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39 Cards in this Set
- Front
- Back
What are the three joints located in the hips?
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- Sacroiliac
- Symphysis pubis - acetabulo - femoral |
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What type of joint is the acetabular joint? What are the ligaments that hold it together?
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- Ball and socket joint
- Held by pubofemoral, ischiofemorla and iliofemoral ligaments |
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What is the hips axis of motion?
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Polyaxial in all directions including circumduction
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What is the normal hip ROM?
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Add 20, Abd 40, Flexion 120, Extension 20, Med/lat rotation 45
(varies between individuals) |
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What do hamstrings do in hip flexion?
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- Hamstrings should allow 70 degrees for hip flexion
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What is the position of the hip?
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- The hips rotates roughly 4 degrees med and lat
- The hip list in FP roughly 5 degrees either way - Hips maybe int or ext rotated due to muscular or osseous factors. |
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How do we diffrentiate muscular and osseous muscle tightness?
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- Test ext and flex position.
- If flex limited, posterior muscles are tight and vice versa - If ext rotation is limited, int rotators are tight and vice versa - If both positions show restricted motion, osseous involvement indicated. |
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What 2 joints does the knee compromise of?
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tibio femorla and patello femoral
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What are the strong ligamentous support at the knee?
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ACL, PCL, Medial collateral ligament, Lateral collateral ligament
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Where does the ACL run, and what role does it have?
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Location - runs post and sup from ant aspect of tibial plateau to posterolateral aspect of intercondylar notch
Role - prevents tibia moving forward on femur and controls rotational motion |
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Where does the ACL run, and what role does it have?
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Location: runs ant and sup from posterior aspect of the tibial plateau to med aspect of the intercondylar notch
Role - prevents the femur from sliding forward on the tibia |
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What role does the medial collateral ligament have? and where does it run?
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Role - Provides medial stability
Location - Originates from med condyle of femur to anteromedial aspect of tibia and med meniscu |
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What stress causes injury to the medial collateral ligament?
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Valgus stress
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What role does the lateral collateral ligament play? and where does it run?
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Role - provides lateral stability
Location - originates from lateral border of femur to head of fibula (cord like) |
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What stress causes injury to the lateral collateral ligament?
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Varus stress
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What role does the med and lat menisci play? and where are they located?
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Role - absorb forces, protect cartilage and aid in stabilisation, lubrication and nutrition of the knee
Located - Intra articular attatchments to tibial plateau |
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What is the patellofemoral joint? What role does it play?
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It is the sesamoid within the quad tendon inserting into the tibial tubercle, and is stabilised by the med and lat patella retinacula
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What are the motions at the knee?
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- Flexion and extension in SP
- Some motion in TP due to condyles and meniscal anatomy - FP motion is pathological |
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What is the range of motion of the knee?
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0 degrees extension
140 degrees flexion |
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What is TP motion in the knee neccessary for?
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In order to 'screw home' the knee in ext, caused by medial rotation of the femur into the larger medial condyle, stabilising the knee and tightening the collaterals
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What does popliteus do?
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Externally rotates the knee on flexion to unlock it
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Describe the knee in gait...
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- Flexes from ext position at heel strike to absorb shock
- Extends from Ffoot loading to lift body and allow swing of opposite leg - Flexes after heel lift to inc propulsion power - Remains flexed in swing for ground clearance, before extension at heel strike |
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What did Blake et al (1979) find in regards to knee pathologies?
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46% of a group of 1500 runners had exp knee pain, many due to acute traumatic events
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What are chronic conditions generally termed?
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Idiopathic, but however may be foot related.
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What is patello-femoral syndrome?
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It is related to subluxation of the patella from its tract, generally at 10-20 degrees of flexion. Leads to cartilage erosion and arthritic changes
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What factors that lead to PFS?
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- Large Q angle (ASIS to patella bisection and patella bisection to tibial tubercle)
- Varus allignment - VMO weakness - Foot pronation |
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What was Tiberio (1987) pusblished theory?
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That excess foot pronation increases medial tibial rotation when the leg should be ext rotated, which leads to femoral int rotation and lat tracking of patella
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What is the ilio-tibial band? and how many people suffer from ilio-tibial band syndrome?
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Ilio-tibial band runs from upper thigh to insert into the lat tibial tubercle. It passes over the lateral femoral condyle with ext and flex, 16% of runners.
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What did Messier (1995) find?
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Found that feet with less pronation more common in ITB syndrome symptom group compared to control group
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What did 3 studies on ACL find?
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3 studies compared ACL to control group found that a measure of pronation was greater for ACL group compared to control group
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What is the theory of pronated feet and ACL straining?
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That foot pronation may allow increase knee flexion, allowing the tibia to slide forward on femur, straining ACL
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What does the 'anterior drawer test' test?
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It assesses the ACL and more specifically the PCL.
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What does the 'lachmen test' test?
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Assesses the ACL for injuries
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What does the 'pivot shift test' test?
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Can help detect ACL injuries
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What force generally injures the menisci?
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Rotational (torsion) forces - asssociated with a 'pop' sound when injured
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What is the McMurray's test? and when should it NOT be used?
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It is used to test to test injury of the Menisci, and is not to be done on an acute painful knee
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How should lower back pain be approached?
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- Through a multidisciplinary approach
- Podiatry can help with identifying and compensating for LLD, orthoses can absorb shock. |
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How does a cavus foot lead to lower back pain?
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- Cavus foot with rigid attitute may transfer GRF to lower back rather than absorbing more distally - which exacerbates injury or increase predopisition
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What else can orthoses correct in terms of lower back?
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Sagittal plane blockade (increase forward lean, increase erector spinae contracture, increase pain)
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