Quiz 2 Flashcards
(136 cards)
1
Q
List the 3 types of muscle tissues, the nervous system they control, and their function
A
Skeletal (Striated): Voluntary, exerts force on bones to create movement at a joint
Smooth (Non-striated): Involuntary, regulates movement of material through the hollow organs of the body
Cardiac (Striated): Involuntary, specialized tissue that regulates the pumping action of the heart
2
Q
Differentiate between epimysium, perimysium, and endomysium
A
Epimysium: Fascia that encases the entire muscle (outermost layer)
Perimysium: Bundles of muscle fibers that are grouped together by fascia, and located within the epimysium
Endomysium: Individual muscle fibers wrapped in fascia, located within the perimysium (innermost layer)
3
Q
What is a sarcomere?
A
The individual contractile unit of a muscle fiber
The length is from one Z band to another
I Bands: Light area, thin filament, made up of actin
A Bands: Dark area, thick filament, made up of myosin
[Note: Myofilaments (actin and myosin) form the zone and bands within the sarcomere]
4
Q
What is connective tissue?
A
Made up of dozens of proteins including collagen
Two major physical properties:
- Tensile strength
- Relative inextensibility
Connective tissue within the muscle is made up of elastic fibers
Elastic fibers are almost found with collagen fibers
5
Q
T or F? Structures with large amounts of collagen tend to limit motion and resist stretch
A
True
(think ligaments and tendons)
6
Q
The ability for skeletal muscle to contract depends on what?
A
- Maximal force production
- Speed of contraction
- Muscle fiber efficiency
7
Q
What is the sliding filament theory?
A
Once binging site is exposed, myosin heads from the thick filament attach to
the exposed binding sites on the thin filament and cross-bridges are formed
8
Q
T or F? Abnormal movement typically begins with neurological changes that control movement, followed by structural changes
A
True
9
Q
T or F? Muscles can shorten in as little as 4-6 week when held in passively shortened positions
A
False, 2-4 weeks
10
Q
What are the two types of musculotendinous receptors?
A
Golgi tendon organs (GTO) and muscle spindle
11
Q
Describe Golgi Tendon Organs (GTO)
A
- Connects approximately 15-20 muscle fibers
- Located between the muscle belly and it’s tendon
- Can sense increased muscle tension when contracted or stretched
- INHIBITS antagonist muscle
12
Q
Describe a muscle spindle
A
- Located in the muscle belly and lies parallel with muscle fibers
- Inhibits antagonist and facilitates agonist
- Causes a stretch reflex contraction
- Has both a static and dynamic component
13
Q
Describe the static and dynamic components of a muscle spindle
A
Static Component:
- Fires all the time
- Provides structural info, fires more rapidly as the muscle becomes stretched
Dynamic Component:
- Fires with sudden changes in position
- Provides movement inro like velocity and direction
14
Q
T or F? GTOs and muscle spindles work together through their reflexive actions to regulate muscle stiffness
A
True
15
Q
Chronic hypertrophy is associated with what?
A
- Structural changes in the size of existing individual muscle fibers
- Number of muscle fibers
16
Q
What is muscle fiber hyperplasia?
A
Defined as the increase of muscle fibers
- Individual muscle fibers can split into two daughter cells, which then develop into new muscle fibers
17
Q
What is muscle atrophy?
A
The loss of muscle size and strength
reasons for atrophy:
- disuse
- aging
18
Q
What is sarcopenia?
A
Atrophy caused by the aging process
- May also be related to decreased ability for the motor unit end plate to continuously repair and reconstruct with advancing age
19
Q
What do the following abbreviations mean?
PROM
AAROM
AROM
A
- Passive range of motion
- Active assisted range of motion
- Active range of motion
20
Q
What are the two types of contraction?
A
Open Kinetic Chain and Closed Kinetic Chain
21
Q
What does isokinetic mean?
A
“same speed”
22
Q
What does “isotonic” mean?
A
“same resistance”
23
Q
What is myostatic contracture (stretching)?
A
Permanent shortening
24
Q
What does FITT stand for?
