Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

myoActivation > Postural Malformations > Flashcards

Postural Malformations Flashcards

1
Q

Sitting:

Weight shifted to one ischial tuberosity

A

Gluteus Maximus
Adductor Magnus

Note the sacrotuberous ligament lies under and fuses with the medial aspect of the gluteus maximus, and this goes right over the ischial tuberosity. So if the gluteus is contracted this will irritate the ischial tuberosity.

Patients will sit with their weight shifted onto one ischial tuberosity because it is painful (consciously or unconsciously) to put pressure on the origin of the hamstrings (including the hamstring portion of the adductor magnus) of the contralateral ischial tuberosity. It is not that contracted muscles of the ipsilateral side are pulling the pelvis onto the ischial tuberosity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q 
Sitting:
On sacrum (not on ischia)
A

Adductor Magnus
Coccyx
Iliopsoas

Sitting on sacrum (not ischia) may relieve irritation to insertion of iliopsoas which does not insert into the ischial tuberosity itself, but rather the (medial) lesser tuberosity of the femur. When in hip flexion (sitting) this lesser tuberosity is in the same plane as the ischial tuberosity and they are adjacent to each other, so irritation of a contracted iliopsoas will manifest in a similar pattern with tenderness around this area which can be relieved with sacral sitting

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Sitting:

Torso lean to one side

A

Gluteus medius
Gluteus Maximus
Quadratus lumborum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Leg malpositions in sitting posture:

Feet internally rotated

A

Tibialis anterior

Medial gastrocsoleus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Leg malpositions in sitting posture: difficulty taking off socks or tying shoes

A 
Iliopsoas (stiff and contracted)
Gluteus Maximus
Gluteus minimus
Piriformis
(Shortened buttock muscles)

Piriformis O is at the front of the sacrum and I is at the upper border of the greater trochanter. It can be considered as part of the buttock complex and alongside contraction with Glute major and medius, that will restrict the ability of the pelvis to tilt forward and take part in flexion at the hip.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Plantar weight distribution- forefoot

- weight on ball of foot

A

Tibialis anterior
Adductors

With weight on the ball of the foot (presumably this means more medially?), the tibialis anterior (which runs under the retinaculum of the anterior ankle to the medial aspect of the foot and then inserts at the base of the 1st metatarsal) is contracted, essentially causing a dorsiflexion which drives the insertion point (1st metatarsal base) into the floor.
With adductor contracture, the adductor Os incl. Longus, brevis, and gracilis are at the more anterior aspect of the pelvis at the pubis (magnus inserts both here but also at the more inferior ischium) and then they trend more posteriorly insert at the distal femur.
Thus, if there is contracture here, the body will tip forward and lead to weight on the more medial and anterior foot (ball of foot).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Plantar weight distribution on forefoot

A

Tibialis anterior
Extensor digitorum longus
Extensor hallucis longus

Extensor digitorum longus (O is at the very proximal lateral condyle of the tibia (like up at the knee!) and runs lateral to the anterior tibialis) and extensor hallucis longus then comes off about a third more distally off of the fibula to then run adjacent/posterior to the EDL and anterior tibialis, and in front of the interosseus membrane. It then goes more medially under the ankle retinaculum in order to insert into the 1st distal phalanx on the dorsal aspect.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Plantar weight distribution - midfoot

- weight on lateral foot

A

Fibularis longus
Fibularis brevis

Shortening tips the body laterally

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Plantar weight distribution-midfoot

- medial foot

A

Abductor hallucis
Adductors

Shortening tips body medially

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Plantar weight distribution- heel

- medial heel

A

Tibialis posterior
Flexor digitorum longus
Flexor hallucis longus
Medial gastrocnemius

Tibialis Posterior arises from the proximal edge and then runs directly on top of the posterior aspect of the interosseus membrane and then the tendon runs posterior to the medial malleolus, wraps around this, and runs against the bones (so is deep to the other foot muscles including brevis muscles) and builds a bit of a “Deep floor” with attachments/ insertions into the tuberosity of the navicular bone on the inferomedial aspect of it, the 3 cuneiforms and most predominantly the medial cuneiform, laterally the cuboid, and the 2nd/3rd/4th MT bases.
Flexor digitorum longus starts at the proximal tibia on the posterior aspect and runs down it longitudinally, wraps around the medial malleolus, and then broadens out into 4 tendons that insert at the distal phalanges of 2/3/4/5 digits.
Flexor hallucis longus comes off of the inferior 2/3 of the fibula and IO membrane, and it runs more laterally along the length of the fibula adjacent to the tibialis posterior until crossing from the lateral to medial aspect of the posterior face of the talus, then also wrapping around the calcaneus through a groove in it (so not the medial malleolus) and then takes a straight shot to insert at the distal phalanx of the hallucis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Plantar weight distribution- heel

