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AT 510 > Exam 2 > Flashcards

Exam 2 Flashcards

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1
Q

What is the definition of massage? (Oxford)

A

The rubbing or kneading of muscles or joints with the hands

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2
Q

De Domenico - “Beard’s Massage”

A
  • certain manipulations of the soft tissue of the body
  • these manipulations are most effectively performed with the hands
  • producing effects on the nervous system, the muscular system, the respiratory system, and the local and general circulation of the blood and lymph.
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3
Q

PTs/ATs use this kind of massage

A

Therapeutic massage

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4
Q

Massage as a modality is used to…

A

bring about physical, physiological, and sometimes psychological changes

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5
Q

Therapeutic Massage

A
  • Promotes stress relief and relaxation
  • mobilize various structures
  • relieve pain and swelling
  • prevent deformity
  • promote functional independence
    all in a person who has a specific health problem
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6
Q

Recreational Massage

A
  • relieves stress
  • promotes relaxation
  • general wellness
    All in a person who has no definable health problems
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7
Q

Massage Techniques

A
  • Heller work/Rolfing
  • Manual lymphatic drainage
  • Sports Massage
  • Thai massage
  • Myofascial Realease
  • Rosen Method (developed by DPT)
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8
Q

General Effects of Massage: Cardiovascular System

A

Circulation
- dilation of superficial vessels via local reflexes
- increase in SV via promotion of venous return
- decrease incidence of DVT
Edema
- increases lymph flow via mechanical pressure
**BP goes up b/c of you (goes down because they relax)
** This has psych, phys, and mechanical effects

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9
Q

General Effects of Massage: Connective Tissue

A

Decreases pain and improves tissue mobility
This is ALL mechanical
Cyriax

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10
Q

General Effects of Massage: Muscle Tissue & Nervous System

A

Muscle Tissue - decreases spasm & muscle hypertension

Nervous Systems - decreases pain (you can make them feel better by making them feel worse)

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11
Q

Indications for Massage

A 
Pain
Edema
Muscle Spasm
Trigger Points
Insufficiencies of Circulation
Contracted Tissue
Specific of General Tension
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12
Q

Contraindications for Massage

A

Can be Absolute or Relative

  • severe distress
  • systemic edema
  • acute conditions (0-48 hrs minimum)
  • over recent surgery
  • increased circulation is not desired
  • contagious skin conditions
  • over foreign bodies/sharp bony prominences
  • over areas of active bone growth
  • over areas of decreased sensation
  • tuberculosis diagnosis
  • over the pregnant abdomen
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13
Q

Therapeutic Relationship

A
  • implicit agreement regarding the roles of the Pt. and DPT.
  • informed consent
  • maintain boundaries
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14
Q

Role of Touch

A
  • interaction is both physical an psychological
  • helps you to identify the pt. state
  • touch can communicate your state of being
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15
Q

How are your hands?

A
  • wash them
  • short fingernails
  • rings
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16
Q

Positioning of Patient

A
  • support given to natural joint curvatures
  • limbs elevated for circulation
  • Pt. should not be supporting any part of themselves
  • Pt. should be comfortable
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17
Q

Draping

A
  • expose the area you will be treating

- parts not treated should be covered by towel or a sheet

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18
Q

Message Media

A

Purpose: to avoid uncomfortable friction between hands and skin

  • best if unscented/hypoallergenic
  • avoid lotions: absorb too quickly
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19
Q

Positioning the Theraptist

A

If the table disappeared would you fall over?

Face patient to monitor

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20
Q

Basic Massage Strokes

A
  • Effleurage
  • Petrissage & compression
  • Friction
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21
Q

Effleurage

A

rhythmic, consistent, stroking

  • superficial: reflex effect, calming
  • deep: reflex and mechanical effect
  • warming of superficial tissues
  • information gathering
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22
Q

Petrissage & Compression

A

intermittent kneading

  • may be unilateral, bilateral or digital
  • increass circulation
  • softens and lengthens tissue
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23
Q

Friction

A

sustained pressure with movement

  • may be linear, cross fiber, circular, scar
  • cyriax cross fiber is a particular technique
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24
Q

Other massage strokes

A
  • jostling
  • percussion
  • direct pressure (sustained w/no movement)
  • myofascial release
  • trigger point techniques
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25
Principals Regarding Massage Strokes
Direction Duration Pressure Rate & Rhythm
26
Direction
linear, cross fiber, distal proximal | *don't go proximal to distal
27
Duration
take adequate time to achieve goal
28
Pressure
varies based on intent, body region, pathology, and patient tolerance
29
Rate & Rhythm
should be purposeful and consistent
30
Regarding Strokes
- work broad and light -> specific & deep - mold hands to pt. body - deep pressure: distal -> proximal - address entire length of muscle of interest - minimize interruptions
31
Lymphatic System Functions
1. Remove excess fluids from tissues 2. Absorption of fatty acids and subsequent transport of fat to the circulatory system 2. Production of immune cells
32
Lymphedema
an accumulation of high-protein fluid that can collect in any body part, but most typically in arms or legs. It usually occurs when they lymph vessels or lymph nodes are blocked or removed
33
Primary Lymphedema
rare and congenital caused by poor development of lymph vessels. ex: milroys disease
34
Secondary Lymphedema
caused by damage to lymph vessels or nodes. | may result from surgery, radiation, neoplasm, irradiation, trauma (scar tissue can block flow)
35
Edema
swelling caused by an increase in fluid in the interstitial, intra-articular or intra-celluar space
36
Types edema
Local Systemic Lymphedema
37
Local edema
edema is confined to an area (ligament sprain)
38
Systemic edema
occurs throughout the body (congestive heart failure) | Contraindicated
39
Precautions for massage
``` Hematoma Non-union fractures Herniated Disks Debilitated patients Malignancies Conditions w/collagen weakening ```
40
Friction Massage Intended purpose
- to mobilize adherent tissue/reduce scar tissue - reduce/mobilize trigger points - increase local circulation - decrease pain
41
Types of Friction Massage
- cross-fiber friction - circular friction - linear/parallel friction - cryiax friction
42
Cross-fiber friction
deep friction applied perpendicular to the direction of the fibers
43
Parallel Friction
deep friction applied in the same direction as the fibers
44
Circular Friction
repeated circular motion, distal to proximal considered
45
Cyriax Friction
deep transverse friction for pain and inflammation relief in musculoskeletal conditions
46
Mechanical Effects of Cyriax
- mobilization of damaged tissue over a small area | - elongation of tissue fibers
47
Physiological Effects of Cyriax
localized hyperemia
48
Histological Effects of Cyriax
- prevents or slows scar formation | - stimulates collagen orientation along lines of stress
49
Neurological Effects of Cyriax
pain inhibition via stimulation of mechanoreceptors
50
Indications for Cyriax
- promote healing of connective and contractile tissue - to retain or regain mobility - pain modulation
51
Contraindications for Cyriax
- acute inflammation - hematoma - conditions that increase bleeding - hemophilia - pt. on anit-coagulants - pt. on steroids - debilitated/open skin
52
DTFM
deep transverse friction massage (cyriax)
53
Body Positioning for DTFM
- Muscles: supported in a position of relaxation or reduced muscle tone - Tendons: position of tension - Ligaments: taunt, as far as the ROM allows
54
Cyriax finger position
middle finger on top of pointer finger
55
Effects of Cyriax Friction
1. Traumatic Hyeremia 2. Movement of Structures, prevents or disrupts adhesions 3. Stimulates mechanoreceptors, causing analgesia
56
Cyriax Friction Key Points
1. friction is applied to an exact location 2. no movement between the fingers and skin 3. friction is applied in transverse direction 4. friction must have adequate amplitude to move completely over the structure 5. friction must be applied at a depth sufficient to reach the target structure
57
Side Lying Manuvers
1. Jostling 2. Hacking 3. Slapping 4. Cupping 5. Gorilla punch
58
Trigger Point Background
- pioneered by Janet Travell MD | - 1st to recognize and define myofascial pain syndrome and trigger points
59
Definition of Trigger Points
focus of hyper irritability in a tissue that when compressed is locally tender an if sufficiently hypersensitive gives rise to referred pain
60
Techniques to treat trigger points
- ice & stretch - spray & stretch - massage - digital compression - PNF - TPPR - muscle stripping
61
what does a biopsied trigger point look like?
- large, rounded - darkly stained muscle fibers - significant increase in diameter of muscle fibers
62
Characteristics of Trigger Points
- cosistent referred pain pattern upon compression - local twitch response elicited by palpation - possible restricted ROM - muscle weakness w/no atrophy - possible autonomic phenomena
63
Two Types of Trigger Points
1. Active Trigger Point | 2. Latent Trigger Point
64
Active Trigger Points
- always tender - produce referred pain - muscle may be weak - limited ROM - w/palpation there is a localized twitch
65
Latent Trigger Points
- painful only when palpated
66
Indications for Intermittent Compression
Edema
67
Contraindications for Intermittent Compression
1. Thrombophlebitis (could dislodge clot) 2. Cellulitis (Could spread the infection) (bloodbourne) 3. Severe congestive heart failure
68
Treatment time for Intermittent Compression
- 10 minutes to 4 hours | - 1 to 2 times per day
69
Duty cycle for Intermittent Compression
45 sec on/15 sec off to 3 mins on/1 min off
70
Pressure for Intermittent Compression
- should never exceed 90-120 mmHg (systolic pressure) - Arm: approx 50mmHg - Leg: approx 60-70 mmHg
71
Types of Swelling
Joint Swelling Interstitial tissue swelling Cell swelling
72
Joint Swelling
caused by presence of blood and joint fluid in joint as a result of tearing - appearance/feel of a water balloon
73
Intersitial tissue swelling
caused by increase of osmotic pressure in tissues - attracts water - appearance of silly putty - pitting edema
74
Cell swelling
cells near death and unable to control the cell membrane can attract water and swell
75
Pitting Edema causes
- congestive heart failure (heart is too stretched out) - venous insufficiency - kidney failure - malnutrition
76
Factors that can cause Edema
- HBP - low blood plasma (alcoholism) - Lymphatic blockage (post mastectomy) (swelling, no drainage) - increased capillary porosity (burns) - increased tissue oncotic pressure (cell destruction w/protein release)
77
Lymphedema
edema caused by obstruction of the lymph channels
78
Treatment of Edema
- elevation - muscular contraction - compression - elastic compression - massage - intermittent compression
79
Treatment Protocol for DTFM
1. initial treatment 5 to 6 minutes 2. first couple of minutes pt may feel mild to moderate tenderness 3. pain should subsides gradually increase the pressure 4. increased by 3 minutes each session, 12 to 15 minute max 5. wait 48 hours between treatment sessions

AT 510 (3 decks)

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