Exam 3 Flashcards
Posture defined
position the body adapts in order to maintain a horizontal gait
Primary curves in spine (as babies) vs secondar curves as we age and start to stand?
primary: thoracic and sacral kyphosis
secondary: cervical and lumbar lordosis
Plum lines are aligned with
EAM acromion thorax posterior to hip anterior midline of knee anterior ankle joint
Sway back posture: Head Neck Thoracic Lumbar Pelvis Hip Knees
forward
slightly extended
flexion/posterior
flattened
posterior/neutral
hyperextended
hyperextended
Handedness pattern:
Shoulders
Arms
Pelvis
dominant side is lower
dominant side is lower
dominant side is elevated
Upper crossed syndrome (forward head and rounded shoulders) shortened muscles:
Lengthened muscles:
short: SCM, pecs, upper trap/lev scap
long: middle, lower trap, serratus ant, deep neck flexors
Scoliosis is named for side of
convexity
Concave side in scoliosis muscles will be …. and convex side muscles will be…
short
lengthened
Highest velocity in gait?
Lowest?
just before double support
at mid-stance
One gait cycle…
right initial contact to right initial contact
During gait, center of mass exhibits a ….curve.
Vertically it creates….. in one gait cycle and side-to-side it creates ….in one gait cycle.
sinusoidal
2 sine waves
1 sine wave
During vertical gait what stance is the highest point on the sinus curve? What is the lowest point?
Side-to-side gait which stances make up the curves?
mid-stance
double support
mid-stance on left and right
What are the 6 determinants of gait?
pelvic rotation in transverse plane
lateral pelvic tilt
lateral shift
knee flexion
ankle DF
heel rise
Pelvic rotation in transverse plane during gait has about …-….degrees of total motion and advances … on the side of the advancing limb.
6-10
anteriorly
Lateral pelvic tilt during gait has about a …. inch pelvic drop on the swing side. If it is greater than 1 inch what does this indicate?
1
weak glute med and min on opposite side (Trendelenburg gait)
Lateral shift during gait is towards….. side and has …-… inch shift.
weight-bearing
1-2
Knee flexion happens in …. part of gait about …-…. degrees.
Foot and ankle motion has …. degrees of DF.
Heel rise is during which stance?
early in stance
15-20
10 degrees
terminal
Stance phase makes up what percentage of gait cycle?
Swing phase?
60%
40%
Stance phases of gait cycle:
Initial contact loading response mid-stance terminal stance pre-swing
Swing phases of gait?
initial swing
mid-swing
terminal swing
Initial contact of gait is when.... This is a period of ..... Hip's degree of flexion... Knee's degree of flexion... Ankle's degree of flexion...
when the foot hits the ground
double support
20-35
0-5
neutral
Loading response phase of gait is ..... This is when the foot ..... It is a period of ..... Hip's degree of flexion: Knee's degree of flexion: Ankle's degree of flexion:
immediately after initial contact until the opposite extremity leaves the ground
is flat
double support
20
15
0-5 of plantarflexion
Mid-stance phase of gait begins..... Ends..... This is where the body.... It is a period of .... Hip's position: Knee's degree of flexion: Ankle's degree of flexion:
when contralateral limb leaves the ground
when body is directly over supporting limb
progresses over the foot
single limb support
neutral to extension
0-5
5 of dorsiflexion
Terminal stance comes after .... and just prior to .... This is where the body .... It is a period of ... Hip's degree of extension: Knee's degree of flexion: Ankle's degree of flexion: What happens to the heel here?
mid-stance
contact of opposite limb
progresses past forefoot
single limb support
20
0-5
10
heel rises
Pre-swing begins when ..... Ends when.... (includes ...) Period of .... Hip's degree of extension: Knee's degree of flexion: Ankle's degree of flexion: MTP's degree of extension:
opposite limb contacts the ground
just prior to lift off
toe off
double support
0-10
45
20 PF
70
Initial swing phase is from .... This is the ..... phase The .... begins to advance. Foot ..... the ground. Hip's degree of flexion: Knee's degree of flexion: Ankle's degree of flexion:
when the limb leaves the ground to maximum knee flexion
acceleration
thigh
clears
15
max about 60
5 of plantarflexion
Mid-swing phase is from .... to ..... Thigh continues to advance. Hip's degree of flexion: Knee's degree of flexion: Ankle's degree of flexion:
max knee flexion
tibia is vertical
25
25 to extension
neutral
Terminal swing phase is from …. to ….
This is where leg reaches to achieve ….
Hip’s degree of flexion:
Knee’s degree of flexion:
Ankle’s degree of flexion:
tibia vertical just prior to initial contact step length 20 5 neutral
Average cadence
110
Single support percentage
Double
40%
20%
Average gait speed
1.37 meters/sec or 3 mph
Stride length is measured from … to … of the …. foot. Average distance.
heel strike to heel strike of same foot
144 cm
Step length is distance measured from … of …. foot to …. of measured foot.
Average
heel strike
other
72 cm
Step width is the distance measured between…
Average
two lines drawn between the midline of each foot during gait
8-10 cm
Step angle is the distance measured….
Average
between two lines middle of heel to middle of second toe parallel to direction of gait
5-7 degrees
Moment definition
application of force at a distance from a point of pivot
Moment’s result in
rotation around stationary point
Moments are created by
ground reaction forces
Moments depend on the ground reaction force vector’s ….
position relative to the joint motion axis of rotation
Moments will influences which muscles need to engage to keep the joint from collapsing…
eccentrically
During initial contact the ground reaction force will be … to hip joint causing a … moment.
The muscles working here would be …. and they are acting ….
anterior
flexion
hip extensors
eccentrically
During initial contact, ground reaction forces will be …. to knee causing a …. moment.
Muscles working here are …. working ….
anterior
extension
hamstrings
eccentrically
During initial contact, the ground reaction force will be … to ankle, so the moment will be ….
The muscles at play will be …. working …..
posterior
plantarflexion
dorsiflexors (tib anterior)
eccentrically
During initial contact, the ground reaction force will be … to subtalar creating a …. moment.
The muscles acting will be … working ….
lateral
pronation
posterior tibialis
eccentrically
During loading response, the ground reaction forces will be … to hip creating a …. moment.
Muscles working here are…. and …. working ….
anterior
flexion
hip extensors and abductors (glute med and max)
eccentrically
During loading response, the ground reaction force will be …. to knee creating a …. moment.
The muscles acting will be ….
posterior
flexion
quads
During loading response, the ground reaction force will be … to ankle creating a … moment.
Muscles acting will be ….
posterior
PF
dorsiflexors (tib anterior)
During loading response, the ground reaction force will be …. subtalar joint creating …. moment.
Muscles at work will be ….
lateral
Pronation
posterior tib
During Mid-stance, ground reaction force will be …. hip creating …. moment.
Muscles working here will be…
posterior
extension
hip flexors and glute med (isometric)
During mid-stance, ground reaction force will be … knee creating … moment.
Muscles at work here …
anterior
extension
little muscle activity needed
During mid-stance phase, ground reaction forces will be …. ankle creating a …. moment.
Muscles at work here are …
anterior
DF
soleus
During mid-stance, ground reaction forces will be …. subtalar creating a ….moment.
Muscles at work here …..and which way?
lateral
pronation
posterior tib
concentrically
During terminal stance, ground reaction force will be …. hip creating a …. moment.
Muscles at work here…
posterior
extension
hip flexors and glute med (isomentrically)
During terminal stance, ground reaction forces will be …. knee creating a …. moment.
Muscles at work here are …
anterior
extension
hamstrings
During terminal stance, ground reaction forces will be … ankle creating a …. moment.
Muscles at work are…
anterior
DF
soleus
During terminal stance, ground reaction forces will be … .subtalar creating a …. moment.
Muscles at play will be ….
medial
supination
peroneals
During pre-swing, ground reaction force will be … hip creating a …. moment.
Muscles at work here are…and they work which way?
posterior
extension
hip flexors
concentrically
During pre-swing, ground reaction forces will be .. knee creating a … moment.
Muscles at play here are ….
posterior
flexion
quads
During pre-swing, ground reaction forces will be … ankle creating a … moment.
Muscles at play and how?
anterior
DF
soleus and gastroc
Concentrically
During pre-swing, ground reaction forces will be …. subtalar causing a …. moment.
Muscles at play …
medial
supination
peroneals
Contents of nucleus pulposus
mucoid few fibrocytes and chondrocytes type II collagen elastin fibers 70-90% water proteoglycans chondrocytes
Annular fibrosis is comprised of …. rings.
Type …collagen.
Outer has more …. while inner has more….
Fibers are positioned at … degrees to horizontal alternating layers.
Designed to resist …, …. and ….forces.
15-25
I
collagen
water
30
distraction
shear
torsional
Vertebral endplate have …caps.
Help to hold …. in place.
Layers of annular fibrosis …. into endplate.
Endplate …. to vertebral body.
cartilaginous
disc
fuse
fuses
Facet joints are … joints.
Cervical facets are oriented more ….
Lumbar 1-4 are oriented in what plane?
Lumbar 5-S1 oriented in what plane?
synovial
45 degree angle between frontal and transverse planes
sagittal
frontal
During flexion in the lumbar spine, which direction does the vertebral body rock?
Inferior facets of superior segment glides … and …
Disc compresses …
…..ligament is stretched.
Intervertebral foramen …
anterior
superiorly and anteriorly
anteriorly
posterior ligaments
enlarges
During lumbar extension, vertebral body rocks ….
Inferior facets of superior segment glide …. and ….
Disc is compressed ….
….ligaments stretched.
Intervertebral foramen …
posterior
inferiorly and posteriorly
posteriorly
anterior
narrows
Axial rotation of lumbar spine is termed by ….
Direction is a point on the ….
Fyettes law says in a neutral spine, rotation and sidebend are coupled in ….
superior segment
anterior vertebral body
opposite directions
Sacrohorizontal angle is normally….
Results in …..shear forces in addition to compression forces.
supports …., …. ,….
40
increased
anterior longitudinal ligament
iliolumbar ligament
wide facets
Nutation is related to ….
Base moves relative to …
anterior sacral tilt
ilium
Counternutation is ….
posterior sacral tilt
Iliosacral motion:
Rotation occurs in … where ASIS is … and PSIS is … in anterior rotation.
sagittal plane
low
high
Iliosacral motion:
Upslip and downslip occurs in … plane.
Upslip is where ASIS and PSIS are ….
Downslip is where ASIS and PSIS are…
frontal
high on one side
low on one side
Iliosacral motion:
Inflare and outflare occurs in …plane.
Inflare is where ASIS is …. to midline and PSIS is ….
Outflare is where ASIS is … to midline and PSIS is ….
transverse
closer to
further from
further from
closer to
The pubic symphysis is a …,….joint.
synarthrotic, cartilaginous
In the thoracic spine, the facets transition head to tail from a more … orientation with … tilt, to a …. orientation with … tilt.
frontal plane
anterior
sagittal plane
no
In the cervical spine, during flexion, the superior segment inferior facets glide … and ….
During extension, they glide …. and ….
During lateral flexion on the concave side glide… and … and on the convex side glide … and ….
During rotation facets on ipsilateral side glide … and on contralateral side glide …
superiorly/anteriorly
inferiorly/posteriorly
inferior and slight posterior
anterior and superior
inferior
superior
In the cervical spine, rotation and side-bending are coupled in the ….
same direction
In the cervical spine, vertebral foramen opening is increased with …
flexion
left lateral flexion
left roation
TMJ is a …joint
synovial
What movements occur at TMJ?
rotation and translation
TMJ structures
mandibular condyles and mandibular fossa
articular disk
ligaments
TMJ disk and mandibular condyle move …. during translation.
During protrusion/retrusion mandible slides …..
During left lateral excursion the left TMJ becomes a …. and the right glides….
During depression there is …. rotation and …. translation (opposite for elevation)
together
downward/upward
pivot point
anteriorly and medially
early posterior rotation and late anterior/inferior translation
Capital extension tests what muscles?
RCP major/minor OC inf/sup splenius capitis longissimus capitis semispinalis capitis
Cervical extension tests what muscles?
splenius
longissimus
semispinalis cervicis
iliocostalis cervicis
Capital flexion tests what muscles?
rectus capitis anterior
lateralis
longus capitis
Cervical flexion tests what muscles?
SCM
anterior scalenes
longus colli
