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Movement Science > Final Exam > Flashcards

Final Exam Flashcards

1
Q

Coxofemoral Joint

A

-synovial, diarthrodial, ball and socket
-flx/ext, ab/ad, IR/ER
-weight bearing and support

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2
Q

Acetabulum

A

-fuse ilium, ischium, pubis
-50 deg inferior and 20 deg anterior

-luneate surface: hyaline cartilage articulating with femur
-acetabular notch + transverse acetabular lig: creates tunnel for BVs
-Acetabular fossa: deepest, does not touch femur

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3
Q

Acetabular Dysplasia

A

shallow acetabulum, prone to instability

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4
Q

Coxa Profunda

A

over coverage of acetabulum leading to impingement

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5
Q

Anterversion

A

-more than 20 deg
-positioned more ant
-instability

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6
Q

Retroversion

A

-less than 20 deg
-positioned more post
-over coverage`

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7
Q

Center Edge Angle

A

-coverage of the femortal head by acetabulum
-lat rim of acetabulu, to center of femoral head
-Norm: 22-50
<20: acetabular dysplagia
>50: pincer- type impingement

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8
Q

Acatabular Inclination

A

-measure of debth
-line parallel to teardrops to lat acetabulum

Norm: 32-45

> acetabular inclination

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9
Q

Acetabular Labrum

A

-ring of fibrocartilage; blends with acetabular lig
-deepens socket
-negative pressurre
-proprioceptive nerves

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10
Q

Femoral Head

A

-hyaline cartilage
-medial, superiorly, anteriorly
-lig teres attached to foeva

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11
Q

Angle of Inclination

A

-frontal plane measurement, smaller in women, greater during childhood

Norm: 125

> 125: Coxa valga: straighter in relation to shaft, less shear on neck, decreases MA of abductors, decreases coverage of acetabulum, associated with genu varum (kids with CP and spasticity have valgum)

<125: Coxa Vara: increased stability and MA, increased shearing forces on neck, associated with genu valgum and SCFE

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12
Q

Angle of Torsion

A

-transverse plane measurement
-axis through head and neck and femoral condyles

Norm: 10-20deg
Anteversion: >15-20; increased internal rotation to compensate, decreased stability; toe in

Restroversion: < 10-15; increased external to compensate rotation; toe out

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13
Q

Most Congruence

A

-flexion, ab, slight ER

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14
Q

Joint Capsule Hip

A

-irregular; dense fibrous tissue
-retinacular fibers: carry BVs
-Femoral neck is intracapsular
-Trochanters are extracapsular

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15
Q

Hip Bursae

A

Lateral:
-trochanteric, reduce friction btwn post facet, glut max, IITB and greater troch

Anterior:
-glut med bursa
-iliopsoas bursa

Posterior:
-ischiogluteal

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16
Q

Ligaments

A

Ligamentum Teres:
-ligament of the head of the femur
-reisits rotation in 90 deg of flexion
-intrarticular but extrasynovial
-attaches from acetabular notch, transverse acetabular lig, to fovea
-secondary blood supply (avascular necrosis)

Iliofemoral Lig:
-Y lig
-ASIS to intertrochanteric line
-anterior stability
-reists ER

Pubofemoral Lig:
-pubis to iliopectineal eminence
-supports inferior femoral neck
-resists ER in Ext

Ischiofemoral Lig:
-posterior acetabulum and labrum to greater troch
-resist IR

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17
Q

Capsuligamentous Tension Hip

A

Close packed: ext, abd, IR
Loose packed: flx, abd, mid-rotation

-ligs taut in ext
-capsule and ligs suport 2/3 body weight w/o muscles
-LoG is post to hip, slight ext
-most vulnerable to post dislocation in flx and abd

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18
Q

Bony Architecture (forces)

A

-trabeculae line up along stress lines
-weightbearing stress passes from SI to acetabulum
-femoral head transfers forces to shaft, bending the neck (superior tensile forces and inferior compressive forces)
-Head, arms and trunk create shearing forces with ground reaction forces

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19
Q

Trabeculae Systems

A

Medial:
-Superior to inferior
-reissts vertical compressive forces

Lateral:
-Lateral to medial
-resists shear forces of HAT and GRF

Zone of weakness:
-lateral and superior to lesser trocanter

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20
Q

Joint Pressures

A

-peak pressure in single limb stances on superior acetabulum
-smaller area in women = higher peak stress
-greatest prevalance of degeneration

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21
Q

Femur on Acetabulum Kinematics

A

-convex on concave

Flx: head spins posteriorly
ext: head spins anteriorly
Abd: head rolls superior, glides inferiorly
Add: head rolls inferior, glides superiorly
IR: head rolls anterior; glide posterior
ER: head rolls posterior; glide anterior

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22
Q

ROM

A

Flexion: 90 w/ ext and 120 w/ flx
Extension: 10-30
Abduction: 45-50
Adduction: 20-30
IR & ER: 40-50

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23
Q

Normal Hip Gait ROM Requirements

A

flx: 30
ext: 10
Ab/ad: 5
IR/ER: 5

Hip Flx for stairs: 60 degrees

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24
Q

Pelvis on Femur

A

-concave on convex

Anterior Pelvic Tilt: hip Flex

Posterior pelvic tilt: hip ext

Lateral Pelvic Tilt: ABd or ADD
-opposite pelvic hike= stance hip ABD
-Opposite pelvic drop= stance hip ADD

Lateral Pelvic Shift: ADD on shift side, ABD on opposite

Forward Rotation: NWB pelvis moves anteriorly, WB moves IR

Backward Rotation: NWB pelvis moves posteriorly, WB moves ER

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25
Pelvifemoral Motion Couples
Forward Bending: spinal flx, APT, hi flx Sidlying Leg lift: hip abd, LPT, lumbar sine bend
26
Hip Flexors
-bring swing limb forward -resist extension -iliopsoas, rec fem, TFL, Sartorius
27
Hip Adductors
-stabilize hip in standing -flex hip from extension -extend from flexed -pectineus: resist flx and abd -add brev, long, mag -gracilis: add and IR of tibia
28
Hip Extensors
-glute max (best MA when hip flexed 70) -hamstrings (least MA when knee flex >90) Assissted by: pos glute med, piriformis, post add mag
29
Hip Abductors
-counteract adds Glute med -abd in all positions -ant flx, IR -post ext, ER -hip flx all IR GLute min: -abd and flx -capsular tightening Assisted by: -glute max, sartorius
30
Hip External Rotators
-ob internus and externus (decreased MA with hip flx, always ER) -gemelli -quad femoris (ER always) -piriformis (hip flx, IR)
31
Hip Internal Rotators
-no primary Assissted by: ant glute med and min, tfl, adductors
32
Hip in Bilateral Stance
-BW distributed equally -1/2 HAT throough pelvis and femoral head -LOG creates extensor -class 1 lever
33
Hip in Unilateral Stance
-stance hip supports compression for HAT and opp leg and abductors -2-3x BW Reduction of forces: -lat lean of trunk tooward stance dec MA -cane ipsi transfers forces -cane contra releaves body weight forces and assist abductors
34
Coxa Valga
-greater angle of inclination >125 -straighter -dec MA of abd -increase dislocation -genu varum
35
Coxa Varum
-lesser angle of inclination <125 -inc MA of Abd -improved congruence -more stress on neck -genu valgum
36
Anteversion
-greater torsion than normal >20 -more joint pressure -less stability -dec MA of abd -head more anterior -more IR, toe in
37
Retroversion
-lesser torsion than normal <10 -stable -head more posterior -more ER, toe out
38
Femoral Acetabular Impingement
-FAI -bony overgrowth on femur and acetabulum -can lead to labral tears s/s: groin pain, dull aching, stiffness CAM: head and neck, athletes, pistol grip Pincer: pelvis and acetabulum, females
39
Hip Labral Tear
-increased probability with dec center edge angle, retroversion, coxa vara -trauma s/s: sharp ant pain, clicking, stiffness
40
SCFE
-slipped capital femoral eiphysis -epiphysis slips down and back S/S: -klein's line -drehmann sign (hip flx with ER) -leg length diff -FAI
41
Swayback
-Glute max paralysis with thoracic kyphosis -pos pelvic tilt -LOG behind greater troch
42
Growth Plates
Femoral head/neck: 18 G troch: 18 Lesser troch: 18 Distal femur: 20
43
Anterior Pelvic Tilt
-tight errectors and hip flexors -weak glutes and abs -increased hip flx -lumbar lordosis -LOG ant to hip
44
Posterior Pelvic Tilt
-weak errectors and hip flexors -tight glutes and abs
45
2 Joints of the Knee
Tibiofemoral joint -distal femur and prox tibia -double condyloid -flx/ext, IR/ER, ABd/ADD Patellofemoral joint -distal femur and patella
46
Tibiofemoral Joint
-medial tibial more anterior and longer -separated by intercondylar notch weightbearing through center of knee Genu valgum: <175 Genu varum: >185
47
Meniscus
Medial: c shaped, restricted, more attachments Lateral: circular, more mmt, popliteus, covers more surface -Post deformation with flx -ant deformation with ext Nutrition: -outer more vascularized -inner gets nutrition from difussion
48
Joint Capsule of the Knee
-close packed: full extension -Posterior boarder: condyles, intercondylar notch -Anterior boarder: quad tendon, patella, patellar lig, extensor mechanism -Extensor Mechanism: medial and lateral retinaculum -Synovial Layer -Fibrous Layer
49
Synovial Layer
Extrasynovia but intracapsular: ACL and PCl, fat pads -Bursae: invaginatons of synovium Plica: folds of membrane, loose tissue -not in everyone -plica syndrome (inflammed) -medial less common, source of pain
50
Fibrous Layer
-Medial patellofemoral lig: thickest band in med retinaculum, stabilized patella in femoral sulcus, blends with MCL -Lateral patellofemoral lig: ITTB to lateral patella
51
MCL
-medial femoral condyle to medial tibia and med meniscus -resist valgus and tibial ER
52
LCL
-lateral femoral epicondyle to fibular head with bicep fem tendon -resistt varus and ER
53
ACL
-posteromedial aspect of lat femoral condyle to anterolateral aspect of medial intercondylar tibial notch -taugh in CC flx -anteromedial (taught in >15 flx) and posterolateral (taught in ext) bundles -ACL retrains quads anterior shear on tibia
54
ACL Injury
-coconttraction ofo hamstrings and quads allow hammies to counter anterior translation from quads -soleus can resist ant translation of tibia in closed chain
55
PCL
-anterolateral aspect of med femoral condyle to posterior aspect of intercondylar tibial notch -taut in CC ext -bigger than ACL -posteromedial (taught in ext) and anterolateral (taught in 80 flx) bundles -restains posterior translation of tibia (knee flexed too)
56
Posterior Capsule
-reinforced by politeus, semimembranosus and LCL -Oblique popliteal lig: expansion of semimembranosus -Posterior Oblique lig: taught in ext, reisist varus/valgus -Arcuate lig: taught in ext, reisist varus/valgus
57
ITB
-extension of TFL and glute max to gerdy's tub -inc lat stability -compresses or rolls during flx/ext
58
Joint Kinematics Knee
CC Flx/ext: femur rolls post and glides ant (ext opp), convex on concave OC Flx/Ext: Tibia rolls psot and glides post (ext opp), concave on convex
59
Knee Extension
-can be limitted by DF
60
Knee Flexion
-can be limited by active insufficiancy of hamstring -passive insufficiency of rec fem
61
Coupled Motions knee
-Flexion with varus -extension with valgus -Terminal knee ext with ER (OC, screw home mechanism) -Flex from full ext OC IR tibia -FLex from full Ext CC ER of femur
62
Knee Flexors
Hamstrings: -SM/ST IR -BF ER Sartorius: flx and IR Gracilis: flx and IR Popliteus: flx and IR Gastroc and Soleus: Valgus/varus
63
Knee Extensors
Quads: VL and VM posterior compressive force Quad tendon Patellar tendon Glute max: in WB Soleus: in WB
64
Patella on Quad
-patella and femoral condyles lengthen MA of quads and increases torque (anatomical pulley) -max MA at 45-60 flx -MA decreases in full ext
65
Quads in Stance
-2x as strong as hamstrings -Soleus and glute max assists with knee EXT OC: quads generate more torque as knee aproches ext (concentric) (les ant tib shear) CC: quads generated more force to control increasing torque (eccentric) (more ant tib shear)
66
Knee Stabilizers
Ant Tib translation: -ACL, ITB, Hammies, soleus, glute max Post tib translation: PCL, quads, popliteus, gastroc Limit Valgus: MCL, ACL, PCL, arcuate, medial muscles Limit Varus: LCL, ITB, ACL, PCL, arcuate, Lat muscles IR TIbia: ACL, PCL, PM capsule ER tibia: PL capsule, MCL, LCL, medial muscles
67
Patella Alta
-longer and higher on femur -unstable
68
Patella Baja
-shorter and lower on femur
69
Motions on Patella
-Translates and rotates on femoral condyles -lateral shift in ext (less compression in ext) -medial shift in flx (most compression in flx) -inferior position with extension and early flx -superior position 90deg -lateral position >90deg
70
Walking Stresses
25-50% BW
71
Running Stresses
5-6x BW
72
Q Angle
-assess resultant pull -measured in EXT -10-15deg norm, >20 mal alignment (genu valgum) -women > men
73
Knee ROM Norms
Normal Range: 5-0-140 Walking: 60-70 flx Running: 130deg Stairs: 80 Sit to stand: 90 IR in 90 flx: 15 ER in 90 flx: 20 ADD/ABD in Ext: 8 deg ADD/ABD in flx: 13-20deg
74
Rearfoot (hindfoot)
-talus -calcaneus
75
Midfoot
-navicular -cuboid -cuneiform
76
Forefoot
-metatarsals -phalanges
77
Foot Motions
Talocrual: DF/PF Subtalar: INV/EV and ABD/ADD Toes: flx/ext Pronation: DF/EV/abd Supination: PF/IV/add Hindfoot: Calcaneovalgus/Calcaneovarus
78
Proximal Tibiofibular Joint
-head of fib and posterolateal tib -convex tiba and concave fibula -functionally ankle, anatomically knee -hypermobility can lead to common fib injury -inv trauma can lock proximal
79
Disttal Tibiofibular Joint
-syndesmosis union -ligaments only, no capsule -injury at syndesmosis can lead to widening of mortise and instability at talocrual
80
Mortise
-talus in socket of distal tibiofibular joint
81
Talocrural Joint
-synovial hinge joint -distal fib/tib on body on talus -inclined lat 14deg, post 23deg, toe out 20deg Proximal: Mortise= concave tibia + malleoi Distal: talus on trochlear surface
82
Medial Collateral Ligaments Ankle
-deltoid lig -fan shaped at navicular, talus, and calcaneus -strong, not injured often (EV injury)
83
Lateral Collateral Lig
-anterior and posterior talofibular lig -calcaneofibular lig -limits inv -weaker, commonly injured
84
Dorsiflexion at Talocrural J
Head of talus rolls dorsally and body of talus glides plantarly -medial rotation -20deg -Closed packed, limited by gastroc/soleus
85
Plantarflexion at Talocrural J
Head of talus and body move oppositely, head rolls plantarly and body of talus glides dorsally -lateral rotation -50deg -small amounts of ABD/ADD or EV/INV -Loose packed, limited by ant tibialis
86
Talus Shape
-wider distally than proximally -lateral facet is larger than medially
87
Subtalar Joint
-Talus and calcaneus -alternating convex/convave improves stability -42deg dorsally, 16deg medially Proximal: concave talus on convex calcaneus, largest facet Distal and Medial: convex facet on inferior body and neck of talus on concave facets on calcaneus Distalmedial <> Proximallateral for mobilizations -non communicating joint cavities
88
Tarsal Canal
-sinus tarsi: lateral -Sustentaculum tali: medial
89
Subtalar Ligs
-Calcaneuofibular Lig -ant/post Talofibular ligs -interoosseous lig -cervical lig (strongest) -deltoid lig
90
Subtalar Motion (WB/NWB)
NWB: -NWB Supination:calcaneal ADD/INV/PF -NWB Pronation: calcaneal ABD/EV/DF WB: calcaneus fixed able to move EV/INV only -WB Pronation: calcaneal EV, talar ADD/PF, tib/fib MR (open packed) -WB Supination: calcaneal INV, talar ABD/DF, tib/fib LR (closed packed)
91
Subtalar ROM
Calcaneal INV: 20-30 Calcaneal EV: 5-10 Bilateral stance: 3-5 EV Heel strike: 3 INV then EV Push off: 5.5 INV
92
Transverse Tarsal Joint
-Talonavicular and calcaneocuboid (immobile) -divides hindfoot and midfoot -linked to subtalar in WB during Sup/pron -25 degrees from ground
93
Talonavicular Joint
-distal convex head of talus and concave proximal navicular
94
Talonavicular Joint Ligs
-Spring lig: from sustentaculum tali on calcaneus to navicular, sling too hold head of talus -Deltoid ligaments reinforce -Bifurcate lig laterally
95
Calcaneocuboid Joint
-distal calcaneus and proximal cuboid -reciprocal concave/convex restricta mmt
96
Calcaneocuboid Joint Ligaments
-Bifurcate lig -Dorsal and long plantar calcaneocuboid ligs
97
Weightbearing Supination
Tibial ER < hindfoot sup < talus and calc drag navicular and cuboid into sup
98
Weightbearing Pronation
Tibial IR < subtalar pron < lateral foo will lift off the grown
99
Tarsometatarsal Joint
-distal tarsals and base of metatarsals -synovial joint -1st: 1 capsule -2nd, 3rd: share capsule -4th and 5th: share capsule 1 Ray: DF, IV, ADD -SUP 5th ray: DF, EV, ABD - SUP (when hindfoot sup in WB to stabilize)
100
Forefoot Varus
-seen in hindfoot pronation
101
Index +
-1st ray longer than 2nd
102
Index -
-morton's -2nd ray loonger than 1st
103
Sesamoids on Hallux
-pulley for FHB and protects FHL in weightbearing
104
Metatarsal Break
-extendion during heel rise -hallux rigidus (hammer toe) -1st MTP 83 ext, 17 flx -42 ex in walking
105
Hallux Valgus
-longer valgus ->15 deg ADD
106
Longitudinal Arches
-medial and lateral -talus is keystone -medial higher than lateral -lessen impact and make foot a rigid lever for gait
107
Transverse Arch
-medial cuneiform keystone -easiest to see at transverse tarsal
108
Spring Ligament
-static stabilizer of arches -sling of talar head -sustem. tali to navicular
109
Interosseous TC Lig
-within ST joint
110
Calcaneal Aponeurosis
-calcaneus to met heads
111
WB Distribution
-Bilateral: talus 50% BW -Unilateral: talus 100%, calc and talonavicular 50% -MET head highest during push off gait -Heel highest during heel strike (85-130% walking, 220% running)
112
Plantar Flexion Muscles
-Tibialis Post: sup, inv -FDL and FHL: weak PF and sup and inv -Plantaris
113
Lateral Compartment Muscles
-Fibularis Brevis/longus: weak PF, eversion, pronation
114
Anterior Compartment Muscles
-DF -Tib ant: DF, supination, inversion -EHL: weak sup -EDL: hindfoot pronator -FIbularis tertius
115
Pes Cavus
-high arch -supinated -decreased shop absortion -ankle sprains common
116
Pes Planus
-low arch -decreaed rigid lever -tirred feel -hallux valgus
117
Club foot
-adduction, varus, equinus, cavus
118
HAT
-head arms and trunk: 75% of BW -Head and ams: 25% -Trunk: 50%
119
Tasks of Gait
1. Maintain HAT 2. Maintain balance/posture 3. Control Feet 4. Generate forward velocity 5. Shock absorption to decrease velocity
120
1 Year Gait Development
-high guard -foot flat -more flexion -wide BOS
121
1.5 Year Gait Development
-more natural gait -heel strike and arm swing -running
122
2-3 Year Gait Development
-normal BOS -can walk on tip toes or hop
123
7 Year Gait Development
-adult-like
124
Adolescents Year Gait Development
-gait stabilizes when growth stops
125
Normal Adult Gait
-0.64s -smooth, energy efficinet, saggital torque, shift COP, arm swing
126
Gait Cycle
Stance: -Initial contact (Preswing): heel contact, flexion hip (20), ant pelvic rotation -Loading response (pre- swing): weightshift, flexed knee (15), DF (7 lack of will show) -Midstance (initial-mid Swing): Neutral hip -Terminal Stance (Terminal Swing): extended hip (20), DF (10 at highest), mtp exetnsion -Pre-Swing (Initial contact and loading response): extension, flexion (40), PF (15) (MTP 60 for windlass) Swing: -Initial Swing (midstance): toe off, most knee flexion (60), -Middle Swing (Midstance): most flexion (25) -Terminal Swing (Terminal Swimg): right before initial contact
127
Double Limb Support
-40%
128
Single Limb Support
-60% -running is 100%
129
Pelvis MMT During Gait
-4-8 deg ant/post -5 deg sup/inf, 4-5cm
130
Step Length
-distance foot advances in relation to the other (heel to heel) -18 inch norm
131
Stride Length
-distance from one foot back to the same foot -Right heel to right heel -3 ft norm
132
Step Width
-horizontal disrance between heels -3.5 inches
133
Cadence
-number of steps per min -110-121steps/min
134
Velocity
-speed of walking -1.2-1.37 m/s or 4
135
Center of Pressure in Feet
IC: heel LR: mid foot MS: lateral forefoot TS: Medial toes
136
Ground Reaction Forces
IC: Ant to hip and knee, post to ankle LR: Post to ankle and knee, ant to hip MS: Ant to ankle and knee, post to hip TS: Ant to ankle and knee, post to hip PS: Post to hip and knee, an to ankle
137
Internal Moments
-counteract external forces IC: ankle DF, hip ext, knee flex LR: ankle DF, hip ext, knee ext MS: ankle PF, hip flx, knee flex TS: ankle PF, hip flx, knee flex PS: ankle PF, hip flx, knee ext
138
O2 Consumption for Walking
-32% norm, 48% old or conditions
139
Rockers
1. Heel (IC) 2. Ankle (LR) 3. Foefoot (TS) 4. Toes (PS)
140
UE Mmt During Walking
-shoudler 6 flx/ 24ext -elbow flx: 20-45
141
Stair Gait
-64% stance, 36% swing` Weight Acceptance (IC): Pull Up (LR): Forward Continuance (MS-PS): Foot Clearance: Most knee flx (90-100) Foot Placement: most hip flx (60)
142
Running Gait
-stance 40%, Float 20%, swing 40%
143
Past Retract
-forceful hip flexion to extencd a flaccid knee

Movement Science (13 decks)

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