Applied Kinesiology > Week 5 > Flashcards

Week 5 Flashcards

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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
What motion occurs at the left hip during right pelvic drop?
hip adduction
26
What are the arthrokinematics of forward/backward rotation of pelvis in CKC?
concave on convex Forward - anterior roll and anterior slide Backward - posterior roll and posterior slide
27
What motion occurs on the stance limb during forward/backward rotation?
Forward - IR of stance joint Backward - ER of stance joint
28
Describe the closed pack, open pack and capsular pattern of the hip
closed pack - full extension w/ slight IR and abduction open packed - moderate flexion, slight abduction, neutral rotation capsular pattern - IR = flexion = abduction
29
If someone performs a straight leg raise (SLR) and they demonstrate excessive anterior tilt of the pelvis, what may this indicate?
weak abdominals due to force coupling
30
Describe the role of the adductor longus in sagittal plane motion.
during hip flexion - contributes to hip extension during hip extension - contributes to hip flexion
31
Describe the force required of the hip abductors to maintain a stable pelvis in SL stance
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
32
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?
left side to increase the moment arm and offset the hip muscles that need to do twice as much work to resist gravity
33
How can we maximize stretching the hamstrings by cueing an individual to tilt the pelvis? What direction of pelvic tilt enhances a hamstring stretch?
anterior tilting of pelvis to stretch hamstrings | - can also add a slight lean forward with neutral back
34
What is considered to be normal genu valgum? Excessive genu valgum? Genu varum?
Normal - 170-175 degrees Genu valgum - <165 degrees Genu varum - >180 degrees
35
Which area of the knee receives greater compression forces with genu varum?
medial compartment compression
36
Which area of the knee receives greater compression forces with genu valgum?
lateral compartment compression
37
What factors lead to genu valgum?
- previous injruy - genetic predisposition - high BMI - laxity of ligaments - abnormal alignment and muscle weakness at either end of lower extremity
38
What knee ligaments have increased stress during genu valgum? What happens to the patella?
- increased stress on MCL due to increased compression on lateral component - increased stress on ACL - excessive lateral tracking of the patella
39
What factors lead to genu varum?
thinning articular cartilage on medial side
40
What happens with genu varum?
- increased medial compartment loading - greater loss of medial joint space - greater knee adduction movement - increased strain on LCL - increased medial joint loading
41
What is genu recurvatum?
excessive hyperextension of the knee
42
Define the Q-angle. What happens if the Q-angle is increased?
- 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
What is the normal Q-angle range?
13-15 degrees
44
Describe the factors that naturally oppose the lateral pull of the Patella.
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
What are the functions of the meniscus?
- distribute weight bearing forces - increase joint congruence - shock absorption
46
What structures have connections to the medial meniscus?
MCl ACL PCL semimembranosus
47
What structures have connections to the lateral meniscus?
ACL PCL popliteus
48
What is the primary function of the ACL?
primary restraint to anterior translation of tibia on femur
49
What is the primary function of the PCL?
Primary restraint to posterior translation of tibia on femur
50
What is the primary function of the MCL?
Primary restraint to valgus force and lateral tibial rotation
51
What is the primary function of the LCL
Primary restraint to varus stresses
52
What assists ACL in resisting anterior translation of the tibia on femur?
iliotibial tract
53
What are 3 factors associated with non-contact injuries?
- strong activation of quad over moderately flexed or nearly extended knee - valgus collapse of knee - excessive ER of knee
54
What are the osteokinematics of the knee?
- flexion/extension - IR/ER - Ab/Adduction
55
What are arthokinematics of flexion of the knee in OKC and CKC?
OKC - concave tibia on convex femur - posterior roll and glide CKC - convex femur on concave tibia - posterior roll and anterior glide
56
What are arthrokinematics of extension of the knee in OKC and CKC?
OKC - concave tibia on convex femur - anterior roll and glide CKC - convex femur on concave tibia - anterior roll and posterior glide
57
What are arthrokinematics of knee IR/ER?
not defined
58
What are arthrokinematics of knee Ab/Adduction?
not defined
59
Describe the screw home mechanism.
