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Anatomy 2 > Final Exam (Cumulative): LE Kinesiology + Gait > Flashcards

Final Exam (Cumulative): LE Kinesiology + Gait Flashcards

1
Q

What is the angle of inclination at birth, and as an adult?

A

Birth: 140-150 degrees (coxa valga)
Adult: 125 degrees (angle reduces over time due to walking)

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2
Q

What is femoral torsion? List the angle at birth and as an adult

A

The angle between the femoral neck and shaft

Birth: 40 degrees (excessive anteversion)
Adult: 15 degrees (normal anteversion)

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3
Q

Describe excessive anteversion

A

Toe points in to compensate and normalize forces (Shortens the internal rotators, lengthens the external rotators and may limit ROM)

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4
Q

What are the arthrokinematics during hip flexion, extension, IR, ER, abduction, and adduction?

A

Flexion: Spin

Extension: Spin

IR: Anterior roll, posterior slide

ER: Posterior roll, anterior slide

Abduction: Superior roll, inferior slide

Adduction: Inferior roll, superior slide

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5
Q

T or F? If you have less than 15 degrees of femoral torsion (anteversion), the patient is considered to have retroverted hip alignment

A

True

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6
Q

If a patient has 140 degrees angle of inclination at the hip, how is he/she likely to stand? why?

A

He/she will likely go into hip abduction because it needs to lower the femoral head when walking to promote stability

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7
Q

Which structures influence joint motion and function?

A
  • Femoral head
  • Acetabulum
  • Acetabular labrum
  • Acetabular ligament
  • Acetabular alignment
  • Capsule and ligaments
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8
Q

How is the acetabulum and femur aligned?

A

Anterior/Lateral orientation (20 degrees from lateral orientation)

This causes the femoral head to become slightly exposed (commonly dislocated anterior as a result)

  • femoral head is covered anteriorly by anterior capsule and iliopsoas
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9
Q

T or F? In order for a posterior dislocation of the femoral head to happen, a fracture of the posterior acetabulum would need to occur

A

True

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10
Q

Not enough coverage of the femoral head is called __________. Over coverage of the femoral head is called _____________

A

Dysplasia, Pincer

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11
Q

List and describe the ligaments of the acetabulofemoral (hip) joint

A

Iliofemoral: Taut in extension/ER

Pubofemoral: Taut in abd/extension/ER

Ischiofemoral: Taut in IR/Extension

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12
Q

Differentiate between open and close packed position

A

Open Packed:
- Least amount of joint surface congruency
- Capsule and ligaments are relaxed
- Joint movement is maximized

Close Packed:
- Most amount of joint surface congruency
- Capsule and supporting ligaments are maximally tight
- Joint movement is minimized

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13
Q

Describe the “close packed” position of the hip

A

Extension, Abduction, Internal Rotation

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14
Q

Describe Femur on Pelvis flexion

A

Spin

  • Slackens anterior capsule and iliofemoral ligament
  • Stretches inferior capsule and gluteus maximus
  • With knee extended during hip flexion, the hamstrings would limit ROM
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15
Q

Describe Femur on Pelvis Extension

A

Spin

  • Increase tension in all ligaments (especially iliofemoral) and ilipsoas
  • With knee flexed, motion is limited due to rectus femoris
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16
Q

Describe Femur on Pelvis Abduction/Adduction

A

Abduction
- Superior roll, inferior slide
- Stretches pubofemoral ligament and adductors

Adduction
- Inferior roll, superior slide
- Stretches superior ischiofemoral ligament and abductors

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17
Q

Describe Femur on Pelvis IR/ER

A

Internal Rotation
- Anterior roll, posterior slide
- Stretches external rotators (piriformis/glute max) and ischiofemoral ligament

External Rotation
- Posterior roll, anterior slide
- Stretches iliofemoral ligament and internal rotators (TFL/glute min)

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18
Q

Describe Pelvis on Femur ant./post. tilt

A

Anterior Tilt
- Slackens most hip ligaments (especially iliofemoral)
- Limited by hip extensors
- Increase lumbar extension (lordosis)

