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fall A 2024 > biomech final > Flashcards

biomech final Flashcards

1
Q

why is foot required to be pliable?

A

to absorb stress and conform to environment

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2
Q

why is foot required to be rigid?

A

to withstand large propulsive forces

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3
Q

what is a normal sensation that a healthy foot provides?

A

protection/feedback to muscles of LE

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4
Q

what is the ankle?

A

talocrural joint
articulation among tibia, fibular, talus

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5
Q

what is the foot?

A

all tarsal bones and joints distal to ankle

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6
Q

rearfoot/hindfoot

A

talus, calcaneus, subtalar joint

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7
Q

midfoot

A

remaining tarsals, transverse tarsal joint, distal intertarsal joints

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8
Q

forefoot

A

metatarsals, phalanges, tarsometatarsal joints

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9
Q

how much weight is transferred through fibula?

A

10%

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10
Q

describe the distal tibia

A

expands to load bear at ankle
twisted externally 20-30 degrees relative to proximal
~called lateral tibial torsion

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11
Q

3 major joints in ankle

A

talocrural
subtalar
transverse tarsal

talus involved with all 3

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12
Q

dorsiflexion/plantarflexion plane

A

sag
ML axis

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13
Q

eversion/inversion plane

A

frontal
AP axis

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14
Q

abd/add plane

A

horizontal
transverse axis

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15
Q

why are fundamental definitions inadequate at ankle?

A

joints have oblique axis rather than standard

they’re weird

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16
Q

pronation at ankle

A

eversion, abd, dorsiflexion
flatfoot

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17
Q

supination at ankle

A

inversion, add, plantarflexion
high arch

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18
Q

nickname for talocrural

A

mortise

concave proximal side
major natural stability to ankle

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19
Q

ML axis in ankle

A

10 degrees superior in medial side of ankle

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20
Q

AP axis in ankle

A

6 degrees anterior on the medial side on ankle

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21
Q

compressive force percentage through tibia vs fibula

A

talus and tibia - 90-95%
talus and fibula - 5-10%

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22
Q

width is talocrural joint articular cartilage

A

~3mm

can be compresses by 30-40% against peak load
if thinner, cannot support as large of a load

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23
Q

arthro in ankle dorsiflexion

A

talus rolls anterior, slides posterior

pulls achilles taut

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24
Q

arthro in ankle plantarflexion

A

talus rolls posterior, slides anterior

anterior capsule taut

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25
Q

factors increases mechanical stability of talocrural

A

increases passive tension
trochlear surface wider ant than post

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26
Q

ROM of right talocrural during gait cycle

A

plantar at heel contact
dorsiflexion during force absorption into stance
at push off, plantar flexion at toe off - propulsive force
small dorsiflexion in swing back & into plantar flexion

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27
Q

what is an ankle mortise injury?

A

extreme and violent dorsiflexion
called high ankle sprain

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28
Q

what is an unstable position in the ankle?

A

full plantarflexion
slackens most collateral ligaments of ankle
places narrower width of talus between malleoli

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29
Q

subtalar joint

A

under the talus

pronation and supination during non weight-bearing
occur al calcaneus moves relative to fixed talus

in weight-bearing pronation and supination occur as calcaneus remains relatively stationary

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30
Q

how much of the total articular surface does the posterior articulation of the subtalar joint occupy?

A

70%

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31
Q

subtalar axis of rotation

A

42 from horizontal
16 from sagittal

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32
Q

what motions make up pronation

A

eversion
abduction

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33
Q

what motions make up supination

A

inversion
adduction

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34
Q

by how much does inversion exceed eversion?

A

double

inv - 22.6 deg
ev - 12.5 deg

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35
Q

passive inv:ev ratio

A

3:1

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36
Q

what limits eversion?

A

lateral malleolus
deltoid lig on medial side

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37
Q

two articulations of the mid tarsal joint

A

talonavicular
calcaneocuboid

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38
Q

what is the most versatile joint in the foot?

A

mid tarsal

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39
Q

what joint allows pronation/supination of midfoot on uneven surfaces?

A

transverse tarsal joints

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40
Q

what muscle is the prime supinator of the foot?

