BE- Part 2 Lower extremity Flashcards
S: 51
The hip can also be called the ____ joint
femoral acetabular joint
What three bones make up the acetabular fossa
pubis
ischium
ilium
Angle of ____ is the vertical line from the center of the femur head to the crest of the acetabulum
angle of wiberg
____ degrees for the angle of femoral inclination
125 degrees
what is the normal angle of femoral inclination
125 degrees
- the angle between the femoral neck and shaft
normal: 125
coxa vara: 125
_________: is the angle between the femoral neck and shaft
angle of femoral inclination
normal: 125
coxa vara: 125
There is a _____ in the trabeculation where the femor is in coxa vara
increase trabeculation
during coxa vara: The femoral head terns ___ in the acetabulum, ___ joint surface which causes a ____ stability
head turns deeper
increase surface
= increase stability
c.c.: When a pt has coxa vara in the femoral joint they are succeptable to ___ & ___
neck fracture
epiphyseal damage
coxa valga is ____ degrees
> 125
during coxa valga the force load is more in line with ____
femoral shaft
during coxa valga the force load is more in line with the femur causes : ____ trabeculation, ____ joint space, ____ stability
decrease in trabeculation
decrease in joint space
decrease in stability
c.c. pts will present with (4) conditions when they hve coxa valga
abductor fatigue & weakness
hip displasia
art tearing
arthrosis
c.c. hip dysplasia: ____
dislocation
ROM of hip in flexion with knee ext. and flex.
90- ext
120 - flex
chief flexors of the hip
psoas iliacus rectus femoris sartorius pectineus
c.c. during birth a hip dysplasia can occur. this will cause:
- underdeveloped prox. femoral epiphysis
- lateral femoral displacement
- increase acetabular roof = putti’s triad
c.c. hip dysplasia will show (3 c.c.) in babies
- diff. leg lengths
- uneven skin folds
- limp
c.c. What are the three sx of Putti’s triad in hip dysplasia
- sup/.lat migration of the femoral head
- Increase acetabular angle
- small head of the femoral epiphysis
Skinner’s line for the hip joint
drawn horizontally
btw the top of the greater trochanter to the superior part of the obturator foramn
____ line for the hip is through the triradial cartilage
hilgenreiners line
ileum
ischium
pubis
What 3 bones of the hip make up the triradial cartilage
ileum
ischium
pubis
When measuring the hip joint the______ will be in the medial lower medial quadrant of the hilgenreiner’s line and perkin’s line
the epiphyseal plate on the femoral head
ROM of hip in extension
10-30
M.’s that ext. the hip (5)
bicep femoris semitend. semimembran. glut max glut med
arthrosis is also known as ___
OA
osteoarthritis
What is the difference btw osteoarthritis and osteroarthrosis
there will be no inflammation in osteoarthrosis
- more bone spurs and tightness
-itis: has redness and swelling
What is the difference btw rheumatory arthritis and arthritis
rheumatory will go through period of flare up
ROM of abduction of the hip
45-50 degrees
TFL
gluts
sartorius
M that preform abduction of the hip
TFL
gluts
sartorius
45-50 degrees
ROM of adduction of the hip
20-30 degrees
adductors
gracilis
pectineus
TFL/ITB restriction sx causes a restriction in (3) movements
Flex
Abd
IR
c.c. there will be an inflammation of ____ during TFL/ITB restriction sx
trochanteric bursitis
effects runners
What is Obers test used to assess
TFL/ITB restriction syndrome
What would a +/- test show in ober’s test (ITB/TFL restriction sx)
place pt in side line position with leg abd.
+: pt add. leg- pain and the movement is not smooth
-: pt. add leg- pain but the leg DOES move smooth
c.c. ____: avascular necrosis of the head of the femur that causes a collapse of the hip joint
Legg- Calve-Perthes Dx
- decrease hip abd, IR
c.c. during legg- calve - perthes dx the pt will display
- decrease hip abd, IR
- poor gait
- leg length discripancies
Two test done for Legg- calve- perthes dx
+ roll test
Patrick F.AB.ER
____% of the pop the sciatic N goes through the piriformis
15%
Pt with piriformis sx will have pain in the pot. hip with they preform ___ & __ movement
abd. and ER
trochanteric bursitis aka ____
pain during ___ & ___
hip pointer
pain during add and ER
The knee is the ___ & ___ of the body
largest and weakest joint of the body
genu valgus angulation at ____ degrees
5 degrees
genu valgus stresses the _____ components
lateral
genu varus stresses the ____ components
medial
during a unilateral stance there is an increase in ____ force on the knee
medial forces
COG is at ___________
1 1/2 inches anterior of the 2nd sacral segment
Where are lines drawn to make the Q angle
- a line through the ASIS
- line through the center of the patella to the tibial tubercle
normal Q angle degrees
0-20 degrees
coxa ___ and genu ___ = knock knees
coxa varum
genu valgum
The medial menisci is ____ shape
C shaped
definition of: congruence
fluidity and smoothness of movement
joint reaction force on knees is __- __ times body weight during standing
1-2x body wt.
joint reaction force on knees is __-__ times body weight during running
3-4x body weight
What are the two phases of gait
stance phase
swing phase
during stance phase the body is over the ___& ___
medial tibial plateau & medial meniscus
During swing phase the body is over the ____
lateral tibial plateau
Which is bigger: medial or lateral tibial plateau
medial plateau
medial meniscus is 3x bigger than the lateral meniscus
___ degrees of flexion in the knee
140
The knee has a “ ____” effect
rolling/ spinning effect
during flexion of the knee there is a rolling/ spinning effect of :
posterior roll of the femur
anterior glide
ACL check
Doing extension of the knee there is a rolling/ spinning effect:
anterior roll of the femur
posterior glide
PCL check
during extension of the knee there is a ___ lig check
PCL
during flexion of the knee there is a ____ lig check
ACL
___ degrees at extension of the knee
0 degrees
___ degrees of recurvatum of the knee
0-5 degrees
muscles that flex the knee
hamstrings
gracilis
calf muscles
popliteus
muscles that extend the knee
Quads
bicep femoris
____ test is done for the collateral lig of the knee
stress test
To test for menisci instability, apply a ____ force to the tibia
compressive
During drawer test of the knee ____ is seen as normal
1/8th of an inch movement
(+) 1/2 an inch of movement
A positive sign during the drawer test of the knee is ____
1/2 inch of movement
normal- 1/8th of an inch
What is involved in the terrible triad
MCL
ACL
Medial meniscus
___ degrees of IR at the knee
30
___ degrees of ER at the knee
45 degrees
M. that preform IR at the knee
gracilis
semitend.
semimembr
M. that preform ER of the knee
Bicep femoris
Patella glides in the ____
patellar/ femoral groove
Full patellar contact occurs at ___ degrees extension all the way to ____ degrees of flexion
0 degrees of ext
90 degrees of flex
past 90 degrees of flexion there is only a ___ patellar contact
medial patellar contact
the knee has a ___ mechanism
screw home
in a screw home mechanism of the knee the tibia twists into a ___ rotation
ER
- probably why we stand with our toes slightly out
hind foot: ___ + ___
talus + calcaneus
mid foot: ___+____+___
navicular + cuboid + cuneforms
fore foot: ___+ ___
metatarsels + phalanges
ankle mortis: ___+ ___+ ___
tibia + fibula+ talus
which arch of the foot bares 96% of the body wt
longitudinal arch
___ arch adjusts and stretches 10% for uneven terrain
longitudinal arch
the plantar apneurosis stretches from the ___ to the ___
calcaneous to the metatarsel heads/ prox phalanges
____ causes the plantar aponeurosis to stress the most
push off during gait
the plantar aponerosis is also known as the ____ arch
longitudinal arch
for an adjustment of a dropped metatarsel head the DC ____
distracts the phalanges and pushes I/S
What is the fick angle
Angle between gait direction and foot axis; Normal “angling out” is 19°
The tibia is in ____ position during pes planus
IR
high arch aka_______
pes cavus
ROM of tibia/ talus joint is ___ degrees
1 degree
Dorsiflexion is ___ dgrees
20 degrees
10% of ____ is required for ambulation
dorsiflexion
action of the tibia on the talus on weight bearing
tibia rotates over the talus
dorsiflexion is limited by the ____
tricep surae
- it limits D.F. more in full extension of the knee
_____ occurs to create a closed pack position of the ankle
the talus wedges into the mortise joint btw the tib and fib
Plantar flexion is ____ degrees
50 degrees
plantar flexion is limited by what 3 muscles
tib. anterior
extensor hallicus longus
extensor digitorum longus
_____ degrees of movement n the subtalar joint
1 degree
the subtalar joint consists of what two bones
calcaneus
talus
during wt. bearing the ___ moves on the ___ of the subtalar jt
talus moves on the calcaneus
calcaneus acts like an anchor to the floor
during non wt bearing the ___ moves on the ___ of the subtalar jt
calcaneus moves on the talus
the talus acts like an anchor to the body
transverse talar joint locks in ____
supination
transverse talar joitn unlocks in ____
pronation
Transverse talar jt moves with ____ foot
forefoot
-opp of hindfoot
transverse talar jt moves opp of ___ foot
hind foot
- moves with forefoot
body weight is controlled by the hip ___ and wt. is over the ___ during gait
controlled by: hip abductors
over: med. tib plateau
name the 5 parts of the stance phase of gait
heel strike foot flat mid stance heel off push off
The foot is supinated during ____ and pronated during ____ in the stance phase of gait
supinated during heel strike
pronated during push off
Name the three portions of the swing phase
acceleration - PF
midswing - PF to neutral
deceleration - DF
The foot is in ____ during acceleration , ___ midswing , and ___ during deceleration of the swiong phase of gait
PF- acceleration
PF to neutral- midswing
DF- deceleration
before 10 yr old our COG is at ____
Adults COG is at ___
10 yr old: at T12 (less stable)
Adults: ant to S2
Infant heads are ___ total height of body
adult heads are ___ total height of body
infants: 1/4th
adults: 1/8th
highest point of gait is ____
midstance
lowest point of gait is ___ & ___
heel strike and push off
Base width ___”
2-4”
step length ___”
15”
length btw R/L during gait
Stride length ___”
30”
heel strike to heel strike of the same foot
(step length is 15”)
Cadence of gait
90-120 steps per min
- count every time there is a heel strike
opposite tandum arm swing means ____
that leg swing is opposite of arm swing during step
During swing phase the advance and non advance ASIS shift ___ degrees
4 degrees
The COG shifts ____ to ___ inches causing a lateral shift to the advanced side
1.5 to 2 inches
“Slap foot” is a sign of ____ meaning that the individual has weak ___
flat foot
weak dorsiflexors
_____ gait: means that the pt is walking abn to decrease pain
antalgic pain
- most likely a soft tis injury
____ gait: there may/ maynot be pain, there will be a true bone or joint lesion.
soft tis is not involved
pt can display ____ gait
arthrogenic gait
- display circumduct gait because they cant bend the joint
contracture gait is cause by ____ causing M contractures
joint disease
Club foot displayes what (3) joint positions
PF
forefoot adduction
hindfoot varus
c.c. _____ foot is when the patient is walking on the dorso-lateral aspect of the foot.
club foot
(it is a equinus gait abnormality)
foot is in PF, forefoot is add., hinfoot is varus
glut max gait aka____
thoracic posterior lurch
“the Nutritionist”
Glut med gait aka___ & ___
trendelenburg’s gait
chorus girl swing
thoracic lateral lurch
- glut med cant hold body wt. during stance phase
- hips swing
hemiplegic gait is seen in ____ patients.
stroke patients
- displays a circumductive gait
Scissor gait aka___
neurogenic or spastic gait
how loretta walked
Scissor gait is a crossover of the ___ M
seen in ___ patients
adductor M
- cerebral palsy
Steppage gait aka_____
foot droppage
steppage gait is caused by weak ____.
The toe ___ & foot slaps
seen in ___ patients
DF
toe drags
foot slaps
syphilis patients
