PTAP 1400 Exam 2
talocrural joint aka carpenters mortise
1 degree of freedom plantar & dorsi flexion talus, distal tibia, & fibula sagital plane
what is the ROM when the ankle is everted
15 degrees
subtalar joint
2 degrees of freedom inversion & eversion abduction & adduction talus & calcaneus frontal plane
what is the ROM when the ankle is dorsi flexed?
20 degrees
transverse tarsal joint
3 degrees of freedom supination & pronation transverse plane calcaneus, cuboid, talus, & navicular
what is the ROM when the ankle is inverted
35 degrees
what percent is swing phase
40%
what is the ROM when the ankle is plantar flexed
50 degrees
how many muscles are in the posterior compartment
6
what percent is stance phase
60%
What are the different types of end-feels?
Empty end feel soft end feel hard end feel firm end feel
what is the function and nerve of tibialis anterior
F: DF & INVERSION N: Deep peroneal nerve
what is the function and nerve of peroneus tertius
F: DF, eversion N: Deep peroneal nerve
what is the function and nerve of peroneus brevis
F: ankle PF and eversion N: superficial peroneal nerve
What is the function and nerve of extensor hallucis longus
F: extension of 1st metatarsal & DF of ankle N: Deep peroneal nerve
what is the function and nerve of peroneus longus
F: foot eversion & PF N: superficial peroneal nerve
what is the function and nerve of extensor digitorum longus
F: toe extension, DF, eversion N: deep peroneal nerve
MMT grade 5/5
FROM, AG, MAX RESISTANCE
MMT grade 3+/5
FROM, AG, MIN RESISTANCE
MMT grade 4/5
FROM, AG, MOD RESISTANCE
MMT grade 3/5
FROM, AG, NO RESISTANCE
MMT grade 2/5
FROM, GM, NO MANUAL RESISTANCE
do you want substitutions when testing for MMT
False- stabilize the joint
MMT grade 3-/5
GREATER THAN 50%, AROM, NO MANUAL RESISTANCE
MMT grade 2+/5
LESS THAN 50%, AROM, AG, NO MANUAL RESISTANCE
MMT grade 0/5
NO AROM, NO MUSCLE CONTRACTION, GM, NO MANUAL RESISTANCE
MMT grade 1/5
NO AROM, VISIBLE OR PALPABLE MUSCLE CONTRACTION, GM, NO MANUAL RESIST
MMT grade 2-/5
PARTAIAL ROM, GM, NO MANUAL RESISTANCE
MMT - gravity minimized (GM)
Patient is positioned so the movement you are testing is performed parallel to floor. if patient is too weak, they will be unable to go AG.
define shin splints
a common painful condition that may affect the muscles that attach to the medial and posterior side of the tibia.
Contraindications for MMT
a joint dislocation or unhealed bone fracture in the region to be tested acute muscle "strain" immediately following surgical procedure to affected tendon cancer in bone presence of posits ossificans infected joint in region to be tested orders from dr
pronation of the ankle & foot
abduction of the forefoot, calcanea eversion and ankle dorsi flexion.
name the 3 different phases in swing phase
accerlation midswing deceleration
supination of the ankle & foot
adduction of the forefoot, calcanea inversion and ankle plantar flexion.
What is the purpose of MMT
an attempt to objectively quantify muscle strength
what does AFO stand for
ankle foot orthosis- common in CVA aka stroke patients.. needed during "foot flat"
what is hard end feel?
bone on bone ex- elbow extension
what are arches formed by?
bones, ligaments, and tendons
what is the rear foot made up of?
calcaneus & talus
Reliability
can the measurement be reproduced over & over with the same result
what is the mid foot made up of
cuboid navicular 3 cuneiforms
extensor digitorum longus
digits 2-5 extension ankle dorsi flexion foot eversion
contraindications for ROM testing
dislocation or unhealed fracture in the region presence of myositis ossificans infected joint unstable joint
validity
does the measurement device actually measure what it was intended to measure ex) accurate goniometer
what is it called when the tibia moves closer to the ankle?
