Musculoskeletal review - end feels, gait, orthoses, ROM, and prosthetics Flashcards Preview

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Flashcards in Musculoskeletal review - end feels, gait, orthoses, ROM, and prosthetics Deck (49):
1

Normal End Feel types

Firm, Hard, Soft

2

Abnormal End Feel Types

Empty, firm, hard, soft, boggy

3

Firm end feels

Should feel like a stretch
Normal examples: DF, finger extension, hip medial rotation, forearm supination
Abnormal examples: increased tone, tightening of the capsule, ligament shortening

4

Hard end feels

Bone to bone
Normal: elbow extension
Abnormal examples: fracture, osteoarthritis, osteophyte formation, HO, MO

5

Soft

Soft tissue approximation - normal
Normal examples: elbow and knee flexion
Abnormal examples: edema, synovitis, ligament instability/tear

6

Emty:

Due to pain: joint inflammation, fracture, bursitis

7

Standard Terminology for Gait (not RANCHO)

Stance:Heel strike, foot flat, midstance, heel off, toe off
Swing: acceleration, midswing, deceleration

8

Peak muscle activity of tibialis anterior during gait

After heel strike - eccentric lowering of the foot (1st rocker)

9

Peak muscle activity of the gastroc-soleus during gait

During late stance phase, responsible for concentric raising of the heel during toe off (terminal stance)

10

Peak muscle activity of the quadriceps group

Two periods: in periods of single support during early stance phase and just before toe off to initiate swing phase

11

Peak activity of the hamstrings group during gait

During late swing phase for decceleration of the swing limb

12

Average BOS

2-4 inches for an adult. Decreases as speed increases

13

Cadence

110-120

14

Degrees of toe out

Angle formed by intersecting heel and second toe. 7 degrees

15

Step length

13-16 inches

16

Stride length

24-32 inches likely (56 inches?)

17

Shoulder medial and lateral rotation ROM

Medial - 70
Lateral - 90

18

Supination/Pronation ROM

0-80

19

Wrist ROM

Flexion - 80
Extension - 70
Radial deviation - 20
Ulnar deviation - 30

20

Metacarpophalangeal motion

Flexion - 90
Hyperextension - 45

21

Thumb motion

MCP flexion - 50
IP flexion - 80

22

Hip ROM

Flexion - 120
Extension - 30
Abduction - 45
Adduction - 30
MR/LR - 45

23

Ankle ROM

DF - 20
PF - 50
IV - 35
EV - 15

24

Cervical ROM

Flexion - 45
Extension - 45
Lateral flexion - 45
Rotation - 60

25

Thoracic and lumbar spine ROM

Flexion - 80
Extension - 25
Lateral flexion - 35
Rotation - 45

26

Q angle

13 degrees in males and 18 degrees in females

27

Solid ankle foot orthoses

Control DF/PF and IV/EV. Can be articulating or not. Articulation allows the tibia to advance over the foot. Trim line is anterior to the medial malleolus

28

Posterior leaf spring AFO

Plastic AFO with trim line posterior to the malleoli. Assists with DF and prevents foot drop. Requires adequate medial/lateral control by the patient.

29

Floor reaction AFO

Assists with knee extension during stance through positioning of calf band and or positioning of ankle

30

Corset

Spine orthosis - constructed of fabric. Abdominal compression and support. Utilized to provide pressure and relieve pain associated with mid and low back pathologies

31

Milwaukee Orthosis

For realignment of spine due to scoliotic curvature. Pelvis to upper chest with corrective padding

32

TLSO

Prevents all trunk motions - common for post-surgical stabilization

33

Symes amputaton

surgical removal of the foot and the ankle joint including the malleoli

34

Chopart disarticulation

Disarticulation at the midtarsal joint

35

Prosthetics: Causes of lateral bending

Prothesis too short, improperly shaped lateral wall, high medial wall, prothesis aligned in abduction
Poor balance, abduction conracture, short residual limb, weak hip abductors, hypersnsitive and painful residual limb

36

Prosthetics: Causes of abducted gait

Prothesis too short, high medial wall, poorly shaped lateral wall, prothesis positionined into abduction, inadequate suspension, excessive knee friction

Abduction contracture, adductor roll, weak hip flexors and adductors, pain over lateral residual limb

37

Prothetics: Causes of circumducted gait

Prothesis too long, too much friction in the knee, socket too small, excessive PF of foot

Abduction contracture, weak hip flexors, difficulty flexing knee, painful anterior distal residual limb

38

Prosthetics: Causes of excessive knee flexion during stance

Socket set forward in relation to foot, foot set in excessive DF, stiff heel, prothesis too long

Knee or hip flexion contracture, pain anteriorly in residual limb, decreased quad strength, poor balance

39

Prosthetics: Causes of vaulting

Prothesis too long, inadequate socket suspension, excessive alignment stability, foot in increased PF

Residual limb discomfort fear of stubbing toe, short residual limb, painful hip/residual limb

40

Rotation of forefoot at heel strike

Excessive toe-out buitl in, loose fitting socket, inadequate suspension, rigid SACH heel cushion

Poor muscle control, weak medial rotators, short residual limb

41

Forward trunk flexion

Socket to big, poor suspension, knee instability

Hip flexion contracture, weak hip extensors, pain with ischial weight baring, inability to initiate prosthetic knee flexion

42

Medial or lateral whip

Excessive roation of the knee, tight socket fit, valgus in the prosthetic knee, improper alginment of toe break

weak hip rotators, knee instability

43

A long prothesis can cause:

Circumduction, abducted gait, excessive knee flexion during stance, contralateral vaulting

44

A short prothesis can cause:

Lateral bending

45

A stiff heel can cause:

Excessive knee flexion during stance

46

A high medial wall can cause:

Lateral bending or abducted gait

47

Inadequate suspension can cause

Abducted gait, rotation of forefoot at heel strike, vaulting, forward trunk flexon

48

A poorly shaped lateral wall may cause:

Lateral bending, abducted gait

49

Pain in the residual limb (based on location) may cause: Ant vs lateral vs overall hypersensitivity

Hypersensitive limb/overall pain: lateral bending or vaulting

Lateral pain: abducted gait

Anterior pain: Circumducted or excessive knee flexion during stance