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AY BMSc Lectures > Gait > Flashcards

Gait Flashcards

1
Q

How many bones are in the foot?

A

26

  • 7 Tarsals (G = talus and calcaneus) (L = cuboid, navic, 3 cunie)
  • 5 MT’s
  • 14 P’s
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2
Q

What are the 2 articulations of the ankle joint?

A

Tibiotalur

Talocrural

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3
Q

What is the range of motion of the subtalar joint in each plane?

A 
C = 13 degrees 
S = 16 degrees
T = 42 degrees
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4
Q

What motion occurs in the coronal plane?

A

Eversion/Inversion

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5
Q

What motion occurs in the sagittal plane?

A

Dorsiflexion/Plantarflexion

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6
Q

What motion occurs in the transverse plane?

A

Abduction/Adduction

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7
Q

What movements are associated with pronation?

A

Eversion
Dorsiflexion
Abduction

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8
Q

What movements are associated with supination?

A

Inversion
Plantarflexion
Adduction

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9
Q

What is the most common shape used in ankle joint replacement?

A

Cylinder

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10
Q

What is bad about cylinder ankle joint replacement?

A

Bad at transmitting lateral loads

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11
Q

Which is the only T-MT joint that can move?

A

1st T-MT

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12
Q

Which structure is vitally important for maintaining all 3 arches?

A

Plantar fascia

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13
Q

What position does the MT joint lock?

A

20 degrees supination

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14
Q

What are the 3 arches of the foot?

A

Lateral
Medial
Transverse

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15
Q

What is the common pillar between the medial and lateral arches?

A

Calcaneus

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16
Q

What is the common pillar between the medial and transverse arches?

A

Base of 1st MT

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17
Q

What is the common pillar between the transverse and lateral arches?

A

Base of 5th MT

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18
Q

What bones lie under the medial arch?

A

Calcaneus
Talus
Navicular
3 Cunieforms

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19
Q

What bones lie under the lateral arch?

A

Calcaneus
Cuboid
4th and 5th MT’s

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20
Q

Which bones lie under the 1st TA (distal)?

A

5 heads of MT’s

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21
Q

Are muscles more important in maintaining the medial or lateral arch?

A

Muscles = Medial

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22
Q

Are ligaments more important in maintaining the medial or lateral arch?

A

Ligaments = Lateral

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23
Q

What is the function of the talus?

A

Transmit load

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24
Q

What is the function of the calcaneus?

A

insertion for AT

larger lever arm, important for propulsion

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25
Q

Which muscle inserts on the styloid of the 5th MT?

A

Peroneus Brevis

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26
Q

Describe the structure of 1st MT

A

Wide and short (takes a lot of load)

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27
Q

Which MT is the most stable? Why?

A

2nd MT - articulates with all 3 cunieforms

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28
Q

What 4 things are needed to have a stable 1st MT?

A

Strong hallux muscle
Strong itself
Stable 1st MT joint
Good sesamoid

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29
Q

What is the function of the sesamoid bones in the foot?

A

Inserted in tendon to increase lever arm of 1st MT

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30
Q

What can result from poor sesamoid bones in the foot?

A

Increased load over 2nd and 3rd MT’s - can cause fracture or sublux of MTP

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31
Q

Which 2 muscles plantarflex the foot?

A

Gastrocnemius

Soleus

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32
Q

How do the gastroc and soleus differ and why is this important?

A

Gastroc - orginates on femur (can felx knee)

Soleus - originates on tibia (no knee action)

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33
Q

What movements does the tibialis posterior enable?

A

Inversion

Plantarflexion

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34
Q

Which movements do the peroneus longus and peroneus brevis allow?

A

Eversion

Plantarflexion

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35
Q

Which movement does the tibialis anterior produce?

A

Dorsiflexion

36
Q

Which muscle contracts in anticipation of HS?

A

Tibialis Anterior

37
Q

Which muscle assists the TA to produce an internal dorsiflexion moment to decelerate the rate of ankle joint plantar flexion?

A

Extensor hallucis longus (contracts eccentrically)

38
Q

How long is the delay in the TA seen in diabetics and how does this present clinically?

A

180ms (normally 10ms) - presents as forefoot slap

39
Q

Why is forefoot slap bad in diabetics?

A

Trauma
Ulcers
FF lasts longer - more ischaemic

40
Q

How does the GRF change through FF?

A

Posterior to anterior

Lateral to media

41
Q

At what stage of the gait cycle does the tibia decelrate?

