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OP GOOD TEST MATERIAL > Orthotics > Flashcards

Orthotics Flashcards

1
Q

Physical presentation of someone with CMT

A
  • Claw toes
  • pes cavus
  • equinus/varus
  • callusing on the 1st and 5th
  • motor and sensory loss
  • stork legs (inverted champagne bottle)
  • intrinsic wasting of hands and feet
  • muscle weakness (foot drop)
  • progressive
  • bilateral
  • distal to proximal
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2
Q

Orthotic Goals for MS

A
  • replace weakened muscle
  • improve balance
  • prevent deformities
  • accomodate fatigue through lightweight options
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3
Q

ABI (acquired brain injury)

A
  • closed, open, penetrating injury to the brain resulting in contusion
  • can result in flacidity or spasticity
  • upper motor neuron lesion
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4
Q

Tarsal tunnel syndrome

A

tibial nerve gets impinged in flexor retinaculum (medial aspect of the foot inferior to the malleoli and anterior to TP, FDL, FHL

  • symptoms include numbness and tingling with digits 1-3,
  • commonly seen with flat feet, pes plano valgus
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5
Q

hammer toes

A

-flexion of the PIP caused by inappropriate footweark and seen with OA

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6
Q

Charcot Marie Tooth

A

-genetic disorder that affects the distal segments of the hands and feet resulting in progressive muscle and sensory loss due to the destruction of the myelin sheath

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7
Q

fracture dislocation of extremity

A

fracture of the bone close to joint that results in dislocation of that joint.

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8
Q

Physical presentation of CP patient

A
  • spasticity
  • contracture
  • crouch gait
  • equinus, varus
  • motor dysfunction
  • scoliosis

Diplegia- pesplanovalgus crouch gait
Hemiplegia- equinus position of the ankle and UE flexor synergy

Can have speech, communication and learning disability

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9
Q

Physical presentation of OA patients

A
  • hallux valgus of the big toe
  • hammer or claw toes
  • pronation of foot
  • gross instability
  • Trendelenburg gait
  • antalgic gait
  • Heberden nodes at DIP
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10
Q

Flexion synergies in upper limb

A
  • elbow flexion
  • wrist flexion
  • finger flexion and adduction
  • thumb flexion and adduction
  • pronation
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11
Q

Extension synergies in lower limbs

A
  • knee hyperextension
  • ankle plantarflexion
  • stj inversion
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12
Q

Amyotrophic lateral scoliosis

A
  • motor neurons die causing symmetrical weakness from distal segments to proximal central
  • orthotic management is to support and prevent contractures
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13
Q

complete vs incomplete fracture

A

complete fracture- 2 distinct fragments from fractured sites

incomplete- still some continuity of the bone at fracture site.

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14
Q

Orthotic goals for SB

A
  • prevent deformity
  • correct a deformity
  • assist in ambulation, standing and transfers
  • ulcer management
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15
Q

Orthotic Goals for CMT

A
  • prevent deformity
  • replace a weakened muscle
  • protect unstable joints
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16
Q

RF varus and flexible FF valgus, what happens

A

Significant pronation is seen during stance. As the STJ begins to pronate the MTJ becomes mobile causing even more pronanation an dmaking the FF valgus flexible

Callus formation on the 1st and 2nd MH

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17
Q

Supination during toe off is achieved by

A
  • forward pelvic rotation of the contralateral swing limb
  • adequate achilles flexibility
  • metatarsal head oblique orientation
  • bone interposition
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18
Q

Functional elements of gait

A

limb stability

  • challenged by the height of COM
  • changing body segments

Progression

  • forward fall of the body
  • swing limb momentum

Energy conservation

  • using momentum to substitute for muscle power
  • displacement of the body in all planes (determination of gait)
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19
Q

Knee flexion LR-MSt

A

Determinant of gait that conserves energy by lowering vertical displacement of the CofG during LR-MSt

Knee flexion after knee strike decreases the vertical height of the CofG by 7/16

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20
Q

What are the determinants of Gait

A
  • Pelvic rotation
  • Lateral pelvic shift
  • Pelvic tilt
  • Knee flexion (stance flexion)
  • Knee motion
  • foot and ankle motion
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21
Q

Goals of orthosis stroke patient

A
  • correct and prevent deformity
  • protect unstable joint
  • maintain joint ROM
  • break synergies
  • improve energy conservation
  • promote weight bearing/ambulation improve safety
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22
Q

What are the intrinsic and extrinsic causes for excess pronation

A

Intrinsic

  • FF Varus & 5th ray
  • PF 5th ray
  • RF Varus
  • FF valgus & 1st ray

Extrinsic

  • Tibial varum
  • internal tibial and femoral version
  • obesity
  • muscle imbalance (spastic peroneals)
  • small gastrocs
  • muscle spasms (eg. RA)
23
Q

Initial Swing

A

Definition: the thigh begins to advance as the foot comes off the floor (62-75 percent)

