Kinesiology Chapter on Joint Types

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Questions and Answers

What type of joints are characterized by having a synovial cavity and free movement?

  • Synovial joints (correct)
  • Suture joints
  • Fibrous joints
  • Cartilaginous joints

Which motion is primarily associated with the sagittal plane?

  • Internal rotation
  • Flexion (correct)
  • Abduction
  • Eversion

What is the primary characteristic of close pack position of a joint?

  • Maximally congruent joint surfaces (correct)
  • Joint fluid accumulation
  • Mild laxity in ligaments
  • Partially congruent joint surfaces

Which type of joint permits slight movement and is typically classified as amphiarthroses?

<p>Cartilaginous joints (D)</p> Signup and view all the answers

What describes the fronal/coronal plane's associated movements?

<p>Inversion and eversion (D)</p> Signup and view all the answers

Which of the following is NOT a distinguishing characteristic of synovial joints?

<p>Muscle layers (A)</p> Signup and view all the answers

During mobilization in open pack position, how are the joint surfaces described?

<p>Minimally or partially congruent (B)</p> Signup and view all the answers

What type of joint can be found at the connection between the tibia and fibula?

<p>Syndesmosis joint (B)</p> Signup and view all the answers

What grade corresponds to complete range of motion against gravity with maximal resistance?

<p>Grade 5 (D)</p> Signup and view all the answers

Which of the following describes 'soft tissue approximation' as an end-feel?

<p>Knee flexion (C)</p> Signup and view all the answers

What is the average pelvic tilt angle considered normal?

<p>11° (D)</p> Signup and view all the answers

Which pelvic type is characterized by a taller height and narrower width?

<p>Android (B)</p> Signup and view all the answers

In manual muscle testing, which grade indicates that there is some but not complete range of motion against gravity?

<p>Grade 3- (A)</p> Signup and view all the answers

Which end-feel is associated with acute subacromial bursitis?

<p>Empty (D)</p> Signup and view all the answers

Which of the following motions describes a lateral pelvic tilt?

<p>Shifting the pelvis to one side (D)</p> Signup and view all the answers

What is indicative of a hard capsular end-feel in a joint?

<p>Osteophyte formation (A)</p> Signup and view all the answers

Which pelvic motion is accompanied by hip extension?

<p>Posterior pelvic tilt (C)</p> Signup and view all the answers

What primarily strengthens during a posterior pelvic tilt?

<p>Abdominals (A), Hip extensors (B)</p> Signup and view all the answers

In which pelvic dysfunction case is the right PSIS higher than the left?

<p>Case 1 (D)</p> Signup and view all the answers

What muscle group is weak during an anterior pelvic tilt?

<p>Lumbar extensors (C), Hip extensors (D)</p> Signup and view all the answers

What is the primary cause of posterior innominate rotation?

<p>Tight gluteus maximus (A)</p> Signup and view all the answers

Which of these values indicates lateral pelvic tilt when the left leg is in stance?

<p>Left hip adduction (C)</p> Signup and view all the answers

What happens to the ASIS during an anterior innominate rotation?

<p>Right ASIS is lower (B)</p> Signup and view all the answers

What is indicated by a right PSIS that is higher compared to the left PSIS in supine position?

<p>Innominate upslip (A)</p> Signup and view all the answers

What indicates hypomobility of the SI joint during the PIEDALLU'S SIGN test?

<p>PSIS moves anteriorly (C)</p> Signup and view all the answers

What is considered a normal Center-edge angle of the hip joint?

<p>25 degrees (B)</p> Signup and view all the answers

What is the normal acetabular anteversion angle range?

<p>15 to 20 degrees (B)</p> Signup and view all the answers

What is the average angle of femoral torsion in adults?

<p>8 to 20 degrees (B)</p> Signup and view all the answers

Which of the following is NOT a compensatory posture related to excessive anteversion?

<p>Toe-out posture (D)</p> Signup and view all the answers

Which muscle is primarily responsible for hip extension?

<p>Gluteus maximus (B)</p> Signup and view all the answers

Which action could lead to tightness of the Gracilis muscle?

