cumulative exam 2

What is needed prior to conducting gait analysis?

Posture assessment

Cephalocaudal Order

an approach to postural assessment from head to toe

Reverse Cephalocaudal Order

assessment of posture from toe to head

Positions in Which to Perform Postural Assessment

anterior, posterior, and lateral

Gait Definition

manner or style of walking

components of stance phase and percent

stance phase is 60 percent

1. heel strike: heel contact

2. loading phase: plantar to floor

3. midstance: body weight over foot

4. terminal stance: heel lift

5. toe off: toe is leaving the ground

components of swing phase and percent

swing phase is 40 percent

1. initial swing: foot is not in contact with the ground

2. mid swing: tibia perpendicular to the ground

3. terminal swing: heel prepares to make contact

Pes Planus

collapsed longitudinal arch (flat foot)

Pes Cavus

elevation of medial longitudinal arch (abnormally high arch)

Calcaneal Varus

over supination standing on edges of feet

Calcaneal Valgus

feet collapsing inward (pronater)

Femoral Anteversion

internal rotation of femur

Femoral Retroversion

external rotation of femur

Lateral Tracking Patella

patella jumps laterally

Medial Tracking Patella

patella jumps medially

Patella Baja

1. inferior pole of patella sits on tibial tuberosity

2. tendon length < patella length

Patella Alta

1. superior and inferior pole of patella sit above the distal aspect of the femur

2. tendon length > patella length

Camel’s Sign

patella alta

Genu Valgum

knocked knees

Genu Varum

bowlegged

Genu Recurvatum

knee hyperextension

Anterior Tilt/Lordotic back (description & cause)

1. pelvic tilts forward pulling the lumbar spine into hyper-lordosis (arch)

2. caused by tight hip flexors, weak abs or glutes

3. can be associated with big boobs

Posterior Tilt/Flat back (description & cause)

1. pelvic tilts back and pulls lumbar spine flat

2. caused by tight hamstrings and tight abs

Forward Shifted Pelvis/ sway back (description & cause)

1. knees hyper extended, hip joints hyper extended, pelvis shifts forward and back, upper trunk shifts backwards to compensate

2. causes by tight hamstrings, weak abs, knee ligament laxity, weak glute max

Adam’s Forward Bending Test purpose

to detect scoliosis

Adam’s Forward Bending Test how to perform

have patient reach for toes

Gluteus Maximus Gait

1. stance phase abnormality

2. trunk is thrusted posteriorly

3. caused by weak glute max.

Calcaneal Gait

1. stance phase abnormality

2. “heel walking”

3. weakness or injury to the triceps surae

Trendelenburg’s Gait

1. stance phase abnormality

2. dropping of the contralateral hip

3. weakness in glute medius and glute min. , causing drop on other side

Stiff Knee Gait

1. swing phase abnormality

2. knee is extended; lifting of the hip

3. stroke, spinal cord injury, cerebral palsy, or meniscus tear/ knee injury

Steppage/Drop-Foot Gait

1. swing phase abnormality

2. foot slaps the ground

3. weakness of the dorsiflexor muscle group

Inversion vs. Eversion Ankle Sprain difference

1. inversion: foot rolls inwards spraining the lateral ligaments (most common)

2. eversion: foot rolls outwards spraining the medial ligaments

What type of joint is formed at the talonavicular joint?

ellipsoid

What type of joint is formed at the calcaneocuboid joint?

saddle

How many bones are in the foot?

26 bones

Identification/Description of Tibiofibular Joint

1. syndesmosis joint

2. proximal and distal joints with interosseous membrane between tibia and fibula

Description of High Ankle Sprain/Ligaments Involved

1. take place at the distal end of the tibiofibular joint

2. syndesmotic ligaments

identification (location) of Each Medial Ligament (ankle and foot)

Identification (location) of Each Lateral Ligament (ankle and foot)

Identification of Arches of the Foot

1. medial longitudinal

2. lateral longitudinal

3. transverse

talocrural and subtalar joint movements and plane of motion

1. plantar flexion and dorsiflexion (talocrural)

2. sagittal plane (talocrural)

3. inversion and eversion (subtalar)

4. transverse plane

trochoidal in refrence to knee

1. internal and external rotational aspect of knee

2. tibiofemoral joint

ginglymus in reference to knee

1. flexion and extension of the knee

1. tibiofemoral joint

arthrodial which joint? in reference to the knee

1. articulation between the patella and femoral groove

2. gliding movements

ACL (# of Bands; Names)

1. 2 bands

2. anteromedial band and posterolateral band

PCL (# of Bands; Names)

1. 1 band

2. posteromedial band

MCL Roles/ Motions Limited

1. prevents valgus forces

LCL Roles/ Motions Limited

1. prevents varus forces

Which meniscus is larger/more c-shaped?

the medial meniscus is larger and more c shaped because of the larger medial femoral condyle

Blood Supply to Meniscus

the deeper into the meniscus is the less blood supply

Identification of Names/Types of Bursae

1. supra patella (on femur)

2. pre patellar (right above knee cap)

3. infra patellar (below knee cap)

4. pes-anserine (medial condyle of tibia)

