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Medicine Year 1 - Semester 2 - Part 2 > GAIT > Flashcards

GAIT Flashcards

1
Q

Describe the positions of joints when standing

A

Hips and Knees are extended

Contraction of calf muscles, intrinsic back muscles and hip abductors - to prevent sway

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2
Q

Muscles involved in standing

A

Erector spinae muscles
Iliopsoas muscle

Plantar flexor muscles (triceps surae)

Rotational axis of ankle joint

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3
Q

What ligament around the hip is most responsible for being able to stand upright with low expenditure of energy ?

A

Iliofemoral ligament (strongest ligament in the body)

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4
Q

What locks the knees ?

A

Knees are ‘locked’ by:

  • Vastus medialis
  • Gluteus maximus
  • Tensor fascia lata (via ilio-tibial tract)
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5
Q

Feature of standing

A

Maximal contact of articular surfaces + minimum muscular activity

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6
Q

Where is the centre of gravity ?

A

Anterior to the ankle joint

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7
Q

Proprioception

A

The sense through which we perceive the position and movement of our body, including our sense of equilibrium and balance.

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8
Q

Describe Sway

A

Anterior
- centre of gravity is anterior to the ankle joint
- Regular small contractions of soleus and gastrocnemius

Lateral
- lateral splay of the feet helps

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9
Q

Anterior Sway (what muscles prevent anterior sway ?)

A

Centre of gravity is anterior to the ankle joint

Regular small contractions of soleus and gastrocnemius - prevent anterior sway

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10
Q

Lateral - sway

A

Hip abductors

Fibular collateral ligament, everters on one side

Hip adductors, tibial collateral lig. and inverters on the contralateral side

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11
Q

Describe the GAIT cycle

A

8 phases in one cycle

Each limb has a stance and swing phase and repeats

Muscle activity is essential but momentum and gravity are equally important.

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12
Q

State the 8 phases of the GAIT cycle

A

Heel strike
Loading response
Midstance
Terminal stance

Pre-swing
Initial & Mid-swing (2 parts)
Terminal swing

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13
Q

Stance phase

A

Heel strike
Loading response
Midstance
Terminal stance

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14
Q

Swing phase

A

Pre-swing
Initial & Mid-swing (2 parts)
Terminal swing

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15
Q

Describe heel strike

A

Flexion of thigh creates a momentum

The right thigh decelerates and drops the right LL and heel to the ground, the foot remains dorsiflexed.

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16
Q

What must be maintained in heel strike - for shock absorption and weight distribution ?

A

The spring and resilience of the right arches must be maintained in heel strike - for shock absorption and weight distribution.

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17
Q

Describe progression from heel strike to loading response

A

The right ankle is dorsiflexed and that dorsiflexion is also pulling the body forwards, over the right foot so that it can accept the body weight in the loading response phase.

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18
Q

What muscles are involved in the heel strike phase ?

A

Tibialis anterior
Glute muscles - decelerating flexion of hip

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19
Q

Describe loading response phase - flat foot

A

Foot rolls on heel - from lateral to medial

Foot starts to go flat and accepts the weight

Arches absorb weight/ shock.

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20
Q

Eccentric contraction - IMP

A

Muscle lengthens, but contracts - to decelerate an action

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21
Q

Concentric contraction

A

Muscle shortens - contracts

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22
Q

Why are inversion injuries more common than eversion injuries at the ankle ?

A

As the initial point of contact is on the lateral side of the foot.

You could possibly over invert the foot - leading to a sprained ankle/ broken ankle.

23
Q

What happens when we are walking on uneven ground ?
(what movements are involved)

A

Inversion
Eversion

24
Q

What happens when we are walking on uneven ground ?
(what joints are involved)

