Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Pediatrics Lecture Material > Musculoskeletal Development and Gait Biomechanics > Flashcards

Musculoskeletal Development and Gait Biomechanics Flashcards

1
Q

When does musculoskeletal development occur during the prenatal period?

A

Occurs during the embryonic period (2nd-8th weeks post conception)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the three parts of the trilaminar embryo and what do they become?

A

1) Ectoderm- skin and nervous system
2) Mesoderm- Muscle and CT
3) Endoderm- Organs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What does the mesenchymal cells transform to? And what time period does it occur?

A

Limb buds

Differentiates into carriage at week 3-4

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

When does joint formation begin and end?

A

Begins- during week 6-8

Ends- early childhood

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Cartilaginous skeleton occurs rapidly and is completed in how many months?

A

3

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Where does primary ossifications of long bones begin?

A

The diaphysis of the long bones

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

When does primary ossification start and end?

A

Week 8 through the 3rd trimester

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Where does secondary ossification of the long bones begin?

A

Begins in the epiphysis of the long bones

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

When does secondary ossification begin and end?

A

Perinatally through 20 years old

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are the three types of bone growth?

A

Epiphyseal: grows in length
Longitudinal: occurs at epiphyseal plate til 20 y.o.
Appositional: Growth in density

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is appositional growth?

A

Accumulation of new bone on the bone surface (i.e. the greater trochanter)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What stimulates appositional growth?

A

Compressive forces; increased WB results in increased thickness and density of the shaft of the bones

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is normal alignment of the spine?

A

Kyphosis present at birth, spinal extension developed by 5th month (with swimming), lordosis begins developing by 7 months (indep. sitting and pull to stand)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Abnormal alignment of the spine is?

A
  1. Kyphosis persisting through 1st year- decreased thoracic extension seen with decreased scapular/thoracic mobility, tight pecs, decreased scapular ROM.
  2. Results in impaired sitting, UE function, respiration.
  3. Scoliosis- lateral curvature of spine due to asymmetry of mm pull (neurological or idiopathic)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

When assessing the spine what are you looking for?

A

Scoliosis- rib hump
Scoliosis is named for the convexity of curve
Observation of spinal alignment in bending forward and ambulation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

At birth the alignment of the hip looks like?

A

Swallow acetabulum, depth increases unit 8 years old when head of femur has full coverage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What do the compressive forces of the femoral head result in?

A

Formation of the hip joint

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Where is maximum congruity in the hip?

A

During hip flexion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Give the position that is greatest for acetabular development.

A

Frog leg position

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Give the angle of inclinations for birth, adult, and atypical.

A

Birth: 145 (valga)
Adult: 125 (normal) {ADD plays a big role here}
Atypical: <125 (vara)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is the definition of “version”?

A

Angular difference between the transcondylar axis of the knee and the axis of the femoral neck.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Give the degrees for normal ante version.

A

Normal: 5-16 degrees anteversion

23
Q

The 5-16 degrees of anteversion allows for what?

A

Allows for the foot to be pointed straight ahead with the femur sitting in the acetabulum

24
Q

What is anteversion and what could it cause?

A

Turning of the femoral head anterior to the frontal plane.
Excessive Anteversion: Can cause IR of femur to put femoral head in acetabulum and cause toe-in. (The W-sit is problematic here)

25
Q

What is retroversion and what could it cause?

A

Turning of the femoral head posterior to the frontal plane

Excessive Retroversion: Femur must ER to achieve joint congruency-causing toe out

26
Q

When assessing hip rotation how should you assess and what is normal for infants and adults?

A

Assess in prone
Infants: IR>ER
Childhood IR=ER
Adults: ER>IR

27
Q

Hip version is assessed how?

A

Assessed during gait

28
Q

Give the degrees for hip flexion at birth, 1 y/o and 5 y/o.

A

Birth: 30-50 degrees contracture at birth
1 year: 10-20 degrees contracture
5 year: 0 degrees contracture

29
Q

Normal knee alignment is considered what?

A

Flexion contracture 20-30 at birth and 1-2 years is 0 degrees

30
Q

Give what is considered abnormal alignment of the knee.

A

Decreased quad activity and increased HS activity due to persistent knee flexion contracture and compensatory problems of crouched gait.

31
Q

The knee is assessed by what angle and how?

A

Popliteal angle

1) Supine, hip and knee flexed to 90
2) Extend knee until resistance, toni at knee

32
Q

When looking at knee alignment and assessment what two variations of tibiofemoral angle might you see?

A 
Genu varum (bow legged)
Genu valgum (knock kneed)
33
Q

Give the degrees for tibiofemoral angles at birth, 3, 3-6, 6+, and adult.

