Exam 2 Flashcards
1
Q
Differentiate between OT and PT’s role in functional ambulation
A
PT focuses on restoring or improving movement, strength, and range of motion
OT focuses on way to improve motor skills needed to do everyday occupations
2
Q
Identify factors affecting functional ambulation
A
- Strength
- Cognition
- Range of motion
- Attention
- Endurance
- Vision
- Balance
- Motivation
3
Q
Sagittal Plane/ Frontal Axis
A
a. Hip flexion/ extension
b. Knee flexion/ extension
c. Dorsiflexion/ Plantar Flexion
d. Toe flexion/ extension
4
Q
Frontal Plane/ sagittal Axis
A
a. Hip abduction/ adduction
b. Ankle inversion/ eversion
5
Q
Transverse Plane/ vertical axis
A
a. Lateral rotation
b. Medial rotation
c. Toe abduction/ adduction
6
Q
hip flexion
A
0 -120
7
Q
knee ROM
A
flexion: 0-135
8
Q
hip extension
A
0-30
9
Q
hip abduction
A
0-40
10
Q
hip adduction
A
0-35
11
Q
hip internal/ external rotation
A
0-45
12
Q
plantar flexion
A
0-50
13
Q
dorsiflexion
A
0-15
14
Q
inversion
A
0-35
15
Q
eversion
A
0-20
16
Q
occupations for hip extension
A
- Laying on stomach
- Full standing
- Walking
- Reaching overhead
17
Q
occupations for hip flexion
A
- Putting on socks
- Sitting and standing from chair
- Climbing stairs
18
Q
joint functions
A
- Connection between bones
- Bind skeletal system together
- Lever system make movement possible
- Make bone growth possible
- Proprioception
19
Q
types of joints
A
- Fibrous joints
- Stability: dense connective tissue
- Sutures of skull, interosseous membranes - Cartilaginous joints
- Slightly moveable
- Pubic symphysis, sternocostal joint - Synovial Joints
- Mobile joints
- Allow purposeful movement
20
Q
anatomy of synovial joint
A
- Bones
- Cartilage
- Joint capsule
- Synovial membrane
- Synovial fluid:
- Muscle:
- Nerves: sensory and motor
- Blood vessels
- Ligaments and tendons
1. Ligaments: connect bone to bone
2. Tendons: connect muscle to bone
3. Limited ability to heal
21
Q
ball and socket joint
A
- Spherical surface fits into concave depression
- Most mobile
- Movement in all 3 axes
- Ex: glenohumeral joint
22
Q
ellipsoid joint
A
- Oval shaped convex end articulates with concave basin of another
- Motion around 2 axes
- Ex: radiocarpal joint
23
Q
saddle joint
A
- Convex and concave articulating surfaces
- Motion in 2 axes
- Ex: CMC joint of thumb
24
Q
hinge joint
A
- Motion in single axis
- Only flexion and extension
- Ex: elbow joint
25
pivot joint
- Motion in 1 axis
- Bones rotating around another
- Ex: atlantoaxial joint
26
gliding joint
- Two flat surfaces of adjacent bones
- Least movement
- Ex: carpal bones of wrist
27
arthro vs osteokinematics
* Osteokinematics: what you see
* Arthrokinematics: what you do not see
28
normal joint end feel
1. Soft: soft tissue approximates
2. Firm: feel tension/ stretch of muscle
3. Hard: bone one bone
29
abnormal joint end feel
- Soft: caused by edema, synovitis
- Firm: caused by increased muscle tone, tight tissue
- Hard: caused by osteoarthritis, hypertrophic ossification
- Empty: No end feel beause pain comes first
30
open pack position
- Position with least amount of joint congruency
- Capsule and ligaments are lax
- Point of greatest mobility
- EX: knee in full partial flexion
31
closed pack position
- Position with maximum joint congruency
- Capsule and ligaments taught
- Point of greatest stability
- EX: knee in full flexion
32
stance phase of gait
1. initial contact: heel strike
2. loading response: flat foot
3. midstance
4. terminal stance: heel off
33
preswing phase of gait
toe off
34
swing phase of gait
1. initial swing: toe off
2. mid-swing
3. terminal swing: heel strike
35
trendelenburg gait
- weak hip abductors
- compensated by contralateral side bending
36
foot drop gait
- weak dorsiflexion
- compensated with hip or knee flexion
37
antalgic gait
- abnormally short stance phase on one leg
38
hemiplegic gait
- extensor spasticity from a stroke
- reduced knee flexion during swing phase
- compensated by contralateral side bend
39
ataxic gait
unsteady, staggering, uncoordinated, wider base of support
40
parkisonial gait
- forward flexed posture
- decreased trunk rotation and arm swing
- short shuffled steps, losing balance
41
use of walking aids for functional ambulation
increase the base of support
42
when are crutches used?