dorsi flexion
which flexion is referenced as "closed packed"?
dorsi flexion is closed packed. closed packed= greatest stability
tibialias anterior
dorsiflexion and inverts foot
extensor hallucis longus
extension of the big toe and dorsi flexion of the ankle
what is the normal arch measured by
feiss line
pes planus
flat foot decrease in shock absorption increase in ankle pronation malalignment in ankle, knee and hip in internal rotation (IR) and cause values of the knee
define foot drop
foot drops into plantar flexion as leg is advances during swing phase gait
name the superficial group of the posterior compartment
gastrocnemius soleus plantaris F: ankle PF N: tibial nerve
Name the different devices that are used to measure ROM
goniometer inclinometer tape measure
name the 5 different phases in stance phase
heal contact foot flat mid distance heel off toe off
what does the air ankle stirrup do ?
helps stabilize lateral supination motion
Pes Canvus
high arch decrease in shock absorption increase in ankle supination
define flat foot
if dorsiflexion are unable to generate sufficient eccentric activation between heel contact and foot flat, the forefoot quickly makes contact with the ground, and makes a slapping sound as the sole of the foot rapidly hits the floor.
what is the "positive test"
indicates anterior talofibular ligament sprain
when preforming goniometry for talocrural dorsiflexion, how should the knee be?
knee should be positioned in knee flexion to prevent passive insufficient from the gastrocnemius muscle
MMT stands for
manual muscle testing
what is the foots primary shock absorber?
medial longitudinal arch
what is the forefoot made up of
metatarsals phalanges
talofibular & calcaneofubular joint
most common injured due to an INVERSION sprain. if torn, will be hyper mobile
Define substitutions
motions that a patient substitutes inadvertently for the one you want--> trying to use another body part or something else to help you get better MMT/ROM.
describe feiss line
navicular tuberosity is intersected by line formed between medial malleolus and 1st MTP, if line falls below then person has pes plantus (flat foot)
what is within normal limits (WNL)
normal limits for that specific person but can differ from person to person.
How do you preform MMT
one hand stabilizes a proximal body part and one hand resists the motion of the muscle being tested.
MMT Against gravity (AG)
patient is positioned so that the motion you are testing is moving away from the floor, against gravity
describe lateral compartment muscle
peroneus longus & peroneus brevis both preform PF & Eversion
what is it called when the tibia moves posteriorly?
plantar flexion
which flexion is references as "open/loose packed"?
plantar flexion is loose packed. loose packed= not stable
what are the 3 parts of the foot?
rearfoot mid foot forefoot
what does the Thompson test measure
ruptured achilles tendon
what is soft end feel?
soft tissue. muscle gets in the way of flexion. ex-knee/elbow flexion. muscle prevents you from full extension, depending on how big specific muscle is.
what does the anterior draw test, test for?
sprain of the anterior talofibular ligament
what is firm end feel
stretch due to tight muscles and joint capsules *most of the body is firm end feel*
what phase does steppage gait happen in?
swing phase steppgae phase= hip flexion & knee extension
during convex on concave, which bone has a convex: tibia or talus?
talus has a convex tibia had a concave
What is empty end feel?
the limitation of motion is not felt because of the patients limited motion due to pain. no real feel, (swelling)
if someone has a "foot drop"/toe drag, it is because of what?
the paralysis of tibilis anterior
What is manual muscle testing
the therapist uses manual resistance to test strength and quantify the strength of the body part.
intrinsic muscles
they have both proximal and distal attachments within the foot. small and with. ex- brevis & minimize
extrinsic muscles
they have proximal attachments within the lower leg or the distal femur as well as distal attachments within the foot. portion of muscle is outside of the foot
name the deep group of the posterior compartment
tibialis posterior flexor digitorum flexor hallucis longus F: ankle PF N: tibial nerve
what does the taller tilt test, test for?
used to assess a lateral ankle sprain and the integrity of the talofibular and calcaneofibular ligaments.
intertester
uses more than 1 tester
intratester
uses the same practionioner
what will happen is the Achilles tendon ruptures?
weakness during plantar flexion