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Biomechanics Final
Podiatry Biomechanics I Final MWU
212
Medical
Post-Graduate
02/12/2012

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Cards

Term
OSCE Subtalar joint total Range of Motion
Definition
- place patient in prone
- rotate leg so longitudinal axis of calcaneus is perpendicular to the ground
- place STJ in neutral
- bisect the leg
-bisect upper 2/3 of calcaneus
-dorsiflex ankle to 90° to lock it out when inverting or everting
- to invert grab at the calcaneocuboid joint
- to evert grab the calcaneuous
- place hinge of goniometer at level of STJ (lat maleolus)
- Measure and calculate STJ range of motion and neutral position.
Term
OSCE Plotting subtalar joint axis
Definition
- place patient in sitting or supine position with knee extended
-rotate leg so longitudinal axis of calcaneus is perpendicular to ground
- Place STJ in neutral
-lock midtarsal joint by placing your thumb over 4th & 5th metatarsal heads
& gently dorsiflexing foot
- push on plantar surface of foot to find the central line that doesn't give
medially or laterally (work from the middle out)
- mark points on bottom of foot as you find them
- continue until you have made 5-6 points from proximal to distal and
connect the straight line
Term
OSCE Neutral Calcaneal Stance Position
Definition
- patient in standing position
- assure patient is in angle & base of gait (march in place)
- assure patients hips & knees extended and torso is straight
- be behind leg being examined with eyes level with ankle
- place STJ in neutral
- bisect upper 2/3 of calcaneous
- goniometer measurement between ground & bisection
- State # of °s and direction of rearfoot deformity
Term
OSCE Tibial influence
Definition
- patient in standing position
- assure patient in angle & base of gait (march in place)
- be behind leg being examined with eyes at ankle level
- put STJ in neutral position
- bisect lower 1/3 of leg
- measure bisection line versus ground with goniometer
- state whether the patient has a tibial varum or valgum
Term
OSCE Relaxed Calcaneal Stance Position
Definition
- patient in standing position
- assure patient is in their angle & base of gait (march in place)
- be behind leg being measured with eyes at ankle level
- align STJ into its resting or relaxed position
- bisect upper 2/3 of calcaneous
- use goniometer to measure bisection line vs ground
- State the number of degrees the heel exhibits in its maximally pronated
position
Term
OSCE Forefoot to Rearfoot Relationship MTJ
Definition
Goniometric measurement
- patient in prone position
- rotate leg so longitudinal axis of calcaneous is perpendicular to ground
- place STJ in neutral
- Lock MTJ by applying dorsiflexing, everting, & abducting force on met
heads 4 & 5
- one arm of goniometer parallel with planter surface of metheads and other
parallel with plantar surface of calcaneous
- measure wether patient has forefoot varus or forefoot valgus
Forefoot Measuring device
- bisects upper 2/3 of calcaneous
- handle of device on bisection
-base of protractor is placed parallel with met heads
- lock out MTJ & take measurement
- Read # of °s of forefoot varus or valgus indicated on protractor
Term
OSCE First Ray Range of Motion
Definition
- pateint in either supine or prone
- pateint's knee extended
- longitudinal axis of calcaneous is perpendicular to ground
- place STJ in neutral
- lock MTJ by applying dorsiflexing, everting & abducting force on met
heads 4 & 5
- Stabalize metatarsal heads 2-5 between thumb & forefinger
- Index finger & thumb of opposite hand placed abobe & below 1st met
head
- pulp of each thumb should be in alignment on plantar surface of patient's
foot
- use 2nd metatarsal as a reference and dorsiflex and plantar flex 1st ray
through ROM
- assess wether 1st metatarsal head is plantar or dorsiflexed
- state the name of the conditions where dorsiflexion exceeds plantarflexion and vice versa
Term
OSCE Ankle Dorsiflexion
Definition
- patient in supine position with knee extended
- place STJ in neutral
- align hinge of goniometer with lateral aspect of calcaneous
- one arm of goniometer with fibula and other arm with along 5th ray
- pace dorsiflexory force along ENTIRE plantar aspect of foot
- measure
- flex patients knee
- place STJ in neutral
- place goniometer
- take measurement while applying dorsiflexory force on ENTIRE plantar
aspect of foot
Term
OSCE Malleolar Position
Definition
- patient in supine position
- patients knee extended
- patients leg is on frontal plane
- place STJ in neutral
- pateints ankel at 90°
- bisect medial malleolus and bring line distal down to plantar surface of
foot
- bisect lateral malleolus in similar fashion
- double check patients leg is in frontal plane, STJ is neutral and ankle is 90°
- goniometer has one arm parallel to table and the other arm parallel to line that connects the malleolar bisections
Term
The MTJ functions to:
Definition
a) accomodation to terrain
b) smooth transition from lateral to
medial in stance phase of gait.
c) maintenance of forefoot loading
during late midstance while STJ
supinates
Term
The talonavicular joint is similar to a _____ joint with almost limitless ROM.