A
Frequency, Intensity, Timing, Type
25
Differentiate between strain and sprain
Musculotendinous (strain), ligament (sprain)
26
Differentiate between the 3 classes of tissue injury
Grade 1:
- Mild pain at the time of injury
- Mild swelling
- Minimal tearing
Grade 2:
- Moderate pain that requires stopping of the activity
- Stress and palpation of tissue will increase pain
- Moderate tearing
Grade 3:
- Near or complete tear
- Stress to the torn tissue is usually painless
27
What are the 3 phases of healing and their time frames
Inflammation: 4-6 days
Proliferation: 4-24 days
Remodeling: 21 days to 2 years
28
Describe the inflammatory phase
- 0-6 days
- vascular changes (vasoconstriction to vasodilation)
- hemostasis occurs
Signs:
- pain at rest
- redness
- swelling
- warmth
- loss of function
- muscle guarding
29
How do you treat a patient during the inflammatory phase? (use POLICE)
P: Protect
OL: Optimal Loading
I: Ice
C: Compression
E: Elevation
30
Describe the proliferative phase
Granulation tissue formation
Signs:
- decreased inflammation
- pain with tissue resistance
31
Describe the remodeling phase
- 21 days to 2 years
- Maturation of connective tissue
- Scar remodeling
Clinical Signs:
- Absence of inflammation
- Pain after tissue resistance
Intervention:
- Stretching
- Strengthening
- Mobility
32
List the normal healing times for the following injuries and their stages
Muscle
- Grade 1: 1-4 weeks
- Grade 2: 3-12 weeks
- Grade 3: 1-6 months
Tendon
- Tendonitis: 3-7 weeks
- Tendonosis: 3-6 months
Ligament
- Grade 1: 1-4 weeks
- Grade 2: 4 weeks to 6 months
- Grade 3: 6-12 months
Meniscus/Labrum: 3-12 months
Bone: 6-12 weeks
33
Differentiate between the different grades of a muscle injury
Grade 1: Small tears (extend to <10% muscle thickness)
Grade 2: Moderate tears (extend to 10-50% muscle thickness)
Grade 3: Significant tears (extending to >50% muscle thickness)
Grade 4: Complete tears
34
T or F? Healing requires approximately 20% more calories than normal, and protein intake should be higher
True
35
List the vitamins and their role in healing
Glucose:
- Energy
Vitamin C:
- Wound healing
- Tissue repair
- Immune function
Vitamin D:
- Bone health and immune function
Vitamin A:
- Cell growth and immune function
36
Which factors impact healing?
- Aging
- Diabetes
- Infections
- Stress
- Medications
- Lifestyle (alcohol, smoking, obesity)
37
What are the causes of mobility impairments?
prolonged immobilization, pain, swelling/inflammation, joint effusion, sedentary lifestyle, postural changes
38
List the affects of immobilization on muscle
- Atrophy
- Decreased muscle tone
- Increased fatigue
- Increase connective tissue
- Muscle fibers are replaced with fatty tissue
39
List the affects of immobilization on tendons and ligaments
- Changes in collagen cross linking
- Collagen weakness
- Bone-tendon insertional site weakness
40
List the affects of immobilization on articular cartilage
- Decreased thickness
- Chondral softening
- Decreased chondrocytes
- Irregular articular cartilage surface
- Decreased synovial fluid
41
List the affects of immobilization on bone and joint capsule
- Bone resorption as a loss of loading
- Disuse osteoporosis
- Decreased joint capsule size
42
Differentiate between the three different extents of soft tissue change
Elastic: Back to resting length
Plastic: New and greater length after stretch
Viscoelastic: Time dependent, slowly lengthens (goes back to resting length after stretch)
43
Differentiate between contractile and non-contractile
Contractile: Has the ability to contract (muscle)
Non-contractile: Does not have the ability to contract (tendons and ligaments)
44
What is connective tissue made up of?
