Soft Tissue Mobilization Flashcards Preview

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Flashcards in Soft Tissue Mobilization Deck (107):
1

CT is considered what type of substance

Colloidal

2

What is heat or pressure that changes ground substance from a dense gel to o more liquid state

Thixotropy

3

What is the piezoelectric effect

The ability of an object to produce a voltage after a mechanical compression stress

4

True or False:
Piezo electricity exists in crystals

True

5

What does CT behave as in the piezoelectric model

A crystal

6

What influences fibroblast and fibroclast activity

Charge

7

What is the ability of a substance to resist flow

Viscosity

8

What is the ability of a substance to rebound from deformation

Elasticity

9

What is the region that represents "setting" of the structure being tested including taking up slack

Toe region

10

Which zone does the deformation usually result in permanent deformation

Plastic zone

11

Which zone is deformation reversible

Elastic zone

12

What is the point of the stress strain curve called where after attaining ultimate stress, the tissue begins to fail

Neck

13

What is the point of the stress strain curve where sudden decrease in stress while strain continues to rise

Failure point

14

What is happening at the neck point of the stress strain curve

Initially microfailure and tissues narrow (necking)

15

What does the sudden decrease at the failure point mean

Substance of the material has begun to fail (tear)

16

What is the stress being lower during unloading for any given strain that occurs during loading

Discrepancy

17

What ia the difference in strain between loading and unloading called

Hysteresis

18

What does hysteresis represent

Energy lost during the test

19

True or False:
After repeated loading the stress strain curve looks identical yet starts at a new point

True

20

What is creep

Applying a constant load to a structure to lengthen it

21

How do you achieve a greater length increase in tissue using creep

Longer duration and less load

22

How is energy lost in a hysteresis loop

In the form of heat

23

What will cause a stiffer substance with higher loading rates to fail

Higher stresses and lower strains

24

What will cause a less stiff substance at higher temperatures to fail

Lower stresses and higher strains

25

Does heating tissue make it easier or harder to induce plastic elongation

Easier

26

What is the response of myofascial tissue to immobilization

Loss of ground substance

27

What are the 3 things that cause ground substance to be lost

1. Loss of glycosaminoglycans and water
2. Loss of interfiber lubrication
3. Loss of interfiber distance

28

What does the loss of ground substance result in

New crosslinks that adhere adjacent collagen fibers together

29

What is the half life of collagen

300-500 days

30

What is the half life of ground substance

1.7-7 days

31

What does nontraumatized CT damage result in

Fibrosis

32

What does traumatized CT damage result in

Scar tissue formation and contracture

33

What did Threlkeld determine

Permanent elongation of collagen fibers requires a force to achieve 3-8% fiber elongation

34

How long does it take for elongation without fiber tearing of 1-1.5% to occur

60 minutes

35

Where are type Ia muscle spindles located

Within muscle parallel to muscle fibers

36

Where are type Ib golgi receptors located (4)

1. Myotendinous junctions
2. Attachment sites of aponeurosis
3. Ligaments of peripheral joints
4. Joint capsules

37

Where are type II pacini and paciniform receptors located (3)

1. Myotendonous junctions
2. Deep layers of joint capsule
3. Spinal ligaments

38

Where are type II ruffini receptors located (3)

1. Ligaments of peripheral joints
2. Dura mater
3. Outer layers of joint capsules

39

What do type Ia muscle spindles respond to

Muscle stretch

40

What do type Ib GTO and GEO respond to

GTO: Muscular contraction
GEO: To strong stretch only

41

What do type II pacini and paciniforms respond to

Rapid pressure changes and vibrations

42

What do type II ruffinis respond to (3)

1. Rapid pressure
2. Sustained pressure
3. Tangential forces (lateral stretches)

43

Where are interstitial type III and IV 50% high threshold and 50% low threshold receptors located

Almost everywhere

44

True or False:
Interstitial type III and IV 50% high threshold and 50% low threshold receptors are the most abundant in the body

True

45

What do interstitial type III and IV 50% high threshold and 50% low threshold receptors respond to (3)

1. Rapid as well as sustained pressure changes
2. HPT
3. LPT

46

What is the result of type Ia muscle spindle activation

Reduction in tone of antagonist, increased tone in agonist

47

What is the result of type Ib golgi receptor activation

Tone is decreased in associated motor units

48

What is the result of type II pacini and pacinform receptor activation

Proprioceptive feedback for movement control

49

What is the result of type II ruffini receptor activation

Inhibition of sympathetic activity

50

What is the result of type III and IV interstitial receptor activation

Changes in vasodilation and plasma extravasation

51

What are the types of mechanoreceptors that have an effect on local fluid dynamics (2)

1. Type III and IV interstitial receptors
2. Type II ruffini receptors

52

What was determined by Staubesand et al when it comes to fascial contractions (2)

1. There are smooth muscle cells embedded within the collagen fibers
2. Intrafascial capillaries, autonomic nerves, and sensory endings

