ScoreBuilders Part 1 Flashcards
1
Q
fibrous joints
A
(synarthroses) minimal movement. ex: sutures, syndesmosis, gomphosis
2
Q
cartilaginous joints
A
(amphiarthroses) has cartilage to connect one bone to another. slightly moveable joints. ex: syndchondrosis, symphysis
3
Q
synovial joints
A
(diarthroses) provide free mvmt btwn bones they join. have five characteristics: joint cavity, articular cartilage, synovial membrane and fluid, and fibrous capsule. ex: uniaxial joint (elbow), biaxial (condyloid: finger, saddle: thumb), multi-axial (plane: carpal jts, ball & socket: hip)
4
Q
shoulder complex articulations
A
sternoclavicular, acromioclavicular, glenhumeral, scapulothoracic articulation
5
Q
elbow
A
hinge joint, reinforced by ulnar collateral and radial collateral ligaments
6
Q
wrist and hand
A
radiocarpal and midcarpal joints. mcp joints, prox and distal interphalangeal joints, and cmc joints
7
Q
hip
A
ball and socket joint. stability provided at joint by: acetabulum, iliofemoral ligament, pubofemoral ligament, and ischiofemoral ligament
8
Q
knee
A
hinge joint. stability by these ligaments: anterior cruciate, posterior cruciate, medial collateral, lateral collateral, ad deep medial capsular
9
Q
ankle
A
hinge joint formed by articulation of tibia and fibula w/talus. medial ligaments: deltoid. lateral ligaments: anterior tibiofibular, anterior talofibular, calcaneofibular, lateral talocalcaneal, and posterior talofibular
10
Q
frontal plane
A
divides body into anterior and posterior. motions are abduction and adduction, occur around an anterior-posterior axis.
11
Q
sagittal plane
A
divides body into right and left sections. flexion and extension occur around a medial=lateral axis.
12
Q
transverse plane
A
divides body into upper and lower sections. rotation occurs around vertical axis.
13
Q
class 1 lever
A
very few class 1 levers in body. one example is triceps force on olectranon with an external counter force pushing on forearm. (seesaw). axis of rotation is btwn effort (force) and resistance (load).
14
Q
class 2 lever
A
resistance (load is btwn axis of rotation and effort (force). length of effort arm is always longer than resistance arm. most instances, gravity is effort and muscle activity is resistance. ex: wheelbarrow
15
Q
class 3 lever
A
effort (force) btwn axis of rotation and resistance (load). shoulder abduction with weight at wrist is a class 3 lever example. most common type of lever in body.
16
Q
ATP-PC system
A
energy system producing ATP during high intensity, short duration exercise. Phosphocreatine decomposes and releases large amount of energy used to construct ATP. provides energy for muscle contraction for up to 15 seconds.
17
Q
anaerobic clycolysis
A
major supplier of ATP during high intensity, short duration activities. 50% slower than ATP-PC system and can provide a person with 30-40 secs of muscle contraction
18
Q
aerobic metabolism
A
used predominantly during low intensity, long duration exercises. yields by far the most atp, but requires chemical reactions.
19
Q
Type 1 Muscle Fibers
A
Aerobic, Red, Tonic, Slow twitch, Slow-oxidative: low fatigability, high capillary density, high myoglobin content, smaller fibers, extensive blood supply, large amt of mitochondria (ex: marathon, swimming)
20
Q
Type 2 Muscle Fibers
A
Anaerobic, White, Phasic, Fast twitch, Fast-glycolytic: high fatigability, low capillary density, low myoglobin content, larger fibers, less blood supply, fewer mitochondria (ex: high jump, sprinting)
21
Q
muscle receptors: muscle spindle
A
throughout belly of muscle. send info to nervous system about muscle LENGTH and or RATE of change of LENGTH. important in control of posture and involuntary mvmts.
22
Q
golgi tendon organ
A
sensory receptors through which muscle tendons pass immediately beyond attachment to muscle fibers. very sensitive to TENSION when produced from an active muscle contraction. average of 10-15 muscle fibers are connected in series with each golgi tendon organ. stimulated through the tension produced by muscle fibers.
23
Q
concentric contraction
A
when muscle shortens while developing tension
24
Q
eccentric contraction
A
occurs when muscle lengthens while developing tension
25
isometric contraction
isometric contraction occurs when tension develops but no change in length of muscle
26
isotonic
occurs when muscle shortens or lengthens while resisting a constant load
27
isokinetic contraction
isokinetic contraction occurs when tension developed by muscle is maximal over full range of motion while shortening or lengthening at a constant speed.
