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DPT 502 > Exam 2 > Flashcards

Exam 2 Flashcards

quiz 3 content and this content

1
Q

what kind of jt is the hip?

A

diarthrodial, ball and socket jt with 3 DF

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2
Q

how does the acetabulum face?

A

lateral, inferior, and anterior

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3
Q

what is the lunate surface of the hip?

A

horse-shoe shaped region on the periphery covered by hyaline cartilage

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4
Q

what is the acetabular fossa of the hip?

A

deep, non-articular, fibrous region for passage of blood vessels

contains fibroelastic fat pad covered by synovial membrane

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5
Q

what is the labrum of the hip?

A

ring of wedge shaped fibrocartilage designed to increase concavity and deepen socket

entire periphery

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6
Q

what kind of cartilage covers 2/3 of the hemisphere of the femoral head?

A

hyaline cartilage

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7
Q

where are most forces on the femoral heads?

A

sup/post aspect

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8
Q

what resists forces in the femoral head?

A

trabeculae with striations in a ideal line to resist forces

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9
Q

what is the fovea capitis?

A

attachment of the ligamentum teres in the femoral head

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10
Q

what does the ligamentum teres do?

A

houses the blood vessels that supply the femoral head

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11
Q

what is the femoral neck?

A

bone connecting the femoral head and shaft b/w the trochanters with trabeculae to resist forces

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12
Q

which 2 hip flexors tend to compensate for weak abductors?

A

TFL and rectus femoris

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13
Q

what is the angle of inclination?

A

the frontal plane angle made b/w the shaft and head/neck of the femur

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14
Q

what is the normal angle of inclincation in adults?

A

120 deg

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15
Q

what is coxa valga?

A

an angle of inclination greater than 125 deg

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16
Q

what condition may be present given these symptoms?:

pt presents with one longer leg and back pain

A

coxa valga

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17
Q

what accomodation can be used for both coxa valga and coxa vara?

A

a heel lift

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18
Q

what is coxa vara?

A

an angle of inclination less than 125 deg

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19
Q

what condition may be present given the folllowing?:

pt presents with one shorter leg and back pain

A

coxa vara

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20
Q

what is the angle of torsion?

A

the transverse plane angle which allows the condyles to remain in the frontal plane

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21
Q

what is the normal angle of torsion?

A

15-20 deg anteversion

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22
Q

what is anteversion?

A

greater than 15-20 deg ant to the frontal plane

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23
Q

with anteversion, will a pt tend to intoe or outtoe?

A

intoe

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24
Q

what is retroversion?

A

less than 15-25 deg ant to frontal plane

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25
Q

with retroversion, wil a pt tend to intoe or outtoe?

A

outtoe

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26
Q

is 5 deg anteversion classified as anteversion or retroversion?

A

retroversion

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27
Q

is the hip a congruent jt?

A

yes!

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28
Q

where is the femoral head exposed?

A

superior and anterior

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29
Q

what is the OPP of the hip?

A

FABER

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30
Q

is the OPP of the hip the most congruent or most mobile?

A

both, OPP in the hip the most congruent and mobile position of the hip

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31
Q

what improves stability of the hip?

A

weight bearing

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32
Q

t/f: the acetabular fossa provides vacuum that serves to improve stability

A

true

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33
Q

in stance, body weight increases ___ times

A

2.5-3

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34
Q

in gait, body weight increases ___ times

A

4-7

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35
Q

what are the primary weight bearing surfaces of the hip?

A

superior lunate

superior posterior femur

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36
Q

what ensures proper nutrition in the hip?

A

compression and release, movement allows influx/efflux

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37
Q

what is the role of the capsuloligamentous complex of the hip?

A

support and passive stability at end range

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38
Q

what can support body weight without muscular activity?

A

CLC

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39
Q

t/f: someone with a SCI can hang on the anterior ligaments for support in standing without muscle activity

A

true

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40
Q

are the acetabulum, femoral head, and femoral neck intracapsular or extrasynovial?

A

intracapsular

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41
Q

what motions does the ligamentum teres resist?

A

flex/add

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42
Q

what is the location of the illiofemoral lig (y lig of Bigelow)

A

AIIS to anterior intertrochanteric line

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43
Q

what is the strongest ligament in the body?

A

the superior band of the illiofemoral lig (y lig of bigelow)

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44
Q

what is the location of the pubofemoral lig?

A

anterior pubic ramus to intertrochanteric fossa

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45
Q

which ligament at the hip forms a Z in the anterior capsule?

A

the pubofermoral lig

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46
Q

what is the location of the ischiofemoral lig?

A

posterior acetabular rim and labrum to the inner greater troch spiraling around the femoral neck

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47
Q

what is the problem with the hip external rotators?

A

they all attach to the same place and therefore put a large amount of force through one landmark

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48
Q

what are the flexors of the hip?

