Posture Assessment

Question 1

When performing the posture exam the PT must be

Answer 1

1. Accurate and thorough- abnormalities are subtle
2. Able to separate parts of body from whole, THEN assess sum of parts in reference to their interaction within the entire body structure

Question 2

Correct posture

Answer 2

1. Alignment of body for max physiological and biomechanical efficiency
2. Minimizes stress/strain imparted to the supporting system by effect of gravity

Question 3

The gravity line is drawn through the body’s center of gravity - located where

Answer 3

2nd sacral vertebra

Question 4

T/F gravity line generally passes through all the joint axes of the body

Answer 4

F

Question 5

If forces acting about a joint are out of balance, _____

Answer 5

Faulty joint motion can occur

Question 6

Most important segments to have muscular and mechanical balance

Answer 6

Head, trunk, shoulders and pelvic girdle

Question 7

Examples of postural faults

Answer 7

Rounded shoulders

Lumbar lordosis

Question 8

Rounded shoulders

Answer 8

Shortened pec major and minor

Question 9

Lumbar lordosis

Answer 9

Tight hip flexors and elongated abs

Question 10

When should posture analysis be performed

Answer 10

After the history and systems review

Question 11

Usually start your observation (after patient is instructed to assume comfortable and relaxed posture)

Answer 11

Proximal lay and move dismally viewing the patient from anterior, lateral, and posterior

Question 12

Head and neck plumb line laterally

Answer 12

Ear lobe to acromion process

Question 13

Shoulder plum line laterally

Answer 13

Acromion process

Question 14

Thoracic vertebra laterally

Answer 14

Bisects the chest symmetrically

Question 15

Lumbar vertebrae laterally

Answer 15

Midway between abdomen, back, and slightly anterior to sacroiliac joint

Question 16

Pelvis and hip plumb line laterally

Answer 16

Anterior to SI joint and posterior to hip joint through greater trochanter

Question 17

Plumb line knee laterally

Answer 17

Slightly anterior to midline of jt

Question 18

Plumb line laterally ankle

Answer 18

Just anterior to lateral malleolus

Question 19

Post plum line head and neck

Answer 19

Bisects head through external occipital protuberance

Question 20

Post plum line shoulder and scapula

Answer 20

Midway between shoulders

Question 21

Post plum line trunk

Answer 21

Spinous processes of thoracic and lumbar vertebra

Question 22

Post plum line pelvis and hip

Answer 22

Plumb line bisects gluteal cleft with the PSIS, iliac crests, and greater throchanters are level

Question 23

Post plum line ankle and foot

Answer 23

Equidistant between medial malleoli

Question 24

Anterior view assess carrying angle of elbow

Answer 24

Men -5 to 10 degrees

Women - 10-15 degrees

Question 25

Anterior plumb line assess if

Answer 25

1. ASIS are level 2. Patellar alignment - straight, inward, outward 3. Angle of toeing out - norm values 5 to 7 degrees for each foot

Question 26

Causes of forward head

Answer 26

1. Tight cervical extensor, upper trap, and lector scapulae | 2. Elongated cervical flexors

Question 27

Causes of rounded shoulders

Answer 27

1. Tight pec major/minor, serratus anterior | 2. Weakness of thoracic extensors, middle trap and rhomboids

Question 28

Signs of rounded shoulders

Answer 28

Acromion process anterior to line | Scapulae abducted

Question 29

Signs of kyphosis

Answer 29

Increased posterior convexity of vertebrae

Question 30

Causes of kyphosis

Answer 30

1. Lengthened thoracic extensors, middle and lower traps, posterior ligaments 2. Tight anterior longitudinal ligament and anterior chest muscles

Question 31

Barrel chest

Answer 31

Increased overall anteroposterior diameter of the rib cage

Question 32

Anterior pelvic tilt

Answer 32

Lordosis

Question 33

Causes of lordosis

Answer 33

1. Tight hip flexors and low back extensors and posterior longitudinal ligament 2. Lengthened and weak lower abdominal muscles

Question 34

Posterior pelvic tilt

Answer 34

Flat back

Question 35

Causes of flat back

Answer 35

1. Tight hamstring | 2. Weak hip flexors

Question 36

When assessing laterally in the pelvis and hip, anterior pelvis drops and is called _____. This is caused by

Answer 36

Anterior pelvic tilt 1. Increased lumbar lordosis and thoracic kyphosis 2. Tight hip flexors 3. Lengthened abdominals

Question 37

Anterior pelvis is raised with minimal curvature in lumbar spine is called ____. And is caused by

Answer 37

Posterior pelvic tilt 1. Tight hamstrings 2. Lengthened hip flexors and lower abdominals

Question 38

Hyper extension of the knee is called ____. And is caused by

Answer 38

Genu recurvatum 1. Tight quads and calves 2. Lengthened posterior capsule and hamstring muscles

Question 39

Head tilt from posterior view

Answer 39

Patient's head lies more to one side of plum line | Caused by tightness of lateral neck flexors on one side

Question 40

Rotated head from posterior view caused by

Answer 40

Tightness of sternocleidomastoid, upper trap, and scalene

Question 41

Posterior view shoulder and scap problems

Answer 41

1. Dropped Shoulder 2. Abducted scapula 3. Winging of scapula

Question 42

Dropped shoulder (one lower than other) caused by

Answer 42

1. Tightness of rhomboid and latissimus Dorsi | 2. Hand dominance (dominant side might be lower)

Question 43

Abducted scap (too far away from midline of thoracic vertebra) caused by

Answer 43

1. Tight serratus anterior muscles | 2. Lengthened rhomboids and middle trap muscles

Question 44

What is scap winging and what is it caused by

Answer 44

Medial border of scapula lifted off the ribs | Caused by weak serratus anterior

Question 45

Problems assessing posterior thoracic and lumbar regions

Answer 45

Scoliosis Lateral pelvic tilt or drop Pelvic rotation

Question 46

Causes of lateral pelvic drop

Answer 46

1. Scoliosis 2. Leg length discrepancy 3. Shortening of contralateral quadratus lumborum

Question 47

Causes of pelvic rotation

Answer 47

Tightness of the medial rotators and hip flexor muscles on the rotated side

Question 48

Bow legs - name and causes

Answer 48

Genu Varum | Caused by coxa valga and structural changes in the alignment of femoral condyles/tibial plateau

Question 49

Knock knees- name and causes

Answer 49

Genu Valgum | Caused by coxa varum and structural changes in the alignment of femoral condyles/tibial plateau

Question 50

Pronated foot/ankle

Answer 50

(pes planus) 1. Calcaneal eversion 2. Midfoot width increase 3. Lowering of medial longitudinal arch

Question 51

Supinated foot/ankle

Answer 51

(Pes cavus) Calcaneal inversion Midfoot width decrease Elevation of the medial longitudinal arch

Question 52

Assessing posture at the beginning of the scanning exam allows PT to assess the entire body and not just the _____

Answer 52

Patient identified problem