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Foot/Gait
Foot/Gait
72
Medical
Graduate
04/30/2016

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Cards

Term
3 plantar arches
Definition
medial
lateral longitudinal
transverse
Term
what is the largest plantar arch
Definition
lateral longitduinal
Term
how do the arches form
Definition
as a result of WB, they are not prsent at birth
Term
what structures make up the medial and lateral longitudinal arch
Definition
metatarsal head to the calcaneus
Term
what is the keystone of the medial and lateral longitduinal arch
Definition
talus
all weight must pass through the talus
Term
what is the keystone of the transverse arch
Definition
middle cuneiform
Term
passive support of the medial longitduianl alrch (4)
Definition
spring ligament
interosseous talocalcaneal ligament
deltoid ligament
plantar aponeuorsis (fascia)
Term
what is the most important static stabilizer of the medial longitdunal arch? why?
Definition
spring ligament
also supports the head of the talus
Term
the arches serve 2 contrasting functions
Definition
weight bearing mobility
weight bearing stability
Term
3 aspects of weight bearing mobility
Definition
dampen the impact of weight bearing
dampen superimposed rotational motions
adapt to supporting surface
Term
2 aspects of weight bearing stability
Definition
distribute weight through the foot for proper weight bearing
conversion of flexible foot to rigid lever
Term
what structure plays into weight bearing mobility/stability? How?
Definition
plantar aponeurosis/fascia
via weight distribution
Term
what is stability with mobility
Definition
tensegrity
Term
plantar fascia attachments
Definition
medial tubercle of the calcaneus
phanalx of each toe
Term
plantar fascia: at the beginning of stance hpase tension increases with a max ____% of body weight
Definition
96%
Term
how much does the PA stretch and deform during stance
Definition
9-12%
Term
if the foot is considered 2 struts and a tie rod what is the tie rod? what are the struts made up of?
Definition
posterior strut: talus and calcaneus
anterior strut: remaining tarsals and metatarsals
tie rod: PA
Term
what is the purpose of the struts
Definition
absorb compression
Term
what is the purpose of the tie rod
Definition
absorb tensile loads
Term
with the tie rod/strut structure what loads are minimized
Definition
bending loads
Term
toe motion at the MTP to pull the PA tight
Definition
extension
Term
how can the toes be extended (OKC/CKC)
Definition
proximal phalanges glide dorsal (toes not fixed)
proximal phalnages glide plantar (toes fixed)
Term
With tightneing of the PA with MTP extensino what structures are drawn together
Definition
the heel and MTP are drawn together (Tie rod shortened)
Term
With tightneing of the PA with MTP extensino what happens to the arch? what does it contribute to?
Definition
arch raises and contributes to supination
Term
what is the windlass mechanism
Definition
tightening of the PA with MTP extension draws the heel and MTP toegether
raises the arch and contributes to supination
PA increases its role in support of the arch with WB
Term
triangle pronation involves what jts and is aka
Definition
transeverse tarsal jt and subtalar jts
flattened foot
Term
trinagle pronation involves the PA how? what limit is present
Definition
regardless of active (NWB) and passive (WB) MTP extension tension is prsent in the PA
the range of MTP extension will be limited d/t limited PA
Term
triangle pronation: raising the height of the traingle via the struts will do what to the tie road
Definition
unload the tie rod
Term
triangle pronation: what must occur to raise the height of the triangle via the struts to unload the tie rod (5)
Definition
tibia subected to lateral rotation force
hindfoot supinates
posteiror strut becomes oblique
medial longitudinal arch height increases
PA is unloaded
Term
How does the foot become a rigid lever for push off
Definition
through the effect of the MTP on the PA, the PA acts with the jts of the hindfoot to contribute to increasing the longitudinal arch (supination) as heel raises
Term
weight distribution depends on what
Definition
shape of arch and line of gravity
Term
in bilateral stance how much weight does the talus recieve
Definition
all of it
50% per talus
Term
50% of the talus weight passes to what articulation/structures
Definition
posterior subtalar articulation to the calcaneus
Term
50% or less of teh talus weight passes to what articulation/structures
Definition
passes anteriorly through the talonavicular and calcanealcuboid jts
Term
Generation (concentric): what are the mm in this group (6)
Definition
hams
gluts
quads
psoas
rectus
plantar flexors
Term
Generation (concentric): Hmas/gluts are used in what stage of the gait cycle
Definition
early stance
Term
Generation (concentric): quads are used in what part of the gait cycle
Definition
early stance
Term
Generation (concentric): psoas, rectus are used in what phase of hte gait cycle
Definition
late stance (heel up)
Term
Generation (concentric): plantar flexors are used in what stage of the gait cycle
Definition
late stance push off
