active vs. Passive Insufficiency Quiz

Study Notes

Active vs. Passive Insufficiency

Relevant only for muscles that cross two joints, such as rectus femoris, semimembranosus, gastrocnemius, biceps brachii, and triceps brachii.
Active insufficiency occurs when a muscle cannot shorten enough to complete the full range of motion (ROM).
Passive insufficiency occurs when a muscle cannot lengthen enough to cover the full ROM across the joints it crosses.

Active Insufficiency

Happens during active movement of the muscles.
A two-joint muscle may lack the ability to shorten adequately, resulting in incomplete ROM at one or both joints.
Examples include:
- Hip flexion is limited when the knee is extended due to rectus femoris.
- Shoulder flexion is restricted when the elbow is flexed due to biceps brachii.
- Hip extension is impaired when the knee is flexed due to the hamstrings.

Passive Insufficiency

Occurs during passive stretching.
A two-joint muscle cannot stretch enough to allow full ROM at both joints simultaneously.
This happens when the muscle reaches maximum stretch, limiting movement.
Examples include:
- Hamstrings causing difficulty in hip flexion when the knee is extended.
- Inability to fully flex the shoulder when the elbow is flexed due to triceps.
- Insufficient knee flexion when the hip is extended due to the rectus femoris.
- Limited dorsiflexion of the ankle when the knee is extended indicates gastrocnemius insufficiency.

Clinical Application

A patient with left hip arthritis can perform a single knee to chest exercise fully but struggles with a straight leg raise beyond 50 degrees. They achieve full ROM with a strap, indicating active insufficiency of the rectus femoris.

Muscle Specific Active Insufficiency

Hamstrings exhibit active insufficiency when trying to perform both hip extension and knee flexion together.
Finger flexor muscles cannot form a tight fist when the wrist is fully flexed, showcasing active insufficiency.

Muscle Specific Passive Insufficiency

Hamstrings can be stretched individually but may not allow full range when both hip flexion and knee extension are attempted together.
Increased hyperextension at the wrist is possible when the fingers are not fully extended, demonstrating passive insufficiency.

Positions of Active Insufficiency

Biceps Brachii: Active insufficiency is present when the shoulder and elbow are flexed with forearm supination.
Triceps Brachii: Active insufficiency arises when the shoulder and elbow are extended.

Positions of Passive Insufficiency

Biceps Brachii: Passive insufficiency occurs when the shoulder and elbow are extended with forearm pronation.
Triceps Brachii: Passive insufficiency can be noted with shoulder flexion and elbow flexion.
Wrist extensors show active insufficiency during elbow flexion and wrist extension, and passive insufficiency during elbow extension and wrist flexion.
Similar patterns are observed in wrist flexors during elbow flexion and wrist flexion.

Description

Test your knowledge on the concepts of active and passive insufficiency, specifically in muscles that cross two joints. This quiz will help you understand the differences and implications of these terms in muscle function and movement. Perfect for students studying anatomy or kinesiology.