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Medical PCM I > Final Exam - Gait Deviations, Aquatic, Vestibular > Flashcards

Final Exam - Gait Deviations, Aquatic, Vestibular Flashcards

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USMLE® Step 1 flashcards
1
Q

Characteristic of circumducted gait

A

Prosthesis swings laterally in a wide area during swing phase

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2
Q

Potential prosthetic cause of circumducted gait

A

Prosthesis is too long

Prosthesis has too much alignment stability or friction in the knee, making it difficult to bend the knee

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3
Q

Potential patient causes of circumducted gait

A

Abduction contracture of the residual limb
Lack of confidence for flexing the prosthetic knee because of muscle weakness or fear of stubbing toe
Habit

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4
Q

Characteristic of vaulting gait

A

Rising on toe of the sound foot permits the individual to swing the prosthesis through with little knee flexion

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5
Q

Potential prosthetic causes of vaulting

A

Prosthesis is too long
Inadequate socket suspension
Excessive stability in the alignment or some limitation of knee flexion such as a knee lock or a strong extension aid

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6
Q

Potential patient causes of vaulting

A

Fear of stubbing toe
Habit
Discomfort in residual limb

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7
Q

Potential prosthetic causes for rotation of prosthesis upon heel strike

A

Too much resistance to plantarflexion by plantarflexion bumper or heel wedge
Too much toe out build into prosthesis
Socket too loose

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8
Q

Potential patient causes for rotation of prosthesis upon heel strike

A

Extend residual limb too vigorously at heel strike

Poor muscle control of residual limb

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9
Q

Characteristic of uneven arm swing

A

Arm on prosthetic side is held close to body during locomotion

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10
Q

Potential patient causes of uneven arm swing

A

Poor balance
Fear and insecurity
Habit

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11
Q

Characteristics of uneven timing

A

Unequal duration steps with usually a very short stance phase on the prosthetic side

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12
Q

Potential prosthetic causes for uneven timing

A

Improperly fitting socket may cause pain
Weak extension aid or insufficient friction in prosthetic knee can cause excessive heel rise with prolonged swing through

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13
Q

Potential patient causes for uneven timing

A

Weak residual limb
Poor balance
Fear and insecurity

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14
Q

Characteristics of long prosthetic step

A

Individual takes longer step with the prosthesis than with the uninvolved LE

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15
Q

Potential prosthetic causes of long prosthetic step

A

Initial flexion in socket is insufficient when an irreducible flexion contracture is present

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16
Q

Potential patient causes of long prosthetic step

A

Flexion contracture that cannot be accommodated prosthetically

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17
Q

Characteristics of excessive trunk extension

A

Individual creates an active lumbar lordosis during stance phase

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18
Q

Potential prosthetic cause of excessive trunk extension

A

Improperly shaped posterior wall causing forward rotation of pelvis to avoid full weight bearing on ischium
Insufficient initial flexion built into socket

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19
Q

Potential patient causes of excessive trunk extension

A 
Hip flexor tightness 
Hip extensor weakness 
Weak abdominals
Habit 
Move shoulders back to gain balance
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20
Q

Characteristics of uneven heel rise

A

Prosthetic heel rises quite markedly and rapidly when the knee is flexed at beginning of swing phase

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21
Q

Potential prosthetic cause of uneven heel rise

A

Insufficient knee joint friction

Inadequate extension aid

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22
Q

Potential patient cause of uneven heel rise

A

Use more power than necessary to force knee into flexion

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23
Q

Characteristics of terminal swing impact

A

Rapid forward movement of the shin piece allows the knee to reach maximum extension with too much force before heel strike

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24
Q

Potential prosthetic cause of terminal swing impact

A

Insufficient knee friction

Too strong knee extension aid

25
Q

Potential patient cause of terminal swing impact

A

Deliberate, forceful extension of residual limb to ensure knee in full extension

26
Q

Characteristics of instability of prosthetic knee

A

Unstable knee creates danger of falling when knee flexes

27
Q

Potential prosthetic cause of instability of prosthetic knee

A

Knee joint too far anterior of TKA line
Insufficient initial flexion built into socket
PF resistance too great, causing knee to buckle at heel strike
Failure to limit DF can lead to incomplete knee control

28
Q

Potential patient cause of instability of prosthetic knee

A

Hip extensor weakness

Severe hip flexion contracture

29
Q

Characteristics of medial or lateral whips

A

Medial whip is present when the heel travels medially on initial flexion and the beginning of swing phase; a lateral whip exists when the heel moves laterally

30
Q

Potential prosthetic causes of medial/lateral whips

A 
Lateral: excessive IR of prosthetic knee
Medial: excessive ER of prosthetic knee 
Overly tight socket 
Excessive valgus of prosthetic knee 
toe break in conventional foot malaligned
31
Q

Characteristics of foot slap

A

Too rapid descent of the anterior portion of the prosthetic foot

32
Q

Potential prosthetic causes of foot slap

A

PF resistance too sfot

33
Q

Potential patient causes of foot slap

A

Drive prosthesis into walking surface too forcibly to assure extension of knee

34
Q

Characteristics of dropoff at the end of stance phase

A

Downward movement of trunk as the body moves over prosthesis

35
Q

Potential prosthetic causes of dropoff at the end of stance phase

A

Inadequate limitation of DF in prosthetic foot

Too short heel in SACH

36
Q

Characteristics of lateral bending of trunk

A

Excessive bending occurs laterally from midline, generally to prosthetic side

37
Q

Potential prosthetic cause of lateral bending of trunk

A

Prosthesis too short
Improperly shaped lateral wall failing to provide adequate support for femur
Prosthetic aligned in abduction, causing wide-based gait

38
Q

Potential patient cause of lateral bending of trunk

A

Inadequate balance
Abduction contracture
Oversensitive, painful residual limb
Habit

39
Q

Characteristics of abducted gait

A

Very wide based gait with prosthesis held away from the midline at all times

40
Q

Potential prosthetic causes of abducted gait

A

Prosthesis too long
Too much adduction built into prosthesis
High medial wall, causing ramus pressure
Improperly shaped lateral wall failing to provide support for femur

41
Q

Potential patient causes of abducted gait

A

Abduction contracture

Habit

42
Q

Thermoneutral

A

93-95

43
Q

Convection

A

Movement of water across the skin or movement of body through water

44
Q

Conduction

A

Physical contact between water and body

45
Q

Radiation

A

Exchange of thermal energy between body and air

46
Q

Four phases of Halliwick

A

Mental adaptation to being in the water
Restore balance from all positions in the water
Inhibit unwanted movement and remain stable in water
Swim from stabilized position

47
Q

Shaw swimming

A

Combines swimming technique with Alexander technique

48
Q

Feldenkrais pool conditions

A

86-94 degrees in chest deep water

49
Q

Bad ragaz pool conditions

A

92-98 and in three to four feet in depth

50
Q

Watsu pool conditions

A

92-96

51
Q

What does Jahara mean

A

Third arm

52
Q

What are the purposes of vestibular rehab

A

Stabilize visual images on fovea of retina during head movements
Postural stability
Spatial orientation

53
Q

What are the otolith organs

A

Saccule

Utricle

54
Q

What is the tonic firing rate

A

80 pulses per second
Rotation of head to the side depolarizes the hair cells and causes increased firing rate. Hyperpolarization occurs on the opposite labyrinth

55
Q

Vestibulo-ocular reflex

A

Maintains gaze stability during rapid head movements

Operates from 60-400 degrees/second

56
Q

What maintains gaze stability when the head is moving at less than 60 degrees per second?

A

Smooth pursuit

57
Q

Meniere’s disease

A

Low frequency hearing loss and episodic vertigo, may have tinnitus
Related to endolymph fluid build-up

58
Q

Perilymphatic fistula

A

Rupture of the oval or round windows causing fluid to leak into the middle ear

Medical PCM I (4 decks)

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