Posture Flashcards

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1
Q

Definition

A

Alignment and positioning of the body in relation to gravity, center of mass, or base of support

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2
Q

Good Posture

A

State of musculoskeletal balance that protects the supporting structures of the body against injury or progressive deformity
Muscles function efficiently; optimum positioning for thoracic and abdominal organs

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3
Q

Poor Posture

A

Faulty relationships increase strain on supporting structures, less efficient balance over base of support

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4
Q

Principles of alignment

A

APTA - “optimizing movement”
Alignment is the foundation for optimal movement and musculoskeletal health requires optimal movement to prevent or minimize painful syndromes

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5
Q

Static vs. Dynamic

Recognize that orientation/organization relative to gravity is…

A
  • continually changing
  • always dynamic; only appears “static” during quiet standing (postural sway)
  • organize for efficiency for readiness to move in any direction
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6
Q

Muscle Imbalances - Biomechanical Theory

A

Constant stress placed on the musculoskeletal system due to habitual postures or repetitive motions - leads to adaptive shortening (weakening?) or lengthening (strengthening?)
The length - tension curve

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7
Q

Muscle Imbalances - Joint motion is changed due to

A

changes of the tissue guiding the motion

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8
Q

Muscle Imbalances - Joint positions suggest

A

which muscles may be elongated or shortened

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9
Q

Muscle Imbalances - Habitual postures can lead to

A

adaptive changes in muscles (and other tissues)

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10
Q

Muscle Imbalances - Neurologic Paradigm (janda)

A

Motor systems are working to maintain homeostasis
Proprioceptive info is integral to motor regulation
Muscle recruitment patterns are established and centralized in the CNS
Tight muscles tend to be more readily activated

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11
Q

Structural faults

A

Trauma
Congenital issues
Disease
May need surgical correction

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12
Q

Structural faults

Biomechanical vs. Neurologic

A

Biomechanical model incorporates structural faults better than neuro

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13
Q

Upper crossed syndrome - Inhibited`

A

Deep cervical flexors
Lower trap
Serratus Anterior

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14
Q

Upper crossed syndrome - Facilitated

A

SCM
Pectoralis
Upper Trap
Levator Scap

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15
Q

Lower Crossed Syndrome - Inhibited

A

Abdominals

Glut Min Med Max

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16
Q

Lower crossed syndrome - facilitated

A

Rectus femoris
Iliopsoas
Thoraco lumbar extensors

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17
Q

Short muscles will

A

Activate quickly

They are set to be facilitated

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18
Q

Lengthened muscles will

A

not be quick to activate

Tend to be inhibited

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19
Q

Functional Faults

A

Habitual postural positions

Repetitive motions

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20
Q

Functional Faults

Biomechanical vs. Neurologic

A

More neurological

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21
Q

Steps to static standing posture analysis

A
  1. Minimal clothing (comfort but need to see structures)
  2. Barefoot - no socks either
  3. Solid standing surface
  4. Minimize background noise
  5. Observation must occur on all four sides - make sure you have space
22
Q

More steps to static standing posture analysis

A
  1. Line of gravity passes through center of mass and falls within base of support
  2. A plump represents line of gravity
  3. Feet are fixed reference point (under hips) - in general 4 in apart and each foot should be toed out about 15 degrees (no more than 25)
  4. need a system
23
Q

Setting up your plump line

A

Post/Ant - position midway between heels

Lateral - position at the calcaneocuboid joint (ant to the lateral malleolus)

24
Q

Palpation

A

In order to establish skeletal landmarks
Inform patient
Start where patient can see (usually lateral)
Always use two hands or make sure the pt knows where your hands are

25
Q

Plumb line falls

A
Just ant to knee jt center
Just post to hip joint center
Through lumbar bodies
Mid shoulder (acromion)
Ext auditory meatus
26
Q

Observing from a post view

A
  1. R and L symmetry
  2. Calcaneal position neutral
  3. Feet with toes slightly out
  4. Muscle tone/definition
  5. Knees straight (popliteal line)
  6. Level pelvis
  7. Spinous processes in line
  8. Scapula parallel and 3 in from spine
  9. Shoulders level
  10. Head and neck on straight
27
Q

