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Muscles and More!
Foot/Ankle Axes of Rotation
Foot Structure/Function
Knee :)
OSCE!
100
What's the function of the tibialis posterior? How would you test this muscle in the "gravity minimized position"?
What is plantarflexion + inversion, sidelying w/foot on the table
100
The talocrural joint has an axis of rotation that is rotated 23 degrees laterally (from neutral). What type of motion does this begin to introduce? Why?
-Inversion/eversion b/c foot is going from a pure medial/lateral axis (plantarflexion/dorsiflexion) toward an A-P axis
100
Where does the fibularis longus originate and insert?
Origin: head and proximal 2/3 of fibula Insertion: plantar base of 1st metatarsal and medial cuneiform
100
What 2 muscles are known as "ACL synergists"?
hamstrings and soleus
100
What are the 5 possible findings of the Ottawa Knee Rule? If any one (1) are present, what does this mean?
1. Age ≥ 55 years 2. Isolated tenderness of the patella 3. Tenderness of the fibular head 4. Inability to flex the knee to 90° 5. Inability to WB both immediately after injury and in the ED for 4 steps -if present - CANNOT rule out a fracture - need radiograph
200
What's the name, and origin and insertion of the muscle you're testing in "Ely's Test"?
What is Rectus Femoris -origin: anterior inferior iliac spine and ilium superior to acetabulum -insertion: base of patella and to tibial tuberosity via patellar ligament
200
In weight-bearing pronation, how do the talus and calcaneus move? In supination?
WB pronation o Calcaneus = eversion o Talus = adduction + plantarflexion WB supination o Calcaneus = inversion o Talus = abduction + dorsiflexion
200
True or False? The tarsal sinus is between the head of the talus and the neck of the calcaneus.
False- the neck of the talus and the neck of the calcaneus
200
True or false? When the "posterior meniscofemoral ligament" runs posterior to the PCL before attaching to the medial femoral condyle, it is called "Humphrey's" ligament.
False - Wrisberg
200
How many ligamentous tests did we learn for the knee joint in Jay's class? Can you name them? Whats our best test for ACL integrity?
1) valgus stress 2) varus stress 3)lachman (prone lochman) 4)anterior drawer 5)posterior drawer 6)posterior sag -lachman
300
What is the name, origin and insertion of the muscle you're squeezing in a "Thompson" test?
Gastrocnemius (medial and lateral head) origin: medial and lateral femoral condyles insertion: posterior aspect of calcaneus via achilles tendon
300
The transverse tarsal joint axes is inclined 57 degrees upward from the horizontal and rotated 52 degrees medially - producing triplanar motion. What is the order of "dominance" of motion from MOST to LEAST? A)plantarflexion/dorsiflexion, inv/ev., abd./add B)Abd./add, inv./ev., plantarflexion/dorsiflexion C)plantarflexion/dorsiflexion, abd./add., inv./ev. D)inv/ev., plantarflexion, dorsiflexion, abd/add.
What is C)plantarflexion/dorsiflexion, abd./add., inv./ev.
300
What 3 bundles of fibers make up the deltoid ligament?
1)tibiotalar fibers 2)tibiocalcaneal fibers 3)tibionavicular fibers
300
What is the function of the articularis genus muscle?
Will pull knee capsule and synovial tissue superior with knee EXTENSION so capsule and synovial tissue do not get compressed by patella
300
How is HVPC different from NMES? What's the dosage for NMES?
HVPC - monopolar pad placement, sensory stimulation NMES - bipolar pad placement, sustained muscle contraction (tetanus) -10 seconds on/50 seconds off, for 10 minutes
400
What is the name, and origin and insertion of a muscle you would want to perform a soft-tissue mobilization on if you found your Pt had lateral tracking issues of their patella related to a tight ITB?
Tensor Fascia Lata origin: ASIS and anterior part of iliac crest insertion: Iliotibial tract that attaches to lateral condyle of tibia
400
Whats unique about the longitudinal axis of the transverse tarsal joint?
an independent axis for inversion/eversion, its SEPERATE from the (above) oblique axis - allowing for inv/ev. independent of plantarflexion/dorsiflexion and abd./add
400
What bones make up the lateral column of the foot? (Hint: there's 4)
-calcaneus -cuboid -metatarsals 4 and 5
400
The angle (in degrees) at which the patella provides the GREATEST moment arm for the quadriceps is.... A)40-50 B)40-60 C)70-90 D)20-60
D) 20-60
400
True or false? Maitland and Kaltenborn techniques are to be implemented using 2-3 sets of 30-60 seconds.
FALSE, 3-4 sets of 30-90 seconds
500
Which intrinsic foot muscle would you MOST want to train to help control excessive pronation and support the medial longitudinal arch? A)lumbricals and extensor hallucis brevis B)opponens digiti minimi C)plantar interossei D)abductor hallucis, quadratus plantae, and abductor digiti minimi E)abductor hallucis, flexor digitorum brevis, flexor hallucis brevis, adductor hallucis
What is E) abductor hallucis, flexor digitorum brevis, flexor hallucis brevis, adductor hallucis abductor hallucis - helps prevent navicular drop and over pronation
500
How many degrees is the subtalar joint axis inclined upwards? What motions dominate because of this?
42 degrees upward from the horizontal, inversion/eversion
500
True or false? The transverse arch is formed by the cuboid, cuneiforms, bases of the metatarsals and is maintained by the fibularis brevis tendon
The transverse arch is formed by the cuboid, cuneiforms, bases of the metatarsals and is maintained by the fibularis LONGUS tendon
500
What is the angle of pull of the VMO fibers on the patella?
50-55 degrees
500
How would you set up a side hop test? How many trials does the Pt get? What % do the involved and uninvolved legs need to be within each other to return to sport?
2 lines are 30 cm (12 inches) apart, timed 10 reps back and forth, 3 practice trials, 3 real trials, within 90% to return