KINS304 Exam #4

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122 Terms

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Hindfoot (rear-foot)
\-talus

\-calcaneus
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Midfoot
\-navicular

\-cuboid

\-3 cuneiforms
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Forefoot
5 metatarsals, 14 phalanges
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The 3 arches of the foot
\-medial longitudinal

\-lateral longitudinal

\-transverse
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Functions of the foot
\-support body weight

\-adapt to uneven surfaces

\-absorb shock
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Gait analysis
the study of human locomotion used to assess posture and coordination during movement
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Gait cycle
the sequence of events between one foot strike and the subsequent foot strike of the same limb
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Stance phase (support phase)
\-foot is in contact with the ground and weight bearing

\-60% of gait cycle
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Swing phase
\-foot is suspended in air and non-weight bearing

\-40% of gait cycle
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When walking, we have periods of…
double support
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What are the five elements of the stance phase?

1. initial contact (heel-strike): when foot touches ground
2. loading response: weight transfers onto supporting limb; joints begin to absorb shock
3. midstance: body is directly over the support limb; joints are stacked
4. terminal stance: body moves forward to prepare for weight transfer; “falling forward”
5. pre-swing (toe-off): limb begins to unload as weight is transferred and accepted by the opposite limb
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What are the three elements of the swing phase?

1. initial swing: foot comes off floor and femur advances forward
2. mid swing: foot clears the ground as the thigh advances forward
3. terminal swing: lower extremity prepares to contact the ground again
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What happens to the stance and swing phases when running?
they switch so…

60% swing phase and 40% stance phase
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What is added as we run?
a flight phase
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Is only one foot or are both feet in contact with the ground when running?
only one foot
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Step
distance between the points of contact of contralateral (opposite) feet
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Stride
distance between ipsilateral (same) points of contact
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What is a healthy gait (stride)?
about 1 second to complete stride
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Which of Newtons Laws can be applied with gait?
Newtons Third Law: with every action there is an equal and opposite directed reaction
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How can ground reaction forces identify gait issues?
\-see how force changes between different activities

\-see how different strike patterns impact forces

\-see how footwear impacts forces

\-see how size/weight impacts forces
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Heel strike
heel lands first, followed by the forefoot
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Midfoot strike
heel and ball of foot land simultaneously
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Forefoot strike
ball of foot lands first, followed by the heel
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Which strike pattern of the foot is best for reduced injury?
not enough research to back up evidence and answer questions
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Compression
due to body weight and gravity
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Hip compression
\-bears up to 3-4x body weight while walking stance phase

\-7x body weight during running
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Knee compression
\-bears about 3x body weight during walking

\-4x body weight during stair climbing
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Ankle/foot compression
\-about equal in body weight during walking

\-about 2-3x body weight during running
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Compressive forces on joints increase or decrease as body weight and activity speed increase?
increase
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Tension
due to passive eccentric loading
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What does tension during the stance phase result in?
results in stored energy which is then used during the push-off/toe-off phases of walking and running
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The use of stored energy reduces the…
metabolic energy cost during gait
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Anatomical factors impacting human gait
\-Q-angle

\-Coxa varus and Coxa valga

\-Genu valgum and Genu varum

\-arch height
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Other factors impacting human gait
\-ROM

\-strength

\-motor function and control

\-balance and stability

\-previous injury
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What will happen if one or more factors is compromised?
other joints will begin to compensate for the injured joint
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Gait change after lateral ankle sprain
\-chronic ankle instability

* increased ankle inversion at initial contact
* lateral foot loading during support phases
* hip adduction during swing phase

\-increased peak ankle plantarflexion moment (rotational force)

\-decreased knee flexion moment during toe-off
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Gait change after ACL injury
\-limb differences between surgical and healthy limb

* decreased knee flexion
* decreased tibial internal rotation
* decreased knee flexion moment
* decreased adduction moment

\-decreased knee flexion angle, decreased knee flexion and adduction moments

\-knee flexion and adduction moments differences present up to 5 years after surgery
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Trendelenburg Gait
\-weakness in and/or instability to control hip abductors

\-gluteus medius/minimus

\-causes the contralateral (opposite) hip to drop
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Steppage gait (foot drop)
\-paralysis of the ankle dorsiflexors

\-increase hip flexion to clear the ground
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Slap gait
\-weakness of ankle dorsiflexors causing the foot to slap during eccentric contraction

\-typically creates audible sound
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What can we do for anatomy/alignment issues?
\-braces

\-orthotics

\-corrective devices
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What can we do for prevention and rehabilitation?
\-increase ROM and flexibility

\-increase strength

\-increase motor function/coordination
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What equipment can we analyze to help gait?
\-footwear