<p>Abduction of the leg (B)</p> Signup and view all the answers

What is a common abnormal finding in femoral torsion?

<p>Angle &gt; 15 degrees (B)</p> Signup and view all the answers

What is the origin of the Gluteus Maximus muscle?

<p>Outer surface of the ilium, sacrum, coccyx (D)</p> Signup and view all the answers

Which action is NOT associated with the Gluteus Maximus?

<p>Medial rotation of the hip (C)</p> Signup and view all the answers

What is the nerve supply for the Gluteus Medius?

<p>Superior gluteal nerve (L4-S1) (A)</p> Signup and view all the answers

Which muscle is responsible for both hip flexion and abduction?

<p>Tensor Fascia Lata (D)</p> Signup and view all the answers

What is the insertion point for the Semitendinosus muscle?

<p>Medial surface of shaft of tibia (B)</p> Signup and view all the answers

Which muscle is considered an external rotator of the hip?

<p>Piriformis (C)</p> Signup and view all the answers

What is the primary action of the Semimembranosus muscle?

<p>Extension of the hip, medial rotation of the knee (A)</p> Signup and view all the answers

Which of the following muscles is part of the internal rotators group?

<p>Pectineus (A)</p> Signup and view all the answers

Which ligament is classified as a primary ligament of the sacroiliac joint?

<p>Anterior sacroiliac (C)</p> Signup and view all the answers

What motion does nutation of the sacrum involve?

<p>Sacral promontory moving anteriorly, inferiorly (B)</p> Signup and view all the answers

What is indicated by a positive Approximation Test?

<p>Sprain of posterior sacroiliac joint ligament (C)</p> Signup and view all the answers

Which test indicates a problem with the anterior sacroiliac ligament?

<p>Gapping Test (D)</p> Signup and view all the answers

What is the normal response for the Gillet's Test?

<p>PSIS moves down indicating hypomobility (B)</p> Signup and view all the answers

During counternutation, how does the pelvic inlet change?

<p>Decreased diameter (B)</p> Signup and view all the answers

What occurs in the Supine Active SLR Test for postpartum patients?

<p>Easier SLR with compression indicates an SI joint problem (B)</p> Signup and view all the answers

Which test is performed in a side-lying position?

<p>Approximation Test (C)</p> Signup and view all the answers

Which motion occurs during pelvic extension?

<p>Posterior pelvic tilt (C)</p> Signup and view all the answers

What does a positive Lasegue's Test indicate?

<p>SI joint pathology (D)</p> Signup and view all the answers

Which term describes the capsular pattern of the sacroiliac joint?

<p>Pain when joints are stressed (C)</p> Signup and view all the answers

In sacral movement, what is the relation between lumbar side flexion and sacral rotation?

<p>Same side: anterior rotation, opposite side: posterior rotation (B)</p> Signup and view all the answers

What does the Flamingo Test assess?

<p>Stress on the SI joint or symphysis pubis (C)</p> Signup and view all the answers

Flashcards

Sagittal Plane

The imaginary vertical plane that divides the body into left and right halves.

Transverse Plane

The imaginary horizontal plane that divides the body into upper and lower halves.

Frontal Plane

The imaginary plane that divides the body into front and back halves.

Fibrous Joint

A joint with little or no movement, such as a suture between skull bones.

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Cartilaginous Joint

A joint with limited movement, such as the intervertebral discs.

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Synovial Joint

A freely movable joint, such as the hip joint.

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Close-Packed Position

The position where joint surfaces are most congruent and ligaments are taut.

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Open-Packed Position

The position where joint surfaces are least congruent and ligaments are lax.

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Manual Muscle Testing

A test that assesses a muscle's ability to move through its range of motion against gravity and resistance.

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Grade 5 Muscle Strength

Indicates normal muscle function, allowing complete range of motion against maximum resistance.

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End Feel

A feeling felt at the end of a joint's range of motion, indicating the type of tissue limiting movement.

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Bone to Bone End Feel

A type of end feel where the movement is stopped by bone contacting bone.

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Android Pelvis

The pelvic shape typically found in males, characterized by a narrower width, smaller pelvic outlet, and a straight supra pubic arch.

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Pelvic Tilt

The angle between a line connecting the ASIS and PSIS and a horizontal line from the ASIS.

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Anterior Pelvic Tilt

A movement where the anterior portion of the pelvis rotates upwards, causing the spine to arch.

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Posterior Pelvic Tilt

A movement where the anterior portion of the pelvis rotates downwards, causing the spine to flatten.

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Lateral Pelvic Tilt

A movement in the pelvis that moves the hip bone to one side.

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Neutral Pelvis

The pelvis is in a neutral position, with the hip bone level and the spine in alignment.

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Lower Crossed Syndrome

A combination of muscle tightness and weakness that can lead to pelvic imbalances.

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Supine to Sit Test

A test used to assess the rotation of the pelvis or innominate bone by observing the position of the ASIS and PSIS in different positions.

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Anterior Innominate Rotation

A condition where the iliac bone on one side of the pelvis is rotated forward.

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Posterior Innominate Rotation

A condition where the iliac bone on one side of the pelvis is rotated backward.

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Center-edge angle (Angle of Wiberg)

The angle between the lateral edge of the acetabulum and a vertical line.

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Acetabular Anteversion angle

The angle between the posterior acetabular wall and a line connecting the posterior and anterior acetabular rims.

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Angle of Torsion of Femur (Femoral Torsion)

The relative rotation (twist) between the femoral shaft and the neck.

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Increased Femoral Torsion (Femoral Torsion >15º)

The angle of femoral torsion where the femur is rotated >15º medially. This causes the shaft to rotate inward.

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Excessive Anteversion

This malalignment leads to issues like Toeing in, Subtalar pronation, and Lateral patellar subluxation.

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Femoral Torsion: Abduction Test

In this test, a patient's leg is abducted with the knee flexed at 90 degrees. If the leg can be abducted further than normal, it may indicate Gracilis tightness.

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Hip Extensors

These muscles help to extend and stabilize the hip joint.

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Piedallu's Sign

This test checks for movement of the PSIS (posterior superior iliac spine) during forward flexion. A positive test indicates hypomobility of the SI joint.

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What is the function of the Gluteus Maximus?

The gluteus maximus is a large, powerful muscle that extends the hip joint and laterally rotates the thigh. It is also essential for the proper functioning of the hip and knee joints through its role in stabilizing the pelvis and preventing excessive rotation of the femur.

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What additional actions does the Gluteus Maximus perform besides hip extension?

The gluteus maximus is a powerful extensor of the hip, but it can also contribute to lateral rotation of the femur, especially during activities like running or walking. The gluteus maximus assists in stabilizing the knee joint and preventing unwanted movements.

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How does the Gluteus Maximus contribute to posture?

The gluteus maximus plays a vital role in maintaining good posture by supporting the pelvis and preventing excessive rotation of the femur. This helps to ensure proper alignment of the spine and the ability to stand and move efficiently.

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What are the consequences of a weak Gluteus Maximus?

Weakness of the gluteus maximus can lead to several problems including difficulty walking and climbing stairs, postural imbalances (like back pain, poor posture), and increased risk of injury to the hip and knee joints. This is because the muscle is required for proper movement and support of the hip and leg.

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What are the actions of the Biceps Femoris?

The biceps femoris, located on the back of the thigh, is a two-headed muscle that plays a key role in extending at the hip and flexing and rotating the knee joint. It serves as a powerful mover of the thigh and leg.

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What are the actions of the Semitendinosus and Semimembranosus ?

The semitendinosus and semimembranosus are located on the back of the thigh and work together to extend the hip and flex and rotate the knee. These muscles are important for walking, running, and other activities that require movement of the leg.

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What is the primary action of the Gluteus Medius?

The gluteus medius, located on the side of the hip, is responsible for abducting (moving away from the midline) the hip, which is crucial for maintaining balance and smooth walking, as well as contributing to rotation of the femur.

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What are the actions of the Gluteus Minimus?

The gluteus minimus is located on the side of the hip and its main action is to abduct (move away from the midline) and internally rotate the hip, contributing to smooth and controlled movements of the leg.

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Nutation

This movement is characterized by the sacral promontory moving anteriorly and inferiorly while the coccyx moves posteriorly and superiorly. This results in a decrease in the pelvic inlet diameter and an increase in the pelvic outlet diameter.

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Counternutation

This movement is the opposite of nutation, with the sacral promontory moving posteriorly and superiorly and the coccyx moving anteriorly and inferiorly. This results in an increase in the pelvic inlet diameter and a decrease in the pelvic outlet diameter.

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Sacroiliac Joint

This joint is formed between the sacrum and the ilium, and has limited movement. It's crucial for weight transfer and stability in the lower body.

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Sacral Apex Pressure Test

This test is performed in prone, where pressure is applied to the apex of the sacrum. Pain over the SI joint indicates a potential sacroiliac joint problem.

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Approximation Test

This test is performed in side-lying with downward pressure applied over the iliac crest. Increased pressure on the SI joint indicates a sprain of the posterior SI joint ligament.

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Oblique Axis Motion

This movement is a combination of nutation and counternutation, resulting in a slight rotation of the sacrum around an oblique axis.

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Gapping Test

This test checks the integrity of the anterior sacroiliac ligament with the patient lying supine. Downward and outward pressure is applied, and pain on the involved side suggests a sprain of the anterior SI ligament.

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Thigh Thrust test

This test evaluates the stability of the SI joint, particularly the sacrotuberous ligament. The patient is supine with the hip flexed at 90 degrees and downward pressure is applied while palpating the SI joint. Pain in this area points to possible sacroiliac joint dysfunction.

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Supine Active SLR Test

During this test, the patient performs an active SLR (straight leg raise) while the examiner compresses the innominate bones. This evaluates SI joint stability and may help identify the SI joint as the source of pain, especially in postpartum concerns.

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Iliolumbar Ligament Test

This test evaluates the integrity of the iliolumbar ligament. The patient lies prone and the examiner applies pressure to the posterior iliac crest, causing twisting motion in the lumbar spine. Pain experienced in the lower back, especially in the iliac crest region, indicates a possible iliolumbar ligament sprain.

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Gillet's Test

This test is used to evaluate the mobility of the sacroiliac joint by assessing the movement of the PSIS (posterior superior iliac spine). The patient stands on one leg while the examiner palpates the PSIS and sacrum. A lack of PSIS movement during knee flexion might indicate hypomobility of the SI joint.

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Ipsilateral Anterior Rotation Test

This test evaluates the stability of the sacroiliac joint by assessing the movement of the PSIS (posterior superior iliac spine) during hip extension. The patient steps back as if taking a step, and the examiner palpates the PSIS. If the PSIS doesn't move upward, it suggests a potential SI Joint issue.

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Sacroiliac Rocking Test

During this test, the patient lies supine with their knee flexed and hip fully flexed and adducted. Pain at the SI joint during this maneuver indicates strain of the posterior ligaments of the sacroiliac joint.

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Tripod Sign

This test evaluates the tension of the hamstrings by assessing the patient's ability to actively extend the knee while in a seated position with the legs dangling. A positive test, where the patient leans backward or extends the trunk indicates tight hamstrings.

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Patrick's Test

This test is used to assess range of motion of the hip joint and look for signs of hip joint limitation. This can be helpful in diagnosing hip pain.

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90-90 SLR Test

This test tests the mobility of the hip by comparing the movement of the PSIS (posterior superior iliac spine) on both sides when the patient performs a straight leg raise. A positive test involves a reduced amount of PSIS movement on one side compared to the other, indicating hypomobility of the ilium on the sacrum on that specific side.

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Study Notes

Pelvis and Hip Anatomy and Kinesiology

  • The outline of topics covers review of terminologies, the pelvis, the sacrum and sacroiliac joint, pelvic and sacral movement, and the hip joint.

Review of Terminologies

  • Planes of Motion:

  • Frontal/Coronal: Abduction, adduction, inversion, eversion, thumb flexion, extension

  • Sagittal: Flexion, extension, plantar flexion, dorsiflexion, thumb abduction & adduction

  • Horizontal/Transverse: Internal rotation (IR), external rotation (ER)

  • Types of Joints:

  • Fibrous Joints (Synarthroses): Minimal to no movement (sutures, syndesmoses, gomphoses).

