Exam 3 Flashcards

1
Q

what makes up a motor unit

A

nerve (motor neuron aka efferent)
muscle fibers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what are the filaments within the sarcomere

A

actin and myosin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

small contractile units

A

sarcomeres

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

sliding filament theory

A

-action potential causes myosin heads to flex and create cross bridges with actin
-myosin pulls actin toward sarcomere center
-H-band becomes smaller
-Z discs move toward center
-changes in sarcomere length

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

I-bands

A

contains actin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

A-band

A

contains myosin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

action potential sequence

A
  1. action potential is released to trigger nerve response at motor end plate
  2. release of Ach at motor end plate initiates muscles response
  3. Ca+2 ions released from SR
  4. Ca+2 ions bind to troponin to slide tropomyosin away from actin binding sites
  5. extended myosin heads attach to actin’s binding sites, creating cross-bridges
  6. myosin contact with actin causes hydrolysis of ATP to ADP and phosphate, producing energy
  7. ADP releases from myosin heads creating “power stroke” as myosin heads move back to uncocked position while attached to actin
  8. new ATP attaches to myosin, detaching myosin from actin
  9. Ca+2 releases from troponin and re-enters SR
  10. tropomyosin covers actin binding sites
  11. sarcomeres returns to proactivity conditions
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

4 whole muscle functions

A

produce movement
maintain posture
stabilize joints
generate body heat

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

characteristics of type 1 muscle fiber

A

slow
small
red
greatest resistance to fatigue
lots of mitochondria
high oxidative capacity
oxidative system
endurance/aerobic activity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

characteristics of type 2A muscle fibers

A

fast
larger
white
moderate to fatigue
high oxidative capacity
ATP-PC system
high-intensity activity less than 2min

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

characteristics of type 2B muscle fibers

A

fastest
largest
white
fatigue easily
minimal mitochondria
glycolytic system
max-intensity bursts, less than 30 sec

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

muscle strength

A

max force a muscle or muscle group can exert
determining factors: genetics, gender, exercise, neural recruitment, lifestyle, muscle fiber type

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

power

A

strength applied over a distance for a specific time (P = Fxd/T)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

components of power

A

strength
speed
coordination
movement efficiency
timing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

muscle endurance

A

ability to perform repeated contractions against less than max load

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

determining factors of muscle endurance

A

energy system used (type 1 recruited first then type 2 if enough stimulation)
quantity of force resisted

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

T/F endurance is inversely proportional to force intensity

A

true

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

strength is developed through

A

low reps with high resistance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

endurance is developed through

A

high reps with low resistance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

rest for strength

A

longer rests between sets and reps

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

rest for endurance

A

shorter rest periods

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

sources of muscle fatigue

A

neural system (out of Ach to use)
energy system (out of ATP)
sarcoplasmic reticulum (runs out of Ca+2)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

T/F according to the sliding filament theory, action potential causes actin heads to flex and create cross-bridges with myosin filaments

