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Management of MS Disorders > Exam 2: Foot & Ankle Pathomechanics > Flashcards

Exam 2: Foot & Ankle Pathomechanics Flashcards

1
Q

What are four etiologies that can cause tissue stress to the foot

A
  1. Weight bearing activities
  2. Biomechanical faults/limitations of the hip, knee, or foot
  3. Disease process
  4. Shoes
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2
Q

True or False:

There is a gradual progression from one segment of the foot to another segment.

A

True

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3
Q

What are 6 reasons to treat pathomechanics of the foot

A
  1. Pain/fatigue
  2. Instability
  3. Postural attitude
  4. Ulcerations
  5. Improved performance
  6. Proximal joint problem
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4
Q

What are 7 general pathomechanic hindfoot/rearfoot conditions

A
  1. Ankle Sprains
  2. Heel/arch pain
  3. Sever’s disease
  4. Subtalar/ankle pain
  5. Tendon injuries
  6. Retrocalcaneal exostosis
  7. Tarsal Tunnel Syndrome
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5
Q

What are 3 general pathomechanic midfoot conditions

A
  1. Lisfranc ligament sprain
  2. Spring ligament sprain
  3. Stiffness from crush injuries
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6
Q

What are 6 general pathomechanic forefoor conditions

A
  1. Metatarsal head pain
  2. Hallux Valgus
  3. Hallux limitus/rigitus
  4. Morton’s neuroma
  5. Morton’s foot
  6. Plantar ulcerations
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7
Q

During initial contact, the pretibial muscles fire (concentrically/eccentrically) in response to the plantarflexion torque of gravity and body weight.

A

eccentrically

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8
Q

What would happen if the pretibs didn’t eccentrically control the foot during initial contact

A

You get a foot slap

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9
Q

During initial contact, the pretibial muscles fire (concentrically/eccentrically) in response to the (dorsiflexion/plantarflexion) torque of gravity and body weight.

A

eccentrically; PF

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10
Q

Which phase of gait do the pretibial muscles fire eccentrically in response to the PF torque of gravity and body weight

A

initial contact

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11
Q

Which phase of gait do the pretibial muscles eccentrically contract to slow down the PF caused by gravity and body weight then ceases at foot flat

A

loading response

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12
Q

During loading response, the pretibial muscles (concentrically/eccentrically) contract to slow down the PF caused by (gravity/muscle force) and body weight then ceases at foot flat.

A

eccentrically; gravity

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13
Q

Which phase of gait is ankle DF controlled by eccentric contraction of the soleus

A

Mid Stance

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14
Q

During mid stance, ankle (DF/PF) is controlled by eccentric contraction of the (gastroc/soleus)

A

DF; soleus

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15
Q

Which muscle works the hardest during mid stance and terminal stance

A

soleus

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16
Q

Ankle dorsiflexors are working (concentrically/eccentrically) during IC and LR, but work (concentrically/eccentrically) during the swing phases.

A

eccentrically in LC/LR

concentrically in swing phases

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17
Q

Which phase of gait does the gastroc and soleus concentrically contract to lift the heel off of the floor at 80% of its max capacity

A

terminal stance

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18
Q

In terminal stance, the gastroc and soleus contract (concentrically/eccentrically) at ___% of its max capacity to lift the heel off of the floor

A

concentrically; 80%

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19
Q

Explain why the soleus, gastroc, posterior tib, FDL, FHL, peroneus longus/brevis all plantarflex

A

Because they run posterior to the axis of motion at the talocrural joint which results in plantarflexion

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20
Q

Which phase of gait do the PF’s, mostly the FDL, FHL, and peroneus longus) assist in causing knee flexion

A

Pre-swing

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21
Q

During pre-swing, the PF’s assist in causing knee (flexion/extension).

A

flexion

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22
Q

During pre-swing, the (dorsiflexors/plantar-flexors) assist is causing knee flexion

A

PF’s

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23
Q

During which phase of gait do the DF’s contract to counteract the PF torque of gravity which keeps the toe from dragging

A

Initial swing

24
Q

During initial swing, the (DF/PF)’s contract to counteract the (DF/PF) torque of gravity to keep the toes from dragging

A

DF’s; PF

25
Q

During which phases of gait do the DF’s continue to contract to equalize PF force of gravity and assure toe clearance

A

mid swing and terminal swing

26
Q

Movement of the Calcaneus in the ____ plane, is a reflection of the ____ joint.

A

frontal; subtalar

27
Q

During initial contact the calcaneus is _____.

A

inverting

28
Q

During midstance the calcaneus is ______

A

perpendicular to the surface

29
Q

During terminal stance and pre-swing, the calcaneus is _____

A

inverting

30
Q

How many degrees of eversion do you need to unlock the midtarsal joints during loading response

A

4-6

31
Q

How many degrees of inversion do you need to lock the midtarsal joints in terminal stance

A

4

32
Q

Where does the plantar fascia run and what is its significance

A

It runs from the calcaneus to the met heads and is the foundation for the arch. Without a plantar fascia the foot would flatten out and overly pronate resulting in a major loss of stability

33
Q

Explain the importance of MTP joint motion, especially the first MTP joint

A

You need adequate DF of the first MTP joint so you don’t drag your toes when you walk. Adequate extension of the first MTP joint is needed for push off

34
Q

If a patient doesn’t have adequate first MTP joint extension for push off, how are they likely to compensate

A

Push off the medial side of the toe instead of directly over it

35
Q

What are three requirements of gait

A
  1. Absorb shock
  2. Adapt to the supporting surface
  3. Propel body forward
36
Q

To observe gait in the frontal plane, you need to be in a (frontal/side/posterior) view

A

posterior

37
Q

To observe gait in the sagittal plane, you need to be in a (frontal/side/posterior) view

A

side

38
Q

To observe gait in the transverse plane, you need to be in a (frontal/side/posterior) view

A

frontal

39
Q

To observe gait in the frontal plane, you need to be in a (frontal/side/posterior) view

A

frontal

40
Q

In initial contact, the heel is slightly (inverted/everted) making the foot (rigid/unrigid)

A

inverted; rigid

41
Q

In midstance, the heel is (parallel/perpendicular) to the supporting surface which means the foot is (rigid/unrigid)

A

perpendicular; unrigid

42
Q

During heel off, the heel is slightly (inverted/everted) to the supporting surface making the foot (rigid/unrigid)

A

inverted; rigid

43
Q

When viewing gait in the sagittal plane (side view), explain what we are looking for during initial contact, midstance, and heel off.

A

IC: Looking for isolated heel contact with a neutral heel

Mid Stance: normal tibial progression creating DF

Heel off: Neutral ankle as the heel comes off the supporting surface

44
Q

When viewing gait in the transverse plane (front view), explain what we are looking for during initial contact

A

The forefoot is slightly inverted and the leg is slightly externally rotated

45
Q

When viewing gait in the transverse plane (front view), explain what we are looking for during mid stance)

A

The medial side of the foot should make contact with the supporting surface due to STJ pronation and leg internal rotation

46
Q

When viewing gait in the transverse plane (front view), explain what we are looking for during heel off

A

The leg should be externally rotated and the STJ supinates

47
Q

If a patient has an abnormally pronatory foot, list the planes of motion that are effected

A

sagittal, frontal, and transverse plane

48
Q

If a patient has an abnormally supinatory foot, list the plane of motion that is effected

A

frontal plane

49
Q

If your assessing a patient with a pronatory foot in the sagittal plane, which motion would you expect to be limites

A

DF

50
Q

A patient with a pronatory foot may lack adequate DF, what are 5 compensations that might occur to give the patient adequate DF AND which compensation is better on the body

A
  1. Increase pronation even more
  2. Knee hyperextension
  3. Hip extension
  4. Hip external rotation
  5. Short stride length *** this is the best compensation to make
51
Q

If your assessing a patient with a pronatory foot in the frontal plane, what are 4 conditions you are likely to see

A
  1. Increased tibia vara
  2. Forefoot varus
  3. Weak posterior tibialis and fibularis longus
  4. Weak hip abductors
52
Q

If your assessing a patient with a pronatory foot in the transverse plane, what are 4 conditions that you are likely to see

A
  1. Weak external hip rotators
  2. Femoral anteversion
  3. Tight medial hamstrings
  4. Internal or external tibial/malleolar tension
53
Q

If your assessing a patient with a supinatory foot in the frontal plane, what are 3 conditions you are likely to see

A
  1. Rigid plantarflexed 1st ray of forefoot valgus
  2. Fixed calcaneal position with high degree of tibia vara
  3. muscle imbalance with stronger invertors
54
Q

The (unrigid/rigid) plantarflexed 1st ray tends to force the STJ joint into (supination/pronation) during stance. This promotes lateral ankle (stability/instability)

A

rigid; supination; instability

55
Q

If you have a patient with a supinatory foot with tibia vara, will the calcaneus have little or a lot of movement

A

little

56
Q

Would a supinatory foot muscle imbalance be due from an upper or lower motor neuron pathology

A

Both

Management of MS Disorders (18 decks)

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