A

rectus femoris-2jt

illiosoas-1 jt

sartorius-2 jt

tensor fascia latae-2 jt

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49
Q

what are the planes of the illiosoas?

A

sagittal>transverse

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50
Q

to increase the difficulty of a illiosoas exercise, what can you do?

A

work in the transverse plane

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51
Q

what is the fxn of the illiosoas?

A

decelerate hip IR at midstance

decelerate hip ext in later stance

accelerate hip flexors at early swing

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52
Q

when is the illiosoas most predominant?

A

at preswing to initial swing

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53
Q

what does the sartorius do?

A

hip flexion, abduction, and ER

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54
Q

what group of muscles propel the limb at early swing and create a synergy with the abdominals and trunk muscles?

A

the hip flexors

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55
Q

how can we isolate a 2 jt muscle?

A

by putting it in passive insufficiency

ie: rectus-extend hip and flex knee

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56
Q

what are the hip adductors/IRs?

A

adductor magnus, longus, and brevis

gracilis

pectineus

glut med (ant)

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57
Q

what planes do the gracilis and pectineus work in?

A

frontal=sag=trans (work equally in all planes)

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58
Q

what is the fxn of the gracilis and pectineus?

A

decelerate frontal plane weight shift w/the contra medius

accelerate hip IR

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59
Q

with a R weight shift, which hip adducts and which hip abducts?

A

R hip add
L hip abd

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60
Q

with a L weight shift, which hip adducts and which hip abducts?

A

L hip add
R hip abd

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61
Q

adductors are also what kind of muscles?

A

internal rotators

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62
Q

can the adductors flex/ex?

A

yes

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63
Q

what are the abductors of the hip?

A

glut med (middle)

TFL

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64
Q

t/f: the glut med and min perform the same actions

A

true

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65
Q

what is the role of the glut med?

A

to keep the pelvis in neutral by producing compressive forces through the hip

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66
Q

does the glut med stabilize the contralateral or ipsilateral hip?

A

contralateral

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67
Q

what are the actions of the TFL?

A

IR, flexion, and abduction

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68
Q

t/f: the abductors are important for frontal plane stability

A

true

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69
Q

anything anterior to the hip will do what three actions?

A

flexion, IR, abduction

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70
Q

what planes do the glut med and TFL work in?

A

frontal>transverse

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71
Q

what is the fxn of the glut med and TFL?

A

decelerate frontal plane weight shift toward the stance leg

decelerate internal tibial rotation at heel strike

accelerate ER and abd at pushoff

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72
Q

should we be training the glut med in isometric single leg stance eccentrics or in concentric side leg lifts?

A

in isometric single leg stance eccentrically

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73
Q

when a muscle is functioning as a decelerator, is it working concentrically or eccentrically?

A

eccentrically

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74
Q

when a muscle is functioning as an accelerator, is it working concentrically or eccentrically?

A

concentrically

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75
Q

what are the external rotators of the hip?

A

PGOGOQ

piriformis

superior gamellus

obturator internus

inferior gamellus

obturator externus

quadratus femoris

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76
Q

what is the role of the external rotators?

A

to decelerate to allow IR to occur

support leg muscles produce trunk rotation contralaterally to facilitate change in motion

eccentrically control the femur from heel strike to midstance

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77
Q

the external rotators work with what 2 muscles?

A

glut med and TFL

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78
Q

t/f: the external rotators are often weak and overused

A

true

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79
Q

what is the step down test used for?

A

testing ER weakness by having the pt step down from a stool w/one leg to see if the leg moves in

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80
Q

what planes do the PGOGOQ muscles work in?

A

transverse>sagittal

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81
Q

what is the fxn of the PGOGOQ muscles?

A

decelerate hip IR at heelstrike

accelerate hip ext and ER at pushoff

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82
Q

besides ER what other motion can the PGOGOQ muscles provide?

A

hip extension

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83
Q

the PGOGOQ muscles work with what other group of muscles?

A

the abductors

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84
Q

80% of the time the sciatic nerve is ___ the piriformis

A

below

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85
Q

do ERs or IRs tend to be weaker? why?

A

depends on hip position, in flexion the ERs are weaker

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86
Q

what is the sequella of weakness in the ERs and IRs?

A

abnormal gait, no controlled heel strike,, and bad pelvic stability

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87
Q

what are the extensors at the hip?

A

glut max

hamstrings

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88
Q

what planes does the glut max work in?

A

transverse>/=sagittal

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89
Q

what is the fxn of the glut max?

A

decelerate hip flex, IR, add at heelstrike

accelerate ER, ext. abd at pushoff

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90
Q

what planes do the hamstrings work in?

A

sagittal>transverse

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91
Q

what is the fxn of the hamstrings?

A

decelerate knee ext and hip flex in swing

decelerate femoral and tibial rotation

accelerate hip ext and rotation at push off

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92
Q

what is the collective fxn of the hamstrings?

A

knee flexion

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93
Q

what muscles control forward lean?

