Gait Cycle Mechanics and Knee Biomechanics
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Questions and Answers

What is the primary pelvic movement during the single-limb support phase of the gait cycle?

  • Posterior tilt
  • Lateral tilt
  • Rotation
  • Anterior tilt (correct)

At what point in the gait cycle does the hip reach approximately 30 degrees of flexion?

  • Terminal Stance
  • Loading Response
  • Initial Swing
  • Initial Contact (correct)

How much does the knee flex during the loading phase after heel contact?

  • 5-10 degrees
  • 15-20 degrees
  • 20-25 degrees
  • 10-15 degrees (correct)

Which phase occupies the largest percentage of the gait cycle during walking?

<p>Stance phase (A)</p> Signup and view all the answers

What occurs during the loading response phase?

<p>The body 'loads' the leg and absorbs landing shock (A)</p> Signup and view all the answers

What action do the quadriceps perform during the loading phase of the gait cycle?

<p>Eccentrically activate (A)</p> Signup and view all the answers

What is the order of hip extension during the gait cycle?

<p>Begins flexed, gradually extends to full extension (B)</p> Signup and view all the answers

What action characterizes the early phase of mid swing regarding pelvis tilt?

<p>Tilts anteriorly (B)</p> Signup and view all the answers

What occurs during the unloading response in the gait cycle?

<p>The body begins to enter the swing phase by unloading weight. (A)</p> Signup and view all the answers

Which ligament of the knee primarily limits valgus movement at the tibia?

<p>Medial collateral ligament (MCL) (B)</p> Signup and view all the answers

What is the effect of flexion on the ligaments of the knee?

<p>Ligaments of the knee are on slack. (C)</p> Signup and view all the answers

What role do the menisci play in knee biomechanics?

<p>They reduce compressive forces at the knee joint. (B)</p> Signup and view all the answers

What is the primary function of the anterior cruciate ligament (ACL)?

<p>Prevents anterior translation of the tibia relative to the femur. (A)</p> Signup and view all the answers

Which mechanism helps maintain knee extension with minimal muscle activation in a standing position?

<p>Screwhome mechanism (D)</p> Signup and view all the answers

What happens to knee rotation during extension?

<p>Rotation in the transverse plane is not available. (B)</p> Signup and view all the answers

How do joint reaction forces work in the knee?

<p>Menisci reduce and manage these forces. (C)</p> Signup and view all the answers

What is the primary role of the quadriceps during midstance?

<p>To control knee flexion and prevent hyperextension (D)</p> Signup and view all the answers

Which muscles are primarily responsible for propulsion in terminal stance?

<p>Gastroc &amp; soleus (C)</p> Signup and view all the answers

During initial swing, what is the action of the hip flexors?

<p>To bring the leg forward (B)</p> Signup and view all the answers

What happens during the pre-swing phase when the stance leg pushes off the ground?

<p>Hip flexors prepare for forward movement into swing (B)</p> Signup and view all the answers

In mid-swing, which muscles are responsible for controlling the momentum of the leg?

<p>Hamstrings (C)</p> Signup and view all the answers

What is the primary function of the tibialis anterior during the swing phases?

<p>To maintain dorsiflexion and prevent foot dragging (D)</p> Signup and view all the answers

Which phase involves the body fully suspended over the planted foot?

<p>Midstance (B)</p> Signup and view all the answers

What occurs during the terminal swing phase as the leg prepares for heel strike?

<p>Hamstrings eccentrically decelerate the leg (A)</p> Signup and view all the answers

Which ligament limits hyperextension and abduction of the hip joint?

<p>Pubofemoral Ligament (B)</p> Signup and view all the answers

Which of the following myotomes is responsible for hip abduction?

<p>L5, S1 (D)</p> Signup and view all the answers

What structure is primarily associated with the medial rotating muscles of the hip?

<p>Obturator artery (A)</p> Signup and view all the answers

Which myotome is associated with knee extension?

