Wk 8- Cavus

Question 1

In gait, the 1st ray must plantarflex to allow for what?

Answer 1

65deg of MTPJ dorsiflexion

Question 2

During gait how do the 1st MTPJ and 1ST ray and other structures work together for dorsiflexion at the 1ST MTPJ

Answer 2

The first 20-30deg of motion is MTPJ dorsiflexion, then the 1st ray plantarflexes, knee flexes and ankle plantarflexes to reach 50-60deg

Question 3

What does normal function of 1st ray incorporate

Answer 3

-heel lift
-STJ supination
-normal sesamoids
-2nd met longer than 1st

Question 4

What does normal function of 1st MTPJ incorporate

Answer 4

-1st ray plantarflexion
-normal sesamoids
-normal muscle function

Question 5

What happens when the 1st met is short?

Answer 5

-excessive plantarflexion to make ground contact
-STJ pronation may occur to make this happen

Question 6

What happens when the 1st met is too long

Answer 6

Unable to plantarflex to allow normal DF to occur
-hallux rigidus/valgus and 1st met/cuneiform extososes may occur

Question 7

What is metatarsus primus elevatus?

Answer 7

Dorsiflexed 1st ray
Cause:
-surgery
-peroneal Longus weakness
-tib ant tight

Question 8

What is ankle equinus

Answer 8

Less than 10deg dorsiflexion
Caused by:
Anterior impingement
Flattened or wide talar dome
Tight posterior muscles

Question 9

What happens in a compensated ankle equinas

Answer 9

-STJ pronation
-MTJ dorsiflexion on rearfoot
-mid foot collapse

Question 10

What does uncompensated equinas look like

Answer 10

-not enough STJ pronation available
-heel doesnt stay down on ground
-short midstance
-excessive FF loading
-tight peroneals and hamstrings

Question 11

When does midtarsal locking occur?

Answer 11

Max pronated position, locks during stance phase to take on load from rearfoot

Question 12

Root theory is based off what?

Answer 12

Criteria for joint positions that are believed to be normal (vertical stance position of leg, calc, STJ)

Question 13

What is an orthopaedic assessment (MSK assessment)

Answer 13

-non weight bearing (OKC)
-weight bearing (CKC):
-Gait
-palpation

Question 14

What is incorporated in the Non weight bearing examination

Answer 14

ROM of hip down to digits and noting on

Quality of motion
Rang of motion
Symmetry
Direction
End feel

Question 15

What is incorporated in the weightbearing assesment of an orthopaedic (biomech form)

Answer 15

• FPI
  -RCSP
  -NCSP
  -tibial position
  -knee alignment
  -posture
  -limb length

Question 16

Is limb length difference common?

Answer 16

Yes. 60-90% of pop

Question 17

How much limb length difference is clinically significant

Answer 17

More than 1-2cm

Question 18

Different types of limb length differences

Answer 18

-structural LLD
-functional LLD
-environmental LLD (uneven footwear/terrain)

Question 19

What is structural LLD due to

Answer 19

Length of femur or tibia

Question 20

What is functional LLD due to

Answer 20

Secondary to arthritis, soft tissue contracture, scoliosis, asymmetrical pronation

Question 21

How to assess for limb length difference

Answer 21

NWB - heel into butt and assess the different heights of knees (structural LLD)
-tape measure ASIS to medial malleolar for quantitative

WB - looking at ASIS level in NCSP compared to RCSP (functional LLD)

Question 22

Treatment for limb length difference

Answer 22

• heel raises
• full length raises
• orthotics
  -stretching