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Applied Anatomy > Gait 2 > Flashcards

Gait 2 Flashcards

1
Q

A patient is in stance phase. What is the main job of their muscles?

A

Primary function of muscles is to control and stabilize the joints of the stance leg as the body passes over them.

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2
Q

What causes the moments that the muscles are counteracting and controlling?

A

The moments are caused by GRFs and vectors of these forces

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3
Q

True or False

Type of muscle activity at a joint depends on the moment occurring at the joint

A

True!

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4
Q

The patient needs to slow/control a movement. What kind of contraction will they be using?

A

Eccentric

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5
Q

A patient is trying to initiate a movement. What kind of muscle contraction will they use?

A

Concentric

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6
Q

If a patient wants to add stability to a joint, how will their muscles be contracting?

A

Isometrically or through co-contraction

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7
Q

A patient is moving their right leg through the swing phase. What are the primary function of the muscles?

A
  • To promote or maintain joint positions
  • Accelerate or decelerate the leg
  • Ensure foot clearance
  • Position the limb for contact
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8
Q

A patient is accelerating their gait. What kind of muscle contraction are they performing?

A

Acceleration requires concentric activity

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9
Q

A patient is decelerating knee extension during terminal swing. What kind of muscle contraction are they using?

A

Deceleration requires eccentric activity

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10
Q

Active contraction to promote a certain position is…
A. Concentric
B. Eccentric
C. Isometric

A

A. Concentric

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11
Q

What force causes knee extension during terminal swing?

A

Momentum helps the knee fully extend during terminal swing.

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12
Q

A patient’s heel contacts the ground. What role is the glute max playing?

A

The glute max provides hip stability and keeps the hip from flexing

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13
Q

You observe a patient with a pelvic drop in IC and LR. What muscle is most likely weak?

A

Gluteus medius. It helps avoid excessive hip adduction/pelvic tilt. It prevents pelvic drop and promotes stability for the leg.

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14
Q

True or False

The quads don’t need to be on at IC

A

False

The quads need to be on at IC

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15
Q

Why should the quads be activated during IC and LR?

A

The knee is initially moved into extension via momentum. Then the joint moment moves to flexion as the body moves over the foot. The quads must be activated to control knee flexion.

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16
Q

What muscles need to be activated to clear the foot and to prevent foot slap gait during IC and LR?

A

The ankle dorsiflexors need to be on to maintain dorsiflexion and then to control ankle plantar flexion and eversion.

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17
Q

When are the most muscles used during gait?

A

The most muscles are used when transitioning from IC to LR because you are getting ready to go on one leg.

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18
Q

During midstance, if the hip abductors are not eccentrically working, what happens?

A

If the hip abductors are not on eccentrically activating, you get a Trendelenburg.

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19
Q

How is a Trendelenburg named?

A

It is named by the side of the pelvis that is up.

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20
Q

During midstance, both the quads and hamstrings are on. What does this do for the knee?

A

It provides stability for the knee in slight flexion

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21
Q

During midstance, the ankle is being controlled by…
A. Dorsiflexors
B. Plantar flexors

A

B. Plantar flexors

They are on to control dorsiflexion caused by the ankle rocker

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22
Q

A patient is in terminal stance, what muscle is eccentrically controlling hip extension?

A

Tensor fasciae latae. The TFL is a hip flexor, so it eccentrically controls hip extension and helps with stability at the knee.

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23
Q

What position does the line of gravity push the knee into during terminal stance?

A

Extension

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24
Q

A patient is in terminal stance and about to push off the ground. What muscles are used to push off?

A

The plantar flexors are concentrically on to push off the ground

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25
Q

True or False

During pre-swing, the hip coming back to neutral is an active process.

A

False

During pre-swing, the hip coming back to neutral is a PASSIVE process

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26
Q

At the end of pre-swing, what muscles turn on to start the swing phase?

A

The hip flexors

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27
Q

At the beginning of pre-swing, why does the hip flex?

A

The hip flexes due to knee flexion and ankle plantar flexion

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28
Q

A patient lifts their heel up to start pre-swing. What will be going on at the knee and hip?

A
  • The knee will flex due to the heel rise
  • The rectus femoris will help with hip flexion
  • The rest of the quads are on at the end of pre-swing to control knee flexion
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29
Q

During pre-swing, what muscles are working at the ankle?

A

Dorsiflexors are controlling for excessive plantar flexion.

30
Q

A patient begins to swing their leg through initial swing. What muscles are working at the hip?

A
  • Sartorius and gracilis pull the hip into flexion.
  • Rectus femoris also helps.
  • At higher velocities, iliacus and psoas also turn on
31
Q

True or False

In initial swing, momentum pulls the tibia forward with no muscle activity

A

False
When you start swinging your leg, the tibia lags behind you because you haven’t generated momentum yet. (Inertia keeps it from moving forward) This is what causes the hamstrings to turn on, flex the tibia, and get it moving.

32
Q

What muscles are working on the ankle at initial swing?

A

Low levels of dorsiflexion because you need to clear the foot.

33
Q

A patient is moving through initial swing and mid swing. What is mainly generating hip flexion?

A

Momentum takes the leg through mid-swing and terminal swing. The hip flexors don’t have to do much because momentum is what moves the hip forward

34
Q

True or False

During mid-swing, the quads are actively extending the knee.

A

False

During mid-swing, knee flexors turn off to allow momentum to begin to extend knee

35
Q

What muscles activate more to clear the toes during mid-swing?

A

Dorsiflexors increase their activity

36
Q

During what phase do 99% of hamstring strains occur?

A

99% of hamstring strains occur in terminal swing because they turn on to control both the hip and knee eccentrically.

