ontogeny Flashcards
for normal stance to occur pelvis should be
parellel to the frontal and sagittal plane
for normal stance to occur legs should be
in sagittal plane
for normal stance to occur subtalar joint should be
in neautral position
for normal stance to occur midtarsal joint should be
locked and maximally pronated
for normal stance to occur the full plantar surface of the foot
should rest on the ground
for normal stance to occur all metatarsal heads should
bear the weight
for normal stance to occur the forefoot
parallels the plantar aspect of rearfoot
for normal stance to occur muscle effort is
not necessary to maintain the structural integrity of the foot
in normal stance, gastrocnemius contraction occurs
to plantarflex the ankle joint allowing for half of the body weight to be transferred to the forefoot
neutral position most commonly discussed relative to the
subtalar joint
for most joints neutral position is the position where
it most has congruity
Neutral position is a position in which
compression forces are maximized and rotational forces are minimized
compression forces are bad or good?
Good
subtalar joint neutral position
where the subtalar joint is neither pronated or supinated
how many points of weight bearing under metatrsal heads
6
2 under the 1st metatarsal head and
1 for each of the lesser metatarsal heads
what should be the position of metatarsals in order for midtarsal joit to be locked and for the metatarsal heads to bear weight
metatrsals 2-4 should be in the maximally dorsiflexed position
inorder for metatarsal heads 1-5 to bear weight properly, they should be
in the center of their ranges of motion
the 1st and 5th rays have independent axis of motion
clinical criteria for normal stance- the knee
in the frontal plane
clinical criteria for normal stance-the tibia
perpendicular to the ground
clinical criteria for normal stance-the ankle joint
should be 90º
clinical criteria for normal stance-the subtalar joint
should be in neutral position ( no deviation from the sagittal plane )
if the calcaneous is inverted, the midtarsal
will be supinated
clinical criteria for normal stance-the midtarsal joint
should be maximally pronated
clinical criteria for normal stance-the 1st and 5th rays are
at the centers of their independent ranges of motion
clinical criteria for normal stance-the 2nd, 3rd and 4th rays
are maximally dorsiflexed
clinical criteria for normal stance-the bisection of the posterior surface of the calcaneus is
perpendicular to the supporting surface
a line connecting the 5 metatarsal heads is
parallel to the supporting surface
perpendicular to the calcaneal bisection
the fetus’ hip joint should be
externally rotated and maximally flexed
the fetus’s legs should be
inernally rotated with the knees maximally flexed
the fetus’s feet should be
plantarflexed and inverted
in utero what is the position of left leg in in relation to right leg
the left leg is usually over the right leg
in fetal position , the hip is
- flexed
- abducted
- externally rotated
in the adult hip is
- neither flexed or extended (vertical)
- at the intersection of the frontal and sagittal planes (neither adducted or abducted )
- at the center of range of motion in the transverse plane
angle of inclination
the angle formed by a line bisecting the neck of the femur and a line bisecting the long axis of the femur
angle of inclination is a ——–plane evaluation
FRONTAL
angle of inclination >140
male —because hip is smaller
angle of inclination <140
female
normal range for angle of inclination at birth
135º-140º
Less angulated means
higher angle number
the less angulated (higher angle number)
the more narrow the hip
as the measured angle gets to 90, the hip will be
wider
angle of inclination is AKA
shaft neck angle
normal adult value for angle of inclination in male
126º-128º
normal adult value for angle of inclination in female
90º-125º
women usually have a ———amount of angulation ( angle closer to 90º)
HIGHER
the adult values are usually reached by the age of
6 years old
ontogeny - femoral version
- soft tissue changes of the femoral head relative to acetabulum
- Angle of anteversion
Angle of anteversion
the angle formed by the neck of the femur with respect to the frontal plane
angle of anteversion is a ——–plane measurement
Transverse
version is
a turning within a joint , involving a soft tissue change
i.e., the change in the angle of anteversion is a versional change
torsion
a twisting within a bone
i.e., the change in the angle of inclination
at birth the angle of anteversion is about
60º externally rotated in the transverse plane with respect to the frontal plane
during development the hip undergoes a ———internal change for finish with the normal adult value of ———-(-internal or external?)
