Fifth Orthotics Mock Exam Flashcards
An idiopathic scoliotic curve with an apex of T-12 should be managed with which type of pad?
Extended lumbar pad
A complete lesion of the femoral nerve as it leaves the lumbar plexus affects, what?
Knee extension
The major flexor of the hip is the…
Iliopsoas
Paralytic equinus during swing phase is often caused by compromise to the…
Common peroneal nerve
A cycle of gait may be defined as all activity that occurs between what?
Heel strike on one limb and subsequent heel strike on the same limb
The troclea is found on the superior border of which bone?
Talus
During closed kinetic chain supination the talus is in what position?
Dorsiflexed and abducted
Toe-out or toe-in is the relationship of the long axis of the foot to the…
Line of progression
The motion of inversion and eversion occurs primarily at which joint?
Subtalar joint
Where should the metatarsal pad be located in relation to the metatarsal heads?
Proximal
For most patients with paraplegia, to stand in KAFO’s they must be allowed to rest on their iliofemoral ligament In order to facilitate this posture, how should the ankles be positioned in the sagittal plane?
A few degrees of dorsiflexion
The medial column of the foot consists of which bones?
Talus, cuneiforms, navicular, metatarsals 1-3
One action of the peroneus longus is to…
Plantarflex the first ray
The proper location of the knee joint on a KAFO is…
Half the distance between the adductor tubercle and the medial tibial plateau
Which of the following ankle joint controls would be indicated for flaccid isolated paralysis of the plantarflexors?
Dorsiflexion stops
Which motion component is not considered part of supination?
Eversion. supination is inversion adduction and plantarflexion
What motion does a cushioned heal simulate?
Plantarflexion at heel strike
If the oblique diameter of the malleoli is 83mm, the inside diameter of the mechanical ankle joint is
94mm
Solid stirrup length is determined by calculating the height by…
Medial malleolus + sole thickness x 2 + heel width
When putting a heel wedge on a shoe for a conventional AFO, the wedge should be placed…
Between the stirrup and the sole
If a patient is wearing a KAFO with bilateral ring locks engaged, the clearance at the knee joint should be
6mm medially and 3mm laterally
During late stance phase of the gait cycle, the hip joint requires how much extension for normal function?
10 degrees
What event does a rocker sole most closely simulate?
Midstance to heel off
When aligning a cam lock for KAFO, the posterior aspect of the ball should be angled…
Distally
When genu varum is present on a lower schema the mid sagittal line connects the perineum and the mark made, where?
30mm medial to the knee
The coleman lateral block test is used to assess mobility for which deformity?
Pronation deformity of the forefoot and/or varus moment of the heel.
The schema for a conventional KAFO should indicate the knee and ankle joint axes to be…
Perpendicular to the mid sagittal line
Tibialis posterior is innervated by which nerve
Tibial nerve
A possible cause for circumduction during gait is…
Equinus knee arthrodesis extensor synergy pattern
True or False: at heel strike the ground reaction line passes anterior to hip and posterior to knee
False?
The greatest amount of dorsiflexion occurs during which part of stance?
Heel off
A trendelenburg sign is caused by loss of the…
Gluteus medius
Orthosis that would be used for congenital hip dislocation include…
Pavlik harness, ilfeld orthosis, von rosen orthosis
In which condition would the fat pad plantar to the metatarsal heads migrate into the sulcus?
Rheumatoid arthritis
You are delineating the schema for a KAFO and genu valgum is evident. The mid-sagittal line will intersect which point first from the perineum
15mm medial to knee
What are the possible causes to hyperpronation?
Tight achilles tendon, posterior tibialis weakness, forefoot varus
A posterior lean is most commonly seen with paralysis of which muscle group?
Hip extensor
With poor grade dorsi and plantar flexors, the most desirable control in a metal AFO is…
Solid ankle
Which test would be useless if the patient presents with bilateral CDH?
Galeazzi test
A varus control strap on a conventional AFO attaches to the ___ aspect of the shoe and wraps around the ____ side bar.
Lateral, medial
A young boy with early signs of muscular dystrophy comes into your office. Since one of the first stages of this disease is weakness of the hip extensors, you would expect him to walk with
Increased lordosis
A condition where there is growth disturbance on the medial proximal aspect of the tibia is
Blount’s disease
The talocalcaneal or talocalcaneonavicular joint forms which joints?
Midtarsal
When fitting the orthosis for CDH which of the following fitting parameters is best indicated for this infant?
90 degree hip flexion and 45 degree hip abduction
HIV is present in blood, seaman, vaginal secretion, breast milk, amniotic fluid, cerebrospinal fluid, synovial fluid. What is it not present in?
HIV is not present in saliva, tears, blisters fluid, urine, facces, vomit, sweat
What are the major functions of the tibialis anterior muscle?
Dorsiflexion and inversion
Foot drop is caused by a lesion of which nerve?
Peroneal nerve
The major flexor of the hip joint is the…
Iliopsoas
The following can cause hip hiking…
KAFO with knee locked in extension, contralateral limb shortened, knee ankylosis
A wrist driven wrist hand orthosis is designed to mechanically assist patients to achieve what type of grasp or prehension?
Three point prehension
The construction of a knight LSO consist of:
Paraspinal bars, lateral bars, pelvic band, thoracic band
The distal palmar trimline for the plastic WHO is trimmed to…
A point just proximal to the distal palmar crease
The ratchet wrist hand orthosis assists quadriplegics in achieving prehension to preform some task, What spinal cord injury level is appropriate for consideration of a ratchet versus a wrist driven WHO?
C5
To prevent pin penetration through the skull and into the brain, what should be used?
Properly adjusted torque drivers
The denis 3 column system includes consideration of…
the severity of spinal injury, the location of spinal injury, the stability of spinal injury
Appropriate treatment for T11-L2 compression fractures include…
The jewett hyperextension orthosis
Genu valgum describes a knee joint that, what?
Is excessively angled medially
One disadvantage of offset knee joint is…
The possible unintentional unlocking on uneven terrain
Proper AFO design must:
Correct flexible deformity
MRI technology is used primarily for imaging:
Soft tissue
Spinal orthosis offer biomechanical control including:
Three point pressure systems, fluid compression and distraction, skeletal fixation and kinesthetic reminders
The radial extension component of the short opponenes hand orthosis comes in contact primarily with what part of the hand?
The 2nd metacarpal joint
The demonstrated MMT grade of 4 would indicate:
the patient is able to move against gravity and some manual resistance
Intrinsic stability of the spinal column is provided by
Bones, discs, and ligaments
The goals of orthotic treatment are to control, what?
Pain, motion, deformity
When seating a patient, the first priority should be to stabilize:
The pelvis and torso
What wrist position is considered to be the resting position?
10 degrees of extension
What advantage does a fracture orthosis offer over a fracture cast?
It can be open for hygiene and dressing changes, it can be adjusted for edemous change
Many spinous processes align:
with the level of the next inferior vertebral body
Which fibular landmark is of particular interest in relation to the peroneal nerve?
The neck
The forces applied by traction systems are
Distractive
The appropriate foot orthosis for a rigid subtalar varus foot would include what?
Include a medial wedge
The cardinal plane that evenly divides the human body front from back is…
The coronal plane
Fluctuating edema can be accommodated by
A conventional AFO with custom shoe
Four-part burst fracture of C1 is commonly called
Jefferson’s fracture
The ortolani test involves…
Relocation of a dislocated hip
The primary function of the intervertebral disc is…
absorption of compressive forces in spinal column
The largest bones of the pelvic extremity are
the femur, tibia, and fibula
Which cervicothoracic orthosis is particularly well-suited for application on supine patients?
SOMI
Foot pronation is a a combination of what?
calcaneal eversion, calcaneal abduction, calcaneal dorsiflexion.
Dynamic forces are introduced to orthotic intervention for two primary purposes. What are these two primary purposes?
Substitution and correction motion
Name the knee joint ligaments that are most often injured in athletic activities that involve planting the foot and turning or twisting
ACL
MCL
Medial Meniscus
The null vertebra is…
Level at/near the center of the curve
Terminal stance occurs at the end of single limb stance, The ground reaction line is generating what?
An extension moment at the hip and knee, a dorsiflexion moment at the ankle
An average walking speed is 113 steps/min or about, how many MPH?
3 MPH
During which phase of gait is the hip hyperextended?
Pre swing
During which phases of gait does the hip reach maximum flexion?
Initial contact, mid swing, deceleration
The muscular activity at initial contact is as follows…
hip extensors, knee extensors, ankle dorsiflexors
The vertical displacement of the center of gravity is…
2 cm
Determinates of gait describes what?
The processes by which the body attempts to resist change to the position of the center of gravity during normal walking
Signs of mature gait include….
Narrow walking base, heel strike at initial contact, reciprocal arm swing, knee flexion wave
The ankle reaches maximum plantarflexion during which phases of gait?
Initial swing, pre swing
Lateral displacement of the hip durning normal human walking is…
1 to 3 inches
At pre swing the ground reaction line is as follows…
anterior ankle, posterior knee, posterior hip
At late midstance the ground reaction line is as follows…
anterior ankle, anterior knee, posterior hip
True or False: Perry lists the three phases of swing in normal gait as pre swing, swing and terminal swing
False
The definition of running is…
absence of double limb support
The horizontal dip of the pelvis during normal human walking equals…
5 degrees
True or False: The stance phase represents about 60%-62% of the gait phase
True
At initial contact, the ankle is in what angular attitude
Neutral (90)
Initial contact is an instantaneous event at the moment the foot first contacts the ground, it is a period of double limb support. The ground reaction line is anterior to the hip joint, anterior to the knee joint and posterior to the ankle joint. Because of this, what is true of the moments being generated at this point?
It is generating a flexion moment at the hip. It is generating a extension moment of the knee. No moment is generated at the ankle.
A stride is defined as…
The equivalent of one gait cycle
True or False: A period of single limb support occurs early in midstance when the foot is flat on the floor and continues to midstance as the leg approaches perpendicular to the ground.
True
How much knee flexion is present from heel strike to loading response and why?
20 degrees minimize vertical displacement of the center of gravity
True or False: there are six determinates of gait, which while described individually, function simultaneously
True
True or False: for practical gait units of measure, the terms stride and step are used. A stride is the same as one gait cycle and is defined as the interval between the initial contact of one leg and initial contact of the other leg.
False
Normal width of walking base is about how many cm?
4 to 5 cm
A step is defined as…
The equivalent of one half a stride
The phase of gait where the ground reaction line falls anterior to the ankle, anterior to the knee, and posterior to the hip is
Terminal stance
The knee is _______ at initial contact
Completely extended
The first indicators of maturing gait include…
Heel strike at the initial contact, reciprocal arm swing, knee flexion wave, the walking base will grow narrower
During which phases of gait does the knee reach maximum flexion?
Acceleration, midswing
Steppage gait is partly characterized by
Excessive hip and knee flexion during swing phase
True or False: circumduction is another strategy for clearing a long swing limb. This compensatory move uses stance side hip adduction to arc the stance foot laterally to clear the foot through the full range
False
True or False: posterior trunk bending serves to move the center of gravity anterior to the hip axis for patients with weak hip extensors
False
The physical pathologies that result in impaired gait are…
Motor deficits, sensory deficits, deformity, pain
True or False: when the knee is unstable in extension, knee stability can be improved by moving the knee axis posterior to the center of gravity. This hyperextension compensates for weakness of the knee extensors or flexors, spastic knee extensors, plantarflexion contracture, gastroc weakness, or excessive orthotic plantarflexion. Over time, simple hyperextension can become genu recurvatum as the ligaments and soft tissue stretch and allow a greater extension range of motion
True
Hip hiking occurs when the swing side hip is elevated to lift the swing limb forward as it moves forward. Typically, this will occur with…
A long swing limb and a short stance limb
One of the most obvious deviations of weak dorsiflexors is
During swing phase, the forefoot fails to clear the ground, during stance phase, foot slap occurs from initial contact to loading response
True or False: a patient with weak ankle dorsiflexors may compensate by using steppage gait
True
Patients trying to clear a relatively long swing limb may to help clear the swing limb by using different compensatory deviations including what?
Lateral trunk bending toward the stance leg, circumduction, vaulting, hip hike
MMT should begin with which grade?
3
The patient should be properly positioned during MMT to do what?
To assure accurate testing
The strength each muscle has to generate a contraction affects what?
The individuals ability to walk safely, move efficiently and to walk efficiently
A patient who demonstrates only palpable or visible contraction is considered to have a muscle strength of what grade?
1