28
open-chain activity
open-chain activity involve distal segment, usually hand or foot, moving freely in space. example: kicking a ball with LE
29
closed-chain activity
involve body moving over a fixed distal segment. example: squat lift
30
densitometry: hydrostatic weighing
method of calculating density of body by immersing in water and measuring amt of water that becomes displaced.
31
densitometry: plethysmography
method of calculating body density utilizing amt of air displacement during testing within a closed chamber.
32
anthropometry: skinfold msrmt
determines overall % of body fat thru msrmt of 9 standardized sites.
33
end feel
type of resistance that is felt when passively moving a joint thru end range of motion.
34
firm end feel
(stretch) ex: ankle DF, finger extension, hip medial rotation, forearm supination
35
hard end feel
(bone to bone) ex: elbow extension
36
soft end feel
(soft tissue approximation) ex: elbow flexion, knee flexion
37
abnormal end feel: empty
cannot reach end feel due to PAIN, ex: joint inflammation, fracture or bursitis
38
abnormal end feel: firm
ex: increased tone, tightening of capsule, ligament shortening
39
abnormal end feel: hard
ex: fracture, OA, osteophyte formation
40
abnormal end feel: soft
ex: edema, synovitis, ligament instability/tear
41
Gait: Standard - Stance Phase (60% of gait cycle)
Heel strike: instant heel touches ground to begin stance phase
42
standard - foot flat
point in which entire foot makes contact with ground and should occur directly after heel strike
43
standard - midstance
point during stance phase when entire body weight is over the stance limb
44
standard - heel off
point in which heel of the stance limb leaves ground
45
standard - toe off
point in which only toe of stance limb remains on ground
46
standard - swing phase (40% of gait cycle)
acceleration: begins when toe off is complete and reference limb swings until positioned directly under body
47
standard - midswing
point when swing limb is directly under body
48
standard - deceleration
begins directly after midswing as swing limb begins to extend and ends just prior to heel strike
49
rancho los amigos terminology
initial contact, loading response, midstance, terminal stance, pre-swing; initial swing, midswing, and terminal swing
50
ROM requirements for normal gait
hip flexion: 0-30, hip extension: 0-15, knee flexion: 0-60, knee extension: 0, ankle DF: 0-10, ankle PF: 0-20
51
Gait muscles: tibialis anterior
activity just after heel strike. eccentric lowering of foot into PF.
52
gait muscles: gastroc/soleus
activity during late stance phase. concentric raising of heel during toe off.
53
gait muscles: quads
single support during early stance phase, and just before toe off to initiate swing phase.
54
gait muscles: hams
activity during late swing phase. decelerating unsupported limb.
55
base of support
distance msrd btwn left and right foot during progression of gait. average BOS is 2-4 inches
56
cadence
of steps an individual will walk over a period of time. average value for an adult is 110-120 steps per minute
57
double support phase
refers to the two times during a gait cycle where both feet are on the ground. does not exist when running
58
gait cycle
sequence of motions that occur from one initial contact of the heel to the next initial contact of the same heel.
59
single support phase
occurs when only one foot is on the ground and occurs 2ce during a single gait cycle
60
step length
distance measured btwn right heel strike and left heel strike. average step length for adult is 13-16 inches
61
stride
distance measured btwn right heel strike and the following right heel strike. average stride length for an adult is 26-32 inches.
62
antalgic gait
involved step length is decreased in order to avoid weight bearing due to pain
63
ataxic gait
gait characterized by staggering and unsteadiness, wide BOS and movements are exaggerated.
64
cerebellar gait
staggering gait
65
circumduction
circular motion to advance leg during swing phase
66
double step
alternate steps are of a different length or different rate
67
equine
gait pattern with high steps, excessive use of gastrocs
68
festinating
festinating patient walks on toes as though pushed. starts slowly, increases and may continue until patient grabs an object in order to stop
69
hemiplegic
abducts paralyzed limb, swings it around and brings forward so that foot comes to ground in front of them
70
parkinsonian
increased forward flexion of trunk and knees, shuffling with quick and small steps.
