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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
Which muscle inserts on the styloid of the 5th MT?
Peroneus Brevis
26
Describe the structure of 1st MT
Wide and short (takes a lot of load)
27
Which MT is the most stable? Why?
2nd MT - articulates with all 3 cunieforms
28
What 4 things are needed to have a stable 1st MT?
Strong hallux muscle Strong itself Stable 1st MT joint Good sesamoid
29
What is the function of the sesamoid bones in the foot?
Inserted in tendon to increase lever arm of 1st MT
30
What can result from poor sesamoid bones in the foot?
Increased load over 2nd and 3rd MT's - can cause fracture or sublux of MTP
31
Which 2 muscles plantarflex the foot?
Gastrocnemius | Soleus
32
How do the gastroc and soleus differ and why is this important?
Gastroc - orginates on femur (can felx knee) | Soleus - originates on tibia (no knee action)
33
What movements does the tibialis posterior enable?
Inversion | Plantarflexion
34
Which movements do the peroneus longus and peroneus brevis allow?
Eversion | Plantarflexion
35
Which movement does the tibialis anterior produce?
Dorsiflexion
36
Which muscle contracts in anticipation of HS?
Tibialis Anterior
37
Which muscle assists the TA to produce an internal dorsiflexion moment to decelerate the rate of ankle joint plantar flexion?
Extensor hallucis longus (contracts eccentrically)
38
How long is the delay in the TA seen in diabetics and how does this present clinically?
180ms (normally 10ms) - presents as forefoot slap
39
Why is forefoot slap bad in diabetics?
Trauma Ulcers FF lasts longer - more ischaemic
40
How does the GRF change through FF?
Posterior to anterior | Lateral to media
41
At what stage of the gait cycle does the tibia decelrate?
HO
42
What is HO to TO also known as?
The propulsion phase
43
What force is present at TO?
Shear force (bonded interface)
44
Which muscle is particularly important in the propulsion phase? Why?
Gastroc contracts = knee flex and deccelerates tibia
45
What is responsible for stability from HO to TO?
Intrinsic muscles
46
What type of flatfoot is seen in CP patients?
Peroneal spastic flatfoot
47
Describe peroneal spastc flatfoot
Fully pronated (intrinsic muscles have to work extra hard)
48
Which ligament is damaged when going over on your ankle?
AITFL (Anterior Inferior Talo Fibular Ligament)
49
What is the function of the AITFL?
Lateral stability
50
Which muscle contracts just before TO in preparation for toe clearance?
Tibialis Anterior
51
What does plantegrade mean?
Neutral position
52
How is gait power calculated?
Angular velocity x Moment (M=Fd)
53
Equation for generating power
Generate = moment + velocity (same direction)
54
Equation for absorbing power
Absorb = moment - velocity (opp direction)
55
Name 3 situations where you might not be able to generate power
AFO Club foot Foot drop
56
Which is the biggest component of the GRF and what is its magnitude?
Vertical force = 1.2-1.3 BW
57
What are the 3 ways of modelling gait?
``` Single point (COM) Inverted pendulum (robots) Rigid Segment ```
58
What pattern is seen in single point modelling of normal gait?
sinusoidal | Low amp
59
What sort of pattern would be seen in single point modelling of a CP patient?
High amp Irregular Not sinusoidal
60
What 2 assumptions are made in rigid segment modelling?
Rigid segments | Pin joints
61
What is a stride length?
Heel strike to heel strike of the same foot | R step length + L step length
62
What is a step length?
Heel strike to heel strike of different foot
63
In general how do stride length and step length change in pathological gait?
``` Stride = same Step = not same ```
64
What are the 4 functional requirements of gait?
Shock absorbing Stability Propulsion Energy efficient
65
What 4 terms describe human gait?
Bipedal Reciprocating Upright Terrestrial
66
What problems can arise from deficiences in shock absorbing?
OA | Injury
67
What are the 4 important types of stability?
Global (keep COM within base of support) Terrain adaptation Joint stability (prevent buckling against gravity) Foot clearance (knee flexion, ankle dorsiflexion)
68
What is the average foot clearance in normal gait?
1cm
69
How is shock absorption achieved?
Controlled "shortening" of the limbs during gait (e.g. knee flexion)
70
What are the challenges to stability?
Top heavy anatomy Mobility of the joints Morphology of the skeletal system
71
Which parts of gait require energy?
Step to step transition Swinging the leg through Balance control Aberrant movement and muscle (co)activation
72
What percentage of the gait cycle is stance and swing?
``` Stance = 60% Swing = 40% ```
73
What are the 2 tasks of the stance phase?
Weight acceptance | Single limb support
74
What is the task of the swing phase?
Limb advancement
75
Why is the inverted pendulum system not ideal?
Doesn't account for knee joint
76
What is Newton's 1st law?
If the net force on an object is zero then the object remains in rest
77
What is Newton's 2nd law?
F = ma
78
What is Newton's 3rd law?
Every action has an equal and opposite reaction
79
What does GRF relate to?
The acceleration of the COM
80
What does the vertical component of the GRF relate to?
Vertical acceleration of he COM
81
Equation for moment
M = Fd
82
What can moments be balanced by?
Muscles Ligaments Joint force
83
How is gait pwoer calculated?
Power = Moment x Angular Velocity
84
If the internal moment and angular velocity are in the ame direction what does this mean?
Power generation
85
If the internal moment and angular velocity are in opposite directions what does this mean?
Power absorption
86
How can the net joint moments be estimated?
From GRF magnitude and orientation relative to anatomical joint centres

AY BMSc Lectures (8 decks)

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