1.Effect of first metatarsal primus elevatus? | decreases hallux dorsiflexion |
2.Patient has a steppage gait type, what nerve is damaged? | Deep peroneal nerve, this gait is seen with CMT, guillain-barre, and foot drop patients. |
3.What joint has equal motion in two planes? | subtalar joint |
4.What is foot structure if you lost common peroneal nerve? | Equinovarus |
5.If lower STJ axis closer to floor, you get more motion in which plane | Frontal plane |
6.What is metatarsal primus elevatus associated with? | Hallux Limitus |
7.What is function of Morton’s extension? | limit first MPJ motion and redistribute forces (solid plate extending under hallux |
8.Highest lift you can put in a shoe? | 1/4 inch, if you add more it will significanlty alter gait |
9.What diagnosis do you suspect in a spastic, adducted, scissor gait? | Cerebral Palsy |
10.What is the best position to place the foot in order to see the appropriate subtalar joint inversion ROM? | maximally dorsiflexed and inverted |
11.When performing neutral suspension casting for orthotics, what position should the foot be? | Minimal DF. for neutral STJ positioning |
12. A 12 year old complains of severe heel pain. You see radiographs and diagnose of calcaneal apophysitis, what treatment do you give? | NSAIDSRICEeliminate activityheel liftsstrechingstrapping |
13. True or False: You can give a heel steroid injection for calcaneal apophysitis? | FALSE |
14.If a patient has a callus sub 2nd metatarsal, what is the underlying cause?a. forefoot varus b. forefoot valgus c. rearfoot valgus | forefoot valgus, hypermobile 1st ray, hallux amputation, keller osteotomy |
15.A 3 year old boy presents with a waddling gait and toruble getting up from his seat, what condition does he have? | muscular dystorphy |
16.Child walks on his toes and his ankle joint is stiff, there is clonus. What is diagnosis? | Spastic equinus |
17. Patient is a healthy runner, they notice that their foot arch is flattening and have pain in the medial arch, what is the diagnosis? | PTTD – posterior tibial tendon dysfunction |
18. Degress of freedom at ankle joint? MPJ joint? | ankle – one axis so 1 degree of freedomMPJ an MTJ are 2 axis so 2 degrees of freedom |
PLANES AND AXIS OF MOTION
1.Sagittal plane? | vertical line dividing into right and left sections |
2.Frontal plane? | vertical line dividing into front and back sections. Passes center of gravity |
3.Transverse plane? | horizontal line divides into upper and lower halves |
4.Define axis | an imaginary line which all motions takes place |
5.Single vs triplane joint motion? | single- plane of motion is perpendicular to axis of motiontriplane-motion depends on degree of angle at joint axis |
6.Motion of knee joint? | Frontal plane axis – controls 140 flexion and 120 extensionLongitudial plane axis – 30 internal and 40 external rotation |
7.Motion of ankle joint? | The axis is lateral, plantar, posterior -> medial, dorsal, anterior.Allows ROM 20-30 dorsiflexion and 30-50 planterflexion |
8.Motion of subtalar joint? | Oblique axis for triplanar(pronation and supination)Axis deviated 42 transverse plane and 16 sagittal plane |
9.Motion of midtarsal joint? | Longitudial axis – passes 150 transverse plane and 9 sagittal plane and allows 4-6 ROM of inversion/eversion |
10.Motion of first ray? | axis angles 45 to frontal and sagittal plane. Allows triplanar motion at 1:1 ratio.As first ray dorsiflexes it inverts 1. When plantarflexes it everts 1. |
11.How many axis at MPJs? | has 2- a transverse and vertical |
Gait Cycle
1.What does one whole gait cycle consist of? | heel contact of the support limb to heel contact of that same limb again |
2.What are the two phase of a gait cycle? | 1) stance 58-62% 2) swing 38-42% |
3.What periods does the stance phase of a gait cycle consist of? | Contact period, midstance period, and propulsion period |
4.What physical/anatomical events occur from the start to the end of the contact period? | starts with heel contact and ends with fore foot loading |
5.What physical/anatomic events occur from the start of the midstance period to its end? | starts with forefoot loading and ends at heel off |
6.What portion of the stance cycle is the propulsion period? | 33% |
7.What is the order of the four moments of gait of a normal gait cycle? | Heel contact, forefoot loading, heel off, toe off |
8.What are the anatomical relations of the body during the beginning of contact period? | -Hip is internally rotated and flexed -Ankle Joint is dorsiflexed -STJ is supinated |
9.During heel contact to forefoot loading of the contact period? | -Hip and leg continue to internally rotate and moves from flexed to extended -Ankle begins to plantarflex (brings forefoot to ground) -STJ pronates -Lateral side of foot bares weight -1st ray plantar flexes |
10.At the beginning of midstance? | -Hip begins to externally rotate -Hip continues to extend -AJ is plantar flexed -STJ is pronated |
11.From forefoot loading to heel off during midstance period of gait? | -Entire leg externally rotates -hip joint is in full extension -ankle joint dorsiflexes (close kinetic chain) -STJ supinates to NP by the end -Heel leaves ground |
12.At the beginning of heel off? | -Hip is still externally rotated -Hip is still extended -AJ is fully plantarflexed -STJ is neurtral |
13.From heel off to toe off during propulsion period of the gait? | -Hip continues to externally rotate -Hip begins to flex -Ankle joint plantar flexes -STJ supinates |
14.Between toe off and heel contact of the swing phase? | -hip internally rotates -hip continues flexion -ankle joint rapidly dorsiflexes -STJ supinates |
15.What happens to the MTJ during midstance period? | MTJ locks because the STJ supinates |
16.When is the ground reactive force (GFR) greater than the body weight during the gait cycle? | at forefoot loading and just after heel off |
17.When the STJ supinates in CKC, what does the talus do? | dorsiflex and abducts |