53

What did Straubesand et al conclude based on their findings

Autonomic nervous system regulated fascial pre tension

54

What form myofibroblasts

Fibroblasts

55

What do myofibroblasts contain

Smooth muscle actin fibers

56

Can myofibroblasts actively contract

Yes'm

57

How long do you hold a passive stretch for a muscle and DCT

Muscle: 30 seconds
DCT: 5 minutes

58

What is the purpose of myofascial release

To relieve soft tissue from the abnormal "grip" of tight fascia

59

What is fascia

CT that surrounds all bodily tissue

60

What is fascia composed of

Primarily collagen with some elastic fibers

61

When doing myofascial release do you pull in the direction of the muscle of across the grain of the muscle

In the direction of the muscle

62

Do you start deep or superficial with myofascial release

Superficial

63

How long do you hold the stretch position for

Until the soft tissue is felt to relax (release) which takes about 3-5 minutes

64

How do you stretch deeper restrictions

Stretch further to take up the slack

65

Where are your fingers located for cranial base release

Right under the occipital condyles

66

What does the release indicate

You can stretch to a new barrier

67

What do spray and stretch techniques deactivate

Gamma spindle response

68

What do spray and stretch techniques use to deactivate gamma spindles

Vapocoolant spray

69

How should the patient and their muscle be positioned for spray and stretch techniques

Patient should be relaxed and the muscle should be slightly tensioned

70

How far away should the spray bottle be for spray and stretch techniques

12-18 inches above skin

71

What angle should you spray at for spray and stretch techniques

30 angle to the skin

72

How do you spray the patient when using spray and stretch techniques

Spray in parallel sweeps covering the mm from TP to RPP area

73

After the vapocoolant spray is applied what do you do next

Apply gentle stretch to elongate the muscle

74

How many times can the spray and stretch technique be repeated

Up to 3 times

75

What is is active release techniques

Pinning the muscle to be elongated and moving the muscle into a lengthened position

76

What is the direct technique of active release

Move into restriction

77

What is the indirect technique of active release

Move away from restriction

78

True or False:
GTOs don't fire during passive stretch the muscle needs to contract for firing of GTOs to occur

True

79

What does the gamma spindle do

Reset the muscle spindle

80

What does the muscle spindle do when active

Increase tone in the agonist

81

What is friction massage used for (4)

1. Loosen adherent fibrous tissue (break up adhesions)
2. Aid in absorption of local edema or effusion
3. Reduce local muscle spasm
4. Treat chronic inflammation in tendon

82

What types of tissues can friction massage be used on (3)

1. Ligaments
2. Tendons
3. Muscle

83

How far should you move back and forth when using friction massage

Only as far as the skin moves

84

What are indications for friction massage for muscular lesions (3)

1. Recent trauma
2. Long-standing scars
3. Lesion at the musculotendinous junction

85

What are the indications for friction massage for tendinous lesions (2)

1. Tendons with a sheath
2. Tendons without a sheath

86

What are the indications for ligamentous lesions (2)

1. Recent sprain
2. Chronic sprain

87

When doing friction massage should the muscle be taught or slackened

Slackened

88

When doing friction massage should the tendon or ligament be taught or slackened

Taught

89

When doing friction massage which way should the massage be

Across the grain of the fibers

90

Friction massage can be used for what (3)

1. Minor muscle tears
2. Ligamentous tears
3. Tendinous tears

91

What are the contraindications for friction massage (6)

1. Inflammation due to bacterial action
2. Traumatic arthritis of a joint
3. Ossification or calcification in soft structures
4. Bursitis
5. Rheumatoid arthritis
6. Pressure on nerves

92

What is the purpose of friction massage

Relief of pain

93

How does friction massage relieve pain (3)

1. May be due to modulation of nociceptive impulses at spinal cord level
2. Due to concurrent activation of mechanoreceptors in tissues closes the gate to painful impulses
3. May stimulate diffuse noxious stimuli that imparts inhibitory controls

94

How long does soft tissue massage occur for

15 minutes

95

What angle is the tool held at for tool assisted STM

30-60 angle with target tissue

96

How do you know which way to do tool assisted STM

By running your fingers along the fiber orientation of the tissue in both directions and determine which is more tight

97

How long do you do tool assisted STM

3-5 minutes

98

True or False:
You must anchor on side of the soft tissue before starting tool assisted STM

True

99

What is the purpose of tool assisted STM (4)

1. Remove adhesions
2. Reduce tone
3. Enhance fibroblast proliferation
4. Improve circulation

100

When do tool assisted STM why can muscle strength decrease or increase afterwards

Decrease: May be due to activation of GTOs which decrease contractility
Increase: May be due to activation of muscle spindles which increase contractility

101

How do you do strain counterstrain

Find a tender point in soft tissue then push on it and tell the patient that is a 10 out of 10 pain then passive move the body part shortening the soft tissue and hold for 90 seconds then move body part back to neutral and release pressure slowly and reassess

102

How much do you want to decrease pain for strain counterstrain

From 10/10 to 3/10

103

Where are tender points located (4)

1. Deep within muscle
2. Tendon
3. Ligament
4. Fascia

104

How big do tender points measure

1 cm or less across

105

What is the muscle energy technique (MET)

Passively move the muscle in desired motion then contract isometrically and hold 3 seconds then relax and push the body part further into the motion

106

What is stress

Tension

107

What is strain

Length