Exam 1 Flashcards
(328 cards)
1
Q
primary goal of PT is to achieve optimal level of symptom free movement including basic to complex activities
A
2
Q
intervention
supervision
data collection
problem solving
clincial decision making
A
patient supervision
3
Q
ICF model does not focus on _____ but health states
A
disability
4
Q
arise directly from health condition
pain/ limited ROM from tendonitis
A
primary
5
Q
resulting from preexisting impairment
shoulder patho from posture
A
secondary
6
Q
combo of primary and secondary impairment
A
composite
7
Q
activity limitations are result of
A
impairments
8
Q
reduced ability of person to perform actions or activities
A
activity limitation
9
Q
decreased independence
A
ADL
10
Q
participation restricts is unable to perform activities or tasks in a
A
community
11
Q
EXAMINATION
EVAULATION
DIAGNOSIS
PROGNOSIS POC
INTERVENTION
OUTCOME
reexamination
referral
A
12
Q
examination identify patient problems
patient _____, review ____, tests& ____
A
history
systems
measures
13
Q
patient history can be
A
family interview
chart review
patient interview
14
Q
areas of deficit confirm the need for a further detailed examination
A
screening process
15
Q
tests and measures can be
A
MMT ROM special tests
16
Q
evaluation data analyzed and organized
A
level of impatient
functional loss / disability
social support living environment
d/c destination
comorbid condition
medical stability
17
Q
identification of disease disorder or condition by evaluating signs and symptoms
A
diagnosis
18
Q
4 main categories to diagnosis
A
musculoskeletal
neuromuscular
cardiovascular / pulmonary
integumentary
19
Q
anticipated patient management requires both interpretation and integration of data
A
POC
20
Q
POC prognosis components
A
anticipated goals and outcomes
specific intervention
duration frequency
criteria for d/c
21
Q
prognosis goals
A
objective
measurable
functional
time limited
22
Q
set LTG ____ then STG follows
A
first
23
Q
specific interventions to achieve goals and outcomes
A
interventions
24
Q
procedural interventions are
A
restorative compensatory preventative
25
outcomes are functional, measurable , patient satification
26
discharge planning keep in mind
HEP, follow up, community, reinitation to PT
27
ability to carry out skill
performance
28
ability to carry out skill and retaining skill
learning
29
figuring out what to do
high instruction with high error
PTA frequent feedback
cognitive
30
fine tuning task
lower instruction lower error
PTA- infrequent feedback, patient can adjust
associative
31
talks are automatic may do take at same time
PTA- feedback only necessary if problems
autonomous
32
flexion extension in _____ plane
sagittal
33
abduction adduction in _____ plane
frontal
34
internal external rotation in ____ plane
_____ axis
transverse
vertical
35
use PROM when
acute inflamed tissue
active motion would hurt healing
paralyzed
best rest
36
PROM goals
maintain joint mobility
prevent contractures
assist circulation
decrease pain
help proprioception
37
AROM-AAROM
able to actively contract
weak muscles
aerobic conditioning
38
AROM goals
maintain elasticity
provide sensory feedback
increase circulation
prevent DVT
develop coordination and motor skills
39
3+-5 needs
resistance
40
self assisted ROM can be _____ or ___
manual or mechanical (wand, pulley)
41
CPM benefits
Prevents adhesions,contractures joint stiffness
42
increased size of individual muscle fibers from increased myofibtillar
hypertrophy
43
decreased in size of individual muscle fibers
atrophy
44
3 factors of muscle performance
strength power endurance
45
ability of a contractile tissue to produce tension and resultant force based on demands placed on muscle
strength
46
ability of neuromuscular system to produce reduce and control forces during functional activities
functional strength
47
the work produced by a muscle per unit of time
power
48
force x distance / time
49
rate of performing work
power
50
greater intensity of exercise the shorter time period taken to generate force, great muscle power
51
single burst high intensity activity
lifting suitcase
52
repeated bursts of lesser activity
climbing stairs
53
increasing the work a muscle must perform or decreasing time allowed to complete activity
power
54
ability to perform low intensity reprieve or sustained activities over long period
endurance
55
contact repeatedly against load
generate tension
resist fatigue
endurance
56