Posterior Tilt
- Taut iliofemoral ligament and rectus femoris
- Decrease lumbar extension

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19
Q

Describe Pelvis on Femur abduction/adduction

A

Abduction
- “Hip hike” on non weight bearing leg
- Limited by pubofemoral ligament and adductors of weight bearing limb

Adduction
- Lowering of non weight bearing limb
- Limited by IT band, abductors of weight bearing limb

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20
Q

Describe Pelvis on Femur IR/ER

A

Internal Rotation
- Iliac crest rotates forward on non weight bearing limb
- Lumbar rotation in opposite direction to keep stable trunk

External Rotation
- Iliac crest rotates backward on non weight bearing limb
- Lumbar rotation in opposite direction

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21
Q

Which muscles are used to anteriorly tilt the pelvis (anterior force couple)

A

Erector spinae and sartorius

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22
Q

Which muscles are used to posteriorly tilt the pelvis (posterior force couple)

A

Rectus abdominis, hamstrings, glute max

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23
Q

The abdominals prevent the pelvis from tilting ________, which promotes “core stability”

A

Anterior

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24
Q

T or F? When the spine is in a fixed position, the iliopsoas works on the pelvis. When the lower extremities are in a fixed position, the iliopsoas works on the L-spine

A

True

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25
Q

List the primary and secondary hip extensor muscles

A

Primary:
- Glute max
- Biceps femoris
- Semitendinosus
- Semimembranosus
- Adductor magnus

Secondary:
- Glute med
- Adductor magnus

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26
Q

List the primary and secondary hip flexor muscles

A

Primary:
- Iliopsoas
- Sartorius
- TFL
- Rectus femoris
- Adductor longus

Secondary:
- Adductor brevis
- Gracilis
- Glute min

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27
Q

List the primary and secondary hip internal muscles

A

Primary:
- None

Secondary:
- Glute min
- Glute med
- TFL
- Adductor longus
- Adductor brevis
- Pectineus

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28
Q

List the primary and secondary hip external rotation muscles

A

Primary:
- Glute max
- Smaller ER muscles

Secondary:
- Glute med
- Glute min
- Obturator externus
- Sartorius
- Biceps femoris

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29
Q

T or F? Torque potential increases when hip flexion approaches 90 degrees

A

True

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30
Q

T or F? When internally rotating at the hip, the anterior fibers of glute med/min go from parallel to perpendicular to longitudinal axis of rotation

A

True

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31
Q

T or F? The moment arm increases 8x when the hip is flexed 90 degrees

A

True

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32
Q

T or F? Some external rotators become internal rotators and create 50% greater torque when the hip is flexed

A

True

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33
Q

List the primary and secondary adductor muscles of the hip

A

Primary:
- Pectineus
- Adductor longus
- Gracilis
- Adductor brevis
- Adductor magnus

Secondary:
- Biceps femoris
- Glute max
- Quadratus femoris

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34
Q

List the primary and secondary abductor muscles of the hip

A

Primary:
- Glute med (greatest moment arm and CSA)
- Glute min
- TFL

Secondary:
- Piriformis
- Sartorius

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35
Q

T or F? Posterior adductor magnus is a powerful extensor regardless of hip angle

A

True

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36
Q

T or F? Adductor longus/brevis and pectineus are hip flexors while adductor magnus is an extensor

A

True

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37
Q

If someone has weak hip abductors while standing on one leg, the _______________ hip will drop, and the patient will likely lean _____________

A

contralateral, ipsilateral

38
Q

T or F? Using a cane in the contralateral hand will reduce joint reaction forces by 36%

A

True

39
Q

T or F? If someone has right hip abductor weakness, the load should be held on the ipsilateral side to balance out bodyweight

A

True

40
Q

T or F? 15% bodyweight load can cause almost 4x body weight compressive force

A

True

41
Q

T or F? Most individuals have slight genu valgus (5-10 degrees)

A

True

42
Q

Genu valgum causes increased joint stress in the __________ tibiofemoral joint while Genu varum increases joint stress in the ___________ tibiofemoral joint

A

Lateral, medial

43
Q

List the norms for knee hyperextension and genu recurvatum

A

Hyperextension: 5-10 degrees
Genu Recurvatum: >10 degrees

44
Q

Which motions can occur at the knee?

