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Extremity Biomechanics > Midterm Review > Flashcards

Midterm Review Flashcards

1
Q

Synovial Membrane and Fluid

A

Membrane is made of 2 layers: Intima and Subintima

Subintima is vascularized and innervated

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2
Q

Functions of synovial membrane

A

2 Functions
Produces and resorbs synovial fluid
Provides immunity to joint cavity (sub)

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3
Q

Fibrous capsule Function

A

Support/stabilize
Guide and limit motion
Absorb shock

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4
Q

Fibrous capsule components

A

Capsular ligaments
Extracapsular ligs
Attachment sites
Vascularized and innervated

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5
Q

Extremity Joint components

A 
Subchondral bone (10x stiffer than bone)
Articular cartilage
Intra-articular cartilage
Fibrous capsule
Synovial membrane
Synovial cavity
Synovial cavity
Periosteum
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6
Q

Synovial Fluid

A 
Rich in GAG's especially Hyaluronic Acid
Shock absorption
Lubrication
Nutrient supply to cartilage
Waste product removal from cartilage
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7
Q

Bursae - General

A

Synovial membrane lined extra-capsular pockets or pouches

Some communicate with the synovial cavity

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8
Q

Bursae Function

A

Lubrication

Padding the joints

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9
Q

Articular Cartilage

A

Hyaline is most common

Joints lined by fibrocartilage: AC, SC, TMJ, 1/2 of SI

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10
Q

Main Components of Articular Cartilage

A

Low cell population density
H2O (80% of total weight)
Collagen (60-70% of dry weight)
GAG (proteoglycans , 30-40% of dry weight)

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11
Q

Function of collagen

A

Provide cartilaginous framework

Provide tensile strength

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12
Q

Sources of Nutrition for Articular Cartilage

A

Synovial fluid

Subchondral bone

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13
Q

Two types of Intra-Articular Cartilage

A

Disc - AC, SC, TMJ, T.F.C

Meniscus - AC, knee

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14
Q

Intra-Articular Cartilage (Innervation, vascularized, function)

A

Innervated:
Outer transition with capsule
Proprioception
Nociception

Vascularized:
Outer - 1/3

Functions:
Increased shock absorption
Increased congruency
increased stability
Decreased function
Increased motion
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15
Q

Cartilage loads

A

Small compressive loads only:
Weak ionic bonding
Fails @ high compressive loads

Large compressive loads —> squeezes fluid film out of the cartilage

Slow oscillations are good: Stimulates matrix synthesis and inhibits chondrolysis
Rapid oscillations or no oscillations are bad: Supresses matrix synthesis and enhances chondrolysis

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16
Q

Changes in DJD (Articular Cartilage)

A

Cell numbers, GAGs, lubrication decreases. Serous fluid, calcification increases

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17
Q

Changes in DJD (Subchondral Bone)

A

Increase calcification: Increase rigidity
Increase thickness: impedes waste removal and nutrient delivery
Decrease shock absorption

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18
Q

Changes in DJD (Intra-articular cartilage decreases)

A

Vascularization, chondrocyte population, GAGS and collagen, shock absorption and flexibility

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19
Q

Spheroid

A

Ball and socket

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20
Q

Arthroid

A

Planar/gliding

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21
Q

Sellar

A

Saddle

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22
Q

Ellipsoid

A

Condyloid

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23
Q

Gingylmus

A

Hinge

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24
Q

Trochoid

A

Pivot

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25
Q

Osteokinematics

A

Uniaxial, biaxial, polyaxial, nonaxial

2 types of motion:
Spin - Stationary mechanical axis
Swing - Mechanical axis moves

Conjoint/conjunct rotation:
Involuntary movement that occurs during swing
Screw home mechanism

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26
Q

Convex Rule

A

Convex on Concave surface movement the convex surface will roll and slide in the opposite direction
Rolls in the same direction as angular motions
Slides in the opposite direction of angular motion

GH JOINT

27
Q

Concave Rule

A

for a concave on convex movement. Concave slides and rolls in the same direction as the movement
Roll is in the same direction as angular motion
Slide is in the same direction as angular motion

Tibia on Femoral Extension

28
Q

Closed
Open
Resting position
Neutral position

A

Tight packed position
Loose packed position
Joint capsule is most relaxed
Joint position at zero degrees

29
Q

Gait cycle terms (R/L Step Length, R/L Foot Angle, Step width, Stride Length)

A

Step length is the length of one foot fall to the other during walking
Foot angle is the angular deviation of the forefoot from the hind foot
Step width is the lateral difference between foot landings
Stride length is the length from one step to the same foot during walking

30
Q

Step Width avg

A

8-10 cm

31
Q

Foot Flare/Angle avg

A

5-7 degrees when walking

Increase stress on lower extremity leads to injury
inefficient motion leads to increased muscle work and decreased stride length

32
Q

Phases of gait cycle

A

Swing - toe off to foot strike, recovery

Stance - Foot strike to toe off, support

33
Q

Walking stances

A

60% stance, 40% swing

Double support

34
Q

Running stances

A

60% Swing, 40% Stance

Float

35
Q

Foot Strike

A

lands ahead of COG
Absorbs shock and adapts to the ground
Foot lands 2 degrees supinated and then pronates