- central heel

A

Medial and lateral gastrocnemius

Soleus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Plantar weight distribution- heel

- lateral heel

A

Lateral gastrocnemius
Vastus lateralis
Biceps femoris

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Stands with one foot weighted; other foot weighted on toes with heel raised

A

Hamstrings

- unable to fill extend knee of affected leg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Toes gripping floor in flexion

A

Flexor digitorum longus

Flexor hallucis longus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Toes elevated without touching floor

A

Extensor digitorum longus
Extensor digitorum brevis
Extensor hallucis brevis

Extensor Digitorum brevis O is at the dorsal and lateral surface of the calcaneus and it then runs along the dorsal aspect of the 2/3/4 MTs and into the phalanges of the digits.
Extensor hallucis brevis O is similarly at the dorsal aspect of the calcaneus, then it runs along dorsal 1st MT and into hallucis phalanx.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Great toe pain, swelling, or bunion

A

Vastus lateralis at midshaft of femur

By being contractured on the lateral mid upper leg, there is an eversion mechanism that leads to increased loading of the first MTP.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Little toe elevation, deformity, or bunionette

A

Vastus medialis at midshaft of femur
Adductor brevis
Abductor digiti minimi

By being contractured on the medial mid upper leg at the vastus medialis and/or adductor brevis there is an inversion mechanism that leads to increased loading of the 5th MTP.
Abductor digiti minimi O is at the lateral process of the calcaneal tuberosity and plantar aponeurosis (plantar fascia) and I is the lateral side of the proximal phalanx of 5th digit.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Achilles’ tendon pain at insertion

A

Vastus intermedius- if pain more lateral treat more medially in muscle; if pain more medial, treat more laterally muscle
Medial and or lateral gastrocnemius
Soleus
Hamstrings

Posterior kinetic chain contracture

Vastus intermedius shortening causes knee hyperextension…think of treating 180 deg opposite… so if more lateral pain then treat more medial on vastus intermedius. If pain more medial then treat more lateral vastus intermedius.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Entire external leg rotation with patella deviated laterally

A

Gluteus Maximus
Vastus biceps femoris

Biceps femoris I is more posterior at the ischial tuberosity, and it inserts more anteriorly at the fibular head.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Entire leg internally rotated with patella medially deviated

A

Adductor longus
Adductor brevis
Adductor magnus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Lower leg internal rotation with centrally located patella

A

Lateral gastrocnemius

Note that the lateral gastrocsoleus inserts on the medial aspect of the calcaneus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Lower leg external rotation with patella central

A

Fibularis longus
Fibularis brevis
Medial gastrocnemius

Note that the medial gastrocsoleus inserts on the lateral aspect of the calcaneus
(Also, FYI, medial muscle bulk is larger and exerts more force than lateral).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Foot Pronation

A

Tibialis posterior
Abductor hallucis
Fibularis longus
Fibularis brevis

Pronation/pes planus can occur from the shortening of the muscles that go more medially into foot (tibialis posterior and abductor hallucis) and also from shortening of the lateral compartment muscles (fibularis) causing a tilt around the “stirrup” of the talus/calcaneus.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Pes planus

A

Tibialis posterior
Abductor hallucis
Fibularis longus
Fibularis brevis

Pronation/pes planus can occur from the shortening of the muscles that go more medially into foot (tibialis posterior and abductor hallucis) and also from shortening of the lateral compartment muscles (fibularis) causing a tilt around the “stirrup” of the talus/calcaneus.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Flattened longitudinal arch

A

Tibialis posterior
Abductor hallucis
Fibularis longus
Fibularis brevis

Pronation/pes planus can occur from the shortening of the muscles that go more medially into foot (tibialis posterior and abductor hallucis) and also from shortening of the lateral compartment muscles (fibularis) causing a tilt around the “stirrup” of the talus/calcaneus.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Supination

A

Tibialis anterior

Supination/ Pes Cavus: occurs from shortening of the tibialis anterior which inserts into the base of the 1st metatarsal and pulls up the entire medial aspect of the foot.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Pes Cavus

A

Tibialis anterior

Supination/ Pes Cavus: occurs from shortening of the tibialis anterior which inserts into the base of the 1st metatarsal and pulls up the entire medial aspect of the foot.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Elevated longitudinal arch

A

Tibialis anterior

Supination/ Pes Cavus: occurs from shortening of the tibialis anterior which inserts into the base of the 1st metatarsal and pulls up the entire medial aspect of the foot.

