First Order Interventions use manipulation, therapeutic exercise, massage or surgery for which 5 conditions?
- microtrauma
- macrotrauma
- repetitive stress
- postural syndromes
- congenital conditions
According to the Therapeutic Order, #4: Correct structural integrity contains which order interventions?
First Order and Second Order Interventions
Second Order Interventions use manipulation, therapeutic exercise, massage or surgery for structural problems that are a result of what?
Stress upon internal systems… e.g., digestive disorders
What are the divisions of the Autonomic Nervous System?
Sympathetic and Parasympathetic
What are the cord levels for the Sympathetic ANS?
T1-L2
What are the 2 parts and cord levels for the Parasympathetic ANS?
- Cranial: III, VII, IX, X
- Sacral: S2, S3, S4
Which 2 influences of the Naturopathic Therapeutic Order happen via central, peripheral, autonomic nervous systems?
- Somato-Visceral influences
- Viscero-Somatic influences
According to Viscero-Viceral Reflexes, what are the influencing factors for local?
Local: Influencing the structure which generate the impulses
According to Viscero-Viceral Reflexes, what are the influencing factors for systemic?
Influencing other structures in response to a given stimuli
Which reflexes are a result of mind influences on the body and vice versa via complex interconnections and interactions?
Psycho-Somato-Visceral Reflexes
What is the study of motion or human movement?
Kinesiology
What concept applies the principles of physics to human motion?
Biomechanics
What is the branch of biomechanics that describes the motion of the body, without regard to forces or torque that may produce the motion?
Kinematics
What are the two branches of kinematics?
- Osteokinematics
- Arthrokinematics
Which branch of kinematics has gross motion of joints in the cardinal planes?
Osteokinematics
Which branch of kinematics has fine bone on bone motion within joints?
Arthrokinematics
What are the 2 types of Kinematic Translation?
- Rectilinear
- Curvilinear
Which Kinematic Translation movement may glide in a straight line?
Rectilinear
Which Kinematic Translation movement may glide in a curved line?
Curvilinear
What are 2 types of Kinematic Motion?
- Rotation
- Translation
Which motion produces body parts that move in a circular path around a pivot point (axis of motion)?
Rotation
Movement of the body in either translation or rotation can be described in which 2 ways?
- Active movement
- Passive movement
Which type of movement is caused by muscle action?
Active movement
Which type of movement is caused by sources outside the body, such as a push by another person or the pull of gravity?
Passive movement
What are the 3 planes of motion?
- Sagittal: [divides into Left and Right]
- Frontal (Coronal): [divides into Front and Back]
- Transverse (Axial): [divides into Upper and Lower]
What is the imaginary line perpendicular to the plane of motion and passing through the center of rotation?
Axis of motion
Bones rotate within a joint in a plane that is ___________ to the axis of rotation?
Perpendicular (90º)
What are the 3 axes and which direction do they run?
X-axis: Frontal (coronal)
Y-axis: Longitudinal (vertical)
Z-axis: Sagittal
Which 2 motions take place in the Sagittal Plane on the Front Axis?
Flexion and Extension
Which 2 motions take place in the Frontal Plane on the Sagittal Axis?
Abduction and Adduction
Which motion takes place in the Transverse Plane on the Longitudinal Axis?
Rotation
What is the determining position on the body for Right & Left and Medial and Lateral?
Midline - direction is determined from there
What is the determining factor for Distal & Proximal and Superior & Inferior?
The head
What describes the motion of bones relative to the three cardinal planes of the body?
Osteokinematics
What type of osteokinematics is the motion of one flat or nearly flat bone surface gliding or slipping over another without appreciable angulation or rotation (little motion)?
Linear motion (gliding)
What are 3 joint examples of osteokinematic linear motion?
- metacarpal joints
- metatarsal joints
- vertebral facets joints
Which osteokinematic motion causes either an increase or decrease in the angle between two bones and may occur in any body plane?
Angular motion (rotation)
What are 6 motion examples of angular motion?
- flexion
- extension
- hyperextension
- abduction
- adduction
- circumduction
In angular motion, flexion does what to the angle between elements?
reduces
In angular motion, extension does what to the angle between elements?
increases
What is extension past the anatomical position of a joint?