Definition
a) ball and socket
Term
The calcaneo-cuboid joint is a _______ joint
that is _____ in the saggital plane and _____ in the frontal plane.
Definition
saddle type, concave, convex
Term
The calcaneo-cuboid joint has motion in
Definition
) all three planes
Term
: Which ligament does not contribute to limit the pronation and supination of the MTJ?
Definition
transverse cuboidal
Term
The MTJ motion occurs around two independent axes which are both oriented in an _____ direction.
Definition
anterior medial dorsal
Term
The longitudinal axis of the MTJ is oriented _____?
Definition
15 degrees from transverse plane
8-9 from sagittal plane
Term
The longitudinal axis is more closely aligned to the ___ and ___ planes. The motion is predominantly _____.
Definition
transverse, sagittal, frontal
Term
Frontal plane motion of the MTJ long axis allows?
Definition
midfoot to respond to variations in rearfoot
Term
The oblique axis is oriented?
Definition
52 degrees from transverse
57 degrees from sagittal
Term
: The oblique axis is oblique to both ___ and ____ planes.
Definition
transverse, sagittal
Term
oblique axis motion is coupled with
Definition
dorsiflexion, abduction
plantarflexion, adduction
Term
The oblique axis allows compensation for?
Definition
equinus
Term
Oblique axis ROM is?
Definition
22 degrees
Term
ROM of the MTJ is controlled by the position of the _____?
Definition
STJ
Term
what decreases MTJ ROM because the axes are more oblique to each other?
Definition
b) STJ supination
Term
Locking mechanism of the MTJ occurs with MTJ?
Definition
pronation
Term
Locking mechanism is assisted by action of which three muscles.
Definition
posterior tibial, peroneus longus & brevis
Term
Motions in the “grounded” segment (MTJ) are seen as ____ in the proximal segment (STJ).
Definition
equal and opposite
Term
Appropriate motion of MTJ in gait facilitates smooth ____ of rearfoot?
Definition
eversion and inversion
Term
During the contact period, MTJ ROM increases with ______.
Definition
) STJ pronation
Term
The MTJ longitudinal axis _____ as the tibialis anterior fires to control plantarflexion
Definition
supinates
Term
The MTJ oblique axis _____ as the long extensors and peroneus terius fire.
Definition
pronates
Term
In midstance, MTJ ROM decreases with _____ of STJ. (both LAMTJ and OAMTJ pronate).
Definition
supination
Term
In the propulsive period, a supinated STJ maintains a?
Definition
locked MTJ (rigid lever)
Term
In the propulsive period, the LAMTJ is ____ allowing the peroneals to shift weight from the laterl to medial side of the foot.
Definition
pronated
Term
In the propulsive period, the windlass mechanism causes the forefoot to be?
Definition
adducted and plantarflexed
Term
The windlass affect is attributed to?
Definition
plantar aponeurosis
Term
In the swing phase, the oblique axis is ____ by pull of the long extensors and the longitudinal axis is ____ by pull of tibialis anterior.
Definition
pronated, supinated
Term
A structural abnormality in which the plantar plane of the forefoot is inverted to the rearfoot.
Definition
forefoot varus
Term
Which is not a possible etiology of forefoot varus?
Definition
dorsiflexed cuboid
Term
A structural abnormality in which the plantar plane of the forefoot is everted to the rearfoot?
Definition
forefoot valgus
Term
A relatively fixed supinated position of the forefoot relative to the rearfoot caused by soft tissue adaptation?
Definition
supinatus
Term
A forefoot compensation where the forefoot is completely on the ground?
Definition
completely compensated
Term
: If the forefoot varus is 3 degrees or less the STJ will compensate?
Definition
by 3 degrees or less
Term
if the forefoot varus is greater than 3 degrees the STJ will compensate?
Definition
to its end range of motion.
Term
Forefoot valgus compensation is by
Definition
inversion
Term
What happens first in forefoot valgus compensation? (remember LASOS)
Definition
longitudinal axis of MTJ inverts
Term
What happens second in forefoot valgus compensation? (remember LASOS)
Definition
STJ supinates
Term
What happens third in forefoot valgus compensation? (remember LASOS)
Definition
Oblique axis of the MTJ supinates
Term
What happens fourth in forefoot valgus compensation? (remember LASOS)
Definition
STJ supinates more
Term
In both fully and partially compensated forefoot varus the STJ remains _____ during the entire gait cycle.
Definition
pronated
Term
The above question causes an “apropulsive gait” which means?
Definition
no active propulsion of the digits
Term
signs or symptoms of a completely compensated forefoot varus?
Definition
a) tailors bunion
b) callus of submet 2
c) muscle fatigue
d) hallux abducto valgus
Term
sign or symptom of a partially compensated forefoot varus?
Definition
a)callus of submet 4 & 5
b) knee strain medially
c) knee strain laterally
Term
when watching a person with forefoot valgus in gait, the first half of midstance the foot is?
Definition
supinated
Term
when watching a person with forefoot valgus in gait, at the end of midstance there is ______ of the STJ.
Definition
pronation
Term
when watching a person with forefoot valgus in gait, in late propulsion the foot?
Definition
supinates
Term
A forefoot valgus with MTJ longitudinal axis compensation may show all of the following signs and symptoms?
Definition
a) contracture of lesser digits
b) callus of submet 1&5
c) lateral knee strain
Term
: First ray motion _____ with STJ pronation and _____ with STJ supination
Definition
increases, decreases
Term
In the stance phase, starting in late midstance and ending in late propulsion, the first ray motion is ______?
Definition
plantarflexing
Term
In the stance phase, starting in late midstance and ending in late propulsion, the first ray motion is plantarflexing, the first ray positions in gait are?
Definition
plantarflexed, everted
Term
The 1st ray position in gait in the swing phase?
Definition
dorsiflexed, inverted
Term
Abnormal STJ pronation in propulsive phase of gait results in?
Definition
hypermobility of 1st ray leading to 1st
MTPJ subluxation
Term
1st Ray hypermobility in the transverse plane can lead to?
Definition
a) forefoot adductus
b) halux abductovalgus
Term
1st ray hypermobility in the sagittal plane can cause?
Definition
a) forefoot rectus
b) hallux limitus/rigidus
Term
characteristics of a plantarflexed 1st ray?
Definition
a) 1st ray abnormal motion
b) STJ pronation in propulsion
c) forefoot is everted to rearfoot
d) 1st ray is hypermobile
e) apropulsive gait
f) (LA S.O.S) compensation
g) unstable hallux, MPJs, lesser digits
h) structural abnormality of 1st ray
Term
characteristics of forefoot valgus?
Definition
a) 1st ray normal range of motion
b) STJ pronation in propulsion
c) forefoot is everted to rearfoot
d) 1st ray is hypermobile
e) apropulsive gait
f) (LA S.O.S) compensation
g) unstable hallux, MPJs, lesser digits
h) structural abnormality of MTJ
Term
characteristics of metatarsus primus elevatus?
Definition
a) structural abmormality – 1st ray is elevated
b) metatarsal head is prominent dorsally
c) STJ slightly pronated or neutral in propulsion
d) 1st ray unstable, MPJs not well stabilized
e) excessive weight is borne on 2nd metatarsal head
f) apropulsive gait
Term
: If the forefoot (1st ray) is unstable during the propulsive period (apropulsive) then the muscle of the foot and leg?
Definition
work harder to stabilized the foot causing muscle fatigue
Term
A plantarflexed 1st ray, forefoot valgus, and metatarsus primus elevatus have the following in common?
Definition
a) STJ pronation during propulsion
b) 1st ray unstable – hallux limitus/rigidus
c) MPJs and lesser digits unstable
d) apropulsive gait
e) muscle fatigue
Term
The overall take home message about pathology within the first rays is?
Definition
it produces and unstable 1st ray
segment with an apropulsive gait
Term
The 5th ray motion is?
Definition
triplanar
Term
5th ray total ROM is?
Definition
20º
Term
5th ray motion is coupled with?
Definition
a) dorsiflexion with eversion
b) plantarflexion with inversion
Term
MTPJs motion in transverse axis is?