Term
absorption (eccentric): mm involved in this group (4)
Definition
psoas
rectus
hams
plantarflexors
Term
absorption (eccentric): what stage are the psoas and rectus active in the gait cycle
Definition
midstance
Term
absorption (eccentric): when are the hams active during the gait cycle
Definition
late swing
very early stance
Term
absorption (eccentric): when is the rectus (only the rectus) active during the gait cycle
Definition
late stance
Term
absorption (eccentric): when are the plantar flexors active
Definition
`early and midstance
Term
Gait characteristisc from IC to midstance: saggital plane: hip: motion, grf, power, muscles
Definition
Motion: Extends
GRF: Ant to Post
Power: Generate (concentric) hip extends
Muscles: Glutmax, hamstrings
Term
Gait characteristisc from IC to midstance: saggital plane: Knee: motion, grf, power, muscles
Definition
motion: flex then extend
GRF: ant to post to ant
Power: generate (knee flex), absorb (knee ext and flexors)
Muscles: hams, quads, gastrocs
Term
Gait characteristisc from IC to midstance: saggital plane: ankle: motion, GRF, power, muscles
Definition
motion: PF then slight DF
GRF: post to ant
Power: Absorbs (DF), generate (PF)
Muscles: Ant tib, soleus, gastroc
Term
Gait characteristisc from IC to midstance: frontal plane: hip: motion, grf, power, muscles
Definition
motion: add then abd
GRF: medial
Power: absorb (hip abd), generate (hip abd)
Muscles: glut med
Term
Gait characteristisc from IC to midstance: frontal plane: knee: motion, grf, power, muscles
Definition
motion: stays neutral
grf: medial
power: generate (knee abd)
Muscles: TFL
Term
Gait characteristisc from IC to midstance: frontal plane: ankle: motion, grf, power, muscles
Definition
inconsitent
Term
Gait characteristisc from IC to midstance: transverse plane: hip: motion, grf, power, muscles
Definition
motion: ER
Power: absorption (IR)
Mm: TFL, glut med, glut min
Term
Gait characteristisc from IC to midstance: transverse plane: knee: motion, grf, power, muscles
Definition
motion: slight ER/IR to neutral
Power: absorb (Ext rot)
Term
Gait characteristisc from IC to midstance: transverse plane: ankle: motion, grf, power, muscles
Definition
inconsistent
Term
Gait characteristisc from midstance to toe off: sagittal plane: hip: motion, grf, power, muscles
Definition
motion: ext then flex
GRF: posterior
Power: absorb (flexors), generate (flexors)
MM: Iliopsoas, RF
Term
Gait characteristisc from midstance to toe off: sagittal plane: knee: motion, grf, power, muscles
Definition
motion: slight ex to flexion
GRF: posterior
Power: small and large absorb (knee extensors)
Small generate: knee flexors
MM: vastus, gastrocs, RF
Term
Gait characteristisc from midstance to toe off: sagittal plane: ankle: motion, grf, power, muscles
Definition
motion: DF followed by rapid PF
GRF: ant
Power: small absorb (PF), Large generate (PF)
MM: Soleus, gastrocs
Term
Gait characteristisc from midstance to toe off: frontal plane: hip: motion, grf, power, muscles
Definition
motion: abd
grf: medial
power: generate (abductors)
muscles: glut med
Term
Gait characteristisc from midstance to toe off: frontal plane: knee: motion, grf, power, muscles
Definition
motion: neutral to abd
grf: medial
power: absorb (Abd)
muscles: TFL
Term
Gait characteristisc from midstance to toe off: frontal plane: ankle: motion, grf, power, muscles
Definition
inconsistent
Term
Gait characteristisc from midstance to toe off: transverse plane: hip: motion, grf, power, muscles
Definition
motion: ER slight
power: small absorb (ER)
Term
Gait characteristisc from midstance to toe off: transverse plane: knee: motion, grf, power, muscles
Definition
motion: neutral
power: small absorb (ligamentous)
Term
Gait characteristisc from midstance to toe off: transverse: ankle: motion, grf, power, muscles
Definition
inconsistent
Term
4 patterns of spastic hemi/diplegia
Definition
drop foot
equinius
jump knee
marked proximal involvement, equnius, flexed stiff knee, anterior pelvic tilt, hipp add, IR
Term
Hemi/diplegia: drop foot (2)
Definition
seen in swing phase
d/t poor DF control
Term
Hemi/diplegia: equinus (5)
Definition
most common type
neutrla or recurvatum knee c extended hip
noted in stance
d/t spasticity of GS
PF overactive
Term
Hemi/diplegia: jump knee (3)
Definition
GS spasticity or contracture
impaired DF in swing phase
flexed stiff knee gait d/t quad/HS co-contraction
Term
How long of an LLD does it have to be to cause articular cartilage changes
Definition
2 cm
Term
in non-CP children, how will they compenstae for an LLD
Definition
equinius
vaulting over the long limb
circumduction
Term
what may yield PFPS (3)
Definition
Q angle
tibial torsion
pronation
Term
How does pes cavus affect wt bearing
Definition
wt bearing is on the hindfoot and tarsals
Term
how does pes planus affect wb/gait
Definition
wt bearing by the midfoot
impaired propulsion phase of gait/running
Term
how can pain affect gait
Definition
overuse injuries
OA
spinal radiculopathy/referred pain
antalgic gait (limping)
trendelenburg d/t painful hip not glut med weakness
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