Knee Joint Flexors which muscle group

hamstrings

Knee Joint Extensors which muscle group

quadriceps

Understanding Screw Home Mechanism weight bearing

1. closed kinetic chain

2. stand to sit: lateral/ external rotation

3. sit to stand: medial/ internal rotation

Understanding Screw Home Mechanism non weight bearing

1. open kinetic chain

2. flexion to extension: lateral/ external rotation

3. extension to flexion: medial/ internal rotation

Q-Angle what is it

the quadriceps angle

Q-Angle definition

1. Noted by the lateral deviation of the femur as it meets with the tibia

2. it is the angle formed by the quads and patella tendon

Q-Angle identification of 2 lines

1. lines 1: anterior superior iliac spine and the center of the patella

2. line 2: center of the patella and the tibial tuberosity

Predispositions for Too Large of Q-Angle?

knee and patella pathologies

Associated Complications w/ High Q-Angle?

1. patella subluxations

2. patella dislocations

3. ligamentous injuries

4. chondromalacia

ACL Injury Common Mechanism

cutting or pivoting with planted foot

PCL Injury/Common Mechanism

high force trauma with bent knee

LCL Injury/Common Mechanism

blow to the inside of the knee (varus force)

MCL Injury/Common Mechanism

blow to the outside of the knee (valgus force)

Primary Functions of the Pelvis (2)

1. support the weight of the upper body when sitting

2. serves as an attachment point for the trunk and lower limb muscles

Hip Joint Description

1. Synovial

2. Diarthrosis

3. enarthrodial

Secondary Functions of the Pelvis (2)

1. transfers weight to the lower limbs while standing

2. protects internal pelvic organs

Components of the Pelvis & Associated Descriptions

▪ Ilium

upper 2/5

Components of the Pelvis & Associated Descriptions

▪ Ischium

posterior and lower 2/5

Components of the Pelvis & Associated Descriptions

▪ Pubis

anterior and lower 1/5

Comparison of Male vs Female Pelvis

1. male: thicker and heavier

2. female broader

Which is/are Intra-Articular Ligament(s) ?

1. ligamentum teres

2. transverse acetabular ligament

Which is/are Extra-Articular Ligament(s) ?

iliofemoral, pubofemoral, and ischiofemoral ligaments

Movements The Hip Ligaments Limits or Supports

▪ Ischiofemoral Ligament

limits

1. extension

2. internal rotation

Movements The Hip Ligaments Limits or Supports

▪ Pubofemoral Ligament

limits

1. extension

2. abduction

Movements The Hip Ligaments Limits or Supports

▪ Iliofemoral Ligament

limits

1. hyperextension

Movements The Hip Ligaments Limits or Supports

▪ Teres Ligament

supplys

1. stabilization

2. blood supply

Muscle Location Principle

muscles are typically names based on there location in the body

Names of Muscle Groups & Their Individual Muscles

▪ Hamstrings

1. semimembranosus

2. biceps femoris

3. semitendinosus

Names of Muscle Groups & Their Individual Muscles

▪ Quadriceps

1. rectus femoris

2. vastus lateralis

3. vastus intermedius

4. vastus medialis

Names of Muscle Groups & Their Individual Muscles

▪ Six Deep External Rotators (i.e. OOPSIQ)

1. obturator internus

2. obturator externus

3. piriformis

4. superior gemellus

5. inferior gemellus

6. quadratus femoris

Names of Muscle Groups & Their Individual Muscles

▪ Adductors

1. adductor magnus

2. adductor longus

3. adductor brevis

Names of Muscle Groups & Their Individual Muscles

▪ Hip Flexors

1. psoas major

2. psoas minor

3. iliacus

ACL Sites of Attachment

Anterior tibia to posterior medial aspect of the lateral femoral condyle

PCL Sites of Attachment

posterior tibia to the anterioir lateral aspect of the medial femoral condyle

LCL Sites of Attachment

lateral epicondyle of the femur to the head of the fibula

MCL Sites of Attachment

medial epicondyle to the medial tibia

ACL Roles/ Motions Limited

1. anterior displacement of the tibia on femur (weight bearing)

2. limits excessive rotation (weight bearing)

PCL Roles/ Motions Limited

1. posterior displacement of the tibia on femur (non weight bearing)

2. limits excessive rotation (weight bearing)

Anatomy definiton

1. study the structure of the body

2. in greek means to cut open

Physiology definition

the body’s function

Kinesiology definition

study of movement

kinetics definition

study regarding forces that produce or resist movement

Kinematics Definition

study of movement without the regard of forces that produce or resist movement

Goniometer: Purpose/Function

measure or asses joint angle

Three Components of Kinematics and how they are implemented

1. movement taking place during activity

2. the position of the body or its segments

3. direction in which that movement occurs

Osteokinematics

movement of bones

Arthrokinematics

movement of joints

Describing/Purpose of Anatomical Position

compare the positioning of one body part to another

1. upright position

2. straight forward

3. feet parallel

4. palms forward

saggitall

1. flexion

2. extension

3. dorsiflexion

4. plantar flexion

5. forward and backwards movement