Definition
dorsiflexion, plantarflexion
Term
MTPJs motion in the verticle axis is?
Definition
abduction, adduction
Term
____ amount of dorsiflexion is required from the MTPJs during normal walking.
Definition
65º
Term
For MTPJs, plantarflexion is or is not required for normal walking?
Definition
is not
Term
the digits dorsiflex in the ______ period of stance to create a stable platform.
Definition
propulsive
Term
The MTPJs are stabilized by the ______?
Definition
flexor digitorum longus
Term
Sagittal plane deviation of the MTJ would bring the oblique axis almost parallel to the ankle axis creating?
Definition
almost pure plantar/dorsiflexion
Term
Sagittal plane medial deviation of the MTJ increases the _____ forces at the oblique axis.
Definition
pronatory
Term
What occurs as the sagittal plane deviation of the MTJ approaches horizontal?
Definition
midfoot breakdown
Term
Midfoot breakdown causes?
Definition
the medial arch to be flat
Term
which is not a sign or symptom of medial deviation from the sagittal plane?
Definition
forefoot valgus
Term
Superior deviation from the transverse plane of the oblique axis is sometimes referred to as? (most common type of deviation seen)
Definition
vertical oblique axis
Term
With Superior deviation of the oblique axis, more _____ and ____ is seen
Definition
adduction, abduction
Term
Midfoot and Talar adduction cause the leg to medially displace over the calcaneus with body weight causing?
Definition
STJ to pronate
Term
Signs and symptoms of superior deviation from the transverse plane are all of the following...
Definition
a) medial collateral knee pain
b) chondromalacia patellae
c) Patella tendon strain
d) prominent talar head medially
e) C-shaped calcaneo-cuboid joint
Term
A change of structure, position or function of one part in response to forces created by a demand from a preceeding or superseding part.
Definition
compensation
Term
Motion in which the foot moves to adjust for terrain or deviations in the position of the trunk or lower extremity.
Definition
Normal compensation
Term
Motion in which the foot moves to adjust for abnormal structure or function of the lower extremity.
Definition
abnormal compensation
Term
Theorem 1 states that
Definition
the heel will always attempt to purchase the ground unless prevented by limitation of motion.
(called PURCHASE)
Term
: Theorem 2 states
Definition
states the rearfoot will always try to compensate perpendicular unless influenced by some proximal or distal force.
(called REARFOOT PERPENDICULAR)
Term
: Theorem 3 states that if driven to valgus more than 2 degrees beyond perpendicular, the rearfoot will
Definition
(called REARFOOT FALLTHROUGH)
fall to its end ROM in direction of eversion
Term
In theorem 4, If the rearfoot is unable to purchase with normal ankle dorsiflexion, the MTJs will?
Definition
unlock and maximally pronate against a
maximally everted foot.
(called EQUINUS)
Term
Theorem 5 states that the forefoot loads under the _____ and compensates by the _______. Therefore the forefoot compensates primarily in the direction of _______ from its fully loaded neutral position.
Definition
lateral, medial, inversion
called FOREFOOT LOADING
Term
According to theorem 6, which is the correct order of forefoot compensation?
Definition
Long MTJ axis, STJ, Oblique axis of MTJ, STJ
called FOREFOOT SEQUENCING)
Term
: According to theorem 7, the metatarsal parabola will splay in a predictable direction as the foot goes through the motions of supination and pronation. The splay pattern for pronation is?
Definition
4th met doesn’t move, 1-3 medial, 5th lateral
called METATARSAL SPLAY)
Term
According to theorem 7, the metatarsal parabola will splay in a predictable direction as the foot goes through the motions of supination and pronation. The splay pattern for supination is?
Definition
4th met doesn’t move, 1-3 lateral, 5th medial
(called METATARSAL SPLAY)
Term
Normal forefoot compensation to when the rearfoot inverts is?
Definition
forefoot will invert
It can’t evert because once the FF is on the ground, it cant evert along the LAMTJ (theorem 5)
Term
Normal forefoot compensation to when the rearfoot everts is?
Definition
To keep the metatarsal on the ground via long axis of the MTJ (theorem 5)
forefoot will invert
Term
Normal rearfoot compensation when the forefoot inverts is?
Definition
rearfoot will do nothing
Unless the wedge(rock..etc) is large enough then it will invert (thereom 1 & 6)
Term
Normal rearfoot compensation when the forefoot everts is?