A

false

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

what fiber type uses oxidative energy system

A

type 1 muscle fibers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
T/F efferent input provides afferents response
false
26
force production determinants
joint angle muscle length muscle size fiber arrangement speed of contraction numbers and type of fibers
27
muscle fiber recruitment
-recruits small (type 1 or 2a) for low intensity and before large (type 2b)
28
monoarticular muscles
recruited before biarticular muscles during low-level activities -cross only 1 joint ex: vastus medialis -provides the force
29
biarticular muscles
control direction of movement during joint motion -cross over 2 joints ex: rectus femoris -provides control over movement
30
static/isometric definition
tension is produced in the muscle without change in muscles length
31
advantages of isometrics/statics
-early in rehab -low joint stress -can be used with weak muscles
32
disadvantages of isometrics/statics
-strength gains isolated to minimal joint angles (not going thru full ROM) -valsalva maneuver can occur more easily with other exercises
33
for optimal strength gains to occur the muscles effort must be at
66% to 100% of its max output
34
dynamic definition
implies that a change in muscles position occurs
35
isotonic
change in the muscles length occurs during activity -concentric: muscle shortens -eccentrics: muscle lengthens
36
isokinetic
velocity is controlled and maintained at a specific speed of movement, but amount of resistance provided to muscles varies (requires equipment)
37
open kinetic chain activities
-distal segments move freely and independently of proximal segments -produce high velocity movements -creates shear stress in joints -have less joint stability -occur in normal and sports activities
38
closed kinetic chain activities
-distal segment is weight bearing and moves with other segments -produce forceful movements -create less shear stress in joints -have more joint stability -occur in normal and sports activities
39
how to evaluate muscle strength
MMT cable tensiometers isokinetic machines free weight or weight machines (1RM) grip or pinch dynamometers
39
from least active to most active ROM
PROM AAROM (assisted) AROM RROM
39
following major surgery which of the following gradients of muscle activity would you use
PROM
40
when should strength exercises start
soon after inflammatory phase of healing and when tissue is in the proliferation phase after flexibility and mobility have been restored
41
T/F straight plane exercises are used to isolate and strengthen weak muscles
true ex: 4-way ankle
42
diagonal plane exercises
used after weak muscles is strong to perform activity correctly
43
progression of strengthening program
isometrics single plane isotonics multiple plane isotonics functional performance specific
44
SNAP principle
specific exercises no pain attainable goals progressive overload
45
SAID principle
Specific Adaptations to Imposed Demands -a muscles will adapt and perform according to the demands placed upon it
46
term used to identify a tendon that presents with pain, swelling, and impaired function
tendinopathy
47
mechanical stress of tendons
repeated stress applied to tendons cause fatigue resulting in tendon failure
48
vascular supply of tendons
tendons lack good blood supply making them more compromised perfusion, which results in tendon failure
49
neural basis of tendons
chronic tendon overuse leads to disproportionate substance P neurotransmitter facilitation, promoting mast cell production
50
intrinsic factors to tendinopathy
age gender pathomechanics genetic or acquired systemic diseases
51
extrinsic factors to tendinopathy
overtraining poor equipment or training surface excessive duration or distance excessive increases in speed
52
tendinopathy management
identify cause correct the cause identify level of tendinopathy use eccentric exercises early
53
T/F according to sliding filament theory, the H-band becomes larger during muscle fiber contraction
false
54
which type of muscle fiber is white, has moderate fiber size, and high oxidative capacity
type 2a
55
example of lower extremity OKC activity
straight leg raise
56
definition of pylometrics
uses quick movement of eccentric activity followed by burst of concentric activity to optimize power output (explosive movements)
57
mechanical components of pylometrics
contractile (sarcomeres) noncontractile (collage, elastic)
58
neurological components of pylometrics
muscle spindles and GTOs
59
contractile components
myofibrils -increase speed of cross bridge detachment -number of cross bridge formations increase -control the noncontractile components
60
noncontractile
muscles tendons connective tissues
61
series elastic components
tendons, sheaths, sarcolemma
62
parallel elastic components
muscles CT
63
concentric contraction
muscle force comes from contractile components and stretch is applied to series elastic components (stretch the muscle = stretch the tendon)
64
eccentric contraction
series and parallel components resist the muscle movement as muscle elongates -contractile components controls speed and quality of movement
65
eccentric movements produce a stretch or
myotatic reflex (aka monosynaptic reflex)
66
what inhibits muscle activity
GTOs -as muscle shortens the GTOs send signals to spinal cord to limit force production
67
3 phases of pylometrics exercises
1. eccentric or lengthening phase where the muscle is prestretched 2. amortization of transition phase amount of time it takes to change from eccentric to concentric 3. concentric or shortening phase to produce the powerful output
68
pre-pylometric consideration
certain levels of strength, flexibility, and proprioception
69
intensity of pylometrics
-magnitude of effort applied during activity (stress) -can change increased weight, height, distance, speed
70
volume of pylometrics
quantity of work (setsxreps) depends on intensity and goals
71
recovery of pylometrics
-amount of rest determines if exercise will be more effective at improving power or endurance -short = endurance -longer = power
72
how often perform pylometrics
rest of 48hrs in between sessions
73
plyometric considerations
-age: 16+ -body weight: increase stress on joint in heavy PTs -comp level: more appropriate level of fitness for plyos over recreational PTs -surface: shock absorbing -footwear: supportive and shock absorbing -proper technique -goals
74
precautions of plyomtrics
time: avoid long session DOMS due to nature of plyos
75
contraindications of plyometrics
-acute inflammation -postoperative conditions -instability
76
if you are focusing on endurance, which of the following activity to rest ratios should you use
1:2
77
which of the following best describes the proper landing technique for plyometric activities
land on midfoot
78
functional exercises
-before performance-specific -involve multiplanar activities, increased stressed and demands -common across different sports
79
performance-specific exercises
-mimic tasks found within the sport -move PT toward safe return to sport -include exercises and skill drills
80
assessment of the PTs ability to perform an exercise or skill drills safely and accurately before being allowed to advance to next level
performance evaluation
81
early to middle program goals
-attain full functional levels of flexibility, strength, endurance, and coordination -achieve full functional ability so normal speed, power, control, and agility are restored
82
late program goals
-restore PTs self confidence in their performance and confidence in injured part -RTP safely and efficiently
83
considerations for basic to final phase therapeutic exercise
-normal motion -multifaceted muscle activity -multiplanar motion and multiple muscle group performance -stabilization and acceleration changes -proprioceptive stimulation -agility and power development -performance-specific skill development -confidence development
84
what is the transition parameter for function or performance specific
proprioception
85
precautions to functional and performance specific
-explain the exercise to the PT -avoid pain and swelling -understand tissue integrity and healing process -know their confidence level -be aware of progression tolerance
86
step by step evaluation determines when the PT should advance to next stage in functional exercise program
final evaluation -determine if PT is ready to RTP
87
final functional eval
-occurs before PT is allowed to RTP -highly individualized -based on specific demands to be placed on PT upon RTP -should be as objective as possible
88
RTP participation steps
1. acute S&S of injury are resolved, no pain or edema present 2. PT has full ROM, normal strength, endurance, cardio endurance, proprioception, agility, coordination in relation to performance skills 3. PT performs all activities as they could prior to injury 4. PT has confidence in ability and ability of injured area without hesitation or doubt
89
performance specific progression would most likely occur in which phase of healing
maturation/remodeling
90
T/F performance specific exercises are multiplanar activities which are foundation for more specific skill activities
false
91
what determine progression of functional activities
proprioception
92
correct order of lower extremity functional progression
NWB -> stork standing -> dynamic -> running
93
massage characteristics
-collection of techniques -muscle spasm relief may enhance lymph drainage -mechanical energy may stretch CT -little impact on blood flow -may stimulate muscle repair
94
light massage
gate control theory explains analgesic benefits (rubbing area overrides nociceptor stimulation)
95
deep massage
activation of descending analgesic pathway explains relied (endogenous opiates)
96
deep friction massage
proposed to increase blood flow and disrupt adhesion
97
myofascial release
activity/injury changes length-tension relationship of fascia and muscles -gamma efferent neurons activity leads to gamma gain, trigger points, myofascial pain syndrome -gamma activity from input of pain
98
indirect myofascial release
place muscle/fascia in relaxed position
99
direct myofascial release
stretch fascia to decrease stress on afferent input
100
direct strain-counterstrain
apply force against restrictive barrier to improve motion
101
indirect strain-counterstrain
move body away from motion-restricting barried to a comfortable position -slowly move body segment -hold for 90-120s
102
long standing pain patterns and related to the spine
myofascial
103
short-duration pain pattern and during tissue repair and early maturation phase
strain-counterstrain
104
joint mobilization
restore joint motion, ease pain, improve willingness to move a joint -uses convex-concave rule -ex: restore posterior glide of talus post injury
105
when a convex surface moves on a concave surface, roll and glide are in
opposite direction
106
when concave surface moves on convex surface, roll and glide are in
same direction
107
muscle energy
PT actively contracts against counterforce in a specific position -addresses cause of pain, leads to pain relief and reduced muscle tension/guarding
108
effectiveness of joint mobilizations
early posterior mobilization of talus may speed recovery and prevent loss of motion after lateral ankle sprain
109
effectiveness of myofascial release
leads to improvement of 4 PTs with carpal tunnel syndrome
110
effectiveness of massage
treat LBP, carpal tunnel, and knee osteoarthritis -low cost, low risk
111
manual cervical traction
-PT is supine -clinician relaxes hands and gradually increases force to increase space between intervertebral bodies -neck position: neutral for upper spine, flexion for lower spine, side-bending to relieve spinal nerves -break pain-spasm cycle
112
mechanical cervical traction
continuous or intermittent setting 15-25lbs 20-30min -may relieve pain from intervertebral disc herniation or stenoiss
113
precautions for cervical traction
-use manual traction for those with history of cervical spinal injury -head positioning may compromise vertebral arteries (risk of stroke)
114
contraindications for cervical traction
-acute injury -suspected dens fracture -osteoporosis and RA
115
lumbar traction characteristics
-relieve pressure on spinal nerves -used for disc injury (lie prone with extension) -harness hugs above iliac crests and lower ribs -PT positioned to decrease pain
116
precautions for lumbar traction
-belt adjustment on very thin or obese PTs -inability to tolerate treatment -claustrophobia from tight belts
117
contraindications for lumbar tractions
-pregnancy -hiatal hernia -advanced osteoporosis -conditions that affect integrity of CT
118
intermittent compression characteristics
-reduce edema and swelling -best treatment of persistent swelling and wounds from venous insufficiency -game ready and normatec
119
considerations of intermittent compression
-setup time is time consuming -PT not actively engages -pain free active exercises may better assists lymph drainage
120
contraindications of intermittent compression
-healing fractures -gross joint instability -infection -thrombophlebitis -pulmonary edema -congestive heart failure
121
effectiveness of traction
high vs low dose -reduce cervical spine pain and radicular symptoms
122
effectiveness of intermittent compression
comparison of modalities, decrease lower limb and hand edema, effusion post ankle sprain
123
pain relief from light massage may be explained by what
gate control theory
124
what is the on time for intermittent compression
30-40 seconds
125
sacroilium and pelvis create a
closed sacroiliac ring
126
3 lever points that attach to the pelvis
spine 2 legs
127
what makes up the lumbopelvic-hip complex
pelvis sacrum lumbar vertebrae hip joints
128
dsyfunction
lack of stabilization; cause of back and pelvic pain
129
stabilization
important in relieving pain and in transmitting forces
130
form closure (SI)
-pelvic ring stability provided by joint shape and structure -reduced with ligament or bone injury/changes
131
force closure (SI)
-stability provided by dynamic forces on pelvic -reduced with muscle (core) injury
132
neuromotor control (SI)
-proper activation and sequential recruitment of muscles -dysfunctional recruitment following injury
133
what makes up the box of the core
diaphragm = top pelvic floor = bottom paraspinals and gluteals = sides and back
134
ability to maintain and control proper SI positioning to provide trunk stability with correct movement of the pelvic and lower extremities
lumbopelvic stabilization
135
what makes up the inner core (deep muscles)
transverse abdominis diaphragm pelvic floor muscles internal oblique
136
what makes up the outer core (superficial muscles)
erector spinae rectus abdominis external oblique gluteal muscles thoracolumbar fascia (QL and lats)
137
trunk movers are
global muscles (large muscles)
138
trunk stabilizers are
local muscles (smaller muscles)
139
pelvis is stable when it is
pelvic neutral
140
abdominal hollowing
-abdomen drawn in to facilitate transverse abdominis and multifidus -does not activate outer core muscles (stabilizing)
141
abdominal bracing
-abdominal and back muscles activate to co-contract (isometric contraction) -activates outer core muscles -provides greater pelvic and spinal stability
142
multifidus is activated when
the transverse abdominis is activated -causes LBP -palpated when PT is able to relax erector spinae
143
combining local and global muscles
maintain pelvic neutral and recruitment of core stabilizers while performing functional and performance specific activities
144
early rehab core exercises
dead bug bird dog goal: recruit core muscles during simple extremity motions while holding proper neutral position
145
purpose of muscle energy treatment techniques in pelvis and SI
relieve barriers and restore balance
146
when identifying SI pathology what should you do first
investigate posture, alignment, and lumbar ROM
147
movement test
-identifies differences in movement between R and L SI sides -identify presence of SI dysfunction or side of a lesion
148
standing forward bend test
-aka Piedallus test -identifies side of lesion -positive test is when one thumb either does not move or moves up (both thumbs should move down)
149
kinetic test
-aka Gillet or one-leg stork -identifies side of SI or IS dysfunction -positive test: thumb does not move down
150
alignment tests for SI
passive and used to identify malalignment and reproduce pain -leg-length, IC height, ASIS height, ASIS to umbilicus
151
PSIS and Sulci tests
positive when one side is deeper than other -examines levels of PSIS and sulci
152
inferior lateral angle test
positive when one side is more posterior and test produces pain
153
sacrotuberous ligament test
positive when one side is looser than other
154
SI joints provide a load transfer between
spine and lower extremities
155
core activation and stabilization steps
-find and maintain pelvic neutral -abdominal hollowing exercises to recruit transverse abdomnis -abdominal bracing to activate local and global muscles -engage abdominal bracing while performing simple ADLs -engage abdominal bracing while performing sport/work specific tasks
156
nutation
proximal sacrum (base) moves into anterior tilt relative to ilium
157
counternutation
posterior tilt of sacral base relative to the ilium
158
during lumbar flexion what occurs
-sacrum rotates posterior to ilia (counternutates) -ischial tuberosities move closer together -iliac crests move apart
159
what occurs during nutation
-sacral base moves forward and downward -IC move closer together -ischial tuberosities move further apart
159
what occurs during counternutation
-sacral base moves backward and upward -IC moves further apart -ischial tuberosities move closer together
160
bilateral hip flexion
anterior pelvic tilt -sacrum moves into counternutation
161
bilateral hip extension
posterior pelvic tilt -sacrum moves into nutation
162
what axis does the pelvis rotate on
diagonal axis
163
sacral flexion injury
MOI: bending and twisting activities, push-pull activities -common on left side (L sulcus is deeper and L ILA more posterior) -may feel a pop -treatment: PT is prone, clinician lifts quad off table and presses on sacrum -at home: both knees to chest
164
forward torsion injuries
-sulci are symmetrical after moving into sphinx position -most common SI injury (L side) -MOI: bending with twisting, getting out of car quickly -pain in back, butt, legs -one side of sacrum is twisted on other -at home: chest is prone on table and twist hips so knees are off table (same as treatment)
165
backward torsion injury
-sulci becomes deeper after moving into sphinx position -MOI: sudden bending and twisting -pain with extension, pain in low back and butt -treatment: bend over on table and PT slowly walks up as clinician pressures on sacrum -at home: press ups or standing trunk extension
166
anterior iliac subluxation: upslip
-always occurs on R MOI: fall on butt or step off a curb -pain on L side, low back, coccyx -R leg shorter, R IC higher, R sacrotuberous ligament is slack -treatment: pull R leg while prone
167
posterior iliac subluxation: upslip
-occurs only on L -MOI: fall on butt or step off curb -L leg shorter, L IC higher, L sacrotuberous ligament is slack -treatment: pull let while supine
168
anterior iliac rotation
-aka anterior innominate lesion MOI: occurs with other lesions -IC is low on involved side, ASIS low, PSIS high -cervical or lumbar symptoms -treatment: PT prone and involved leg off table and they resists hip flexion (knee is flexed) -at home: pelvic tilt and knee to chests
169
posterior iliac rotation
-aka posterior innominate lesion -MOI: after a fall or sudden hamstring contraction -antalgic gait with reduced hip extension on involved side, pain in butt or knee -ilium posteriorly rotated, ASIS, PSIS, and IC high on involved side; short leg on involved side -treatment: prone hip extension -at home: press ups and hip flexor stretches