Kinematics

  • A 5 degress PF
  • K 60 degrees Flexion
  • H 15 degrees flex

Kinetics

  • A ext PF due to weight distribution of
  • K thigh advancement and tibial inertia (flex torque)
  • H tibial inertia maintain hip ext torque

Muscles

  • A dorsiflexors
  • K biceps femoris and sartorius
  • H R.F. iliacus, adductor longus, gracilis
24
Q

Treatment theories for scoliosis. Essential components when fabricating, fitting/ modifying

A

-Stable pelvic base

outrigger or extension to implement corrective forces

  • force couples
  • lumbar corrective forces apply pressure on transverse processes
  • thoracic corrective forces apply pressure to ribs
25
Q

compression stress

A

shortening forces perpendicular to cross sectional areas

26
Q

tensile stress

A

lengthening forces

27
Q

shear stress

A

oblique external load, stress in parallel to surface

28
Q

young’s modulus

A

measurement of the slope of stress strain curve, in a measurement of the elastic deformation stage and in a measurement of stiffness

29
Q

what are true/false and floating ribs

A

true- direct articulation (1-7)
false- indirect articulation (8-10)
floating- no articulation (11-12)

30
Q

what does intercostal space contain

A

muscle fascia, vessels and nerves

31
Q

femoral neuropathy

A

loss of function

32
Q

spinal nerve and curves pass through

A

intervertebral foramina

33
Q

axial skeleton

A

skull, spine, ribs sternum manubrium

34
Q

appendicular skeleton

A

shoulder girdle, pelvic gridle and limbs

35
Q

fibrous capsule

A

circumferential and encapsulates the entire acetabular rim and femoral neck. stabilizes the joint

36
Q

acetabular labrum

A

surrounds the acetabulum and increases surface area of the socket but sacrifices mobility

37
Q

acetabular labrum

A

surrounds the acetabulum and increases surface area of the socket but sacrifices mobility

38
Q

transverse ligament

A

bridges the acetabular notch

39
Q

ischiofemoral ligament

A

posterior
O: body of the ischium
I: medial to GT

Prevents extension and internal rotation

40
Q

Intertrochanteric crest vs intertrocanteric line

A

crest is posterior
line is anterior

both connect the GT to the Lesser T

41
Q

Iliofemoral ligament

A

Anterior
O: anterior inferior iliac spine
I: intertrochanteric line

Prevents extension and adduction

42
Q

Pubofemoral ligament

A

Inferior medial
O: iliopubic eminence
I: inferior neck of the femur

Prevents abduction and some extension

43
Q

Rib humb

A

Prominence of the ribs on the convexity side of the curve due to vertebral rotation and is measured by the forward bend test (Adams)

44
Q

FF valgus

A

forefoot wrt to the rearfoot in an everted position

compensation

  • STJ supination (LR-MSt) to bring the lateral side of the foot down
  • callus formation is on the 1st and 5th MH

uncompensated
-BW on the medial aspect of the foot

complications
-lack of shock absorption and knee pain

45
Q

Spina bifida

A

neural tube defect resulting in malformation of the neural tube. results in impairments below the lesion level. UPPER and LOWER

46
Q

Cystica myelomeningocele

A

meninges and S.C protrude through the spinal column in a cystic sac. accompanied by neural deficit below the lesion level

47
Q

cystica meningocele

A

meninges protrude through the spinal column while the spinal cord remain intact

48
Q

occulta

A

meninges and SC remain intact. dimple and small tuft of hair are the only symptoms

49
Q

Terminal Swing

A

the knee extends the limb to prepare to contact the ground for initial contact

Kinematics
A- Neutral
K- 5 degrees flexed
H- 20 degrees flexed

Kinetics
A- int df moment
K- tibial momentum causing external extension moment
H- tibial momentum causing external hip flexor moment

Muscle
A- dorsiflexors
K- quads
H- hamstrings decelerate and gluteals prepare for IC in frontal plane

50
Q

Terminal Stance

A

forefoot provides the locker where the feet and limb move forward to allow progression of the stance limb

Kinematics
A- 10 degrees DF
K- 5 degrees F
H- 20 Extend

Kinetics
A- anterior
K- Anterior
H- Posterior

Muscle
A- PF, Tib post, Peroneals
K- Biceps Femoris
H- Illiofemoral Ligament, TFL

51
Q

List ways to measure maturity and growth remaining for scoliosis patient

A
  • riser sign
  • Menarch 2 years after left of growth
  • wrist bone
  • vertebral epiphysis
52
Q

Mid Swing

A

The thigh continues to advance and the knee begins to extend

Kinematics
A- Neutral
K- 25 degrees Flexed
H- 25 degrees Flexed

Kinetics
A- internal DF moment
K- tibial momentum creating knee extension moment
H- tibial momentum creating hip flexor moment

Muscles
A- DF
K- extension controlled by hamstring
H- controlled by hamstring

53
Q

ligaments of the vertebral column

A 
Anterior Longitudinal- 
Posterior Longitudinal
Interspinous
Intertransverse
Supraspinous
Ligamentum Nuchae
Ligamentum Flavum

OP GOOD TEST MATERIAL (2 decks)

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