29
Q

Asymmetrical bulkened gastrocsoleus

A

Ipsi gastrocnemius
Ipsi soleus

Medial gastrocsoleus more prone to strain than lateral

30
Q

Tethered or vacuum packed skin on shin (mostly seems on bottom of squat base tests)

A

Any scar

Tethered areas of skin

31
Q

Hyperextended knee, genu recurvatum

A

Quadriceps- palpate you determine specific muscles involved

32
Q

Knee hyperflexion

A

Hamstrings- palpate to find specific muscles involved.

33
Q

Genu varum (bow legged)

A

Tensor fascia lata
Vastus lateralis

If bilateral will be bow legged

34
Q

Genu valgus (Knock kneed)

A

Adductors- palpate specific muscles to determine those involved

If bilateral knees touch (knock kneed)

35
Q

Patella medially shifted and lower leg internally rotated

A

Vastus medialis

36
Q

Lateral patellar deviation with lower leg externally rotated

A

Vastus lateralis

Patellar tendon is torqued laterally

37
Q

Anterior pelvis tilt

A

Adductor longus
Iliopsoas

Adductor longus O is at the pubis symphysis and it then inserts into the posterior aspect of the femur. Thus if shortened it will tilt the pelvis anteriorly. Likewise, iliopsoas O is posterior, but it runs over the inguinal canal/ pubis symphysis and inserts into the lesser trochanter of the femur (more posterior to the anterior psoas), thus if shortened will also cause anterior tilt.
– Iliopsoas has very significant ramifications (along with SCM) because they cross the midline.

38
Q

Posterior pelvic tilt

A

Gluteus Maximus
Hamstrings- palpate for specific muscles involved.

With posterior tilt, glute max inserts at the anterior femur and crosses over the ischial tuberosity en route to this. Through a somewhat different mechanism, the hamstrings I at the ischial tuberosity, and so with contraction will pull on the posterior segment of the pelvis, causing the tilt.

39
Q

Iliaca crest depression

A

Gluteus minimus

For Lateral Pelvic Tilts, it is important to determine if one side is elevated compared to a normal contra side, if it is depressed d/t a normal contra side, or if it is elevated/depressed along with a depressed/elevated contra side.
When it is not clear, palpation of a tender:
* quadratus lumborum translates into an elevated iliac crest on the ipsi side
* gluteus minimus/vastus lateralis translates into a depressed iliac crest on the ipsi side.

40
Q

Iliac crest elevation

A

Quadratus lumborum
Quadratus lumborum fascia

For Lateral Pelvic Tilts, it is important to determine if one side is elevated compared to a normal contra side, if it is depressed d/t a normal contra side, or if it is elevated/depressed along with a depressed/elevated contra side.
When it is not clear, palpation of a tender:
* quadratus lumborum translates into an elevated iliac crest on the ipsi side
* gluteus minimus/vastus lateralis translates into a depressed iliac crest on the ipsi side.

Often with asymmetrical iliac crests, employ the torso twist test and may find contralateral pain, where that triceps abdominus/semilunaris should be treated.

41
Q

Lateral pelvic shift

A

Gluteus minimus
Gluteus medius
Vastus lateralis

Vastus lateralis O is the greater trochanter. Contraction and shortening of this muscle along with the gluteus medius and minimus pull the pelvis through a shift towards the ipsi side.

42
Q

Pelvic rotation

A

Tensor fascia lata
Rectus femoris
Contralateral gluteus medius

For rotation, the rectus femoris and TFL shorten and pull the ipsi ASIS in a rotatory mechanism closer toward them (down and around, following the trajectory of the ASIS), and the contra gluteus medius, (which is attached to the ilium on the most posteromedial aspect, where it is making S-I contact on the other side of this edge) when shortened, pulls the contra greater trochanter of the femur back and around to the ipsi side

43
Q

Protracted (elevated) costal margin

A

Serratus anterior (contralateral)

This elevates the costal margin

44
Q

Depressed abdominal musculature at costal margin (anterior cinch)

A

Triceps abdominus

Rectus abdominus

45
Q

Unilateral mid torso depression

A

Triceps abdominus

Rectus abdominus

46
Q

Lateral torso shift at iliac crest

A

Triceps abdominus
Quadratus Lumborum

Lateral shift of entire torso reflects shortening/ contraction of lateral musculature

47
Q

Panus with Inguinal skin crease formed by soft tissue bulk

A

Entire length of Inguinal skin crease

Tension restricts pelvic movement and promotes weight gain

48
Q

Rotund protuberant belly

A

Rectus abdominus
Triceps abdominus

Abdominal muscle contraction creates a tense muscular wall

49
Q

Flank skin crease (posterior cinch)

A

Fascial band between 12th rib and skin creates this crease

50
Q

Humeral head elevation

A

Levator scapula
Platysma
Trapezius

Shortened muscles attached to the shoulder elevate the scapula

51
Q

Humeral head depression

A

Triceps abdominus
Latissimus dorsi

Lateral abdominal musculature depresses the shoulder through fascial tension

52
Q

Anteriorly displaces humeral head

A

Pectoralis major
Serratus anterior

A shortened pectoralis major pulls the humerus medially… Pectoralis major inserts at the proximal third of the humerus anteriorly. Thus when in tension will pull the unit anterior.

