Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Semester 5 FSNM Exam 5 > Abnormal Gait > Flashcards

Abnormal Gait Flashcards

1
Q

What you observe depends on

A

Type and extent of CNS pathology
Prior or resulting impairments
Compensatory strategies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is the problem with grouping people based on distinct gait patterns

A

Saying that a certain diagnosis will result in a certain gait pattern and this is not true
Does not take comorbidities or variations into consideration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

9 gait patterns

A 
Ataxic
Stiff/rigid
Waddling, foot drop
Veering
Freezing, start/turn hesitation
Wide based
Narrow based
Cautious
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Ataxic gait description

A

irregular cadence and progression

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Ataxic gait - can be seen with

A

Cerebellar ataxia
Sensory ataxia
Chorea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Stiff/Rigid gait description

A

Loss of flexibility, stiffness of legs and trunk

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Stiff/Rigid gait can be seen with

A

Spasticity
Parkinsonism
Dystonia
Diffuse cortical and subcortical dx, multi-infarct

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Weakness gait description

A

Waddling and foot drop

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Weakness gait can be seen with

A

Muscle disorders
Peripheral neuropathies
Corticospinal tract lesion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Veering gait description

A

Deviation of gait to one side

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Veering gait can be seen with

A

Vestibular disorders

Cerebellar disorders

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Freezing gait description

A

Start and turn hesitation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Freezing gait can be seen with

A

Parkinsonism
Multi-infarct state
Normal pressure hydrocephalus
Frontal lesions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Wide based gait description

A

widened base with standing and walking

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Wide based gait can be seen with

A

Midline, cerebellar disorders
Multi-infarct state
In conjuction with other ataxic syndromes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Narrow based gait description

A

narrow base with standing and walking

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Narrow based gait can be seen with

A

Idiopathic parkinsonism

Spasticity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Cautious gait description

A

slowing, short steps and en bloc turns

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Cautious gait can be seen with

A

Non specific, multifactorial

Subcortical white matter lesions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Bizarre gait description

A

Strange gait patterns that fit none of the other categories

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Bizarre gait can be seen with

A

Psychogenic dx
Dystonia
Fear of falling gaits

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Video - describe hemiplegic gait

A

Arm in clinical UE pattern
Circumduction of the foot is the most characteristic
If mild - will see circumduction and then arm might just not swing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Video - describe parkinsonism gait

A

Universal flexion at all joints
Festination - small steps
Maybe tremor too

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Video - describe cerebellar gait

A

Broad stand and wide staggering gait
Tend to fall towards side of illness
Trunk sway in standing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Video - describe stomping gait

A

Slam foot down to get vibration into trunk to know that foot is on ground - see this more in dark because with light they can use vision

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Video - diplegic/CP gait description

A

Ext spasm, walk on toes

Circumduction but also adduction spasm - if bad can see scissor gait

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Video - myopathic or waddling gait description

A

Normally when we step, the hip we step with moves up

With this patient population, can’t hold pelvis so hip drops and trunk leans

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Video - neuropathic or steppage gait description

A

Need high steppage because of foot drop

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

How do impairments contribute to abnormal gait - list the 3 main impairments that will contribute to abnormal gait

A

Motor
Sensory
Perception/Cognitive

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Motor impairments - primary

A

Weakness/Paresis
Spasticity
Coordination difficulties

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Motor impairments - secondary

A

Soft tissue contractures

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Primary motor impairments - weakness - PF leads to changes in

A

progression - wont be able to propel body forward to the next step
wont see heel lift at terminal stance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Primary motor impairments - weakness - PF - leads to what with gait (step length and speed)

A

Shorter step length

Reduced gait speed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Primary motor impairments - weakness - PF - how does it affect knee motion

A

Reduces knee flexion velocity at toe off

Will see less knee flexion during swing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Primary motor impairments - weakness - PF - compensatory strategies

A

Hip flexors to pull off

Inc in hip and/or knee moments depending on force generating capacity available

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Primary motor impairments - weakness - DF - What will you see at initial contact

A

Flat foot at heel strike

Initial contact with heel, but foot will drop quickly and you get foot slap due to poor eccentric control of the TA

37
Q

Primary motor impairments - weakness - DF - what will you see during swing

A

Foot drag, reduced toe clearance

38
Q

Primary motor impairments - weakness - DF - compensation

A

Steppage gait

39
Q

Primary motor impairments - weakness - Quad - what will you see

A

Difficulty controlling knee during loading in early stance and vertical support in midstance
Normally we have eccentric control with loading response to accept the weight

40
Q

Primary motor impairments - weakness - quads - compensation

A

Hyperextension of knee at midstance

Forward trunk lean - COG shifts forward, line of force falls anterior to knee and pushes knee into hyperextension

41
Q

Primary motor impairments - weakness - Hamstring - what is the impact

A

Normally they contract eccentrically to decelerate at terminal swing - when weak they wont slow down the swinging forward motion so the knee may snap into extension

42
Q

Primary motor impairments - weakness - hip flexors - Hip flexor moment is produced at

A

initiation of swing, normal gait requires 2+ strength

43
Q

Primary motor impairments - weakness - hip flexors - inadequate activation leads to

A

Impacted limb advancement and loss of momentum to flex the knee

44
Q

Primary motor impairments - weakness - hip flexors - leads to what with step length and toe clearance

A

shortened step length

decreased toe clearance during swing

45
Q

Primary motor impairments - weakness - hip flexors - compensations

A

PPT and abdominals
Circumduction
Contalateral vaulting
Lean trunk towards opposite limb

46
Q

Primary motor impairments - weakness - Hip abductors/glut med - normally do what and inadequate activation leads to what

A

stabilize pelvis with stance

inadequate activation leads to trendelenburg, pelvic drop on opposite side of weakness

47
Q

Primary motor impairments - weakness - hip abductors/glut med - compensation

A

trunk leans over the ipsilateral side during stance phase

48
Q

Primary motor impairments - weakness - hip abductors/glut med - hip abductors on swing limb contribute to what

A

adequate regulation of step width

Might see narrowed step width, loss of mediolateral stability

49
Q

Primary motor impairments - Weakness/Force generation - impaired control through loss of

A

both eccentric and concentric contractions

50
Q

Primary motor impairments - Weakness/Force generation - Affect on

A

progression (gait speed)
equilibrium/postural control
adaptation

51
Q

Primary motor impairments - spasticity - impact gait in 2 ways

A

Inappropriate mm activation (particularly when mm is normally being lengthened)
Stiffness due to altered mechanical properties of the mm (intralimb/segmental coordination is disrupted)

52
Q

Primary motor impairments - spasticity - PF - common with

A

MOST COMMON

Stroke, CP, TBI

53
Q

Primary motor impairments - spasticity - PF - affects what phases of gait

A

stance and swing

54
Q

Primary motor impairments - spasticity - PF - how is stance phase impacted

A

Foot position - there is an absent heel strike
Normally the tibia would rotate over the foot - TS is lengthened and spasticity pulls it back and does not let tibia rotate over the foot and you get hyperextension at the knee

55
Q

Primary motor impairments - spasticity - PF - how is swing phase impacted

A

Tow drag

Reduced foot clearance

56
Q

Primary motor impairments - spasticity - PF - gait speed and step length

A

Reduced gait speed

Shortened step length on the contralateral side

57
Q

Primary motor impairments - spasticity - PF - TS and Post tib spasticity together - puts the foot in what position

A

equinovarus
foot contact often made with lateral border first, sometimes first met head is elevated and wont even make contact with the ground

58
Q

Primary motor impairments - spasticity - quads - what happens to gait

A

excessive knee extension during stance

overall stiff leg gait

59
Q

Primary motor impairments - spasticity - what happens to gait if quad spasticity is prolonged

A

reduces knee flexion at toe off

Overall stiff leg gait

60
Q

Primary motor impairments - spasticity - hamstring - leads to what

A

excessive knee flexion

61
Q

Primary motor impairments - spasticity - hamstring - common in

A

CP

62
Q

Primary motor impairments - spasticity - hamstring - primary contributor to what type of gait