A

HO

42
Q

What is HO to TO also known as?

A

The propulsion phase

43
Q

What force is present at TO?

A

Shear force (bonded interface)

44
Q

Which muscle is particularly important in the propulsion phase? Why?

A

Gastroc contracts = knee flex and deccelerates tibia

45
Q

What is responsible for stability from HO to TO?

A

Intrinsic muscles

46
Q

What type of flatfoot is seen in CP patients?

A

Peroneal spastic flatfoot

47
Q

Describe peroneal spastc flatfoot

A

Fully pronated (intrinsic muscles have to work extra hard)

48
Q

Which ligament is damaged when going over on your ankle?

A

AITFL (Anterior Inferior Talo Fibular Ligament)

49
Q

What is the function of the AITFL?

A

Lateral stability

50
Q

Which muscle contracts just before TO in preparation for toe clearance?

A

Tibialis Anterior

51
Q

What does plantegrade mean?

A

Neutral position

52
Q

How is gait power calculated?

A

Angular velocity x Moment (M=Fd)

53
Q

Equation for generating power

A

Generate = moment + velocity (same direction)

54
Q

Equation for absorbing power

A

Absorb = moment - velocity (opp direction)

55
Q

Name 3 situations where you might not be able to generate power

A

AFO
Club foot
Foot drop

56
Q

Which is the biggest component of the GRF and what is its magnitude?

A

Vertical force = 1.2-1.3 BW

57
Q

What are the 3 ways of modelling gait?

A 
Single point (COM) 
Inverted pendulum (robots) 
Rigid Segment
58
Q

What pattern is seen in single point modelling of normal gait?

A

sinusoidal

Low amp

59
Q

What sort of pattern would be seen in single point modelling of a CP patient?

A

High amp
Irregular
Not sinusoidal

60
Q

What 2 assumptions are made in rigid segment modelling?

A

Rigid segments

Pin joints

61
Q

What is a stride length?

A

Heel strike to heel strike of the same foot

R step length + L step length

62
Q

What is a step length?

A

Heel strike to heel strike of different foot

63
Q

In general how do stride length and step length change in pathological gait?

A 
Stride = same 
Step = not same
64
Q

What are the 4 functional requirements of gait?

A

Shock absorbing
Stability
Propulsion
Energy efficient

65
Q

What 4 terms describe human gait?

A

Bipedal
Reciprocating
Upright
Terrestrial

66
Q

What problems can arise from deficiences in shock absorbing?

A

OA

Injury

67
Q

What are the 4 important types of stability?

A

Global (keep COM within base of support)
Terrain adaptation
Joint stability (prevent buckling against gravity)
Foot clearance (knee flexion, ankle dorsiflexion)

68
Q

What is the average foot clearance in normal gait?

A

1cm

69
Q

How is shock absorption achieved?

A

Controlled “shortening” of the limbs during gait (e.g. knee flexion)

70
Q

What are the challenges to stability?

A

Top heavy anatomy
Mobility of the joints
Morphology of the skeletal system

71
Q

Which parts of gait require energy?

A

Step to step transition
Swinging the leg through
Balance control
Aberrant movement and muscle (co)activation

72
Q

What percentage of the gait cycle is stance and swing?

A 
Stance = 60% 
Swing = 40%
73
Q

What are the 2 tasks of the stance phase?

A

Weight acceptance

Single limb support

74
Q

What is the task of the swing phase?

A

Limb advancement

75
Q

Why is the inverted pendulum system not ideal?

A

Doesn’t account for knee joint

76
Q

What is Newton’s 1st law?

A

If the net force on an object is zero then the object remains in rest

77
Q

What is Newton’s 2nd law?

A

F = ma

78
Q

What is Newton’s 3rd law?

A

Every action has an equal and opposite reaction

79
Q

What does GRF relate to?

A

The acceleration of the COM

80
Q

What does the vertical component of the GRF relate to?

A

Vertical acceleration of he COM

81
Q

Equation for moment

A

M = Fd

82
Q

What can moments be balanced by?

A

Muscles
Ligaments
Joint force

83
Q

How is gait pwoer calculated?

A

Power = Moment x Angular Velocity

84
Q

If the internal moment and angular velocity are in the ame direction what does this mean?

A

Power generation

85
Q

If the internal moment and angular velocity are in opposite directions what does this mean?

A

Power absorption

86
Q

How can the net joint moments be estimated?

A

From GRF magnitude and orientation relative to anatomical joint centres

AY BMSc Lectures (8 decks)

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