non weight bearing precautions
43
posterior leaf spring AFO
provide assist with dorsiflexion
least supportive
44
semi-solid AFO
provide dorsiflexion assist, some ankle stability, some control at knee
45
solid AFO
limits all foot and ankle motion
provides dorsiflexion assist and prevent knee hyperextension
46
KAFO
little to no voluntary control at the knee and foot with some voluntary control of the hip and trunk
47
HKAFO
complete or partial loss of voluntary control of trunk and lower extremities
48
RGO
assists with advancing LE in patients with weak muscles
49
ROM contraindications
rom should not be completed to avoid injury
joint dislocation or unhealed fracture
immediately after surgery any soft tissue surrounding joints
50
ROM precautions
- joint hypermobility
- recently healed fractures
- active inflammation at joint
- using pain meds or muscle relaxants
51
types of ROM evaluations
1. screening
2. occupation based
3. formal
52
OTPF intervention types
1. interventions to support occupations
2. occupations and activities
3. education and training
4. advocacy
5. group
6. virtual
53
why does a client not have full ROM
1. muscle weakness
2. scar tissue
3. arthritis
4. soft tissue contracture
54
PROM
1. limb relaxed
2. therapist moves body part completely
55
why to do PROM
- maintain range of motion
- prevent adhesions or contractures
- maintain joint mobility
56
why do stretching
increase range of motion
57
why do Joint mobilization
- increase joint mobility and maintain joint play
- joint capsule tightness
58
A/AROM
client actively begins movement, assistance from external force to complete motion
59
why do A/AROM
- increase AROM
- build strength
60
AROM
- client moves independently
- therapist may may change gravity resistance
61
why do AROM
- maintain full range of motion
- have full ROM but needs to strengthen
62
What to do to maintain PROM
PROM
AROM
63
what to do to increase PROM
stretching
joint mobilization
splinting
64
what to do to increase AROM
AROM
resistance training
65
skeletal muscle characteristics
excitability: respond to stimulus
contractility: contract, generate force
extensibility: stretch
elasticity: return to resting length
66
skeletal muscle fiber types
slow twitch
fast twitch
67
slow twitch fibers
- low force
- long duration
- resistance to fatigue
- rely on oxygen
- postural muscles
68
fast twitch fibers
- higher velocity
- more force and mobility
- fatigue quickly
- superficial muscles
69
strength of muscle contraction depends on
1. number of fibers in motor unit
2. number of motor units recruited
70
parallel muscle shape
greater ROM, less strength
- biceps
- triceps
- rhomboids
71
pennate muscle shape
greater strength, less ROM
- deltoid
- lumbricals
72
passive insufficiency
- multi-joint muscle can't fully lengthen to allow full ROM at all joints it spans
- agonist muscle contraction is inhibited because antagonist muscle is maximally lengthened
73
passive insufficiency example
the hip extensors are maximally stretched when the knee is extended, limiting further hip flexion
74
tenodesis
closing of the fingers through tendon action rather than muscle contraction
75
C6 SCI
- weak innervation of wrist extensors but no innervation wrist and finger flexors
- use passive wrist flexion to extend fingers to grasp
76
active insufficiency
agonist muscle action is inhibited due to its excessive shortness
- muscles reduced ability to produce force at the end range
- tendons are maximally short limiting ability to contract
77
active vs passive insufficiency
Passive: decrease ability to produce full ROM
active: decreased ability to produced full strength
78
MMT purpose
1. determine clients strength
2. determine neurological involvement
3. inform treatment plan
4. assess progress
79
