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What qualifies as a LLD?
>1cm diff
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What is RCSP difference that will lead to LLD?
>3 degrees
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What is latrogenic?
shoe gear, orthoses
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What is gold standard for measuring LLD?
multiple view x-rays
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What size pads do you use for WB measurements?
2mm
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What is a pad limit b/f utilizing permanent shoe modifications?
10mm (=1cm)
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Does the shorter limb of LLD sup or pron?
Supinate
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T/F It is better to lengthen than shorten a limb?
F, better to shorten than lengthen
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What type of hip problem exists if there is not discrepancy b/t knee flexed/extended?
Osseus
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Avg head-to-neck angle of femur?
125-130
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Femoral condyle developmental angle changes?
- Birth = 30-35
- 1 yr = 25-30
- 5 yr = 20-25
- 15 yr = 10-15
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How is the hip range of motion for a 3 yr. old?
internal and external ROM are equal
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What does a hip flexed ROM test measure?
Hip rotation in swing phase
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What does a hip extended ROM test measure?
Hip rotation in Stance phase
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Normal internal hip ROM?
35-50 degrees
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Normal external hip ROM?
25-40
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In gait, when is the hip internally rotated?
Heel contact and toe lift off same foot
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In gain, when is the hip externally rotated?
opp toe off to same toe lift off
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Body weight increases on hip upon heel strike and STJ supination?
- heel strike: 4x body weight
- STJ Supination: 7x body weight
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Hip flexors function?
- Flex hip
- accelerate external motion
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Hip extensors
- Hamstrings
- Gluteus maximus
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Hip extensor functions?
extend hip
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Hip adductors
- Adductor magnus, longus and brevis
- Gracilus
- pectineus
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Hid adductor functions?
- adduction
- flexion
- external rotation
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Hip abductors
Gluteus minimus, medius, IT Band
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Internal rotators
adductors' 2nd function
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Normal vertical displacement of body during gait?
5cm (2 in)
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Stride
distance b/t heel contact of one foot to heel contact of same foot
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Step
heel contact of one foot to heel contact of the opposite foot
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Normal base of gait?
3.5 inches
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Normal angle of gait?
12-15 degrees
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What muscle controls supination and slow pronation?
Tibialis posterior
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What mm decelerates the tibia?
Soleus
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What mm provide knee extension?
Gastroc & Soleus
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What mm smooth out supination?
FB and FL
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What mm compress the tarsus posteriorly?
FL and PT
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What mm stabilizes the 1st met against the tarsus?
PL
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T/F the toes bear weight during contact and midstance
F, they do not bear weight during contact or midstance
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What mm assist ankle dorsiflexion?
EDL, EHL and TA
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What mm mainly cause STJ pronation?
FDL
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What 3 x-ray angle measurements do not change with sup/pro?
- Met adductus
- Digital abductus
- Calcaneal inclination
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If Tibial Varum is >5 degrees, what must happen to get foot on ground?
Pronation
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Most common cause of intoeing?
Internal tibial torsion
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What is a deformity caused by a large Q-angle?
genu valgum (w/ coxa varum)
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Knee Flexion - CKC movement?
Slide anterior / roll posterior
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Knee extension - CKC movement?
slide posterior / roll anterior
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During knee extension, what pulls knee anteriorly?
PCL
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During knee flexion, what pulls knee posteriorly?
ACL
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Tibia and femur movements during extension screw home mechanism?
- Tibia: external rotation
- Femur: internal rotation
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Tibia and femur movements during flexion of screw home mechanism?
- Tibia: internal rotation
- Femur: external rotation
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What is the Helfet Test?
- To test screw home mechanis
- * flex knee, draw line in patella and tuberosity then extend. If correct, tuberosity will be lateral to patella
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Equinus compensation
- STJ pronation
- MTJ pronation
- smaller stride
- abducted gait
- genu recurvatum
- early heel lift
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Longitudinal MTJ axis degrees
- 8 degrees sagittal
- 15 degrees Transverse
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Which is more common, superior or medial OAMTJ deviations?
Superior
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Which is harder to help with orthotics, superior or medial deviations of MTJ?
Superior
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Name the five common shoe modifications
- rocker bottom
- heel lift
- met bars
- flares
- buttress/stabilizers
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When do you use a heel lift?
LLD > 1cm (or 10mm)
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What is the goal of a rocker bottom foot?
- Allow patient to get over the foot
- unload forefoot or heel
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What is the function of shoe flares?
support medial and/or lateral heel movement
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What is the diff b/t a flare and a buttress (stabilizer)?
A buttress goes up into the shoe while a flare goes out from the sole
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What are the four purposes of AFOs?
- 1) support
- 2) alignment
- 3) limit motion (pain control)
- 4) sub for inadequate muscle control
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What is the diff b/t a Static AFO and a Dynamic AFO?
- Static: limits AJ motion
- Dynamic: allows AJ motion (sagittal)
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Diff b/t custom made and customized?
- Custom made: molded
- customized: fit to customer
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