Chapter 8 Plumbline and Gait (page 18) Flashcards by IAM GroupE

Bad posture is often simply a bad habit, due to _______________, or as the __________________.

Misuse of the capacities of the body

Sequelae of some sort of trauma

How well did you know this?

Not at all

Perfectly

While joint integrity is maintained primarily by _______________, ultimately muscular activity
plays a key part in the maintenance of ____________, and maintains _____________.

Ligamentous structure

Good posture

Kinetic Work

How well did you know this?

Not at all

Perfectly

Muscles that are excessive in length are usually ______, and allow ___________ of opposing muscles. Muscles that are too short are usually ______, and maintain opposing muscles in a ______________.

Weak

Adaptive shortening

Strong

Lengthened position

How well did you know this?

Not at all

Perfectly

The word “tight” has two meanings. It may be used interchangeably with the word ______, or it may be used to mean ______.

Short

**Taut **(Short or lengthened muscle)

How well did you know this?

Not at all

Perfectly

Normally, the body is kept in the correct posture by the balancing action of opposing muscle groups and by the efficient working of the nervous system which controls this type of muscular activity; such activity is an anti-gravity reaction and is called ____________.

Postural Tone

How well did you know this?

Not at all

Perfectly

________ is the force by which all bodies are attracted to the earth; if unopposed, the body would f all to the ground.

Gravity

How well did you know this?

Not at all

Perfectly

The Centre of Gravity is a point at the exact centre of the __________; in ideal posture, it lies ________________, and moves upwards, downwards and sideways during activities.

Mass of the body

Approximately 1 inch anterior to S2

How well did you know this?

Not at all

Perfectly

The body is always trying to right itself within the _____________.

Gravitational field (Gravity Line)

How well did you know this?

Not at all

Perfectly

_____________ is a mechanism whereby the correct posture of the body is maintained at rest or during activity.

Postural Reflex

How well did you know this?

Not at all

Perfectly

_________ of postural deformity involves muscular hypertonicity, but no bony changes – can be corrected (prevention).

1st degree

How well did you know this?

Not at all

Perfectly

_________ is termed as a structural deformity involving extensive bony changes and correctible only with surgery (symptomatic relief).

3rd degree postural deformity

How well did you know this?

Not at all

Perfectly

___________ postural deformity involves muscular, fascial, and some bony changes - can help prevent further changes (maintenance).

2nd degree

How well did you know this?

Not at all

Perfectly

During the growing years, self-consciousness about early increases in height or developing breasts can affect posture, even into adulthood. This is an illustration of ____________ cause of postural inefficiency.

Psychological

How well did you know this?

Not at all

Perfectly

__________ is the most common direct organic cause of bad posture; with this condition, other
structures cannot take the burden and may give way leading to sprains, avulsions, dislocations.

Muscle Weakness

How well did you know this?

Not at all

Perfectly

Defective eyesight, constitutional weakness, respiratory or cardiac weakness are examples of __________ causes of postural inefficiency.

Heredity (Hereditary)

How well did you know this?

Not at all

Perfectly

Cramped, crouched or flexed positions for prolonged periods result in alteration of the vertebral curvatures and stretching or torsion of certain muscle groups. This is an illustration of ______________ as causes of postural inefficiency.

Occupations or Bad Habits

How well did you know this?

Not at all

Perfectly

Absence of back rests, incorrect desk or keyboard height, chair too high without foot support or standing too long are examples of ________________.

Detrimental Work Conditions

How well did you know this?

Not at all

Perfectly

_________________________ will overdevelop certain muscles at the expense of others.

Repeated carrying of heavy loads

How well did you know this?

Not at all

Perfectly

Posture may appear to be _____, yet the individual may be very flexible and the position of the body may change readily.

Faulty

How well did you know this?

Not at all

Perfectly

“IDEAL” POSTURE

body: __________________
hip and knee joints: _________
abdomen: _____________
arms hang from shoulders, with elbows and fingers: __________
head: _______________

Well-balanced, weight equal on both feet
Extended but not hyperextended
Retracted and lax
Slightly flexed
Erect and relaxed

How well did you know this?

Not at all

Perfectly

“IDEAL” POSTURE:

Back shows anatomical curves from caudad to cephalad:
__________ (sacral)
__________ (lumbar spine)
__________ (thoracic spine)
__________ (cervical spine)

**Kyphotic
Lordotic
Kyphotic
Lordotic **

How well did you know this?

Not at all

Perfectly

Ideal Posture can never be said to be established until _________________ of which the person is not aware

It has become a habit

How well did you know this?

Not at all

Perfectly

The ___________ refers to setting the vertical in a specific position for the view. When standing, that point is _________ – the point that moves the least in reference to the line, the most stable point in the person’s posture.

Fixed Point

Nearest the floor

How well did you know this?

Not at all

Perfectly

Post erior View:

Head in _____________, neither _____________
Cervicle spine is _______
Shoulders are ______, not _______________
Scapulae are ______ (should not be _______ and medial borders about _______ apart)

Neutral position (midline), Tilted nor rotated
Straight
Level, Elevated or depressed
Level (“winged” 3-4 inches apart)

How well did you know this?

Not at all

Perfectly

Posterior View - Thoracic and lumbar spines are \_\_\_\_\_\_\_ - Waist angles are \_\_\_\_\_\_ - Arms are _________ from body and \_\_\_\_\_\_\_\_\_\_\_\_ - PSIS are \_\_\_\_\_\_\_

**Straight** **Level** **Equidistant, Equally Rotated** **Level**

Posterior View - Gluteal folds are \_\_\_\_\_\_\_ - Greater trochanters are \_\_\_\_\_\_ - Lower extremities are \_\_\_\_\_\_\_\_\_\_ - Feet should have \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

**Level** **Level** **Straight** **Normal Alignment**

**Lateral View** Plumbline points _________ to lateral malleolus ________ to axis of knee joint __________ to axis of hip joint ___________ vertebral bodies of lumbar vertebrae ___________ to apex of coronal suture Earlobe in line with _________ and _________ of iliac crest

* *- slightly anterior - slightly anterior - slightly posterior - passes through - slightly posterior - acromion process, high point of iliac crest**

* *Anterior View** - Head is _______ on shoulders - Posture of jaw is \_\_\_\_\_\_\_\_\_ - Tip of nose is in line with \_\_\_\_\_\_\_\_\_\_\_\_\_\_ - Shoulders are _____ and trapezius is equal on both sides with \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ - The dominant arm is usually lower causing the slope on that side to be \_\_\_\_\_\_\_\_\_\_ and the shoulder \_\_\_\_\_\_\_\_\_\_\_

**Straight/Level** **Normal** **Sternal notch and xiphoid process** **Level, Respect to muscle bulk and slope** **Slightly greater, slightly lower**

* *Anterior View** - Clavicles & acromioclavicular joints are \_\_\_\_\_\_\_\_\_\_ - \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ of the sternum and ribs - “Carrying angle” of each elbow is about _____ degrees - Both palms face the \_\_\_\_\_\_\_

**Level and equal** **Normal alignment** **5-15** **Body**

* *Anterior View** - High points of iliac crest are \_\_\_\_\_\_\_\_\_\_\_ - Patella apex points \_\_\_\_\_\_\_\_ - Head of fibula are \_\_\_\_\_\_\_ - Malleoli are \_\_\_\_\_\_ - Arches of feet are \_\_\_\_\_\_\_\_ - Feet angle out (usually ___ degrees)

**The same height** **Straight down** **Level** **Level** **Normal** **10 **

Any tilting of the pelvis involves simultaneous movements of the ________ and \_\_\_\_\_\_\_\_\_\_. These movements may be caused by, or may cause, \_\_\_\_\_\_\_\_\_\_\_\_\_.

**Low back** **Hip joints** **Muscle imbalances**

Note four (4) examples of skeletal postures.

* *a. Ideal posture b. Kyphosis-lordosis-scoliosis posture c. Flat-back posture d. Sway-back posture**

POSTERIOR TILT: The pelvis tilts \_\_\_\_\_\_\_\_, causing the hip joints to _____ and the lumbar spine to \_\_\_\_\_\_\_\_.

**Backward** **Extend** **Flatten**

\_\_\_\_\_\_\_\_\_\_\_\_: Apparent leg length difference. This will cause to lengthen same side leg.

**Anterior Tilt**

ANTERIOR TILT: The pelvis tilts forward ____________ between the pelvis and the anterior thigh, resulting in flexion of the hip joint; the low back \_\_\_\_\_\_\_\_\_, therefore ________________ lumbar lordosis.

**Decreasing the angle** **Arches forward** **Increasing**

What are the possible causes of a Lateral Tilt?

**Handedness pattern Carrying body weight more to the “high” side True leg length difference SI dysfunction**

LATERAL TILT: One hip is \_\_\_\_\_\_\_\_\_\_\_\_\_ and correction occurs \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_.

**Higher than the other hip** **Above throughout the spine**

For a left-handed person, the handedness pattern is: - The left shoulder is ______ than the right; the pelvis deviates slightly towards the \_\_\_\_\_\_\_ - The left hip appears slightly ______ than the right - The ____ gluteus medius is usually weaker

**Lower** **Left** **Higher** **Left**

The Stance Phase consists of: (in order)

**Heel strike Foot flat Midstance (a.k.a. single leg stance) Heel off Toe off**

The Swing Phase consists of: (in order)

**Initial swing (acceleration) Midswing Terminal swing (deceleration)**

The gait cycle is divided into 2 major phases: - The stance phase consists of _____ of the gait cycle - The swing phase consists of _____ of the gait cycle

**60%** **40%**

The phases start with ________ and end with the next \_\_\_\_\_\_\_\_.

**Heel strike** **Heel strike**

This is the brief time in walking when both feet are making contact on the floor at the same time.

**Double stance**

What is the most weight-bearing phase during gait?

**Midstance of the same leg (Stepping leg)**

Most hip pathologies present themselves during what phase?

**Midstance of the same leg (Stepping leg)**

Double stance _________ when the pace increases and jogging or running starts.

**Decreases/ Disappears**

* *Heel strike to foot flat** (Muscles active) - \_\_\_\_\_\_\_\_ will fire eccentrically to absorb shock at the knee - \_\_\_\_\_\_\_\_\_\_\_\_\_, fires eccentrically to lower fore-foot, to the ground, for foot flat

**Quadriceps** **Anterior compartment of the leg**

* *Foot flat to mid-stance** (Muscle active) - \_\_\_\_\_\_\_\_ will fire concentrically, to (\_\_\_\_\_\_\_\_\_\_ only during resisted, i.e. uphill or stair climbing) - At mid-stance, _____________ will fire isometrically to steady pelvis

**Hamstrings** **Gluteus Maximus** **Hip Abductors (Gluteus Medius)**

* *Heel off to push/toe off** (Muscles active) - \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ fire concentrically, to propel the body forward

**Plantarflexors and long toe flexors**

* *Acceleration/ initial swing** (Muscle active) - \_\_\_\_\_\_\_\_ fire concentrically, ______________ start to fire concentrically later in this stage to shorten length of the leg through mid swing

**Hip flexors** **Hamstrings and dorsiflexors**

* *Mid-swing** (Muscle active) - ____________ fire concentrically to start to extend knee once leg is passed mid-point of mid-swing

**Quadriceps**

**Deceleration/ terminal swing** (Muscles active) - _________ fire eccentrically to slow extension of the knee and slow the leg back down to ground speed - Foot is in _____ due to active contraction of the __________ in preparation for the next phase

**Hamstrings** **Dorsiflexion** **Anterior compartment**

This abnormal gait pattern is due to pain during the stance phase and thus remains on the painful side for as little time as possible (short stance phase).

**Antalgic Gait**

An ataxic gait marked by unsteadiness and staggering making one have the appearance of being drunk.

**Cerebellar Gait**

The individual has difficulty initiating the first step, once initiated, the steps are small and shuffling.

**Glue-footed gait**

\_\_\_\_\_\_\_\_\_\_\_ - This type of gait marked by excessive hip abduction in the swing phase (seen in some upper motor lesions).

**Scissor gait**

This is described as unsteady, staggering gait.

**Ataxic gait**

The patient abducts the paralyzed limb, swings it around and brings it forward so the foot comes to the ground in front.

**Hemiplegic gait**

This gait is characterized by weakness or paralysis of abductor causes the hip to drop on the affected side during the swing phase.

**Trendelenburg gait** **aka gluteus medius gait**

This is usually caused by paralysis or weakened anterior compartment (tibialis anterior etc.)

**Foot drop gait**

This type of gait is marked by short steps may become successively more rapid.

**Parkinson's gait**

Gait with high steps (maybe seen with foot drop), if the dorsiflexors are paralyzed then the client must lift the leg up to clear the floor during swing phase.

**Equine gait**

**Steppage or Footdrop Gait** The patient has \_\_\_\_\_\_\_\_\_\_\_\_, resulting in a foot drop. To compensate and to avoid dragging the toes against the ground, the patient lifts the knee higher than normal; this results in a \_\_\_\_\_\_\_\_\_\_\_.

**Weak or paralyzed dorsiflexor muscles** **High steppage gait**

**Scissors Gait** The result of spastic paralysis of the \_\_\_\_\_\_\_\_\_, causes the knees to be drawn together so that the legs can only be swung forward by swinging the hips forward with great effort. This is seen in ________ and may be referred to as a \_\_\_\_\_\_\_\_\_\_\_.

**Hip adductor muscles** **Spastic paraplegics** **Neurogenic or spastic gait**

**Antalgic Gait** The stance phase on the affected leg is _______ than on the non-affected leg as the patient attempts to “get off” the affected leg as quickly as possible.

**Shorter**

**Arthrogenic Gait** This is due to \_\_\_\_\_\_\_\_\_\_\_\_. If the knee or hip is fused, or if the knee has recently been removed from a cylinder cast, the pelvis must be elevated by exaggerated plantarflexion of the other ankle & circumduction of the stiff leg to provide \_\_\_\_\_\_\_\_. This compensates for the \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_.

**Stiffness, laxity, or deformity** **Toe clearance** **Lack of flexion in the hip or knee**

**Short Leg Gait** If one leg is shorter than the other, or if there is a deformity in one of the bones of the leg, the patient will demonstrate ____________ and the pelvis will \_\_\_\_\_\_\_\_\_\_\_\_, creating a limp. The weightbearing period may be the same for both legs. It is also termed \_\_\_\_\_\_\_\_\_\_.

**A lateral shift to the affected side** **Tilt down on the affected side ** **Painless osteogenic gait**

**Ataxic Gait** If the patient has poor sensation or lack of muscle coordination, there is a tendency toward \_\_\_\_\_\_\_\_\_\_\_\_\_. The patient also watches the feet while walking. The gait is described as \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_.

**Poor balance and a broad base** **Irregular, jerky and weaving**

**Ataxic Gait** With \_\_\_\_\_\_\_\_\_\_\_\_\_, the gait is a lurch or stagger and all movements are exaggerated. With \_\_\_\_\_\_\_\_\_\_\_, the feet slap the ground because they cannot be felt.

**Cerebellar Ataxia** **Sensory Ataxia**

**Gluteus Maximus Gait** If the gluteus maximus muscle is weak, the patient will thrust the thorax posteriorly at (gait phase) __________ to maintain hip extension of the stance leg. The resulting gait has a \_\_\_\_\_\_\_.

**Initial Contact** **Lurch**

**Trendelenburg Gait** If the gluteus medius muscle is weak, the patient will exhibit an \_\_\_\_\_\_\_\_\_\_\_\_\_\_, thrusting the thorax laterally to keep the center of gravity over the ______ leg.

**An execesive lateral list** **Stance**

**Psoatic Limp** It may be due to ___________ of the _______ muscle. The limp shows classically as \_\_\_\_\_\_\_\_\_ of the hip. The patient will exaggerate movement of the pelvis and trunk to help move the thigh into \_\_\_\_\_\_.

**Weakness or reflex inhibition** **Psoas Major** **Lateral rotation, flexion and adduction** **Flexion**

**Stiff Knee or Hip Gait** Characterized by \_\_\_\_\_\_\_\_\_\_ of the other foot occurs and the affected leg swings forward \_\_\_\_\_\_\_\_. Because loss of flexibility in the hip or knee or both, gait length is different for both legs. When the stiff limb is weight bearing, the gait length will be \_\_\_\_\_\_\_\_.

**Excessive plantarflexion** **Through an arc** **Smaller**

Chapter 8 Plumbline and Gait (page 18) Flashcards

(73 cards)