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Applied Kinesiology > Week 5 > Flashcards

Week 5 Flashcards

1
Q

Describe the angle of inclination of the hip and coxa valga/coxa vara

A

coxa valga - > 125 degrees

coxa vara - < 125 degrees

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2
Q

Describe the angle of torsion and list norms

A
  • Between axis through femoral head/neck and the distal femoral condyles
  • norm = 8-20 degrees
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3
Q

What is excessive anteversion and how might that impact an individual’s hip?

A
  • increased angle of torsion
  • reduces hip stability
  • increased hip IR and decreased ER
  • pigeon toeing
  • commonly found w/ coxa valga
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4
Q

What is retroversion of the hip and how might that impact an individual’s hip?

A
  • decreased angle of torsion
  • increased hip ER and decreased IR
  • may cause impingement
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5
Q

What is the center edge angle? List the norm and abnormal positions of center edge angle.

A
  • measurement of acetabular depth, amount of space covered from acetabula (roof)
  • norm = 25-35 degrees
  • > 45 degrees =coxa profunda
  • <16 degrees = dysplasia
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6
Q

What is Cam deformity as it relates to Femoral acetabular impingement (FAI)?

A
  • extra bone at anterior-superior region of femoral head and neck junction
  • loss of natural tapering of femoral head
  • impingement occurs of bulge of femoral head against acetabulum
  • IR w/ flexion maximizes impingement
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7
Q

What is Pincer deformity as it relates to Femoral acetabular impingement (FAI)?

A
  • Abnormal bony extension of anterior–lateral rim of acetabulum
  • Often associated with deep acetabulum or overly retroverted acetabulum
  • Flexion and IR causes premature abutment of femur against acetabulum
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8
Q

What is the position of maximal bone congruency for the hip?

A

articular congruence - flexion, abduction, slight ER

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9
Q

What are the ligaments of the hip?

A
  • iliofemoral ligament
  • pubofemoral ligament
  • ischiofemoral ligament
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10
Q

What is the function of the iliofemoral ligament?

A
  • anterior stability
  • limits IR and ER
  • tighten w/ extension
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11
Q

What is the function of the pubofemoral ligament?

A
  • limits ER in hip extension

- tighten w/ extension

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12
Q

What is the function of the ischiofemoral ligament?

A
  • primary restraint to IR

- tighten w/ extension

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13
Q

What is the function of the transverse acetabular ligament?

A
  • protect blood vessels that travel beneath it to get to the head of the femur
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14
Q

What is the function of the acetabular labrum?

A
  • deepens concavity

- seal to maintain negative intra-articular pressure

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15
Q

What is the function of the ligamentum teres?

A
  • conduit for blood supply to the femoral head
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16
Q

What are the osteokinematics of hip in OKC?

A
  • flexion/extension
  • abduction/adduction
  • ER/IR
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17
Q

What are arthrokinematics of hip flexion/extension in OKC?

A

Convex on concave

Flexion
- superior roll and inferior glide (anterior roll and posterior glide)

Extension
- Inferior roll and superior glide (posterior roll and anterior glide)

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18
Q

What are arthrokinematics of hip ab/adduction in OKC?

A

Convex on concave

Abduction
- Superior roll and inferior glide

Adduction
- Inferior roll and superior glide

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19
Q

What are arthrokinematics of hip IR/ER in OKC?

A

Convex on concave

IR
- medial roll and lateral glide

ER
- lateral roll and medial glide

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20
Q

What are osteokinematics of pelvis in CKC?

A
  • anterior/psoterior pelvic tilt
  • lateral tilt
  • Forward/backward rotation
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21
Q

Anterior and posterior tilting produces what motions at the hip?

A

anterior tilting - hip flexion

posterior tilting - hip extension

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22
Q

What are arthrokinematics of pelvis during anterior/posterior tilting in CKC?

A

concave on convex

Anterior tilting
- anterior roll and anterior slide

Posterior tilting
- Posterior roll and posterior slide

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23
Q

What are arthrokinematics of pelvis during abduction/adduction in CKC?