Hyperextension
In angular motion, abduction moves _____ the vertical axis.
away from
In angular motion, adduction moves ______ vertical axis.
toward
In angular motion, what movement is a circular motion without rotation?
Circumduction
What 4 motions make up circumduction?
- flexion
- abduction
- extension
- adduction
What movement is the rotation of the forearm so palm faces forward (upward)?
Supination
What movement is the rotation of the forearm so the palm faces to the rear (downward)?
Pronation
What movement is the turning of the sole of the foot inward or medially, and standing with weight on the outer edge of the foot?
Inversion
What movement is the turning of the sole of the foot outward or laterally, and standing with weight on the inner edge of the foot?
Eversion
What movement is extension at the ankle from neutral 90º (pointing toes)?
Plantar flexion
What movement is flexion at the ankle from neutral 90º (lifting toes)?
Dorsiflexion
Which motion is the superior direction or upward movement?
Elevation
Which motion is the inferior direction or downward movement?
Depression
Protraction and retraction are movements applied to which 3 areas?
- Jaw
- Shoulders
- Pelvis
Which motion moves anteriorly in the horizontal plane (pushing forward)?
Protraction
Which motion moves posteriorly in the horizontal plane (pulling back)?
Retraction
Which movement is important for hand function and enables the hand to grasp objects?
Thumb opposition
Which motion is thumb movement towards fingers or palm (grasping)?
Opposition
Which motion is movement of thumb back to anatomical position?
Reposition
What is a series of articulated segments linked together (i.e. connection between pelvis, thigh, leg, and foot)?
Kinematic chain
Within a kinematic chain, the terms “open” and “closed” are used to indicate what?
Which end of the extremity is fixed (anchored) to the earth or an immovable object
Which kinematic chain is when the distal segment of the chain is NOT FIXED to the earth or an immovable object, therefore… the distal segment is free to move?
Open kinematic chain (OKC)
Which kinematic chain is when the distal segment of the chain IS FIXED to the earth or an immovable object, therefore… the proximal segment is free to move?
Closed kinematic chain (CKC)
During knee flexion, which chain would be referred to if the tibia is moving on the femur? (i.e. sitting in a chair swinging the lower leg)
Open chain
During knee flexion, which chain would be referred to if the femur is moving on the tibia? (i.e. standing from a seated position)
Closed chain
What are the 3 functional classifications of joints?
- Synarthrosis: (immovable)
- Amphiarthrosis: (slightly movable)
- Diarthrosis: (freely movable)
What are the 3 structural classifications of joints?
- Fibrous (generally immovable)
- Cartilagenous (both movable and immovable)
- Synovial (generally freely movable)
T/F: Fibrous joints have a joint capsule
False! They have NO joint capsule.
What are the 2 movements of a fibrous joint?
- Synarthrodial
- Amphiarthrodial
In fibrous joints, the amount of movement is dependent upon the…
Length of connective tissue fibers connecting bones
What are the 3 types of fibrous joints?
- Suture
- Gomphosis
- Syndesmosis
Which fibrous joint occurs only between bones of the skull?
Sutures
What are the 3 functions of fibrous joints - sutures?
- hold bones tightly together
- allows bone growth during youth
- ossified later in life … “synostosis”
Which type of joint has the following characteristics: Peg-in-socket fibrous joint and articulation of tooth into alveolar socket?
What is the fibrous connection?
Gomphosis; short periodontal ligament
Which type of fibrous joint has bones connected by ligaments and have amphiarthrodial movement?
Syndesmosis
Depending on length of collagen fibers cartilaginous joints may have which 2 types of movement?
- Synarthrodial (immovable)
- Amphiarthrodial (slightly moveable)
What are 2 types of cartilaginous joints?
- Synchondrosis
- Symphysis
What are 2 examples of synchondrosis, cartilaginous joints?
- epiphyseal plate joining diaphysis to epiphysis (temporary joint)
- costosternal joint
What type of cartilage joint is fused to shock-absorbing pad of fibrocartilage? What are 2 examples?
- intervertebral joints
- pubic symphysis
Which joint has bones separated by a fluid-filled joint cavity connected by ligaments of dense connective tissue, permitting freedom of movement?
Synovial joints
What are the 6 types of synovial joints, based on structure and type of motion?
- Gliding joints
- Hinge joints
- Pivot joints
- Condyloid joints
- Saddle joints
- Ball-and-socket joints
What is surrounded by epimysium and contains muscle fascicles?
Skeletal muscle
What is surrounded by perimysium and contains muscle fibers?
Muscle Fascicle
What is surrounded by endomysium and contains myofibrils?
Muscle Fiber
What is surrounded by sarcoplasmic reticulum and consists of sarcomeres?
Myofibril
Sarcomere contains which 2 types of filaments?
Thick and Thin filaments
What is the name of the site where axon and muscle fiber communicate?
Neuromuscular Junction
What are 5 basic components of the neuromuscular junction?
- motor neuron
- motor end plate
- synaptic cleft
- synaptic vesicles
- neurotransmitters
Motor nerve impulses cause release of acetylcholine (ACh) from synaptic vesicles which bind to receptors on the motor end plate and generate what?
muscle contraction
During muscle relaxation what breaks down acetylcholine?
acetylcholinesterase
During muscle relaxation, calcium moves back into which structure?
sarcoplasmic reticulum
This single motor neuron and all the muscle fibers it controls is the functional connection between the nervous system and the muscular system.
Motor unit
What happens when when a motor unit fires?
All the muscle fibers contract together
T/F: One neuron may innervate several muscle fibers
True
T/F: Only one muscle fiber will be innervated by one motor neuron
FALSE!! One muscle fiber may be innervated by several motor neurons
What is the purpose of one muscle fiber potentially being innervated by several motor neurons?
This creates both large and small motor units
Fine control: extraocular muscles (20 fibers)
Strength control: gastrocnemius (1,000 fibers)
T/F: One muscle fiber may act with several motor units depending upon demand
True
What is a single brief stimulus to a muscle that produces a quick cycle of contraction and relaxation lasting less than 1/10 second?
Twitch
T/F: a single twitch contraction is strong enough to do useful work
FALSE!! A single twitch contraction is NOT strong enough to do any useful work
Normal activities require more tension than is produced by single fiber twitch … they involve _______ ______ ______ of the whole muscle.
sustained muscle contraction
What is the term for when relaxation is complete before the next stimulus occurs, each contraction is a little stronger than previous?
Treppe
What is the term: if a second stimulus is applied before relaxation is complete, the second contraction is greater?
Wave summation (temporal summation)
What is the term: with higher frequency of stimulation, muscle relaxation between contractions is reduced?
Tetanus
Which type of tetanus produces peak tension during rapidly alternating cycles of contraction and partial relaxation?
incomplete tetanus
Which type of tetanus is sustained maximal contraction at peak tension, typical of normal muscle contraction?
complete tetanus
Twitch,a single muscle contraction happens throughout which 3 phases?
- latent
- contraction
- relaxation
Twitch occurs with which type of frequency stimuli?
low frequency (up to 10 stimuli/sec)
T/F: During twitch, each stimulus produces a wave of varying twitch responses
FALSE!! Each stimulus produces an identical twitch response
Treppe, gradually increased contraction intensity during sequential stimulation occurs with which type of frequency stimuli?
moderate frequency stimuli (between 10-20 stimuli/sec)
What are the characteristics of treppe contractions?
Each subsequent contraction is stronger than previous one until, after a few stimuli, all contractions are equal
What is the term for a rapid sequence of stimuli causing the muscle twitches to fuse together, each contraction being stronger than the one before,gradually generating more strength of contraction?
Wave Summation (temporal summation)
Wave summation (temporal summation) occurs with which type of frequency stimuli?
higher frequency stimulation (20-40 stimuli/second)
T/F: During wave summation, each stimulus arrives before the previous twitch is over.
True
During wave summation, as the frequency of stimulus increases, the frequency of contraction does what?
increases
Tetanus (incomplete) has what type of sequence of stimuli and occurs with what type of frequency stimulation?
- very rapid sequence of stimuli
- higher frequency stimulation (20-40 stimuli/second)
What are 2 characteristics of incomplete tetanus?