Eversion of calcaneus
abduction of foot and the calcaneus
Dorsiflexion of calcaneus
Tibia and femur Internally Rotate

36
Q

Rearfoot striker

A

Walking, jogging, slow running
foot and talus plantar flexes
Tibialis anterior eccentrically controls the plantar flexion and pronation of the foot

37
Q

Forefoot striker

A

Fast running
Foot dorsiflexes
Gastroc-Soleus controls dorsiflexion
Tibialis anterior and posterior control pronation

38
Q

Midstance

A

COG is directly over the stance limb
Foot is pronates relative to neutral
Inversion, adduction and plantar flexion of the calcaneus
Tibia and femur extend and externally rotate

39
Q

Take off

A

COG is anterior to the stance foot
Tibialis anterior rapidly inverts the calcaneus. This will help to lengthen the leg so that the opposite foot does not hit the ground
Weight of plantar surface shifts medially across metatarsal break
Peroneus longus lifts cuboid and lateral foot and depresses and plantar flexes first ray
Slight pronation occurs at the end of take off

40
Q

Swing phases

A

Initial swing
Mid swing
Terminal swing

41
Q

Stance phases

A

Footsrike
Midstance
Take off

42
Q

Initial swing

A

knee flexes and tibia internally rotates
Hip extends and externally rotates
Hip flexors eccentrically decelerate

43
Q

Mid-swing

A

Hip flexors contract to accelerate leg
Gluteals and hamstrings eccentrically contract to decelerate the limb
Foot goes from neutral to slightly dorsiflexed to avoid contact with the ground

44
Q

Terminal Swing

A

Hip extensors and knee flexors accelerate the limb backwards

Hamstrings

45
Q

6 important joints of the foot and ankle

A 
Talocrural
Subtalar (pronation and supination
Choparts or midtarsal
Lisfranc’s 
Tarsometatarsal jont
Metatarsalphalangeal
46
Q

Rear foot bones

A

Calcaneus and talus

47
Q

Midfoot bones

A

Navicular, cuboid, cuneiforms

48
Q

Forefoot

A

metatarsals, phalanges (also called rays)

49
Q

Arches of the foot KEYSTONES

A

Medial: talus
Lateral: cuboid
Transverse: 2nd metatarsal

50
Q

Arches of the foot STAPLES

A

Medial: spring ligament
Lateral: plantar ligament
Transverse: transverse metatarsal ligament

51
Q

Arches of the foot TIEBEAMS

A

Plantar fascia

Intrinsic muscles

52
Q

Arches of the foot SUSPENSORS

A

Medial: anterior and posterior tibialis

Lateral and transverse: Peroneus longus and brevis

53
Q

Plantar Fascia

A

Inelastic tiebeam
Medial and lateral calcaneal tubercle to the bones and fascia of the toes
Tenses when someone rises on toes or walks
Windlass effect

54
Q

Intrinsic muscles of the foot

A

act as springlike tie beams to support the arch

can fatigue with pronation syndrome and overuse

55
Q

Subtalar joint

A

Locks and unlocks the transverse tarsal joint
in a pronated state the transverse tarsal joints are parallel and unlocked - increased flexibility
In a supinated position the joints are twisted and locked - increased stiffness

56
Q

Pes cavus - Supinated foot

A 
High arch
Inverted heel
Curved, stiff
Decreased shock absorption
Lateral shoe wear down
Weakened tibialis anterior allows peroneus longus to pull foot into plantar flexion

Metatarsalgia and stress related injuries
Metatarsals are at a greater angle to the ground

57
Q

Static Listings of Pes Cavus

A 
Inverted, anterior calcaneus
Lateral talus
Superior navicular
Plantar flexed metatarsal
Extended proximal phalanges

Supinated weight bearing foot lengthens the lower limb

58
Q

Pes Planus - Pronated foot

A

Low arch, arch appears normal when unweighted but drops when under load
Everted heel (rearfoot valgus)
Straight and usually flexible
Decreased shock absorption
Medial shoe breakdown
Overstretched or weakened spring ligament, plantar fascia, and tibialis posterior tendon

59
Q

Pes planus - Static listings

A 
Everted, posterior calcaneus
Medial talus
Inferior navicular
Dorsiflexed metatarsals
Flexed proximal phalanges
Pronated weight bearing foot shortens the lower extremity
60
Q

Rearfoot Varum

A

Inverted position of the hind foot

common cause of pronation syndrome

61
Q

Forefoot varum

A

Medial forefoot is elevated
Excessive pronation that lasts into takeoff
Inhibited supination during takeoff

62
Q

Forefoot Valium

A

Lateral forefoot is elevated

Often leads to decreased pronation and ankle sprains

63
Q

Posting and shoes

A

Forefoot varus - medial forefoot post
Rearfoot varus - medial rearfoot post
Forefoot valgus - lateral forefoot post

Extremity Biomechanics (1 decks)

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