Definition
rearfoot will do nothing
Unless the wedge(rock..etc) is large enough then it will evert (thereom 1 & 6)
Term
The lateral malleoulus is larger and extends further distally and more posteriorly than the medial malleolus.
Definition
Term
The medial malleoulus determines the position of the ankle joint axis.
Definition
FALSE the lateral malleolus does
Term
The ___ joint is the most stable joint in the lower extremity.
Definition
ankle
Term
What makes the ankle joint so stable?
Definition
ligaments, shape of talus
Term
ankle plantarflexion is limited by:
Definition
a) anterior talofibular ligament
b) deltoid ligament
c) talus against the tibia
Term
Ankle dorsiflexion is limited by?
Definition
a) triceps surae
b) posterior talofibular ligament
c) posterior deltoid
Term
The talar dome is wider posteriorly than anteriorly
Definition
false
It is wider anteriorly
Term
The talar dome being wider anteriorly than posteriorly leads to more stability especially in
Definition
dorsiflexion
Term
The talar dome is wider ___ and smaller ____.
Definition
laterally medially
Term
Congruency between the talar dome and the tibial plafond is 90%. How much lateral displacement of the talus can cause a 42% reduction in congruency?
Definition
1mm
Term
Location of the ankle joint axis is just inferior of the?
Definition
medial & lateral malleoli
Term
The axis of the ankle joint is directed?
Definition
laterally, posteriorly & plantarly
Term
The ankle joint axis is
Definition
oblique to all three planes.
Term
Motion in the ankle joint is
Definition
pronatory/supinatory with dominance in the sagittal plane.
Term
with regard to ankle joint axis.
Definition
-axis is different from person to person
-axis is different from non-weight bearing to weight bearing more transverse plane motion in OKC
-axis is constantly changing from dorsiflexion to plantarflexion
Term
What is the name of the test used to measure ankle joint ROM (dorsiflexion) called?
Definition
silfverskiold test
Term
When measuring ROM on the ankle, what can go wrong?
Definition
pronating the STJ, allowing the knee to flex or hyperextend
Term
What is the minimum ROM for dorsiflexion and plantarflexion of the ankle joint?
Definition
dorsiflexion 10, Plantarflexion 20
Term
There is more ROM in the ankle joint as an adult than at birth.
Definition
false-Birth has 75⁰, adult has 5-10
Term
In OKC dorsiflexion foot moves toward the tibia. In CKC, dorsiflexion tibia moves ...
Definition
anterior over planted foot
Term
In OKC plantarflexion tibia moves posterior over planted foot. In CKC, plantarflexion foot moves away from tibia.
Definition
false
OKC – foot moves away from tibia
CKC – tibia moves posterior over planted
foot
Term
In OKC ankle joint movements are determined by:
Definition
position of the axis, shape of joint surfaces
Term
: In OKC, ankle joint motion is controlled by?
Definition
collateral ligaments,integrity and stability of joint surfaces
Term
In CKC, ankle joint movements are controlled by?
Definition
position of the axis, shape of joint surface
Term
In CKC, ankle joint motion is controlled by?
Definition
ground reactive forces, muscles
Term
At heel contact, ground reactive force posterior to the ankle joint cause a _______ moment.
Definition
plantarflexory
Term
At heel contact, muscles anterior to the ankle?
Definition
contract to decelerate ankle plantarflexion
Term
ankle joint in midstance is characterized by?
Definition
relative dorsiflexion as the body passes
over the weight bearing foot
Term
n midstance, excessive dorsiflexion of the tibia must be resisted or the person would fall forward. What muscles do this?
Definition
soleus, PT, FDL, FHL, some PL
Term
In midstance, the femur continues forward as the tibia is decelerated by calf muscles and knee extension results. What to muscles work together to provide knee extension?
Definition
gastroc nemius, soleus
Term
In terminal stance, ground reactive force anterior to the ankle result in?
Definition
dorsiflexion
Term
In pre-swing, the ankle rapidly ________ reaching 20 degrees by toe-off.
Definition
plantarflexes
Term
In the swing phase, muscles dorsiflex the ankle to allow toes to clear ground. What muscle is the major dorsiflexor is this process?
Definition
extensor hallucis longus
Term
What define equinus?
Definition
<10⁰ ankle joint dorsiflexion w/ neutral STJ
10⁰ are needed as the tibia advance relative to the talus
Term
The soleus and grastrocnemius act to extend the knee by?
Definition
soleus pulling on tibia, gastroc pulling on femur
called a flexion moment
Term
The most common form of equinus (congenital or acquired) caused by tight gastrocnemius w/ less than 10 degrees of dorsiflexion w/ knee extended.
Definition
gastroc equinus
Term
Equinus caused by a tight triceps surae and will have less than 10⁰ dorsiflexion w/ knee extended and flexed. Achillies tendon is taught
Definition
Gastrosoleal equinus
Term
Equinus with an abrupt end to dorsal ROM due to impingement of tibiotalar articulation.
Definition
osseous equinus
Term
This equinus has 10⁰ of dorsiflexion at ankle but functionally needs more because of a plantarflexed forefoot.
Definition
pseudo equinus
forefoot loads earlier due to anterior cavus foot
Term
A new etiology of ankle equinus is?
Definition
failure of translation of the fibula
Term
which is not a feature we may see in gait of a person with equinus?
Definition
Genu Varum
Term
proximal compensation mechanisms for equinus can be?
Definition
a) hip flexion
b) genu recurvatum
c) lordosis
Term
Note: distal compensations for equinus: fully, partially, and uncompensated.
Definition
Term
There is insufficient ROM in ankle, STJ, or MTJ to permitt heel to contact the ground in this equinus (toe walker).
Definition
uncompensated
Term
: In this equinus, there is sufficient ROM to permit the heel to contact the ground but insufficient motion to allow tibia to angulate 10⁰ to the foot during gait (bouncy gait).
Definition
partially compensated (no, it's not a personality thing!)
Term
In this equinus, there is sufficient ROM to permit the heel to contact the ground and sufficient motion to allow tibia to angulate 10⁰ to the foot during gait. (arch flattening)
Definition
fully compensated
Term
Clinical findings for uncompensated equinus include?
Definition
callus formation under ball of foot
,contracted lesser digits
Term
clinical findings for partially compensated equinus?
Definition
sheer callus submet 2
calf, thigh, lower back pain
stress on articular surface of ankle joint
Term
clinical findings for fully compensated equinus?
Definition
a) HAV 2ndary to hypermobile 1st ray
b) sever calluses met heads 2,3,4
c) severe arch fatigue, leg cramps, thigh and lower back pain
d) forefoot supinatus
e) hammered 5th digit
Term
Increasing the resting length of the gastroc-soleus complex through stretching exercises or surgery is the only treatment for equinus.
Definition
false
heel lifts to decrease tension on achilles tendon is another method.
Term
The ankle joint can functionally adapt/remodel overtime to deformities impede normal ROM.
Definition
Term
Subtalar joint motion is
Definition
triplanar
Term
The STJ axis runs?
Definition
distal-medial-dorsal to proximal-lateral-plantar (dmd-plp)
Term
The STJ axis is:
Definition
16° from sagittal, 42° from transverse, 48° from frontal
Term
MTJ motion occurs primarily in what plane about the longitudinal axis
Definition
frontal
Term
Frontal plane motion is primarily?
Definition
inversion / eversion
Term
MTJ motion occurs in what plane(s) about the oblique axis?
Definition
sagittal and transverse
Term
MTJ motion in sagittal and transverse planes about the oblique axis is coupled how?
Definition
50% dorsiflexion/ abduction with 50% plantar flexion /adduction
Term
MTJ longitudinal axis is 75 deg from the frontal plane it is essentially perpendicular to what plane?
Definition
frontal
Term
If MTJ longitudinal axis is essentially parallel to?
Definition
sagittal and transverse planes
Term
1st ray has equal motion in what planes
Definition
frontal and sagittal
Term
1st ray axis is parallel to what plane?
Definition
transverse
Term
STJ pronation affects 1st ray motion by?
Definition
increasing motion
Term
STJ supination affects 1st ray motion by?
Definition
decreasing motion
Term
5th ray motion is?
Definition
triplane motion (pronation, supination)
Term
5th ray axis orientation is similar to?
Definition
STJ
Term
The central 3 rays and IPJs motion occurs in?
Definition
sagittal plane
Term
The central 3 rays and IPJs axis is?
Definition
parallel to the transverse and frontal planes
Term
Motion occurs in the transverse plane about what axis?
