Midterm Flashcards
(101 cards)
1
Q
An evaluation Process Should be :
A
- Performed after the first treatment
- performed prior to and after each additional treatment
- modified and progressed as needed
2
Q
What should be included in a subjective History:
A
- Basic information (age, gender , level of function etc)
- MOI
- pain characteristics
- past medical history , family and social
- previous tx, dx tests, surgical procedures , medications
- patient goals
3
Q
What should be in the objective evaluation
A
- Visual inspection for posture, gai, functional performance
- Asseses factors directly or indirectly contributing the dysfunction
- Palpation
- ROM(pain, goniometric measurements)
4
Q
What is in the acute protective phase?
A
- Patient education
- Active/ passive ROM
- Muscle setting ( isometric exercises)
- Multiangle isometrics
- exercises to maintain other body areas
5
Q
Promotion from protective to moderate protective phase (subacute) :
A
- Complete or almost complete pain free ROM 80-90%
- perform isotonic exercises- body weight or weights for endurance
- proprioception and balance exercises
- cardiovascular exercises
- whole body exercises
6
Q
Promotion from Moderate to minimum protection phase ( chronic)
A
- full pain free ROM
- Strength 80% of opposite side
7
Q
Minimum Protective Phase (chronic)
A
- continue whole body and cardiovascular exercise
- functional activités
- Plyometrics
8
Q
Name some adverse reactions to exercises
A
- Increased pain
- increased inflammation
- decreased ROM
- increased recovery time
9
Q
_____ = Fluid connective tissue
A
Liquid Matrix
10
Q
______= Fibroconnective tissue
A
- poor blood supply
- high fiber density extracellular matrix
- Adipose tissue, tendons , ligaments
11
Q
_______ = Supportive connective tissue
A
- rigid extracellular matrix
- cartilage - poor blood supply
- Bone - rich blood supply
12
Q
Name some examples of acute trauma
A
- Abrasions, incisions, lacerations, avulsions , punctures
- Contusions
- strains
- sprains
- Fx’s
- Neuropraxia
- axonotmesis
- Neurotmesis
13
Q
Name some examples of Chronic/repetitive trauma
A
- tendinosis
- tenosynovitis
- stress fx
- neuralgia
- neuroma
14
Q
Schwann cells are more likely ton regenerate if ________
A
new axon branches are able to make contact
15
Q
Regeneration occurs at a slow rate of _____
A
2-4mm/day
16
Q
_____ and _____ cells play a major role in regeneration of muscle healing
A
- Satellite
- dormant progenitor
17
Q
A balance between ______ and ____ must be created to allow for optimal regeneration
A
- immobilization
- movement
18
Q
List some competencies for therapeutic exercises
A
- explain the stress - response model
- explain the physiological and emotional response to trauma
- describe the basic principle of interaction among different factors
- explain the importance of providing health care information to all involved in patient care
- explain the basic techniques of counseling and communication
19
Q
What are the four stages of rehabilitation according to Taylor and Will
A
- ROM and rest
- Strength
- coordination
- Return to Play
20
Q
ROM should be assessed for :
A
- Quality of movement
- Quantity of movement
- Pain associated with movement
21
Q
What the indications for Active ROM
A
- patients who need to increase :
- ROM
- Muscular Strength
- Neuromuscular Control
- Flexibility
22
Q
What are some Contraindications For Active ROM
A
- muscle contraction causes pain
- places unneeded stress on healing tissue
- abnormal motion is present
- structure is unstable
23
Q
Name some indications of Passive ROM
A
- Regain ROM
- Increase ROM
- Maintain ROM
24
Q
name some contraindications for Passive ROM
A
- connective tissue disorders
- traumatic injuries
- recent fx
25
Describe what Cyriax's method is
- Pain with active and passive ROM in the same direction = more inert tissue(bone, big, bursar, cartilage, capsule, fascia)
- pain wit active rom in one direction and pain with passive rom in the opposite direction=contractile tissue (muscle, tendon, nerve)
26
Name indications for resisted ROM
- assess muscle strength
- increase muscle strength
- determine muscle control
- asses muscular injury
27
name some contraindications for resisted ROM
- recent Fx
- tendon tears
- muscle tears
- postoperatively
28
Define length- tension relationship
- muscles ability to develop tension based on the position of the muscle at time of contraction
- muscles develop peak force production mid ROM
- Muscles required to contract at a shortened or lengthen position will produce less force
29
Define the stretch reflex
mechanoreceptors and GTOs inform the CNS about musculotendinous length and tension
- the MS and GTO protect the muscle
30
Muscle spindles responds to changes in ____
muscle length
31
GTOs respond to ____ and ___
- muscle lengthening
| - tension
32
High- Velocity stretch
- results in firing of muscle spindles
| - increases risk of soft tissue injury and failure
33
Low intensity stretch
- decreases risk of tissue failure
| - increase likelihood of plastic changes
34
Duration of stretch ;
SHORT=
LONG-
Short= elastic changes (
35
Pre- practice stretching
- decreases the risk of injury
- active warm- up
- increases blood flow
- sport specific
- determined by amount of stretch- shorten cycles in activity
- should be individualized
36
Post - practicing stretch
- Prevents DOMs
| - Elicits plastic changes
37
Oscillation techniques are _______________
typically applied at a speed of 1-2 oscillations/seconds for a duration of 1-2 minutes
38
Muscle contraction occurs when ______________
myosin heads pull actin filaments inward , shortening the sarcomere
39
Contraction occurs when:
1. nerve impulse triggers the release of acetylcholine
2. acetylcholine causes the release of calcium
3. calcium binds with troponin
4. Troponin rotates tropomyosin to expose sites for myosin head attachment
5. cross bridges form when myosin heads attach to actin binding sites
6. myosin heads flex and generate movement
7. ATP allows actin to detach from myosin
9. ATP attaches to myosin another cross bridge forms
40
Slow -Twitch (type I ) fibers :
- use oxygen for energy, resistant to fatigue
| - less powerful that type II endurance activities
41
Type II A fibers use _____ and _____ for energy
- oxygen
| - glycogen
42
Type IIB fibers uses _____ for energy and ____ easily
| it generates ________ contractions
- glycogen
- fatigues
- rapid , powerful
43
______ muscle contraction with no change in length
Isometric
44
Example of a setting isometric exercise
- quadriceps sets
45
Example of static isometric exercise
isometric push against a wall or doorframe
46
Example of mulitangle isometric exercise
- quadriceps sets at various angles of flexion
47
Isometric contractions are held ___ seconds , for ___ repetitions
- 5-6 sec
| - 8-10 reps
48
Concentric muscle concentrations ______________
muscle shortening while generating force to overcome resistance
49
Eccentric muscle contractions ________
muscle lengthening to slow resistance > the muscle's force production
50
Age _____ affects muscle's ability to produce force
negatively
51
maximum strength gains occur at _____ years
- 20-25 years
52
After the age __, strength decline is___ % per year
- 25
| - 1%
53
Age 40 has ____ % of force production at 25 years
- 85%
54
Age 60 has __% of force production at 25 years
65%
55
Age 85 has 40% of force production at 25 years
40%
56
________ stability is maintenance of posture and balance
Static
57
____ Stability is production and control of movement
Dynamic
58
_____ stability are prime movers (Rectus abdomens, paraspinals , obliques)
Global
59
___ stability are segmental stability ( Transverse abdomens, multifidus)
local
60
Name the Abdominal wall muscles
- internal oblique
- external oblique
- transverse abdominis
61
How can you test for endurance of the core muscles?
- Biering- Sorenson extensor endurance test
| - Side support test
62
How do you test for Abdominal Strength
-SLR test
63
How should core stabilization exercises be approached?
- focus on endurance and strength
- avoid loading end range of motion positions
- encourage abdominal coactivation
- use abdominal bracing during exercises
- challenge the entire kinetic chain
64
Describe the Neurophysiological Model
- Uses kinetic energy that is produced when muscle is place on a quick stretch
- Muscles spindles activated during quick stretch
- Reflexive message sent to spinal cord
- Muscle tension increases for a short time (.15 sec)
65
Explain the Stretch Shortening Cycle
it is stored kinetic energy in the SEC and through the stretch reflex
66
Three phases of plyometric exercises are:
1. Eccentric / down phase
2. Amortization/ Transition phase
3. Concentric / up Phase
67
What occurs in the eccentric/down phase
- Agonist muscles are being stretch/loaded
- Muscle spindles are stimulated
- SEC starts storing kinetic energy
68
What occurs in the Amortization/ transition phase
- Brief, strong, isometric contraction is produced
| Ia afferent nerves synapse with the alpha motor neuron
69
What occurs in the Concentric phase/ Up phase
`1. Agonist muscles contract and uses stored energy
70
What is required before implementing a plyometric program
adequate strength
71
What are the guidelines to be met for max speed
- 5 squats in 5 seconds with 60% of body weight
| - 5 bench presses in 5 seconds with 60% body weight
72
Explain what isokinetic exercise is
- is a form of resistance exercise performed at a constant velocity
- results in changes in muscle length but velocity of the contraction is controlled by a preset constant velocity
- is performed on isokinetic machines
- uses a speed that the pt must meet
73
T/F
| Cardiac Output is the amount of blood ejected by each beat
```
false
Stroke Volume
(cardiac output= stroke volume + heart rate)
```
74
Cardiac Output may increase_____ times the resting level during high-intensity aerobic exercise
4 to 5
75
Cardiac Output Increases_____ with initiation of exercise
rapidly
76
Stroke Volume increase ____ until ______ of VO2 max is achieved
steadily
| 45%-50%
77
Heart Rate increases ___ with VO2 max and exercise intensity
linearly
78
_____ is responsible for increases in cardiac output once maximal stroke volume is achieved
Heart Rate
79
Muscles can receive up to _____ of total blood flow during maximal endurance training
80-90%
80
What produces quick energy by the use of ATP and creatine phosphate. involved in short duration high intensity and supplies the body with energy for 5-20 sec
Phosphagen System
81
_____ is the break down of glucose to pyretic acid
Glycolysis
82
What happens to aerobic capacity and O2 consumption after the age of 25
- Aerobic capacity decreased 1% a year
| - Maximal O2 consumption decreases 5-15% decade
83
During aquatic exercise, the body will float by placing ____ directly above ___
- Center of gravity
| - center of buoyancy
84
Aquatic exercise toward the surface= ______
buoyancy - assisted exercise
85
Aquatic exercise toward the bottom = ______
buoyancy resisted exercise
86
_____ provides an excellent source of resistance or drag
viscosity
87
The viscosity of water is ____ greater than that of air, so there is _____ resistance to movement in water
- 15 times
| - greater
88
Viscosity allows Muscle ____ without ____
- strengthening
| - weights
89
Viscosity coupled with buoyancy allows ______________
strengthening with decreased stress on the joints
90
How is Hydrostatic Pressure beneficial to therapy
- decrease swelling and improve joint position
- produces force perpendicular to the body
- provides positional awareness, which improves proprioception
- assists in decreasing joint and soft tissue swelling that result after injury or arthritis
91
Name some indications for aquatic exercise
- weight - bearing restrictions
- decrease in pain
- promote early mobility because limited Rom
- increased circulation
- assist in coordination, proprioception and balance
- help with neuromotor timing
- assists with sensory integration, especially with pediatrics
- great motivational and psychological tool
- help improve activity with clients who are deconditioned
92
Name some Precautions for aquatic exercises
- respiratory conditions (COPD)
- Cardiac conditions
- complications with pregnancy
- Decrease core temp
- Ear conditions
- Braces
- Anxiety of water
- Diabetes
- meds that alter cognition
- tactile or temp hypersensitivity
- othrostatic hypotension
- Hx of allergies
- easy for client to get overworked in water
- any precaution on land
93
Name the contraindications for aquatic exercises
- very unstable vital signs
| - Lung capacity
94
If a patient demonstrates any of the following, the aquatic exercise should be stopped
1. shortness of breath , weakness or fatigue
2. Faint, lightheaded, dizzy
3. Nausea
- Red faced of flushed
5. pain / pressured in chest
6. pounding or irregular heartbeat
7. confusion or loss of sense of direction
95
the _____ system is a key component of the sensory information from the musculoskeletal to our nervous system
Somatosensory
96
the ___ system provides feedback regarding the position of the head
Vestibular system
97
receptors in the _____, along with the otoliths, detect positional changes of the head
semicircular canal
98
_____ receptors are located in soft tissue structures and provide information regarding joint position and tissue strain
joint receptors
99
list some joint receptors
- Ruffini
- pacinian corpuscles
- golgi tendon organ - like receptors
- free nerve endings
100
______ found near musculotendinous junctions and they monitor muscle tension or effort force production
Golgi tendon organs
101
_____ located in the muscles and they transmit information regarding muscle length change or rate of change to the CNS
Muscle Spindles