developed by having muscle contact against a light load for many religions or sustain contraction
endurance
57
low resistance , high reps, extended time
endurance
58
increased oxidative and metabolic
endurance
59
improves function
fewer effects of joints
more comfy
endurance
60
load that exceeds the metabolic capacity of muscle must be used if muscle performance enhanced
muscles must be challenged
if demand remains constant muscle will be maintain not improved
overload principle
61
progressive loading
application
62
intensity _____
volume _____
strength
endurance
63
SAID
specific adaptation to imposed demands
64
on which exercise programs should be built
specificity
65
body systems adapt overtime to stress placed on them
extension of wolffs law
66
possible exercise should minic function
specificity training
67
adaptive changes in the body system such as increase strength or endurance
reversibility principle
68
short fibers design in ___ force producing
high
69
long parallel with high rate of _______but less ____
shortening
force
70
low force smaller fibers slow twitch
resistant to fatigue, aerobic, red, high capillary
high type I
71
high force large fibers fast twitch high fatigue anaerobic white
high type II
72
force output from greatest to least
eccentric - isometric - concentric
73
concentric contraction is
____ speed ____ tension
high
low
74
eccentric contraction
_____ speed ____ tension
high
high
75
tonic red oxidative
type I
76
phasic white glycolytic
type II
77
aerobic
type I
78
anaerobic
type II
79
biceps brachii gastro are
type II
80
postural muscles soleus are
type I
81
factors influence fatigue
health status
diet
lifestyle
82
90-95% of force producing capacity return in ___minutes
3-4
83
DOMS
delayed onset muscle soreness
84
greater tension produced by _______contraction leads to DOMS
eccentric
85
best treatment for DOMS
active recovery light exercise
86
boys have ___ muscle mass
girls have ____ muscle mass
5x
3.5
87
peak strength for women is age __
men is age ___
20
30
88
strength declines ___ year
1%
89
rapid gain in tension to neural responses not adaptive change in muscle
resistance exercise
90
increased size of individual muscle fibers from increased myofibllar volume
hypertrophy
91
increased number of muscle fibers
hyperplasia
92
increased bone density
decreased osteoporosis
decreased osteoarthritis
bone
93
increased tensile strength
connective tissue
94
direction of muscle fibers and line of pull of muscles to be strengthen
alignment
95
holding down a body segment of holding body steady
stabilization
96
amount of resistance weight imposed on contracting muscle during each rep
intensity
97
improve muscle performance, muscle must be loaded to extent greater than load usually by muscle
intensity
98
beginning of program
early stage of soft tissue
children older adults
improve muscle endurance v
slow velocity isokinetic
submaximal loads
99
goal is to increase strength and power
increase muscle size
last phase of rehab
conditioning with no known patho
maximal loads
100
subjective based of experience and judgement
manual
101
objective based on rep maximum
mechanical
102
greatest amount of weight a muscle can move through ROM a specific number of times
repetition maximum
103
delorme and oxford
10 RM
104
DAPRE
6 RM
105
bench press is ___ % BW
30
106
biceps curls is ____%
10
107
triceps curls is ___%
15
108
leg press is ___%
50
109
knee extension is ___%
20
110
knee flexion is ___%
15
111
total number or reps and sets of particular exercise during single session
volume
112
higher the intensity ____ the volume
lower the intensity ____ the volume
lower
higher
113
increase muscle strength is
____ sets of ____ reps
2-3 sets of 6-12 reps
114
increase muscle endurance
____ sets of _____ reps
40-50 reps
115
Sequence in which exercises are performed ___ impact fatigue
does
116
Multiple muscle groups
large muscle groups before small muscle groups
117
Multi joint muscle groups
multi joint before single joint
118
appropriate warmup ____ intensity before ____ intensity
higher
lower
119
number of exercise session per day or week
frequency
120
low intensity and volume programs can have _____ sessions per day
multiple
121
endurance exercises can be performed ____ times per week
5-6
122
maintance programs must be performed ___ times a week
two
123
total number of weeks or months a strengthening exercise program is carried out
duration
124
early changes from neural adaptations
2-3 weeks
125