Definition
vertical
Term
Subtalar joint varus
Definition
The heel is inverted to the leg in STJ NP (non-weight bearing)
Term
Rear foot varus is best described as
Definition
STJ is in neutral position and heel is inverted to the ground (weight-bearing
Term
Subtalar Valgus is when the Heel is everted to the leg in STJ NP (non-weight bearing)
Definition
Term
Rear foot valgus is
Definition
when the STJ is in NP (weight bearing) and heel is everted to the ground?
Term
Tibial varum is when the STJ is in NP in stance and the distal aspect of the leg is _____ relative to the proximal aspect.
Definition
inverted
Term
Tibial valgum (STJ in NP) in stance is when the distal aspect of the leg is ___ relative to the proximal aspect.
Definition
everted
Term
Normal tibial varum in adults is?
Definition
1-4 degrees
Term
The NCSP measurement is best described as
Definition
Angle between the bisected calcaneus and the ground while in stance
Term
Normal NCSP values are?
Definition
0-4º inverted
Term
What info NCSP will tell us?
Definition
a) rear foot deformity
b) STJ NP + Tibial Influence
c) position of the calcaneous in STJ NP stance
Term
The angle between the bisection of the distal 1/3 of the tibia and the ground?
Definition
Tibial influence
Term
RCSP is?
Definition
angle between the bisection of the calcaneus and ground while in relaxed stance
Term
What does tibial influence tell us?
Definition
information about the amount of rear foot deformity attributed to the tibia
Term
In RCSP the Subtalar joint is in its?
Definition
relaxed position
Term
What does RCSP tell us?
Definition
information about the position of compensation
Term
The compensation mechanism for rearfoot varus is?
Definition
pronation of STJ
Term
The compensation mechanism in rearfoot varus allows the inverted calcaneus to?
Definition
pronate to perpendicular
Term
What is the condition in which a person with rear foot varus has enough STJ eversion available to overcome the deformity (calcaneus eversion to perpendicular 0º)?
Definition
compensated rearfoot varus
Term
What is the condition in which a person with rear foot varus has some STJ eversion available to reduce the deformity?
Definition
partially compensated rearfoot varus
Term
A partially compensated rearfoot varus often has associated problems?
Definition
lateral column problems (hyperkeratosis)
Term
If a compensated rearfoot varus has >4º inversion, then the resulting compensation is considered?
Definition
hyperpronatory
Term
An uncompensated rearfoot varus has no STJ eversion available to reduce the deformity.
Definition
Term
The compensation mechanism for rearfoot valgus is?
Definition
STJ increased pronation
Term
If the NCSP shows <3 degrees of Rearfoot valgus, then?
Definition
NCSP = RCSP (everted a little)
Term
If the NCSP shows >3 degrees of rearfoot valgus, then?
Definition
STJ max pronation will occur
Term
If the NCSP show over 10 degrees of rear foot valgus, then?
Definition
STJ max pronation + 2-3 degrees additional pronation
Term
factors affecting rearfoot position?
Definition
a) STJ axis and relation to adjacent muscles
b) muscular dysfunction
c) Subtalar varus & valgus
d) Rearfoot varus & valgus
e) tibial varum & valgus
f) tarsal coalition
Term
Fibularis brevis, longus, tertius and the extensor digitorum longus are considered?
Definition
pronators
Term
The Tibialis anterior is considered?
Definition
supinator
Term
Supinators insert on the _______ side while pronators insert on the _______ side.
Definition
medial, lateral
Term
If the supinators are weak then the foot will?
Definition
) pronate
(because the pronators overpower them)
Term
If the pronators are weak, then the foot will?
Definition
supinate
Term
If the STJ is restricted in motion due to an abnormal union between bones, the condition is called?
Definition
tarsal coalition
Term
In propulsion an abnormal amount of STJ pronation leads to?
Definition
hypermobility and abnormal shearing forces
Term
Hypermobility caused by STJ pronation during the propulsive phase leads to?
Definition
joint subluxation
Term
Abnormal shearing forces caused by STJ pronation during the propulsive phase leads to?
Definition
calluses
Term
similarities in rearfoot varus and equinus?
Definition
both cause perstistant STJ pronation in contact and midstance with STJ remaining pronated in propulsion
Term
In rearfoot varus (large degree), the STJ undergoes ____ during propulsion, but remains pronated.
Definition
supination
Term
In equinus, there is only a slight STJ pronation just before propulsion resulting in STJ subluxation.
Definition
NOPE! Massive STJ pronation just before propulsion causing STJ subluxation
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