- sustained fluttering contractions
- muscle fibers partially relax between contraction
Tetanus (complete) has what type of sequence of stimuli and occurs with which type of frequency stimulation?
- very rapid sequence of stimuli … no relaxation
- maximum frequency stimulation (40-50 or > stimuli/second)
What are 2 characteristics of complete tetanus?
- no relaxation between contractions
- twitches fuse into smooth, prolonged contraction
What are the 3 functional classifications of neurons?
- Sensory
- Motor
- Interneuron
Which classification of neurons contains afferent neurons that transmit impulses from receptors to the brain or spinal cord?
Sensory
Which classification of neurons has efferent neurons that transmit impulses from the brain or spinal cord to the effector sites such as muscles, glands, or organs?
Motor
Which classification of neurons has association neurons that transmit impulses from one neuron to another?
Interneuron
Which “A” Fibers have the following characteristics?
- fastest conducting and largest diameter
- motor efferents
- muscle spindle afferents
α - A alpha (100 ms)
Which “A” Fibers have the following characteristics?
- touch and pressure afferents (mechanoreceptors)
β - A beta (50 ms)
Which “A” Fibers have the following characteristics?
- motor efferent to muscle spindle
γ - A gamma (20 ms)
Which “A” Fibers have the following characteristics?
- skin temperature and pain (noxious stimuli)
δ - A delta (15 ms)
Which nerve fiber types are myelinated?
Type A and Type B
Type C are UNMYELINATED
Which nerve fibers are slower and are sympathetic preganglionic?
“B” fibers: (7 ms)
Which nerve fibers are slower conducting than A fibers,
are the smallest diameter, sense pain (burning, aching), and are sympathetic postganglionic?
“C” fibers: (1ms)
What is the basic functional unit of nervous system, having an automatic response to stimulus without conscious thought?
Spinal cord reflex arc
What are the 5 basic components of the spinal cord reflex arc?
- sensory receptor
- sensory neuron
- interneuron
- motor neuron
- effector organ
Which portion of the spinal cord reflex arc transmits AP stimulated by sensation?
sensory receptor
Which portion of the spinal cord reflex arc transmits impulses to spinal cord?
sensory neuron
Which portion of the spinal cord reflex arc connects or switches impulses to other neurons?
interneuron
Which portion of the spinal cord reflex arc transmits motor impulses?
motor neuron
Which portion of the spinal cord reflex arc responds with reflex contraction of muscle or gland?
effector organ
What is the sense of position and movement of one’s own limbs and body without using vision (somatosensory) to include: sense of body and limb position, sense of speed and direction of limb joint movement, and sense of muscle length and tension?
Proprioception
What are the 3 types of mechanoreceptors that detect proprioception?
- Muscle spindle receptors
- Golgi tendon organs
- Joint kinesthetic receptors
Where are muscle spindle receptors located?
within the fleshy part of a muscle
Muscle spindle receptors consist of which type of muscle fibers which are modified muscle fibers enclosed in a capsule within which other type of muscle fibers?
intrafusal muscle fibers; extrafusal muscle fibers (voluntary skeletal muscle)
The ends of the intrafusal fibers (muscle spindles) are contractile and attach to the extrafusal fibers. What do the muscle spindles detect?
-the rate at which the muscle fibers are stretched and their length
Changes in length of muscle fibers aids in ________ and _______ of muscle contraction.
coordination and efficiency
What are the 2 types of intrafusal fibers:
Nuclear bag fibers
Nuclear chain fibers
In nuclear bag fibers, nuclei are concentrated in the central “bag” part of the fiber. The ends of the fibers have what 2 characteristics?
striated and contractile
The contractile fibers of the nuclear bag fibers are attached to the _________ fibers and the contractile ends receive input from which type of neurons?
extrafusal; gamma motor neurons
The nuclear bag is sensitive to sudden rate of change in what?
muscle length (phasic)
Nuclear chain fibers have nuclei that are spread in a “chain-like” fashion in the center of the fiber. Like the nuclear bag fibers, the ends of the fibers are striated and contractile, however the contractile fibers are attached to what?
the ends of the nuclear bag muscle fibers
Nuclear chain fibers are sensitive to what type of muscle action?