muscle hypertrophy increased vascularazation occur
6-12 weeks
126
MODERATE INTENSITY
____ minute test between sets
____ hours between sessions
2-3
48
127
HIGH INTENSITY
____ minute rest period between sets
___ hours between sessions
4-5
128
patients with pathologies
children / elderly
low intensity exercise
129
rest __ min between sets by performing Un resisted exercise or repeating exercise on Uninvolved limb
3
130
_____ recovery is more efficient than ____ recovery
active
passive
131
form or type of exercise the manner in which the exercise is carried out
mode
132
manual vs mechanical
constant vs variable load
accommodating load
body weight
forms of resistance
133
Type of muscle contraction
isometric
isotonic
isokinetic
134
isotonic has _____ and ______ contractions
concentric and eccentric
135
CONCENTRIC
as velocity of muscle shortening ______ the force muscle can generate _____
increases
decreases
136
ECCENTRIC
velocity for muscle lengthening _____ force production ______ then levels off
increased
increased
137
slow to medium velocities of limb movement
patient controlled moving weight
controlled mobility
138
fast velocities
demand for desired activities
return to function phase
139
Functional activities are
isokinetic training
speed specific (SAID)
plyometrics
140
must have ___ control before can achieve ____ control
static
dynamic
141
dynamic (isotonic) can be
concentric eccentric
PNF
open kinematic closed kinematic chain
142
variable resistance can be
manual / theraband/ tubing
specialized equipment - effectiveness
143
accommodating resistance is
isokinetic dynamometer
144
static exercise in which muscle contracts and produces force without change in length of muscle
NO visible joint motion
isometric
145
no mechanical work is performed
isometric
146
force x distance
isometric
147
greatest amounts of tension and force can be produced by muscle
isometric
148
contracting muscle shortening, lever arms being moved in direction of muscle fiber contraction
Concentric
149
positive work
concentric
150
contracting muscle lengthening, lever arms being moved away direction of muscle fiber contraction
eccentric
151
negative work
eccentric
152
activate muscle spindle with quick stretch to facilitate contraction
PNF
153
manually resist movement pattern
PNF
154
distal segment free to move without causing motions at adjacent joints
open chain
155
muscle activation occurs in muscles that cross moving joint
open chain
156
movement at one joint causes motions at distal as well as proximal joints
closed chain
157
external load remains constant which can be
free weights
weight machines
pulleys
158
contracting muscle is only challenged
maximally at point where ROM is max torque of resistance matched the max torque of muscle
constant resistance
159
the resistance is altered throughout range of motion
variable resistance
160
manual resistance
cam or lever arm
hydraulic / pneumatic
VARIABLE resistance
161
elastic band or tubing resistance (theraband/ tubing)
stress on joints
greatest at end range of motion
prone developing overuse inflammation
162
max effort during each rep contracting muscle produce max force output with variable tension in all ROM
Accommodating resistance
163
muscle must match the pre set speed of machine before ____ is generated
resistance
164
3 fundamental strength
delorme
oxford
daPRE
165
musculoskeletal injury
allows systematic and gradual progression
allows for warm up
delorme
166
de lorme establish ___ repation maximum
10
167
takes advantage of muscle fatigue during exercise
oxford
168
oxford allows ___ Reletion maximum
10
169
progressive overload
adding resistance while muscle fatigued
delorme
170
reduced resistance as muscle fatigued
oxford
171
DAPRE
Daily adjustable progressive resistive exercise
172
optimum # of reps for individual strength
Dapre
173
DAPRE has ___ RM with ___ sets with variable reps
6
4
174
0-2 reduce weight ___ lbs
3-4 reduce weight ____ lbs
5-6 keep ___
7-10 increase weight ___ lbs
11+ increase weight ____ lbs
5-10
0-5
same
5-10
10-15
175
contraindications to resistance exercise
acute inflammation
pain
neuromuscular disease
severe cardiopulmonary disease
176
Anterior horn cell disease
GULLIAN barre
177
inflammatory muscle disease
poliomyositis
178
noncontractile soft tissue is
ligaments tendons joint capsule fascia muscle connective tissue skin
179
support structures of body
noncontractile tissue
180
composition of tissue
collagen
elastin
reticulum
