Observations and Measurements Flashcards
plumb line
- 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
head-neck measures
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
tragus to wall difference
mean?
subject stands with heels and glutes against the wall and tester measures horizontal difference between tragus and wall
- mean: 11 cm
CV angle
cranial vertebral angle
- use C7 spinous process and tragus of the ear to create an angle with a horizontal line
forward head posture and headaches
FHP people tend to have more tension type headaches
- this is unrelated to migranes
is CVA impacted by the thoracic spine?
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
Cobb angle
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
mean Cobb angle thoracic spine
40° from T4 -T12 (starts at T4 because this is where the curvature of thoracic spine really begins)
kyphosis
mean Cobb angle of lumbar spine
45° from L1-L5
lordosis
h
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thoracic kyphosis trends with age
- progressively increases with age (gravity causes intervertebral discs to degenerate)
Dowager’s hump
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
lumbar lordosis trends with age
- 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
gender differences in lumbar lordosis
women generally have a deeper lordosis than males
pelvic parameters and lumbar lordosis
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
what are the different Kendall postural patterns?
- kyphosis-lordosis
- swayback
- flatback
kyphosis-lordosis Kendall postural pattern
increased thoracic kyphosis
increased lumbar lordosis
anterior pelvic tilt
swayback Kendall postural pattern
increased thoracic kyphosis
decreased lumbar lordosis
posterior pelvic tilt
flatback Kendall postural pattern
decreased thoracic kyphosis
decreased lumbar lordosis
posterior pelvic tilt
iliac crests and ASIS levels
- tell us about pelvic tilt (right/left)
- also influenced by weight distribution
AC and SC joint levels
tell us about angle of clavicle, we can compare to horizontal
- is clavicle elevated, depressed, flat?
hip (femoral) rotation related to patella
- 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
degree of toe out
reflects what’s happening at the hip, ankle and knee
- neutral position = 0-10° toe out
knee valgus/varus
- 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
root of spine of scapula (ROSS)
where spine of scapula meets medial border
scapular protraction
measure distance from ROSS to midline of vertebral column on each side and compare
- mean: 7-10 cm
scapular rotation
the angle of spine of scapula can tell us about rotation
- greater angle is more superior rotation
- smaller angle is more inferior rotation
scapular winging
entire medial border of scapula seems to lift off
anterior tilt of scapula
inferior angle of scapula seems to lift off back
rearfoot position
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
too many toes…
… on lateral side?
… on medial side
lateral side = pronated foot
medial side = supinated foot
medial longitudinal arch angle (MLAA) landmarks
- medial malleolus
- tubercle of navicular
- head of 1st metatarsal
neutral MLAA
neutral: 130-150°
what does it mean to have a larger MLAA?
smaller MLAA?
larger angle = more supinated foot, higher arch
smaller angle = more pronated foot, lower arch
