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1
Q

how many vertebrea in the spine?

A

29

2
Q

how many cervical vertebrea?

A

7

3
Q

how many thoracic vertebrea?

A

12

4
Q

how many lumbar vertebrea?

A

5

5
Q

how many sacral vertebrea?

A

5 - fused from sacrum

6
Q

which region of the spine is the most mobile?

A

cervical spine

7
Q

when a segment is more mobile you sacrifice what?

A

stability

8
Q

ROM flexion cervical spine

A

0-45

chin to chest

9
Q

ROM extension cervical spine

A

0-45

forehead parallel to floor

10
Q

ROM L/R side-bending

A

0-45

11
Q

ROM L/R rotation

A

0-80

12
Q

which region of the spine is the most ridged?

A

thoracic spine

13
Q

what is the main function of the thoracic spine?

A

protect the viscera

14
Q

what’s the difference btw the corstovertebra jt and the costotransverse jt?

A

costovertebral : jt btw head of rib and lat side of vertebral body (1 rib touches 2 vertebral bodies)
costotransverse : jt btw rib and transverse process of the vertebrea

15
Q

ROM flexion thoracic spine

A

20-45

16
Q

ROM extension thoracic spine

A

15-20

17
Q

ROM L/R side bending

A

25-45

18
Q

ROM L/R rotation

A

35-50

19
Q

which mvt of the spine comes mostly from the thoracic spine?

A

side bending

20
Q

F or T

ROM flexion and extension of the thoracic spine does not depend on posture

A

FALSE

21
Q

ROM lumbar flexion

A

first 60° from Lx and next 25° from hip = total 70-90

22
Q

ROM Lx extension

A

30-50

23
Q

ROM Lx side bending

A

30

24
Q

ROM Lx rotation

A

35

25
Q

what are the components oft the motion segment in the spine?

A

2 adj vertebrae that forms 3 jts (1 intervetebral jt and 2 z-joints)

26
Q

how many pairs of facets joints in the spine?

A

24

27
Q

what are the 2 major motions z-joints are capable of doing?

A
gliding upward (during spine flexion)
gliding downward (during spine extention)
28
Q

what happens if the mvt of the z-joints happen in the same direction bilaterally?

A

flexion or extension of the spine

29
Q

what happens if the mct of the L and R z-joints happen in opposite direction? (i.e upward gliding on R side and downward gliding of L side)

A

side bending

30
Q

btw which vertebrea can we find IV dics?

A

C2-S1

31
Q

what increases concavity and stability in the hip joint? (2)

A

acetabular labrum

transverse acetabular ligament

32
Q

what type of jt is the hip jt?
how many DOF?
what are tht mvt possible?

A

ball and socket
3 DOF
flex/ext, ABD/ADD, IR/ER

33
Q

which is more stable : hip or shoulder?

A

hip

34
Q

which is more mobile : hip or shoulder?

A

shoulder

35
Q

what is the primary fct of hip jt?

A

WB : support weight of upper body in static (errect) and dynamic (walking, running) postures

36
Q

Hip AROM/PROM

flexion

A

110-120

37
Q

Hip AROM/PROM

extension

A

10-15

38
Q

Hip AROM/PROM

ABD

A

45-50

39
Q

Hip AROM/PROM

ADD

A

25-30

40
Q

Hip AROM/PROM

IR (w/ hip at 90° flexion)

A

30-40

41
Q

Hip AROM/PROM

ER (w/ hip at 90° flexion)

A

40-60

42
Q

Hip EF

flexion

A

tissue approx or elastic

43
Q

Hip EF

extension

A

capsular

44
Q

Hip EF

ABD

A

elastic (tight ABD) or capsular (flexible ABD)

45
Q

Hip EF

ADD

A

tissue approx or capsular

46
Q

Hip EF

IR

A

capsular

47
Q

Hip EF

ER

A

capsular

48
Q

ROM hip

Normal gait

A

flex : 30°
ext : 10°
ABD/ADD : 5°
ER/IR : 5°

49
Q

T or F
Activities such as walking of uneven surfaces, stairs, sitting cross legged require more ROM than normal gait at the hip?

A

T

50
Q

Muscles hip

flexion

A
psoas
illiacus
sartorius
TFL
rectus femoris
pectineus
adductor brevis
adductor longus
adductor magnus
glut med
glut min
51
Q

Muscles hip

extension

A
adductor magnus (post fibers)
glut max
glut med
biveps femoris
semimem
semitend
52
Q

Muscles hip

ABD

A
sartorius
TFL
piriformis
glut mex
glut med
glut min
gemellus sup
gemellus ing
obturator internus
53
Q

Muscles hip

ADD

A
pectineus
adductor brevis
adductor longus
gracilis
adductor magnus
glut max
54
Q

Muscles hip

IR

A
TFL
glut med
glut min
semimem
semitend
55
Q

Muscles hip

ER

A
psoas
illiacus
sartorius
adductor brevis
glut max
glut med
piriformis
gemellus sup
gemellus inf
obturator internus
obturator externus
quadratus femoris
biceps femoris
56
Q

T or F

superior tibiofibular jt is part of the knee complex

A

F

57
Q

major role of knee jt?

A

supporting the body during dynamic and static activities

58
Q

AROM/PROM knee

flexion

A

135

59
Q

AROM/PROM knee

extension

A

0-15 (>0 = hyperextension)

60
Q

AROM/PROM knee

medial rotation

A

10

61
Q

AROM/PROM knee

lateral rotation

A

10

62
Q

EF knee

flexion

A

soft tissue approx (gastroc hit hamstring)

63
Q

EF knee

extension

A

capsular

64
Q

EF knee

medial rotation

A

capsular

65
Q

EF knee

internal rotation

A

capsular

66
Q

role of meniscus

A

increases the stability of the joint

help distribute WB forces by reducing friction btw jt

67
Q

what is the role of ligaments in the knee?

A

stability considering the lack of body restraint to any knee mvt

68
Q

what is a common MOI for samage to PCL?

A

fall on flexed knee

69
Q

whats the terrible triad

A

medial menisci
ACL
MCL

70
Q

what is a smtg that commonly happens during an ACL tear?

A

hear a pop

71
Q

who am i?

i resist hyperextension of the knee (tibia going too anterior)

A

ACL

72
Q

who am i?

i resist hyperflexion of the knee (tibia going too post)

A

PCL

73
Q

who am i?

i resist valgus stresses at the knee

A

MCL

74
Q

who am i?

i resist varus stresses at the knee

A

LCL

75
Q

what ligaments at the knee are not repairable with Sx?

A

MCL and LCL

76
Q

all ligaments at the knee all together restrain which mvt?

A

torsion stresses

77
Q

Muscles knee

flexion

A
sartorius
gracilis
biceps femoris
semi-mem
semi-tend
plantaris
popliteus
gastroc
78
Q

Muscles knee

extension

A

rectus femoris
vastus lat
vastus intermedius
vastuc medialis

79
Q

Muscles knee

IR

A
gracilis
sartorius
semi-mem
semi-tend
popliteus
80
Q

Muscles knee

ER

A

biceps femoris

81
Q

what is the least congruent jt in the body?

A

patellofemoral jt

82
Q

what mostly controls the paterllofemoral jt?

A

quad ms

83
Q

what is the primary role of the patellofemoral jt?

A

eccentric pully to reduce the friction btw the quad ms and the femoral condyles

84
Q

why does the patella perform its functions w/o restricting knee motions?

A

its mobility!

85
Q

what are the mvt possible at the patella?

A

med and lat tilting
med and lat rotation
med and lat glide

86
Q

failure of the parella to glide, rotate or tilt appropiately can lead to : (3)

A

restriction in knee ROM
instability of the patellofemoral jt
pain caused by erosion/friction of the patellofemoral surfaces

87
Q

Mvt of the patella

in full knee extension

A

sits on ant surface of distal femur

little or no contact w/ jt surface

88
Q

Mvt of the patella

in knee flexion

A

slides distally on femoral condyles
seating btw the femoral condyles
diff parts of patella enter into contact w/ demur

89
Q

Mvt of the patella

in full knee flexion

A

sinks into intercondylar notch

90
Q

how many bones in ankle/foot complex?

A

28

91
Q

how many articulations in ankle/foot complex?

A

55

92
Q

what is the role of jts and ligaments of ankle/foot complex?

A

stabilizers

constantly adapt during WB activites

93
Q

what are the bones of the rearfoot/hindfoot?

A

talus and calcaneus

94
Q

what are the functions of the rearfoot?

A

convert torque of the LL

infleunce fct and mvt of midfoot and forefoot

95
Q

what are the bones of the midfoot?

A

navicular
cuboid
3 cuneiforms

96
Q

what are the fct of the midfoot?

A
transmits motion from the rearfoot to the forefoot 
promotes stability (adjusting to uneven surfaces)
97
Q

what are the bones of the forefoot?

A

metatarsals

bones of the toes

98
Q

what is the function of the forefoot?

A

mobility

99
Q

what does the ankle/foot complex must meet?

A

stability and mobility

100
Q

which mvt does the talocrural(ankle) jt permit?

A

DF

PF

101
Q

ROM ankle

DF

A

20 from neutral

102
Q

ROM ankle

PF

A

30-50 from neutral

103
Q

EF ankle

DF

A

capsular

104
Q

EF ankle

PF

A

capsular

105
Q

what is the subtalar jt?

A

jt btw talus and calcaneus

106
Q

what is the role of the subtalar jt?

A

inversion and eversion of hindefoot (50% of total apparent ankle inversion/eversion)

107
Q

what is the anatomical characteristic of the subtalar jt?

A

3 articular surfaces provide a triplanar mct around a single joint axis

108
Q

ROM ankle

inversion

A

0-35

109
Q

ROM ankle

eversion

A

0-15

110
Q

what is supination of subtalar jt?

A

combined mvt of inversion , PF and ADD of calcaneus

111
Q

what is pronation of subtalar jt?

A

combined mvt of eversion, DF and ABD of calcaneus

112
Q

what are the motions at the midtarsal jt complex?

A

rotation motion into inversion and eversion
forefoot DF/ADD
forefoot PF/ABD

113
Q

what is the mistarsal jt complex?

A

talonavicular + calcaneocuboid articulations

114
Q

who am i?
during gait, i permit adaptation of the foot to uneven terrain in early stance and i provide a stable foot during terminal stance.

A

midtarsal jt complex

115
Q

what are the motion at the MTPs jt?

A

flexion/extension

ABD/ADD

116
Q

what is the motion at the IPs joint?/

A

flexion/extensions

117
Q

How many degrees of DF needed during normal gait?

A

60

118
Q

How many degrees of DF needed during sprinting, deep squatting?

A

> 90

119
Q

what is the roles of the big toe?

A

provide stability to medial aspect of foot

provide normal propulsion during gait

120
Q

Muscles ankle

PF

A
gastroc
soleus
plantaris
fibularis brevis
tibialis posterior
flexor digitorum longus
flexor hallucis longus
121
Q

Muscles ankle

DF

A

tibialis anterios
extensor digitorum longus
extensor hallucis longus
fibularis tertius

122
Q

Muscles ankle

inversion

A
tibialis anterior
extensor hallucis longus
tibialis posterior
flexor digitorum longus
flexor halluces longus
123
Q

Muscles ankle

eversion

A

extensor digitorum longus
fibularis longus
fibularis brevis
fibularis tertius

124
Q

who am i?
i am flattened saclike structures that are lined w/ a synovial membrane and filled w/ synovial fluid and i allow smooth and frictionless motion btw continuous ms, tendons, bones, ligaments, skin.

A

bursae

125
Q

signs and symptoms of bursitis?

A
inflammation
localized tenderness
warmth
edema
rednedd of the skin (if superficial)
loss of function = pt will avoid contracting ms bcs it will cause pain in bursa
126
Q

MOI of bursitis? (2)

A

too much mvt -> irritation

direct trauma on the bursa

127
Q

common bursae that become inflamed

A
subacromial 
olecranon
ilipsoas
trochanteris
ischial
prepatellar
infrapatellar
anserine
128
Q

tx for bursitis

A
  1. decrease inflammation (peace and love)
  2. once inflammatory phase finish : reassess strength, posture and mct patterns to determine why bursa is getting iritated
  3. tx to decrease risk of coming back
129
Q

what is the difference btw tendon and ligament?

A

tendon will become taut or slack dependeing on whether it is shortened or lenghtened od the ms belly is contracted
ligament will remain taut thru-out all mvt

130
Q

how to tendo transform w/ age?

A

become weaker and stiffer

131
Q

who am i?
inflammatory rx to a tendon injury
microscopic teaing and inflammation of tendon tissue
commonly resulting from fatigue than direct trauma

A

tendinitis

132
Q

who am i?
often happens in >35 y.o
degenerative process of tendon - tendon thickening
no inflammatory cells present

A

tendinosis

133
Q

signs of tendon patho

A

strong but painful contraction of involved musculotendinous structure (RISOM strong and painful)
TOP

134
Q

Tx tendon patho

A
  • inflammatory phase = PEACE and LOVE

- when inflammatory phase done of w/ tendinosis = work on factors that may be causing pain (posture, weak ms)

135
Q

MOI ligament patho

A

trauma (jt position during trauma gives you an idea of which ligaments may have been injured)

136
Q

which structure is the last line of defence in the body in a MSK injury?

A

ligaments = often before they srained, ms aroung tried to prevent it but could not

137
Q

objective signs of ligament sprain grade I

A

no bruising
min loss of fct
min loss of structural integrity

138
Q

tx ligament sprain grade I

A

work on proprioception

139
Q

objective signs ligament sprain grade II

A

significan structural weakening

bruising and swelling

140
Q

tx ligament sprain grade II

A

PEACE
may need brace, taping (to protext from further injury)
proprioception
strengthen ms around jt to prevent re-injury

141
Q

objective signs ligament sprain grade III

A

initially lots of pain
bruising and swelling
loss of structural integrity
marked abnormal motion

142
Q

tx ligament sprain grade III

A

may need Sx (not for ankle tear)
proprioception
strengthening of surrounding ms

143
Q

MOI ms strain?

A

fatigue
overuse or improper use
trauma

144
Q

Signs 1st degree ms strain?

A

no or min loss of strength and restriction of mvt
minor swelling and discomfort
local tenderness may be present
tenderness increases when ms is stretched
pain with ms contractiong and stretching
RISOM = strong but painful

145
Q

tx 1st degree ms strain?

A

pt can continue normal activity but monitored not to exacerbate the injury
inflammatory phase : PEACE
strenghen ms : eccentric, concentric, functional
proprioception

146
Q

signs 2nd degree strain?

A
clear loss of strength
pain when using the ms (stretching and contracting)
moderate to severe pain
brusing and swelling (major sign)
some loss of fct and stability
147
Q

tx 2nd degree ms strain?

A

3-28 days of rehab
inflammatory phase : PEACE
strenghen ms : eccentric, concentric, functional
proprioception

148
Q

signs 3rd degree strain?

A

severe pain
loss of fct initually - no pain w/ contraction
once inflammatory phase id done may have to pain
pt unable to contract ms and uses synergist ms to move the jt

149
Q

tx 3rd degree ms strain?

A

surgical intervention is often necessary
3 weeks - 3 months of rehab
educate about swelling and bruising
effleurage to help w/ bruising

150
Q

signs of hypomobility? (2)

A

decreased ROM

early capsular EF

151
Q

tx hypomobility? (2)

A

ROM exs

mobilisation

152
Q

signs generalized hyperbomobility? (2)

A

multiple joitn hyperlaxity

increased ROM bila and at multiple jt

153
Q

when does local hypermobility occur?

A

reaction to neighbouring stiffness (hypomobility) or injury

154
Q

signs local hypermobility? (2)

A

increased ROM when compared to the other side

normal EF

155
Q

tx local hypermobility? (3)

A
  1. find stiffness and work on hypomobility
  2. education pt not to stay at end range for prolonged periods
  3. strengthen ms around jt
156
Q

what’s the difference btw the anatomical jt and the physiological jt?

A

anatomical jt = articular surfaces + jt capsule + ligaments + intra-articular structures = inert structures

physiological jt (jt complex) = anatomical jt + ms + tendons + nerves + blood vessels = contractile structures

157
Q

what type of jts are synovial jts?

A

diarthrosis

158
Q

in which types of jt can hypo/hypermobility occur?

A

diarthrosis

159
Q

T or F

synarthrosis allows a lot of mvt

A

FALSE

160
Q

how do we call a synarthrosis w/ fibrous tissue?

give an example.

A

syndesmosis

between radius ans ulna

161
Q

how do we call synarthrosis w/ cartilage?

give an example.

A

synchondrosis

pubic symphysis

162
Q

how do we call a synarthrosis w/ bone?

give an example.

A

synostosis

bones of the skull

163
Q

who am i?

study of the mvt of one articular surface on another w/o regard to the mvt of the bone or the forces producing the mvt.

A

arthrokinematics

164
Q

which mvt does arthrokinematics decribe? (4)

A

slides
glides
spins
swings

165
Q

who am i?

study and measurement of motion of a bone in space (from the anatomical position)

A

osteokinematics

166
Q

which mvt does osteokinematic decribe? (2)

A

osteokinematic rotaiton

translation

167
Q

explain the convex-concave rule.

A

if convex bone moves on the concave bone : the convex bone will move in the opposite direction of the glide occuring at the jt
if concave bone moves on convex bone, the concave bone will move in the same direction of the gldide occuring at the jt
NB :distal bone always move on proximal bone

168
Q

who am i?

i am a type of synovial jt that pairs together only one pair of articulating surfaces.

A

simple

eg : knee

169
Q

who am i?

i am a type of synovial jt that includes more than one articulating pair in a single capsule.

A

compound

eg : elbow

170
Q

who am i?

i am a type of synovial jt that has an articular disc.

A

complex

eg : sternoclavicular

171
Q

who are the 2 only jts in the body that has 3 DOF?

A

shoulder

hip

172
Q

how many DOF can allow a unmodified ovoid jt?

give an example.

A

3

hip

173
Q

how many DOF can allow a modified ovoid?

give an example.

A

2

MCP

174
Q

how many DOF can allow an unmodified sellar jt?

A

2

175
Q

which jt is the only unmodified sellar jt in the body?

A

1st CMC

176
Q

how many DOF can allow a modified sellar jt?

give an example.

A

1

IP jts

177
Q

what patho/injury happens in the resting position commonly? why?

A

capsular or lgament sprains

this position causs the brunt of any external force to beb borne by the jt capsule or surrounding ligaments

178
Q

in which position we do mobilizations?

A

resting position

179
Q

what patho/injuries happen in closed packed position?

why?

A

fractures and dislocations

maximal stability of joint so no further motion is possible in that direction

180
Q

in which position there is minimal jt volume?

A

closed packed position

181
Q

in which position there is minimal jt surface contact?

A

resting position

182
Q

in which position the jt capsule and ligaments are tight or maximally tensed?

A

closed-packed position

183
Q

in which position there is maximal contact btw the concave and convex articualr surfaces?

A

closed-packed position

184
Q

in which position the periarticular structures are most lax and allow the greatest ROM?

A

resting postition

185
Q

in which position there is maximal jt volume?

A

resting position

186
Q

what is the patient’s position of comfort (symptom-relieving)?

A

resting position

187
Q

what are the major 2 systems that plays a role in balance?

A

visual and somatosensory

188
Q

T or F

proprioception is dependent of vision

A

F

189
Q

what triggers ms spindles in the body?

A

rapid/excessive ms lengthening

190
Q

wha’ts the response of ms spindles?

whats the name of this reflex?

A

ms contraction

myotactic reflex

191
Q

whats the main role of ms spindles clinically?

A

protective against acute injury = contracts muscles that has been lengthen too much to protect the fibers from tearing

192
Q

what’s the trigger of golgi tendon organ?

A

excessive ms contraction OR passsive stretch

193
Q

what’s the response of golgi tendon organ?

what’s the name of this reflex&

A

inhibition of the agonist and contraction of the antogonist

inverse myotactic reflex

194
Q

what’s the main role of golgi tendon organs?

A

decreasing the tension on the agotnist ms

195
Q

who am i?
i allow to relax an agonist muscle while contracting hte antoganist ms. i cam be done by ms spindles and goldi tendon organs. i allow smooth coordinated mvt of the body.

A

reciprocal inhibition

196
Q

what’s the role of mechanoreceptor in proprioception?

A

by registering the speed and amount of deformation, they indicate position and mvt of their associated structures.

197
Q

name 2 types of mechanoreceptors and where we can find them.

A

pacinian corpuscules = skin, connective tissues, ms and tendons
ruffini corpuscules = jt capsules

198
Q

what’s the trigger of pacinian corpuscule?

A

vibration and deep pressure

199
Q

what’s the trigger of ruffini corpuscule?

A

distortion of jt capsule

200
Q

why is balance important in rehab?

A

dictates mvt strategies w/i the CKC

201
Q

what are the 2 reasons that can explain why a person can have impaired balance CLINICALLY?

A
  1. position of COG relative to the base of support is not accurately sensed
  2. automatic mvt required to bring the COG to a balanced position are not timely or effectively coordinated
202
Q

T OR F

Proprioceptive exercises should begin as early as possible in the rehab program even if NWB.

A

T

203
Q

T or F

Proprioceptive exercises cannon reduce the rate of recurrence injuries.

A

F

204
Q

T or F

It’s normal to feel pain when doing proprioceptive exercises.

A

F

205
Q

What are the 3 phases of proprioceptive exercises?

A
  1. Static stabilization w/ CKC loading and unloading (weight shifting)
  2. Transitional stabilization X = stimulation of dynamic postural responses
  3. Dynamic stabilization X = jumping, running
206
Q

give an example of weight shifting X for UE.

A

standing and leaning on a tx table

….

207
Q

give an example of partiel WB LE X.

A

walking with support ensuring correct heel-toe mvt

….

208
Q

what should proprioceptive X always include?

A

sudden alteration in jt positioning

209
Q

which axis runs from left to right?

A

frontal

210
Q

which axis runs in a dorsal-ventral direction?

A

sagittal

211
Q

which axis runs in a cranial-caudal direction?

A

longitudinal

212
Q

which plane divides the body into R and L halves?

A

sagittal

213
Q

which plane divides the body into anterior and posterior halves?

A

frontal

214
Q

which plane divide the body into cranial and caudal halves?

A

transverse

215
Q

what’s the use of OP during AROM?

a) if ROM is full
b) if ROM is not full

A

a) screen for EF but not the real one

b) screen for pain with pressure

216
Q

if AROM w/ OP is full, mandatory to do PROM?

A

no

217
Q

what are the normal EF? (4)

A

bony
capsular
elastic (stretching of ms/tendon)
soft tissue approximation (eg : ms bump into ms)

218
Q

what are the abnormal EF? (7)

A
ms spasm
springy block
loose/soft
spongy
early capsular
hard
empty
219
Q

soreness in ms is normal for how much time after X?

A

24-48h

220
Q

Rest time btw ea sets?

A

60-90 sec

221
Q

rest time btw strengthening sessions?

A

48h

222
Q

Any discomfort/reproduction of sx that lasts more than ___ after the intervention is unacceptable.

A

1-2hrs
*normal to go up 2 pts on VAS during X but should return to baseline line w/i 2hrs following the X
FOR ANY X (strengthening and flexibility)

223
Q

Number of reps for low intensity strengthening exercise?

A

10-15

224
Q

Number of reps for moderate intensity strengthening exercise?

A

8-10

225
Q

Number of reps for high intensity strengthening exercise?

A

6-8

226
Q

Modalities for isometric strengthening exercises?

A

Frequency : every day
Hold : 6 sec
Reps : 1-10
Intensity : low-moderate

227
Q

when is isometric X used? (2)

A
  1. when jt mvt is restricted

2. to prevent atrophy and decrease go structures strength

228
Q

Modalities to increase ROM following acute injury or painful condition?

A

Intensity : low
Duration : no hold or 0-5 sec
Reps : 5-10
Frequency : 2-5x/day

229
Q

Modalities to increase ROM of hypomobile joint OR lexibility of relatively short ms?

A
Intensity : moderate senstaion of stretch
Duration : 10-30 sec
Reps : 2-6 
Frequency : 2-3/week
OP is needed
230
Q

when is eccentric X used? (4)

A
  1. déconditioned or low endurance pt
  2. tendonitis presentations
  3. plateaus in strength gains
  4. late-stage rehab and performance training
231
Q

for muscle endurance, how many reps per set?

A

> 20

232
Q

what kind of dysfunction is this?
AROM and PROM painful and limited
RISOM not painful

A

Inert

233
Q

when there’s pain and limitation in every direction and early caps EF, what pathology is it?

A

capsular pattern

234
Q

True or False

Only joints that are controlled by ms can have a capsular pattern.

A

T

235
Q

Characteristics of capsular pattern in wrist?

A

flexion and extension equally limited

236
Q

Characteristics of capsular pattern in elbow

A

flexion limitation > extension limitation

237
Q

Characteristics of capsular pattern in shoulder.

A

ER limitation > ABD > IR

Flexion/extension lightly limited

238
Q

Hypermobility in one direction is a sign of what?

A

Ligament or capsule injury

239
Q

RISOM painful and strong

A

minor, local lesion of ms/tendon (1st or 2nd degree strain)

240
Q

RISOM painful and weak

A

major lesion of ms/tendon (3rd degree strain or avulsion fracture)

241
Q

RISOM painless and weak

A

neuro lesion or complete rupture of ms/tenson

242
Q

RISOM painless and strong

A

normal

243
Q

how much time to achieve a short term goal?

A

1-2 weeks

244
Q

how much time to achieve a long term goal?

A

4-6 weeks

245
Q

what are the 5 components of a functional goal?

A
Actor
Behaviour
Condition
Degree
Expected time
246
Q

who am i?

the contact of two bones is limiting the mvt

A

bony EF

247
Q

who am i?

jt capsule provides firm limitation; hard arrest to mvt w/ sime give when the capsule or ligaments are stretched

A

capsular EF

248
Q

who am i?

stretching of ms/tendon - more elastic feel

A

elastic EF

249
Q

who am i?

tissues meet each other and stop the mvt

A

soft tissue approximation EF

250
Q

who am i?

protection mechanism - feels jerky or shaky - injured tissue

A

muscle spasm EF

251
Q

who am i?

bouncy stoppage that occurs prior to end range - usually torn cartilage, or foreign body in the jt

A

springy block EF

252
Q

who am i?

abnormal motion is allowed where a ligament or joint capsule should prevent it

A

loose/soft EF

253
Q

who am i?

squishy or boggy - indicating swelling in the jt

A

spongy EF

254
Q

who am i?

bone contacts bone

A

hard EF

255
Q

who am i?

hypomobility

A

early capsular EF

256
Q

who am i?

produced solely by pain, PT feels no tissue resistance - indicative of serious patho

A

empty

257
Q

if pain is present before resistnace or EF, the pt symptoms are considered____

A

irritable

258
Q

signs of inert dysfunction (3)

A
  1. AROM and PROM are painful in same direction
  2. pain occurs as the end range approach
  3. RISOM can be painful if some compression appearing at the jts
259
Q

when are capsular pattern assesed?

A

PROM and EF

260
Q

signs of contractile dysfunction? (2)

A

AROM and PROM produce or increase pain ptomes and are restricted in opposite direction
RISOM prod or increase pain

261
Q

what are the 2 most important and precise tx principles? when are they used?

A
  1. control pain and inflammation (acute)

2. promote and progress healing (subacute)

262
Q

when pt is inflammed what is a sign with PROM?

A

pain inreported before tissue resistance is felt by clinician

263
Q

when is PEACE used?

what does it stand for?

A
immediately following a soft tissue injury (1-3 days)
P - protect
E - elevate
A - avoid anti-inflammatories
C - compression (taping, bandages)
E - educate
264
Q

what are the goals during the inital phase of intervention for acute lesions? (6)

A
  1. decrease pain
  2. control edema and inflammation
  3. protect from further damage
  4. improve ROM
  5. reduce ms atrophy - isometric X
  6. maintain aerobic fitness
265
Q

what is the best use of ice?

A

ice the structure for 10 mins after an irritation

266
Q

when is LOVE used?

what does it stand for?

A
3-5 days post soft tissue injury
L = load (don't wait for inflammatory phase to be done, start as soon as painhas reduced)
O = optimism
V = vascularisation = aerobic X
E = exercise
267
Q

The rehab procedures depend on … (3)

A

type of tissue involved
extent of the damage
stage of healing

268
Q

in which phase of healing do we find these clinical findings?