ground substance
181
resist tensile deformation
strength and stiffness
Provide stability
collagen fibers
182
provides extensibility
small loads
would fail without deformation at higher loads
elastin fibers
183
elastin results in
FLEXIBILITY
184
collagen fibers provide
STABILITY
185
provide tissue with BULK
reticulin
186
organic gel containing water
reduces friction
transports nutrients and metabolism
maintains space to prevent cross link
resist compressive forces
Ground substance
187
behavior determined by
proportion of collagen and elastin
structural orientation
188
collagen absorbs most of the _____ force
tensile
189
collagen elongated quick under ___ loads as tension ____ fibers stiffen
light
increases
190
collagen is ___ stronger than elastin
5x
191
collagen resists_________ forces
deforming
192
elastin provides
extensibility
193
ground substance PG absorbs the ______ forces
compressive
194
collagen fibers random
weak resist tension
skin
195
major joint ligament more patrols
lager cross sect area
ligaments joint capsule fascia
196
collagen fibers are parallel
resist greatest tensile loads
tendons
197
strength of connective tissue is related to ability to ___ a load or stress
resist
198
force per unit area
internal reaction or resistance to external
stress
199
stretching force applied perpendicular to cross sec area, direction away from tissue
tension
200
compressive force applied perpendicular to cross sectional area of tissue in direction towards tissue
compression
201
force parallel to cross sectional area
shear
202
the amount of deformation that occurs when load (stress) is applied is
strain
203
mechanical deformation of connective tissue
strain
204
mechanical strength of connective tissue structures
stress strain curve
205
slack taken up as the wavy collagen fibers straighten
toe region
206
deformation (strain) is directly proportional to ability of collagen to resist force (stress)
tissue return to its original size and shape when load is released
elastic region
207
point beyond which the tissue will not return to original shape and size
elastic limit
208
range beyond elastic limit to point of tissue rupture
tissue strained within this range will have perm deformation
plastic range
209
weakening of tissue
less force needed to continue deformation
failure rapidly
Necking
210
load at the time of tissue failure
breaking strength
211
loss of integrity of tissue
failure
212
load beyond elastic limit that produces permanent deformation within tissue
once point is reached there is permanent tissue deformation
single load or multiple submaximal loads
yield strength
213
greatest load the tissue sustain
ultimate strength
214
influences on stress strain curve
resilience
toughness
creep
structural stiffness
heat production
fatigue
215
ability to absorb energy within elastic range
resilience
216
ability to absorb energy within plastic range
too much energy is absorbed rupture will occur
toughness
217
stiffer tissue has higher slope in elastic range
less deformation with greater amount of stress
contractures and scar tissue
structural stiffness
218
energy is released as heat when stress is applied, tissue distends easier as it is heated
heat production
219
elongation of tissue resulting in perm deformation/ failure
creep
220
dependent upon amount of force and rate at which force applied
greater load more rapid rate of creep
221
Lesser loads for longer time will result in greater deformation
Increased temp increases creep
greater dispensablity
222
cyclic loading of tissue may cause failure if time is not allowed for tissue to repair
fatigue
223
greater applied load ____cycles needed to produce tissue dialtire
fewer
224
most functional activity occurs in ___ region
toe
225
tissue taken through ROM with gentle stretch puts tissue in
elastic region
226
complete recovery from normal deformation
elastic region
227
individual fibers do not ____ they rupture
stretch
228
rupturing of fibers in plastic range results in increased length
deformation is perm
229
max load and strength reached there is increased strain without an increase in ____
stress
230
if stress is maintained in ___ period the tissue rapidly fail
necking
231
creep allows rearrangement of fibers bonds and ___ redistribution
water
232
increased tissue temp will increase
creep
233
cyclic loading or repeated stress incaresed heat production and tissue ___
remodeling
234
tissue failure can occur from either a single event (acute strain) or from respective submaximal stress (overuse)
235
remodeling capabilities of connective tissue allow tissue to respond to report ive loads of time is allowed between ____ repair
tissue
236
age or injury more precaution because
collagen loses elasticity
decreased ground substance
blood supply reduces healing
237
collagen turnover
weak bonds between new unstressed fibers
weakening of tissue
238
greater cross linking between disorganized fibers and
decreased effectiveness of ground substance maintains space and lubrication
adhesion formation
239
returning to normal takes __ months of cyclic loading
5
240
increased compliance of tissue due to increase of elastic
effects of inactivity
241
decreased max tensile strength
rate of adaption to stress is slower
increased tendency for overuse syndrome
effects of age
242
effect on mechanical properties of collagen
deceased tensile strength
fibrofuyebdesth next to injection site delay up to 15 weeks
Effects of corticosteroids
243
connective tissue repair with modalities
electrical stimulation
superficial/ deep Heat
244
controlled stress with
ROM progression
grade I and II joint mobs
joint loading
functional activity
245
act of rubbing, kneading, stroking parts of body with hand or instrument
massage
246
pain killing chemicals released by massage more potent than morphine
endorphins
247
reflexive effects of massage
pain
circulation
metabolism
248
benefits of reflexive
series of responses occur as result of sensory stimulus of cutaneous receptors
249
effects on pain
gate control theory - stimulation of large afferent fibers blocks transmission of pain info carried to small fibers
250
stimulation of painful areas can facilitate release of endorphins and enkephalins
affects pain info in spinal tracts
release of endogenous opiates
251
blood trapped in extremity
venostasis
252
excess interstitial fluid
edema
253
vessels emptied during massage through mechanical action as well as increased sympathetic activity
Vasodilation
254
effects on circulation
histamine release
lymphatic flow increase
255
techniques that stretch muscle elongate fascia or mobilize soft tissue adhesive are all
mechanical techniques
256
massage toughens yet softens skin (removed dead cells) stretches sup tissues
loosens adhesions and scar tissue (fibrous)
assist venous and lymphatic flow
257
_______ effect helps patients feels as if someone is helping them
hands on
258
massage releases
serotonin/ dopamine
259
massage decreases
pain
neuromuscular excitability
lactic acid
edema
myofascial trigger points
scar tissue
adhesions
muscle spasm / cramps
260
massage increase
healing
circulation
joint mob
healing
blood flow
ROM
261
massage contraindications
conditions spread along skin
acute inflammation - RA
loss of skin or joint integerify -SI subluxation
262
____ most important tool in massage therapy
hands
263
pressure determined by type of amount of tissue present (comfort of pt)
rhythm steady and even
duration depends on patho, size, age, condition
when edema is present
no pain or create ecchymosis
264
direction of force should be in direction of muscle fibers and circulatory flow
begin and end with effleurage
elevate body part if necessary/ possible
use lubricant
265
position right so you don’t perform a strain
stroke should begin at or below joint and end above the joint
line with venous flow
266
use of massage to increase ROM
mechanical touch
267
support and general relaxation
expressive touch
268
use caution for analgesic creams
and remove excess with towel and alc
ask patient about allergies (unscented)
269
prone position
pillows under ____ and ____
stomach ankles
neck shoulders back butt posterior UE LE
270
supine position
pillows under ___ and ____
head and knees
face neck chest anterior UE and LE
271
supine positioning
pillows under ___ and ____
head knees
face neck chest anterior UE LE
272
ultize seating when ___ is too painful
prone
neck upper back shoulder
273
targeted treatment to reduce pain
hoffa massage technique
274
classical massage technique
Four basic strokes are ______
effleurage
petrissage
tapotement
vibration
275
any stroke that glides over skin without attempt to move deep muscle mass
effleurage
276
gliding horizontal stroke, most used
pressure drag speed direction rhythm
light to mod pressure
increase depth gradually
effleurage
277
technique that is a kneading manipulation
petrissage
278
knee or milk the muscle in vertical direction