A

concave on convex

Abduction
- superior roll and superior slide

Addiction
- Inferior roll and inferior slide

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24
Q

What motion occurs at the left hip during right pelvic hiking?

A

hip abduction

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25
Q

What motion occurs at the left hip during right pelvic drop?

A

hip adduction

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26
Q

What are the arthrokinematics of forward/backward rotation of pelvis in CKC?

A

concave on convex

Forward
- anterior roll and anterior slide

Backward
- posterior roll and posterior slide

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27
Q

What motion occurs on the stance limb during forward/backward rotation?

A

Forward - IR of stance joint

Backward - ER of stance joint

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28
Q

Describe the closed pack, open pack and capsular pattern of the hip

A

closed pack - full extension w/ slight IR and abduction

open packed - moderate flexion, slight abduction, neutral rotation

capsular pattern - IR = flexion = abduction

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29
Q

If someone performs a straight leg raise (SLR) and they demonstrate excessive anterior tilt of the pelvis, what may this indicate?

A

weak abdominals due to force coupling

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30
Q

Describe the role of the adductor longus in sagittal plane motion.

A

during hip flexion - contributes to hip extension

during hip extension - contributes to hip flexion

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31
Q

Describe the force required of the hip abductors to maintain a stable pelvis in SL stance

A

Hip abductor force must work twice as hard to prevent pelvic from dropping due to gravity because hip abductor moment arm is 1/2 the length of joint reaction force

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32
Q

If a patient has R hip pathology resulting in weakness of the R hip abductors what side should we recommend the use of a cane to decrease joint forces in the R hip with single leg stance and why?

A

left side to increase the moment arm and offset the hip muscles that need to do twice as much work to resist gravity

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33
Q

How can we maximize stretching the hamstrings by cueing an individual to tilt the pelvis? What direction of pelvic tilt enhances a hamstring stretch?

A

anterior tilting of pelvis to stretch hamstrings

- can also add a slight lean forward with neutral back

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34
Q

What is considered to be normal genu valgum? Excessive genu valgum? Genu varum?

A

Normal - 170-175 degrees

Genu valgum - <165 degrees

Genu varum - >180 degrees

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35
Q

Which area of the knee receives greater compression forces with genu varum?

A

medial compartment compression

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36
Q

Which area of the knee receives greater compression forces with genu valgum?

A

lateral compartment compression

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37
Q

What factors lead to genu valgum?

A
  • previous injruy
  • genetic predisposition
  • high BMI
  • laxity of ligaments
  • abnormal alignment and muscle weakness at either end of lower extremity
38
Q

What knee ligaments have increased stress during genu valgum? What happens to the patella?

A
  • increased stress on MCL due to increased compression on lateral component
  • increased stress on ACL
  • excessive lateral tracking of the patella
39
Q

What factors lead to genu varum?

A

thinning articular cartilage on medial side

40
Q

What happens with genu varum?

A
  • increased medial compartment loading
  • greater loss of medial joint space
  • greater knee adduction movement
  • increased strain on LCL
  • increased medial joint loading
41
Q

What is genu recurvatum?

A

excessive hyperextension of the knee

42
Q

Define the Q-angle. What happens if the Q-angle is increased?

A
  • estimation of the line of pull of quadriceps
  • angle formed by line connecting ASIS to middle of patella and line connecting tibial tuberosity to middle of patella
  • increased Q-angle increases lateral force on the patella which makes patella prone for dislocations
43
Q

What is the normal Q-angle range?

A

13-15 degrees

44
Q

Describe the factors that naturally oppose the lateral pull of the Patella.

A

Local Factors

  • patella alta - raised lateral facet of trochlear groove
  • VMO
  • medial patella retinacular fibers

Global factors

  • excessive genu valgum
  • compensated Trendelenburg sign
  • everison of subtalar joint
  • ER of knee
  • IR of knee while walking
45
Q

What are the functions of the meniscus?

A
  • distribute weight bearing forces
  • increase joint congruence
  • shock absorption
46
Q

What structures have connections to the medial meniscus?

A

MCl
ACL
PCL
semimembranosus

47
Q

What structures have connections to the lateral meniscus?

