Posture and Gait Assessment

Question 1

Posture (vertical line)

Answer 1

1) external auditory meatus
2) anterior body of C7
3) acromion of the scapula
4) middle of the glenohumeral joint
5) anterior third of the sacrum
6) center of the greater trochanter
7) just behind the center of the knee
8) 1” anterior to the lateral malleolus

Question 2

Kyphosis - Lordosis

Answer 2

The spine has an hourglass appearance. The head is held forward, the neck is hyperextended, the thoracic spine is flexed more than usual and the lumbar spine is hyperextended so that the pelvis is tilted anteriorly. The knees are slightly hyperextended.

Question 3

Swayback

Answer 3

The head is held forward, the neck is in slight extension. The thoracic spine is displaced backwards and the lumbar spine is flattened. This causes the pelvis to be tilted posteriorly and the hip joints are hyperextended along with the knees.

Question 4

Military Back

Answer 4

The head is the neutral position. The cervical spine retains its normal curvature along with the thoracic spine. The lumbar spine is hyperextended and the pelvis is tilted anteriorly.

Question 5

Muscles involved with Acceleration

Answer 5

Hip Flexor

Question 6

Abnormal Acceleration

Answer 6

abnormal acceleration and swing with thrusting of the trunk backwards to passively swing the leg

Question 7

Muscles involved with Heel Strike

Answer 7

Hip Extensor

Question 8

Abnormal Heel Strike

Answer 8

Forward lurch of the trunk on heel strike and the patient compensates with excessive lordosis

Question 9

Muscles involved with Stance Phase

Answer 9

Hip Abductors

Question 10

Abnormal Stance Phase

Answer 10

trendelenburg (lurching) gait

Question 11

Muscles involved with Heel Strike, Toe Off

Answer 11

Hip Adductors

Question 12

Abnormal Heel Strike, Toe Off

Answer 12

abnormal rotation of the leg and pelvis

Question 13

Muscles involved with Heel Strike, Acceleration

Answer 13

Knee Extensor

Question 14

Abnormal Heel Strike, Acceleration

Answer 14

knee buckles especially in walking downstairs

Question 15

Muscles involved with Deceleration, Heel Strike

Answer 15

knee flexors

Question 16

Abnormal Deceleration, Heel Strike

Answer 16

knee snaps out too hard at the end of the swing and the knee buckles with the heel strike

Question 17

Muscles involved with Swing Phase, Heel Strike

Answer 17

Foot Dorsiflexors

Question 18

Abnormal Swing Phase, Heel Strike

Answer 18

foot drop, steppage gait, foot slaps with heel strike

Question 19

Muscles involved with Toe Push-Off

Answer 19

Foot plantar flexors

Question 20

Abnormal Foot Plantar Flexors

Answer 20

short step on the affected side with poor push off

Question 21

Antaligic Gait

Answer 21

the patient favors one leg by putting as little weight as possible on it in order to reduce the pain on that side

Question 22

Choreic Gait

Answer 22

jerky twitching and dancing gait
Huntington Disease
Rheumatic Fever

Question 23

Deteriorating Tandem

Answer 23

worsening tandem walk while counting from 50 backwards is an early sign of Alzheimer’s disease

Question 24

Drunken Gait

Answer 24

this is the classic wide-based staggering gait seen in cerebellar disease

Question 25

Festinating Gait

Answer 25

shuffling (propulsion) gait with the tendency to accelerate as the patient leans forward seen in Parkinson's Disease

Question 26

Hemiplegia Gait

Answer 26

the spastic leg is extended and rotated internally the feet is inverted and plantar flexed and the limb is swung outward to keep the foot off the ground seen in Cerebra Vascular Accident

Question 27

Scissor Gait

Answer 27

stiff shuffling movement with the legs crossing over due to increased adductor tone seen in cerebral palsy or paraplegia

Question 28

Sensory Ataxic Gait

Answer 28

wide-based uneven gait with high steps and slapping of the feet on the ground seen in patients with dorsal column pathology as in tabes dorsalis, vitamin b12 deficiency or diabetes mellitus

Question 29

Steppage Gait

Answer 29

the patient has to excessively flex the hip and knee to allow the drop foot to clear the ground when walking seen with good drop (peripheral neuropathy)

