Exam 3 Review

Question 1

Gluteus Medius Gait

Answer 1

• AKA Trendelenburg Gait
• Related to a lateral lurch gait
• Trunk (or pelvis) falls excessively on the swing side
• Compensates by leaning toward the stance leg, keeping COG over the stance leg and allows swing leg to clear the ground
• Use a cane on the opposite side of the weakness

Question 2

Gluteus Maximus Gait

Answer 2

• Sagittal plane stability and restraint of forward progression
• Restrains the forward movement of the femur in late swing of normal gait
• When paralyzed, the trunk must be thrown posteriorly at heel strike, preventing the trunk from falling forward
• Backward lean is typical

Question 3

Quadriceps Gait

Answer 3

• Hip extensors and plantar flexors
• Forward trunk bending/rapid plantar flexion after initial contact
• Gluteus maximus and soleus pull the femur and tibia posteriorly
• Results in knee hyperextension and eliminates the need for quad activity

Question 4

Plantar Flexor Gait

Answer 4

• AKA sore foot gait
• Weakness of plantar flexor group
• Greater ankle DF and knee flexion during stance
• Shortened step length on the affected side
• Abrupt lift-off rather than a rocking motion
• Increased quad activity to stabilize knee during stance

Question 5

Anterior Tibialis Gait

Answer 5

• Anterior compartment muscles

- Can produce 2 specific gait patterns: slap foot gait and steppage gait (use hip flexors since dorsiflexion is gone)

Question 6

Normal ROM for Knee

Answer 6

Flexion
- Active ROM
~Hip Extended → 120 degrees
~Hip Flexed → 140 degrees
- Passive ROM → 160
Extension
~Active/Passive ROM → -5 to 10 degrees

Question 7

Normal Hip Flexion

Answer 7

120

Question 8

Normal Hip Extension

Answer 8

30

Question 9

Normal Hip Abduction

Answer 9

45

Question 10

Normal Hip Adduction

Answer 10

30

Question 11

Normal Hip ER

Answer 11

45

Question 12

Normal Hip IR

Answer 12

45

Question 13

Angle of Inclination

Answer 13

The angle formed by the meeting of the axis of the shaft of the femur with the long axis of the femoral neck and head

Question 14

Angle of Torsion

Answer 14

Head and neck of femur rotate outward from shaft of femur

Question 15

Coxa Varum

Answer 15

• <120
• Can actually increase stability of the joint if not too extreme
• Can predispose the femoral neck to fracture

Question 16

Coxa Valgum

Answer 16

• > 135
• Decreases amount of femoral articular surface in contact with the superior and central labrum
• Decreases stability of the hip
• Predisposes hip to dislocation

Question 17

Femoral Retroversion

Answer 17

• <15 degrees
• W/out ER the femur, the retroversion causes the neck of the femur to impinge on the front of the acetabulum and puts significant pressure on the labrum
• Greater ROM of hip ER than IR
• Causes duck walk (toeing out)

Question 18

Femoral Anteversion

Answer 18

• > 15 degrees
• Causes pigeon toe (toeing in)
• Common cause of “winking patella”
• Femur must medially rotate to restore congruence to the joint
• Predisposes hip to anterior dislocation

Question 19

Kinematic Chain Pronation

Answer 19

• Pelvis –> (R) CCW; Fwd Translation; Anterior Rotation
• Hip –> Flexion; Adduction; Internal Rotation
• Knee –> Flexion; Valgus; Tibial Internal Rotation
• Ankle –> Dorsiflexion
• Subtalar –> Calcaneal Eversion; Talar Adduction and Plantarflexion
  Midtarsal –>Unlocking
  First Ray –> Unlocking

Question 20

Kinematic Chain Supination

Answer 20

• Pelvis –> (R) CW; Bwd Translation; Posterior Rotation
• Hip –> Extension; Abduction; External Rotation
• Knee –> Extension; Varus; Tibial External Rotation
• Ankle –> Plantarflexion
• Subtalar –> Calcaneal Inversion; Talar Abduction and Dorsiflexion
• Midtarsal –> Locking
• First Ray –> Locking