A

crouched gait

63
Q

Primary motor impairments - spasticity - hamstring - what does it do to the knee with gait

A

prevents the knee from extending during terminal swing - knee flexion at initial contact
knee flexion can persist throughout stance

64
Q

Primary motor impairments - spasticity - hamstring - big problem with this is

A

One of the most energy demanding

Heavy demands on the quads to prevent collapse of limb during stance

65
Q

Primary motor impairments - spasticity - hamstring - step length

A

short steps

66
Q

Primary motor impairments - spasticity - hip abductors - particularly problematic during

A

swing phase - as hip flexes the entire leg moves medially - scissor gait if medially enough and crosses midline
Limb might cross body and hit other elg

67
Q

Primary motor impairments - spasticity - hip abductors - BOS

A

reduces the BOS - affects mediolateral stability

68
Q

Primary motor impairments - coordination problems - can be (3)

A

abnormal synergies
impaired intersegmental coordination
co-activation

69
Q

Primary motor impairments - Abnormal synergies - are what

A

Simultaneous recruitment at multiple joints, stereotypical movement patterns
Loss of fractionation and selective control

70
Q

Primary motor impairments - abnormal synergies - often seen with

A

corticospinal lesions and stroke

71
Q

Primary motor impairments - abnormal synergies - what type of synergy pattern is often seen

A

primitive mass synergy patterns

  • everything flexes in swing and everything extends in stands
  • But the timing and bursting is not appropriate
72
Q

Primary motor impairments - abnormal synergies - gait speed

A

Slow!

Poor transitions from swing/stance

73
Q

Primary motor impairments - abnormal synergies - often consistent with

A

poorer locomotor recovery

74
Q

Primary motor impairments - impaired intersegmental coordination

A

impaired relative timing btw hip knee ankle

not a weakness or a spasticity problem, but a timing problem

75
Q

Primary motor impairments - impaired intersegmental coordination - seen with who

A

cerebellar pathology, ataxic gait

76
Q

Primary motor impairments - impaired intersegmental coordination - what type of gait patterns

A

Staggering
Veering
Variability in stepping

77
Q

Primary motor impairments - coordination problems

A

Co-activation

Loss of selective recruitment

78
Q

Primary motor impairments - coordination problems - seen with

A

Stroke, CP
Could be a primary problem due to CNS lesion/pathology or could be compensatory as a means to increase postural support/stance and therefore increasing overall stiffness

79
Q

Primary motor impairments - coordination problems - energy

A

higher energy demands

80
Q

Secondary musculoskeletal impairments include what

A

changes in passive properties of mm

Soft tissue contracions - Ankle extensor contracture, hip/knee flexion cotnracture

81
Q

Secondary musculoskeletal impairments - PF does what to gait

A

Affect foot position at initial contact
Tibia can’t rotate over foot in stance
Hyperextension at knee
Reduced foot clearance and toe drag during swing

82
Q

Secondary musculoskeletal impairments - Hip flexion does what

A

hip cannot extend
trunk flexes forward
shortens step length

83
Q

Secondary musculoskeletal impairments - hip flexion does what to step length and speed

A

Shortens step length

Affects overall progression/speed

84
Q

Secondary musculoskeletal impairments - hip flexion - seen with

A

Spastic CP

Older adutls

85
Q

Secondary musculoskeletal impairments - knee flexion does what

A

Limits knee extension at terminal swing - foot not placed appropriately
Need more mm effort to control the knee

86
Q

Sensory impairments - include

A

Somatosensory
Proprioceptive
Visual defects

87
Q

Cognitive impairments - Alzheimer’s

A

Advanced Alzheimer’s you will see a gait disorder

Motor and cognitive centers are connected! So with disruption to cognition, you will see gait disturbance

88
Q

Sensory impairments - visual disturbance does what

A

impairs planning, obstacle control, path finding and planning

89
Q

Sensory impairments - somatosensory disturbance does what

A

Inability to feel foot on the floor would lead to a wider base gait, more time in double limb (reduced speed) to allow them to get more somatosensory info coming in

Semester 5 FSNM Exam 5 (5 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions