lecture shit Flashcards
1
Q
in upper cross syndrome there is tight/shortness of which 2 mm posteriorly and which mm anteriorly ?
what muscles are weak
A
tight/short upper traps and levator and right pecs and weak deep neck flexors and week rhomboids , low and mid traps and SA
2
Q
what is weak with posterior pelvic tilt
A
abds and glutes
3
Q
what is weak with an anterior pelvic tilt
A
hip flexors , erector spinae and quads
4
Q
swayback is ___ kyphosis and ___ lordosis
A
increase
decrease
5
Q
what will be tight with swag back
A
hip extensors
6
Q
what is weak with sway back
A
HF or lower abs
7
Q
what type of knee formation willl be present with swayback
A
genu recurvatum
8
Q
genu recurvatum ____ stress on ___ knee and compression of ___ knee
A
increases
posteiror
anterior
9
Q
what type of pelvic tilt will someone with swayback have
A
posteiror
10
Q
how will someone head and shoulders be with swayback
A
forward
11
Q
someone with lordosis will have tight …
A
HF and/or back extensors
12
Q
what will be weak on someone with lordosis
A
Hip extensors or abs
13
Q
what kind of pelvic tilt will someone with lordosis have
A
anterior
14
Q
someone with lordosis will have ___ shear forces on lumbar vertebrae and __ compression forces on lumbar vertebrae
A
increased 2x
15
Q
someone w flat back will have ___ kyphosis and ___ lordosis
A
decreased 2x
16
Q
someone with flat back will have ___ head, __ pelvic tilt and knee ___
A
forward
posterior
flexion
17
Q
what will be tight with someone with flat back
A
hip extensors
18
Q
what mm will be weak in a patient with flat back
A
HF and back extensors
19
Q
anterior posterior sway is ___ - ___ mm in quiet stance for young adults
A
5-7
20
Q
mediolateral sway is __ - ___ mm in quiet stance in young adults
A
3-4
21
Q
does laying on your side or on your back put more pressure on our lumbar disc
A
side
22
Q
does stnading up straight or sitting down causing more pressure on your lumbar disc
A
sitting
23
Q
when sitting the keyboard slop should not be greater than ___°
A
15
24
Q
what are the 3 subsystems for balance
A
visual
somatosensory
vestibular
25
what are 2 self reported outcome measures for balance/confidence
ABC scale and falls efficacy scale
26
what is the difference between static vs dynamic balance
static feet don’t move
dynamic feet move
27
what 2 mm connects on ASIS
sartorius and TFL
28
what mm connects on AIIS
rec fem
29
the extension moments of the hip is counteracted by ___ and the ___ ligaments
iliopsoas and the iliofemoral ligament
30
what is weak and tight with anterior pelvic tilt
erector spinae is tight and hip flexion
abs and glutes are weak
31
what muscle are tight and weak for posterior pelvic tilt
abs and glutes are tight
erector spinae and HF are weka
32
what is the normal angle of inclination of the hip? what is it called if it is greater than normal or less than normla?
125°
> coxa valga
< coxa vara
33
is coxa valga structural or functional? does it lead to a shorter or longer limb?
structural
longer
34
does coxa valga or vara increase the likelihood of femoral dislocation
valga
35
coxa vara can lead to what hip path
SCFE
36
is the patients limb shorter or longer with coxa vara
shorter
37
what is the normal measurement of anteversion
10-20
38
excessive femoral anteversion leaders to ____ hip IR rom and ___ hip ER ROM
increase
decrease
39
if excessive femoral anteversion is uncompensated what will the toes do
go in
40
how does the body compensate for excessive femoral anteversion
tibial external rotation
41
femoral retroversion leaders to ___ hip ER ROM and ___ hip IR ROM
increased
decreased
42
if femoral retroversion is compensated what will happen ? if uncompensated?
comp= tibial IR
uncom= toe out
43
what is the abnormal capsule end feel fro HIP
IR > Ext> Abd
44
how much ROM is needed for HF to rise from a seat position
100 °
45
how much hip flex , hip abd , and hip ER is need for tieing shoes
HF = 115
HIP ABD= 18
HIP ER = 13
46
what is normla HF , hip abd , and hip ER to sit cross legged
HF= 85
hip abd= 35
hip ER= 45
47
what is lateral femoral cutaneous neuralgia a cause from
anterior hip replacement
48
what is hip dysplasia
acetabulum does not fully cover the femoral head
49
what are symptoms of hip dysplasia
groin pain
possible limp
feeling unstable
possible LLD
50
what hip path is bone overgrowth causing dysfunctional approximation of the femoral neck and acetabulum
femoral acetabular impingement (FAI)
51
which FAI is more common in young athletic males
CAM impingement
52
what can FAI lead to
labral tears
OA
“C” sign holding anterolateral hip
53
what can be caused by
◦Rotational force through planted limb
◦Repetitive microtrauma from FAI
◦Repetitive microtraumas from
abnormal muscle firing pattern
labral tears
54
what does Hip OA result in
posture with HF
decreased Hip extension during gait
may see compensatory lumbar extension
55
if patient has latin in the hip and IR > 15°, pian associated with IR , morning stiffness of the hip for < 60 mins and over 50 years what can we conclude they have
HIP OA
56
what are the 5 variables for the clinical prediction rule for diagnosing hip OA in ppl with unilateral hip pain
1) Squatting was an aggravating factor
2) Active hip flexion caused lateral hip pain
3) Scour test with adduction caused lateral hip or groin pain
4) Active hip extension caused pain
5) Passive IR of less than or equal to 25 degrees
57
T/F: Specifically report of anterior thigh or groin pain (+LR 3.86) and constant low back/buttock pain ( +LR 6.50) appear better than standalone tests for hip OA
TRUE
58
Femoral neck fractures are especially common in individuals >60 years, especially in women, as a result of ____ .
osteoporosis
59
which way is the hip directed after a femoral neck fx
abducted and ER
60
what are the anterior precautions for a THA
hip extension , hip ER and ABD
61
what are the precautions for postieor THA
no hip flexion past 90° , hip IR and hip ADD
62
what outcome measure for you use for THA
harris bc talks about pain , stairs , walking , support , ROM
63
what 2 outcome measures are for the ACL
lysholm knee scale and tegner activity scale
64
what is the normal tibiofemoral angle
165-175
65
if the tibiofemoral angle is < 165 what is it called ? > 175?
genu valgum < 165
genu varum > 175
66
what is the angle between the longitudinal axes of femoral shaft and tibial shaft
tibiofemoral angle
67
what is the normal Q angle
10-15
68
when is there a malaligment for the Q angle
> 20°
69
what are malalignment of the Q angle cause
genu valgum
excessive femoral anteversion
tibial external rotation
70
increased Q angle leads to increase risk for what
lateral patellar subluxation
71
what can genu valgum potentially lead to
over pronation for the foot
longer leg
ER of the tibia
OA of the laterla knee
72
genu varum can potentially lead to …
____ of the foot
____ leg
___ ___ of the tibia
OA do the ____ knee
supination of the foot
shorter leg
IR of the tibia
OA do the medial knee
73
what is considered abnormal knee hypertension
passed 5° of hyperextension
74
what are some causes of rent recurvatum ( hypertension past 5)
anterior pelvic tilt
quad weakness
gastroc/soleus weakness
ankle PF contracture or DF resitriction
75
what are the 2 results of genu recurvatum
anterior tibiofemoral compression
posterior knee laxity
76
Causes
◦ Immobilization
◦ Prolonged wheelchair use
◦ Sleeping with pillows under knees ◦ Capsular adhesions
◦ Abnormal hamstring tone
what path is this
knee flexion contractures
77
knee flexion contractures lead to loss of hip ___
extension
78
what is normal about of knee ext ROM for walking
60-70
79
how much knee ext ROM do you need to safely climb stairs
83
80
what knee flexion ROM do you need to safely descend stairs
90°
81
what knee flexion ROM do you knee to get u from a chair
105°
82
how much knee flexion ROM do you need to ride a bike
115*
83
Causes:
◦ Trauma: Excessive compression to anterior knee
◦ Microtrauma: Patellar maltracking ◦ Genu valgum
◦ Hip abductor weakness
what path is this
patellofemroal pain syndrome
84
what is the key sign on how a patient will present with patellofemoral pain syndrome
pain with descending stairs
85
people with patellofemoral pain syndrome have weakness in what 3 mm
hip abd , extensors and ER
86
Causes:
◦ Overuse/overload of the patellar tendon
◦ Repetitive landing on hard surfaces with poor mechanics
what path is this
patellar tendinitis (jumpers knee)
87
what is the key sign on how the patient will present with patellar tenonitis
pain with ascending stairs
88
Causes:
● Overuse/overtraining of the lateral knee
● Postural deviations
● Biomechanical issues from proximal and
distal joints
what path is this
IT band syndrome
89
what will be tight , weka and positive with IT band syndrome
tight - TFL/IT band/piriformis
weka - glute max / med
positive- obers test
90
a patient with a meniscal tear may present how
popping , clicking , locking
delayed swelling
91
Causes:
◦ Rapid direction change on planted foot or sudden stop
◦ Incorrect biomechanics with landing from a jump
◦ Medially directed blow to the knee
◦ Non-contact/ contact
what path
ACL tear
92
how may a patient with an ACL tear present
rapid swelling
decreased quad activation
feeling of knee giving away
93
Causes:
◦MVA/Dashboard injuries ◦Athletic hyperextension injuries
what path
PCL tear
94
Causes:
◦ Valgus hit to the knee
◦ Forceful tibial external rotation
what path
MCL tear
95
Causes:
◦Forceful varus force to the knee
◦Forceful tibial external rotation
what path
LCL tear (rare injury in isolation)
96
what is the main priority for TKA
full ext of knee
97
what outcome measure for TKA
KOOS
98
what is considered the hind foot
tibia
fib
talus
calcan
99
the LOG falls ___ to the ___ malleolus
anterior
lateral
100
___ activity counteracts the DF moment
soleus
101
if you are observing the foot from the posteior angle and you see to many toes laterally what position is the foot in
pronation
102
if the medial part of the foot caves in what does the indicate? what about bulges?
caves is supination
bulge is pronation
103
in the anterior fire the tibia is center aligned with __- ray
2nd
104
what movements are associated with pronation for the foot
eversion
abduction
DF
105
what movements are associated with supination for the foot
inversion
adduction
PF
106
what axis is eversion and inversion on ?
abduction /adduction?
DF/PF?
all for the foot
EV/INV = anteroposterior axis
ADD/ABD= vertical axis
DF/PF= mediolateral axis
107
what joint in the ankle is considered the mortise joint
talocrural joint
108
what motion is done at the talocrual joint
DF and PF
109
is the articular surface of the talocrural joint more narrow anteriorly or posteriorly
posteriorly
110
what is the main component of supination and pronation
sup = PF
pro= DF
111
what is the normal hind foot inversion and eversion
5°
112
what are the dynamic supports of the foot
tib post
tib ant
FHL
fib longus
intrinsic plantar mm
113
what are the 4 passive support of the foot
plantar apon
short plantar lig
long plantar lig
plantar calcaneonavicular lig (spring)
114
pronation of the foot can also be called hind foot ___
vagus
115
supination of the foot can also be called hind foot ___
varus
116
what drives the position for the midfoot and forefoot
calcaneus
117
hind foot valgus= calcaneal ___
hind foot varus = calcaneal ____
eversion
inversion
118
laterla ankle sprain that is causes by PF and IV will effect what lig
anterior talofibualr lig
119
lateral ankle sprain that is caused by DF and IN will cause damage to which lig
calcaneofibular lig
120
lateral ankle sprain that is casues by full DF and IN will cause damage to which lig
posteior talofibular lig
121
Causes:
◦ Forceful eversion of the foot throughout a range of DF
what path
medial ankle sprain
122
what ligaments would be injured w medial ankle sprain
deltoid lig and post tibfib lig
123
what is the cause of high ankle sprain
forceful talar external rotation with the ankle planted in DF
124
injury to the post tib would lead to ___ instability and excessive ____
midfoot
pronation
125
Causes:
◦Inappropriate, chronic inflammation of tendon
◦Underlying cause: faulty foot biomechanics
◦Overuse injury
what path?
posteior tibialis tendinopathy
126
what age group is effected by posteior tibialis tendinopathy and why
older people bc arch gets lower
127
what is the mm action for post tib
PF
128
what are the 4 clinical test for posterior tibialis tendinopathy
pain on tendon palpation,
swelling around the tendon,
pain/weakness with tibialis posterior contraction, pain during or inability to perform a single-leg heel raise (SLHR)
129
what was most reliable for posteior tibialis tendinopathy
single heel rise test
130
Causes:
◦Inappropriate, initial chronic inflammation of tendon
◦Underlying cause: faulty foot biomechanics
◦Overuse injury “wringing effect” to watershed area
what path
achilles tendinopathy
131
The patient typically complains of “being kicked” or “shot” behind the ankle, and clinical examination often reveals a gap in the tendon.. what path is this
achilles tendon rupture
132
tarsal tunnel syndrome can be from what 2 causes
ovepronation of the foot or rolling the ankle medially
133
what runs thru the tarsal tunnel anterior to posteior
tib post
flexor dig longus
tibial artery
tibial vein
tibial never
FHL
134
Causes:
◦ Forceful plantarflexion of the foot with toe extension
◦ Repeated microtrama with foot overpronation
◦ Repeated microtrauma with “heel spu
what path
plantar fasciitis (heel pain)
135
how will the pateint present with plantar fasciitis
pain at medial arch
pain with initial steps after immobility but also worse after prolonged WB
136
how much GT extension is needed for normal walking
70°
137
if there is not at least 70° of GT extension during walking what will the foot do
move into over pronation and created adduction
138
an angle between the metatarsal and proximal phalanx that is > ___ is abnormal
15
