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Y1 Orthopaedics > Gait and limp - week 23 > Flashcards

Gait and limp - week 23 Flashcards

Gait types and normal cycle

1
Q

Describe hemiplegic gait?

A

unilateral

spastic flexion upper limb

extension lower limb

stiff affected side

foot drop, stiff leg and circumduction

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2
Q

What causes a hemiplegic gait?

A

lesion in the central nervous system

eg stroke

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3
Q

Describe a diplegic gait?

A

Bilateral - similar to hemiplegic gait

lower limb adducted

scissoring gait

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4
Q

Causes of a diplegic gait?

A

Spinal cord lesion

Bilateral brain lesion (cerebral palsy, MS, tumour)

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5
Q

Describe a parkinsonian gait?

A

rigidity and bradykinesia

slow, shufflin, stooped, resting tremour, slow turning

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6
Q

Causes of parkinsonian gait?

A

Parkinsons Parkinsonian disorders (eg Vascular Parkinson’s disease
Dementia with Lewy bodies. Drug-induced Parkinsonism)

Issues with basal ganglia

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7
Q

Describe an ataxic gait?

A

broad based stance
staggering
difficulty turning

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8
Q

Describe three types of ataxic gait?

A

cerebellar
sensory
vestibular

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9
Q

Causes of each ataxic gait?

A

cerebellar (stroke, alcoholism, b12 deficiency, genetics like Frederich’s ataxia)

sensory (peripheral neuropathy)

vestibular (Labyrinthitis)

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10
Q

Describe a neuropathic gait?

A

A high stepping gait

weakness of distal limb

foot drop

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11
Q

What causes neuropathic gait?

A

weakness of ankle dorsiflexion muscles

L5 radicuolpathy
common peroneal nerve palsy

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12
Q

Which nerves are affected causing the neuropathic gait?

A

L4, L5, S1

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13
Q

Describe a myopathic (Trendelenburg) gait?

A

waddling gait

lateral flex of trunk away from leg in swing phase to counter centre of gravity

circumduct of leg

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14
Q

Causes of myopathic gait?

A

Systemic: hyper and hypoparathyroidism, PMR, poly and dermatomyositis

Muscular dystrophies: Duchennes and Beckers

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15
Q

What is a choreiform (hyperkinetic) gait?

A

lip-smacking, grimacing

writhing

involuntary movements

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16
Q

Causes of a choreiform (hyperkinetic) gait?

A

Basal ganglia disease

Huntingtons
CP

17
Q

Describe an antalgic gait?

A

limping

reduced stance phase

18
Q

Causes of antalgic gait?

A

any lower limb pain

eg OA, inflammatory disease, trauma, nerve entrapment

19
Q

Describe the gait cycle

A

Heel-strike (right)
Foot flat R
Mid stance
Heel off L
Toe off L
Swing L
Heel strike L

20
Q

What is a good exam to quickly assess a patients gait and balance?

A

The get up and go test

Assess to standing from chair, walking, turning around and sitting down

Y1 Orthopaedics (16 decks)

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