A 
Birth: ~17 degrees genu varum 
3 years: 0-12 degrees genu valgum 
3-6 years: 5-12 degrees genu valgum 
6+ years: 5-7 degrees genu valgum 
Adult: 5-7 degrees genu valgum
34
Q

What is considered normal DF for Birth, 1, 4, 5, and adult?

A 
Birth: 70-80 degrees 
1 year: 25-45 degrees
4 year: 20-60 degrees 
5 year: 10-20 degrees 
Adult: 8-15 degrees
35
Q

What are the normal values for PF for birth, 1, and 5 years?

A

Birth: 15-30 degrees
1 year: 45 degrees
5 year: 45+ (full)

36
Q

At birth what are the values for neutral STJ and forefoot varus?

A

STJ: 10 degrees varus
Varus: 12-15 degrees

37
Q

When does eversion stop decreasing?

A

at age 7

38
Q

As an adult what is STJ and forefoot varus?

A

STJ: 2-3 degrees varus
Varus: 0-2 degrees

39
Q

What are the determinants of walking in the development of gait?

A 
Single limb Stance 
Walking velocity 
Cadence 
Step length 
Ratio of pelvic span to ankle span (wide based gait)
40
Q

During birth to 9 months how does gait develop?

A

1) Working on antigravity movements
2) Antigravity strength gained in first 9 months essential for indep. ambulation
3) Flexion contracture at hip
4) Physiological varus at tibiofemoral angle

41
Q

What are the major characteristics of a 9-15 month olds walking?

A
  1. Wide BoS 2. Hip ABD, flexion, and ER
  2. Knee flexion and varus
  3. Full foot initial contact in PF, heel everted
  4. Short stride, increased cadence
  5. Relative foot drop in swing
  6. High Guard
42
Q

Discuss some of the characteristics of balance and strength during the gait of 9-15 month olds.

A
  1. Balance comes M/L first and then A/P
  2. Hip strength is inadequate to control gravitational forces
  3. Gait similar to an adult walking on ice
  4. Postural alignments made by movements of entire body
  5. Initial patterns similar to kicking in early infancy
  6. Co-activation of antagonistic muscles
  7. Limiting factor: extensor strength (not pattern-generating abilities)
  8. CoM is closer to head/upper trunk
  9. Fat:muscle mass still high- therefore relative weakness
43
Q

Describe what is happening during the early stages of walking with the UE and trunk.

A

UE: High guard and non reciprocal arm swing
Trunk: Forward, lateral shift to advance

44
Q

From the pelvis to the ankle what would an early walker look like?

A

Pelvis: Ant. tilt, hip hike to clear floor, excessive rotation to increase step length
Hip: Stance Phase-Excessive flexion (contracture and weakness)
Knee: Stance Phase-Excessive flexion
Ankle: Initial Contact- foot flat or little PF
Swing Phase- PF
Step direction: Taken on diagonal increasing
BoS

45
Q

When a child is 18-24 months old there is a change in their UE movements while walking. What is it?

A

High guard is decreasing and reciprocal arm swing begins

46
Q

What is happening in the LE during gait when a child is 18-24 months old?

A

Hip: more extension in stance
Knee: immature flexion wave; more extension at IC
Ankle: Immature heel strike begins
Feet: Narrower BoS

47
Q

As velocity increases in gait a child will do what to keep their balance?

A

They will revert back to the 12 month pattern to help them keep their balance

48
Q

Discuss the the cadence, step length, and CoM for a child 18-24 months old.

A

Cadence: Increased compared to adult gait
Step length: decreased compared to adult
CoM: moves distally (which increases stability)

49
Q

Walking experience is important for what during the 18-24 month period?

A

New balance and postural control strategies

50
Q

What part of gait become amore stable during this time?

A

Single leg stance

51
Q

If a child’s gait begins to smooth out during this time what can you assume is occurring?

A

A decrease of co-contraction of antagonistic muscles.

52
Q

The LE of a 2+ year old are changing; describe those changes in the pelvis, knee, and ankle.

A

Pelvis: excess rotation still present
Knee: Full extension in stance is immature and stance knee flexion remains until 3 years old
Ankle: Heel-toe doesn’t begin tip 3 y/o

53
Q

What are some of the major characteristics of a 3-3.5 year old walking?

A 
Genu valgus
Femoral anteversion is decreasing 
CoM near Lumbar spine
Heel eversion decreasing
Heel strike consistent with knee flex of opp. leg
Reciprocal arm swing
54
Q

A 6-7 year old has gone through changes in their walking from a 3-3.5 year old. Describe some of those changes.

A

Stability by 4-6 y/o
Fully mature by 7 y/o
Heel position is in neutral
CoM is at 3rd lumbar vertebra (sacral as adult)

Pediatrics Lecture Material (7 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions