Week 3 - Posture Assessment Flashcards Preview

DPT730: Physical Therapy Examination > Week 3 - Posture Assessment > Flashcards

Flashcards in Week 3 - Posture Assessment Deck (70):
1

In which part of the patient visit is the Posture Assessment?

critical part of the physical examination

2

What does the posture assessment allow the PT to do?

assess the entire body NOT just the patient identified problems (PIP).

-allows us to begin our evaluation in a very global manner looking at the entire body from a standpoint of alignment.

3

In performing a posture assessment a therapist must ___ (2)

1. be Accurate and thorough
2. be able to Separate parts of the body from the whole during the examination, THEN assess the sum of the parts in reference to their interaction within the entire body structure

4

Why must a therapist be accurate and thorough in a posture exam?

many postural abnormalities are subtle in appearance.

5

After separating parts of the body from the whole during examination, THEN

assess the sum of the parts in reference to their interaction with the entire body.

6

When thinking about posture, how is it important to begin? Why?

Defining what we consider to be correct or typical posture. Knowing what this is will permit us to consider what might be abnormal postures.

7

What is Correct Posture?

Is the alignment of the body with maximal physiological and biomechanical efficiency.

8

What does Correct Posture minimize?

Stresses and strains imparted to the supporting system (extremities, especially lower, pelvic region, and then trunk) by effect of gravity.

9

What is the GRAVITY LINE also referenced to as?

Reference or Plumb Line

10

What is the importance of the gravity line?

Ideally, passes through the axes of all the joints with the body segments aligned.

11

What is the gravity line represented by?

Vertical line drawn through the body's center of gravity (located at the 2nd sacral vertebra)

12

What does the gravity line serve as a reference point for?

from which gravitational effects on individual body segments are assessed.

13

T/F: the gravity line does not respond to constantly altering body position during upright postures.

False: the gravity line is a reference line that DOES respond to constantly altering body position during upright postures.

14

T/F: in general, the gravity line does not pass through all the axes of the human body.

True

15

T/F: even individuals with excellent posture can't come close to fulfilling the ideal criteria.

False: individuals with excellent posture CAN come close to fulfilling the ideal criteria.

16

T/F: It is ideal to have gravitational forces pass through the center of joint axes to assist in balancing muscle, ligament, and other soft-tissue structures acting about each joint.

True

17

What can happen if forces acting about a joint are out of balance?

faulty joint motion can occur

18

What are the most important segments to have muscular & mechanical balance?

Head, trunk, shoulders, and & pelvic girdle.

19

When do Postural Faults occur?

when muscular, ligament, & soft-tissue structure imbalances develop.

20

How does the Postural Fault: Rounded Shoulders occur?

can be the result of shortened pectoralis major and minor muscles.

21

How does the Postural Fault: Lumbar Lordosis occur?

can occur when the hip flexors are tight and abdominals are elongated.

22

What is involved in the procedure of a posture analysis?

viewing from an ANTERIOR, POSTERIOR, AND LATERAL perspective, the body's anatomical alignment relative to an established reference line - The Gravity Line

23

What does the Gravity Line do during posture analysis procedure?

The gravity line, or reference / plumb line, divides the body into equal from and back halves, and bisects the body laterally.

24

The posture analysis is performed after ___.

AFTER history and systems review (HOAC model)

25

How should the patient be clothes during a posture analysis?

minimally clothed

26

How should the patient be instructed when performing a posture analysis?

Patient should be instructed to assume comfortable and relaxed posture.

27

What tools are necessary when performing a posture analysis?

Requires use of gravity (plumb) line, rulers, tape measures, and goniometers.

28

T/F: When performing a posture analysis, we usually start proximally and move distally.

True

29

In the Lateral View, what is the ideal alignment for Head and Neck?

Plumb line falls through ear love to acromion process.

30

In the Lateral View, what is the ideal alignment for Shoulder?

Plumb line falls through the acromion process.

31

In the Lateral View, what is the ideal alignment for Thoracic Vertebra?

Plumb line bisects the chest symmetrically.

32

In the Lateral View, what is the ideal alignment for Lumbar Vertebra?

Plumb line falls midway between abdomen, back, and slightly anterior to Sacroilliac joint.

33

In the Lateral View, what is the ideal alignment for Pelvis and Hip?

Plumb line falls anterior to SI joint and posterior to hip joint through greater trochanter.

34

In the Lateral View, what is the ideal alignment for Knee?

Plumb line passes slightly anterior to midline knee joint.

35

In the Lateral View, what is the ideal alignment for Ankle?

Plumb line passes just anterior to lateral malleolus.

36

In the Posterior View, what is the ideal alignment for Head and Neck?

Plump line bisects head through external occipital protuberance.

37

In the Posterior View, what is the ideal alignment for Shoulder and Scapula?

Plumb line falls midway between shoulder.

38

In the Posterior View, what is the ideal alignment for Trunk?

Plumb line bisects the spinous processes of throacic and lumbar vertebrae.

39

In the Posterior View, what is the ideal alignment for Pelvis and Hip?

Plump line bisects gluteal cleft with the PSIS, illiac crests, and greater trochanters are level.

40

In the Posterior View, what is the ideal alignment for Knee?

Plumb line is equidistant between knees.

41

In the Posterior View, what is the ideal alignment for Ankle and Foot?

Plumb line is equidistant between medial malleoli.

42

In the Anterior View, what is the ideal alignment for the Upper Extremity?

Assess carrying angle of elbow.

43

What are normal carrying angles?

Men = 5 to 10 degrees
Women = 10 to 15 degrees

44

Do Men have equal, less, or more of a carrying angle?

Less

45

In the Anterior View, what is the ideal alignment for the Lower Extremity?

1. Assess if ASIS are level
2. Patellar Alignment
3. Angle of Toeing Out

46

What do you look for in Patellar Alignment?

Straight, inward, outward

47

What are the normal values of Angle of Toeing out?

Norm values 5 to 7 degrees for each foot.

48

What are common Postural Faults of the LATERAL view for Head and Neck? Describe and list causes.

Forward Head
-Head lies anterior to plumb line.
-Causes:
1. Tight cervical extensor, upper trap, and levator scapulae muscles.
2. Elongated Cervical flexors

49

What are common Postural Faults of the LATERAL view for Shoulder? Describe and list causes.

Rounded (or Forward) Shoulders
-Acromion Process lies anterior to plumb line
-Scapulae abducted
-Causes:
1. Tight pectoralis major and minor, serratus anterior muscles.
2. Weakness of thoracic extensors, middle trapezius and rhomboid muscles.

50

What are common Postural Faults of the LATERAL view for Thoracic and Chest? Describe and list causes. (1/2)

Kyphosis
-Increase posterior convexity of vertebrae.
-Causes:
1. Lengthened thoracic extensors, middle and lower trapezius muscles, posterior ligaments
2. Tightness of anterior longitudinal ligament and anterior chest muscles

51

What are common Postural Faults of the LATERAL view for Thoracic and Chest? Describe and list causes. (2/2)

Barrel Chest
-Increased overall anteroposterior diameter of rib cage.
-Common in individuals who have asthma as child.

52

What are common Postural Faults of the LATERAL view for Lumbar Region? Describe and list causes. (1/2)

Lordosis
-Hyperextension of the lumbar vertebrae
-Causes:
1. Anterior pelvic tilt
2. Tightness of hip flexor and low back extensor muscles and posterior longitudinal ligament
3. Lengthened anterior longitudinal ligament and lower abdominal muscles.

53

What are common Postural Faults of the LATERAL view for Lumbar Region? Describe and list causes. (2/2)

Flat Back
-Flattening (loss of normal lordosis) of lumbar vertebrae.
-Causes:
1. Posterior pelvic tilt
2. Tightness of hamstrings muscles
3. Weakness of hip flexor muscles

54

What are common Postural Faults of the LATERAL view for Pelvis and Hip? Describe and list causes. (1/2)

Anterior Pelvic Tilt
-Both ASIS are anterior to the symphysis pubis
-Causes:
1. Increased lumbar lordosis and thoracic kyphosis
2. Tightness of hip flexors
3. Lengthened abdominal muscles

55

What are common Postural Faults of the LATERAL view for Pelvis and Hip? Describe and list causes. (2/2)

Posterior Pelvic Tilt
-Symphysis pubis lies anterior to ASIS
-Causes:
1. Tightness of hamstring muscles
2. Lengthened hip flexor and lower abdominal muscles

56

What are common Postural Faults of the LATERAL view for Knee? Describe and list causes.

Genu Recurvatum
-Hyperextension of the knee
-Causes:
1. Tightness of quadriceps and calf muscles
2. Lengthened posterior capsule and hamstring muscles

57

What are common Postural Faults of the LATERAL view for Foot and Ankle? Describe and list causes.

Forward Posture
-Plumb line is posterior to body because trunk is shifted forward.
-Weight is increased on the metatarsal heads of feet.
-Causes:
1. Contracture of posterior trunk muscles
2. Tightness of anterior compartment muscles
3. Balance related issues

58

What are common Postural Faults of the POSTERIOR view for Head and Neck? Describe and list causes. (1/2)

Head Tilt
-Patient's head lies more to one side of the plumb line
-Causes:
1. Tightness of lateral neck flexors on one side

59

What are common Postural Faults of the POSTERIOR view for Head and Neck? Describe and list causes. (2/2)

Head Rotated
-Head is rotated to the left or right of the plumb line
-Causes:
1. Tightness of sternocleidomastoid, upper trapezius, and scalene muscles

60

What are common Postural Faults of the POSTERIOR view for Shoulder and Scapula? Describe and list causes. (1/3)

Dropped Shoulder
-One shoulder is lower than the other
-Causes:
1. Tightness of rhomboid and latissimus dorsi muscles
2. Hand dominance (dominant side may be lower.

61

What are common Postural Faults of the POSTERIOR view for Shoulder and Scapula? Describe and list causes. (2/3)

Adducted Scapula
-Scapula too close to midline of thoracic vertebra
-Causes:
1. Tightness of rhomboid muscles
2. Lengthened pectoralis major and minor muscles

62

What are common Postural Faults of the POSTERIOR view for Shoulder and Scapula? Describe and list causes. (3/4)

Abducted Scapula
-Scapula too far away from midline of thoracic vertebra
-Causes:
1. Tighness of serratus anterior muscles
2. Lengthened rhomboids and middle trapezius muscles

63

What are common Postural Faults of the POSTERIOR view for Shoulder and Scapula? Describe and list causes. (4/4)

Winging of Scapula
-Medial border of scapula lifted off the ribs
-Causes:
1. Weakness of serratus anterior

64

What are common Postural Faults of the POSTERIOR view for Thoracic and Lumbar Regions? How can it occur and then develop?

Scoliosis
-Can occur as C-shaped lateral curvature with vertebral rotation presenting as either a thoracic, thoracolumbar, or lumbar curve.
-Can develop into an S-shaped curve that effects both the thoracic and lumbar regions.

65

What are common Postural Faults of the POSTERIOR view for Pelvic and Hip? Describe and list causes. (1/2)

Lateral Pelvic Tilt
-One side of the pelvis is higher than the other side.
-Causes:
1. Scoliosis
2. Leg length discrepancy
3. Shortening of contralateral quadratus lumborum

66

What are common Postural Faults of the POSTERIOR view for Pelvic and Hip? Describe and list causes. (2/2)

Pelvic Rotation
-Plump line falls to the right or left of the gluteal cleft.
-Causes:
1. Tightness of medial rotators and hip flexor muscles on the rotated side.

67

What are common Postural Faults of the POSTERIOR view for Knee? Describe and list causes. (1/2)

Genu Varum (bow legs)
-Distal segment of the leg deviated inward toward midline in relation to proximal segment
-Causes:
1. Coxa valga
2. Structural changes in alignment of femoral condyles/tibial plateau

68

What are common Postural Faults of the POSTERIOR view for Knee? Describe and list causes. (2/2)

Genu Valgum (knock knees)
-Distal segment of the leg deviates outward away from the midline in relation to proximal segment
-Causes:
1. Coxa varum
2. Structural changes in alignment of femoral condyles/tibial plateau

69

What are common Postural Faults of the POSTERIOR view for Foot and Ankle? Describe and list causes. (1/2)

Pes Planus (pronated)
-Calcaneal eversion
-Midfoot width increase
-Lowering of medial longitudinal arch

70

What are common Postural Faults of the POSTERIOR view for Foot and Ankle? Describe and list causes. (2/2)

Pes Cavus (supinated)
-Calcaneal inversion
-Midfoot width decrease
-Elevation of the medial longitudinal arch