A

hamstrings

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94
Q

the hamstrings create a synergy with what muscles?

A

abdominal/trunk muscles

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95
Q

what is the lateral hamstring?

A

biceps femoris

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96
Q

what are the medial hamstrings?

A

semitendinosus

semimembranosus

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97
Q

is the glut max IR stronger at 0 deg or 90 deg?

A

90 deg

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98
Q

is the glut max ER stronger at 0 deg or 90 deg?

A

0 deg

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99
Q

is the glut max stronger as an IR or ER?

A

IR

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100
Q

with the hip in extension, does the glut max and most of glut med perform ER or IR?

A

ER

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101
Q

with the hip in extension, do the deep rotators perform ER or IR?

A

ER

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102
Q

is hip extension stronger in ER or IR?

A

ER

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103
Q

with hip flexion, do the glut max and most of glut med ER or IR?

A

IR

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104
Q

with hip flexion, do the deep rotators ER or IR?

A

ER (except piriformis)

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105
Q

is hip flexion stronger in ER or IR?

A

IR

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106
Q

in neutral, muscles posterior to the hip axis do what?

A

ER

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107
Q

as the muscles become anterior to the axis of the hip, what do they do?

A

IR

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108
Q

which hip extensor is typically tight and which is typically weak?

A

weak=glut max

tight=hamstrings

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109
Q

how can we differentiate b/w the 2 major hip extensor muscles?

A

glut max=knee flex, resist hip ext

hamstrings=knee ext, resist hip ext

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110
Q

does the depth of the acetabulum provide primarily spin or roll and glide?

A

spin

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111
Q

in OKC at the hip, is the glide in the same or opposite direction of the osteokinematic movements?

A

opposite

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112
Q

in CKC at the hip, is the glide in the same of opposite direction of the osteokinematic movements?

A

same

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113
Q

what is the capsular pattern at the hip?

A

flex>abd>IR

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114
Q

what is the OPP of the hip?

A

30 deg FABER

the most congruent and most mobile position of the hip

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115
Q

what is the CPP of the hip?

A

max ext, IR, and abd

most stable position with the least glide

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116
Q

what is the end feel of flexion at the hip?

A

elastic/tissue approximation

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117
Q

what is the end feel of extension at the hip?

A

tissue stretch, elastic

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118
Q

what is the end feel of abduction at the hip?

A

tissue stretch, elastic

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119
Q

what is the end feel of adduction at the hip?

A

elastic/tissue approximation

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120
Q

what is the end feel of IR/ER at the hip?

A

tissue stretch, elastic

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121
Q

what needs to be taken into account with end feels?

A

what is feels like and where it is

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122
Q

in the OKC, how much hip flexion is there?

A

120-125 deg (w/knee flex)

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123
Q

in the OKC, how much hip extension is there?

A

9-19 deg

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124
Q

in the OKC, how much hip abduction is there?

A

39-46 deg

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125
Q

in the OKC, how much hip adduction is there?

A

15-31 deg

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126
Q

in the OKC, how much hip ER is there?

A

32-47 deg

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127
Q

in the OKC, how much hip IR is there?

A

32-47 deg

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128
Q

what are the closed chain motions at the hip?

A

ant/post rot=flex/ext

up/downslip=add/abd

out/inflare=ER/IR

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129
Q

what is lumbopelvic rhythm?

A

1) lumbar
2) lumbopelvic
3) hip

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130
Q

in bilateral stance, where is the LOG? what motions does this produce?

A

post to hip

hip extension

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131
Q

where is the COP in bilateral stance?

A

b/w the LEs

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132
Q

in bilateral stance, is there a lot of muscle activity or CLC activity?

A

CLC activity

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133
Q

in unilateral stance, where is the COP?

A

with the supported limb foot

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134
Q

t/f: in unilateral stance, the adduction moment must be counterbalanced by the abduction moment

A

true

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135
Q

in unilateral stance, the jt rxn forces are largely due to what muscle force?

A

abductor

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136
Q

what are the stress reducing strategies at the hip?

A

1) lateral trunk lean
2) ipsilateral cane use
3) load adjustment
4) contralateral cane use

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137
Q

how does lateral trunk lean reduce stress at the hip?

A

leaning over the painful/weak limb reduces the need for abductor muscle torque by decreasing the moment

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138
Q

what is the downside of lateral lean to decrease stress to the hip?

A

it increases energy expenditure, putting stress on the spine (LBP)

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139
Q

how does ipsilateral cane use reduce stress at the hip?

A

up to 15% of BW through the canereduces forces

cane on the same side of the pain

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140
Q

how does load adjustment reduce stress at the hip?

A

placing loads over the painful/weak hip reduces the adductor moment and need for abductor counterforce

reduces the forces the abductors have to bear

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141
Q

how does contralateral cane use reduce stress at the hip?

A

it assists abductor muscles in providing counterforce which reduces the need for abductors to work as hard

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142
Q

what are the motions that can occur at the knee?

A

sag=flex/ex (most)
trans=rot
front=abd/add

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143
Q

is the medial or lateral femoral condyle larger?

A

the medial condyle is 1.7x larger

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144
Q

where does the posterior cruciate lig run?

A

from the posterior tibia to the anterior femur

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145
Q

where does the anterior cruciate lig run?

A

from the anterior tibia to the posterior femur

146
Q

which menisci is more commonly injured?

A

the medial meniscus

147
Q

what is the shape of the medial meniscus?

A

C

148
Q

what is the shape of the lateral meniscus?

A

O

149
Q

what is the capsular pattern at the knee?

A

flex more limited than ext

150
Q

what is the end feel for knee flexion?

A

soft tissue approximation

151
Q

what is the end feel for knee extension?

A

elastic, capsular, tissue stretch

152
Q

where do the cruciates traverse through at the knee?

A

the intercondylar fossa

153
Q

when does the skrew home mechanism occur?

A

in terminal extension during the last 20 deg of extension

154
Q

in the OKC, what is the skrew home mechanism? how is it unlocked?

A

the tibia “locks” in lateral rotation during knee extension

tibia medially rotates during flexion to “unlock”

155
Q

what lig guides the skrewhome mechanism?

A

ACL

156
Q

in the CKC, what is the skrew home mechanism? how is it unlocked?

A

the femur “locks” in medial rotation during knee extension

the femur laterally rotates during flexion to “unlock”

157
Q

what is the CPP at the knee?

A

full knee ext

158
Q

what is the OPP at the knee?

A

resting in about 25 deg of knee flexion

159
Q

what are the articular surfaces at the knee?

A

concave tibial plateau and convex femur

160
Q

in the OKC at the knee, are the roll and glide the same or opposite directions?

A

same

161
Q

in the CKC at the knee, are the roll and glide the same or opposite directions?

A

opposite

162
Q

what are the roll and glide for knee flex/ext in the OKC at the knee?

A

ext=ant roll and glide
flex=post roll and glide

163
Q

what are the roll and glide for knee flex/ext in the CKC at the knee?

A

ext=roll ant, glide post
flex=roll post, glide ant

164
Q

in the OKC at the knee, does IR or ER “unlock” the skrewhome mechanism?

A

IR

165
Q

what is the largest capsule in the body?

A

tibiofemoral capsule

166
Q

what is the hallmark sign of an ACL injury?

A

edema in the tibiofemoral capsule

167
Q

what pierces the tibiofemoral capsule?

A

popliteus

168
Q

with knee flexion, the collaterals are ___, with knee extension, the collaterals are ____.

A

slack, taut

169
Q

are the collateral ligs usually repaired?

A

no

170
Q

do you want jt play at the knee? why or why not?

A

yes, bc it lessens the risk for a tear

171
Q

what are the 2 portions of the MCL?

A

superficial (anterior) and deep (posterior) with a bursa b/w them

172
Q

what motion does the MCL restrain?

A

med knee valgus (especially when flexed)

173
Q

what motion does the LCL resist?

A

lat knee varum

174
Q

what are the 2 bundles of the ACL?

A

AMB and PLB (ant/med bundle and post/lat bundle)

175
Q

what motion does the ACL resist?

A

anterior translation of the tibia on the femur

posterior translation of the femur on the tibia

176
Q

what muscle restrains the same motion as the ACL?

A

the hamstrings

177
Q

what are the 2 bundles of the PCL?

A

AL and PM bundles (ant/lat and post/med bundles)

178
Q

what motion does the PCL resist?

A

posterior translation of the tibia on the femur

anterior displacement of the femur on the tibia

179
Q

what things often cause PCL injuries?

A

tackle from the front, pushing the tibia back

car accidents

180
Q

which mensci is more mobile?

A

the lateral meniscus

181
Q

what is the shape of the menisci?

A

wedge shaped, thickest in outer rim

182
Q

describe menisci movement with knee flex/ext

A

flex=post
ext=ant

med moves 6 mm
lat moves 12 mm

183
Q

what is the role of the menisci?

A

absorb shock, disperse loads, keep jt separation to prevent bone on bone contact

184
Q

t/f: TFJ and PFJ movements occur simultaneously

A

true

185
Q

what is the motion at the PFJ in the OKC?

A

patella moving on the femoral condyles

186
Q

what is the motion at the PFJ in the CKC?

A

femoral condyles gliding under the patella

187
Q

where does the patella sit in extension?

A

at the proximal end of th eintercondylar groove w/the apex in line w/the TFJ margins

188
Q

t/f: weakness at the hip can cause patella tracking issues

A

true

189
Q

poor control of the hip muscles can lead to what syndrome of the patella?

A

patellofemoral pain syndrome

190
Q

if the hip muscles can’t control the femur, the knee starts to collapse into ___ causing the patella to track____

A

valgus, laterally

191
Q

in full extension is there much contact b/w the patella and femur?

