Midterm Flashcards Preview

PT > Midterm > Flashcards

Flashcards in Midterm Deck (101)
Loading flashcards...
1

An evaluation Process Should be :

- Performed after the first treatment
- performed prior to and after each additional treatment
- modified and progressed as needed

2

What should be included in a subjective History:

- 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

What should be in the objective evaluation

- Visual inspection for posture, gai, functional performance
- Asseses factors directly or indirectly contributing the dysfunction
- Palpation
- ROM(pain, goniometric measurements)

4

What is in the acute protective phase?

- Patient education
- Active/ passive ROM
- Muscle setting ( isometric exercises)
- Multiangle isometrics
- exercises to maintain other body areas

5

Promotion from protective to moderate protective phase (subacute) :

- 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

Promotion from Moderate to minimum protection phase ( chronic)

- full pain free ROM
- Strength 80% of opposite side

7

Minimum Protective Phase (chronic)

- continue whole body and cardiovascular exercise
- functional activités
- Plyometrics

8

Name some adverse reactions to exercises

- Increased pain
- increased inflammation
- decreased ROM
- increased recovery time

9

_____ = Fluid connective tissue

Liquid Matrix

10

______= Fibroconnective tissue

- poor blood supply
- high fiber density extracellular matrix
- Adipose tissue, tendons , ligaments

11

_______ = Supportive connective tissue

- rigid extracellular matrix
- cartilage - poor blood supply
- Bone - rich blood supply

12

Name some examples of acute trauma

- Abrasions, incisions, lacerations, avulsions , punctures
- Contusions
- strains
- sprains
- Fx's
-Neuropraxia
- axonotmesis
- Neurotmesis

13

Name some examples of Chronic/repetitive trauma

- tendinosis
- tenosynovitis
- stress fx
- neuralgia
- neuroma

14

Schwann cells are more likely ton regenerate if ________

new axon branches are able to make contact

15

Regeneration occurs at a slow rate of _____

2-4mm/day

16

_____ and _____ cells play a major role in regeneration of muscle healing

- Satellite
- dormant progenitor

17

A balance between ______ and ____ must be created to allow for optimal regeneration

-immobilization
- movement

18

List some competencies for therapeutic exercises

1. explain the stress - response model
2. explain the physiological and emotional response to trauma
3. describe the basic principle of interaction among different factors
4. explain the importance of providing health care information to all involved in patient care
5. explain the basic techniques of counseling and communication

19

What are the four stages of rehabilitation according to Taylor and Will

1. ROM and rest
2. Strength
3. coordination
4. Return to Play

20

ROM should be assessed for :

1. Quality of movement
2. Quantity of movement
3. Pain associated with movement

21

What the indications for Active ROM

- patients who need to increase :
- ROM
-Muscular Strength
- Neuromuscular Control
- Flexibility

22

What are some Contraindications For Active ROM

- muscle contraction causes pain
- places unneeded stress on healing tissue
- abnormal motion is present
- structure is unstable

23

Name some indications of Passive ROM

- Regain ROM
- Increase ROM
- Maintain ROM

24

name some contraindications for Passive ROM

- 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