- 10 degrees of ER with terminal extension needed clear medial femur - to unlock the knee, knee must IR to clear medial condyle
60
Describe the closed pack, open pack and capsular pattern of the knee.
closed pack - full extension open packed - 25 degrees off flexion capsular pattern - flexion > extension
61
What position of the knee puts the patella at greatest risk for dislocation and why?
full knee extension - patella has least congruency with joint
62
Describe the external torque demands of the quad with a leg extension vs a squat from 0-90 degrees.
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
Compare and contrast safe vs unsafe landing patterns
Unsafe - larger knee EMA - smaller hip EMA - stiff landing Safe - small knee EMA - Large hip EMA - increased hamstring to quad contraction pattern
64
Describe the functions of the foot and ankle.
- 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
List the joints of the ankle/foot complex.
- proximal/distal tibiofibular joints - talocrural joint - talocalcaneal joint - transverse tarsal joint (talonavicular and calcaneocuboid joint) - tarsometatarsal - metatarsophalangeal joints - interphalengeal joints
66
What bones make up the hindfoot?
talus and calcaneus
67
What bones make up the midfoot?
- navicular - cuboid - 3 cuneiform bones
68
What bones make up the forefoot?
metatarsals and phalanges
69
What is the closed packed position of the proximal and distal tibiofibular joints?
weight bearing dorsiflexion
70
List the component OKC ankle motions associated with pronation. List the component ankle motions associated with supination.
Pronation - Pros do ABs Every Day - Abduction - Eversion - Dorsiflexion Supination - Sadly Injury ADDs Pain - Inversion - Adduction - Plantarflexion
71
List the component CKC ankle motions associated with pronation. List the component ankle motions associated with supination.
Pronation - Eversion - Adduction - Plantarflexion Supination - Inversion - Abduction - Dorsiflexion
72
Describe the functions of the medial collateral (deltoid) ligament and the lateral collateral ligament.
MCL (deltoid) - limit eversion/pronation LCL - limit inversion/supination
73
What is the main motion at the Talocrural joint?
plantar and dorsiflexion
74
What are arthrokinematics of dorsi and plantarflexion?
convex on concave Dorsiflexion - anterior roll, posterior slide Plantarflexion - posterior roll, anterior slide
75
Describe the closed pack, open pack and capsular pattern of the Talocrural joint.
closed pack - weight-bearing dorsiflexion open packed - 10 degrees of plantarflexion w/ neutral inversion/eversion capsular pattern - plantarflexion > dorsiflexion
76
What are the main motions at the subtalar joint?
inversion/eversion and abduction/adduction
77
Describe what occurs with supination and pronation in non-weight bearing position and weight bearing posting during CKC.
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
Describe the closed pack and open pack of the subtalar joint.
closed pack - full inversion open pack - mid inversion/eversion and mid plantar/dorsiflexion
79
What joints make up the transverse tarsal joint? What function does it serve?
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
Describe the closed pack, open pack and capsular pattern of the transverse tarsal joint.
closed pack - supination open pack - mid range of supination/pronation capsular pattern - limitations in dorsiflexion, plantarflexion, adduction and IR
81
What is the function of the tarsometatarsal joints?
regulate position of the forefoot in relation to the weight-bearing surface
82
Describe what happens with the supination twist.
- 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
Describe what happens with the pronation twist.
- 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
Describe the 2 deformities outlined that may occur at the 1st MTP joint.
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
What is the one of the main functions of the plantar fascia?
- support medial longitudinal arch in weight bearing
86
Describe the windlass effect.
- plantarflexion lifts calcaneus - body weight transferred over metatarsal heads - causes extension of metatarsophalangeal joints - stretches (winds up) plantar fascia - strengthens midfoot
87
Define pes planus. What effect does this foot posture have on the the overall function of the foot?
- 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
What is the navicular drop test? What does it assess?
- 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
What role does the posterior tibialis muscle play in stance phase of ambulation?
- decelerates (eccentrically) pronating rearfoot in loading response
90
What is pes cavus?
increased medial longitudinal arch
Applied Kinesiology
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