A
  • Sagittal
  • Transverse (knee needs to be slightly flexed)
  • Frontal
45
Q

T or F? IR and ER increases with greater angles of flexion

A

True

46
Q

At 90 degrees of knee flexion, ER to IR (of tibia on femur) is __:__

A

2:1

47
Q

Describe “screw home rotation”

A
  • Locking knee in full flexion (last 30 degrees)
  • 10 degrees of ER
  • Cannot be performed independently
  • External Rotation and extension maximizes contact area and joint stability
  • To initiate knee flexion, popliteus “unlocks” the knee
48
Q

MCL limits _______ stress, LCL limits ________ stress

A

Valgus, Varus

49
Q

T or F? The collateral ligaments are taut in full extension

A

True

50
Q

Superficial fibers of MCL are most taut in ___ of the knee

A

ER

51
Q

Knee extension increases the length of the lateral ligaments by _____ in comparison to full flexion

A

20%

52
Q

T or F? The cruciate ligaments of the knee are intracapsular and covered in synovium

A

True

53
Q

Describe the ACL

A
  • Runs in a superior, lateral, posterior direction
  • Most fibers become taut as knee approaches full extension
  • A taut ACL will limit anterior slide (knee extension)
  • Most common ligament injured
  • 70% of injuries are non contact
  • Occurs with landing, cutting, decelerating
54
Q

Describe the arthrokinematics of the knee joint during flexion/extension

A

Flexion (open chain): Posterior roll and slide
Flexion (closed chain): Posterior roll, anterior slide

Extension (open chain): Anterior roll and slide
Extension (closed chain): Anterior roll, posterior slide

55
Q

Describe the PCL

A
  • Runs in a superior, medial, anterior direction
  • Most fibers become taut as knee approaches knee flexion (peak tension 90-120)
  • Elongates 20% between full extension and 90 degrees (3% per 10 degrees)
  • Posterior slide of tibia is limited by PCL during open chain flexion
  • Limits anterior slide of femur on tibia in closed chain flexion
  • Occurs with falling on a flexed knee, dashboard injury
56
Q

How is the patellofemoral joint (PFJ) stabilized?

A
  • Quadricep muscle force
  • Joint congruency
  • Passive restraint from retinaculum and capsule
57
Q

T or F? Patellofemoral joint (PFJ) osteoarthritis is more common than tibiofemoral joint (TFJ) osteoarthritis

A

True

58
Q

Describe the kinematics of the patellofemoral joint (PFJ) during open and closed chain movement

A

Open Chain:
- Patella slides on the trochlea
- Follows tibia during extension

Closed Chain:
- Trochlea slides relative to the fixed patella/tibia

59
Q

When is the patellofemoral joint (PFJ) most stable?

A

Maximum stability:
- Fully flexed (135+ degrees), soft tissue provides the patella with stability
OR
- Partially flexed (60-90 degrees), bony structure provides the patella with stability

Minimal stability:
- Minimally flexed (20 degrees)

60
Q
A
61
Q

Describe the knee extensors

A
  • Vastus medialis/lateralis produce 80% of the torque
  • Rectus femoris produces 20% of the torque
  • Collectively generate 66% more force than knee flexors
62
Q

Describe the quadriceps torque/angle relationship at the knee

A

Tibial on Femoral Movement:
- Increases from 90 to 0 degrees of knee flexion
- Largest from 45 to 0 degrees of knee flexion
- Smallest from 90 to 45 degrees of knee flexion

Femoral on Tibial Movement:
- Decreases from 90 to 0 degrees of knee flexion
- Largest from 90 to 45 degrees of knee flexion
- Smallest from 45 to 0 degrees

63
Q

Why is knee extension torque limited at the end range of motion (full extension)?

