Hand and upper limb Flashcards
(24 cards)
how do you tx pts without grip ability?
teach to snap wrist back to give grip as result of length of extrinsic flexors & extensors
increase pull of FDS & FDP, as wrist extends, flexes fingers
as fingers flex, radial border of index finger contacts thumb for pinch
what is tenodesis?
passive tension can produce movements of joints when the muscle is elongated over 2 or more joints
when do OTs use tenodesis?
movement training after surgery (tendon transfer)
bracing for SCI
what is starlings law?
muscles have an optimum length at which they are capable of generating the most tension
near midrange (btwn max short + max long)
why is the midrange position optimum length?
b/c actin and myosin can bind most effectively in mid range
how do you tx an impinged median nerve?
position = flexed wrist
strengthen extensors, splint, hold in midrange position
What defines a true synergy?
multi articular muscle which causes movement at each joint it crosses
2nd muscle which opposes the multiarticular muscles action at 1 joint at least
group of muscles that prevent movement at another group
how do muscles move joints?
by developing tension that is used to exert force
what is tension?
magnitude of force developed
How is active tension accomplished?
via contractile elements within muscle itself
how is passive tension accomplished?
develops from change of position in the passive elastic components in muscle
what is the length-tension relationship of muscles?
direct relationship btwn length of muscle and tension it is capable of generating
what should you remeber about a 2 joint muscle?
it can contract on both ends
what is active inefficiency?
when muscle is too short & must eliminate other muscles
inability to generate tension wen it is maximally shortened
which muscles are most likely to become actively + passively insufficient and why?
multijoint muscles b/c they undergo greater changes in length than a single joint muscle
how do you MMT an actively insufficient muscle?
knock out other mucles
be aware of all joints muscles cross
what is passive insufficiency?
when muscle-tendon unit lacks sufficient length to allow the joints to move through full ROM
why does passive insufficiency occur?
muscles that are maximally stretched cannot produce much tension b/c actin and myosin cant interact
what is passively insufficient when a pt is in prone with hip extended and knee flexed?
rectis femoris prevents ful ROM of hip extension + knee flexion
what is normal (5) muscle range?
full AROM against gravity
holds against strong resistance
what is good (4) muscle range?
full AROM against gravity
holds against moderate resistance
what is fair (3) muscle range?
full AROM against gravity
cant hold against resistance
what is poor (2) muscle range?
full AROM gravity eliminated
cant hold against resistance?
what is trace (1) muscle range?
tendon/muscle develps tension that can be felt
no movement seen