71
scissor gait pattern
legs cross midline upon advancement
72
spastic
stiff mvmt, toes catch and drag, legs held together, hip and knee joints slightly flexed
73
steppage
gait pattern in which feet and toes are lifted thru hip and knee flexion to excessive heights; usually secondary to DF weakness.
74
tabetic
high stepping ataxic gait pattern where feet slap ground
75
trendelenburg
glute medius weakness; excessive lateral trunk flexion and weight shifting over stance leg
76
vaulting
swing leg advances by compensating thru combination of elevation of pelvis and PF of stance leg
77
muscle insufficiency
muscle contraction that is less than optimal due to an extremely lengthened, or extremely shortened position of the muscle.
78
active insufficiency
when a 2 joint muscle contracts (shortens) across both joints simultaneously
79
passive insufficiency
when a 2 joint muscle is lengthened over both joints simultaneously
80
dynamometer
measures strength through use of a load cell or spring loaded gauge. (ex: grip strength-pounds)
81
dynamometry: make test
eval procedure where a patient is asked to apply a force against the dynamometer.
82
dynamometry: break test:
eval procedure where patient is asked to hold a contraction against pressure that is applied in opposite direction to contraction.
83
joint mobilization
passive movement technique designed to improve joint function
84
indications for joint mobs
indications for joint mobs restricted joint mobility, restricted accessory motion, desire neuro effects
85
contraindications for joint mobs
active disease, infection, advanced osteoporosis, articular hypermobility, fracture, acute inflammation, muscle guarding, muscle guarding, joint replacement
86
grade I
small movement performed at beginning of range
87
grade II
large amplitude movement performed within the range, but not reaching limit of range and not returning to beginning of range
88
grade III
large amplitude movement performed to limit of range
89
grade IV
small amplitude movement performed at limit of range
90
rheumatism
condition found in a number of disorders characterized by inflammation, degeneration or metabolic derangement of connective tissue, soreness, joint pain and stiffness of muscles. different conditions present with rheumatism. goals are to alleviate pain, decrease inflammation, maintain strength and functional mobility
91
osteoarthritis
chronic disease that primarily involves weight bearing joints. causes a degeneration of articular cartilage. risk factors include trauma, repetitive microtrauma, and obesity. cartilage becomes soft and damaged, bone thickens.
92
RA
systemic autoimmune disorder of unknown etiology. presents with a chronic inflammatory reaction in synovial tissues of a joint that results in erosion of cartilage and supporting structures within the capsule.
93
avulsion fracture
portion of bone becomes fragmented at site of tendon attachment from a traumatic and sudden stretch of tendon
94
closed fracture
break in a bone where skin over site remains intact
95
comminuted fracture
bone that breaks into fragments at the site of injury
96
compound fracture
break in a bone that protrudes thru skin
97
greenstick fracture
break on one side of a bone that does not damage periosteum on opposite side. often seen in children.
98
nonunion fracture
break in a bone that has failed to unite and heal after 9-12 months
99
stress fracture
break in a bone due to repeated forces to a particular portion of the bone
100
spiral fracture
break in a bone shaped as an S due to torsion and twisting
101
bursitis
condition caused by acute or chronic inflammation of bursae. pain and swelling limits range.
102
contusion
sudden blow to part of body that can result in mild to severe damage to superficial and deep structures. ROM, ice, compression are treatments
103
edema
increased volume of fluid in soft tissue outside of a joint capsule
104
effusion
increased volume of fluid within a joint capsule
105
genu valgum
knees touch while standing with feet separated. will increase compression of lateral condyle and increase stress to medial structures. also called knock-knee.
106
genu varum
bowing of knees. will increase compression of medial tibial condyle and increase stress to lateral structures. also called bowleg.
107
kyphosis
excessive curvature of spine in posterior direction usually in thoracic spine.
108
lordosis
excessive curvature of spine in anterior direction usually in cervical and lumbar spine.
109
myositis ossificans
condition of heterotopic bone formation that occurs 3 to 4 wks after a contusion or trauma within the soft tissue
110
osteoporosis
thinning of bone matrix with eventual bone loss and increased risk for fracture. usually found in postmenopausal women
111
q angle
degree of angle when measureing from midpatella to ASIS and tibial tubercle. normal q angle is 13 degrees for man and 18 degrees for a woman.
112
scoliosis
scoliosis lateral curvature of spine.