A
  • Short moment arm
  • Muscle shortening (active insufficiency)
64
Q

Which factors can affect patellar tracking?

A
  • Q angle
  • Abnormal trochlear morphology
  • VMO
  • Retinaculum
  • Femur kinematics
  • Hip strength
  • Foot pronation
65
Q

Which factors affect the length of the internal moment arm (IMA)?

A
  • Shape and position of patella
  • Shape of distal femur (depth of intercondylar groove)
66
Q

What is the average Q angle?

A

13-15 degrees

67
Q

LEFT OFF ON SLIDE 41 OF KNEE LECTURE

A
68
Q
A
69
Q
A
70
Q
A
71
Q
A
72
Q
A
73
Q
A
74
Q
A

SLIDE 47

75
Q

List the knee flexors/rotators and their function

A

Hamstrings
- Semimembranosus: IR
- Semitendinosus: IR
- Biceps Femoris: ER
(All do hip extension, knee flexion)

Sartorius/Gracilis
- Hip flexion
- Knee IR

Pes Anserine Tendons
- Dynamic stability to medial knee
- Resist valgus and ER

Popliteus
- Unlocks the knee

76
Q

T or F? Knee flexors can accelerate or decelerate the lower leg during swing phase

A

True

77
Q

T or F? Knee flexor torque production is at its greatest when the hip is extended with slight knee flexion

A

True

78
Q

T or F? Moment arm is greatest at 50-90 degrees of knee flexion

A

True

79
Q

T or F? Muscle length plays a more important role in comparison to leverage

A

True

80
Q

What are the two main goals of the foot?

A
  • Foot needs to be flexible to absorb stress
  • Also needs to be rigid to withstand large propulsive forces
81
Q

Which bones make up the talocrural joint (TCJ)?

A

Fibula, Tibia, Talus

82
Q

Which bones make up the rearfoot, midfoot, and forefoot?

A

Rearfoot:
- Talus
- Calcaneus
- Subtalar joint

Midfoot:
- Navicular
- Cuboid
- Cuneiforms
(+ transverse tarsal joints, distal intertarsal joints)

Forefoot:
- Metatarsals
- Phalanges
(+ tarsometatarsal joint)

83
Q

List the planes and axis of dorsiflexion, plantarflexion, eversion, inversion, abduction, adduction

A

Dorsiflexion/Plantarflexion
- Sagittal plane
- Media/Lateral axis

Eversion/Inversion
- Frontal plane
- Anterior/Posterior axis

Abduction/Adduction
- Transverse plane
- Vertical axis

84
Q

Which movements make up pronation and supination of the ankle?

A

Pronation:
- Dorsiflexion
- Abduction
- Eversion

Supination:
- Plantarflexion
- Adduction
- Inversion

85
Q

T or F? Pronation and supination are triplanar motions

A

True

86
Q

Describe the Talocrural joint (TCJ)

A
  • “Mortise” joint
  • Convex talus, Concave tibia/fibula
  • 90% of forces pass through tibia and talus
  • 3mm of articular cartilage
87
Q

Describe the Talocrural joint osteokinematics

A
  • Oblique axis due to lateral malleolus inferior and posterior to medial
  • 1 degree of dorsiflexion with pronation
  • 1 degree of plantarflexion with supination
88
Q

T or F? Ankle rolls while plantarflexed causes soft tissue injuries whereas ankle rolls while dorsiflexed causes a fracture

A

True

89
Q

The talus is _________, the calcaneus is __________

A

Concave, Convex

90
Q

When dorsiflexing in a closed chain position at the talocrural joint, the roll is _________ and the slide is __________

A

Anterior, Anterior

91
Q

LEFT OFF ON SLIDE 17 OF FOOT AND ANKLE LECTURE

A

Anatomy 2 (8 decks)

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