* goal is to decrease impulse and aid in shock absorption
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6 steps to a kinematic analysis

1. Ask questions
2. Optimal perspective
3. Optimal viewing distance
4. Number of trials
5. Attire and environment


1. Video camera
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Cerebrum
controls conscious thought and intellectual function, memory storage and processing
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Cerebellum
coordinates motor patterns, responsible for balance and coordination
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Brain Stem
responsible for autonomic functions (breathing, heart rate, body temperature, organ function, sensory information, etc)
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The spine has how many bones?
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Functions of the spine
\-protect spinal cord

\-support body weight

\-muscle attachments

\-enables motion in 3 cardinal planes
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Spinal curvatures aid in…
shock absorption
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Primary curvatures
thoracic and sacral regions; present at birth
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Secondary curvatures
cervical and lumbar regions; develop as we support our body weight
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Scoliosis
lateral curvature of spine
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Kyphosis
increased thoracic curvature
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Lordosis
increased lumbar curvature
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What vertebrae has the largest ROM?
cervical
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What vertebrae has limited ROM?
thoracic
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Increased size helps withstand and reduce stress in what vertebrae?
lumbarI
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In lumbar, as surface area increases, what decreases?
stress
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Stress
distribution of force within a body
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Compression
pressing/squeezing force directed axially
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Tension
pulling/stretching force directed axially
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Bending
asymmetric loading that produces compression on one side and tension on the other side
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Shear
force directed parallel or tangent to a surface
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Torsion
twisting force around the longitudinal axis
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Combined
simultaneous action of 2+ types of loading and is the most common type of loading
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What are the cushions of the spine?
intervertebral discs
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What type of mechanical loads does the spine go through?
\-Standing and daily activities= axial compression

\-During flexion, extension, and lateral bending= compression and tension

\-Rotation: shear stress
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What are the facet joints of the spine?
\-assist in load bearing, and help resist compressive loads, shear forces, and rotational torsion

\-increased load during hyperextension
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Where is most stress placed on in the spine?
L4-S1 discs and facet joints
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What is the primary load affecting the spine?
compression
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What significantly increases the load on the lumbar spine?
sitting, slouching, bending, lateral flexion, and rotation
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Deformation
change in shapeq
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What is the yield point in the load-deformation curve?
point where deformation is permenant
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What is the elastic region on the load-deformation curve?
temporary deformation
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What is the plastic region on the load-deformation curve?
the point of no return for deformation
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Over time, our tissues lose…
elasticity
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Acute loading
\-application of a single force of sufficient magnitude to cause injury to a biological tissue

\-macrotrauma: high load, low frequency
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Repetitive loading
\-repeated application of a subacute load that is usually of relatively low magnitude

\-microtrauma: low load, high frequency
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Examples of acute loading
\-concussions

\-dislocations

\-spinal injury

\-strains

\-sprains

\-dislocations
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Examples of repetitive loading
\-disc herniations

\-low back pain

\-parkinsons and alzheimers

\-stress fractures
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Spondy
repetitive hyperextension of the spine
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Disc herniations
protrusion of the nucleus pulposus from the annulus fibrosus
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What are some common causes of disc herniations?
\-disc generation

\-poor mechanics

\-repetitive flexion and/or twisting
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Common culprits of low back pain
\-poor mechanics

\-muscular weakness

\-overweight/obesity
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What Newtons Law corresponds with traumatic brain injuries?
Newtons First Law: a body in motion will stay in motion unless acted upon by an external force
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Momentum
influenced by mass, velocity, and direction of the bodies involved
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Impulse
must consider the magnitude and timing of the force
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Impact
large force over a small time interval
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Concussion
“trauma-induced alteration in mental status that may or may not involve loss of consciousness”
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Physical symptoms of a concussion
\-nausea

\-vomiting

\-headache

\-light/noise sensitivity
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Cognitive symptoms of a concussion
\-confusion

\-amnesia

\-difficulty remembering

\-difficulty concentrating
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Emotional and behavioral symptoms of a concussion
\-irritability

\-sadness

\-nervousness/anxiety

\-opposite of normal mood

\-change in sleep patterns
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Prevention for concussions
\-education

\-proper form and coaching

\-activity tracking and modification

\-neck strengthening
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What are the motions at the knee joint?
\-flexion

\-extension

\-internal rotation

\-external rotation
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What does the patella do for the knee?
\-increases the mechanical effectiveness of the quads by changing the line of pull and increasing the lever arm

\-increases contact area between structures

* reduces friction
* decreases pressure/stress
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Menisci are the ___ of the knee
shock absorbers
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Menisci aid in…
proprioception
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Ligaments enhance the ___ of the knee joint
stability
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What are the two collateral ligaments?
Lateral Collateral and Medial Collateral