113
shoulder dislocation
true separation of humerus from glenoid fossa
114
shoulder separation
disruption in stability of acromioclavicular joint
115
sprain
acute injury of ligament. grade I: mild pain and swelling, little or no tear of ligament. grade II: mod pain and swelling, minimal instability of joint, min to mod tearing of ligament resulting in decreased ROM. grade III: severe pain and swelling, substantial joint instability, total tear of ligament, substantial decrease in ROM
116
strain
acute injury of tendon, muscle. grade I: localized pain, min swelling and tenderness. grade II: localized pain, mod swelling, tenderness and impaired motor function. grade III: palpable defect of muscle, severe pain and poor motor function
117
tendonitis
acute or chronic inflammation of a tendon.
118
(start of peds) congenital hip dysplasia
(start of peds) congenital hip dysplasia malalignment of femoral head with acetabulum. develops during last trimester in utero. asymmetrical hip abdution with tightness and apparent femoral shortening of involved side. testing includes ortolani test, barlow maneuver, and u/s. treatment initially attempts to reposition femoral head within the acetabulum thru constant use of a harness, brace, splint or traction. PT may be indicated after cast removal for stretching, strengthening, and caregiver education.
119
congenital limb deficiencies
malformation that occurs in utero secondary to impaired developmental course. classified longitudinal or transverse. causative factor is an abnormality present at conception when a bone lacks potential to form. primary characteristic is a missing long bone suce as the radius. treatment may focus on symmetrical mvmts, strengthening, ROM, weight bearing and prosthetic training.
120
congenital torticollis
characterized by a unilateral contracture of the SCM muscle. causative factors include malposition in utero, breech position and birth trauma. usually dx'd within first three weeks of life. lateral flexion to same side as contracture, rotation toward opposite side. treatment conservative for the first year with emphasis on stretching, active ROM, position and caregiver education. possible surgery.
121
legg-calve-perthes disease
degeneration of femoral head due to avascular necrosis. disease is self limiting and has 4 phases: condensation, fragmentation, re-ossification and remodeling. presents with pain, decreased ROM, antalgic gait, positive Trendelenburg sign. primary treatment focus is to relieve pain and maintain femoral head in proper psition.
122
osgood-schlatter disease
also known as traction apophysis that results from repetitive traction on the tibial tuberosity apophysis. caused by repeated tension to the patella tendon over the tibial tuberosity in young athletes which results in a small avulsion of the tuberosity and swelling. self limiting condition includes point tenderness over patella tendon at insertion on tibial tubercle, antalgic gait and pain with increasing activity. treatment is conservative with focus on education, icing, and eliminating placing strain on the patella tendon.
123
osteogenesis imperfecta
connective tissue disorder that affects formation of collagen during bone development. 4 classifications of osteogenesis imperfecta vary in levels of severity. caused by genetic inheritance with type I and IV considered autosomal dominant traits, and types II and III considered autosomal recessive traits. characteristics: brittle bones, weakness, impaired respiratory function. treatment begins at birth with education on proper handling and facilitation of movement.
124
scoliosis
lateral curvature of spine that can be classified as infantile, juvenile, adolescent or adult. structural curve cannot be corrected with active or passive mvmt and there is rotation of vertebrae towards the convexity of the curve. results in a rib hump over thoracic region. primary causative factor for a non structural curve is a leg length discrepancy. treatment is based on type and severity, generally curves that are less than 25 degrees require monitoring, btwn 25 and 40 degrees are treated with orthotic management, and beyond 40 degrees require surgery.
125
talipes equinovarus
deformity of ankle/foot known as clubfoot.
126
juvenile rhematoid arthritis
most common chronic rheumatic disease in children and presents with inflammation of joints and connective tissues. systemic juvenile RA occurs in 10-20% of children with JRA and presents with acute onset and other symptoms. polyarticular JRA accounts for 30-40% of children with JRA and presents with high femal incidence, RF+ majority and arthritis in more than 5 joints. oligoarticular (pauciarticular) JRA accounts for 40-60% of children with JRA and affects less than 5 joints. treatment includes medication to relieve inflammation and pain and PT.
127
Foot orthotics
semirigid or rigid insert worn inside a shoe that corrects foot alignment and improves function.
128
AFO
primary purpose is to assist with dorsiflexion and prevent foot drop, can also influence knee control. commonly described for patients with peripheral neuropathy, nerve lesions or hemiplegia
129
KAFO
provide support and stability to knee and ankle. allow for a lock mechanism at the knee that provides stability. ankle is also held at proper alignment.