<p>L3, L4 (B)</p> Signup and view all the answers

What is the role of the Ischiofemoral Ligament in the hip joint?

<p>Limit adduction and flexion (D)</p> Signup and view all the answers

What is the primary function of the meniscus in the knee joint?

<p>To reduce localized pressure and improve congruency (C)</p> Signup and view all the answers

Which dermatomes correspond to the upper thigh region?

<p>L1, L2 (A)</p> Signup and view all the answers

Which artery primarily supplies the hamstrings and adductors?

<p>Profunda Femoris artery (C)</p> Signup and view all the answers

How is the medial tibial plateau shaped compared to the lateral tibial plateau?

<p>It is larger and C-shaped (B)</p> Signup and view all the answers

Which movement corresponds to a 'superior roll and inferior glide' of the femur?

<p>Abduction (C)</p> Signup and view all the answers

What is the primary function of the superior gluteal artery?

<p>Supply the piriformis muscle (B)</p> Signup and view all the answers

During internal rotation in open chain, what motion occurs at the femur?

<p>Anterior roll and posterior glide (D)</p> Signup and view all the answers

What effect does lateral rotation have on the knee joint's congruency?

<p>It maintains optimal congruency (B)</p> Signup and view all the answers

What happens during flexion in terms of movement at the head of the femur?

<p>Posterior spin on the acetabulum (B)</p> Signup and view all the answers

In a closed chain scenario, which movement incurs a medial roll and glide of the acetabulum on the femur?

<p>Adduction (C)</p> Signup and view all the answers

What is a consequence of the shape of the tibial plateaus in relation to their respective menisci?

<p>They accommodate different meniscus shapes and enhance stability (A)</p> Signup and view all the answers

Which muscle is attached to the Anterior Inferior Iliac Spine?

<p>Rectus femoris (A)</p> Signup and view all the answers

What structure does the Patellar ligament attach to?

<p>Tibial Tuberosity (A)</p> Signup and view all the answers

Which of the following landmarks is associated with the biceps femoris long head?

<p>Ischial Tuberosity (C)</p> Signup and view all the answers

What major change occurs in a woman's body during pregnancy regarding cardiac function?

<p>Increased cardiac output (B)</p> Signup and view all the answers

The center of mass in pregnant women is displaced forward due to which factor?

<p>Enlarging uterus (D)</p> Signup and view all the answers

Which ligament is associated with the Medial Epicondyle of the Femur?

<p>Medial collateral ligament (MCL) (B)</p> Signup and view all the answers

What is a significant effect of pregnancy on breast tissue?

<p>Mammary glands enlarge (A)</p> Signup and view all the answers

Which muscle is primarily associated with the Inferior/Superior Pubic Rami?

<p>Gracilis (D)</p> Signup and view all the answers

Flashcards

Double Support

The period during walking where both feet are in contact with the ground, allowing the body to shift weight from one leg to the other.

Initial Contact

The first phase of gait where the heel contacts the ground, and the body's momentum is counteracted by the ground reaction force.

Loading Response

The period where the body absorbs the impact of the heel strike and begins transferring weight to the stance leg.

Midstance

The portion of gait where the body is fully supported by the stance leg, allowing the swing leg to move forward.

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Terminal Stance

The phase where the body prepares to shift weight onto the swing leg.

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Pre-Swing

The phase where the body prepares to move the swing leg forward.

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Initial Swing

The phase of gait where the swing leg moves forward to prepare for the next step.

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Mid Swing

The phase where the swing leg continues to move forward and prepares for heel contact.

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Joint Reaction Forces

The forces that act on a joint during movement. These forces contribute to stability.

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Collateral Ligaments

The medial and lateral collateral ligaments help limit excessive sideways motion (adduction and abduction) of the tibia.

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Cruciate Ligaments

The anterior cruciate ligament (ACL) prevents the tibia from sliding forward too far relative to the femur, while the posterior cruciate ligament (PCL) prevents the tibia from sliding backward.

