Observations and Measurements

Question 1

plumb line

Answer 1

• from external auditory meatus to the ground to fall on calcaneal cuboid joint
• gives a vertical reference of where the line of gravity is and how it acts on the joints of the body

Question 2

head-neck measures

Answer 2

can give us an idea of flexion/extension tendencies of neck

• plumb line and external auditory meatus - should run through ear
• tragus to wall difference
• CV angle

Question 3

tragus to wall difference

mean?

Answer 3

subject stands with heels and glutes against the wall and tester measures horizontal difference between tragus and wall
- mean: 11 cm

Question 4

CV angle

Answer 4

cranial vertebral angle

- use C7 spinous process and tragus of the ear to create an angle with a horizontal line

Question 5

forward head posture and headaches

Answer 5

FHP people tend to have more tension type headaches

- this is unrelated to migranes

Question 6

is CVA impacted by the thoracic spine?

Answer 6

yes - CVA depends on C7 which sits on T1 as a platform for the whole cervical spine
- more exaggerated thoracic kyphosis means a smaller CVA

Question 7

Cobb angle

Answer 7

a radiographic measuring of the curvature of spinal segments

• draw lines from top and bottom vertebral bodies of the segment and then draw lines perpendicular to them
• the angle these lines meet at is the Cobb angle

Question 8

mean Cobb angle thoracic spine

Answer 8

40° from T4 -T12 (starts at T4 because this is where the curvature of thoracic spine really begins)
kyphosis

Question 9

mean Cobb angle of lumbar spine

Answer 9

45° from L1-L5

lordosis

Question 10

h

Answer 10

h

Question 11

thoracic kyphosis trends with age

Answer 11

• progressively increases with age (gravity causes intervertebral discs to degenerate)

Question 12

Dowager’s hump

Answer 12

a type of hyperkyphosis

• most common in post-menopausal women
• after menopause, bone density often decreases so bone can change shape over time because of excessive bone loss

Question 13

lumbar lordosis trends with age

Answer 13

• increases between ages 2 and 20 based on how humans start movement
• decreases up to 20% in adults
• pregnancy can increase lumbar lordosis to accommodate new balance of weight

Question 14

gender differences in lumbar lordosis

Answer 14

women generally have a deeper lordosis than males

Question 15

pelvic parameters and lumbar lordosis

Answer 15

pelvis (esp. the sacrum) serves as base for lumbar spine

• depending on the sacral slope, the lordosis may be deeper or more shallow
• pelvic tilt also affects lumbar lordosis

Question 16

what are the different Kendall postural patterns?

Answer 16

• kyphosis-lordosis
• swayback
• flatback

Question 17

kyphosis-lordosis Kendall postural pattern

Answer 17

increased thoracic kyphosis
increased lumbar lordosis
anterior pelvic tilt

Question 18

swayback Kendall postural pattern

Answer 18

increased thoracic kyphosis
decreased lumbar lordosis
posterior pelvic tilt

Question 19

flatback Kendall postural pattern

Answer 19

decreased thoracic kyphosis
decreased lumbar lordosis
posterior pelvic tilt

Question 20

iliac crests and ASIS levels

Answer 20

• tell us about pelvic tilt (right/left)

- also influenced by weight distribution

Question 21

AC and SC joint levels

Answer 21

tell us about angle of clavicle, we can compare to horizontal
- is clavicle elevated, depressed, flat?

Question 22

hip (femoral) rotation related to patella

Answer 22

• by looking at which direction the patella is facing (also comparing with tibial rotation) to tell us about how femur is rotated relative to the hip
• patellae facing laterally = external rotation
• patellae facing medially = internal rotation

Question 23

degree of toe out

Answer 23

reflects what’s happening at the hip, ankle and knee

- neutral position = 0-10° toe out

Question 24

knee valgus/varus

Answer 24

• where centre of foot is relative to the centre of knee
• valgus = foot lateral to knee - can be structural or from muscle pathologies
• varus = foot medial to knee - dictated more by skeletal structure

Question 25

root of spine of scapula (ROSS)

Answer 25

where spine of scapula meets medial border

Question 26

scapular protraction

Answer 26

measure distance from ROSS to midline of vertebral column on each side and compare
- mean: 7-10 cm

Question 27

scapular rotation

Answer 27

the angle of spine of scapula can tell us about rotation

• greater angle is more superior rotation
• smaller angle is more inferior rotation

Question 28

scapular winging

Answer 28

entire medial border of scapula seems to lift off

Question 29

anterior tilt of scapula

Answer 29

inferior angle of scapula seems to lift off back

Question 30

rearfoot position

Answer 30

can be valgus, neutral or varus

• references the long axis of the leg with the midline of calcaneus
• observe signs of pressure distribution under the heel
• too many toes sign

Question 31

too many toes…
… on lateral side?
… on medial side

Answer 31

lateral side = pronated foot

medial side = supinated foot

Question 32

medial longitudinal arch angle (MLAA) landmarks

Answer 32

• medial malleolus
• tubercle of navicular
• head of 1st metatarsal

Question 33

neutral MLAA

Answer 33

neutral: 130-150°

Question 34

what does it mean to have a larger MLAA?

smaller MLAA?

Answer 34

larger angle = more supinated foot, higher arch

smaller angle = more pronated foot, lower arch