Final Written Flashcards
One of the reasons for creating the ottawa knee rules include which statment
Overuse of radiographic studies causing a significant economic health care problem in the USA
The stride length in running consists of approximately what percentage of the walking gait cycle
60%
Bilateral simultaneous transverse compression squeeze of the foot helps to isolate the involved bone when adjusting an
Superior navicular
According to teh article posted on BB how to choose running shoes. A person shopping for running shoes with a neutral (normal) foot, should look for what type of shoe
Stability
The alleged part 4 NBCE examination extremity move named posterior cunieform, the angel of knee flexion is
45 degrees
Primary shock absorption of the lower extremity is accomplished by the ___ and secondary shock absorption is accomplished by __
Medial longitudinal arch
Knee flexion
Looking at shoe wear patterns can be very informative, when finding lateral heel counter tilt and lateral midfoot compression of the sole, which footwear could you recommend to your patient
Curved last with valgus rearfoot posting
According to the american orthopedic foot and ankle society lacing article on BB, people with narrow feet should use which lacing technique when tying running shoes
Use the eyelets farthest away from the tongue of the shoe
According to lab, when long axis tractioning a superior first cunieform, which way does the intern open the joint
Towards you
In lab class, when evaluating the knee move known as wobble, what is this looking at
Fixation of the tibial plateua
According to lab protocols, the 4th met base is adjusted with the patient in what position
Prone leg extended
Hallux valgus deformity involves a misalignment of the proximal 1st met bone in which way do we adjust the bone
Medial and internal
When a patient presents with knee pain to a doc, other than an eduactaed chiro giveing specific diagnosis, what general diagnosis is that patient likely to be given
Chondromalacia patella
A patient presents with pain just lateral to the anterior margin/crest of the left tibia. After clearing the spine, an anterior talus was foudn and corrected. Which other subluxation would you commonly suspect and correct next on this same patient
Anterior cuboid
Met heads most commonly fixate in which direction
Inferior
The tibia must internally rotate up to 20 degrees to accomplish full knee
___ which position is this for the knee and which muslce is responsible
Flexion
Open pack position
Popliteus
In the handout/article semi-weight bearing sub-talar neutral casting on BB which type of orthotic is best described as it restricts motion from the proper sequence
Accomodative orthotics
When measuring the forefoot so posting can be included for orthotics how many degrees will the intrinsic forefoot varus angulation already be
0-6 degrees
The ottawa knee rules research states that the overuse of radiographs was due to fear of lawsuits and which other reason
Failure to obtain an adequate history
Accordin gto how to choose running shoes, to determine what type of foot your patient has you should perform
The wet test
In the FHL article the atuhor mentions the callus pattern associated iwth FHL would be
Under the medial side of the 1st, 2nd, and 3rd met heads and sometimes the 5th met head
Normal first met phalangeal joint dorsiflexion without load should be approximately
70 degrees
A soft counce home test could indicate a potential ____ misalignment
Posterior tibia
After a patient has bunion surgery on the right foot, while co-managing the recovery and rehabilitation of your patient whidch side of the body should the cane be held and used for support
Right
According to ottawa ankle rules, midfoot x-rays are required if there is pain and ____ and in the ER
Bone tenderness at the base of the 5th metatarsal
In the FHL article the author mentions that once a diagnosis of FHL is made this is best managed by
Custom orthotic
According to FHL article comon pathologies associated to FHL in the foot are
Morton’s neuroma
According to the article on BB the role of plantar fascia, gastroc-soleus complex and windlass effects of the dynamic foot the ___ articulation has been described in current literature as one of two joints that undergo a self-locking mechanism that attempts to prevent overpronation at the late midstance phase of gait. The other is the ___ as it changes function
Calcaneocuboid
SI joint
Plantar fascitis and the windlass mechanism - researchers reported that low dye taping is helpful in subjects with which kind of foot
Pes cavus
According to Dr. Kevin Hearon and as practiced in lab, sub-talar neutral is a position of the foot where ____ joint is equally congruent both on the medial and lateral sides of the foot
Talo-navicular
Following the adjusting protocols taught in class, could these improve the neurological and biomechanical components of the vertebral subluxation adn associated extra spinal articular misalignments
Yes
Which muscle responsible for 1st 15 degrees of kene flexion
Popliteus
Closed kinetic chain
Putting into action the subtalar joint, locking and unlocking mechanisms of the midfoot across the trans-tarsal joint
Medial arch of foot keystone
Navicular
Abnormal weight bearing patient may also have pinch calluses on the lateral and/or medial edges of the foot from
Hyper supination and hyperpronation
If subluxated it will block normal motion in the mortise talus and tibia due to the altered weight distribution and the affect upon the locking and unlocking mechanisms of the foot and may lead to numerous foot complaints
Talus
Most common position of ankle injury
Plantar flexion/inversion
Function of fibula during dorsiflexion above 90 degrees will create
Palpable rising of the fibular head
One cause is loss of transverse arch, usually due to altered biomechnics
Mortons neuritis/neuroma
ASIS to center of patella/tibial tuberosity to center of patella. 20 degrees unstable for all.
Q (quadriceps) angle
Pain behind the kene on the medial side associated with weak vastus lateralis
Patellar femoral arthralgia
Pain behind kneecap lateral side while running down hills or down slopes
Excessive lateral patellar syndrome
Impact at the fibular head may affect
The common peroneal nerve
Iliotibial band hypertonicity may also cause lateral knee pain with an
External snapping hip sound
Iliopsoas may also affect the hip and create an
Internal snapping hip
Use a cane for hip joint support
Opposite side of problem
Pain with no instability
2 weeks healing period
Checking lower extremity
Distal to proximal
Plantar fascitis in 8 visits
95% responsed to conservative care
A lateral deviation pain on the medial side of. MTP joint can result in external rotation
Hallus valgus (bunions)
Neuropathy of the posterior tibial nerve
Tarsal tunnel syndrome
Cause tight external structures, IT band
Snapping hip
Reasons for creating ottawa knee rules include which
All of the above
The swing phase consists of approx what percentage of walking gait cycle
35-40%
Jogging percent walking gait
70%
Both legs are on the ground about
25% of gait cycle
When evaluating th efoot for normal weight bearing forces, this occurs in which order and through which structures
Calcaneous, the lateral aspect of hte foot, 5th met head adn 1st met head
Runner 25 miles a week, how often should change shoes
Once every 4 months
Coxafemoral distraction has SCP
Distal tib/fib
Shoe wear - find medial head counter tilt and medial forefoot outer side wear
Overpronation
Rigid material in hind foot and extra firm support in medial longitudinal arch
Pinch calluses are caused by
Loss of medial longitudinal arch
Dorsiflexion of the met phalangeal joint causes plantar fascia to tighten midfoot to externally rotate, raising the longitudinal arches
Windlass effect
Under load 1st MTP should normally dorsiflex up to how many degrees
35
Hallux valgus bunsion deformityh involves proximal 1st met joint in which way
Lateral and external
Tarsal tunnel syndrome involves pathology of which one structure
Posterior tibialis nerve
Pain just lateral to anterior margin/crest of left tibia
Inferior navicular
Mal-positioned tongue of the shoe
Superior navicular
The tibia must externally rotate up to 20 degrees to accomplish full knee
Extension - close packed position
Intrinsic forefoot varus angulation
4-6 degrees
Criteria for ordering radiographs ottawa knee
Pt 55, tenderness over patella an dinability to flex knee to 90 degrees
Staright shaped and rigid mid sole
Pes planus
Possible subluxation of cuboid muscle test
Peroneus
Posterior tibia may mimic
Medial meniscus tear
Avulsed right anterior talofibular ligament would require surgery. Which side body cane
Right
Foot and knee cane
Same side
Hip cane
Opposite side
Ottawa ankle, midfoot x-rays are required if there is pain and ___ in the eR
Inability to bear weight both immediately