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Menisci of the Knee

The medial and lateral menisci act as shock absorbers, cushioning the knee joint, and reducing compressive forces.

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Arthrokinematics

The motion of a joint's bony surfaces during movement, influenced by ligament tension.

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Screwhome Mechanism

The knee joint's ability to lock in extension, requiring minimal muscle effort to maintain a standing position.

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Factors Influencing Screwhome Mechanism

A mechanism that allows for smoother movements during gait. It involves tension in the ACL, the shape of the medial femoral condyle, and muscle actions.

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Terminal Stance (Heel Off)

The phase of gait where the heel of the stance leg lifts off the ground and the body shifts weight forward to prepare for the next step. The opposite leg begins to make initial contact with the ground.

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Terminal Swing

The phase of gait where the swing leg slows down before making heel contact with the ground. It involves full knee extension and hamstring engagement.

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Pre-Swing (Toe-Off)

The phase where the body prepares to move the swing leg forward. It involves pushing off the ground with the toe and engaging the gastrocnemius and soleus muscles to propel the body forward.

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Profunda femoris artery

The profunda femoris artery branches off the femoral artery and supplies blood to the adductor muscles of the thigh.

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Perforating arteries

The perforating arteries arise from the profunda femoris artery and provide blood to the hamstrings and adductor muscles.

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Obturator artery

The obturator artery supplies blood to the muscles of the medial thigh compartment, including the adductors.

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Superior gluteal artery

The superior gluteal artery supplies blood to the piriformis, gluteus muscles, and tensor fasciae latae.

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Inferior gluteal artery

The inferior gluteal artery supplies blood to the pelvic diaphragm, piriformis, quadratus femoris, gluteus maximus, uppermost hamstrings, and the sciatic nerve.

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Iliofemoral ligament

The iliofemoral ligament helps prevent hyperextension at the hip joint.

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Pubofemoral ligament

The pubofemoral ligament limits hip hyperextension and abduction.

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Ischiofemoral ligament

The ischiofemoral ligament limits excessive hip extension, adduction, and flexion.

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Femur's Role in Knee Alignment

The shape of the femur causes the distal portion to be located behind the proximal portion, allowing for a straight line of gravity when the knee is fully extended.

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Menisci Function

The menisci are C-shaped (medial) and O-shaped (lateral) cartilaginous structures that:

  • Increase the congruency of the joint, reducing localized pressure
  • Improve joint stability
  • Contribute to proprioception
  • Reduce friction
  • Distribute weight.
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Tibial Plateau Shape

The medial tibial plateau is larger and C-shaped to match the larger, C-shaped medial meniscus. The lateral plateau is smaller to accommodate the O-shaped lateral meniscus.

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Open Chain Hip Arthrokinematics

Movement of the femur on the acetabulum in an open chain (leg moving freely).

  • Abduction: superior roll, inferior glide
  • Adduction: inferior roll, superior glide
  • Internal rotation: anterior roll, posterior glide
  • External rotation: posterior roll, anterior glide
  • Flexion: posterior spin
  • Extension: anterior spin
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Closed Chain Hip Arthrokinematics

Movement of the acetabulum on the femur in a closed chain (leg fixed and acetabulum is moving).

  • Abduction: lateral roll and glide
  • Adduction: medial roll and glide
  • Internal rotation: anterior roll and glide
  • External rotation: posterior roll and glide
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Hip Joint Movement

The hip joint is capable of movement in all 3 planes: sagittal, frontal, and transverse.

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Hip Joint Shape

The hip joint has a concave acetabulum and a convex femur.

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Importance of Lateral Rotation

Lateral rotation of the femur is required for maximum hip joint congruency. This alignment helps achieve stability and optimal joint function.

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Iliac Crest

The uppermost part of the hip bone, serving as a point of attachment for muscles involved in abdominal and hip movements.