Steady changes of the length of the muscle (tonic)
The central non-contractile region of the “bag” and “chain” is wrapped by what, that send input about length of the spindle to the CNS.
sensory nerve endings
What are the 2 types of sensory nerve endings?
- Primary endings type Ia fiber
- Secondary endings type II fiber
What type of endings are associated with primary endings type Ia fiber? What are the 3 characteristics of primary endings type la fiber?
annulospiral sensory endings;
- larger diameter
- conduct impulses faster (100 ms)
- respond to rate of change in the muscle fiber length
What type of endings are associated with secondary endings type II fiber? What are the 3 characteristics of secondary endings type II fiber?
flower spray sensory endings;
- smaller diameter
- conduct impulses more slowly
- respond to overall length of the muscle fiber
Where do gamma motor neurons come from?
the CNS
The central non-contractile region is wrapped by ______ and ____ sensory neurons that send input about the rate and amount of length change to the CNS
type Ia and type II
The contractile ends of muscle spindle receptors receive input from which type of neurons to contract?
gamma motor neurons
Extrafusal fibers of muscle spindle receptors are innervated by which type of neurons?
alpha motor neurons
Muscles are stretched by contraction of _______ muscles and by movements that occur when we lose our balance.
antagonist
Muscle spindles sense changes in muscle tension and do what?
compensate for the stretch
Muscle spindles sense changes in muscle length because as the muscle is stretched the muscle spindle is what?
also stretched
T/F: Stretching activates the sensory neurons of the spindle causing them to signal the spinal cord and brain.
True
The CNS activates alpha motor neurons that cause the muscle (extrafusal) to ________ to resist further stretching.
contract
Response to stretching can be what 2 things?
- monosynapatic spinal reflex
- stretch response controlled by the cerebellum
Which reflex makes a rapid adjustment to prevent a fall?
monosynapatic spinal reflex
Which response is controlled by the cerebellum and regulates muscle tone? (Example: the steady force of a non-contracting muscle to resist stretching)
stretch response
Gamma motor neurons let the brain do what to the spindle to stretch?
preset the sensitivity
When the brain signals gamma motor neurons to fire, the which muscle fibers contract and become tense so that very little stretch is needed to stimulate the sensory endings?
intrafusal muscle fibers
Making the spindles highly sensitive to stretch is advantageous because which reflexes have little margin for error?
balance reflexes
What are encapsulated nerve endings located at the junction of tendon and muscle?
Golgi tendon organs (GTOs)
GTO ends have numerous terminal branches associated with bundles of collagen fibers in the tendon which detects which 3 things…
- force of muscle contraction
- tension applied to the tendon
- prevents contracting muscle from applying excessive tension to tendons
What portion of the muscle produces sudden relaxation of the muscles and plays a role in muscle tone imbalance, muscle spasm and tender points?
GTO
Tendons stretch as the muscle contracts causing increased tension at the tendon. Increased tension stimulates which neurons from the Golgi tendon organs?
Ib sensory neurons
Golgi tendon organs are sensitive only to ________ stretch.
intense
Sensory neurons enter the spinal cord and synapse with which type of interneurons?
inhibitory
Interneurons synapse with alpha motor neurons and…
• _______ neurotransmitters are released
• which _______ the alpha motor neurons which innervate extrafusal muscle to which the Golgi tendon organ is attached
inhibitory; inhibits
Muscle relaxes and reduces tension applied to the tendons which…
protects tendon and muscle from damage
What response is a sudden increase in muscle tension causes a decrease in muscle tone via involuntary muscular relaxation?
Dynamic response
What response is a sustained or gradual increase in muscle tension causes a decrease in muscle tone?
Static response
T/F: Arranged in a series, Golgi tendon organs respond to fast, quick stretch by resetting a muscles’ length and inhibiting its synergistic stabilizers while facilitating its antagonist.
FALSE!!! Arranged in a series, Golgi tendon organs respond to slow stretch by resetting a muscles’ length and inhibiting its synergistic stabilizers while facilitating its antagonist
Golgi tendon organ may serve a protective function by….
reflexively inhibiting its agonist at the end range of joint motion
Which is located within muscle belly (intrafusal), muscle spindle or GTO?
Muscle spindle
Which uses sensory and motor innervation, muscle spindle or GTO?