Observing from an ant view

A
  1. Weight bearing
  2. Toe position - toed out
  3. Tibias should be straight (no bowing)
  4. Knee should be in slight valgus
  5. Patella equal height and forward facing
  6. Muscle definition
  7. Greater troch equal
  8. ASIS height equal
  9. Equal iliac crest height
  10. Umbilicus should be midline
  11. Symm thoracic cage
  12. Shoulders horizontal and equal height
  13. Head and neck straight forward
28
Q
Lordotic Posture 
Head
Cervical
Thoracic
Lumbar
Pelvis
Knee
Ankle
Elongated and weak
Short and strong
A
Head = neutral
Cervical = normal (slightly ant)
Thoracic = normal (slightly post)
Lumbar = hyperextended (lordosis)
Pelvis = ant tilt
Knee = slightly hyperextended
Ankle = slightly plantar flexed 
Elongated and weak = ant abdominals, hamstrings elongated and may or may may not be weak
Short and strong = low back and hip flexors
29
Q

Kyphotic Lordotic Posture
Short and tight
Weak and elongated

A

Short, tight = neck extensors and chest muscles, Hip flexors
Weak = neck flexors and upper back extensors and abdominals will be elongated and weak, hip extensors too

30
Q

Flat back posture

A
Forward weight shift
Head - forward 
Cervical - extended
Thoracic - upper flexion, lower flat
Lumbar - flat or extended 
Pelvis - post tilt
Hp - extended
Knee - extended
Ankle - plantar flexed
31
Q

Sway back posture
Strong
Weak

A

Strong (short, tight) - Neck extensors, chest muscles, upper IO, hip extensors
Weak = neck flexors, upper back extensors, EO, hip flexors
Knees are hyperextended
Upper trunk is shifted rearward

32
Q

Headedness

A

For every inch of forward head posture, it can increase the weight of the head on the spine by an additional 10 pounds

33
Q

Psoterior view - Scapulae

A

Flat against thorax
4-6 in btw medial borders equidistant from T spine
Sup angle and inf angle situation btw T2 and T7

34
Q

Posterior view - shoulders and UEs

A

Neutral roation
Elbow (olecranon) oriented visibly
Forearm/hand neutral/against body (using both supination and pronation - not anatomical position)

35
Q

Closer look - spine - primary curves

A

Kyphosis throughout in utero and early infancy

Persist in thoracic and sacrococcygeal regins

36
Q

Closer look - spine - secondary curve

A

Lordotic curves develop with postural control (head control, sitting, standing)

37
Q

Closer look - pelvis - Post view

A

PSISs and iliac crests on same horizontal plane

38
Q

Closer look - pelvis - Ant view

A

ASISs and iliac crests on same horizontal plane

39
Q

Closer look - pelvis - lateral view

A

ASISs and pubic symphysis on same frontal plane
PSIS and ASIS on same horizontal plane - normal posture has ASIS slightly below PSISs
Ant tilt inc lordosis
Pst tilt dec lordosis

40
Q

Knee - typical development progression

A

Bowed (varus) - infancy, pre standing/walking
Straighten - upright, bipedal activities
Valgus - childhood
Less valgus (many females) or slight varus (many males) - 6 to 7 years

41
Q

Closer Look - Feet Ant view

A

Medial longitudinal arch by 6 or 7 years

Toes flat on floor, in line with respective metatarsals

42
Q

Closer look - feet post view

A

Vertical calcaneous and achilles tendon

43
Q

Closer look - knees, feet, LEs

A

Hips in neutral rotation
Femoral condyles and patallae in frontal plane
Feet toed out
A line passes through center of hip joint center of knee joint - 2nd MTP joint

44
Q

Closer look - knee variations

A

Postural - apparent in standing; not strucutral; usually not seen in supine

45
Q

Varus

A

Postural bowlegs
Hips IR
Knees hyperextended
Feet pronated

46
Q

Valgus

A

Postural knock-knees
Hips ER
Knees hyperextended
Feet supinated

47
Q

Scoliosis

A

Affects more females than males
Onset is often peripubertal
Influenced by postural habits

48
Q

Functional Scoliosis

A

Associated with handedness, back spasms

May not be apparent with forward bending

49
Q

Strucutral Scoliosis

A

Persists with forward bending (screening) - further assessment with x-rays

50
Q

Posture can be assessed

A

in other positions besides standing (sitting, working stations)
Dynamically and statically
With technological aids (still photos, video)

51
Q
Handedness
Head
Cervical
Shoulder
Scapulae
Thoracic and lumbar
Pelvis
Hip
LE
Feet
A

Head = erect, neither tilted nor rotated
Cervical = straight
Shoulder = right low
Scapulae = adducted, right slightly depressed
Thoracic and lumbar = curve is convex toward the left
Pelvis = lateral tilt, high on right
Hip = right adducted and slightly medially rotated, left abducted
LE= straight, neither valgus nor varus
Feet = right is slightly pronated