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MS II > Manual Therapy > Flashcards

Manual Therapy Flashcards

1
Q

Which type of manual therapy is described as needing speed and the patient cannot stop movement?

a. spinal manipulation
b. spinal mobilization
c. none of the above
d. all of the above

A

spinal manipulation

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2
Q

Which type of manual therapy is described as oscillations, varying amplitudes, the patient can stop movement?

a. spinal manipulation
b. spinal mobilization
c. none of the above
d. all of the above

A

spinal mobilization

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3
Q

What are the 3 mechanisms of manual therapy?

A

mechanical
neurophysiological
placebo

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4
Q

This mechanism of manual therapy is moving a joint which creates a mechanical stimulus stimulating the tissue, decreasing spasm and increasing ROM

a. mechanical
b. neurophysiological
c. placebo
d. none of the above

A

mechanical

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5
Q

This mechanism of manual therapy is the effect on the brain

a. mechanical
b. neurophysiological
c. placebo
d. none of the above

A

neurophysiological

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6
Q

This mechanism is something that influences what the patient feels/thinks about what were doing

a. mechanical
b. neurophysiological
c. placebo
d. none of the above

A

placebo

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7
Q

What are the mechanisms of manual therapy?

A 
create space
stretch collagen/off set load
gate control 
blood flow 
locked joint 
disc pressure 
plasticity 
placebo 
neuromuscular effect 
graded exposure 
patient expectations 
range of motion 
money/cost
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8
Q

This mechanism of manual therapy takes tension or stress/strain off of a particular tissue that you are targeting with therapy

a. create space
b. stretch collagen/offset load
c. blood flow
d. plasticity

A

stretch collagen/offset load

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9
Q

This mechanism is of manual therapy is concluded as the local dorsal horn mediated inhibition of c-fiber input is a potential hypoalgesic mechanism of spinal manipulation for asymptomatic subjects

a. create space
b. gate control
c. blood flow
d. locked joint

A

gate control

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10
Q

Manual therapy _ blood flow which is good for _ nerve sensitivity

A

increases

decreasing

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11
Q

Patients are able to identify where the therapist is manually pressing improves

A

homonculus

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12
Q

biological plasticity has both a _ effect and _

A

mechanical

neuroplasticity

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13
Q

_ can enhance with identification

A

plasticity

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14
Q

Placebo can show induced biological changes in

A

CNS activation
opioid pathways
dopamine production

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15
Q

Placebo can show induced psychological responses in

A

expectation of benefit
conditioning/learning effect
negative effect

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16
Q

Manual therapy gives an immediate _ effect

A

hypoalgesia

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17
Q

this is defined as the thinking underlying clinical practice

A

clinical reasoning

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18
Q

Clinical reasoning incorporates recognizing

_ and _-testing

A

pattern recognition

hypothesis-testing

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19
Q

Predisposing physical, psychosocial and environmental circumstances is a

a. clinical pattern
b. common error of clinical reasoning

A

clinical pattern

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20
Q

An overemphasis on findings which support existing hypothesis is a

a. clinical pattern
b. common error of clinical reasoning

A

common error of clinical reasoning

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21
Q

It is important to ignore findings that do not support the favored hypothesis (true/false)

A

false

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22
Q

This is defined as the awareness and ability to think about your thinking

a. clinical reasoning
b. metacognition
c. error of clinical reasoning
d. none of the above

A

metacognition

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23
Q

Patients want to know

A

what is wrong with me?
how long will it take?
what can I do for it?
what can you do for it?

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24
Q

reasoning categories of clinical reasoning

A 
sources 
prognosis 
management 
pathobiology
contributing factors
dysfunction
precautions
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25
Q

With the prognosis, it is important to focus on

a. pain
b. function
c. none of the above
d. both

A

function

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26
Q

Improve _ and _ will come down

A 
function 
pain
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27
Q

the more complex the pain, the more likely a multidisciplinary approach is needed (true/false)

A

true

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28
Q

The pain, action programs, and stress regulation is the

a. output
b. input
c. processing
d. none of the above

A

output

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29
Q

The various biological systems protect

a. output dominant
b. input dominant
c. processing dominant
d. none of the above

A

output dominant

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30
Q

Sensory and cognitive is a part of

a. output
b. input
c. processing
d. none of the above

A

processing

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31
Q

CNS, brain, central sensitization, hyperalgesia, allodynia are

a. output dominant
b. input dominant
c. processing dominant
d. none of the above

A

processing dominant

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32
Q

The tissue sampling, environment, nociception, peripheral nerve are categorized as

a. output
b. input
c. processing
d. none of the above

A

input

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33
Q

What are contributing factors of clinical reasoning to be aware of?

A

yellow flags

outside factors that influence their pain experience

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34
Q

This concept is defined as open mindedness, mental agility, mental discipline linked with a logical and methodical process of assessing cause and effect

A

Maitland concept

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35
Q

The central theme of the Maitland concept is to have a positive personal commitment to understand what the patient is enduring (true/false)

A

true

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36
Q

Maitland concept puts an empahsis on

A 
clinical reasoning
detail 
approach to the patient 
signs and symptoms 
technique
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37
Q

Maitland concept of assessment

A

continuous
analytical
before, during, and after treatment
be open-minded, non-judgmental

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38
Q

How long do you treat a patient before you see results?

A

dont see within 4-6 treatments - may be missing something

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39
Q

optimum improvement per session means pushing them harder when something is working for treatment (true/false)

A

false

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40
Q

Objective measures

a. sign
b. symptoms
c. comparative sign
d. none of the above

A

sign

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41
Q

patient subjective reporting

a. sign
b. symptoms
c. comparative sign
d. none of the above

A

symptom

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42
Q

passive or active movement is _

A

physiological movement

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43
Q

spin, roll, glide of the articular surfaces

a. active physiological movement
b. passive physiological movement
c. accessory movement
d. comparative sign

A

accessory movement

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44
Q

Measurements of progress, identifiable, what they have trouble doing functionally

a. sign
b. symptoms
c. comparative sign
d. none of the above

A

comparative sign

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45
Q 
What is normally seen with screening for red flags?
spinal movement is _ 
associated _ 
_ _ _ 
_ onset of symptoms
A

unaffected by spinal movement
associated symptoms (heartburn)
past medical history
insidious onset of symptoms

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46
Q

A patient is unaffected by spinal movement, has associated symptoms, PMH. onset of symptoms is insidious. These characteristics can be categorized as

a. yellow flags
b. red flags
c. cancer
d. systemic issues

A

red flags

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47
Q

A patient has a PMH of cancer, failure to improve within 1 month of tx, under the age of 20, family history or sudden explained weight loss can be classified as

a. yellow flags
b. red flags
c. cancer
d. systemic issues

A

cancer

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48
Q

A patient has a PMH of cancer, failure to improve within 1 month of tx, over the age of 50, family history or sudden explained weight loss can be classified as

a. yellow flags
b. red flags
c. cancer
d. systemic issues

A

cancer

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49
Q

Risk factors for cancer

A

age > 50 y/o
age < 20 y/o
personal history of cancer

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50
Q

Symptom location for pain in patients older than 50

a. UE
b. long bones of extremities
c. axial skeleton
d. LE

A

axial skeleton

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51
Q

Symptom location for pain in patients under the age of 20

a. UE
b. long bones of extremities
c. axial skeleton
d. LE

A

long bones of extremities

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52
Q

A symptom description of initial ache that progresses to constant, sharp, incapacitating can be classified as

a. systemic issues
b. yellow flag
c. red flag
d. cancer

A

cancer

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53
Q

Pain that is related to cancer is

a. traumatic
b. gradual
c. insidious
d. none of the above

A

insidious

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54
Q

A patient is aggravated by loading their bones through weight-bearing activities and unloading alleviates pain, this can be

A

cancer

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55
Q

Night pain is a red flag (true/false)

A

true

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56
Q

What can also be causing night pain?

A

neuropathic pain

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57
Q

When you wouldn’t/shouldnt use a physical test or technique under any circumstances

a. precaution
b. contraindication
c. red flag
d. none of the above

A

contraindication

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58
Q

Depending upon the skill, experience and training of the practitioner, type of test or technique selected, the amount of leverage and force used, and the age, general health and physical condition of the patient

a. precaution
b. contraindication
c. red flag
d. none of the above

A

precaution

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59
Q

It is safe to be aggressive with strength of the technique and not reassess (true/false)

A

false

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60
Q

safety in manual therapy should be

gradual/quick

A

gradual

continually assessed

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61
Q

MT contraindications of bony issues

A 
tumor 
infection 
metabolic
congential 
iatrogenic
inflammatory 
traumatic
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62
Q

MT neurological contraindications

A

cervical myelopathy
cord compression
cauda equina syndrome
nerve root compression with increasing neurological deficit

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63
Q

MT vascular contraindications

A

diagnosed with vertebrobasilar insufficiency
aortic aneurysm
bleeding disorder

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64
Q

MT contraindications: lack of

A

not examining someone

lack of pt consent

65
Q 
adverse reaction to previous MT 
disc herniation or prolapse
pregnancy 
spondylolisthesis 
psychological dependence upon manipulative techniques 
ligamentous laxity 
a. MT contraindications
b. MT precaution
A

MT precautions

66
Q

How should you make MT safer?

A

appropriate training
thorough history and exam
clinical reasoning skills
graded mobilization

67
Q

Fear and anxiety, family concerns, failed treatment, persistent pain, job issues, different explanations fall under

a. cancer screening
b. yellow flags
c. red flags
d. contraindications

A

yellow flags

68
Q

_ flags enter into the system during the processing stage

A

yellow

69
Q

Emotions, behaviors, family, work, compensation can be

a. red flags
b. yellow flags
c. precautions
d. contraindications

A

yellow flags

70
Q

fear of increased pain, depression, irritability, anxiety, and stress are

a. yellow flags
b. red flags
c. warning signs
d. patterns

A

yellow flags

emotions

71
Q

behaviors of extended rest, poor compliance, extreme pain ratings, excessive reliance on aids/devices, sleep disturbance, high intake of alcohol or medication, work

A

yellow flags

72
Q

overprotective and punitive responses from family

A

yellow flags

73
Q

manual work, work history, belief that work is harmful, unhappy at work, low educational background, working shifts, negative previous experiences at work with LBP

A

yellow flags

74
Q

lack of financial incentive to return to work, extended time off work, number of claims, previous history of LBP

A

compensation

yellow flags

75
Q

conflicting diagnosis, passive treatments, number of health care providers, lack of satisfaction

A

yellow flags

76
Q

tools for screening yellow flags

A

FABQ
Tampa Scale of Kinesiophobia
pain catastrophization scale
Orebo musculoskeltal pain screening questionnaire
Keele STarT back screening tool
Acute low back pain screening (ALBPS) questionnaire

77
Q

SINS stands for

A

severity
irritability
nature
stage

78
Q

A finding of debilitating, high-intensity pain

a. severity
b. irritability
c. nature
d. stage

A

severity

79
Q

A finding of small movement causes a lot of pain and take awhile to subside

a. severity
b. irritability
c. nature
d. stage

A

irritability

80
Q

A finding of deep, burning, type of pathology

a. severity
b. irritability
c. nature
d. stage

A

nature

81
Q

SINS plus includes

A

stability

82
Q

SPINS includes

A

pain mechanism

83
Q

What are the categories of a subjective exam?

A 
kind of disorder
history 
site of symptoms 
behavior of symptoms
special questions
84
Q

This part of the subjective exam is the main problem which can typically be pain, limited movement, limited ROM, weakness, numbness, decreased function

a. history
b. kind of disorder
c. site of symptoms
d. behavior of symptoms

A

kind of disorder

85
Q

the kind of disorder is from the (patient/therapist) perspective

A

patient

86
Q

What do you need to get from the subjective history part?

A

onset of disorder
progression
diagnosis, tx and effect
previous history

87
Q

How and when did this start?
What kind of symptoms were present when it started?
Did any of the symptoms spread anywhere else?
How long did it take for the symptoms to come on?
What were you doing around the time of the onset?
What do you think happened?
Why do you think you hurt?
these questions help you determine
a. type of disorder
b. onset of disorder
c. progression of disorder
d. diagnosis

A

onset of disorder

88
Q 
Is it getting better, worse or the same?
If (better, worse or the same) in which way?
these questions help you determine 
a. type of disorder 
b. onset of disorder
c. progression of disorder
d. diagnosis
A

progression of the disorder

89
Q

What information do you need to get from the site of symptoms?

A

area
depth
nature
correlation

90
Q

The nature of the site of symptoms can tell you

A

constant vs intermittent

variable vs non variable

91
Q

You should target each symptom they mark on the body chart (true/false)

A

false

prioritize

92
Q

If their body map is intact and sharp, what should you do for treatment?

a. pain science
b. mobilization
c. traditional manual therapy
d. don’t treat

A

manual therapy

93
Q

If their body map is smudged, what should you do for treatment?

a. pain science
b. mobilization
c. traditional manual therapy
d. don’t treat

A

pain science

94
Q

Aggs, eases, SINS, latency and daily pattern describe

a. site of symptoms
b. depth of symptoms
c. nature of diagnosis
d. behavior of symptoms

A

behavior of symptoms

95
Q

What do you need to ask for special questions?

A

review of systems
cancer screen
inflammation
vertebrobasilar insufficiency

96
Q

What do you need to consider with vertebrobasilar insufficiency?

A

5 D’s
and
3 N’s

97
Q

5 D’s for vertebrobasilar insufficiency

A 
dizziness
diplopia
dysphagia
drop attacks
dysarthria
98
Q

And vertebrobasilar insufficiency

A

ataxia

99
Q

3 N’s for vertebrobasilar insufficiency

A

nystagmus
numbness
nausea

100
Q

Outcome measures used for subjective examing

A

function
fear
pain catastrophization

101
Q

5 reasons to do a physical exam

A 
confirm subjective hypothesis/diagnosis 
find comparative signs 
choose techniques and treatment
determine pts movement limits
determine pits willingness to move
102
Q

Determining if the symptoms are peripherally or centrally initiated

a. sources of symptoms
b. mechanism of symptoms
c. site of symptoms
d. diagnosis

A

mechanism of symptoms

103
Q

The possible structures at fault and determining what should be examined on day 1

a. sources of symptoms
b. mechanism of symptoms
c. site of symptoms
d. diagnosis

A

sources of symptoms

104
Q

For planning the physical exam consider

A 
mechanism of symptoms
sources of symptoms 
when to limit the exam
if you should do a neuro eval 
comparative signs
105
Q

Limits of physical exam

A

point of onset
partial reproduction
total reproduction
production of referred symptoms

106
Q

Let the patient demonstrate the aggravating movements (true/false)

A

true

107
Q

Non-verbal cues are irrelevant, dont tell you anything (true/false)

A

false

108
Q

When looking at the patient move, what should you be looking for?

A 
distortion of the movement 
quality 
speed, rhythm, willingness to move, ROM 
where movement occurs 
limits 
status of ceased movement
109
Q

Consider what concepts for planning the treatment

A 
patient symptoms 
pathology
goals and objectives 
prognosis 
techniques available
110
Q

Joint positioning mid ROM, large amplitude, grade 2 will treat

a. stiffness
b. pain
c. impaired function
d. ROM

A

pain

111
Q

Joint positioning end ROM, small amplitude, grade 4 will treat

a. stiffness
b. pain
c. impaired function
d. ROM

A

stiffness

112
Q

This grade is a small amplitude, beginning of the ROM

a. grade I
b. grade II
c. grade III
d. grade IV

A

grade I

113
Q

This grade is a large amplitdue, beginning to mid ROM, free of resistance

a. grade I
b. grade II
c. grade III
d. grade IV

A

grade II

114
Q

This grade is a large amplitdue, mid to end ROM, into resistance, stiffness

a. grade I
b. grade II
c. grade III
d. grade IV

A

grade III

115
Q

This grade is small amplitude, stretching into stiffness

a. grade I
b. grade II
c. grade III
d. grade IV

A

grade IV

116
Q

According to the Maitland concept, what rhythm should you use to treat pain?

a. fast
b. aggressive and slow
c. smooth and even
d. increase as you go

A

smooth and even

117
Q

According to the Maitland concept, what rhythm should you use to treat stiffness?

a. staccato
b. aggressive and slow
c. smooth and even
d. increase as you go

A

staccato

118
Q

According to the Maitland concept, how should you advance a technique?

A 
increase amplitdue 
move into some discomfort 
increase speed, maintain smoothness
slight staccato oscillations 
place the joint on a stretch before mobilizing
119
Q

With muscle spams, you should oscillate (true/false)

A

false

120
Q

To treat pain according to maitland concept use a

a. comfortable position, comfortable technique, small amplitude, slow speed, smooth rhythm, and long duration
b. end ROM position, firm technique, large amplitude, small amplitude in between, quicker speed, staccato rhythm, short duration
c. comfortable position, comfortable technique, large-amplitude, slow speed, smooth rhythm, short duration
d. end ROM position, firm technique, small amplitude, large amplitude in between, quicker speed, staccato rhythm, expect discomfort, longer duration

A

comfortable position, comfortable technique, large-amplitude, slow speed, smooth rhythm, short duration

121
Q

To treat stiffness according to maitland concept

a. comfortable position, comfortable technique, small amplitude, slow speed, smooth rhythm, and long duration
b. end ROM position, firm technique, large amplitude, small amplitude in between, quicker speed, staccato rhythm, short duration
c. comfortable position, comfortable technique, large-amplitude, slow speed, smooth rhythm, short duration
d. end ROM position, firm technique, small amplitude, large amplitude in between, quicker speed, staccato rhythm, expect discomfort, longer duration

A

end ROM position, firm technique, small amplitude, large amplitude in between, quicker speed, staccato rhythm, expect discomfort, longer duration

122
Q

The tissues, environment, nociception, and peripheral nerve are what part of the pain process?

a. input
b. output
c. processing
d. psychological

A

input

123
Q

The CNS, brain, central sensization, hyperalgesia, allodynia symptoms is part off which system with pain?

a. input
b. output
c. processing
d. psychological

A

processing

124
Q

Pain, sympathetic, motor, immune, adrenaline, cortisol, respiration, language are related to the _ part of pain

a. input
b. output
c. processing
d. psychological

A

output

125
Q

The primary lesion or dysfunction is located in the spinal cord, brainstem, and cerebral hemispheres affects the _ part of pain

a. input
b. output
c. processing
d. psychological

A

processing

126
Q

A patient demonstrates disproportionate pain and disproportionate aggravating and easing factors, this is due to the _ part of pain

a. input
b. output
c. processing
d. psychological

A

processing

127
Q

A patient has diffuse palpation tenderness and nothing eases their pain, it is a _ issue

a. input
b. output
c. processing
d. psychological

A

processing

128
Q

This type of pain is proportionate, aggravating and easing factors, intermittent sharp, dull ache or throb at rest with no night pain

a. peripheral neurogenic
b. nociceptive
c. processing
d. psychological

A

nociceptive

129
Q

Pain is dermatomal or cutaneous distribution, positive neurodynamic and palpation with a history of nerve pathology

a. peripheral neurogenic
b. nociceptive
c. processing
d. psychological

A

peripheral neurogenic

130
Q

Maitland focused on

a. pathology
b. biopsychosocial
c. social issues
d. signs and symptoms

A

signs and symptoms

131
Q

Loui believed that for collagenous tissues to elongate it takes

a. manual therapy
b. mobilization
c. education
d. time and repetition

A

time and repetition

132
Q

(small/large) amplitude motions can be seen as a modulation effect on (peripheral/nociceptive) input to CNS

A

large

nociceptive

133
Q

(continuous/repetitive) oscillations on a spinal level, often at various angles help _

A

repetitive

restore body maps in the brain

134
Q

A cornerstone concept of Maitland is

A

test and retest

135
Q

Which system is powerful when it comes to pain?

A

vision

136
Q

Hands-on manipulation has been shown to activate the (descending/ascending)

A

descending inhibitory mechanisms to help modulate acute pain

137
Q

this model involves exposing a person to a small amount of stimulus for a short amount of time and over time, this exposure is increased

a. body maps
b. neuroplasticity
c. manual therapy
d. graded exposure

A

graded exposure

138
Q

patient expectations are a _ effect

A

placebo

139
Q

changes in the size and shape of the _ _ can correlate with increased pain and disability

A

body maps

140
Q

treatments for _ improve SLR

A

neuroplasticity

141
Q

reboot of muscles via spinal reflexes; essentially, describes the change in muscle activity seen before & after a manual technique

a. neuroplasticity
b. placebo
c. neuromuscular effect
d. manipulation

A

neuromuscular effect

142
Q

What was the first school to teach manipulation?

A

Andrew Taylor Still

osteopathy

143
Q

Who wrote the four branches of physiotherapy are manipulation of muscle and joints, therapeutic exercise, electrotherapy, hydrotherapy?

a. McMillan
b. Maitland
c. Cyriax
d. Mennell

A

Mary McMillan

144
Q

Who wrote the textbook of orthopedic medicine?

a. Mennell
b. Maitland
c. Cyriax
d. McKenzie

A

James Henry Cyriax

145
Q

Who is famous for teaching therapists about manipulation?

a. McKenzie
b. Maitland
c. Cyriax
d. Mennell

A

Cyriax

146
Q

Who defined joint dysfunction and joint play which cannot be produced by the action of voluntary muscles?

a. McKenzie
b. Mennell
c. Cyriax
d. Maitland

A

John Mennell

147
Q

Who explained the concept of facilitated segment?

A

Alan Stoddard

148
Q

Who came up with the concept of repeated movements being preferred direction, centralization, peripheralization?

a. McKenzie
b. Maitland
c. Cyriax
d. Mennell

A

Robin McKenzie

149
Q

The ability to respond appropriately to relevant information during a patient encounter?

a. clinical reasoning
b. reflection in action
c. metacognition
d. knowing in action

A

knowing in action

150
Q

Clinical reasoning is the application of _ _, and _ _ to patient _ on an _ level

A

relevant knowledge
clinical skills
management
individual

151
Q

with clinical reasoning, you need to find out if its _ to the patient

A

relevant

152
Q

Clinical reasoning is likely more important than the actual treatment itself (true/false)

A

true

153
Q

The assessment is the most important part according to the Maitland concept (true/false)

A

true

154
Q

This type of pain is proportionate, aggravating and easing factors, intermittent sharp, dull ache or throb at rest

a. nociceptive
b. peripheral
c. processing
d. none of the above

A

nociceptive

155
Q

This type of pain is no night pain, dysesthesia, burning, shooting or electric

a. nociceptive
b. peripheral
c. processing
d. none of the above

A

nociceptive

156
Q

This type of pain is dermatomal or cutaneous in distribution, positive neurodynamic and palpation, with a history of nerve pathology or compromise

a. nociceptive
b. peripheral
c. processing
d. none of the above

A

peripheral neurogenic

157
Q

This type of pain is disproportionate pain, disproportionate aggravating and easing factors, diffuse palpation tenderness, psychosocial issues

a. nociceptive
b. peripheral
c. processing
d. none of the above

A

processing

158
Q

What is the most important central theme in pain according to the maitland concept?

A

approach to the patient

MS II (17 decks)

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