O - Biomechanical Exam (Lab) Flashcards
when pt walks into clinic:
what type of pt is a supine exam important and why
someone walking toe in or toe out
* good to look to see if there is a long bone abnormality (femur or lower leg)
* is it bony or soft tissue
how can the knee influence the sagittal and frontal planes
sagittal: flexion contracture & recurvatum
frontal: varus & valgus
when is a better time to measure Q angle and why
dynamically - SL squat or step down
people could have normal alignment in static but valgus collapse dynamically
norms:
* females: 15-18deg
* males: 8-10deg
what is a malleolar position assessment? what are the norms? what would be abnormal?
tibial torsion/fibular migration
position of malleoli relative to table
norms: 15-25deg external malleolar torsion
abnormal: internal, <15, closer to 0 (likely toes in)
when born tib and fib straight across, as develop fib moves post which gives angle of TC joint
if you see someone toeing in or out, what is the process to figure out if it a bony abnormality
start at greater troch
palpate med and lat fem condyle
* in line w the table? or retro/anteverted?
* if retroverted, put them in neutral & do quad set to hold
malleolar prominent tips, looking up from bottom
* use inclinometer on one (number doesn’t really matter bc won’t write a goal to change it)
malleolar position:
* >25deg - likely out toe
* <15deg - likely in toe
what is the gold standard for measuring leg length
standing radiograph
unnecessary for most people
what are 2 things to do before measuring leg length and why
bridge - eliminate rotation
gentle traction - eliminate elevation
what are 2 ways to measure leg length and what are considerations of each
ASIS to medial malleolus
* problem is going over tissue bulk/swelling will make one seem longer than the other
hooklying w feet together, are knees level
* are femur or tibia longer
* this is subjective
what makes it true FF equinus as opposed to fake
stuck in position
* fake equinus - people will collapse into position in supine but can be moved out of the position
what is FF equinus
PF deformity of MTJ
lacking 10deg DF
what are the 3 ways to assess midtarsal joint mobility
longitudinal axis
oblique axis
lock-up
why is midtarsal joint mobility such a key piece to the assessment
if limitation in TC DF, pts collapse through midtarsal joint to compensate
if lacking TC mobility/DF, how will the pt’s gait present if MTJ is mobile vs rigid
mobile - pronation in late stance
rigid - early heel rise
how is MTJ mobility assessed in longitudinal vs oblique axis
longitudinal: FF inv and eve
oblique: FF DF-ABD, FF PF-ADD
why do you measure DF in a lock-up position
gives supinatory bias, inv calcaneus
* takes away mobility thru midfoot to assess TC specifically
in gait TC should be in neutral or slightly supinated when DF - measurement mimics needed function
oblique and longitudinal axises cross/are perp in sup –> more rigid foot
axises are parallel in pron –> more mobility
internal joint mechanics help dictate amt of mobility
what is the Feiss line
medial malleolus to where 1st MT hits ground
* assess position of navicular relative to line –> shows arch height
why are 1st and 5th rays assessed separately
each have their own axises
what is the significance of a PF 1st ray being mobile or rigid
PF 1st ray - hit ground early
mobile - ground will push ray up
* he doesn’t care bc the functional impact is basically 0
rigid - can’t move once hits ground
* problematic
