Foot n Ankle and Gait

Ankle sprain is usually due to which of the following occuring?

Inversion

Length of plantar fascia?

Medial calcaneal tubercle to head of metatarsal bones (continuous with achilles)

What is widely considered the most sprained ligament of the body?

anterior talofibular

Where will patient present with pain with ankle sprain?

anterolateral

Eversion sprain of ankle is less common and typically has to do with what ligament?

deltoid ligament (associated with avulsion fracture)

Eversion ankle sprain presents with pain where?

inferior to medial malleolus

A high ankle sprain is usually involving what ligament?

ligament for distal tibia and fibula

High ankle sprain is usually occuring from what movement?

external rotation of foot (plant and twist)

Head of the talus rotating medially and inferiorly results in what?

pes planus

Can pes planus be due to the aquisition of it AND/OR being born with it?

True

What is frequently seen with claw toes?

pes cavus

What is usually involving spring ligament and causing exessive stress on aponeurosis of foot?

plantar fascitis

What is a heel spur? What is it associated with?

osteophyte formation at medial tubercle of calcaneus

associated with stress on plantar fascia

What presents with painful growth b/t 3rd and 4th metatarsal and is typically a benign tumor of nerve tissue?

morton’s neuroma

Bunion is what?

large boney protuberance at toes; usually 1st MTP joint

Bunion is associated with what?

hallux valgus

Tailor’s bunion is usually on which MTP?

1st

Walking is important for transportation, indepedence, and a marker for what?

overall health

A series of movement that follow a cyclic pattern to translate the body across a plane with as much efficiency and as little effort as possible describes what?

Gait

How many adjustments must be made to keep body’s COG in stable position?

numerous

What is gait defined as?

the manner in which one walks (posture and movement mechanics)

What is described by the time from when initial foot makes contact untol contralateral foot makes contact?

step

What is described by the time from when a foot initially strikes the ground to the secondary strike the same foot?

Stride

How many steps is each stride comprised of?

Two

Stride refers to how many limbs?

A single limb

What is described by the period of time when the foot is in contact with the ground?

Stance phase

What is described by the period of time when leg is moving forward? (off ground)

The swing phase

What phase makes up 60% of the gait cycle?

Stance phase

What phase makes up 40% of the gait cycle?

Swing phase

Weight acceptance, single limb support and limb advancement makeup, what division of the gait cycle?

tasks

What is the most demanding task in the stance phase?

Weight acceptance

Single limb support has what properties?

Full weight is supported on one leg

Occurs during 40% of each step or 80% of total stride

Single limb support is heavily reliant on what mechanism?

Lateral stability mechanism

During double limb support of the stance phase what percent does each step take? What percent does the total stride take?

10% for each step

20% for total stride

What component of the stance phase is the foot level with the ground? Where are the head, arms, and torso in relation to foot?

Foot flat; the head, arms and trunk is still somewhat posterior to foot

What component of the stance phase is the bodies weight directly over the supporting lower extremity?

Mid stance; the head arms, trunk and lower extremity are lined up

What is the toe off phase?

The plantar flexor push off the ground; known as propulsion

During the initial contact, what are the hip knee and ankle musculature doing?

Eccentric controlling motions of plantarflexion, hip flexion, and knee flexion

How how many degrees of hip flexion and knee extension should there be at initial contact?

30° of hip flexion

Full knee extension

During the foot flat phase the knee is in how many degrees of flexion? The ankle is how many degrees of plantarflexion?

15 to 20° of knee flexion

5 to 10° of plantar

During the mid stance, the ankle is in 5° dorsiflexion and accepts what? What type of contraction do the knee and hip do?

accept the full effect of gravity

knee and hip extend with concentric contraction

What will the hip do during toe off?

Internally rotate

The pre-swing/acceleration/early swing phase begins when?

Once the toe leaves the ground

The initial swing continues from what?

From pre-swing until knee reaches maximal flexion

At which phase of the swing phase is the tibia in a vertical position under the body?

Middle swing

The late swing is also known as what?

deceleration or terminal swing

What phase of swing phase is the tibia vertical to initial contact?

Late swing

Passive hip and knee flexion is generated by what muscles during terminal stance phase/initial swing phase?

iliopsoas and rectus femoris

What will the hip do during the swing phase?

Externally rotate

During the terminal swing phase to prepare the foot to hit the ground, the knee and hip extensors will activate to do what?

Control weight acceptance

During the terminal swing phase to prepare the foot to hit the ground, the knee and hip flexors will do what?

Dominate the motion

During the terminal swing phase to prepare the foot to hit the ground, the dorsiflexors will do what?

Eccentrically control heel strike

What direction does the upper extremity move in relation to the lower extremity during gait?

Contralateral

Spastic or scissor gate is what? What is it associated with what?

knees and thighs hit each other while walking in a crisscross manner

Cerebral palsy

What is propulsive gate? What is it associated with?

stooped and stiff posture with head and neck bent forward

Parkinson's

Ataxic gait is what?

Unsteady walk with feet thrown out

Usually intoxicated or drunk

What is waddling gait?

Walk resembling that of a duck

What is steppage gait?

Foot hangs with the toads pointing down and scraping ground walking

What are the important factors of the windlass mechanism?

Great toe dorsiflexes

arch height increases

Plantar fascia tightens