130
craig-scott KAFO
designed specifically for persons with paraplegia. allows a person to stand with a posterior lean of trunk.
131
HKAFO
indicated for patients with hip, foot, knee, and ankle weakness. can control rotation at hip and abduction/adduction. heavy and restricts patients to a swing to or swing thru gait pattern.
132
reciprocating gait orthosis (RGO)
incorporates a cable system to assist with advancement of lower extremities during gait. when patient shifts weight onto a selected lower extremity, the cable system advances the opposite LE.
133
parapodium
standing frame designed to allow a patient to sit when necessary. primarily used in peds.
134
corset
constructed of fabric to provide abdominal compression and support.
135
halo vest orthosis
invasive cervical thoracic orthosis that provides full restriction of all cervical motion. commonly used with cervical spinal cord injuries to prevent further damage or dislocation.
136
milwaukee orthosis
designed to promote realignment of spine due to scoliotic curvature.
137
taylor brace
thoracolumbosacral orthosis that limits trunk flexion and extension through a 3 point control design.
138
thoracolumbosaral orthosis (TLSO)
utilized to prevent all trunk motions and is commonly utilized as a means of post surgical stabilization.
139
factors that influence vascular disease
hypertension, aging, diabetes, infection, poor nutrition, cigarette smoking
140
risk factors for amputation
vascular disease (atherosclerosis, arteriosclerosis), venous insufficiency, buerger's disease, diabetes. malignancy/tumor (osteosarcoma), congenital deformities, infection, and trauma
141
types of LE amputations
hemicorporectomy (surgical removal of pelvis and both LEs), hemipelvectomy (surgical removal of one half of the pelvis and LE), hip disarticulation (surgical removal of lower extremity from pelvis), transfemoral (surgical removal of LE above knee joint) knee disarticulation: thru knee joint, transtibial: below knee joint, syme's foot at ankle joint with removal of malleoli, chopart's: disarticulation at midtarsal joint, transmetatarsal: midsection of metatarsals
142
prosthetic training for transfemoral amputation
length of residual limb with regard to leverage and energy expenditure, no ability to weight bear thru the end of the residual limb, susceptible to hip flexion contracture, adaptation required for balance, weight of prosthesis, and energy expenditure
143
prosthetic training for transtibial amputation
loss of ankle and foot functions, residual limb does not allow for weight bearing at its end, WB in prosthesis should be distributed over the total residual limb, patella tendon should be the area of primary weight bearing, adaptations required for balance, and susceptible to knee flexion contracture.
144
possible complications with amputations
neuroma: bundle of nerve endings that group together an d produce pain due to scar tissue. phantom limb: refers to a painless sensation where patient feels that limb is still present. phantom pain: refers to patient's perception of some form of painful stimuli.
145
wrapping guidelines for amputees
elastic wrap should not have wrinkles, diagonal and angular patterns should be used and should not be wrapped in circular patterns, provide pressure distally to enhance shaping, anchor wrap above knee for transtibial amputations, anchor wrap around pelvis for transfemoral amputations, promote full knee extension for transtibial amputations, promote full hip extension for transfemoral amputations. secure wrap with tape, do not use clips, use 3-4 inch wrap for transtibial and 6 inch wrap for transfemoral, rewrap frequently to maintain proper pressure.
146
components of a prosthesis
socket, suspension, knee, shank, foot
147
gait deviations of amputee: lateral bending
causes: prosthesis too short, improperly shaped lateral wall, high medial wall, prosthesis aligned in abduction, poor balance, abduction contracture, improper training, short residual limb, weak hip abductors on prosthetic side, hypersensitive and painful residual limb
148
gait deviations of amputee: abducted gait
causes: prosthesis may be too long, high medial wall, poorly shaped lateral wall, prosthesis position in abduction, inadequate suspension, abduction contracture, improper training, adductor roll, weak HF and adductors, pain over lateral residual limb
149
gait deviations of amputee: circumducted gait
causes: prosthesis may be too long, too much friction in knee, socket too small, excessive PF of prosthetic foot, abduction contracture, improper training, weak HF, inability to initiate prosthetic knee flexion
150
gait deviations of amputee: excessive knee flexion during stance
socket set forward in relation to foot, foot set in excessive DF, stiff heel, prosthesis too long, knee flexion contracture, hip flexion contracture, poor balance, decrease in quad strength
