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114 Cards in this Set
- Front
- Back
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What is the normal ankle joint motion during gait
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The ankle is slightly dorsiflexed at heel contact, plantarflexes t oachieve ground contact, dorsiflexes as the tibia moves over the foot, plantarflexes during propulsion and dorsiflexes durign swing phase
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What is ankle equinus?
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Ankle equine is a saggital plan deformity in which there is less than 10 degrees of available dorsiflexion a the ankle joint when the STJ is in neutral postion and the midarsal joint oblique axis is locked. Ankle equinus may be osseous or muscular.
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What are the cause of ankle equinus
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Osseus morphology of articular surface
muscular: - spastic paralysis, tonic spasm, weak dorsiflexors, tight hamstrings, prolonged bed rest |
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describe the compensated equinus foot
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The compensatded equinus foot has excessive subtalar joint pronation to achieve dorsifexion, unlocking of hte midarsal jmoint with midfoot collapse. It is associated with pronation induced pathologies and is very destructive.
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What happens in uncompensated equinus foot type
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The heel cannot touch the ground resulting in a bouncy gaint. THere is exessive weight vearing on the forefoot leading to forefoot plant callosities and clawing of the lesser digits, secondary hamstring contracture, supinator muscle contracture and proximal compensations such as genu recurvatum, abducte dor adducted angle of gait, excessive knee flexion and hip flexion
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What is the treatment for ankle equinus
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Heel lift to reduce strain; orhoses ot control exessive pronation
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Where is the subtalar joint axis
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16 degrees from the sagittal palne. 42 degrees fro mthe transverse plane.
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What happens if the subatlar joint has a more vertical axis?
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There is more transverse plane motion.
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What happens if the subtalar joint has a more horizontal axis
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There is more frontal plane motion
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Describe the liongitudinal axis and oblique axis of the midtarsall joint
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The longtudinal axis is 15 degrees frmo the tranasverse plane and 9 degrees fro mthe sagittal plane. The oblique axis is 52 degrees fro the transverse plane and 57 degrees from the saggital plane
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What happens when the oblique axis of the midtarsal joint is high
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Whe the oblique axis of the midtarsal join is high, there will be large degrees of forefoot abduction with compensatory STJ and oblique axis MTJ pronation
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What happens when the oblique axis of the midtarsal joint is high?
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When the oblique axis of the midtarsal joint is high, there will be large degrees of forefoot abduction with compensatory STJ and oblique axis MTJ pronation.
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What happens when the oblique axis of themidtarsal joint is low?
*** Describe the axis of he motion of the nakle joint |
*** There will be small degrees of forefoot adduction with compensatory STJ and oblique axi s MTJ pronation
***The axis roufhly aligns the tips of the malleoli apporoimately 8 degres to the trranverse plane. The motin is mainly dorsiflexion with small amounts of abduction adn plantarflexion with smal amounts of adduction |
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What happens in the uncompensated forefoot varus foot type?
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There is no pronation available at the at the STJ, therefore the forefoot is held in the inverted position through the gait cycle. The foot exhibits excessive lateral contact throught stance phase, with very late stance phase weightbearing on the IPJ of the hallux as the limb moves forward. Hyperkeratosis may be present on the 5th MPJ and IPJ of the hallux. There may be excessive lateral shoe wear.
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What is forefoot supinatus?
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Forefoot supinatus is a triplanar, acquired soft tissue contracture of the forefoot in a supinated position around the longitudinal axis fo the midtarsal joint cause bby heel valgus. Teh heel valgus with subtalar joint pronation causes a copmensatory supination around the longitudinal axis of eh midtarsal joint.
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What is the cause of forefoot supinatus?
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over time, the soft tissues will adapt to this position and the forefoot wil appear inverted when palced in the subtalar join neutral position. THe peroneus longus streteches and elongates. The tibialsis anterior shortens and contracts.
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What are Newtons' 3 law?
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The law of inertia
F=ma action, reaction |
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What happens to the tibia when the foot supinates?
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0.44 degrees of outward rotation of the tibia occur for every degee of supination of the foot. This indicates that hte joints act together as a universal joint
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When is adult gait pattern attained?
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Between the ages of 7 and 9
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What type of rotation occurs during gait
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Rotation in the transverse plan about a vertical axis occcurs in the entire limb. The ammount of rotation increases from the proximal to the distal segments. THe rotation is internal during swing phase and the first 15 per cent of stance phase. Normally, during walking on level ground, the pelvis rotates and average of 8 degreees the femur 15 degrees, and the tibi 19 degrees.
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When does external rotation occur during gait?
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Rotation in the transverse plane about a vertical axis occurs in the entire limb. The amount of rotation increases from the proximal to the distal segments. The roatation is internal during swing pahse and the first 15 per cent of stance phase. Normally, during walking on level ground, the pelvis rotates an average of degrees, the femur 15 degrees and the tibia 19 degrees
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When does external rotation occur during the gait cycle?
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From after 15% of stance phase until just after toe off
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Dexcribe the trochlea of the talus
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The trochlea of the talus is an averafe of 2.4 m wider anteriorly than posteriorly. The trochlea is a protion of a c cone Teh base of the cone is toward the fibula with a longer radius laterally than medially; resulting in a larger anteropsterior displacement of the fiublar than of the tibial malleolous when the foot is fixed on the floor and the leg moves over it.
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Describe the axis of the ankle joint
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The axis of rotation of the ankle joint runs between the distal lips of hte malleoli and is directed laterally and posteriorly when projected in trhe transverse plane. THer eis 20-30 degrees of external rotation in relation ot the knee axis. The axis runs laterally and downward when projected on a coreonal plane (average of 80 degree to the long axis of the tibi)
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Describe the motion of the ankle during gait
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The motion of the ankle during gait is plantarflexion occurs fro mheel strke through the first 10 per cent of the cycle; then dorsiflexion occurs from heel off to 40 percent of the cycle, at which time plnatar flexion again occurs during the swing phase the ankle iks normally in dorsiflexion.
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What is the metarasophalngeal break?
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The metatarsophalngeal break refers to the oblique axis throught he second ot fifth metatrsophalangeal joints THe nagle between the break nad the long axis of the foot varies from 54 to 73 degrees. During push-off the hindfoot and midfoot are angle outward as the heel is inverted. THe metarsal break distributes weight on all of the metarsal heads rather than o nthe longest only.
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When druing gait do the anterior compartment muscles act and what is their functoin?
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The anterior compartment muscles act primarily during the swing and early stance phas of gaitn and this action enable the foot to clear the ground during swing phase and then allows it to be placed gently on the ground after heel strike.
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When durign gait do the calf muscles act and what is their function?
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The posterior or calf muscle act from mdstance to toe-off. They aid the foot in propulsion.
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What happens to the subtalar joint during gait?
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The subtalar joint quickly everts 10 degrees with in the first 8% of stance phas eof gait. Once the forefoot contacts the floor. ther is a slow reversal of motion, with inversion occurring as the heel rises during terminal stance
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What muscle has the greatest inversion torque on the subtalar joint?
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The tibialis posterior has an 88% mechanical advantage over the tibialis anterior deu to its larger cross section and greater lever arm. Although the tibialis posterior muscle has hte longest inversion lever to the subtalar joint aix , the five times greater mass of the soleus mucle overcomes it shorter lever arm resulting in an inversion torque twice that of the tibialis posterior.
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How muc subtalr jont rotation occurs during gait?
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6 degrees in normal feet and 12 degrees in flatfeet.
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What is the function of the intrinsic muscles of the foot
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The intrinsic muscles function to help elevate the longitudinal arch of the foot and inverthe the calcaneal and act in conjunction with tplantar aponeurosis and gasrocsoleus muscle to carry out thse functions
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Wwhere does the gastrosoleus muscle insert in relatio to the subtalar joint axis?
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medial to the subtalar joint axis.
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How much motion is present aqt the metarsophalangeal joint in the normal foot.?
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90 degrees of extensio and 30 degrees of flexion
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What is flexor stabilization?
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Flexor stabilization occurs during the stance phase of gait. The interossei muscles are overpowered by the lexor digitorum longus. The pul fo the FDL is altered i the pronaory direction causing an increased pull on the distal phalanx of toes two throug five resulting hammer digits..
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Whta is exxtensor subvstiution?
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Extensor substitution occurs when the long extensor muscles overpower the lumbricales. The lumbricales act to stabilize hte digits during swing phae and coutneract the extensor digitorum longuis pull Whe the lumbricales are weakened a high arche dfoot develops with hammer toes.
