gait and ontogeny Flashcards
(59 cards)
1
Q
subtalar joint neutral position
A
- joint is neither pronated or supinated
- a bisection of the leg would also bisect the calcaneus
2
Q
met heads in neutral position/normal stance
A
- all met heads should bear weight
- 6 points total: 2 under 1st met head, 1 under each lesser met head
- mets 2-4 should be maximally dorsiflexed, mets 1 and 5 should be at their center of range of motion
3
Q
clinical criteria for normal stance: tibia, patella, ankle joint, subtalar joint
A
- patella is in frontal plane
- tibia is perpendicular to ground and in sagittal plane
- ankle joint is at 90°
- subtalar joint is neutral
4
Q
fetal position: hips, legs, feet
A
- hips are externally rotated and maximally flexed
- legs are internally rotated, knees maximally flexed
- feet are plantar flexed and inverted
5
Q
angle of inclination: how is it measured?
A
- shaft-neck angle
- frontal plane measurement
6
Q
angle of inclination: birth vs adulthood
A
at birth: 135-140°
adulthood:
- males 126-128°
- females 90 - 125°
7
Q
angle of anteversion: how is it measured?
A
- angle formed by neck of femur w/ respect to frontal plane
- transverse plane measurement
8
Q
angle of anteversion: birth vs adulthood
A
- at birth: 60° externally rotated in transverse plane w/ respect to frontal plane
- undergoes 50° internal change: 10° externally rotated in adulthood
9
Q
angle of anteversion: in-toeing vs out-toeing
A
- in-toeing can occur if a greater than normal versional change occurs (internally rotates too far)
- out-toeing can occur if a less than normal versional change occurs (stays too externally rotated)
10
Q
femoral torsion: how is it measured?
A
- angle between the neck of femur and bicondylar line
- transverse plane measurement
11
Q
femoral torsion: angles at birth vs adulthood
A
- birth: 30° internally rotated
- adulthood: 10° internally rotated
12
Q
femoral torsion: in-toeing vs out-toeing
A
- in-toeing can occur is the angle is greater than normal/too little torsional change occurs
- out-toeing can occur if the angle is less than normal/greater than normal torsional change occurs
13
Q
how are knees at 0° in transverse plane?
A
angle of anteversion is 10° external, angle of femoral torsion is 10° internal –> together, 0°
14
Q
tibial plateau position: how is it measured?
A
- posterior angulation relative to sagittal plane
- sagittal plane change
15
Q
tibial plateau: birth vs adult angle
A
- at birth: angulated 30° posteriorly
- in adulthood: angulated 5° posteriorly
16
Q
genu recurvatum
A
- hyperextended knees
- can be from too much tibial plateau change
17
Q
genu procurvatum
A
- unable to fully extend knees
- can be from too little tibial plateau change
18
Q
frontal plane bowing of tibia: birth vs adulthood
A
- birth: 15-30° varus
- adult: 0-2° varus
19
Q
knee position changes after birth
A
- birth: genu varum is present
- age 2: knee straightens
- ages 4-6: becomes slightly genu valgus
- straightens, goes back to genu valgum at 12-14
- age 14: knee is straight
20
Q
tibial torsion: how is it measured?
A
- malleolar position is measured
- bisection of tibia proximally to bisection of medial and lateral malleoli distally
- frontal plane measurement
21
Q
tibial torsion: birth vs adulthood
A
birth: 0°
adulthood: 13-18° externally rotated
22
Q
tibial torsion: in-toeing vs out-toeing
A
-in-toeing can occur if tibial torsion is decreased
- out-toeing can occur if tibial torsion is decreased
23
Q
talar adduction: birth vs adulthood
A
at birth: head and neck are adducted 33° relative to body of talus
in adulthood: head and neck are adducted 22° relative to body of talus (undergoes abduction)
24
Q
talar adduction: in-toeing
A
can result from lack of ontogeny of head and neck of talus (talus doesn’t abduct enough from birth position)
25
valgus rotation of head of talus: what is it?
talar head rotates in frontal plane, bringing medial foot to ground
26
valgus rotation of head of talus: birth vs adulthood
- birth: head is everted 10° relative to transverse plane
- adulthood: 40° valgus (undergoes valgus torsion)
27
calcaneal ontogeny: how does calcaneus change over development?
- begins inverted
- straightens to be at intersection of sagittal and frontal planes, perpendicular to transverse plane
28
calcaneus: angle at birth vs adulthood
- birth: 15-30° varus
- adulthood: 0°
29
terminal double support
heel strike to opposite toe off
30
initial double support
opposite heel strike to contralateral toe off
31
step
advancement of one foot
32
cadence
steps/min
33
stride
advancement of both feet
34
walking speed
time to walk set distance
(stride length/gait cycle)
35
stride length
heel contact to heel contact of same foot (2 steps)
R step length + L step length
36
step length
heel contact to heel contact of other foot
37
step width
distance between heel centers
38
foot angle
degree of toe out w/ line of progression
39
phases of weight acceptance
heel strike and foot flat
40
phases of single limb support
midstance through heel lift (terminal stance)
41
phases of limb advancement
preswing, initial swing, midswing, terminal swing
42
phase 1: heel strike speed, contact
- tibialis anterior slows movement of foot to floor
- contact is made on lateral border of heel
43
phase 1 heel strike: positions of each joint (hip, knee, ankle, subtalar)
- hip and knee are internally rotating
- foot is supinated and rigid
- subtalar joint is slightly inverted
44
foot flat: soft tissue changes
- soft tissues expand, arches lower
- allows lower limb to internally rotate
45
foot flat: positions of each joint
hip: extending, internally rotating
knee: flexing to ~15°
ankle: plantar flexing so foot meets floor
subtalar joint: pronating (foot is pronated ~4°)
46
midstance: what's happening
-weight is taken onto one limb (this limb is at midstance of gait cycle), other limb is swinging through for next step
47
midstance: positions of each joint
hip and knee: begin to straighten (extending), stop rolling inwards
ankle: dorsiflexing, foot stops rolling inward
subtalar joint: supinating to neutral position for propulsion
48
terminal stance: what's happening
- rigid for propulsion
- load is taken onto forefoot, pressure is between 1st and 2nd toes so 1st MPJ can bend
- heel lift occurs at end
49
terminal stance: positions of each joint
hip: extending
knee: maximal extension, then begins to flex
ankle: rapid plantar flexion
subtalar: almost maximum supination
50
preswing: what's happening
double support: other foot hits ground and takes on pressure
big toe of foot in preswing is last to leave ground
51
preswing: positions of each joint
hip: flexing from maximally extended position
knee: flexing
ankle: maximum plantar flexion
subtalar: maximum supination
52
initial swing: positions of each joint
hip: flexing, externally rotating
knee: flexing near maximal
ankle: slight dorsiflexion
subtalar joint: rapid pronation
53
midswing: positions of each joint
hip: flexing, beginning to internally rotate
knee: maximum speed of rotation
ankle: dorsiflexing to neutral
subtalar: pronating
54
terminal swing: positions of each joint
hip: flexing, beginning to internally rotate
knee: extending close to full extension for limb advancement
ankle: dorsiflexed to neutral
subtalar: moving towards slight supination
55
age where adult heel strike, normal knee flexion appears
age 2
56
age where reciprocal arm swing develops
age 4
57
age where adult base of gait develops
age 4
58
in pediatric gait, the _______ phase is decreased to minimize demand for _________
swing phase; single leg support
59
geriatric gait: length of double vs single support
- double support is longer than single
- stride length decreased