Question 30

Waddling (lurching) Gait

Answer 30

The patient leans to the same side as the weight is being placed. This is due to either paralysis of the gluteus medium and minimum muscles and may be also seen in patients with hip replacements; aka Trendelenburg gait seen in Duchenne Muscular Dystrophy and Patients with Hip Replacements

Question 31

Musculoskeletal Exam

Answer 31

1) Explain the procedure to the patient 2) Obtain permission 3) Observe the patient's gait while walking to the exam table 4) Place the patient in the standing position and observe the spine for any abnormal curvature 5) Palpate the spine for tenderness, muscle spasm and segmental hypo mobility 6) Observe the active and passive ranges of motion of the cervical, thoracic and lumbar regions 7) Inspect and palpate the shoulder, elbow, wrist and finger joints 8) Examine the active and passive ranges of motion of the above joints 9) Inspect the hands for swelling of joints and atrophy of muscle groups 10) Inspect and palpate the hip, knee, and ankle joint 11) Examine the active and passive ranges of motion of the above joints 12) Inspect the feet for joint swelling and deformities 13) Record findings 14) Interpret finding in the light of the history

Question 32

Neck ROM Flexion

Answer 32

60

Question 33

Neck ROM Extension

Answer 33

70

Question 34

Neck ROM Lateral

Answer 34

45

Question 35

Neck ROM Rotation

Answer 35

80

Question 36

Thoracic ROM Flexion

Answer 36

50

Question 37

Thoracic ROM Extension

Answer 37

30

Question 38

Thoracic ROM Rotation

Answer 38

30

Question 39

Lumbar ROM Flexion

Answer 39

80

Question 40

Lumbar ROM Extension

Answer 40

35

Question 41

Lumbar ROM Lateral

Answer 41

25

Question 42

Shoulder ROM Flexion

Answer 42

180

Question 43

Shoulder ROM Extension

Answer 43

50

Question 44

Shoulder ROM Abduction

Answer 44

180

Question 45

Shoulder ROM Adduction

Answer 45

50

Question 46

Shoulder ROM Rotation

Answer 46

90

Question 47

Elbow ROM Flexion

Answer 47

140

Question 48

Elbow ROM Pronate / Supinate

Answer 48

90

Question 49

Wrist ROM Flexion

Answer 49

90

Question 50

Wrist ROM Extension

Answer 50

70

Question 51

Wrist ROM Abduction

Answer 51

20

Question 52

Wrist ROM Adduction

Answer 52

55

Question 53

MCP ROM Flexion

Answer 53

90

Question 54

MCP ROM Extension

Answer 54

10

Question 55

MCP ROM Abduction

Answer 55

20

Question 56

PIP ROM Flexion

Answer 56

90

Question 57

DIP ROM Flexion

Answer 57

60

Question 58

Hip ROM Flexion

Answer 58

120

Question 59

Hip ROM Extension

Answer 59

30

Question 60

Hip ROM Abduction

Answer 60

45

Question 61

Hip ROM Adduction

Answer 61

30

Question 62

Hip ROM Internal Rotation

Answer 62

40

Question 63

Hip ROM External Rotation

Answer 63

45

Question 64

Knee ROM Flexion

Answer 64

150

Question 65

Knee ROM Rotation

Answer 65

5

Question 66

Ankle ROM Plantar

Answer 66

40

Question 67

Ankle ROM Dorsiflexion

Answer 67

20

Question 68

Ankle ROM Inversion

Answer 68

30

Question 69

Ankle ROM Eversion

Answer 69

20

Question 70

1st MTP ROM Flexion

Answer 70

45

Question 71

1st MTP ROM Extension

Answer 71

70-90

Question 72

Stance Phase

Answer 72

heel strike: initial contact foot flat: loading response push off: mid-stance acceleration: terminal stance

Question 73

Swing Phase

Answer 73

toe-off: pre-swing swing through: initial then mid-swing heel strike: terminal swing

Question 74

heel strike

Answer 74

initial contact | stance phase

Question 75

foot flat

Answer 75

loading response | stance phase

Question 76

push off

Answer 76

mid-stance | stance phase

Question 77

acceleration

Answer 77

terminal stance | stance phase

Question 78

toe-off

Answer 78

pre-swing | swing phase

Question 79

swing through

Answer 79

initial then mid-swing | swing phase

Question 80

heel strike

Answer 80

terminal swing | swing phase