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What is the function of the intrinsic muscles of the foot
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The intrinsic muscles function to help elevate the longitudinal arch of the foot and inverthe the calcaneal and act in conjunction with tplantar aponeurosis and gasrocsoleus muscle to carry out thse functions
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Wwhere does the gastrosoleus muscle insert in relatio to the subtalar joint axis?
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medial to the subtalar joint axis.
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How much motion is present aqt the metarsophalangeal joint in the normal foot.?
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90 degrees of extensio and 30 degrees of flexion
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What is flexor stabilization?
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Flexor stabilization occurs during the stance phase of gait. The interossei muscles are overpowered by the lexor digitorum longus. The pul fo the FDL is altered i the pronaory direction causing an increased pull on the distal phalanx of toes two throug five resulting hammer digits..
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Whta is exxtensor subvstiution?
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Extensor substitution occurs when the long extensor muscles overpower the lumbricales. The lumbricales act to stabilize hte digits during swing phae and coutneract the extensor digitorum longuis pull Whe the lumbricales are weakened a high arche dfoot develops with hammer toes.
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What is the function of the intrinsic muscles of the foot
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The intrinsic muscles function to help elevate the longitudinal arch of the foot and inverthe the calcaneal and act in conjunction with tplantar aponeurosis and gasrocsoleus muscle to carry out thse functions
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Wwhere does the gastrosoleus muscle insert in relatio to the subtalar joint axis?
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medial to the subtalar joint axis.
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How much motion is present aqt the metarsophalangeal joint in the normal foot.?
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90 degrees of extensio and 30 degrees of flexion
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What is flexor stabilization?
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Flexor stabilization occurs during the stance phase of gait. The interossei muscles are overpowered by the lexor digitorum longus. The pul fo the FDL is altered i the pronaory direction causing an increased pull on the distal phalanx of toes two throug five resulting hammer digits..
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Whta is exxtensor subvstiution?
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Extensor substitution occurs when the long extensor muscles overpower the lumbricales. The lumbricales act to stabilize hte digits during swing phae and coutneract the extensor digitorum longuis pull Whe the lumbricales are weakened a high arche dfoot develops with hammer toes.
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What is position of the subtalr joint durign running?
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The subtalar joint is pronated during the entire running cycle
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What is the ground reaction force during running?
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Depending on the runner's weight the ground reaction force is between three to eight times the body weight during running
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When would the moment arm and the lever arm be the same?
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When the lever arm is perpendicular ot the action line of hte muscle.
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The action of a force applied to an object., which tends to rotate the object about an axis known as?
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moment
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How many degrees of freedom would a rigid body moving tghrough space without any restraints conain?
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6 degrees of freedom
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Whyat type of material requires ver little stress to produce a sgnificant amount of strain?
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a material which is elastic
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What type of material requires a sizable amount of stress to produce a small amount of strain?
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a material which is rigid
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How is the stiffness of a given material represented on the stress strain curve
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The slope of the curve in the elastic region
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When a bone is subjected to three-point bending, whre is the first palce that fracure will occur
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the tensile side
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What happens when a ligament is loade at a relatively high rate of loading?
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When a ligament is loaded at a relatively fast rate of loading, ligamentous failure occcurs.
When a ligament is loaded at a realively slow rate of loading the ligament will avulse off the bone. This is tru for tendeos as well |
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What is an anisotropic substance?
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An anisotroic substance has a grain, i.e. wood, bone, tendon and therfore will demonstrate different properties depending upon the direction in which it is loaded. Metal has no grain and is an example of an isotropic substance and will demonstrate the same properties no matter which direction in which it si loaded.
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When standing up right in th eantomic postion, wher edoes the cent of gravity pass with respect ot the hips, knees, and ankle.
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The center of gravity passes posterior ot he hips, anterior to the knee and anterior o the ankle.
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What is the coefficient of friction for joints in the human body?
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The coefficient of friction for joints in the human body is about .005
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When do most ligament fail?
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6-8% elongation
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How does the ligamentum flavum differ from the other ligaments in the body?
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It has a higher percentage of elastin. THis results in great elasticity with virtually no pastic deformation. THerefore the ligamentum flavum ahs the mechanical properties of being both highly elastic and brittle. The human aorta has a very high content of elastin
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What does friction depend upon and what is friction completely independent of?
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Friction is dependent upon types of surfaces in contact and the coefficient of friction. Friction is nearly independent of surface area velocity
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Why is it NOT possible to fully flex the wrist and make a fist?
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It is not possibe to fully flex the wrist and make a fist at he smae tiem because of active insuffiency. Active insufficiency occurs in 2-joint muscles and is cause by the inability of a 2-joint muscle to fully contract over both joints.
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What is the funciton aimportna e of ankle dorsiflexion
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about 10 degrees of dorsifion is required for normal gian. dorsiflexion is necessar to enable gorund clearnce
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Why is ankle planarfelxionimprtnt
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genartes power for propulsion
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what is the normal range of passive ankel dorsifexion and plantarflexion
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dorflxion 20 degreees
plantarfexion 50 degrees |
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What is themtion of the longitudinal axis fo the mditarsal joint?
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the motin is pronation supination, predominatly nt he rforntal plane
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What is the motion of the oblique axis of the midarsal joint?
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the motion is pronation / supiantion predominatly inthe sagittal and transverse plane
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How does the motion of the longitudinal axis of the idarsal joitn compare to the motion of the subtalr jont
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the motions of the loangtudinal axis fo the midarsal joint and subtalar joint are oopposites in other words when the stj pronates the long axi sof the mtj supnades and vice versa. su[pination fo the long axi fo the mtj will unlocckth mditarsaljont
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What mucle will caue supination th ehtlong axis of the MTJ
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the tibilais anterior will cause supinto f the long asxi fo themtj
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what muscle will causew pronation f the oblique axis f the mtj
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the peroneus longs will caue pronation fo the oblque axi fo themtj. grond reactifv force will asl caue proantion the obliqu axi fo theMTJ
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how does the subtalar joint influence the midtarsal joint?
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subtalar joint pronation increaes the range of motion aavailabe at he MTJ, which make the foot flexible. Subtalar jointsupinationdecreaess the range of motin availabe at he mTJ which make hte foot rigid
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what does recent research revedal about themidarsal jont?
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it is 2 separate joints
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What does the first ray const of ? whre is its axis?
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the first ray consists of a functionusint oar articulations betweent ht e1st met and medial cuneiform. the axis of the 1st ray is 45 degrees to the frontal nad sagittal planes
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whatare the motins of the 1st ray?
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the motion is dorsiflexin wiht inverison and palntarfelxion with eversion
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What are the major muscles of he first ray?
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the major muscles actin on the first ray are the tibialsi anterioand the peroneus ongus
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What are hte mtions of the first ray during gait
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the first ray dorseflexes wehn the foot pronaes and platarflexes durign proulsiton to enable normal MPJ dorsifexion. The first ray should be paralle t o the plane of he lesser rays. there shoudl be equal amounts of dorsifelxionand plantarflexion
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What can produce a plantarflexed 1st ray?
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weak gastcnemius
hypertoncity fo of peroenus longus weak tibialsi anteri, cavus foot type |
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Describe the subtalar joint
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the subtlar joint is formed by the posterio talcalacaneal joint and theacetabulum pedis lodign the talr head. the basic motion at the joint is that of supinatin( plantarfexion, adduction, inversionj) or proantion (dorsiflxion, abduction, everison) the subtalar joint moiton is guided by ther intrinsic ligaments, theinterosseous talocalcaneal ligament of hte tarsal canl nd the cervical ligmaent. Further support is provided by the extrinsic legaments: the cacaneofiublar ligament and the tibiocaclcanela fascicle fo he deltoid ligemnt.
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what is meant by acetabulum pedis
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the acetabulu mpedis formed by thre calcaneal mdidle and anteriro surfaces conncect tot he naviuclar articualr surface by the inferio and superomedial calcaneonaviuclar ligaments. Teh acetabulum pedis ahs a variable vlume capacity adaptint ot he positon of ht talar heaed
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what is the passive rangeo fmtionm fo the stj
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avareage range ofmotionis about 20 to 30 degrrees ofinverion and about 5 to 10 degrees of evefrsion. HOwever ranges of stj form 10 to 65 degres have been seen
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describe the hypermobile 1st ray
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the ypermobile 1st ray has a high arch non-weatbearng, with the arhc flattening out on weightbearng. hyperkeratoses are likely to be present under the 2nd met head. the ypermobile plantarflexed 1st ray has been associated with juvenile HAV, morton's neuroma, lesser toe deformiteis, plantar fasiitis, and 1st me tcuneiform exostosis
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describe the rigid planatarflexd 1st ray
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the rigid palntgarfexed qst ray is high arched off weight bearing and on weightberaing. the heel will be in tghe varus position when standing. callosities will be present under the 1st and 5th met heads and udner the latgeral heel. the rigid plantarflexed 1st ray wi sassociated with seamoidietis, chronic inversion ankle sprains, tibial stress fractue, medial knee pain, and lower back pian
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what is the cause of dorsivlexed 1st ray
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a dorsiflexed 1st ray also called metarsus primus elevatus, my be condgital r acquired. it may be caued by hypertonciity fo the tibialis anero muscle or weaknes of he peroneus long us mucle.
a dorsiflexed 1st ray may be associated with forefoot supinatus, dorsal jamming of the 1st mpj and commonly associated with haallux liimtius and rigidus |
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What is a flexible forefoot valgus deformity
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a flexibl forefoot balgus is one in which the MTJ has suffeicnt ROM to compensate fo the everted forefoot
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What is a flexible forefoot valgus deformity
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a flexibl forefoot balgus is one in which the MTJ has suffeicnt ROM to compensate fo the everted forefoot
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What is a rirdi forefoot valugs
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a rigid forefoot balgus is one in whic thre is inadequtate MTJ ROM to comepsnate sot he STJ msut supinate to bring the foefoot heo the gorund. the patomeacnics ar that the forefot is everat at tforefoot lading, te long axis of the mtj supinates and the stj supinates
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What is a rirdi forefoot valugs
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a rigid forefoot balgus is one in whic thre is inadequtate MTJ ROM to comepsnate sot he STJ msut supinate to bring the foefoot heo the gorund. the patomeacnics ar that the forefot is everat at tforefoot lading, te long axis of the mtj supinates and the stj supinates
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what happens ot the foot witha rigid forefoot valgus
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the foot is high archednoneweighbeairng and wight bearing the heel is inverted when statnding. there is restricted mitonfo the mtj and contractred lesser digits. ther are calussesunder the 1st and mth emtatrsal head and the alteral heel
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what happens ot the foot witha rigid forefoot valgus
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the foot is high archednoneweighbeairng and wight bearing the heel is inverted when statnding. there is restricted mitonfo the mtj and contractred lesser digits. ther are calussesunder the 1st and mth emtatrsal head and the alteral heel
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What is the rigid forfoot valgus foot tpe associated with
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the irgid forefoot vagus deformity s associated withsseamoiditis, chronci inversion andkle sprains, tibial stres fracture andn medialknee pain and low back pain
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What is the rigid forfoot valgus foot tpe associated with
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the irgid forefoot vagus deformity s associated withsseamoiditis, chronci inversion andkle sprains, tibial stres fracture andn medialknee pain and low back pain
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what is blount's deiseasw
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a lateral slippage of the proximal tibial epphyiss
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what is blount's deiseasw
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a lateral slippage of the proximal tibial epphyiss
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What ht eh patomechancis ofrefoot varus according to root biomechnaics
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the entire foot is in na inverted position. the is increased gorund reaction force lateral to the stj at jforefoot loading the stj pronates until the ofroefoot contacts the cgorudn of thestj franof motionis exhauseted
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What ht eh patomechancis ofrefoot varus according to root biomechnaics
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the entire foot is in na inverted position. the is increased gorund reaction force lateral to the stj at jforefoot loading the stj pronates until the ofroefoot contacts the cgorudn of thestj franof motionis exhauseted
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what is fullly compensated rearfot varus accodrding to rot biomechanics
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in a fully compensted refoot varus the is sfficient stj ROM to bring the medial broder ofhte forefoot the gourdn. Ther eis a very rapdid contact phaso fo pronation pronatiojn extennds uhtli lheel lift . the forefoot wil b ehyeprmobile and the is ovruse of hte supinato muscualtture
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what is fullly compensated rearfot varus accodrding to rot biomechanics
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in a fully compensted refoot varus the is sfficient stj ROM to bring the medial broder ofhte forefoot the gourdn. Ther eis a very rapdid contact phaso fo pronation pronatiojn extennds uhtli lheel lift . the forefoot wil b ehyeprmobile and the is ovruse of hte supinato muscualtture
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What are signs and symptosm fo refoot biomchechanics?
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mediu march hetng nonweaghtbearing with slight owering of hte archon wiehgbearing; excessive alteral shoe wear, haglund's deformity, tneinitis fo the tibialsi anterior, tibialsi pesterio and tlong flexors; all porantion induce patholigies
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What are signs and symptosm fo refoot biomchechanics?
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mediu march hetng nonweaghtbearing with slight owering of hte archon wiehgbearing; excessive alteral shoe wear, haglund's deformity, tneinitis fo the tibialsi anterior, tibialsi pesterio and tlong flexors; all porantion induce patholigies
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what happpens i n unocompensated reafoot varus according to root biomchangics
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the foot strikes the gorund in an inverted psosiotn, (as id does normally) bu thtre will be inadequte shock absourption form the stj, ther ewill be lateral instability. and cquire dplantrfelxed 11st ray may develop
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what happpens i n unocompensated reafoot varus according to root biomchangics
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the foot strikes the gorund in an inverted psosiotn, (as id does normally) bu thtre will be inadequte shock absourption form the stj, ther ewill be lateral instability. and cquire dplantrfelxed 11st ray may develop
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discuss orthot ic mangae of refoot varus deformity.
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the puropos eof orthotic mangaement ofr refoot defomrity is to eleimante STj compensation and bring th egroudn oup to the foot. THis may accomplised witha modified root orthosis oar blake inverted orhtosis
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discuss orthot ic mangae of refoot varus deformity.
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the puropos eof orthotic mangaement ofr refoot defomrity is to eleimante STj compensation and bring th egroudn oup to the foot. THis may accomplised witha modified root orthosis oar blake inverted orhtosis
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What is forefoot varus nad its theoretical cause
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foefoot vaurs is a fixed, ossious ocngential deformity whi cwhichte forefoot is inverted realteve to the refoot when the subtalr join is int heneutral psoitoan athe oblique axiosof the mtj is lock (pronated) however a ture forevoot varus occusr only with avery few conditions sch as tev (clubfoot0. Ms toften and inerted forefoot is actually foerfoot supiantes and the supinatus is aconesatory inversoin of ro rer foot vlagus upoin standing. theoreticallly foefoot varus wsa conseider to be due toinadquate torison fo the hd nd nect of healus during featl development, wbu thsi is not wel supornts and hs shwone to bincorrec
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what isthe pathomechnidcs of foefoot supinatus
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the foefoot isninverae daht formfoot loaidng htreis increased gornd reaction force lateral t othe stj axis, the stj proantes untion the forfoot contst the gorund or stj ROM is exhausted
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describe a fully compenstaed foefoot varus foot ype
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the fullly comensated foefoot vau sfot type consis tos fenogh avialab le stj ROM to bring the einteir forfoot in contact wht ground
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describ eth partiallly compensate dfoerfoot varus foot type
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the paritally conmesated foefoot varus foot type has insuficient stj rom to bring the entir forefoot incatc wit hgeroun
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describ eth uncompensatied foefoot varu soot type
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int euncompenstae dfoefoot varu sfoot yep ther eis no stj rangoe fomito
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what are the effect os fht efully compensated foefoft vrus foot ytpe
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the fot is mechan ically usntable ther eis breakndown fo the mtj as midfofto mobility increases the anle fo jupl fo htepeonous longus isl altered rendierng hte forefooot nstalbe. there is adecreaed lever arm or the tgiabilasnaterio. the angle of pull of the fdl become more obliqu leadiont ot cuklinfo hte toes
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what are some pathaolgoies associ wf fully compensate foerfoot vrus foottyp
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virutally all
mdial tibial stress syndrom, plantar sfsiitis, tibialsi pesteior otenidntis, patello-foemarl syndorm, lesser digit deformity, hallux abducto valgus |
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what happens inteh uncompensateated forefoot vrus foot type?
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the is no pronation availavat at STJ thjefoe the foefoot is held at ht inverti posionto throug haait scyle hte. foot exhibits excessive lateral contac throught stanc ephse with very late stance phase wiehgtbearon ontheIPJ of hte hallx as the limb moves forward. hyperketossi may be rpesent otn eh 5tgh MPJ and iPJ of hte hallux. the may be xcescciv elateral shoe wera
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What is foefoot supiantus
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foefoot supinatis is atriplantar acqurid softissue contractue of hte foefoot int a supinatd postion around the longitudina axi so fhte mdisarsal joint casue by heel balgus. the helel havgusl with sutalar joint proantion casuea socmosatory spuionatio n aroudn the loigntiudina axis of hte mtj.
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