  • decrease pain and swelling
  • increase in pain-free AROM and PROM
  • pain and tissue resistnc occur at the same time during PROM
  • ROM still not WNL
A

proliferative

269
Q

when to we expect full ROM following a soft tissue injury?

A

3-4 weeks (proliferative)

270
Q

in which phase of healing do we find this clinical finding?

- pain typically felt at the end of range w/ PROM, after tissue resistance has been encountered by clinician

A

remodelling

271
Q

when does the inflammatory phase happen?

A

first 48-72hrs and up to 10 days

272
Q

when does the proliferative phase happen?

A

from day 3 and last 3-6 weeks

273
Q

when does the remodelling phase happen?

A

from day 9 and lasts 6 weeks to 12 months

274
Q

pain occurs when in proliferative phase?

A

w/ activity or motion of involved area

275
Q

pain occurs when in remodelling phase?

A

after the activity

276
Q

if morning stiffness last <1h , what is the nature of pain?

A

mechanical

277
Q

what are the 3 red flags?

A

cancer
cardiovascular system
neurological

278
Q

gait patterns tends to be variable and irregular until __ y.o

A

7

279
Q

what is a gait cycle?

A

what happens in 1 leg between 2 consecutive initial contact w/ the floor

280
Q

what are the 2 phases of the gait cycle? and what are there proportions?

A
stance phase (60-65%)
swing phase (35-40%)
281
Q

in a gait cycle :

  • how many single stance periods?
  • how many double stance periods?
A
  • 1

- 2

282
Q

what are the 5 subphases of the stance phase? briefly describe them.

A
  1. initial contact = heel strike, period of double leg stance
  2. load response = flat foot, single-led stance
  3. midstance = single-leg stance
  4. terminal stance = heel off, double-stance
  5. preswing = toe push off, double-stance
283
Q

what are the 3 subphases of the swing phase? briefly describe them.

A
  1. initial swing = acceleration, rapid knee flex and DF
  2. midswing
  3. terminal swing = deceleration, active quads to control knee ext, active hamstring to control hip flexion
284
Q

what is the normal expected base/step width?

A

5-10 cm

285
Q

what is the difference btw the step length and the stride length?

A

step : distance btw contact of R foot on the floor and L foot on the floor
stride = gait cycle = distance btw foot-to-floor contact of the same foot

286
Q

what is the purposes og lateral pelvic shift during gait? (2)

A
  1. center the weight of body over the stance leg for balance

2. ADD of WB limb

287
Q

if feet are farther apart what happens to lat pelvic shift?

A

increases

288
Q

what is the normal expected step length?

A

72 cm

289
Q

what is the normal expected stride length?

A

144 cm

290
Q

what is the normal expected lat pelvic shift?

A

5 cm

291
Q

what can be the reason of a high vertical pelvic shift?

A

pt unable to flex knee or DF foot to clear toes during swing pase

292
Q

high pt of vertical pelvic shift happens during?

A

midtance

293
Q

low pt of vertical pelvic shift happens during?

A

initial contact

294
Q

if pat has early increased flexion at knee and early PF where is the gait problem?

A

initial contact -> relieve the stress on painful tissues at the heel

295
Q

which gait phase is shortened bcs pt want to hurries thru this phase to decease pain if pt has painful hip, knee or ankle consition

A

midstance

296
Q

what is the trendelenburg sign?

A

when glu med is weak, pt tilt the trunk on opposite side of weakness during mistance

297
Q

if pt pushed off on lat aspect of foot, what gait phase is altered?

A

preswing

298
Q

what can happens if PF is weak?

A

abscent preswing

299
Q

what is the corect way to use a cane?

A

in the contraloat upper limb

cane need to touche the ground at the same time as the heel

300
Q

what structure is weak if the pelvis is thrusted foreward during initial swing?

A

quadriceps ms

301
Q

what is a step-page gait?

A

during midswing, the hip flexes excessively so that the toes can clear the ground bcs the DF are weak.

302
Q

which structure is weak is heel stike is excessively harsh during terminal swing?

A

hamstring ms -> weak so cannont control the deceleration and slowly bring the knee into extension