A

Subtalar and Transverse Tarsal joints

25
State the muscles involved in loading response
Inversion - tibialis anterior - tibialis posterior Eversion - fibularis longus - fibularis brevis
26
State the muscles involved in inversion - loading response and their innervation
Tibialis anterior - deep fibular nerve Tibialis posterior - tibial nerve
27
State the muscles involved in eversion - loading response and their innervation
Fibularis longus Fibularis brevis (both superficial fibular nerve)
28
Describe mid stance
One limb carries the entire body weight, whilst the other limb is lifted Eccentric contraction of plantar flexors - controls dorsiflexion Hip abductors - stabilises pelvis
29
State the muscles involved in mid stance, and their innervation (hip abductors)
Gluteus medius Gluteus minimus Superior gluteal nerve
30
Describe terminal stance
Start to push off Heel is off the ground Foot rocks on forefoot Momentum must be created by drawing the body forwards over the ankle Forefoot starts to push off
31
State the muscles involved in terminal stance
Gastrocnemius Soleus (Triceps surae) Gluteus medius Gluteus minimus Hip abductors
32
Features of terminal stance
Right ankle is plantar flexed Left foot is off the ground -> pelvis is stabilised Plantar arch is heightened
33
Muscles involved in plantar flexion of the ankle
Gastrocnemius Soleus (Triceps surae)
34
Muscles involved in stabilising the pelvis
Gluteus medius Gluteus minimus Hip abductors
35
Plantar aponeurosis
Calcaneus to Fibrous flexor sheaths
36
State the muscles involved in heightening the arches
Flexor hallucis/ digitorum longus Tibialis anterior Tibialis posterior Fibularis longus Intrinsic muscles of the foot
37
Describe the pre-swing phase
The right lower limb is about to enter the swing phase Right ankle: - plantar flexion - powerful push-off Right toes - flexion - powerful push off Right hip - extends slightly to help forward momentum
38
State the muscles involved in the pre-swing phase and their innervation
Plantar flexors: - gastrocnemius - soleus - (tibialis posterior) TIBIAL NERVE Toes: - flexor hallucis longus - flexor digitorum longus - flexor hallucis brevis - flexor digitorum brevis - quadratus plantae TIBIAL NERVE MEDIAL BRANCH OF TIBIAL NERVE Hip: - biceps femoris - semitendinosus - semimembranosus - gluteus maximus SCIATIC NERVE INFERIOR GLUTEAL NERVE
39
State the plantar flexors involved in pre-swing phase
Plantar flexors: - gastrocnemius - soleus - (tibialis posterior) TIBIAL NERVE
40
State the toe muscles involved in pre-swing phase
Toes: - flexor hallucis longus - flexor digitorum longus - flexor hallucis brevis - flexor digitorum brevis - quadratus plantae TIBIAL NERVE MEDIAL BRANCH OF TIBIAL NERVE
41
State the thigh muscles involved in pre-swing phase
- biceps femoris - semitendinosus - semimembranosus - gluteus maximus SCIATIC NERVE INFERIOR GLUTEAL NERVE
42
Describe initial and mid-swing phase
Right LL enters initial -> mid swing Left LL takes all the body weight Right LL is lifted up, toes must clear the ground
43
State the movements of the joints in initial and mid swing
Right hip - flexion Right knee - flexion Right ankle & toes - dorsiflexion
44
State the right hip flexors involved in initial and mid swing and their innervation
Iliopsoas Rectus femoris Sartorius Femoral nerve L1-3 (psoas major)- iliopsoas
45
State the right knee flexors involved in initial and mid swing and their innervation
Hamstrings (popliteus) Gastrocnemius, Sartorius Sciatic nerve (hamstrings) Tibial nerve (popliteus)
46
State the right ankle and toe dorsiflexors involved in initial and mid swing and their innervation
Tibialis anterior Extensor digitorum longus Extensor hallucis longus DEEP FIBULAR NERVE
47
How is balance maintained during initial and mid swing phase ?
Plantar-flexion - plantar muscles as well Dorsiflexion Inversion - tibialis posterior and anterior Eversion - fibularis longus and brevis
48
Dorsal column / cerebellar injury
Problems with GAIT - walking is mostly an unconscious action - if you loose proprioceptive feedback: gait ataxia
49
Ataxia
Loss of proprioceptive feedback from a muscle OR Motor problem (loss of nerve supply to a muscle)
50
Describe terminal swing
Right lower limb is thrown further forwards The right side of the pelvis moves anteriorly, using momentum to internally rotate at the left hip.
51
Describe movement of joints during terminal swing
Right hip - further flexion - lateral rotation to keep the foot positioning forwards
52
State the lateral rotators of the hip and their innervation
Piriformis Obturator Internus + Superior Gemellus Quadratus Femoris + Inferior Gemellus
53
State the innervation of the lateral rotators of the hip
L5 --- S1-2

Medicine Year 1 - Semester 2 - Part 2 (53 decks)

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