A. Knee extension
a complete lesion of the femoral nerve as it leaves the lumbar plexus affects what motion?
A. knee extension
B. hip adduction
c. hip
... [Show More] extension
d. knee flexion
e. ankle plantarflexion
the femoral nerve
what is the largest nerve of the lumbar plexus?
Iliopsoas
what is the primary flexor of the hip?
common peroneal nerve
paralytic equinus during swing phase is often caused by injury to what nerve?
Equinus deformity
toe is in a down position, dorsiflexion limitation of the ankle
heel strike on one limb and a subsequent heel strike on the ipsilateral side
what is a cycle of gait defined as?
C. Line of progression
toe in or toe out is the relationship of the long axis of the foot to the:
A. subtalar joint
B. ankle joint axis
C. line of progression
D. Knee axis
subtalar joint
what joint do the motions of inversion and eversion occur primarily at?
talus, tibia, fibula
what bones make up the talocrural joint?
dorsiflexion and plantar flexion
essentially a hinge type joint
what motion occurs in the talocrural joint?
resist over-eversion of the foot
what is the primary action of the medial ligament of the ankle?
resist over-inversion of the foot
what is the primary action of the lateral ligament of the ankle?
tibialis anterior, extensor hallucis longus, extensor digitorum longus
what muscles produce dorsiflexion of the ankle?
gastrocnemius, soleus, plantaris and posterior tibialis
what muscles produce plantarflexion of the ankle?
talus and calcaneus
what bones form the subtalar joint? (aka talocalcaneal joint)
talonavicular, calcaneocuboid
what joints make up the midtarsal joint?
the anterior talar head and the concavity on the navicular
what makes up the talonavicular joint?
the anterior facet of the calcaneus and the posterior cuboid
what makes up the calcaneocuboid joint?
midtarsal joints (talonavicular and calcaneocuboid)
what are the Chopart joints?
tarsometatarsal joints
what are the Lisfranc joints?
1st metatarsal and medial cuneiform
what makes up the medial column of the tarsometatarsal joints?
2nd and 3rd metatarsal and intermediate and lateral cuneiforms
what makes up the middle column of the tarsometatarsal joints?
4th and 5th metatarsals and the cuboid
what makes up the lateral tarsometatarsal joints?
inversion and eversion, dorsiflexion an plantar flexion
what motions are produced at the subtalar joint?
inversion and eversion. flexion and extension
what motions are produced at the midtarsal joint?
flexion and extension, abduction and adduction
what motions are produced at the metatarsalphalangeal joints?
flexion and extension
what motions are produced at the IP joints?
D. shortened step length on contralateral side
a complete lesion of the tibial nerve on one leg will result in what gait deviations?
A. foot slap on ipsilateral side
B. gluteus medius limp on contralateral side
C. Shortened step length on ipsilateral side
D. shortened step length on contralateral side
(posterior lower leg muscles)
gastrocnemius, soleus, plantaris, popliteus, tibialis posterior, flexor digitorum longus, flexor hallucis longus
what muscles are innervated by the tibial nerve?
cervical lateral flexion
what is the C3 myotome
shoulder elevation
what is the C4 myotome
shoulder abduction
what is the C5 myotome
elbow flexion, wrist extension
what is the C6 myotome
elbow extension, wrist flexion
what is the C7 myotome
thumb extension, finger flexion
what is the C8 myotome
finger abduction and adduction
what is the T1 myotome
hip flexion
what is the L2 myotome
knee extension
what is the L3 myotome
ankle DF
what is the L4 myotome
great toe extension
what is the L5 myotome
PF, eversion, hip extension
what is the S1 myotome
knee flexion, PF
what is the S2 myotome
Scheuermann's Disease
a developmental disorder of the spine
abnormal growth of the thoracic spine
anterior portion of the thoracic vertebrae do not develop as fast as the posterior portion resulting in exaggerated kyphosis
Blount's disease (osteochondrosis deformans tibiae)
-growth disorder of the tibia
-characterized by inward bowing of the lower leg that worsens over time
-tibia vara
Leg-Calve-Perthes Disease
-avascular necrosis of the proximal femoral head resulting from compromise of the tenuous blood supply to this area
-usually occurs in children aged 4-10 years old
-may occur after an injury to the hip
-typically unilateral
Heel strike (initial contact)
at which part of gait are the most number of muscles active?