A

tibialis posterior

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41
Q

arthro of navicular around talus in supination

A

spin

cave on vex

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42
Q

transverse tarsal joint rarely moves without:

A

subtalar joint

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43
Q

two AoR at transverse tarsal joint

A

long: ev/inv
oblique: abd/dorsi and add/plantar

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44
Q

amount of pure inv/ev of midfoot

A

inv - 20-25 deg
ev - 10-15 deg

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45
Q

what bones form the medial arch?

A

calc, talus, navi, cuneiforms and associated three MTs

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46
Q

other structures that assist medial arch in absorbing loads

A

plantar fat pads, sesamoid bones, superficial plantar fascia

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47
Q

where does weight fall when one stands normally?

A

near talonavicular joint

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48
Q

what maintains height of medial longitudinal arch during standing?

A

deep plantar fascia

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49
Q

with a fallen arch, what happens to support arch?

A

muscles compensate for arch

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50
Q

pes planus

A

flattening of arch

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51
Q

rigid pes planus

A

dropped arch in non weight bearing

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52
Q

flexible pes planus

A

dropped arch only when foot loaded

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53
Q

pes cavus

A

abnormally raised medial longitudinal arch

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54
Q

characteristics of pes planus

A

excessive calc eversion
increased flexibility of foot
uneven weight distribution
hallux valgus
postural symptoms

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55
Q

characteristics of pes cavus

A

limited pronation
rigidity
uneven weight distribution
digital contractures
tendency for lateral ankle instability/sprains

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56
Q

percent of change of height of med long arch in stance phase

A

60%

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57
Q

how pronation connects to hip

A

pronation of foot causes int rot, flex and add at hip

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58
Q

how pronation connects to knee

A

increased valgus stress

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59
Q

how pronation connects to rearfoot

A

lowers med long arch

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60
Q

consequences of rearfoot varus

A

over supinated at toe off
excessive use of peroneals
over stress of MT
dorsiflexion of great toe trying to force 1st MPJ down

high med arch

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61
Q

consequences of rearfoot valgus

A

over pronated at toe off
overstretching of deltoid ligaments

collapsed arch

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62
Q

newton’s 3rd law

A

equal and opposite reaction

weight is a force downwards
ground reaction force is upwards

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63
Q

3 other components of diagonal GRF

A

vertical
horizontal
ML

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64
Q

when does someone slow down?
(gait slide 2)

A

when GRF is backwards
when heel hits the ground

65
Q

when is GRF highest

A

weight fully through heel
weight fully through toes

66
Q

are COG and COM the same in human body?

A

no

just in uniform object like a book

67
Q

COG

A

depends on posture

68
Q

COM

A

stays in body

69
Q

eccentric contractions in gait

A

go with gravity

squatting down before a jump

70
Q

concentric contractions in gait

A

against gravity

jumping up

71
Q

what is flexor torque

A

GRF behind the joint

72
Q

extensor torque

A

GRF in front of the joint

73
Q

forces in trendelenburg

A

more ML force
less AP force

74
Q

what are the pretibial muscles?

A

dorsiflexors

75
Q

heel rocker

A

initial contact to foot flat
ankle plantarflexion

76
Q

ankle rocker

A

foot flat to heel off
dorsiflexion

77
Q

forefoot rocker

A

heel off to toe off
ankel PF and MTP DF

78
Q

examples of when rockers may not happen correctly

A

knee surgery
bracing
in pain
wearing high heel

79
Q

1 cycle/stride

A

heel strike to heel strike of the same foot
2 steps
2 phases ( stance and swing)

80
Q

1 step

A

between right and left heel strikes

81
Q

stance phase

A

right heel strike to right toe off

when right foot is in contact with ground
60% of gait cycle

82
Q

swing phase

A

right toe off to next right heel contact

right foot in the air
40% of gait cycle

83
Q

how long is a stride length?

A

144 cm

84
Q

how long is a step length?

A

72 cm

85
Q

what is foot angle?

A

5-7 deg externally rotated

86
Q

what is step width?

A

8-10 cm

87
Q

what happens with a larger foot angle?

A

larger step width
reduced step length
reduced stride length

88
Q

what happens with smaller foot angle

A

<5 deg results in in toeing

89
Q

gait velocity

A

3 mph

90
Q

ground clearance in gait

A

min 1 cm

91
Q

cadence of gait

A

133 bpm

purple haze - left up right up

92
Q

how many periods of single and double limb support?

A

2 each

93
Q

how much is first double limb support?

A

0-10%

weight transferred from left to right

94
Q

first period of single limb support

A

10-50%

right in stance, left in swing

95
Q

second period of DLS

A

50-60%

weight transferred from right to left

96
Q

second period of SLS

A

60-100%

right in swing, left in stance

97
Q

what do faster speeds do to gait?

A

DLS disappear and there are periods where both limbs are off the ground

98
Q

what do slower speeds do to gait?

A

give greater stability
increase DLS

99
Q

how many events in stance phase?

A

5

100
Q

heel contact

A

right heel contacts the ground at 0%

101
Q

foot flat

A

right foot flat on ground at 8%

102
Q

mid stance

A

legs parallel at 30%

103
Q

heel off

A

between 30-40%
the instant the right heel comes off the ground

104
Q

toe off

A

at 60%
instant right toes come off the ground

105
Q

GRF at toe off

A

push backward so GRF is anterior

ank- PF
knee - ex
hip - ex

106
Q

how many parts to swing phase?

A

3

107
Q

early swing

A

60-75%
right foot behind left

108
Q

mid swing

A

75-85%
legs parallel

109
Q

late swing

A

85-100%
after parallel to right heel strike

110
Q

RLA gait phases

A

initial contact
loading response
mid stance
terminal swing
pre swing
initial swing
mid swing
terminal swing

111
Q

traditional gait phases

A

heel strike
foot flat
mid stance
heel off
toe off
acceleration
mid swing
deceleration

112
Q

sagittal plane movement in pelvis vs other LE joints

A

much smaller in pelvis

113
Q

sagittal movement at pelvis throughout gait

A

at right heel contact, neutral
0-10%, small posterior tilt
just after mid stance, begins anterior tilt
2nd half of stance, posterior tilt
initial and mid swing, anterior tilt
terminal swing, posterior tilt

in double leg support, posterior pelvis tilt

114
Q

what is pelvic tilt in gait caused by?

A

hip joint capsule
hip flexors
hip extensors

115
Q

in those with hip contractures, how does their pelvis tilt in the second half of stance?

A

exaggerated anterior tilt

116
Q

which pelvic tilt can compensate for increased lumbar lordosis?

A

excessive anterior pelvis tilt
compensate for lack of passive hip extension

117
Q

sagittal movement of hip throughout gait

A

at heel contact, flexed 30 deg
before toe off, max extension of 10 deg
during pre swing, hip flexion initiated
by toe off, 0 deg flexion
during swing, continued flexion to bring LE forward

118
Q

overall ROM needed at hip for walking

A

30 deg flexion
10 deg extension

119
Q

how do individuals with limited sag hip mobility go unnoticed?

A

movement of pelvis and lumbar spine compensate for reduced hip motion

120
Q

how is hip extension detectable through observational skills?

A

anterior pelvis tilt and increase in lumbar lordosis

121
Q

sagittal movement of knee throughout gait

A

at heel contact, flexed 5 deg
during initial 15%, flex to 10-15 deg
until about heel off, approaches near full extension
by toe off, reaches about 35 deg flexion
by beginning of mid swing, reaches about 60 deg flex

122
Q

what is slight knee flexion in gait controlled by?

A

eccentric action of quads

shock absorption and weight acceptance

123
Q

what is the point of knee flexion?

A

toe clearance

124
Q

sagittal movement at talocrural joint throughout gait

A

at hell contact, slight PF 0-5 deg
during the first 8%, foot is flat
during stance, 10 deg DF
after heel off, begins the PF
just after toe off, 15-20 deg PF
during swing, DF

125
Q

how is plantarflexion of controlled during first 8% of gait?

A

eccentrically by doriflexors

126
Q

average ROM in ankle for normal gait?

A

10 deg DF
20 deg PF

127
Q

what happens at ankle to allow toes to clear the ground?

A

DF

128
Q

what causes premature heel off?

A

lack of ankle DF form tight achilles

129
Q

what is toeing out?

A

compensation for limited DF
rolls off medial foot in second half of stance

130
Q

increased pronation as compensation for DF

A

greater stresses to soft tissue of foot

131
Q

how would someone compensate for DF during toe clearance?