A

ACL
PCL
popliteus

48
Q

What is the primary function of the ACL?

A

primary restraint to anterior translation of tibia on femur

49
Q

What is the primary function of the PCL?

A

Primary restraint to posterior translation of tibia on femur

50
Q

What is the primary function of the MCL?

A

Primary restraint to valgus force and lateral tibial rotation

51
Q

What is the primary function of the LCL

A

Primary restraint to varus stresses

52
Q

What assists ACL in resisting anterior translation of the tibia on femur?

A

iliotibial tract

53
Q

What are 3 factors associated with non-contact injuries?

A
  • strong activation of quad over moderately flexed or nearly extended knee
  • valgus collapse of knee
  • excessive ER of knee
54
Q

What are the osteokinematics of the knee?

A
  • flexion/extension
  • IR/ER
  • Ab/Adduction
55
Q

What are arthokinematics of flexion of the knee in OKC and CKC?

A

OKC - concave tibia on convex femur - posterior roll and glide

CKC - convex femur on concave tibia - posterior roll and anterior glide

56
Q

What are arthrokinematics of extension of the knee in OKC and CKC?

A

OKC - concave tibia on convex femur - anterior roll and glide

CKC - convex femur on concave tibia - anterior roll and posterior glide

57
Q

What are arthrokinematics of knee IR/ER?

A

not defined

58
Q

What are arthrokinematics of knee Ab/Adduction?

A

not defined

59
Q

Describe the screw home mechanism.

A
  • 10 degrees of ER with terminal extension needed clear medial femur
  • to unlock the knee, knee must IR to clear medial condyle
60
Q

Describe the closed pack, open pack and capsular pattern of the knee.

A

closed pack - full extension

open packed - 25 degrees off flexion

capsular pattern - flexion > extension

61
Q

What position of the knee puts the patella at greatest risk for dislocation and why?

A

full knee extension - patella has least congruency with joint

62
Q

Describe the external torque demands of the quad with a leg extension vs a squat from 0-90 degrees.

A

OKC - greatest torque with leg extension is between 45-0 degrees of extension - external moment arm is longer as leg moves into 0 degrees of extension

CKC - greatest torque with squat is between 45-90 degrees of knee flexion - external moment arm is longer the more flexed the knee is/deeper the squat

63
Q

Compare and contrast safe vs unsafe landing patterns

A

Unsafe

  • larger knee EMA
  • smaller hip EMA
  • stiff landing

Safe

  • small knee EMA
  • Large hip EMA
  • increased hamstring to quad contraction pattern
64
Q

Describe the functions of the foot and ankle.

A
  • foot able to sustain large weight-bearing stresses
  • stable foot to provide appropriate BOS
  • foot is a rigid lever for pushing off
  • foot must be mobile enough to accommodate and adapt to uneven terrain and absorb shock when foot hits the ground
65
Q

List the joints of the ankle/foot complex.

A
  • proximal/distal tibiofibular joints
  • talocrural joint
  • talocalcaneal joint
  • transverse tarsal joint (talonavicular and calcaneocuboid joint)
  • tarsometatarsal
  • metatarsophalangeal joints
  • interphalengeal joints
66
Q

What bones make up the hindfoot?

A

talus and calcaneus

67
Q

What bones make up the midfoot?

A
  • navicular
  • cuboid
  • 3 cuneiform bones
68
Q

What bones make up the forefoot?

A

metatarsals and phalanges

69
Q

What is the closed packed position of the proximal and distal tibiofibular joints?

A

weight bearing dorsiflexion

70
Q

List the component OKC ankle motions associated with pronation. List the component ankle motions associated with supination.

A

Pronation - Pros do ABs Every Day

  • Abduction
  • Eversion
  • Dorsiflexion

Supination - Sadly Injury ADDs Pain

  • Inversion
  • Adduction
  • Plantarflexion
71
Q

List the component CKC ankle motions associated with pronation. List the component ankle motions associated with supination.