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Anterior Superior Iliac Spine

The bony prominence located at the front of the pelvis, serving as an attachment point for muscles involved in hip flexion and thigh movement.

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Anterior Inferior Iliac Spine

The bony prominence located at the front of the pelvis, below the ASIS, serving as a point of attachment for the rectus femoris muscle.

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Ischial Tuberosity

The bony prominence situated at the back of the pelvis, serving as a point of attachment for muscles involved in hip extension and knee flexion.

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Inferior/Superior Pubic Rami

The bony structures located at the front of the pelvis, serving as attachment points for muscles involved in hip adduction and thigh movement.

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Patella

The knee cap, a sesamoid bone that protects the knee joint and provides leverage for the quadriceps muscles.

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Tibial Tuberosity

The bony bump located on the front of the shinbone, serving as an attachment point for the patellar ligament.

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Medial Epicondyle of Femur

The bony prominence located on the inner side of the femur, serving as an attachment point for muscles and ligaments involved in knee stability.

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Study Notes

Biomechanics of the Stance Limb

  • Initial contact begins with the heel striking the ground. The pelvis tilts slightly anteriorly. The hip flexes ~30 degrees at the start of the gait cycle, extending gradually to ~10 degrees of hip extension. The knee is flexed ~5 degrees at heel contact, further flexing to ~10-15 degrees during loading.
  • Loading response: The body weight is absorbed through the stance leg, and pelvic tilt becomes more anterior. Knee flexion continues. Quads are activated eccentrically during this phase. Pre-swing phase - the knee nears full extension until toe-off.
  • Midstance: Body weight is fully supported by the stance leg. Knee extends and the body is suspended over the planted foot. The glutes and hip flexors are active in propelling the body forward.
  • Terminal stance: Heel of the stance leg lifts off the ground and the body moves forward to prepare for swing. Gastrocnemius and soleus muscles propel the body forward. Hip flexors are activated.
  • Pre-swing: The stance leg continues propelling the body forward to swing the other leg. Gastrocnemius and soleus muscles are active. Hip flexors initiate this forward movement.
  • Initial swing: The swing limb begins once the foot leaves the ground. Knee flexion begins and hips continue to flex, driving the leg forward. Quadriceps assist in bringing the leg forward.
  • Mid-swing: The leg directly moves beneath the body. The knee extends. Hip flexors move the leg forward. Hamstrings decelerate the leg to prepare for the next step. Tibialis anterior controls dorsiflexion.
  • Terminal swing: The leg slows down before preparing for the next heel strike. The knee fully extends (concentric quad action) for the next step. Hamstrings eccentrically decelerate the leg.

Biomechanics of the Knee

  • Knee ligaments: MCL (Medial Collateral Ligament) limits valgus (abduction of tibia), LCL (Lateral Collateral Ligament) limits varus (adduction of tibia), ACL (Anterior Cruciate Ligament) limits anterior translation of tibia/posterior translation of femur. PCL (Posterior Cruciate Ligament) limits posterior translation of tibia/anterior translation of femur.
  • Joint reaction forces: Compressive forces are reduced by medial and lateral menisci. Screwhome mechanism (locking mechanism) allows to maintain knee extension with minimal extensor muscle activation.
  • Arthrokinematics: Role of the meniscus in reducing localized pressure and improving joint stability, and increasing joint congruency. Shape of medial and lateral tibial plateau accommodates the shape of the menisci.

Additional Notes

  • Pelvic Rhythm: The pelvis tilts posteriorly before the spine extends. The glutes and hamstrings pull the pelvis backward.
  • Trendelenburg Sign: Contralateral pelvis drop, indicating weakness in the gluteus medius or minimus muscles.

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Description

This quiz tests your knowledge on the mechanics of the gait cycle, focusing on pelvic movements and knee function during various phases. Questions cover aspects such as leg support, flexion angles, and the roles of ligaments and menisci in knee biomechanics. Assess your understanding of how these elements contribute to efficient movement.

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