Hip
Femoral anteversion leads to what osteokinematic change at the hip?
What is...
Hip internal rotation
What position do you perform joint play?
What is...
Open/loose pack position
What is the "true" ankle joint? What actions happen here?
What is...
Talo-crural joint between tibfib & talus
Biomechanically it is the "upper joint" of the ankle complex
Main actions: Dorsiflexion/Plantarflexion
What is...
Cervical: Mobility
Thoracic: Stability
Lumbar: Weight bearing
What are Z joints?
What is...
Articulation between inferior articular process of superior vertebra & superior articular process of inferior vertebra
The hip ball and socket has how many degrees of freedom? What are the movements in each plane?
What is... 3 degrees of freedom
Frontal plane: ADD/ABD
Transverse plane: IR/ER
Sagittal plane: Flexion/Extension
What stresses do ACL/PCL resist?
What stresses do MCL/LCL resist?
What is...
ACL/PCL: checks anterior & posterior glide, respectively
MCL/LCL: resists valgus stress & varus stress respectively
What is the primary mechanism of stability in the ankle?
What is...
Ligamentous (passive)
What structural component makes C3-C6 unique?
What is...
Uncinate processes on vertebral bodies aka Joints of VonLuschka. It allows for Flexion/Extension tracking and weight bearing force transmission across the anterior elements.
They are synovial joints.
What is the purpose of the spinal curvature (in the sagittal plane)?
There are 2 answers.
What is...
1. Attenuate shock
2. Maintain bipedal visual orientation
During hip flexion, what is happening osteokinematically and arthrokinematically?
What is...
Osteokinematics: Femur moving anteriorly on acetabulum
Arthrokinematics: Convex femoral head gliding posteriorly on concave acetabulum
Why is the MCL thicker?
What is...
We typically assume valgus stress with weight bearing
Pronation & supination are both triplanar motions, explain each
What is...
Pronation: ABD, Dorsiflexion & Eversion
Supination: ADD, Plantarflexion & Inversion
Coupled Motion: combined pattern of side bending and rotation always occur at the same time in which region of the spine?
What is...
Cervical
What are the two components of the anterior column? What do each resist?
What is...
Annulus fibrosis = concentric rings, resist torsion in T/L spine
Nucleus pulposus = 90% water, collagen & proteoglycans, resist compression
A weak gluteus medius leads to what?
What is...
Trendelenburg sign (aka contralateral hip drop)
What are the mechanisms of stability at the knee joint?
Think about the Tibial-femoral and Patello-femoral
What is...
Ligamentous (passive): ACL/PCL/LCL/MCL
Muscular (Dynamic): Quad dynamically pulls on patella in extension
Structural (passive) via retinaculum
The first MTP joint accepts 1/2 body weight in stance and gait, what amount of extension does it need for normal gait push off?
BONUS: What 2 muscles are really important for push off in gait?
What is...
60-70 degrees
Tibialis posterior & Flexor hallucis longus
What position is the worst for disc pressure? What position is the best?
What is...
Standing bending over (hinged at hips) picking up heavy object.
Laying down supine.
Why is nerve compression & disc herniation less likely to occur in the T spine?
What is...
No plexus, relatively small nerve roots. T spine is less mobile, so less bending & twisting that could cause potential nerve compression or herniation.
How would the body compensate for a painful hip joint during gait?
What intervention would you provide as a PT?
What is...
Lateral sway of the trunk
Use a cane on the opposite side to offset the base of support
Explain what is happening arthokinematically of the femur on the tibia during the screw home mechanism going into terminal extension (closed chain)
What is...
Femur internally rotates on tibia going into terminal extension in a closed chain position.
Why are 90 percent of ankle sprains inversion stress?
There are 3 parts to this answer.
What is...
Fibular malleolus is lower, more structurally sound (why eversion sprain is less common) --> tibial malleolus can't check inversion as well
Medial ligaments (deltoid) are larger and thicker
Initial foot loading begins with rearfoot inversion
What is the Thoracic Spine Rule?
What is...
T spine is divided into groups of 3 for landmarks. In relation to spinous processes and transverse processes
Ex: T1-T3 SP & TP same level
Ex: T4-T6 SP 1/2 level below TP
Ex: T7-T9 SP full level below TP
What position do patients with degenerative disc disease (spondylolysthesis) avoid? What do they like? Explain why.
BONUS: what ligament is affected by this?
What is...
Extension because it increases the compression on the nerve roots; they like flexion because it relieves the compression/impingement on the nerves
BONUS: Ligamentum flavum becomes weak as arthritis can occur in the facet joints