PCM Flashcards
gait cycle: average step length
14-16 inch
gait cycle: average cadence
90-120 steps/ min (higher by 6 in women)
gait cycle: average speed
3 mph
gait cycle: definition
from heel strike to heel strike of the same foot
gait cycle: 2 phases
stance and swing
gait cycle: positions
heel strike –> foot flat –> heel off –> toe off –>heel strike
gait cycle: “swing” phase occurs in between which foot positions
toe off to heel strike
gait cycle: “propulsion” is made of which 2 foot positions
heel off and toe off
whats the name for the foot joint connecting the 5 metatarsals to the distal most tarsal bones
lisfranc joint
whats the name for the foot joint connecting hind foot (calcareous and talus) to mid foot structures (cuneiforms, cuboid, and navicular)
midtarsal (chopart) joint
mm responsible for lowering foot to ground for “contact” phase of gait cycle
extensor digitorum longus, tibialis anterior
what must the tibia do after heel strike in order for calcaneus to evert and talus to drop (which unlocks mid tarsal joints for shock absorption)
internally rotate
during mid stance, the body’s center of gravity shifts where
from behind to over the foot
as the body passes over mid-foot, it places ankle in maximal dorsiflexion. this puts maximal preload on what mm
gastroc-soleus complex
whats the term for the effect that occurs when 1st metatarsophalangeal joint extends resulting in plantar fascia that elevates the arch and further assists in foot supination
windlass effect
most problems with gait cycle occur during which phase
stance phase
which part of gait cycle is also called initial contact
heel strike
which part of gait cycle is also called loading response
foot flat
which part of gait cycle is also called terminal stance
heel off
which part of gait cycle is also called pre swing
toe off (50-60% of the stance cycle is spent here)
when the left foot is in mid stance where is the right foot
mid swing
when the left foot is in initial contact where is the right foot
terminal stance
which gait cycle phase provides limb and trunk stability
mid stance
which gait cycle phase provides weight release from stationary foot
pre swing
we have single limb support for how much of our gait cycle
80%
how much does your center of gravity move in a superior/ inferior motion during gait cycle
less than 2 in
how does our center of gravity shift superior/ inferior during gait cycle
early stance: weight transferred to foot. the hip on the non weight bearing side drops 2 in
how do we “lengthen” the femur during gait cycle
innominate (pelvis) rotates anterior 4 ish degrees
which gait disturbance: adopted limp to avoid pain on weight bearing structures, short stance phase on affected side
antalgic gait
which gait disturbance: stiffness in affected joints, plantar flex opposite to affected side to increase clearance, affected leg is circumducted, step is shorter
arthrogenic gait
which gait disturbance: unsteady, uncoordinated walk, broad base of support needed, loss of sensation/ control, staggering, watches feet when walking
ataxic gait
which gait disturbance: leg stiff, no flexion of knee and ankle, form a semicircle with rotation on each step
hemiplegic gait
which gait disturbance: full foot drop, hip raised high to clear toe, quiet gait usually
steppage (foot drop, high step, neuropathic) gait
which gait disturbance: small shuffling steps, hypokinesia (slowness of movement), reduced stride length and walking speed while cadence rate is increased
parkinsonian (festinating) gait
What are some causes of antalgic gait
Trauma, osteoarthritis, pelvic girdle pain, coxalgia, tarsal tunnel syndrome
What are some causes of arthrogenic gait
Osteoarthritis of hip/ knee, Post orthopedic surgery
What are some causes of ataxic gait
Vestibular, cerebellar hemmorrhage, friedreich’s ataxia, pontine cerebellar atrophy, chronic mercury poisoning, posterior fossa tumor, alcoholism, drugs
What are some causes of stoppage gait
Peroneal nerve injury (lumbar disc herneation, MS, Giuliani barre, parkinsons)
Abnormal depression of the chest
Pectus excavatum
Abnormal expansion of the chest (pigeon chest)
Pectus carinatum
Curvature of cervical spine
Lordosis
Curvature of thoracic spine
Kyphosis
Curvature of lumbar spine
Lordosis
Curvature of sacral spine
Kyphosis
What does the acronym NURSE stand for
Name, understand, respect, support, explore
What does. CAGE stand for and when do we use it
Men. >14 drinks per week. Or 4 per day
Women»_space;>7. Drinks per week or 3 per day
What are the 5. Ps of sexual questioning
Partners Prevention Protection Practices Past history of STDs
What does SAFE stand for
Safety, abused, friends/ family, emergency plan
For domestic violence
Another name for fibrous joint
Synarthrosis
Another name for cartilagenous joints
Amphiarthrosis
Another name for synovial joints
Diarthrosis
3 fibrous joints
Cranial sutures, syndesmosis (tibiofibular), gomphosis
2 kinds of cartilaginous joints
Hyaline- synchondrosis (costochondral/ epiphyseal plate)
Fibrocartilage- symphyses (intervertebral disc)
What covers the ends. Of bones that are involved in synovial. Joints to reduce friction
Hyaline cartilage
Articular (hyaline) cartilage at synovial joints does not have blood or nerve supply so how does it get nourishment?
Synovial fluid
Whats hiltons law
Nerves supplying a joint also supply the muscles moving the joint and skin covering it
What is wolfs law
Bone is increased or reabsorbed wherever needed
Complete loss of articular cartilage, thickening of subchondral bone
Eburnation
Fragments of cartilage or bone floating free in synovial fluid (often in degenerative joint disease)
Joint mice (osteochondromatosis)
What type of arthritis is not inflammatory
Osteoarthritis is erosion of cartilage that buffers the bones
Whats in the central compartment of the hip
Labrum, ligamentum teres, articular surface
What tests. Can be performed to assess central compartment. Of hip
Log roll, c sign, Labral load, labral distract, Scour, apprehension, faber
What is in the peripheral compartment of the hip
Femoral neck, synovial lining
What tests can assess the peripheral compartment of hip
Log roll, Ely’s, rectus femoris
What is in the lateral compartment of hip
Glut min, piriformis, IT band, trochanteric bursae
What is in the anterior compartment fo hip
Iliopsoas insertion, iliopsoas bursae
Name the test: you ask a patient to stand with all weight on the affected leg and watch for the opposite hip to drop
Trendelenburg sign
DTR for. The knee tests what spinal nerve segment
L4
What gets injured in the unhappy triad fo the knee
ACL, MCL, medial meniscus
DTR of achilles tendon is checking nerve function at what spinal segment
S1
What spinal nerve segments are tested by biceps. Brachii DTR
C5
What spinal nerve segments are tested by brachii radialis DTR
C6
What spinal nerve segments are tested by triceps DTR
C7
Shoulder. Muscles that do flexion
Anterior deltoid, coracobrachialis
Shoulder muscles that do extension
Latissimus dorsi, teres major
When carrying angle is reduced
Cubitus varus
When carrying angle is increased
Cubitus valgus
Varus stress test of elbow looking at what joint structure
LCL: radial collateral ligament
Valgus stress test of elbow looking at what joint structure
MCL: ulnar collateral ligament
Radial head subluxation due to tear of the ___ is nursemaids elbow
Annular ligament
What elbow motion is coupled with pronation
Ulnar abduction and posterior radial head glide
What elbow motion is coupled with supination
Ulnar adduction, radial head anterior glide
How does colles fracture present
(Distal radius fracture)
Dorsal and radial displacement of wrist/ hand
Dequervain syndrome will give what positive test
Finkelstein
How can you test for carpal tunnel syndrome
Phalens, tinnel, ok sign