A

no, there is minimal contact

the inferior pole is in contact with the suprapatellar fat pad

192
Q

during flexion, the patella glides ___

A

inferiorly

193
Q

when is there max contact between the patella and femur?

A

at 90 deg knee flexion

194
Q

in knee ext, PFJ compression forces are ___

A

smaller

195
Q

in knee flex, PFJ compression forces are ___

A

larger

196
Q

are the quad isometric forces greater at 15 deg or 90 deg?

A

90 deg

197
Q

in the OKC at the knee, where are the greatest forces? least forces?

A

greatest forces=full ext

least forces=90 deg flex

198
Q

in the CKC at the knee, where are the greatest forces? least forces?

A

greatest forces=90 deg

least forces=near full ext

199
Q

when doing OKC treatment at the knee, should we avoid full ext or 90 deg flex? during CKC?

A

OKC=avoid full ext

CKC=avoid 90 deg flex

200
Q

what stabilizes the medial knee?

A

VMO, pes anserine, MCL, medial retinacula, patellofemoral ligament, med meniscopatellar ligament

201
Q

what stabilizes the lateral knee?

A

retinacula, vastus lateralis, ITB, elevated lateral trochlear facet (projection ant), rectus femoris, vastus intermediate, patellar ligament

202
Q

what is the best way to fix patellofemoral pain?

A

control the femur

203
Q

what abnormalities alter forces at the knee?

A

TFL weakness

ITB tightness

obesity

genu valgum/varus

overpronation of the foot

changes in alignment of the femur, tibia, and foot

204
Q

what is the Q angle?

A

angle of the quads relative to the lower leg

ASIS–>central patella–>tib tub

insight into forces on the patella

larger angle=greater forces bringing the patella into lat position

205
Q

what is the normal Q angle for men and women?

A

women=12-18 deg

men=10-15 deg

206
Q

what are the 2 ways to measure leg length?

A

ASIS to med mal

GT to la mal

207
Q

where do the quads have max torque?

A

at 50-60 deg knee flexion

208
Q

what is extensor lag?

A

inability of the quads to have enough force to hold the knee in extension (often post surgery)

209
Q

in bilateral standing, each tibial plateau receives what % BW?

A

45% BW

210
Q

in unilateral stance, what happens to compression forces through the knee?

A

they double

211
Q

where is the LOG in unilateral stance at the knee?

A

medial to the TFJ

212
Q

does the medial or lateral compartment of the knee absorb 60% of the forces in unilateral stance?

A

medial

213
Q

in unilateral stance, does the knee tend to go into genu valgus or varus?

A

genu varus ???

214
Q

why are there substantial forces through the knee during sit to stands?

A

bc there in an increase in quad torque, putting forces through the knee

215
Q

what is the predominent factor affecting knee torque?

A

the length-tension relationship

216
Q

in what position can the knee create the greatest torque for flexion? least?

A

greatest torque=hip flex, knee ext

least torque=hip ext, knee flex

217
Q

what position should you put a pt into to put max force through the hamstrings?

A

hip flexion, knee extension

218
Q

how would you strengthen the gluts and take out the hamstrings?

A

out the hamstrings in a less optimal position (knee flexion)

219
Q

vastus lateralis

A

O: lat/post femur, high as GT abd post as linea aspera

I: tib tub via patellar tendon, converges 12-15 to lat/sup patella

A: knee ext, patella lat

N: femoral L2-4

220
Q

what is the largest knee extensor next to the the rectus femoris?

A

vastus lateralis

221
Q

does the vastus lateralis cross the hip and have any hip fxns?

A

nope

222
Q

vastus medialis

A

O: med/post femur intertrochanteric line and linea aspera

I: tib tub via patellar tendon, med sup patella, med patellar retinaculum

A: knee ext (longus), medial patellar stabilization(oblique) (esp in ext)

N: femoral L2-4

223
Q

vastus intermedius

A

O: ant femur

I: tib tub via patellar tendon

A: knee ext

N: femoral L2-4

(not palpable)

224
Q

why does the rectus femoris become insuffient?

A

bc it’s a 2 jt muscle

225
Q

which quad is the most efficient knee extensor? why?

A

the vastus intermedius bc of its central location

226
Q

do the hamstrings create greater force in OKC or CKC?

A

CKC

227
Q

how do the hamstring restrain the tibia?

A

they restrain anterior translation of the tibia

228
Q

what are the fxns of the hamstrings?

A

little force in OKC, greater force in CKC

restrain ant tib translation

decelerate rotation right b4 heel strike

229
Q

t/f: the knee flexors can control the pelvis moving on the femur during forward bending

A

true

230
Q

where is the popliteus located?

A

runs obliquely from the medial knee to the lateral femur

231
Q

what is the fxn of the popliteus?

A

“unlocking” the fully extended knee

232
Q

in the OKC, does the popliteus rotate the tibia or femur? internally or externally?

A

rotates the tibia internally

233
Q

in the CKC, does the popliteus rotate the tibia or femur? internally or externally?

A

rotates the femur externally

234
Q

the popliteus assists what ligament in what action?

A

the popliteus assists the PCL in preventing forward sliding of the femoral condyles

235
Q

how does the popliteus protect the lateral meniscus from impingement?

A

the popliteus pulls the lateral meniscus posteriorly with knee flexion

236
Q

what are the internal tibial rotators?

A

semitentinosus

semimembranosus

gracilis

sartorius

popliteus

237
Q

what are the tibial external rotators?

A

biceps femoris

238
Q

what is the fxn of the gastrocs?

A

cocontraction with the quads to stabilize the leg

knee flex

CKC-flex

239
Q

plantaris

A

O: sup lat condyle b/w lat gastrocs and popliteus

I: calcaneous via tendon

A: weak knee flexor

N: tibial (L5-S1)

(not always present)

240
Q

what is the pes anserine?

A

the main knee stabilizer on the proximal medial knee where 3 knee flexor muscles insert (semiten, gracilis, sartorius)

241
Q

does the pex anserine reinforce the MCL or LCL? medial capsule or lateral capsule?

A

MCL and medial capsule

242
Q

does the pes anserine resist valgus or varus forces?

A

valgus

243
Q

what are the single jt muscles acting at the knee?

A

vasti, popliteus, short head of biceps fem

244
Q

what are the muscle fxn characteristics of 1 jt muscles?

A

work synergistically with agonist

uniplanar (many sag)

more energy requirements

245
Q

when are 2 jt muscles more efficient?

A

when lengthened at one jt and shortened at the other

246
Q

t/f: multijt muscles work in one plane

A

false, they are often multiplanar

247
Q

what position would put the rectus fem in active insufficiency and the hamstrings in passive insufficiency?

A

hip flexion, knee extension

248
Q

what position would put the rectus femoris in passive insufficiency and the hamstrings in active insufficiency?

A

hip extension, knee flexion

249
Q

when the hip and knee are both in flexion, what is happening at the rectus femoris and the hamstrings?

A

rectus femoris=elongated at the knee, shortened at the hip

hamstrings=elongated at the hip, shortened at the knee

acting synergistically

250
Q

what are the synergistic roles of the hamstrings and rectus fem with the hip and knee in flexion?

A

hip flexors position the limb

hamstrings produce force

251
Q

when the hip and knee are both in extension, what is happening at the rectus femoris and hamstrings?

A

rectus femoris=enlongated at the hip, shortened at the knee

hamstrings=elongated at the knee, shortened at the hip

252
Q

what are the synergistic actions of the rectus fem and hamstrings with the hip and knee in extension?

A

hip flexors position the knee

hamstrings produce powerful hip extension

253
Q

does knee flexion and ankle plantarflexion produce active or passive insufficiency of the gastrocs?

A

active insufficiency

254
Q

what is the optimal position for the plantarflexors to produce force?

A

knee extension, ankle plantarflexion

255
Q

what are the prime movers of knee extension?

A

vasti and rectus femoris

256
Q

what are the prime movers of knee flexion?

A

semiten, semimem, biceps fem, and popliteus

257
Q

what are the prime movers of knee IR?

A

semiten, semimem, sartorius, gracilis, popliteus

258
Q

what are the prime movers of knee ER?

A

biceps fem (aided by TFL)

259
Q

what are the 2 roles of the foot?

A

to be a mobile adapter and rigid lever

260
Q

what makes up the rearfoot?

A

talus and calcaneous

261
Q

what makes up the midfoot?

A

navicular, cuneiforms, and cuboid

262
Q

what makes up the forefoot?

A

phalanges

263
Q

what metatarsals articulate with the cuboid?

A

the 4th and 5th metatarsals

264
Q

what are the articular surfaces of the proximal tibfib jt?

A

convex tibial facet and concave fibular facet forming a planar synovial jt

265
Q

what is the distal tibfib jt?

A

syndesmosis jt stabilized by the tibfib interosseous ligament

266
Q

what is the role of the distal tibfib jt?

A

movement allows for the talus to fit in the mortis and allows for full ankle motion

267
Q

what triplanar motions make up pronation at the tibfib jt?

A

dorsiflexion, eversion, abduction

268
Q

what triplanar motions make up supination at the tibfib jt?

A

plantar flexion, inversion, adduction

269
Q

when the ankle dorsiflexes, where does the fibula migrate?

A

superiorly

270
Q

when the ankle plantarflexes, where does the fibula migrate?

A

inferiorly

271
Q

what motions occur at the talocrural joint?

A

dorsiflexion/plantaflexion

272
Q

what motions occur at the subtalar jt?

A

inversion/eversion

273
Q

what motions occur at the midtarsal jt?

A

dorsiflexion/plantarflexion

inversion/eversion

abduction/adduction

274
Q

what are the articular surfaces of the talocrural jt?

