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anatomy > exsc 460 exam 2 > Flashcards

exsc 460 exam 2 Flashcards

1
Q

anterior line of gravity passes through what?

A

anterior superior iliac spine
bisects the knee
bisects the ankle
foot at the second toe

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2
Q

bones in the hindfoot

A

talus and calcaneus

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3
Q

hindfoot joint

A

subtalar or talocalcaneal joint

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4
Q

function of hindfoot

A

conversion of rotatory forces of the lower extremity

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5
Q

movements of hindfoot

A

gliding and rotation

pronation and supination

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6
Q

bones in the midfoot

A

navicular, cuboid, and cuneiforms

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7
Q

midfoot joint

A

transtarsal joint

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8
Q

function of midfoot

A

transmits movement from rearfoot to forefoot and promotes stability

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9
Q

2 axis’ of the midfoot

A

oblique and longitudinal

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10
Q

when subtalar joint pronates,

A

transtarsal planes become parallel and foot becomes flexible

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11
Q

as subtalar joint supinates,

A

transtarsal planes converge medially and foot becomes rigid and lever-like

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12
Q

bones in forefoot

A

metatarsals and phalanges

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13
Q

name the 2 functions of the feet

A

support: stability for upright posture with minimal muscle effort, flexibility to adapt to uneven terrain
locomotion: rotation of tibia and fibula during gait, flexibility for shock absorption during gait, rigid lever during push-off

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14
Q

function of the arches

A

absorb and distribute GRF produced by body during ambulation or static erect posture
assist ambulation by increasing speed and agility

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15
Q

longitudinal arch

A

may be divided into medial and lateral
Feiss’ line used during assesment: line drawn from inferior tip of medial malleolus to plantar surface of first metatarsal phalangeal joint. navicular tuberosity

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16
Q

Hallux Valgus

A

big toe deviates away from midline of body and toward midline of foot
metatarsus primus varus

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17
Q

etiology of hallux valgus

A 
mal foot posture, pronated or flat foot
forefoot varus
tight shoes
hereditary
abnormal mechanics during 1st phase of gait
arthritis
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18
Q

pathological changes of hallux valgus

A 
abnormal excess stress on medial aspect of head of 1st metatarsal
callus formation
bursitis
exostosis
bunion formation
severe loss of plantar flexion
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19
Q

management of hallux valgus

A

prevention: proper fitting shoes, properly fitting orthotics, improve ankle dorsi flexion ROM
conservative: doughnut pad, toe crests, toe splint, ice massage for inflammation and pain, exercises to strengthen flexor and extensor muscles of great toe.

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20
Q

surgeries to fix hallux valgus

A

weight bearing xray required

structural: problem is osseous
positional: problem is soft tissue
combined: requires surgical correction of bone and soft tissue

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21
Q

Hallux Varus

A

big toe deviates towards midline of body and away from midline of the foot. uncommon in the west.

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22
Q

etiology of hallux varus

A

congenital: majority of cases
acquired: idiopathic, develops spontaneously in middle age, related to chronic arthritis

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23
Q

Management of Hallux Varus

A

mild cases respond to passive stretching exercises for adductor hallucis and proper footwear.
more severe cases require surgery.

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24
Q

mallet toe

A

flexion contracture of distal phalanx

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25
Q

diagnosis of mallet toe

A

can occur on any of 4 lateral toes

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26
Q

pathological changes of mallet toe

A

usually asymptomatic, possible formation of corn of callus over dorsum of affected joint

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27
Q

claw foot

A

condition characterized by extension of the metatarsophalangeal joints and flexion of interphalangeal joints.

