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Flashcards in Midterm Deck (109)
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1

what is ankylosis? Is passive movement possible?

fusion of the joint

no

2

What are the absolute contraindications for joint mobilizations? (8)

- malignancy in area
- active inflammation and/or infectious joint
- ankylosis of joint
- fracture at the joint
- practitioner lack of ability
- neurological deterioration
- diseases with affect integrity of ligaments
- arterial insufficiency

3

What are relative contraindications for joint mobilizations? (6)

- excessive pain or swelling
- arthroplasty (joint replacement)
- hypermobility
- metabolic bone disease
- pregnancy
- spondylolisthesis

4

What direction are you assessing with Grade 3 distraction?

general mobility

5

What is the dosage for joint mobilization oscillations?

- 1-3 seconds each
- 1-5 sets for 15-30 seconds each

6

What is the dosage for joint mobilization sustained holds

1-5 sets for 15-30 seconds each

7

What direction will you do grade 1 and 2 joint mobilizations?

the direction doesn't matter; must be done in open packed positions

8

How many times should joint mobilizations with movements be done before reassessing joint motion?

10 times

9

What is the ability of contractile tissue to produce tension and a resultant force based on demand placed on the muscle

muscle strength

10

What is the ability of the neuromuscular system to produce, reduce, or control forces during functional activities in a smooth coordinated manner

muscle functional strength

11

What is the ability of related to the strength and speed of a movement; the amount of work produced by a muscle in a given amount of time

muscle power

12

What is the ability to perform low-intensity, repetitive, or sustained activities over a prolonged period of time

muscle endurance

13

Which muscle fibers atrophy fastest?

type 1 fibers - endurance fibers

14

Which type of muscle fibers shows the greatest hypertrophy?

type 2 fibers - strength/power fibers

15

What occurs at the capillary beds during hypertrophy?

there is no change because there is no extra demand for O2 for strength and power - they are anaerobic

16

What are resistance training guidelines for children under 7

- no "formal" training
- encourage daily physical activity and bodyweight exercises
- emphasize multi-joint, functional movements
- increase weight by no more than 5% at a time

17

What muscle performance training would have some sort of time/speed component to it combined with strength?

TUG test

18

What does FITT stand for?

Frequency
Intensity
Time
Type

19

Training zone of 1 RM for sedentary/untrained patients

30 -40% of 1 RM

20

Training zone of 1 RM for highly trained patients

over 80% of 1 RM

21

Training zone of 1 RM for normal patients

60 - 80% of 1 RM

22

________ recovery leads to more rapid recovery than _______

active is more rapid than passive

23

What type of exercise has an analgesic effect based on research?

isometric exercise

24

At a minimum, how long should a static isometric muscle contraction hold last

6-10 seconds

25

When can patients progress to the mobility phase of their exercise prescription?

when signs of inflammation have disappeared
- some patients can skip tissue healing phase and go right to mobility phase

26

What kind of exercises would you do during the tissue healing phase?

ROM and isometrics

27

What kind of exercises would you do during the mobility phase?

ROM and stretching exercises

28

What is required for the patient to progress from the mobility phase to the performance initiation/stabilization and motor control phase?

pain free ROM
- they do not have to have full mobility, just has to be pain free

29

What type of exercises can be used in the performance initiation/stabilization and motor control phase

concentric, eccentric, and isometric
- apply the SAID principle

30

What is required for the performance improvement phase?

pain free ROM
- does not have to have full mobility, just has to have pain free ROM

31

What is the goal of BFR?

mimic the effects of high intensity exercise by recreating a hypoxic environment using a cuff while performing low intensity exercises

32

Does PROM increase strength and endurance?

No

33

reciprocal inhibition

When the stretch reflex is activated in a muscle being lengthened (antagonist), inhibition in the muscle on the opposite side of the joint may occur

- relaxation of muscles on 1 side of a joint to accommodate contraction on the other side of the joint
- activating the agonist to get the antagonist to relax

34

What part of the muscle control reciprocal inhibition?

muscle spindles

35

What part of the muscle controls autogenic inhibition?

golgi tendon organs

36

autogenic inhibition

When tension develops, the GTO fires and decreases tension in the muscle-tendon unit being stretched, enabling a muscle to be elongated against less muscle tension

- ability for a muscle to relax when it experiences increased tension
- activating the antagonist to get the antagonist the relax

37

When is PNF stretching more appropriate?

when muscle spasm limits motion

38

When is PNF stretching less appropriate?

for stretching long-standing, fibrotic contractures

39

antagonist contraction

- hold-relax
- using autogenic inhibition
- stretch range limiting (antagonist) muscle to end range, then have patient contract muscle, then stretch farther

40

agonist contraction

- contract relax
- using reciprocal inhibition
- stretch range limiting (antagonist) muscle to end range, then have patient contract agonist (opposite) muscle, then stretch antagonist

41

When is agonist contraction useful?

- when muscle guarding restricts muscle lengthening and joint movement
- when the patient can't generate a strong, pain-free contraction of antagonist

42

What does SBAR stand for?

Situation
Background
Assessment
Recommendation

43

nociceptive vs neuropathic pain

nociceptive - increased sensitivity to a peripheral nerve, usually from an injury

neuropathic - injury to a nerve

44

What are the 5 moments for hand hygiene?

1) BEFORE touching the patient
2) BEFORE clean/aseptic procedures
3) AFTER a body fluid exposure risk
4) AFTER touching the patient
5) AFTER touching a patient's surroundings

45

What PPE should be worn with contact precautions?

gloves and gown

46

What PPE should be worn with droplet precautions?

gloves and mask

47

What PPE should be worn with airborne precautions?

masks and respirators

48

PNF overflow (irradation)

Spread of a muscle response from stronger to weaker muscles – the more resistance you apply, the more muscles recruited

49

What does PNF manual contact do?

stimulates the muscle to reinforce the movement AND guide the direction of the movement

50

Where is the therapist position during PNF stretching?

directly in line with the desired motion and should be facing the direction of the desired movement

51

What is applied manually during PNF patterns to facilitate muscle contraction?

traction

52

D1 Flexion UE pattern

- the most important motion is eating

- shoulder flexion, adduction, ER
- forearm supination
- wrist radial deviation
- fingers flexed

53

D1 Extension UE pattern

- throw away the trash

- shoulder extension, abduction, IR
- forearm pronation
- wrist ulnar deviation
- fingers extended

54

D2 Flexion UE pattern

- drawing the sword and throwing it behind you

- shoulder flexion, abduction, ER
- forearm supination
- wrist radial deviation
- fingers extended

55

D2 Extension UE pattern

- putting the sword back

- shoulder extension, adduction, IR
- forearm pronation
- wrist ulnar deviation
- fingers flexed

56

What pattern is the involved and non-involved side doing during lift and reverse lift?

- involved side doing D2 pattern
- non-involved side doing D1 pattern

57

What pattern is the involved and non-involved side doing during chop and reverse chop?

- involved side doing D1 pattern
- non-involved side doing D2 pattern

58

rhythmic initiation steps

1) therapists performs PROM
2) therapist has patient perform AAROM
3) patient performs AROM
4) patient performs AROM against resistance

59

alternating isometrics

Patient performs isometric contraction while resistance is applied to agonist and antagonist – very little joint movement occurs
- best for core strength

60

dynamic reversals

Apply resistance through the pattern on both sides
- ex: resist D2 flexion then resist D2 extension

61

fast/quick stretch

- Provide a quick stretch of the agonist when changing directions
- Produces a relatively short-lived contraction of the agonist's muscle and short-lived inhibition of the antagonist muscle which facilitates a muscle contraction (muscle spindle)

62

Repeated contraction/stretch

- Move through a pattern pausing and applying a quick stretch, press through more motion, pause, quick stretch, push
- Emphasizes strengthening in specific ranges throughout the motion

63

dynamic reversal hold

Same as dynamic reversals but with an isometric hold at end of the motion prior to changing directions

64

agonist reversal

Reversing the type of contraction you are eliciting from your patient, working concentrically, isometrically, then eccentrically

65

Antalgic Gait

Short, choppy steps because they don’t want to bear weight on the involved side

66

What hip deviation will cause forward trunk lean?

- weak quads
- hip flexure contracture
- weak lumbar or hip extensors
- hypomobile anterior hip capsule - they can't get into extension

67

What hip deviation will cause decreased hip extension? What will this do to their steps?

- Tight hip flexors
- Decreased anterior joint mobility
- Weak glutes

- shorten their steps

68

If glute max is weak how will my body compensate?

Rock themselves back and use their trunk to create hip extension

69

What might you see with weak gluteus medius?

Hip drop on contralateral side

70

What can cause knee hyperextension during gait?

- Quadriceps weakness – doesn’t control the knee eccentrically so the sling it back to lock out the knee
- Hamstring weakness
- Increased tone of quadriceps
- Compensation for plantarflexion contracture or spasticity
- hypermobile posterior capsule

71

What can cause decreased knee extension during gait?

- Quadriceps weakness (unable to straighten knee) – tight anterior joint capsule
- Knee joint hypomobility
- Hamstring contracture or stiffness
- Strategy to avoid heel rocker

72

What is equinus gait? What may cause this?

excessive plantarflexion during gait

- Tib ant weakness
- Plantarflexion contracture
- Hypomobility of talocrural joint – posterior capsule hypomobile
- Compensation for short leg/short stride length
- Painful heel/avoiding heel rocker

73

What is calcaneal gait? What may cause this?

- increased dorsiflexion

- tib anterior contracture
- weak gastroc
- hypomobility talocruel joint

74

What is Equinovarus gait?

- club foot
- Ankle plantar flexion and subtalar inversion

75

What often causes foot drop? What muscles would you MMT? What muscles would be tight?

- Often due to dorsiflexor weakness caused by paralysis of common peroneal nerve

- tib anterior MMT
- tight gastroc soleus (PF)

76

What might cause foot flat?

- Weak dorsiflexors
- limited ROM
- hypomobility
- normal immature gait pattern (neonatal)

77

What position is the foot in during excessive supination?

varus

78

What position is the foot in during excessive pronation?

valgus

79

What might cause inadequate push off?

- Result of weak plantar flexors
- Tight/spastic dorsiflexors
- Hypomobile talocrural joint – anterior (convex on concave)
- Pain in forefoot

80

What causes excessive anterior pelvic tilt?

- Weak hip extensors
- Hip flexion contracture
- Abdominal muscle weakness
- Limited hip extension ROM

81

What causes excessive posterior pelvic tilt?

- tight hamstrings
- hip flexor weakness
- low back pain
- limited lumbar extension ROM

82

anatomical vs functional leg length discrepancies

- anatomical - one bone is longer than the other

- functional - bones are the same length but something is causing one leg to be longer or shorter than the other

83

What are causes for waddling gait?

- Tight IT band
- Contralateral hip abductor weakness
- Limited hip or knee flexion- leans to contralateral side to compensate to clear foot
- Commonly seen with pain in hip related to arthritis

84

What is Sensory Ataxic Gait?

- abnormal and uncoordinated movements
- often seen with cerebellar disorders

85

What is Festinating Gait?

- flexed forward gait often seen with Parkinson's
- short, choppy steps

86

A 2 handed device is required for which weight bearing statuses?

NWB
TTWB
PWB

87

A 1 handed device can be used with what weight bearing statuses?

WBAT
FWB

88

4 point gait weight bearing status

no weight bearing restrictions

89

modified 4 point gait weight bearing restrictions

no weight bearing restrictions

90

3 point gait weight bearing status

NWB

91

modified 3 point gait weight bearing status

TTWB, PWB, or WBAT

92

2 point gait weight bearing status

no weight bearing restrictions

93

modified 2 point gait weight bearing status

no weight bearing restrictions or WBAT

94

consequences of shallow seat depth on wheelchair

thighs are not properly supported, affecting weight distribution and comfort, pelvic position

95

consequences of deep seat depth on wheelchair

sacral sitting
- Individual slouches, sliding buttocks forward and posteriorly tilting pelvis

96

consequences of side width too wide on wheelchair

- difficult to reach the drive wheels
- Individual may lean to one side to rest on the armrests

97

consequences of side width too narrow on wheelchair

excessive pressure on lateral aspects of pelvis and thighs

98

consequences of back height too high in wheelchair

restricts movement, skin irritation over inferior angles of scapulae

99

consequences of back height too low in wheelchair

decreased trunk stability, postural deviations

100

What is ideal seat to footplate length?

set so that the thigh rests parallel to the cushion surface with the foot comfortably placed on the footrest

101

consequences of too high seat to footplate length

individual may sacral sit in order to rest feet on footplates

102

consequences of too low seat to footplate length

pressure distribution along thigh is uneven

103

What are the areas at risk for pressure while in a wheelchair?

- inferior angle of scapula
- sacrum/coccyx
- Ischial tuberosity
- greater trochanter
- popliteal fossa

104

What impairments are you targeting with oscillation mobilizations?

- muscle guarding
- pain
- joint hypomobility

105

What impairments are you targeting with sustained hold mobilizations?

- joint mobility - end range
- pain - beginning range to mid range

106

D1 Flexion LE pattern

- Hip flex, add, ER
- Dorsiflexion
- Inversion
- Toes extended

107

D1 Extension LE pattern

- Hip ext, abd, IR
- Plantar flexion
- Eversion
- Toes flexed

108

D2 Flexion LE pattern

- Hip flex, abd, IR
- Dorsiflexion
- Eversion
- Toes extended

109

D2 Extension LE pattern

- Hip ext, add, ER
- Plantar flexion
- Inversion
- Toes flexed