A shortened serratus anterior pulls the scapula forward.

53
Q

Elbow flexion

A 
Biceps brachii (usually long head)
Brachialis

Shortened muscles flex the elbow joint.
The long head of biceps is usually responsible.

54
Q

Restricted Head rotation

A

Levator scapulae
Upper fibers of trapezius

Posterior neck musculature with obliquely positioned fibers are most responsible for pain with rotation

LS O is at transverse process of C1-4 and I is at the superior angle of the scapula. This along with Upper fibres of traps, which O at the posterior occipital medially and I along the shoulder girdle at the scapular spine, acromion, and the clavicle, have Os and Is on opposite sides of a transverse plane through the body via obliquely oriented fibres, and thus with shortening will lead to rotational malalignment.

55
Q

Restricted Rotation with chin depression

A

Contralateral SCM

56
Q

Restricted Lateral neck tilt

A

Contralateral scalene

Contracted scalene muscles restrict a lateral tilt in the contralateral direction

57
Q

Lateral shift of head

A

Platysma
Scalene

Shortened lateral muscles may pull the head away from the midline.
Pain symptoms may be more pronounced on the opposite side originating in the stretched tissues.

58
Q

Anterior thrust/head forward position

A

Sternocleidomastoid
Platysma
Sterna fascia
Rectus abdominus

Shortening of any of the structures between the mastoid processes and The symphysis pubis may contribute to head forward posture.

From Anatomy Trains: The SCM is uniquely positioned, in standing posture, to create lower cervical flexion at the same time it creates upper cervical hyperextension. The exact cervical level where this switch is made varies with posture, but it usually between C2 and C3.

59
Q

Pain or difficulty with lying supine, especially on the exam table without a pillow.

A

Abdominal musculature
Abdominal scars

Shortening of these muscle prevents full lengthening of the anterior torso

60
Q

Painful/unable to lie in the lateral decubitus position, especially in sleep

A

Gluteus Maximus
Gluteus minimus
Gluteus medius
Vastus lateralis

Pressure on these muscles in sustained contraction leads to disturbed sleep

61
Q

If Scoliosis, what postural malposition to assess?

A

Lateral pelvic tilt: elevated iliac crest due to QL or QL Fascia; depressed iliac crest due to glute Min

Pelvic rotation: TFL, rectus femoris, contra glute Med

ParaSpinal muscles in the spinal concavity

Scoliosis May have origins in the large muscles around the pelvis

62
Q

Discuss progression thru catenated cycles of superman shoulder BASE tests

A

1st catenated cycle (identify palpable painful points first)
• latissimus dorsi
• teres major, teres minor, or lateral infraspinatus
2nd catenated cycle (needle randomly without identifying palpable painful points)
• triceps (random line of insertions along upper arm)
• posterior fibers of deltoid
3rd catenated cycle (identify palpable painful points first)
• infraspinatus Go 3/4 depths with 1 inch needle… don’t want to go too deep d/t
• supraspinatus foramenae and paper thin
4th catenated cycle (pinch up muscle to needle randomly)
• middle fibers of trapezius
5th catenated cycle if necessary (supine treatment position)
• pectoralis minor
• pectoralis major

63
Q

Name the phase and corresponding muscles of scapular reach

A

If restriction in

1)
glenohumeral extension then biceps brachii, Ant and post deltoid, platysma

2)
Forearm pronation then biceps brachii and supinator

3)
Elbow flexion then triceps brachii

4)
Glenohumeral addiction, then posterior fibers of deltoid and platysma

5)
Wrist radial deviation then extensor carpi ulnaris and flexor Carpi ulnaris

6) extension of all digits then flexor digitorum profoundis and superficialis

7)
Spinal extension then triceps abdominus

64
Q

Muscles Controlling Mandibular Movement:

Protrustion

A

Lateral pterygoid

Assisted by medial pterygoid

65
Q

Muscles Controlling Mandibular Movement:

Retraction

A

Posterior fibers of temporalis
Deep part of masseter
Geniohyoid
Digastric

66
Q

Muscles Controlling Mandibular Movement:

Depression

A

Gravity
Digastric
Geniohyoid
Mylohyoid

67
Q

Elevation

A

Temporalis
Masseter
Medial pterygoid

68
Q

Lateral Translation

A

Lateral Pterygoid

69
Q

Name the components of Orbicularis Oris

A 
Levator labii superioris
Zygomaticus major
Buccinator
Risorius
Platysma
Depressor anguli oris

myoActivation (1 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions