Gait and Nerve Injuries Flashcards
Describe the stance phase of walking
Initial contact with floor (heal touches ground) intitated by hip flexion, knee extension
and Ankle dorsiflexion.
Foot takes load (standing straight on leg) achieved by knee extension (Hip and ankle neutral).
Move onto ball of foot Hip extension and ankle plantarflexion.
Push-Off achieved by ankle plantarflexion and toe flexion (greater toe last to leave).
Describe the swing phase of walking
Leg lift and foot raise achieved by hip flexion, knee flexion and dorsiflexion.
Swing achieved by Hip flexion knee extension and dorsiflexion.
What small adjustments do we make in each step to walk the way we do?
Our hip swings creating internal rotation at your posterior foot and external rotation at your anterior foot. This minimises the drop in centre of gravity by effectively lengthening the limb.
Adduction of the hips minimises lateral shift in centre of gravity. This is done by all muscles in the medial thigh.
The hip is stabilised from dropping by the gluteus medius and minimus muscles.
What is Neurapraxia
Stretch damage to a nerve. The axon and nerve sheaths are intact and there is no Wallerian degeneration. Recovery is complete.
What is Axonotmesis
Compression or traction injury to a nerve. There is axon damaged, potential Nerve sheath damage but the Epi, peri and endoneurium ok. Wallerian degeneration will take place and there is a Partial/Full recovery.
What is Neurotmesis
Rupture or avulsion damage to a nerve. There is axon disruption, nerve sheath disruption, wallerian degeneration and there will be no recovery without surgery to align the nerves.
What is Wallerian Degeneration
Wallerian Degeneration is when the nerve ending distal to the nerve body degenerates and dies. Axonal regeneration is at about a rate of 2mm per day.
What is piriformis syndrome
Piriformis Syndrome – hypertrophy of the piriformis causing compression of the sciatic nerve.
What is Meralgia Paraesthetica?
Entrapment of the lateral cutaneous nerve of the thigh.