37
Q

What role are the hamstrings and glute max playing in terminal swing?

A

Strong hamstring and glute max contraction control hip flexion to get ready for IC.

38
Q

What is eccentrically controlling knee extension during terminal swing?

A

The hamstrings are strongly contracting to control the rate of knee extension to prepare for IC.

39
Q

Most strains occur during…
A. Concentric activation
B. Eccentric activation

A

B. Eccentric activation or controlling activations

40
Q

What muscles are acting at the ankle during terminal swing?

A

The dorsiflexors are preparing for IC.

41
Q

A child is 18 months old, what stage of developing gait should they be at?

A

Gait should already be developed. It typically develops within 11-15 months.

42
Q

A 7 month old child is having trouble maintaining postural control. Will they most likely develop gait faster or slower than usual?

A

They will probably develop gait slower than usual. The rate controller is the ability to maintain postural control in sitting which is developed within the first nine months. If they can correct themselves and move around in sitting, they are more likely to be able to control their trunk while walking.

43
Q

What does initial gait look like?

A
  • high-guard, or flexed and abducted upper extremities
  • wide base of support (wider step width)
  • shortened steps and stride
  • fast cadence
  • increased hip external rotation (gives a wider BOS)
  • slightly decreased hip flexion and extension
  • absence of heel strike at initial contact
44
Q

Why do kids take small steps?

A

They have big heads, so their head is kind of pulling them forward since gait is just falling and catching yourself. They take small steps to try and catch up with the mass of their body.

45
Q

Children walk with their toes pointed out. What does this help with?

A

Hip external rotation give them a wider BOS.

46
Q

True or False

Children contact the ground with the whole foot rather than the heel.

A

True!

Some kids are also toe walkers, and they will hit with the balls of their feet first.

47
Q

At what age does the gait cycle mostly normalize?

A

It has mostly normalized to an adult gait between 3-5

48
Q

What aspects of gait normalize around 3-5?

A
  • heel to toe pattern. Start to make IC with the heel
  • Step width normalizes because they can balance over one leg now
  • Joint ROMs
  • Time spend in stance decreases because they have increased motor control and coordination during ambulation
49
Q

When do step length, cadence, and velocity begin to normalize?

A

These are all dependent on body height and limb length, so they do not stabilize until full skeletal growth is achieved.

50
Q

What is one of the most common complaints you might hear in a clinic?

A

Inability to run

51
Q

What is the #1 cause of injury in running?

A

Running!

It may have been too much, too soon, too fast, or too “off”

52
Q

A patient comes in with an injury that is preventing them from running. They would like to get back to running. What is your goal as a therapist?

A
  • Reduce the likelihood or reoccurrence of injury

- Improve technique or competitiveness

53
Q

What are the goals of running?

A
  • project body forward quickly
  • dissipate impact sufficiently
  • maintain balance in single support
  • reposition LE’s appropriately and efficiently
54
Q

True or False

The goals of running are not similar to the goals of walking.

A

False

The goals are similar to walking, but at a higher rate and greater force

55
Q

During running IC is…
A. Made on the heel like walking
B. More directly under body - because body is moving forward
C. Is made on the ball of the foot

A

B. More directly under body - because body is moving forward

56
Q

What is missing in running gait as opposed to walking gait?

A

There is no double limb support phase. There is always a flight phase that takes the place of the double limb support.

57
Q

During running, the ankle has…
A. Increased PF, DF, pronation, and supination
B. Decreased PF, DF, pronation, and supination

A

A. Increased PF, DF, pronation, and supination

58
Q

How is knee flexion affected by running?

A

The has increased flexion in early stance and swing

59
Q

You are watching a patient run. What do you observe about the arc of motion in the hip?

A

The hip swings through a larger arc of motion. The arc is dependent on speed. The hip has increased flexion (90 deg) and extension (45 deg)

60
Q

A patient is running and displays a lot of trunk movement, is this good?

A

No, the goal of the trunk is to be as stable as possible.

61
Q

A patient is running and displays increased transverse plane motion in the pelvis, is this good?

A

Yes. Increased transverse plane rotation is normal in running.

62
Q

What occurs at the arms during running?

A
  • Increased shoulder ROM

- Increased elbow flexion

63
Q

Elbow motion increases with…
A. Jogging
B. Sprinting

A

B. Sprinting

Elbow flexion is static at 90 deg with jogging, but there is more motion with sprinting

64
Q

If a patient does not have increased eversion and inversion during running, what will they experience more of?

A

Increased eversion and inversion increases duration of impact. It is increasing impulse which helps dissipate momentum. This patient will experience higher ground reaction forces.

65
Q

If the mid-foot is locked during running, what is the patient’s body preparing for?

A

A locked mid-foot provides rigidity for propulsion.

66
Q

What joint locks/un-locks the mid-foot?

A

The subtalar joint locks/un-locks the mid-foot

67
Q

What does an unlocked mid-foot provide for?

A

It allows the foot to adapt to the surface it is planted on.

68
Q

How is foot position the main cause of injury in running?

A

Prolonged or excessive pronation or supination are the main causes of injury. What happens at the foot affects the rest of the chain from the bottom up. It could cause strain in places it shouldn’t be.

69
Q

What are GRF’s influenced by?

A
  • velocity - higher velocity = higher ground reaction force
  • vertical displacement - how high you go when you run
  • shoes - different types of shoes are made for certain body types
  • surface - stress fracturs are much more likely on cement
70
Q

What do GRF’s influence?

A
  • foot pressures
  • joint forces
  • joint moments
  • impact and shock

Applied Anatomy (13 decks)

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