170
pubic subluxation
-superior: isometric hip flexion -inferior: isometric hip extension -isometric abduction and adduction (fixes leg length differences)
171
inflares and outflares
-inflare: distance from ASIS to umbilicus is short on affected -outflare: distance from ASIS to umbilicus is greater on affected -common in soccer MOI: falling on IC or direct blow -groin, leg, hip pain -treatment: isometric hip adduction (inflares), hip flexion, adduction, medial rotation at same time (outflares) -at home: inflares same as treatment; outflares same
172
program considerations for SI and pelvis
-LBP and hip should be address to eliminate sites of referred pain -use with hip strengthening and flexibility exercises -include core exercises, strength, function training for mainenance of pelvic neutral, agility
173
vertebral artery insufficiency S&S
dizziniess lightheadedness nausea blurry vision tinnitus headaches facial sensory deficiencies
174
cervical joint mobs
-distraction: aka traction -central posterior-anterior: apply pressure to spinous process -unilateral PA: apply pressure to transverse process and move side to side
175
thoracic joint mobs
-central PA: spinous -unilateral PA: transverse -unilateral costovertebral PA: apply pressure where the ribs connect to the vertebrae
176
lumbar joint mobs
-central PA: spinous -unilateral PA: transverse -rotation: rotate the transverse processes of the lumbar or they can rotate themselves
177
how long should a stretch be held for
30 seconds and only once
178
what is required for good posture
core support
179
what is necessary for full spinal recovery
good posture and mechanics
180
must have endurance for back health
local muscles
181
must have strength for back health
global muscles
182
types of strengthening exercises for the spine
aquatic swiss-ball foam roller weights: dumbbells, pulleys, machines, med balls
183
basic principles of agility and coordination exercises for the spine
-start once strengthening exercises are mastered -include trunk rotation and plyometrics that involve higher forces, quicker movements, and functional multiplane motions -pelvic stability should be maintained ex: resisted leg lifts and med ball exercises (Russian twists)
184
problems associated with LBP
-reduced proprioception -reduced muscle endurance -lack of muscle coactivation -delayed core muscles recruitment -hip muscle imbalances -reduced trunk stability -muscle coactivation reduces pain
185
LBP treatment program
-addresses all the problems -pelvic neutral -soft-tissue mobilization -joint mobs -proprioceptive, strength, endurance exercises -functional and performance-specific exercises in pelvic neutral
186
William's flexion exercises
1. sit up in a flexed knee position to strengthen abs 2. pelvic tilt to strengthen gluteal muscles 3. single knee to chest and double knee to chest to stretch erector spinae 4. seated reach to the toes with knees extended to stretch erector spinae and hamstrings 5. in quadruped position with 1 knee forward under chest and other hip and knee in extension to stretch TFL and iliofemoral ligament 6. starting in standing and moving to full squat to strengthen quads
187
McKenzie back program
1. lie prone for 5 min 2. lying prone with elbows under shoulders for 5 min 3. prone press-up position; prone with elbows extended out in front of you 4. standing trunk extension 5. seated cat cows/ slouch to upright 6. double knee to chest
188
integrated rehab program for the spine
-PTs are active -early use of modalities -use manual techniques, exercises, and education -pelvic neutral -proper posture and body mechanics -correction of deficiencies
189
causes of upper and lower crossed syndromes
-poor postural habits -muscle imbalances: tight and lengthened muscles
190
tight muscles of upper crossed syndrome
upper trap levator scapulae pec
191
lengthened muscles of upper crossed syndrome
deep cervical muscles serratus anterior rhomboids middle and lower trap
192
tight muscles of lower crossed syndrome
hip flexors and back extensors
193
lengthened muscles of lower crossed syndrome
abdominals and gluteals
194
posture characteristics of upper crossed syndrome
forward head rounded shoulders upper cervical spine lordosis thoracic kyphosis
195
posture characteristics of lower crossed syndrome
lumbar lordosis protruding abdomen anterior pelvic tilt hip flexion knee hyperextension
196
how to treat crossed syndromes
-multifactorial approach -PT education -soft tissue and joint treatments -postural changes -stretching and strengthening exercises -changing habits
197
common spine injuries that require rehab
-sprains and strains -spondylosis -spondylolysis -spondylolisthesis -disc lesions -microdiscetomy -spinal fusion -facet injuries -TOS
198
rehab progression for the spine
-perform a thorough exam -establish a problem list -establish goal list -create treatment program (manual and corrective exercises) -know injury precautions -reassess and change program periodically -move through short to long term goals
199
cervical and upper thoracic spine rehab inclusions
-core exercises -posture correction -all neck and scapular muscles -lumbar spine
200
lumbar and lower thoracic spine rehab inclusions
-core exercises -posture correction -hip strengthening -lats strengthening
201
Fryett's first law
-regards normal vertebral coupled motions -when lumbar or thoracic spine is in neutral, side-bendings occurs to opposite side of that vertebral levels rotation
202
Fryett's 2nd law
-regards pathological coupled motions -when spine is in either flexion or extension (out of neutral), side-bending and rotation of the vertebrae will be towards the same side
203
Fryett's 3rd law
-regards total available spinal coupled motions -if motion of the spine occurs in one plane (side-bending or rotation), motion in other plane is diminished
204
facet dysfunctions
-identify positional dysfunction (position in which it is stuck in) and motion restriction (unable to move into it) -open vs closed -left vs right
205
TOS treatment program
-symptom control via modalities and position instruction -soft-tissue mobilization of the cervical spine and scapular movements -improve joint mobility of first rib -cervical and thoracic spine mobilization -flexibility and strengthening, once inflammation has subsided -correction of posture and body mechanics -breathing instructions
206
what is a common site for a lumbar area trigger point
QL
207
what is the final progression of the dead bug exercise
stabilization with arm and unsupported leg movement
208
the McKenzie back program can be used for what
postural syndromes
209
where is glycogen stored
mitochondria
210
during conditioning a volleyball player uses 10lb weight for a elbow curl, his biceps work harder when
muscle contracts concentrically
211
you are helping a sprinter to work in improving his power, you know that one way to facilitate the muscle spindles in his quads is to have him
stretch quads immediately before sprints
212
which factor provides a muscles additional force during eccentric contractions
series elastic components and parallel elastic components contribute to overall tension development
213
true statements regarding plyometric exercises
-plyometrics use quick movements of eccentrics followed by burst of concentric to optimize power output -with eccentric contraction, the speed of cross-bridge detachment increases -short neurological pathway of the muscle spindles action is relied upon for force production
214
microscopic tears of tendon caused by repeated trauma
tendinosis
215
most importnat treatment element in dealing with tendinopathy is
identifying and relieving the cause
216
a max isometric contraction can be sustained for how many seconds before fatigue becomes evident
5-10s
217
ultimate goal of plyometrics
increase power production
218
T/F a normal functional activity is usually performed in a therapeutic exercise program before plyometric
false
219
T/F final evaluations prior to returning to activity can be generally subjective
false
220
an example of an advanced functional activity for a baseball pitcher
throwing a med ball
221
T/F functional testing may include running, jumping, or agility, tests for time or distance
true
222
to distract the lower region of the cervical spine, the neck should be placed in
flexion
223
what are advanced skills needed for performance-specific exercises
speed and control
224
performance specific progression would most likely occur in which phase of healing
maturation/remodeling
225
T/F during functional activities, muscles act as stabilizers, accelerators, or decelerators
true
226
T/F all PNF extremity movements incorporate rotation and diagonal patterns
true
227
indirect release techniques are most likely to
decrease gamma gain
228
T/F it is better to overestimate an athletes ability to withstand functional stresses than to underestimate it
false
229
contraindications for joint mobs
advance osteoporosis bone to bone end feel infection
230
long term goals should include
RTP
231
pelvic neutral is
-one of first positions taught to PT with a weak core -position in which spine should always be placed
232
T/F SI joint has no motion
false
233
an example of a coupled motion occurs when the pelvis moves into a posterior tilt and
the hips flex
234
which of the following is a mechanism for backward torsion of SI joint
bending and twisting activities
235
T/F muscle energy on the SI joint uses a mild resistance to realign joint segments
true
236
the kinetic test could be used to identify
SI dysfunction
237
T/F pelvic floor muscles provide pelvic stabilization because of their transverse arrangement in the pelvis
true
238
a prone plank exercise strengthens
abdominal muscles
239
muscle of the outer core
external oblique
240
an SI standing forward bend test indicated
side of lesion