  • Cartilaginous Joints (Amphiarthroses): Slightly movable (synchondroses, symphyses).

  • Synovial Joints (Diarthroses): Free movement (5 distinguishing characteristics: joint cavity, articular cartilage, synovial membrane, synovial fluid, fibrous capsule).

  • Open and Close Pack Position:

  • Open Pack: Joint surfaces are minimally/partially congruent, capsule is lax, ligaments are lax, mobilizations are possible.

  • Close Pack: Joint surfaces are maximally/fully congruent, capsule is taut, ligaments are taut, mobilizations cannot be perfomed.

  • Manual Muscle Testing:

  • A grading system used to evaluate strength of muscles (5-Normal, 4-Good, 3+-Fair+, 3-Fair, 3--Fair-, 2+-Poor+, 2-Poor, 2--Poor-, 1-Trace, 0-Zero).

  • End Feel:

  • Bone to Bone (Hard): Elbow extension

  • Soft Tissue Approximation (Soft): Knee flexion

  • Tissue Stretch (Soft): Ankle dorsiflexion

Additional End-Feel Examples

  • Early muscle spasm: Protective spasm after injury
  • Late muscle spasm: Spasm due to instability
  • "Mushy" tissue stretch: Tight muscle
  • Spasticity: UMNL
  • Hard capsular: Frozen shoulder
  • Soft capsular: Synovitis
  • Bone to bone: Osteophyte formation
  • Empty: Acute subacromial bursitis
  • Springy block: Meniscus tear

Pelvis

  • Anatomy: The pelvis consists of the ilium, ischium, pubis, sacrum, and coccyx. Detailed anatomical landmarks on the ilium, ischium, and pubis are listed.
  • Motion: Anterior pelvic tilt, posterior pelvic tilt, lateral pelvic tilt, pelvic shift, and pelvic rotation.
  • Special Tests: Various specific tests detailed, including the supine to sit test, tests for sacroiliac joint involvement, etc.

Sacrum and Sacroiliac Joint

  • Anatomy: Includes the superior articular processes, sacral foramina, sacral canal, sacral promontory, superior articular facets, and the sacrococcygeal joint, and ligaments, including the ilio-lumbar, short sacroiliac, and long posterior sacroiliac ligaments.
  • Motion: Nutation, Counternutation, Oblique axis motion (forward & backward torsion).
  • Muscles: Relevant muscles for motion, including primary and secondary ligaments (see detailed sections).
  • Special Tests: Multiple specific tests to assess sacroiliac joint involvement (e.g., Approximation test, Gapping test, Sacral apex pressure test, etc., with specific descriptions of the test process and potential findings).

Hip Joint

  • Anatomy: The hip joint features the acetabulum, femoral head, ilio-femoral, pubo-femoral and ischio-fiboral ligaments.
  • Motion: Flexion, extension, abduction, adduction, internal rotation, and external rotation.
  • Muscles: Details of the hip flexor and adductor muscles (Psoas Major, Iliacus, Sartorius, Tensor Fascia Latae, Rectus Femoris, Pectineus).
  • Special Tests: Includes detailed descriptions along with the process and potential findings.

Pelvic Motions/Motions

  • Description of pelvic motions in relation to hip motion
  • Description of posterior, anterior, and lateral pelvic tilt
  • Discussion of pelvic rotation

Lumbo-Pelvic Rhythm

  • Description of the normal movement of the lumbar spine and hip during motions.
  • Charts of normal and abnormal ranges of motions.

Stability

  • Description of structures contributing to hip stability: femoral head, acetabulum, and acetabular labrum.
  • Descriptions of ligaments of the hip: iliofemoral, pubofemoral, ischiofemoral ligaments.
  • Charts of the range of motion of the hip during normal activities

Special Tests

  • Descriptions of specific tests, including descriptions of how to perform tests and what to look for to diagnose problems.

Summary of Special Tests

  • Summary of tests with various conditions found throughout the presentation
  • Descriptions of various possible findings

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