A

increased knee and/or hip flexion

132
Q

what can cause limited DF in swing?

A

PF tightness
calf spasticity
joint dysfunction
DF weakness

133
Q

are frontal or sagittal plane movements bigger?

A

sagittal movements larger

134
Q

frontal movement at pelvis throughout gait

A

downward motion as result by gravity and controlled by eccentric activation of right hip abductors

135
Q

how is frontal movement at pelvis best observed?

A

in front or behind

136
Q

total pelvis ROM in gait through PonF add and abd

A

10-15 deg

137
Q

frontal movement at hip throughout gait

A

elevation and depression

during stance, primarily PonF

138
Q

3 reasons why excessive movement at pelvis and hip in frontal plane are observed

A

weak hip abductors
reduced shortening of swing limb
discrepancy in limb length

139
Q

what is the drop of contralateral iliac crest during stance controlled by?

A

eccentric activation of hip abductors

140
Q

frontal movement at knee throughout gait

A

in the last 20% of gait, 5 deg adduction

141
Q

frontal movement at ankle throughout gait

A

very small

142
Q

frontal movement at foot and subtalar joint throughout gait

A

at heel contact, inverted 2-3 deg
until midstance, rapid eversion to 2 deg
after midstance, starts to invert
between heel and toe off, reaches 6 deg inversion
during swing, slightly inverted

143
Q

what is rapid pronation of foot good for?

A

provides a flexible and adaptable foot structure for making contact with ground

144
Q

what is inversion of foot good for?

A

more rigid foot structure, which helps propel the body forward

145
Q

horizontal movement at pelvis throughout gait

A

0-15% - int rot
15-60% - ext rot
60-100% - int rot

146
Q

horizontal movement at femur throughout gait

A

0-18% - int rot
18-60% - ext rot
60-100% - int rot

147
Q

horizontal movement at tibia throughout gait

A

0-20% - int rot
20-60% - ext rot
60-100% - int rot

148
Q

horizontal movement at subtalar joint throughout gait

A

0-30% - everting
30-55% - inverting
55-100% - everting

149
Q

horizontal movement at midfoot throughout gait

A

0-30% - increasing pliability
30-55% - increasing stability
55-100% - increasing pliability

150
Q

ROM at hip during gait

A

IC - 20 flexion
IC-LR - 20 flexion
LR-MS - 0
MS-TS - 20 extension
TS-PS - 10 extension
PS-IS - 15 flexion
IS-MS - 25 flexion
MS-TS - 20 flexion

151
Q

ROM at knee during gait

A

IC - 0
IC-LR - 20 flexion
LR-MS - 5 flexion
MS-TS - 0
TS-PS - 40 flexion
PS-IS - 60 flexion
IS-MS - 25 flexion
MS-TS - 0

152
Q

ROM at ankle during gait

A

IC - 0
IC-LR - 5 PF
LR-MS - 5 DF
MS-TS - 10 DF
TS-PS - 15 PF
PS-IS - 5 PF
IS-MS - 0
MS-TS - 0

153
Q

muscles at hip during gait

A

IC - E hams
IC-LR - C glutes, hams
LR-MS - C glutes, E glute med
MS-TS -
TS-PS - E iliopsoas, adductors
PS-IS - C iliopsoas
IS-MS - C iliopsoas
MS-TS -

154
Q

muscles at knee during gait

A

IC - C quads
IC-LR - E quads
LR-MS - C quads
MS-TS -
TS-PS - E quads
PS-IS - C hams
IS-MS - C hams
MS-TS - C quads, E hams

155
Q

muscles at ankle during gait

A

IC - pretibs
IC-LR - E pretibs
LR-MS - E gastroc, soleus
MS-TS - E soleus
TS-PS - C gastroc, soleus
PS-IS - C pretibs
IS-MS - C pretibs
MS-TS - pretibs

156
Q

subtalar open chain pronation

A

calc - evert
talus - stable
forefoot - abs, DF

157
Q

subtalar closed chain pronation

A

calc - everts
talus - add, PF
forefoot - stable

158
Q

subtalar open chain supination

A

calc - inverts
talus - stable
forefoot - add, PF

159
Q

subtalar closed chain supination

A

calc- inverts
talus - abd, DF
forefoot - stable

fall A 2024 (10 decks)

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