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DPT Spring 2024 > Traction > Flashcards

Traction Flashcards

1
Q

_________ is a tensional mechanical force applied to the body in a way that separates the joint surfaces and elongates surrounding soft tissues

Two types?

A

Traction

Manual
Mechanical

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2
Q

Traction can be applied to both the _______ and _______ extremity

A

lower
upper

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3
Q

Effects of Traction

______ joint surfaces
_______ protrusions of nuclear disc material
______ soft tissue
______ muscles
_______ joints
________ transmission of pain by stimulation of sensory mechanoreceptors

A

distract
reduce
stretch
relax
mobilize
gate

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4
Q

_______ _______ is the separation of two articular surfaces perpendicular to plane of articulation

A

joint distraction

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5
Q

Distraction of facet joints can decrease ______ related to mechanical ______ of the joints or compression of spinal nerve roots as they pass through the intervertebral foramina

A

pain; loading

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6
Q

Joint distraction may reduce pain from ______ joint injury or nerve root _______

A

facet
compression

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7
Q

With traction, force applied must be enough to cause ________ of soft tissues around the joint

A

elongation

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8
Q

With traction, if the force is too small it may elongate the soft tissue but not _______ joint surfaces of the spine

A

seperate

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9
Q

With traction, a force of ______% body weight might elongate soft tissue

A

25

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10
Q

With traction, there is a force of at least _____% body weight and max of ______% required to distract lumbar apophyseal joints

A

50
60

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11
Q

With traction, there is a max force of _____% of body weight for cervical apophyseal joints

A

7

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12
Q

With reduction of spinal disc protrusions: suction is caused by decreased ______ _______

A

intradiscal pressure

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13
Q

With reduction of spinal disc protrusions: There is increasing tensions on the ______ ________ ligament at posterior part of disc thus pushing disc material anteriorly

A

posterior longitudinal

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14
Q

Lumbar disc protrusion may be reduced with traction force of at least ____ pounds or at least _____% of body weight

A

60
50

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15
Q

Cervical disc protrusion may be reduced with traction force of at least ____-_____ pounds or at least ____% of body weight

A

15; 30
7

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16
Q

Soft tissue stretching is using a moderate-load, prolonged force such as that provided by spinal traction has been shown to increase the length of _______ and to increase ______ mobility, even when complete joint surface seperation is not achieved

A

tendons
joint

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17
Q

__________ traction: Gating of pain transmission by stimulation of mechanoreceptors by oscillatory movements

A

intermittent

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18
Q

_______ traction: Depression of monosynaptic response caused by stretching the muscles for several seconds

A

static

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19
Q

Traction has been recommended as a way of mobilizing _____ and _____ joints to increase joint mobility or decrease joint pain

A

spinal; peripheral

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20
Q

Clinical indications: spinal pain with or without radiculopathy caused by

_____ bulge or ______
_____ ______ impingement
joint _________
subacute joint __________
________ muscle spasm

A

disc; herniation
nerve root
hypomobility
inflammation
paraspinal

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21
Q

Spinal disc buldge or herniation has longer hold time in intermittent traction
______ seconds on and ______ seconds off

A

60
20

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22
Q

Decreased efficacy in treatment of lumbar disc could be due to:

______ of disc protrusion in those studied

Too smalll sample size to see ________ effect

Disc herniation has become _______
Insufficient ______ force used

A

severity
treatment
calcified
traction

23
Q

Nerve root impingement

More effective if used soon after _____ of symptoms

More effective in ______ spine

Can be caused by ligament _________, loss of disc ______ result in narrowing of ________ foramen, ________ or swelling of spinal nerve root or spondylolisthesis

A

onset
cervical
enrichment; height; intervertebral; osteophytes

24
Q

With joint hypomobility and traction

Traction can glide and distract ____ facet joints and stretch surounding _____ _____ so may improve symptoms of spinal hypomobility

A

spinal
soft tissue

25
Q

With joint hypomobility and traction:

can be improved by adjusting the degree of spinal _____ and positioning the ______ spine in more flexion localizes force to upper lumbar/lower thoracic

positioning in _____ or ______ localizes force to lower lumbar

cervical ______ localizes force to lower cervical, neutral or slight ________ focuses force on upper cervical

A

flexion
lumbar
neutral
extension
flexion
extension

26
Q

Subacute joint inflammation

May reduce ______ on inflamed joint surfaces

May decrease pain by _____ ______ mechanism

May maintain normal fluid exchange in spinal joints to decrease _______ caused by chronic inflammation

DO NOT USE IN ______ INJURY PHASE

A

pressure
gate control
edema
ACUTE

27
Q

Muscle spasm

Traction can decrease pain by interrupting pain- _____- pain cycle

Inhibit ______ _____ neuron firing

Alleviate protective muscle spasms by decreasing underlying ______ of pain

A

spasm
alpha motor
causes

28
Q

Contraindications:

Where ______ is contraindicated

Acute ______ or ________

________ or unstable joints

Assess _______ first

____________ of symptoms with traction

Uncontrolled ___________

A

motion
injury; inflammation
hypermobility
motion
peripheraalization
hypertension

29
Q

Precautions for traction

Structural diseases or conditions affecting the _______ in the area being treated

Examples:
_________
_________
______ ________
_________

A

tissue
tumor
rheumatoid arthritis
osteoporosis

30
Q

Once an ________ fragment has become displaced and is no longer connected to the body of the disc, traction is not likely to change the position of the disc fragment, therefore treatment is not likely to improve the patient’s symptoms

A

annular

31
Q

_______ _______ protrusions: Medial movement of the nerve root by the traction force may increase impingement of the disc on the nerve root

A

medial disc

32
Q

If severe pain resolves fully with traction, it may indicate traction has _______ rather than decreased pressure on a _____ _____ causing a complete nerve block

Check ______, reflexes and strength before and after

A

increased
nerve root
sensation

33
Q

When determining whether patient presentation is likely to respond to treatment with traction:

Desired ________ effect
_________/precautions
_________ of treatment

A

therapeutic
contraindications
location

33
Q

What are two additional precautions for cervical traction?

A

TMJ; Dentures

34
Q

Mechanical Traction Advantages

______ and ______ well controlled, readily graded, and replicable

Doesn’t require the clinician to be _______ with patient throughout treatment

Allows application of _____ or _______ traction

Static devices are ________

A

force; time

present

static; intermittent

inexpensive

35
Q

Mechanical Traction Disdvantages

___________ __________ devices are expensive

_____-_______ to set up

Lack of patient _______ or _______

Restriction by _______ or halter poorly tolerated by some patients

Mobilizes broad regions of the _____ rather than individual segments, this potentially promotes hypermobility

A

electrical motorized

time consuming

control; participation

belts

spine

36
Q

Motorized Mechanical Traction Units

Uses _____ ______ to apply traction forces to cervical or lumbar spine

Allow accurate control over _____ being applied

Can provide _____ or _______ traction

Maximum force is about ____ kg ( _____ lb)

Allow great variation in patient ______

Newer models can store clinical protocols and track patient ____ severity and ______

A

electric motor
forces
static; intermittent
70; 154
positioning
pain; location

37
Q

Positioning of the patient
Lumbar traction:

Supine: ______ position of spine

Greater seperation of _______ structures such as facet joints and intervertebral foramen

Prone: ________ position of spine

Greater seperation of _____ structures including disc spaces

Greater lumbar ______ relaxation (less _____ firing)

A

flexed
posterior
extended
anterior
paraspinal
EMG

38
Q

Positioning of patient:
Cervical Traction
Allows traction force to not have to overcome _______ of gravity

Patient is in _____ and can relax

A

force
supine

39
Q

Cervical Traction
Patient Position:

Upper Cervical: ____-______ degrees flexion

Mid Cervical: _____-______ degrees flexion

Lower Cervical: ____-_____ degrees flexion

A

0; 5
10; 20
25; 35

40
Q

REMINDER:
For lumbar traction you must use a _____ traction table with the area of. spine to be distracted positioned over the split

A

split

40
Q

Safety issues: Purpose is ______ friction which allows improved traction _____

A

decreased; force

41
Q

Safety issues: Don’t forget to ______ table as the last step before starting traction

A

unlock

42
Q

Always give the patient the _______ _______!!!

A

safety switch

43
Q

Parameters for Lumbar Traction

Goal of treatment: Initial/acute phase

Force: ___-____ lbs

Hold/Relax Times: ______

Total Traction Time (min): ___-_____

A

30; 45
static
5; 10

44
Q

Parameters for Lumbar Traction

Goal of treatment: Joint distraction

Force: ______ % body weight

Hold/Relax Times: ___/____

Total Traction Time (min): ____-____

A

50
15
20; 30

45
Q

Parameters for Lumbar Traction

Goal of treatment: Decrease ms. spasm

Force: ______ % body weight

Hold/Relax Times: ___/____

Total Traction Time (min): ____-____

A

25
5; 5
20; 30

46
Q

Parameters for Lumbar Traction

Goal of treatment: Disc problem or stretch soft tissue

Force: ______ % body weight

Hold/Relax Times: ___/____

Total Traction Time (min): ____-____

A

25
60; 20
20; 30

47
Q

For Lumbar Traction

For all treatments, force should start low ( ____-_____ lb)) the first time to assess patient response and avoid muscle guarding or spasms. Then gradually increase to optimal levels.

A

30; 45

48
Q

Parameters for Cervical Traction

Goal of treatment: Initial/acute phase

Force: ___-____ lbs

Hold/Relax Times: ______

Total Traction Time (min): ___-_____

A

8; 10
static
5; 10

49
Q

Parameters for Cervical Traction

Goal of treatment: Joint distraction

Force: ______ % body weight or ____-____ lbs

Hold/Relax Times: ___/____

Total Traction Time (min): ____-____

A

7
20; 29
15; 15
20; 30

50
Q

Parameters for Cervical Traction

Goal of treatment: Decrease ms. spasm

Force: ____-_____ lbs

Hold/Relax Times: ___/____

Total Traction Time (min): ____-____

A

11; 15
5; 5
20; 30

51
Q

Parameters for Cervical Traction

Goal of treatment: Disc problems or stretch of soft tissue

Force: ____-_____ lbs

Hold/Relax Times: ___/____

Total Traction Time (min): ____-____

A

11; 15
60; 20
20; 30

52
Q

Documenation for Traction
should include…

______ or ______

Angle of ______

________
- amount of ____
- _______ of traction treatment
- ______ ______ (Proportion of time at max pull vs min pull)

Any _______ or ______ gradual steps

________ response (assessment)
Relate to improvement in ______ ______

A

static; intermittent
application
dosage
tension
duration
duty cycle
ascending; descending
patient
functional activity

DPT Spring 2024 (30 decks)

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