Gait Flashcards
What happens when you are standing
Maximal contact of articular surfaces + minimum muscular activity
Hips and knees extended
- Stable and held mainly by ligaments
- Knees are locked by vastus medialis and gluteus maximus and tensor fascia lata via iliotibial tract
Contraction of calf muscles, intrinsic back muscles and hip abductors to prevent sway
Proprioception
What locks the knees
Knees are locked by vastus medialis and gluteus maximus and tensor fascia lata via iliotibial tract
What is proprioception
The sense though which we perceive the position and movement of our body, including our sense of equilibrium and balance
Stance phase
60% of gait cycle
Swing phase
40% of gait cycle
Terminal stance
Start of push off
Heel is off the ground
The Left Lower Limb (LL) is about to take the body weight - atm it is in swing phase
Momentum must be created by drawing the body forwards over the ankle
Forefoot starts to push off
Start with ankle and foot
What movements are involved in terminal stance
The toes of the right foot are dorsiflexed
Right ankle is plantar flexed by triceps surae (gastrocnemius, soleus)
Fibrous flexor sheaths are pulled
Left foot is off the ground (pelvis is stabilised)
* gluteus medius and minimus
* hip abductors
The plantar aponeurosis is pulled and draws the calcaneus anteriorly and heighten the arch
Check powerpoint slide
What maintains the arch in the terminal stance
Preswing
The Right Lower Limb is about to push-off and enter the Swing Phase
What is the movement of the right ankle in pressing and what muscles facilitate this
Plantarflexion
Powerful Push-off
Gastrocnemius
Soleus
(Tibialis Posterior)
What nerve innervates Gastrocnemius, Soleus and Tibialis Posterior
Tibial nerve
What movement is the left ankle making in preswing and what muscles facilitate this
Dorsiflexion
Tibialis Anterior
Extensor Digitorum Longus
Extensor Hallucis Longus
What nerve innervates Tibialis Anterior, Extensor Digitorum Longus and Extensor Hallucis Longus
Deep fibular nerve
What is the movement of the right toes in preswing and what muscles facilitate this
Plantarflexion
Powerful Push-off
Flexor Hallucis Longus
Flexor Digitorum Longus
Flexor Hallucis Brevis
Flexor Digitorum Brevis
Quadratus plantae
What nerve innervates flexor hallucis longus, flexor digitorum longus, flexor hallucis brevis and flexor digitorum brevis
Tibial nerve
Medial Plantar Branch of Tibial
What is the movement of the right hip in pre swing and what muscle facilitates this
Extends slightly to help forward momentum
Biceps femoris (long and short head)
Semitendinosus
Semimembranosus
Gluteus maximus
What nerve innervates the hamstrings
Sciatic nerve
Inferior gluteal nerve
Initial and mid-swing
Right LL enters initial -> Mid Swing, while the Left LL takes all the body weight
Right LL is lifted up, and the toes must clear the ground
What is the movement of the right ankle and toes in initial and mid-swing and what muscle facilitates this
Dorsiflexion
Tibialis Anterior
Extensor Digitorum Longus
Extensor Hallucis Longus
What is the movement of the right knee in initial and mid-swing and what muscle facilitates this
Flexion
Hamstrings
(Popliteus)
Gastrocnemius, sartorius
What nerve innervates popliteus
Tibial nerve
What is the movement of the right hip in initial and mid-swing and what muscles facilitate this
Flexion
Iliopsoas
Rectus Femoris
Sartorius
What nerve innervates iliopsoas and rectus femoris
Femoral nerve (Iliacus and rectus femoris)
L1, 2, 3 (Psoas)
Foot drop
weakness of muscles in the feet and ankles that causes difficulty with the ability to flex the ankles and walk normally
Foot drop is associated with kind of nerve injury?
L5 radiculopathy and traumatic damage to the common peroneal nerve
Which muscles are involved in weight bearing in the hip during Mid Swing
Gluteus medius
Gluteus minimus
What nerves innervate quadriceps femoris, gluteus maximus and tensor fascia lata
Femoral nerve
Inferior gluteal nerve
Superior gluteal nerve
Weight-bearing (left) arches are maintained actively by
Flexor digitorum longus
Tibialis anterior
Tibialis posterior
Fibularis longus
Intrinsic muscles of the foot
Balance is maintained by interplay between
Plantarflexion (plantar muscles as well)
Dorsiflexion
Inversion (tibialis anterior and posterior)
Eversion (fibularis longus and brevis)
Terminal swing
Right LL is thrown further forward
The right side of the pelvis moves anteriorly too, using momentum to internally rotate at the left hip
What movements are the right hip involved in in terminal swing and what muscles facilitate this
Further Flexion
Lateral Rotation to keep the foot pointing forwards
Lateral Rotators of the Hip
What nerve roots innervate lateral rotators of the hip
L5, S1, 2
Heel strike
Flexion of thigh creates a momentum
The right thigh decelerates and drops the Right LL and heel to the ground, the foot remains dorsiflexed
The spring and resilience of the right arches must continually be maintained for shock absorption and weight distribution
What position is the right ankle in in heel strike
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
Loading response (foot flat)
Foot roolls on heel - from lateral to medial
Foot starts to go flat and accepts the weight Arches absorb weight
point when the entire plantar surface of the foot comes in contact with the ground
What muscles are involved in inversion of the foot
Tibialis anterior
Tibialis posterior
What muscles are involved in eversion of the foot
Fibularis longus
Fibularis brevis
What happens when walking on uneven ground?
Loading response (flat foot)
What happens in midstance
What happens in anterior and lateral sway