B. lateral thigh distal to the GT, lateral aspect of the foot and the medial condyle of the femur
For correction of genu valgum, forces should be applied over the:
A. lateral condyle of the femur, lateral aspect of the foot and the head of the fibula
B. Lateral thigh distal to the GT, lateral aspect of the foot and medial condyle of the femur
C. Anterior thigh poplitial fossa and dorsal surface of the foot
D. perineum, dial aspect of the foot and lateral condyle of the femur
E. medial condyle of the femur, medial aspect of the foot and the head of the tibia
D. insure that the mechanical ankle axis coincides with the anatomical ankle axis in the transverse plane
the purpose of measuring external rotation of the ankle joint is to:
A. determine total amount of internal rotation of the tibia in a normal adult
B. allow for toe out
C. determine amount of anterior deflection of the lateral sidebar
D. insure that the mechanical ankle axis coincides with the anatomical ankle axis in the transverse plane
D. insure that the medial and lateral mechanical ankle axes are parallel in the coronal plane
C. 10 degrees of varus or valgus, 20 degrees of anterior posterior angulation
what is the maximum acceptable malalignment of a tibial fracture that can be managed with an off the shelf fracture orthosis?
A. 5 degrees of valgus/varus, 30 degrees of anterior-posterior angulation
B. no more than 5 degrees of varus/valgus, 10 degrees of AP angulation
C. 10 degrees of varus/valgus, 20 degrees of AP angulation
D. 10 degrees of valgus, 30 degrees of AP angulation
A few degrees of relative DF
for most patients with paraplegia to stand in KAFOs they must be allowed to rest on their iliofemoral ligaments. In order to facilitate this posture, how should the tibias be posistioned sagittally in relationship to the ground?
osteogenesis imperfecta
congenital osteoporosis, along with fractures before and during birth is indicative of which condition
arthrogryposis
-non-progressive condition characterized by multiple joint contractures and involves muscle weakness
-found at birth
-most common form is amyoplasia (hands, wrist, elbows, shoulders, feet, hips and knees are affected)
-severe conditions involve the jaw and spine
spina bifida
-birth defect that occurs when the spine and the spinal cord don't form properly
-neural tube defects
spina bifida occulta
-mildest form of spina bifida
-results in a small separation or gap in one or more vertebrae
-many pts dont even know they have it
-typically no signs or symptoms due to no nerve involvement
-may see hair/tuft, dimple, or birthmark above the spinal defect
meningocele
form of spina bifida where the protective membranes around the spinal cord push out through the opening of the vertebrae forming a sac filled with fluid
-the sac does not contain nerves so damage to the spinal cord are less likely (later complications are possible)
myelomeningocele
-most severe form of spina bifida
spinal canal is open along several vertebrae in the lower or middle back
-membranes and spinal nerves push through an opening at birth forming a sac on the baby's back (typically exposing tissues and nerves)
-prone to life threatening infections
serial casts
what is the best initial recommendation for a new born patient with talipes equino varus?
club foot (talipes equinovarus)
common foot abnormality where the foot points downward and inward
-present at birth
-involves the foot and lower leg
-more common in males
denis browne orthosis
-treatment for developmental dysplasia of the hip (DDH)
-cuffs around the baby's upper thigh that are attached to a bar to hold the hips and knees flexes and hip abducted
developmental dysplasia of the hip (DDH)
-dislocation of the hip caused by an abnormal development of the hip joint in some babies
B. a lateral heel wedge
a flexible hindfoot varus might be corrected using:
A. a metatarsal bar
B. a lateral heel wedge
C. a Thomas heel
D. a medial heel wedge
Thomas heel
a shoe correction used to bring the heel into varus and prevent depression in the region of the head of the talus
D. a heel lift
which of the following shoe modifications is most likely to be used for a fixed equinus deformity?
A. a cushioned heel
B. a thomas heel
C. a reverse heel
D. a heel lift
half the distance betwee the adductor tubercle and the medial tibial plateau
what is the correct location for the mechanical knee joint on a KAFO
unreliable family support, poor upper extremity strength, obesity, 20 degree hip flexion contractures
what are some contrindications for a RGO?
relive the metatarsal heads; elevate the transverse arch
metatarsal pads function to _____ as well as _____.
D. DF stop
which of the following ankle joint controls would be indicated for a patient with paralysis of the plantarflexors
A. DF assist
B. PF stop
C. PF assist
D. DF stop
A. 25mm proximal, 12mm anterior
in relation to the apex of the great trochanter, where is the mechanical hip joint located?
A. 25mm proximal, 12mm anterior
B. 25mm proximal, 12mm posterior
C. 25mm anterior, 12mm proximal
D. 25mm lateral, 12mm distal
femoral nerve
what nerve innervates the quadriceps?
L2-L4
what is the nerve root of the obturator nerve
obturator externus, adductor longus, adductor brevis, part of the adductor magnus, gracilis, pectineus
what muscles are innervated by the obturator nerve? [Show Less]