50º
10º
External
what is the benefit of the 50º internal change during development ?
better seating of the femoral head within the acetabulum
at fetal position we need to be ——–rotated
externally
if the angle of anteversion is greater than normal or (greater than 10 º external this would indicate
a less than normal developmental versional change
clinically, this may be a cause of out-toein
transverse plane changes will create
transverse plane deformity
if the angle of anteversion is less than normal ( or less than 10º external) this would indicate
a greater than normal developmental versional change.
if the angle of anteversion is less than normal ( or less than 10º external) this condition may be referred to as
retroversion
clinically this may be the cause of in-toeing
retroversion is the cause of
in-toeing
Retro is changes
going PAST normal
Femoral torsion
the angle formed by the axis through the head and neck of the femur and the transcondylar line of the distal femur
femoral torsion is a ———plane measurement
Transverse
femoral torsion is AKA
angle of antetorision
angle of declination
angle of femoral torsion
at birth the normal angle of femoral torsion is
about 35º internally rotated
the normal adult value of angle of femoral torsion is
10º internally rotated
the change of angle that occurs in the angle of femoral torsion between newborns and adults is from
greater internal rotation to a position of lesser internal rotation therefore the change is in the direction of EXTERNAL torquing
if the angle of femoral torsion is greater than normal (or greater than 10º internal) then this would indicate
a less than normal developmental torsional change
clinically this may be the cause of in-toein
if the angle of femoral torsion is less than normal ( less than 10º internally rotated ) then this would indicate
greater than normal developmental torsional change
this condition may be referred to as retrotorsion
clinically this may be a cause of out-toeing
in-toeing is more of
anteroversion rotation
out-toeing is more of a
retroversion rotataion
if we start at 30 go past 10
retro torsion
knee position-in a normal adult, the angle of anteversion is
10º external
knee position-in a normal adult, the angle of femoral torsion is
10º internal
as a result of angle of anteversion and angle of femoral torsion in adults the knee should be at
0º in the transverse plane, or parallel to the frontal plane
the anterior aspect of the tibial plateau extends further ———-than the posterior aspect of the tibial plateau
superiorly
this is a sagittal plane change
why babies can’t straighten their knees
because the changes in tibial plateau have not occurred yet
at birth the tibial plateau is angulated
30º posteriorly
the adult normal value for tibial plateau is
5º
if too much change in the position of the tibial plateau has occurred
genu recurvatum may be present
at birth the tibia has a varus attitude of
15-30º
in the adult the normal value of bowing of the tibia is
0-2º
valgus/varum is
frontal plane deformity
frontal plane bowing of the tibia
the distal aspect of tibia is directed towards the midline compared to the proximal aspect of the tibia. However, the measurement is made with respect to the ground
tibial torsion
tibial torsion refers to the transverse plane rotation of the distal aspect of the tibia relative to the proximal aspect of the tibia
normal value of tibial torsion at birth
0º
normal value of tibial torsion in adults
18-23º external
can we measure true tibial torsion?
no because the fibula is in the way-so we measure mealleolar position
malleolar position is the relationship between
the bisection of tibia proximally to the bisection of medial and lateral malleoli distally
clinically we measure the angle formed by the bisection of the medial and lateral malleoli with respect to what plane?
frontal plane
for measuring the angle formed by the bisection of medial and lateral malleoli the knee and therefore the proximal tibia should be in what plane ?
frontal plane
normal values of malleolar position at birth
0º
normal values of malleolar position in adults :
13-18º external
true tibial torsion is ……………. than malleolar position
5º greater
because the fibular malleolus is slightly anterior to the distal tibial bisection
because of the difference between true tibial torsion and malleolar position we should use
15-20º external as the normal tibial torsion and not the 13-18º
