Anatomy of locomotion

Question 1

What is resting posture?

Answer 1

Minimal muscular activity
Feet splayed and slightly apart
Hips and knees extended

Question 2

Which muscles make up the triceps surae?

Answer 2

Two headed gastrocnemius, soleus

Question 3

What is static posture?

Answer 3

How you hold yourself when you’re not moving (sitting, standing, sleeping). Body segments aligned and in fixed positions. Usually achieved by coordination and interaction of various muscle groups

Question 4

What does ITB do?

Answer 4

Locks knee in hyperextension (rigid support pillar, important stabilizer of knee in extension and partial flexion in walking and running

Question 5

How does the popliteal contribute to resting posture?

Answer 5

Unlocks knee (lateral rotation of femur during stance, medially rotates tibia in swing). Posterior pull on lateral meniscus prevents crushing in knee flexion

Question 6

Why is normal gait efficient?

Answer 6

Uses gravity and momentum, most energy in level walking is eccentric dorsiflexion after heel strike and plantar and toe flexion at push-off

Question 7

What is a stride equivalent to?

Answer 7

2 steps

Question 8

Process of walking

Answer 8

• Starts with ‘heel strike’ (heel on ground) and finishes with toe-off
• Hip and knee flex to draw limb forward
• Foot dorsiflexes immediately after toe-off so the foot clears the floor
• Hip abductors stabilize pelvic girdle and prevent pelvis dropping on contralateral side

Question 9

Which muscle extends hip?

Answer 9

Gluteus maximus

Question 10

Which muscles flex the knee?

Answer 10

Hamstrings (biceps femoris, semitendinosus, semimembranosus)

Question 11

Which muscles do plantar flexion?

Answer 11

Gastrocnemius, soleus, plantaris, achilles tendon

Question 12

Which muscles flex the hip?

Answer 12

Iliopsoas, rectur femoris, sartorius, pectineus, tensor dascia lata

Question 13

Which muscles extend the knee?

Answer 13

Quadriceps

Question 14

Which muscles perform dorsiflexion?

Answer 14

Tibialis anterior, extensor digitorum/hallucis longus

Question 15

How much of normal gait is stance?

Answer 15

60%

Question 16

How much of normal gait is standing?

Answer 16

40%

Question 17

Characteristics of toddlers walk

Answer 17

Slower, high cadence, flexed elbows

Question 18

What is the stretch shortening cycle?

Answer 18

Eccentric followed by concentric

Question 19

What is a concentric action?

Answer 19

Muscles are shortened and force is produced

Question 20

What is amortisation?

Answer 20

Stretched muscles store energy

Question 21

What is an eccentric action?

Answer 21

Muscles actively lengthened

Question 22

What is the flight stage?

Answer 22

Completely off ground

Question 23

What is an asymmetrical gait?

Answer 23

One limb is normal and the other stiff

Question 24

What is hemiplegic gait caused by?

Answer 24

MS and prolapsed vertebral disc

Question 25

Characteristics of hemiplegic gait

Answer 25

Asymmetrical Affected limb in extension with feet inverted Ankle plantar flexion causes toes on affected side to drag on floor Affected leg circumducts

Question 26

Why do you circumduct your leg in abnormal gaits?

Answer 26

To prevent feet dragging on floor

Question 27

Characteristics of spastic gait

Answer 27

Findings similar to hemiplegic gait but bilateral Limbs stiff, feet inverted and internally rotated Excessive adductor tone draws hips together Spasticity causes leg overlap Circumduction of both legs

Question 28

What is spastic gait caused by?

Answer 28

Cerebral palsy

Question 29

What is the parkinsonian gait caused by?

Answer 29

Tremor, rigidity, bradykinesia

Question 30

Characteristics of parkinsonian gait

Answer 30

``` Short stepping, shuffling Minimal arm swing Difficulty when turning around/stopping walking/initiating new movements Stooped posture Hypomimia Hypokinetic gait ```

Question 31

What is hypomimia?

Answer 31

Expressionless face

Question 32

What causes ataxic gait?

Answer 32

Stroke, alcoholism, MS

Question 33

Symptoms of ataxic gait

Answer 33

Broad based, unsteady, if unicerebellar lesion present, patient may lean towards affected side

Question 34

What is a foot drop?

Answer 34

Weakness of dorsiflexion, so foot drops and toes drag during swing phase

Question 35

What causes foot drop gait?

Answer 35

Motor weakness of nerves supplying tibialis anterior (common perineal nerve)

Question 36

Characteristics of foot drop gait

Answer 36

Foot drop High stepping gait Feet stamping

Question 37

What causes Trendelenburg gait?

Answer 37

Hypo/hyper parathyroidism Acromegaly Duchenne's muscular dystrophy

Question 38

Characteristics of Trendelenburg gait?

Answer 38

Hip abductors are weak (can't contract and stabilise pelvis during stance phase) Circumduction and waddling prevents foot from dragging

Question 39

What is acromegaly?

Answer 39

Increased size of bones

Question 40

What is the Trendelenburg sign?

Answer 40

Drop in pelvis when lifting leg opposite weak gluteus medius because of weak hip abductors Compensated by leaning towards affected side to let affected leg come off ground

Question 41

What is pes planus?

Answer 41

Flat foot Arch collapses, can be congenital or acquired. Insufficiency of tib post or plantar fascia and calaneoclavicular joint Talar head displaces interiomedially

Question 42

What is ITB syndrome?

Answer 42

Iliotibialband syndrome | Iliotibial band is overused (e.g. long distance runners) causing it to become tight and inflamed

Question 43

What is jumpers knee?

Answer 43

Inferior patella pain

Question 44

What is shin splints?

Answer 44

Anterior shin pain (overexertion in untrained). Tib ant microtrauma on periosteum. DDx (stress fracture, compartment syndrome)