Biomechanics Development Flashcards

1
Q

how is the newborn skeleton different from the adult skeleton

A

made of cartilage
-more compliant
-weaker and capable of creep
bone greadually copies configuration of cartilage over the first 25 years of life

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2
Q

shear forces

  • orientation to epiphyseal plate
  • caused by…
  • results in…
A

parallel to epiphyseal plate
normal pull of muscle around a joint
results in normal torsional changes in long bones
ex. lateral tibial torsion

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3
Q

compression forces

-orientation to epiphyseal pate

A

perpendicular to plate

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4
Q

what determines the size, shape and mass of your bones

A

genetics
environment
mechanical forces applied to bone through movement
pathology

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5
Q

skeletal development timeframe

A

5th week of gestation to end of skeletal ossification (25 years)

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6
Q

neonatal biomechanical problem list

A
rigid kyphotic spine
hip soft tissue contractures
shallow acetabulum
femoral structure
genicular differences
tib-fib torsion
ankle and foot structure
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7
Q

resolution of rigid kyphotic spine

  • when and how does it begin?
  • when can a child perform a cobra
  • what is required to successfully perform a cobra?
A

begins in 1st month of life as baby learns how to lift head against gravity in prone
capable of cobra by 4th or 5th month
requirements
-controlled extension throughout cervical, thoracic, and lumbar spine
-stabilize pelvis via simultaneous contraction of gluteal muscles

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8
Q

development of full mature spinal curves take ____

A

years of movement against gravity in a quadruped, sitting and standing position

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9
Q

hip soft tissue contractures

-which structures contribute to tightness

A

hip flexion
-iliofemoral and ischiofemoral (anterior) ligaments
-hip flexors (iliopsoas, sartorius, rectus femoris)
lateral rotation contracture

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10
Q

hip flexion contracture impeded what arthrokinematic movement?

A

distal and anterior glide of femoral head

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11
Q

shallow acetabulum

-how does acetabular shelf form?

A

muscle tension and body weight
-act to pull the femoral head into the acetabuluim
activities that apply hip extension, medial rotation, and abduction force (newborn kicking, 4 point, crawling, standing)

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12
Q

differences in the femur between a newborn and adult

A

coxa valga
antetorsion
femoral varus bowing

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13
Q

angle of inclination in newborn

A

150 degrees (adult 125)

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14
Q

how is the issue of coxa valga resolved

A

enlarge of greater trochanter
-due to action of piriformis, gluteus medius, and gluteus minimus
-i.e., external rotators, abductors, and extensors
this compression leads to a laying down of bone tissue along the uppermost border of the femoral neck

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15
Q

femoral varus bowing

-how does it resolve?

A

resolves by cantilever flexure drift

-compression forces cause resorption of bone on convex side and new bone growth on concave side

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16
Q

femoral antetorsion

  • what is it?
  • angle in newborns
  • angle in adults
A

medial twist of the femoral shaft, distal on proximal
newborn - 40 degrees
adult - 10 degrees

17
Q

how does antetorsion resolve in children

A

resolution of hip flexion contracture
-allows glut. max. and add. magnus to fire
consistent tensile loading by the muscles that extend and laterally rotate the hip

18
Q

what muscle stabilizes the pelvis/femur during actions that extend and laterally rotate the hip
-this muscle with contribute to resolution of…

A

gluteus medius

-will contribute to resolution of antetorsion and coxa valga

19
Q

why does the newborn appear laterally rotated if they have femoral antetorsion

A

soft tissue contracture (lateral rotators)

retroverted acetabulum

20
Q

appropriate femoral torsion values at

  • birth
  • 1 year
  • 9 years
  • adult
A

birth: 40
1 year: 35
9 years: 21
adult: 15-20

21
Q

differences in knee between newborn and adult

A

flexion contracture
medial genicular position
genu varum

22
Q

how great is the knee flexion contracture in newborns?

-when does it resolve?

A

30 degrees

resolves in first few months of life

23
Q

medial genicular position

  • newborn appears to have…
  • when does it resolve
  • resolves with what type of activities
A
apparent tibial varum
resolves with knee flexion contracture
activities
-belly crawling
-walking
-these activites apply lateral rotation force to proximal tib-fib
24
Q

changes in genu valgum/varum from birth to adulthood

-what causes the changes

A

genu varum early in development
-stimulates bone growth on medial condyles
genu valgus at 2-3 years
-stimulates bone growth on lateral condyles
genu valgum resolves through weight bearing

25
how much genu valgum/varus is present at... - birth - 3 years
birth -17 degrees varum 3 years -12 degrees valgum
26
genu valgum to ideal alignment - how much valgum is present at 8 years - how does it resolve
``` 8 years: 5 degrees resolution: compression forces on condyles due to -decrease in coxa valga -genicular position -femoral varus bowing ```
27
lower leg torsion at the transmalleolar axis (TMA) - torsion in newborn - torsion in adult
newborn: 0 degrees adult: 20 to 30 degrees posterior to frontal plane (fibula behind tibia)
28
how does TMA torsion occur to resolve to adult values? | -what type of movements cause this?
requires lateral rotatory torque across growth plates of tibia and fibula movements -toe standing -ambulation
29
"W" position may lead to increased...
femoral anteversion
30
sitting on the feet is commonly associated with...
internal tibial torsion
31
differences in ankle between newborns and adults
excessive talocrural dorsiflexion | shortened fibula
32
differences in ankle between newbors and adults
hindfoot varus - open chain | hindfoot valgus during infancy and the onset of weight bearing
33
relaxed calcaneal stance angle | -equation
RCS = 7 minus (age of child) -Valmassey this is the amount of calcaneal valgus they should have
34
foot progression angle - how is it measured? - negative versus positive value - what should values be at birth, 3 years, and adult
``` angle between -longitudinal axis of foot -line of progression of gait in-toeing = negative value out-toeing = positive value birth: 10 degrees 3 years: 2-6 degrees adult = 0- degrees ```
35
thigh-foot angle | -how is it measured
prone knee at 90 degrees foot in congruity measure posterior thigh bisection and plantar heel bisection -so you draw a line through the middle of the thigh and a line through middle of the heel to the 2nd toe, and you compare the angle they make
36
typical thigh-foot angle at - 1 year - 3 years - 5 years - 15-19 years - adult
``` 1 year: -3 degrees (toes point medially) 3 years: +5 degrees 5 years: +11 degrees 15-19 years: +12 degrees adult: +18 degrees ```
37
antetorsion vs anteversion
antetorsion -relation of femoral head to femoral condyles anteversion -relation of femoral head to frontal plane