Collagen, Elastin/retaculin, and nonfibrous ground substance
45
Collagen fibers are responsible for...
strength and stiffness of tissue
46
T or F? Collagen fibers withstand high tensile loads while proteoglycans withstand high compressive loads
True
47
List the affects of inactivity on collagen strength
- Decreased size and number of collagen fibers
- Increased percent of elastin to collagen = increased tissue compliance
- Collagen fiber weakness = decreased stiffness
48
List the affects of corticosteroid on collagen strength
- Decreased organization of collagen fibers
- Decreased collagen fiber synthesis
- Decreased strength of collagen fibers
- Necrosis of collagen near the injection site
49
List the affect of age on collagen strength
- Decreased stiffness and strength of collagen fibers
- Slower adaptation to loads placed on tissues
50
Describe the collagen fiber orientation of tendons, skin, ligaments/jointcapsules/fascia
Tendons:
- Collagen fibers are parallel
- Resists greatest tensile load
Skin:
- Collagen fibers are random
- Limited resistance to tensile load
Ligaments/jointcapsules/fascia:
- Collagen fibers vary
- Resists multidirectional forces
51
What is "creep"?
Long stretch, low load (if a person holds a stretch for an extended period of time, it will lengthen very slowly)
52
What are the three types of stretching?
Static (good for increasing length)
- Long duration
- Low load
Ballistic (tissue trauma, greater residual soreness)
- Short duration
- High velocity (and rapid)
Dynamic (before activities, enhances performance)
- Short duration
- Low velocity
53
What are the phases of a dynamic warmup?
Phase 1: Gradual increase in HR and breathing
Phase 2: Joint mobilization to increase temp
Phase 3: Short dynamic, active stretches
54
T or F? Most injuries occur in the eccentric phase of activity?
True
55
What are the functions of glucose, vitamin a, vitamin c, and vitamin d?
Glucose: Energy
Vitamin A: Cell growth and development/immune function
Vitamin C: Wound healing, tissue repair, immune function
Vitamin D: Bone health and immune function
56
What are the functions of magnesium, copper, zinc, and iron?
Magnesium: Protein/collagen synthesis
Copper: Collagen cross-linking
Zinc: Wound healing, protein synthesis
Iron: Collagen production
57
Which vitamins/minerals are recommended after a bone injury?
- Calcium
- Vitamin D
- Vitamin K2
58
T or F? Elderly males heal slower than elderly females
True, because wound healing is largely affected by estrogen
59
Which factors affect healing?
Diabetes, infection, stress, medications, lifestyle (smoking, alcohol, obesity)
60
List the indications and contraindications of stretching
Indications:
- Scar tissue formation
- Adhesions
- Contractures
- Muscle weakness
Contraindications:
- Bony end feel
- Recent fracture
- Osteoporosis
- Acute inflammation or infection
- Hypermobility
61
Describe the 4 parts of the stress-strain curve
Toe region
- Collagen fibers straighten out
- Most activity occurs in this range
Elastic range (goal of dynamic stretching)
- Muscle returns to resting position after load is removed
Plastic range (goal of static stretching)
- Permanent tissue deformation
- Doesn't return to resting position after release
- Collagen fibers rupture
Failure point
- Tissue ruptures
62
When is a 5 minute warmup without a recovery interval ideal?
When is a 15 minute warmup with a 5 minute recovery interval ideal?
5 min warmup, no recovery: Better power output if anaerobic exercise is done right after
15 min warmup, 5 min recovery: Better for improving mean and peak power in anaerobic exercise
63
T or F? 6-10% of bodyweight resistance with dynamic warmup is ideal
True
64
What are the 4 signs of overload?
- Pain
- Tenderness
- Swelling
- Warmth
65
List the parameters for stretching
- 2-3 sets, 30-60 seconds each
- 2-5x per week
66
List the types of manual, mechanical, and self stretches
Manual: Static, PNF
Self Stretch: Static, Ballistic, Dynamic, PNF
Mechanical: Device/brace/cast
67
What are the 3 types of PNF stretching?
Contract-Relax (CR), Agonist Contraction (AC), Contract-Relax Agonist Contract (CR-AC)
68
T or F? When the length of the moment arm increases, the leverage increases
True
69
T or F? Estrogen is better for healing while testosterone is better for building muscle
True
70
Humans can lose up to _____ to _____ of muscle mass between the ages of 25 to 80 years of age
1/3, 1/2
71
What is sarcopenia?
Muscle atrophy caused by age
72
CDC suggests that adults partake in at least _______ minutes of moderate exercise every week, with at least ____ days of strength training
150, 2
73
What are the 4 training principles?
- Overload: To improve a system, it needs to be exercised beyond normal loads
- Specificity: Selecting a specific exercise to improve on a particular task
- Reversibility: Training effects begin to be lost as soon as training stops
- Individuality: Variation in response to a training program between individuals
74
T or F? A longer lever arm makes an exercise more difficult while a shorter lever arm makes an exercise easier
True
75
Differentiate between inertia and momentum
Inertia: Resistance of a body to change in velocity
Momentum: Body in motion stays in motion unless acted on by an outside force
76
A body with a relative density (RD) <1 will _______, while a body with a relative density (RD) >1 will _______
Float, Sink
77
External pressure of water causes a _______ increase in blood volume, and increasing the work needed for breathing by ______
60%, 60%
78
What is hydrostatic pressure (HP)?
The pressure the fluid exerts on an object
79
T or F? Increased central blood volume combined with a more forceful contraction increases stroke volume by an average of 35% with immersion to neck level
True
80
What is PNF?
Definition: Hands on treatment used to facilitate effective patterns of movement in patients with both neurologic and MSK impairments
81
What type of grip is used for PNF?
Lumbrical grip
82
T or F? Resistance during PNF can elicit isotonic, isometric, or eccentric contractions
True
83
Differentiate between traction and approximation
Traction: Separation of joint surfaces (pulling)
Approximation/Compression: Compression of joint surfaces (pushing)
84
List and describe the different PNF patterns?
UE: D1 and D2 (flexion and extension)
LE: D1 and D2 (flexion and extension)
Chopping/Lifting: With head and trunk movement
85
Describe D1 UE Flexion
Shoulder: Flexion, Adduction, ER
Forearm: Supination
Wrist: Radial deviation
Fingers: Flexion
86
Describe D1 UE Extension
Shoulder: Extension, Abduction, IR
Forearm: Pronation
Wrist: Ulnar deviation
Fingers: Extension
87
Describe D2 UE Flexion
Shoulder: Flexion, Abduction. ER
Forearm: Supination
Wrist: Radial deviation
Fingers: Extension
88
Describe D2 UE Extension
Shoulder: Extension, Adduction, IR
Forearm: Pronation
Wrist: Ulnar deviation
Fingers: Flexion
89
Describe D1 LE Flexion
Hip: Flexion, Adduction, ER
Ankle: DF, Inversion
90
Describe D1 LE Extension
Hip: Extension, Abduction, IR
Ankle: Plantarflexion, Eversion
91
Describe D2 LE Flexion
Hip: Flexion, Abduction, IR
Ankle: Dorsiflexion, Eversion
Toes: Extension
92
Describe D2 LE Extension
Hip: Extension, Adduction, ER
Ankle: Plantarflexion, Inversion
Toes: Flexion
93
What is a chop? What is a reverse chop?
Chop: Bilateral asymmetrical UE extension with neck and trunk flexion
Reverse Chop: Bilateral asymmetrical UE flexion with neck and trunk extension
94
What is a lift? What is a reverse lift?
Lift: Bilateral asymmetrical UE flexion
Reverse Lift: Bilateral asymmetrical UE extension
95
How do PNF techniques differ with different goals?
Strengthening: Rhythmic initiation (teaches the pattern)
Stretching: Increases mobility/stretching (contract relax)
96
What is rhythmic initiation of PNF?
Promotes learning of a new movement, muscular coordination, and independent movement
Occurs in 4 phases
- Passive
- Active assisted
- Active
- Resisted
97
What is rhythmic stabilization?
Alternating isometric contractions against resistance with a goal of increasing strength and stability
98
What is facilitated stretching (hold relax)?
Limb is moved to end range of motion, performs sub-maximal contraction (5 seconds), patient then relaxes, then clinician helps patient move further into the movement
99
What does Wolff's Law state?
Bones adapt to the mechanical stress placed on them
100
Define and describe "Plyometrics"
Definition: Exercise involving repeated rapid stretching and contracting of muscles to increase muscle power
Uses elastic properties of connective tissues and the stretch reflex of the neuromuscular unit
Stored elastic energy is used during the shortening phase
101
What are the contraindications of plyometrics
- Pain, inflammation, joint stability
- Post op patients
- Inadequate flexibility and strength
Precautions include children or elderly individuals
102
How many off days/hours between two plyometric workouts?
48-72 hours (2-3 days)
103
How do you know whether or not a patient is suitable for plyometrics?
- 80-85% muscle strength
- 90% pain free ROM
- Must exhibit strength and stability of proximal regions of the body
104
How should you progress plyos?
- Speed
- Intensity
- Recovery (more reps in set)
105
Which tests can assess whether or not an athlete is ready to "return to sport"
- Triple hop
- Depth jump
- Shoulder tap test
- Hand held dynamometry
106
T or F? An athlete can have input on whether or not they believe they are ready to return to sport, but should not make the final decision
True
107
Define "strength"
The ability to generate the required force for a specific movement pattern/task
108
Define "stability"
The ability to maintain control of a joint movement or position via the coordinated actions of surrounding tissues and the neuromuscular system
(broken into either "active" or "passive" stability)
109
What is the "SAID" principle?
S - Specific
A - Adaptations
I - Imposed
D - Demands
110
The majority of patients partake in a physical therapy program between ____ and ____ weeks
6, 12
110
What are the 3 stages of the general adaptation syndrome (GAS)?
- Alarm reaction (Body's initial response to stress)
- Stage of resistance (Body strives towards restoring hemostasis after initial stress)
- Stage of exhaustion (Body is no longer able to cope)
111
Youth should participate in at least ___ mins of exercise per day
60
112
What age is considered child/pre-adolescent?
Female: 11 years old
Male: 13 years old
113
What age is considered adolescent?
Female: 12-18
Male: 14-18
114
T or F? When training youth individuals, begin each training session with a 5-10 minute dynamic warmup, followed by 1-3 sets of 6-15 repetitions (upper and lower body exercises)
(2-3x per week)
True
115
At what age can an individual begin lifting?
7 years old
116
T or F? Healing and muscle building requires increased metabolic activity
True
117
T or F? Skeletal muscle contractile protein is the largest protein reservoir
True
118
What is the optimal protein intake?
1.0-1.2g per kg of bodyweight
119
How much sleep is recommended for adolescents, children, and adults?
Children (3-5 years old): 10-13 hrs
Children (6-12 years old): 9-12 hrs
Adults/Adolescents (10-19 years old): 7-9 hrs
120
What is sleep apnea?
Breathing will start and stop while sleeping (often associated with obesity)
121
What is sleep insomnia?
The inability to fall and stay asleep
122
How much rest should a patient get after doing plyos?
3 days
123
Which principle states that a load applied with the tissue kept at a constant length will result in decreased internal tension until equilibrium is reached?
Stress relaxation
124
Which PNF pattern would be used to help a fisherman cast a line
Chop
125
Which PNF pattern would be used to help a passenger buckle their seat belt (using right hand? Lift or Reverse lift?
Reverse lift
126
What is the innermost layer of the skeletal muscle tissue?
Endomysium
127
Which type of injury impacts a muscle tendon?
Strain
128
Loading, Ice, and Elevation may be utilized during which phase of tissue healing?
Inflammatory
129
Pain occurring after the onset of tissue resistance is most consistent with which phase of tissue healing?
Remodeling phase
130
Treatment in which phase might involve single plane motion, low intensity exercise, and isometrics?
Proliferative phase
131
Which principle states that a load applied with the tissue kept at a constant length will result in decreased internal tension until equilibrium is reached?
Stress-relaxation
132
T or F? It is appropriate to use aquatic therapy when you are trying to combat the effects of osteoporosis to increase bone growth
False, you want to load the bone to strengthen it (Wolff's law)
133
When doing plyos, which phase stores potential energy?
Eccentric
134
T or F? An infected wound is an absolute contraindication to aquatic therapy
True
135
A patient is only permitted to partially weight bear <25% of their weight through their right LE. Should the patient immerge into the water up to the ASIS or C7?
C7 (the more immerged you are in water, the less stress placed on your legs)