A

proximally: concave “adjustable mortis” formed by the malleoli

distal: convex talus

275
Q

in the OKC, what is the roll and glide at the talocrural joint?

A

convex on concave=opposite roll and glide

276
Q

in the CKC, what is the roll and glide at the talocrural jt?

A

concave on convex=same roll and glide

277
Q

what are the medial ligs of the ankle?

A

deltoid ligs

plantar calcaneonavicular (spring) lig

278
Q

is the medial or lateral ankle more robustly supported?

A

medial

279
Q

what are the ligs at the lateral ankle?

A

ATF (most injured)
PTF
calcaneofibular lig (bw ATF and PTF)

280
Q

what is the most injured lig in the body?

A

ATF (ant tibfib)

281
Q

where is the axis of motion for the tibfib jt?

A

14 deg inf to the transverse plane
23 deg post to the frontal plane

axis through the malleoli

282
Q

the medial malleolus is ___ and ___ and the lateral malleolus is ___ and ___

A

anterior, superior; posterior, distal

283
Q

what is the primary motion at the tibfib jt?

A

sagittal plane motion (26 deg dorsi, 48 deg plant)

284
Q

what happens during OKC plantarflexion at the tibfib jt?

A

posterior roll, anterior glide

285
Q

what happens during OKC dorsiflexion at the tibfib jt?

A

anterior roll, posterior glide

286
Q

what is the subtalar jt?

A

3 distinct articulations (ant, mid, post) with the tarsal tunnel separating the post and ant/mid articulations

talus, calcaneous, and navicular

287
Q

what is the axis of motion for the subtalar jt?

A

42 deg sup to transverse plane
16 deg med to sagittal plane

288
Q

how much eversion/inversion occurs at the STJ?

A

20-30 deg eversion

5-12 deg inversion

289
Q

during foot prontation, does the tibia move into IR or ER?

A

IR

290
Q

during foot supination, does the tibia move into IR or ER?

A

ER

291
Q

when the foot moves out, where does the tib tub move? when the foot moves in?

A

out, in

292
Q

what is the mittered hinge of the ankle?

A

when the tibia moves in the transverse plane, the foot moves in the frontal plane

293
Q

what are the midtarsal jts?

A

talonavicular jt and calcaneocuboid jt

294
Q

what is the talonavicular jt?

A

the convex talus head articulates w/concave navicular

MOBILE ball and socket jt in the medial column

295
Q

what is the calcaneocuboid jt?

A

anterior calcaneous and proximal cuboid

interlocking wedge that resists gliding

rigid support in the lateral column (LESS MOBILE)

296
Q

what is the longitudinal axis of the midtarsal jt?

A

15 deg sup to the transverse plane
9 deg med to sagittal plane

inv/ev

297
Q

what is the oblique axis of the midtarsal jt?

A

52 deg sup to transverse plane
57 deg med to sagittal plane

dorsi/plant

298
Q

if there is limited dorsiflexion, what can you do to engage the oblique axis of the midtarsal jt?

A

outoe

299
Q

what is the tarsometatarsal jt?

A

5 synovial jts b/w the distal tarsal bones and base of the metatarsals and bw the metatarsals

300
Q

what structures are in a ray?

A

metatarsal and its associated set of phalanges

301
Q

what is the most mobile ray of the foot?

A

1st ray

302
Q

what is the least mobile ray of the foot?

A

5th ray

303
Q

does dorsi or plantarflexionn accompany inversion of the rearfoot during the loading phase of gait?

A

dorsiflexion

304
Q

does dorsi or plantarflexion accompany eversion of the rearfoot?

A

plantarflexion

305
Q

when is the foot a rigid lever?

A

pushoff

306
Q

when is the foot a mobile adaptor?

A

heel strike to midstance

307
Q

t/f: a pronated foot is a mobile foot

A

true

308
Q

what is the problem with overpronators?

A

they have a floppy foot at pushoff

risk for plantar fascitis

309
Q

what is the problem with a high arch?

A

its a bad shock absorber

good at pushoff but bad at heel strike

310
Q

what are the articular surfaces of the metatarsophalangeal joint?

A

convex metatarsal head and concave proximal phalynx

311
Q

what are the OKC chain motions at the MTP jts?

A

flexion: roll and glide plantar

extension: roll and glide dorsally

312
Q

what are the actions at the MTP jts?

A

extension: 65-85 deg (rarely see more than 30)

flexion: 30-40 deg

abduction: 0-10 deg

313
Q

what is the metatarsal break?

A

the line where the MTPs line up

oblique axis where toe extension occurs

314
Q

t/f: 1 MTP extension is critical for gait

A

true

315
Q

do the feet supinate or pronate when raising onto the toes?

A

supinate

316
Q

what is the keystone of the medial longitudinal arch of the foot?

A

the talonavicular jt (med jt of the MTJ)

317
Q

what is the primary load-bearing structure of the foot?