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28
Q

etiology of claw foot

A

congenital or acquired
associated with forefoot adductus, arthritis, or neuromuscular pathology
result of defective lumbricals and interossei muscles
associated with pes cavus or equinus

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29
Q

pathological changes of claw foot

A

hard corns or calluses over dorsal surface of toes

may effect gait and functional ability

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30
Q

management of claw foot

A

if acquired, corrective footwear

if congenital, surgery

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31
Q

Hammer toe

A

condition characterized by extension of the metatarsophalangeal and distal interphalangeal joints and flexion in the proximal interphalangeal joint

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32
Q

etiology of hammer toe

A

seems to be congenital because bilateral.
caused by improperly fitting shoes
significant number are idiopathic

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33
Q

diagnosis of hammer toe

A

usually involves only one toe, primarily 2nd but sometimes 3rd

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34
Q

pathological changes of hammer toe

A

calluses or hard corns develop over proximal interphalangeal joint of affected toe.

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35
Q

management of hammer toe

A

proper fitting shoes: adequate toe box
taping of affected toe
severe: surgical fusion

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36
Q

Pes Planus

A

flat foot, depression or loss of longitudinal arch, decrease in angle of inclination of calcaneus

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37
Q

assessment of pes planus

A

anterior line of gravity
heel should be in neutral position
Feiss’ line

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38
Q

types of pes planus

A

rigid, congenital: secondary to tarsal coalition

flexible, acquired: break down of support tissue over extended period of time.

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39
Q

diagnosis of rigid pes planus

A

rare, talus drops medially and inferiorly, navicular drops, produces medial bulge
accompanying soft tissue contractures

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40
Q

diagnosis of flexible pes planus

A

when non weight bearing arch appears normal

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41
Q

management of pes planus

A

no pain: no treatment
conservative: arch supports, proper fitting shoes, exercise to strengthen muscles responsible for maintenance of longitudinal arch.
surgery reserved for severe cases after conservative management failed.

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42
Q

assessment of pes planus

A

anterior line of gravity
heel should be in neutral position
Feiss’ line

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43
Q

types of pes planus

A

rigid, congenital: secondary to tarsal coalition

flexible, acquired: break down of support tissue over extended period of time.

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44
Q

diagnosis of rigid pes planus

A

rare, talus drops medially and inferiorly, navicular drops, produces medial bulge
accompanying soft tissue contractures

45
Q

diagnosis of flexible pes planus

A

when non weight bearing arch appears normal

46
Q

treatment of pes cavus

A

if recognized early, stretching and orthotics
when late structural changes, surgery is required.
plantar fasciotomy
treatment for flexible pes cavus is orthotics.

47
Q

Pes Cavus

A

high arch, excessively high longitudinal arch

48
Q

Etiology of Pes Cavus

A

primary: develops after 3 years-idiopathic
dropping of forefoot, forefoot is pronated, contracture of plantar fascia, heel varus, clawing of toes.
secondary: number of causes, neurological disorders, myopathies, soft tissue overactivity or weakness, direct trauma to foot.
flexible or rigid

49
Q

diagnosis of pes cavus

A

high arch
tight plantar fascia
claw foot
heel varus

50
Q

pathological changes of pes cavus

A

painful calluses form on plantar surfaces of metatarsal heads and on dorsum of clawed toes.
forefoot is thickened and splayed.
toes don’t touch the ground.
function diminished in activities involving prolonged ambulation.
shock absorption reduced leads to increased stress fractures and strains.

51
Q

treatment of pes cavus

A

if recognized early, stretching and orthotics
when late structural changes, surgery is required.
plantar fasciotomy
treatment for flexible pes cavus is orthotics.

52
Q

Equinus

A

condition where foot is plantar flexed on itself or on leg

53
Q

metatarsal equinus

A

foot is plantar flexed on itself at level of tarsometatarsal joint

54
Q

forefoot equinus

A

foot is plantar flexed on itself at level of midtarsal joint

55
Q

osseous block

A

normal dorsi flexion at the ankle is limited due to an impingement of tibia on neck of talus

56
Q

muscular

A

an acquired or congenital shortness of gastrocnemius and soleus prohibits dorsiflexion at ankle, most common cause

57
Q

diagnosis of equinus

A

10 degrees of dorsiflexion needed for normal midstance phase of gait.
compensations:
apropulsive gait
early heel-off
flexion or recurvatum at the knee
abnormal pronation of midtarsal and subtalar joints

58
Q

pathological changes of equinus

A

calluses
claw foot or hammer toe
hallux valgus
plantar fasciitis

59
Q

treatment of calcaneal varus

A

orthotics with medial heel wedge to correct heel varus while allowing normal subtalar pronation.

60
Q

Calcaneal (heel) varus

A

deformity exhibited when non weight bearing by an inverted calcaneus. calcaneus is closer to midline.

61
Q

Etiology of calcaneal varus

A

failure of calcaneus to completely derotate from original infantile position. feet develop in supinated position.

62
Q

diagnosis of calcaneal varus

A

subtalar joint pronates to bring calcaneus vertical to the ground and forefoot in contact with the ground.
component of supinated foot.

63
Q

pathological changes of calcaneal varus

A

reduced shock absorbing ability.

lateral ankle sprains.

64
Q

treatment of calcaneal varus

A

orthotics with medial heel wedge to correct heel varus while allowing normal subtalar pronation.

65
Q

Calcaneal (heel) valgus

A

deformity exhibited while non weight bearing by an everted calcaneus. calcaneus is further from the midline.

66
Q

etiology of calcaneal valgus

A

failure of toddlers arches to develop properly
secondary to femoral neck anteversion, genu valgum,
due to medial weight thrust

67
Q

diagnosis of calcaneal valgus

A

Helbing’s sign, medial bowing of achilles tendon
navicular tuberosity is lower (Feiss’ line)
component of pronated foot

68
Q

pathological changes of calcaneal valgus

A

associated with problems involving pronated feet

69
Q

treatment of forefoot varus

A

orthotic devices

70
Q

forefoot varus

A

deformity exhibited when forefoot is inverted to bisection of posterior calcaneus

71
Q

etiology of forefoot varus

A

result of failure of head and neck of talus to completely derotate from original infantile position

72
Q

diagnosis of forefoot varus

A

during weightbearing, compensation at triplanar subtalar joint usually allows medial forefoot to contact the ground.
produces heel valgus, seen as medial bowing of Achilles tendon.

73
Q

pathological changes of forefoot varus

A

resembles pes planus or pronation
8 degrees of forefoot varus should result in 8 degrees of calcaneal eversion.
hallux valgus
callus formation under head of 5th metatarsal

74
Q

treatment of forefoot varus

A

orthotic devices

75
Q

Calcaneal (heel) valgus

A

deformity exhibited while non weight bearing by an everted calcaneus. calcaneus is further from the midline.

76
Q

etiology of calcaneal valgus

A

failure of toddlers arches to develop properly
secondary to femoral neck anteversion, genu valgum,
due to medial weight thrust

77
Q

diagnosis of calcaneal valgus

A

Helbing’s sign, medial bowing of achilles tendon
navicular tuberosity is lower (Feiss’ line)
component of pronated foot

78
Q

pathological changes of calcaneal valgus

A

associated with problems involving pronated feet

79
Q

treatment of supination

A

orthotics with lateral posting in forefoot and hindfoot.

strengthening weak muscles and stretching tight ones. surgery reserved for rigid cases.

80
Q

forefoot varus

A

deformity exhibited when forefoot is inverted to bisection of posterior calcaneus

81
Q

etiology of forefoot varus

A

result of failure of head and neck of talus to completely derotate from original infantile position

82
Q

diagnosis of forefoot varus

A

during weightbearing, compensation at triplanar subtalar joint usually allows medial forefoot to contact the ground.
produces heel valgus, seen as medial bowing of Achilles tendon.

83
Q

pathological changes of forefoot varus

A

resembles pes planus or pronation
8 degrees of forefoot varus should result in 8 degrees of calcaneal eversion.
hallux valgus
callus formation under head of 5th metatarsal

84
Q

treatment of forefoot varus

A

orthotic devices

85
Q

Pronation

A

deformity of foot consisting of combination of heel valgus and forefoot abduction

86
Q

etiology of pronation *

A 
compensatory due to problems such as: 
forefoot varus 
rearfoot varus
limited ankle dorsiflexion
tibia vara
genu varum
87
Q

diagnosis of pronation

A

may be evident during static posture, excessive pronation or pronation for too long at wrong phase of gait cycle.
forefoot abduction
navicular tuberosity is lower
Helbing’s sign

88
Q

pathological changes of pronation

A

can lead to subsequent malalignments in the lower limb.

bilateral pronation causes accentuated lumbar lordosis

89
Q

treatment of pronation

A

orthotics
medial posting needed in the hindfoot
exercise for muscle imbalance or tightness
surgery rare

90
Q

Supination

A

deformity of foot consisting of a combination of heel varus and forefoot adduction

91
Q

etiology of supination

A 
failure of the foot to derotate from original infantile position.
muscle imbalance
compensatory due to:
forefoot valgus
rearfoot valgus
limb length discrepancy
92
Q

diagnosis of supination

A

forefoot adduction: anterior line of gravity runs lateral to second toe.
navicular tuberosity is higher due to rotation of forefoot.
lateral bowing of achilles tendon.

93
Q

pathological changes of supination

A

ankle sprains and overuse injuries, loss of force absorption, stress fractures

94
Q

treatment of supination

A

orthotics with lateral posting in forefoot and hindfoot.

strengthening weak muscles and stretching tight ones. surgery reserved for rigid cases.

95
Q

Pronation

A

deformity of foot consisting of combination of heel valgus and forefoot abduction

96
Q

etiology of pronation *

A 
compensatory due to problems such as: 
forefoot varus 
rearfoot varus
limited ankle dorsiflexion
tibia vara
genu varum
97
Q

diagnosis of pronation

A

may be evident during static posture, excessive pronation or pronation for too long at wrong phase of gait cycle.
forefoot abduction
navicular tuberosity is lower
Helbing’s sign

98
Q

pathological changes of pronation

A

can lead to subsequent malalignments in the lower limb.

bilateral pronation causes accentuated lumbar lordosis

99
Q

treatment of pronation

A

orthotics
medial posting needed in the hindfoot
exercise for muscle imbalance or tightness
surgery rare

100
Q

Supination

A

deformity of foot consisting of a combination of heel varus and forefoot adduction

101
Q

etiology of supination

A 
failure of the foot to derotate from original infantile position.
muscle imbalance
compensatory due to:
forefoot valgus
rearfoot valgus
limb length discrepancy
102
Q

diagnosis of supination

A

forefoot adduction: anterior line of gravity runs lateral to second toe.
navicular tuberosity is higher due to rotation of forefoot.
lateral bowing of achilles tendon.

103
Q

pathological changes of supination

A

ankle sprains and overuse injuries, loss of force absorption, stress fractures

104
Q

treatment of supination

A

orthotics with lateral posting in forefoot and hindfoot.

strengthening weak muscles and stretching tight ones. surgery reserved for rigid cases.

105
Q

Club Feet-Talipes

A 
congenital gross deformity of the foot.
direction may vary:
equinus
calcaneus
varus
valgus
106
Q

etiology of talipes

A 
cause is idiopathic, theories:
intra-uterine compression
arrest in fetal development
dysplasia of muscles
abnormal tendon insertion
107
Q

club foot combinations

A 
talipes varus
talipes valgus
talipes equinus
talipes calcaneus
talipes equino varus: most common
108
Q

treatment of talipes

A

conservative: gradual manipulative reduction
stretching contracted tissue
corrective casting, changed every 1-2 weeks for 6-8 weeks.
correction is maintained by daily stretching by parents.
wearing of clubfoot or prewalker shoe.
operations confined to soft tissue prior to 8 or 9 yrs of age.

anatomy (22 decks)

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