compress lift
stimulates muscle spindle/ golgi tendon
softens fascia pliable
Skin rolling
rhythmic hand over hand
compress 45 to push tissue
petrissage
279
hands relaxed
penetrating effect that stimulates subcutaneous
stimulate flow of blood
stimulate peripheral nerve endings
tapotement
280
a percussion massage, hacking cupping slapping beating tapping and pinching
tapotement
281
a fine tremulous movement made by hand or fingers placed firmly against a part causing part to vibrate
vibration
282
vibration causes trembling movement from ____ through ____
forearm
elbow
283
technique performs with small circular motions that penetrate into depth of muscle tendon or ligament
not by moving finger on skin -
by moving tissues under skin
friction massage
284
loosen adherent fibrous tissue
inflammation decrease
absorption of local edema
reduce local spams
provide deep pressure over triggers
friction massage
285
in chronic inflammation the process gets ___ and is never completed
stuck
286
increases inflammation to point where process gets completed and healing can progress
friction massage
287
place tissue on slight stretch
thumb or index to exert deep pressure perpendicular to tissue
7-10 min every other day
apply ice to and following
friction massage
288
technique of using finger pressure over acupuncture or trigger points to decrease pain
acupressure / trigger point massage
289
systems of forces whose interplay is thought to regulate all bodily functions
no distinction between blood vessels/ nerves
acupuncture points
290
areas of increased electrochemical activity
trigger points
291
friction like circular motions
thumb index middle finger elbow
more pressure more effective
painful intial my
1-5 minutes per pint
acupuncture/ trigger point
292
group of techniques used for purpose of relieving soft tissue form and normal grip of tight fascia
myofasical release
293
normal sequence
1 light effleurage
2 deep effleurage
3 petrissage
4 tapotement (accupressure/trigger point/ friction)
5 petrissage
6 deep effleurage
7 deep effleurage
294
work from ___ body to ____ body
upper
lower
295
start with client ___
prone
296
assist with client turning over to ___
supine
297
continue with lower body to upper body ending with ___ head and ____
neck head face
298
locate target issue
integrity of tissues
confirm treatment spot
299
heavy to light is ____
light to heavy is
oxford
de lorme
300
allows for increased intensity
de lorme
301
DAPRE is _ reps and _ sets
6
4
302
strengthen and stiffness more collagen more stable
stronger than elastin
collagen fibers
303
extensibility w small loads will break quickly
elastin fibers
304
bulk- reticulin fiber
________reduces frictions provides nutrients gets rid of space cross link and compressive forces
ground substance
305
skin is random collagen fibers
ligaments/ capsule/ fascia more parallel
tendons- parallel/ most tensile
306
forces out on it
stress
307
pulling away from force
tension
308
pushing down towards tissue (joints)
compression
309
parallel force
shear
310
tissue will deform to a certain extent
strain
311
slack taken up as collagen straighten
toe region (daily life)
312
stress pulls apart gets to limit then return to original state (ROM)
elastic range
313
feeling stretch cannot go past
elastic limit/ plastic range
314
grade 3 is full tear
don’t want necking
necking- tissue will rupture and break
breaking strength/ tissue fails
failure - loss of integrity of tissue
why we go slow
315
ability to absorb within elastic range
resilience
316
ability to absorb energy in plastic range
toughness
317
elongation of tissue resulting in deformation of tissue due to stress
creep
318
go to elastic limit further would be Y increase extensibility;
warmup
treadmill , hot pack
319
more quickly in slow twitch fibers
atrophy (postural muscles) 3 days - week recovery
320
tension speed
go slow
staying away from muscle spindles (stretching)
muscle spindle fiber
321
needs to be activated
picks up tension of stretch
hold more relax more - ROM
Golgi tendon organ
322
agonist contraction
autogenic inhibition
323
contract agonist , antagonist relax
reciprocal inhibition
324
no muscle pathology present (short time)
myostatkc
325
CNS lesion, spascity/ rigidity
pseudomyostatic
326
intrarticular pathology adhesion
osteophyte formation joint effusion
arthrogenic
327
cannot be revered by non surgical intervention
fibrotic
328
stretch for 30 sec
hold 1 min - gastro
5-10 sec hold manual