A

medial longitudinal arch

318
Q

what maintains the MLA?

A

plantar fascia, spring lig, med TMT jt, plantar ligs, instrinsics/extrinsics

319
Q

what is the primary support of the MLA?

A

plantar fascia

320
Q

what is the role of plantar fascia in the MLA?

A

allows the arch to expand and contract to accomodate the forces placed on it

321
Q

what is the transverse arch of the foot?

A

the arch across the width of the foot

322
Q

what is the keystone of the transverse arch of the foot?

A

the middle cuneiform

323
Q

what tendon supports the transverse arch of the foot?

A

peroneous longus

324
Q

what is the function of the plantar arches of the foot/

A

weight distribution

adapting the foot to a rigid lever

dampens the shock of weight bearing

adapts to changes in the support surface

325
Q

what structures should be in line in a normal MLA of the foot?

A

the 1st metatarsal head, navicular tubercle, and medial malleolus

326
Q

what is pes planus?

A

flat foot from a dropped navicular tub

could be from tight gastrocs

floppy foot

more eversion /pronation=valgus

327
Q

what is pes cavus?

A

high arch from a raised navicular tub

rigid foot that doesn’t accomodae well

poor force absorber

inversion/supination=varus

328
Q

what fx can result from pes cavus?

A

march/stress fx

329
Q

what is hallux abducto valgus?

A

a bunion where the 1 metatarsal goes in

330
Q

during normal gait, what happens to the foot from heelstrike to pushoff?

A

at heelstrike, the foot is supinated then rapidly moves to pronation then back to supination at pushoff to become a rigid lever again

331
Q

when someone has high arches, what is the foot doing from heelstrike to push off?

A

mroe supination at heel strike and push off

332
Q

when someone has flat feet, what is the foot doing from heel strike to push off?

A

less supination at heel strike and push off

333
Q

if a muscle is medial to the longitudinal axis of the STJ of the foot, what does it do?

A

invert

334
Q

if a muscle is lateral to the longitudinal axis fo the STJ of the foot, what does it do?

A

evert

335
Q

if a muscle is anterior to the talocrural axis of the foot, what does it do?

A

dorsiflex

336
Q

if a muscle is posterior to the talocrural axis of the foot, what does it do?

A

plantarflex

337
Q

if a muscle if fruther from the longitudinal axis of the STJ or the talocrural axis, is it stronger or weaker?

A

stronger

338
Q

what muscle is the strongest plantarflexor?

A

gastrocs

339
Q

what muscle is the strongest inverter and dorsiflexor?

A

tibialis anterior

340
Q

what are the prime movers of plantarflexion?

A

gastrocs

soleus

341
Q

what are the prime movers of dorsiflexion?

A

tibialis anterior

342
Q

what are the prime movers of toe flexion?

A

flexor hallicus longus

flexor digitorum longus

343
Q

what are the prime movers of inversion?

A

tibialis anterior

tibialis posterior

344
Q

what are the prime movers of eversion?

A

peroneous longus

peroneous brevis

345
Q

is the gastroc a phasic or postural muscle?

A

phasic

346
Q

is the soleus a phasic or postural muscle?

A

postural

slow twitch

tonic

347
Q

what muscles make up the superficial posterior group of the foot?

A

gastroc

soleus

plantaris

348
Q

what muscles make up the deep posterior group of the foot?

A

Tom, Dick, and Harry!!!

posterior tibialis

flexor hallicus longus

flexor digitorum longus

349
Q

what motions does the deep posterior group of the foot perform?

A

plantarflexion and invertion

350
Q

what muscles make up the anterior group of the foot?

A

tibialis anterior

extensor hallicus longus

extensor digitorum longus

351
Q

what is the primary dorsiflexor at the ankle?

A

tibialis anterior

352
Q

what does the tibialis anterior do?

A

dorsiflex, control pronation, invert

353
Q

if the tibialis anterior is damaged, what occurs during gait?

A

foot slap at heel strike to midstance

354
Q

what does the extensor hallicus longus do?

A

extend toes and evert ankle (can invert too bc of placement next to the longitudinal axis)

355
Q

what does the extensor digitorum longus do?

A

extend the toes, evert the foot

356
Q

what muscles make up the lateral group of the foot?

A

peroneous longus and brevis

357
Q

what does the lateral group of the foot do?

A

primary everters of the ankle and foot

assist with stabilizing the arches (transfer forces from lat to med foot)

358
Q

where does the peroneous longus attach?

A

the bottom of the foot at the base of the 1st metatarsal

359
Q

where does the peroneous brevis attach?

A

the base of the 5th metatarsal

360
Q

are most of the intrinsics of the foot on the plantar or dorsal side of the foot?

A

plantar

361
Q

what do the instrinsics of the foot do?

A

provide stability/balance to the foot during activity

support the transverse arch

abductor hallicus helps support the MLA

DPT 502 (9 decks)

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