indications for therapeutic exercise
- favorable for diabetes, osteoporosis, cancer
- increases in bone mineral density, bowel transit,glucose uptake in muscle, improve back pain
80
precautions for therapeutic exercise
- acute illness or injury
- heart disease, heart conditions
81
muscle strength treatment
- increase strength with higher loads and few repetitions
- add resistance to get muscle hypertrophy
82
muscle endurance
use low load and increase number of repetitions
83
coordination
increased by daily high repetition, contextually relevant tasks,, low resistance
84
isometric exercise
muscle length is constant while active tension is produced against immoveable resistance
Advantages: easy to perform, tolerated better by inflammation
Disadvantages: don't easily transfer to function, may increase bp
85
isotonic exercise
progressive resistance exercise
- dumbells, resistance bands
- functional and occupation based
86
Strengthening for muscle grade 0/5, 1/5
1. passive ROM
2. stretch is PROM is limited
3. work in across gravity planes
87
strengthening for muscle grade 2/5
1. AROM across gravity
2. work against light resistance
3. A/AROM against gravity
88
strengthening for muscle grade 3/5
1. build endurance in across gravity
2. build endurance in against gravity
3. light resistance
89
strengthening for 4/5
1. gradually increase resistance to movement
2. various types of muscle contractions
90
primary motions of scapula
1. elevation and depression
2. protraction and retraction
3. upward and downward rotation
91
sternoclavicular joint
- triaxial, saddle joint
92
acromioclavicular joint
biaxial, gliding joint
93
glenohumeral joint
ball and socket joint
- triaxial
94
subacromial space contents
1. rotator cuff tendons
2. bursa
3. LH biceps tendon
95
coracoacromial ligament
protects structures in the subacromial space
prevents superior translation of the humerus
96
primary motions of glenohumeral joint
1. flexion and extension
2. abduction and adduction
3. lateral and medial rotation
4. horizontal abduction and adduction
97
requirements for smooth overhead motion of the arm
1. clavicle rotation and elevation
2. scapula upward rotation
3. humerus abduction
98
scapula elevation
1. trapezius
2. rhomboid major/ minor
3. levator scapulae
99
depression of scapula
1. trapezius
2. serratus anterior
3. pectoralis minor
100
scapula upward rotation
1. trapezius
2. serratus anterior
101
scapula downward rotation
1. rhomboid major/ minor
2. levator scapulae
3. pectoralis minor
102
scapula protraction
1. serratus anterior
2. pectoralis minor
103
scapula retraction
1. trapezius
2. rhomboid major/ minor
104
shoulder flexion
ROM: 0-170
end feel: firm
105
shoulder flexion agonists
1. deltoid
2. pectoralis major
3. biceps brachii
4. coracobrachialis
106
shoulder extension
ROM: 0-60
end feel: firm
107
shoulder extension agonists
1. deltoid
2. latissimus dorsi
3. teres major
4. pectoralis major
5. triceps
108
shoulder abduction
ROM: 0-170
end feel: firm
109
shoulder abduction agonists
1. deltoid
2. supraspinatus
110
shoulder adduction agonists
1. latissimus dorsi
2. teres major
3. infraspinatus
4. pectoralis major
5. triceps
6. coracobrachialis
111
shoulder horizontal abduction
ROM: 0-45
end feel: firm
112
shoulder horizontal abduction agonists
deltoid
113
shoulder horizontal adduction
ROM: 0-135
end feel: firm
agonists: deltoid
114
shoulder external rotation
ROM: 0-90
end feel: firm
115
shoulder external rotation agonists
1. deltoid
2. infraspinatus
3. teres minor
116
shoulder internal rotation
ROM: 0-70
end feel: firm
117
shoulder internal rotation agonists
1. deltoid
2. subscapularis
3. latissimus dorsi
4. teres major
5. pectoralis major
118
why document?
1. reimbursement
2. legal document
3. communication
4. justification