Muscle spindle
Which contain nuclear bag fibers… primary afferent only, fast stretch, dynamic; muscle spindle or GTO?
Muscle spindle
Which chain fibers… primary and secondary afferents, slow stretch, static; muscle spindle or GTO?
Muscle spindle
Which detect muscle length and rate change, muscle spindle or GTO?
Muscle spindle
Which have involuntary muscular contraction, muscle spindle or GTO?
Muscle spindle
Which are located within tendon (extrafusal), muscle spindle or GTO?
GTO
What has sensory innervation only, muscle spindle or GTO?
GTO
What detects tendon tension and rate of change, muscle spindle or GTO?
GTO
Which has a dynamic response…quick stretch, muscle spindle or GTO?
GTO
Which has a static response … postural tone, muscle spindle or GTO?
GTO
Which involves involuntary muscular relaxation, muscle spindle or GTO?
GTO
Joint kinesthetic receptors are located where, containing encapsulated and free nerve endings
in and around synovial joint capsules
Joint kinesthetic receptors are stretch receptors that detect what 5 things?
- direction of movement of the joint
- acceleration/deceleration of joint
- pressure in joint
- excessive joint strain
- postural changes, along with input from skin receptors, Ruffini and Merkel’s discs
What are the 3 types of joint kinesthetic receptors?
- Pacinian corpuscles
- Ruffini corpuscules
- Free nerve endings
What have the following characteristics?
• located in connective tissue and synovial joint capsules
• respond to rapid pressure changes
• respond to stretch
• respond to acceleration and deceleration of joint movement
Pacinian corpuscles
What have the following characteristics?
• located in synovial capsules and ligaments
• respond to deep rapid and sustained pressure
• especially responsive to lateral stretch
• detects changes in joint angles
• ligament receptors adjusts muscle tone
Ruffini corpuscles
What has the following characteristics?
• located in most body tissues… joint capsules, ligaments, tendons, fat pads, menisci and periosteum
• respond to rapid and sustained pressure
Free nerve endings
What is located in the following?
• Capsule (fibrous capsule and part of synovial membrane)
• Capsular and cruciate ligaments
• Knee menisci
Small Ruffini
What is located in the following? • Fibrous capsule • Adipose tissue • Ligaments • Knee menisci • Annulus fibrosis cervical discs
Pacini
What is located in the following?
• Ligaments, capsular, intracapsular, extracapsular
• Capsular, between fibrous and synovial layers
• Menisci
• Cervical discs
Large Ruffini: (Golgi tendon organ)
What is located in the following? • Capsule (fibrous and intima) • Fat pads • Ligaments • Menisci
Free nerve endings
Proprioceptors affect tone via what 3 reflexes?
- Quick Stretch Reflex
- Reciprocal Inhibition
- Autogenic Inhibition
What is the reflex that has a reflex response from muscle spindles and produces contraction of the muscle being stretched?
Quick Stretch Reflex
What are the 3 functions of the Quick Stretch Reflex?
- monitors status of muscle activity
- guards against potential injury
- respond to rapid and sustained pressure
What is the sequence of the quick stretch reflex?
- stretching (via muscle contraction) stimulates the muscle spindle (intrafusal)
- within the spinal cord the sensory neuron activates the alpha motor neuron (monosynaptic)
The alpha motor neuron stimulates the muscle (extrafusal) to do what?
contract and to resist the stretch
Quick Stretch Reflex follows which 4 actions?
- Muscle is stretched
- Muscle spindle afferent to spinal cord
- Monosynaptic
- Alpha motor neuron stimulates agonist
What has the following characteristics?…
• reflex response from muscle spindles
• inhibits the muscle opposite the contracted muscle
Reciprocal Inhibition (reciprocal innervation)
What is a function of Reciprocal Inhibition?
it induces inhibition (relaxation) of an antagonist so that the agonist can contract and cause joint movement
What is the sequence of reciprocal inhibition?
- Muscle is stretched
- Muscle spindle afferent to spinal cord
- Inhibitory interneuron relaxes antagonist
What characteristics involve…
• reflex response from Golgi tendon organs
• an inhibitory response to a muscle that develops too much tension… either via shortening or lengthening
Autogenic Inhibition
What are the functions of Autogenic Inhibition …
- guards against potential injury to a muscles’ fibers
- muscle relaxation reduces tension applied to the muscle and tendons and protects them from damage
What is the sequence of Autogenic Inhibition?
