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How many degrees is the longitudinal axis of the MTJ from transverse and sagittal?
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What plane is perpendicular to the MTJ?
Frontal (inversion/eversion)
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What is the maximum ROM for the longitudinal axis of the MTJ?
8 degrees
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What is the minimum ROM for the longitudinal axis of the MTJ?
4-6 degrees
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What is the ROM for the oblique axis of the MTJ?
22 degrees
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How do the sagittal and transverse planes of the MTJ function together?
- Dorsiflexion/abduction
- Plantarflexion/adduction
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What decreases MTJ ROM, supination or pronation?
Supination
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Does MTJ ROM increase or decrease with supination?
decrease (increase with pronation)
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What is complete/partial compensation?
- Complete: Forefoot on ground
- Partial: Forefoot not on ground
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At what degree will the STJ compensate to the end of its motion?
>3 degrees RF valgus/FF varus
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How do you compensate for FF valgus and Plantarflexed 1st Ray?
- LA SOS
- -Long Axis MTJ
- -STJ
- -Oblique Axis MTJ
- -STJ
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What is apropulsive gait?
When the STJ stays pronated due to FF varus so it does not supinate for good propulsion
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In FF Varus complete compensation, where do you see the callus?
2nd met head
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In FF Varus partial compensation, where do you see the callus?
4 & 5 met heads
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In FF valgus with compensation, wehre do you see the callus?
1 & 5
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What happens to the 1st Ray motion with Pronation/Supination?
- Pro: increased motion
- Sup: decreased motion
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Does the 1st ray evert or invert during plantarflexion?
Everts ( during propulsive phase)
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What is the pathology caused in propulsion if you can't supinate the 1st ray?
- Apropulsive gait
- Hypermobility and subluxation
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What is the shared theme for compensation b/t FF valgus and 1st ray ROM?
LA SOS
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What is the difference b/t 1st ray in a plantarflexed 1st ray and FF valgus?
- Plantarflexed = abnormal 1st ray motion
- FF valgus= normal 1st ray motion
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What is metatarsus primus elevatus?
- 1st ray dorsiflexed
- callus above 1st met head on dorsal side of foot
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What type of axial motion does the 5th ray have?
Triplanar motion
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What are the two axes and their associated movements of the 5th ray?
- Transverse: dorsiflex/plantarflex
- Vertical: abduct/adduct
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How many degrees of 1st ray dorsiflexion are required for normal gait?
65
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What is the measurement for normal vertical displacement during gait?
2-5 cm
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What do the high/low points represent on a gait chart?
- High: midstance and swing
- Low: Double limb support
- **(2 of each)
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What is normal ankle dorsiflexion?
10 degrees
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T/F: The toes bear weight durig contact and midstance
False
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What are the degrees for normal angle/base of gait?
- Angle: 7-10 degrees
- Bae: 1-2 inches
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What are normal degrees for NCSP?
0-4 degrees
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What does NCSP tell us?
- Rearfoot deformity (varus or valgus)
- ***Varus is most common
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What are normal degrees of tibial influence?
1-4 degrees tibial varum
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At what degree is RF valgus normal?
less than 3 degrees
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What degrees reach cause maximum RF valgus?
3-10 degrees
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At what degree will RF valgus evert past max?
>10 degrees
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What is tarsal coalition?
When two bones fuse together
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What is Hypermobility?
- When there is STJ pronation during the propulsion phase
- (there should be supination)
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Is the lateral malleolus smaller/larger and does it extend anterior/posterior?
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What type of axis exists in the ankle joint?
Oblique to all three planes
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In OKC, how many degrees of transverse plane motion are available?
26.5
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How many degrees of trans motion available in ankle joint at CKC?
8.4 degrees
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What four muscles resist excessive dorsiflexion?
PT, FDL, FHL, PL (fibularis tertius)
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What three muscles help resist plantarflexion?
EDL, EHL, TA
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What muscle is the main dorsiflexor?
EHL
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What is a pedorthist?
fits and fabricates shoes, prostheses and accomodative orthoses
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What is the job of a CO?
- ***Certified orthotist
- orthoses, including braces, to fix problems
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What is the job of a CP?
- ***certified prosthetist
- Make artificial limbs
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What is the job of a certified prescription foot orthotic lab?
-make functional and accomodative foot orthoses, AFOs, foot fillers
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What three materials are used for an athletic orthesis?
- Polypropylene
- polyethylene
- fiberglass
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What two materials are used for a dress orthosis?
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Which material is used mainly for comfort and pressure relief, polypropylene or plastazote?
Plastazote
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What are three rearfoot post materials in order of hardness?
- Polypropylene
- Crepe (EVA)
- Cork (breakdown over time)
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What is the strongest topcover orthosis material?
Neolon (Spenco)
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Which is stronger a milled FFO or pressed FFO and why?
- Milled
- thinner and the striations make it stronger
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What are two reasons to use a neutral shoe?
- Under pronators
- high arch feet
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What are two reasons to use a stability shoe?
- Mild pronator
- normal/low arch
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What are two reasons to use a stability plus shoe?
- moderate pronation
- normal/low arch
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When do you use a motion control shoe?
Extreme over-pronation
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What are the three rules of shoe consideration?
- 1) Where shoe bends: at ball
- 2) heel counter: more=stable, less= comfort
- 3) torque: more = comfort, less = stable
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Can you ever evert the FF?
- No
- ***against theorem 5 (only inversion)
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What is the FF response w/rearfoot varus/valgus?
inversion
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What is the RF response to FF eversion/inversion?
- Nothing
- **unless maxed then the RF follows
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What is normal compensation?
When the body, trunk move in a different direction or weird terrain is encountered.
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What is abnormal compensation?
Due to abnormal structure/function of lower extremity
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How are normal and abnormal comp. accomplished?
Pro/supination
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What is the max degree of inversion of the LAMTJ?
7 degrees
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What is the max degree of supination of the STJ?
4 degrees
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