A

Pronation

  • Eversion
  • Adduction
  • Plantarflexion

Supination

  • Inversion
  • Abduction
  • Dorsiflexion
72
Q

Describe the functions of the medial collateral (deltoid) ligament and the lateral collateral ligament.

A

MCL (deltoid) - limit eversion/pronation

LCL - limit inversion/supination

73
Q

What is the main motion at the Talocrural joint?

A

plantar and dorsiflexion

74
Q

What are arthrokinematics of dorsi and plantarflexion?

A

convex on concave

Dorsiflexion - anterior roll, posterior slide

Plantarflexion - posterior roll, anterior slide

75
Q

Describe the closed pack, open pack and capsular pattern of the Talocrural joint.

A

closed pack - weight-bearing dorsiflexion

open packed - 10 degrees of plantarflexion w/ neutral inversion/eversion

capsular pattern - plantarflexion > dorsiflexion

76
Q

What are the main motions at the subtalar joint?

A

inversion/eversion and abduction/adduction

77
Q

Describe what occurs with supination and pronation in non-weight bearing position and weight bearing posting during CKC.

A

weight bearing

  • supination (medial longitudinal arch is higher) - calcaneus inverts, talus abducts and dorsiflexes
  • Pronation (medial longitudinal arch is lower) - calcaneus everts, talus adducts and plantarflexes

Non-weight bearing

  • supination - calcaneus inverts, adducts, and plantarflexes
  • pronation - calcaneus everts, abducts, and dorsiflexes
78
Q

Describe the closed pack and open pack of the subtalar joint.

A

closed pack - full inversion

open pack - mid inversion/eversion and mid plantar/dorsiflexion

79
Q

What joints make up the transverse tarsal joint? What function does it serve?

A

talonavicular and calcaneocuboid

  • link between hindfoot and forefoot
  • add supination/pronation ROM of subtalar joint in OKC
  • compensate at forefoot for hindfoot position in CKC
80
Q

Describe the closed pack, open pack and capsular pattern of the transverse tarsal joint.

A

closed pack - supination

open pack - mid range of supination/pronation

capsular pattern - limitations in dorsiflexion, plantarflexion, adduction and IR

81
Q

What is the function of the tarsometatarsal joints?

A

regulate position of the forefoot in relation to the weight-bearing surface

82
Q

Describe what happens with the supination twist.

A
  • Substantial weight-bearing pronation of the hindfoot results in supination of the transverse tarsal joint to counter rotate the forefoot
  • If this supination is not sufficient the entire forefoot will also supinate
83
Q

Describe what happens with the pronation twist.

A
  • Full subtalar supination results in supination at the transverse tarsal joint as well
  • At this point, the forefoot must pronate in order to maintain contact with the ground
84
Q

Describe the 2 deformities outlined that may occur at the 1st MTP joint.

A

Hallux limitus (turf toe)

  • gradual and significant limitation of motion, articular degeneration and pain
  • unable to flex through big toe

Hallux valgus (bunion)

  • Progressive lateral deviation of great toe
  • can lead to lateral dislocation
85
Q

What is the one of the main functions of the plantar fascia?

A
  • support medial longitudinal arch in weight bearing
86
Q

Describe the windlass effect.

A
  • plantarflexion lifts calcaneus
  • body weight transferred over metatarsal heads
  • causes extension of metatarsophalangeal joints
  • stretches (winds up) plantar fascia
  • strengthens midfoot
87
Q

Define pes planus. What effect does this foot posture have on the the overall function of the foot?

A
  • abnormally dropped medial longitudinal arch (flat foot)
  • compromises ability to support and dissipate loads
  • tibialis posterior is having to work harder to maintain the arch which can lead to injury
88
Q

What is the navicular drop test? What does it assess?

A
  • Measurement of distance between navicular tuberosity and ground in subtalar joint neutral and with relaxed foot posture
  • assess if medial longitudinal arch is at a sufficient height, 7 mm is normal
89
Q

What role does the posterior tibialis muscle play in stance phase of ambulation?

A
  • decelerates (eccentrically) pronating rearfoot in loading response
90
Q

What is pes cavus?

A

increased medial longitudinal arch

Applied Kinesiology (7 decks)

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