- GTO stretched
- Ib afferent
- Inhibitory interneuron relaxes agonist
- Excitatory interneuron contracts antagonist
Several clinical techniques to relax or facilitate muscles utilize which 3 techniques?
- Quick Stretch
- Autogenic Inhibition
- Reciprocal Inhibition reflexes
The following techniques taught in the Naturopathic Manipulative Therapeutics (NMT) class sequence are based on which reflexes…
- Post-isometric Relaxation
- Muscle Energy technique
- Strain-Counterstrain
Which reflexes have the following characteristics?
• part of a routine orthopedic and neurological examination
• test the integrity of the components of the simple reflex arc and contributes to determining if there is a lower motor neuron lesion or an upper motor neuron lesion
Deep Tendon Reflexes (DTRs)
What describes the motion that occurs between the articular surfaces of joints?
Arthrokinematics
Most joint surfaces are curved with one surface being relatively convex and the other relatively concave
________… curved or rounded outward
________… hollowed or rounded inward
Convex; Concave
The convex-concave relationship has which 4 characteristics?
- increases contact surface area of the joint
- contributes to increased joint stability
- increases dissipation of contact forces
- helps guide motion between the bones
What are the 5 movements that occur between joint surfaces?
- Roll
- Slide
- Spin
- Distraction and Longitudinal Traction
- Compression
Which joint movement resembles a tire rotating (rolling) across the pavement; multiple points along one rotating articular surface contact multiple points on another articular surface?
Roll
Which joint movement resembles a stationary tire sliding on a stretch of icy pavement; a single point on one articular surface contacts multiple points on another articular surface?
Slide (glide)
Which joint movement has joint surfaces being pulled apart?
Distraction and Longitudinal Traction
Which joint movement resembles a spinning top on one spot on the floor; a single point on one articular surface rotates on a single point on another articular surface … rotates around a stationary longitudinal mechanical axis?
Spin
Which joint movement is a decrease in the space between two joint surfaces?
Compression
Roll occurs under which 3 circumstances?
- in the direction of movement
- occurs on incongruent (unequal) surfaces
- usually occurs in combination with sliding or spinning
When a mobilization technique is applied to produce a slide in the joint it is referred to as a _______.
glide
What is an example of sliding?
carpal bones sliding along their facet surfaces
What term describes the relationship of rolling and sliding motion within a joint when one joint surface is convex and the other surface is concave?
Convex-on-Concave and Concave-on-Convex Rule
Which motion indicated when the concave side of a joint is stabilized (anchored) and the convex joint surface slides (glides) in the opposite direction as it rolls?
Convex-on-concave motion
Which motion is indicated when the convex side of a joint is stabilized (anchored) and the concave joint surface slides (glides) in the same direction as it rolls?
Concave-on-convex motion
What is the clinical significance of the Convex-Concave Rule?
These rules serve as a basis for joint mobilization techniques
According to the Convex-Concave Rule, mobilizing a joint to restore movement requires that the clinician do what to the joint which facilitates (restore) the natural arthrokinematic motions at the joint.
apply external forces
What is the term for movement of bones done voluntarily (osteokinematics)?
Physiological Movements
What is the name given to the arthrokinematic movements within the joint and surrounding tissues that are necessary for normal joint range of motion, but cannot be performed voluntarily, they are necessary for full range of physiological motion to occur and ligament and joint capsule limitations (tightness) cause movement restrictions or aberrant joint motion.
Accessory Movements
What is the term for motions that occur within the joint but only as a response to an outside force, it is determined by joint capsule’s laxity and can be demonstrated passively, but not performed actively.
Joint play
What is the term for a way to interpret and measure joint play movements?
End-feel
True/False: According to the Convex-Concave Rule, treatment often combines facilitation of physiological mobilization (osteokinematic) and accessory movements (arthrokinematic) to restore a particular joint movement.
True
Follow the Convex-Concave Rule to restore what, which will increase pain-free joint range of motion?
normal joint play
