Chapter 3 and 4 Flashcards

1
Q

Structures affected through the ROM:

A

muscles, joint surfaces, capsules, ligaments, fasciae, vessels, and nerves

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2
Q

Functional excursion

A

distance a muscle is capable of shortening after it has been elongated to its maximum

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3
Q

Example of active insufficiency.

A

bend the knee to shorten the gastroc. in order to focus on the soleus, flex the elbow and supinate and flex shoulder to shorten the bicep

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4
Q

Example of passive insufficiency.

A

extending the knee and flexing the hip to lengthen the hamstrings

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5
Q

Passive ROM (PROM)

A

movement of a segment within the unrestricted ROM that is produced entirely by an external force with little to no muscle contraction, external force may be from gravity, machine, another person, or another part of the individual’s own body

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6
Q

Active ROM (AROM)

A

movement of a segment within the unrestricted ROM that is produced by active contraction of the muscles crossing that joint

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7
Q

Active-Assisted ROM (AAROM)

A

assistance is provided manually or mechanically by an outside force because the prime mover muscles need assistance to complete the motion

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8
Q

Indications for PROM

A
  • passive motion is beneficial but active motion would be detrimental to the healing process
  • patient is not able to or not supposed to actively move a segment as when comatose, paralyzed, or complete bed rest
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9
Q

When a patient is able to contract the muscles actively and move a segment with or without assistance _____ is used.

A

AROM

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10
Q

This type of ROM increases circulation and prevents thrombus formation.

A

AROM

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11
Q

Passive motion does NOT:

A
  • prevent muscle atrophy
  • increase strength or endurance
  • assist circulation to the extent that active, voluntary muscle contraction does
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12
Q

Patient preparation:

A
  1. communicate with patient
  2. prepare the region and drape patient
  3. position the patient in comfortable position with proper body alignment and stabilization
  4. position yourself so proper body mechanics can be used
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13
Q

Perform ROM smoothly and rhythmically, with ___ repetitions.

A

5-10

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14
Q

Determines flexibility:

A
  • muscle length
  • joint integrity
  • extensibility of periarticular soft tissues
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15
Q

Dynamic flexibility

A

active mobility or active ROM

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16
Q

Passive flexibility

A

passive mobility or passive ROM

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17
Q

Contractures

A

adaptive shortening of the muscle-tendon unit and other soft tissues that cross the joint that results in a significant resistance to passive or active stretch and limitation of ROM

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18
Q

Myostatic contracture

A

musculotendinous unit has adaptively shortened and there is a significant loss of ROM, but there is not specific muscle pathology, no decrease in individual sarcomere length

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19
Q

Pseudomyostatic contracture

A

impaired mobility and limited ROM may be the result of hypertonicity (spasticity or rigidity) associated with a CNS lesion such as a CVA, SCI, or traumatic brain injury

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20
Q

Arthrogenic and Periarticular contractures

A

adhesions, synovial proliferation, irregularities in articular cartilage, or osteophyte formation

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21
Q

Fibrotic contracture

A

fibrous changes in the connective tissue of muscle or periarticular structures causing adherence of these tissues (generally irreversible)

22
Q

Contraindications for stretching

A
  • bony block that limits joint motion
  • recent fracture and bony union is incomplete
  • acute inflammatory or infectious processes
  • sharp, acute pain
  • hematoma
  • hypermobility
  • shortened structures are assisting the patient with stability (paralysis, for example)
23
Q

Interventions to increase mobility of soft tissues.

A
  • manual or mechanical/passive or assisted stretching
  • self-stretching
  • neuromuscular facilitation and inhibition techniques
  • muscle energy techniques
  • joint mobilization/manipulation
  • soft tissue mobilization and manipulation
  • neural tissue mobilization
24
Q

Tenodesis

A

slight hypomobility in the long flexors of the fingers while maintaining flexibility of the wrist enables the patient with SCI who lacks innervation of the intrinsic finger muscles to develop a grasp ability

25
Q

Elasticity

A

ability of soft tissue to return to its pre-stretch resting length directly after a short-duration stretch force has been removed

26
Q

Viscoelasticity

A

time-dependent property of soft tissue that initially resists deformation, but if stretch force is maintained, change in length can be achieved but it will return to original length when force is removed (only non-contractile tissues)

27
Q

Plasticity

A

tendency of a soft tissue to assume a new or greater length after the stretch has been removed

28
Q

Contractile tissues have which properties?

A

elasticity and plasticity

29
Q

Primary source of muscle’s resistance to passive elongation?

A

connective tissue framework (epimysium, perimysium, endomysium)

30
Q

Muscle spindle

A

sensitive to quick and sustained (tonic) stretch, receive and convey information about the changes in length of a muscle and the velocity of length changes (intrafusal muscle fibers)

31
Q

Gamma motor neurons

A

innervate the contractile polar regions of intrafusal fibers and adjust the sensitivity of the muscle spindle

32
Q

Alpha motor neurons

A

innervate extrafusal muscle fibers (motor unit)

33
Q

Intrafusal muscle fibers

A

nuclear bag fibers (primary type Ia afferents) - quick and tonic stretch
nuclear chain fibers (secondary type II afferents) - tonic stretch only

34
Q

Golgi tendon organ (GTO)

A

sensory organ located near the musculotendinous junctions of extrafusal muscle fibers, low threshold for firing so it monitors and adjusts movement or the tension in muscle during passive stretch

35
Q

Autogenic inhibition

A

GTO has an inhibitory impact on the level of muscle tension in the muscle-tendon unit in which it lies, particularly if the stretch force is prolonged

36
Q

Responsible for the strength and stiffness of tissue and resist tensile deformation.

A

collagen fibers

37
Q

Fibers of tendons and ligaments are composed mostly of?

A

type I collagen

38
Q

Building blocks of collagen microfibrils.

A

tropocollagen crystals

39
Q

_________ fibers provide tissue with bulk.

A

Reticulin

40
Q

Ground substance is made up of ___________ and ____________.

A

proteoglycans (PGs) and glycoproteins

41
Q

Proteoglycans (PGs)

A
  • hydrate the matrix
  • stabilize the collagen networks
  • resist compressive forces
42
Q

Glycoproteins

A

linkage between the matrix components and between the cells and matrix opponents

43
Q

GTO transmit sensory information via ___ fibers.

A

Ib

44
Q

The structural element that absorbs most of the tensile stress.

A

collagen

45
Q

Grade I ligament strain

A

microfailure: rupture of a few fibers in the lower part of the plastic range

46
Q

Grade II ligament strain

A

macrofailure: rupture of a great number of fibers resulting in partial tear further into the plastic range

47
Q

Grade III ligament strain

A

complete rupture or tissue failure

48
Q

Tissue response to prolonged stretch forces as a result of viscoelastic properties.

A

creep and stress relaxation

49
Q

Cyclic stretching vs. ballistic stretching

A

cyclic is slow-velocity and ballistic is high-velocity

50
Q

PNF stretching is designed to affect the non-contractile/contractile elements.

A

contractile (more appropriate for use with muscle spasm vs. fibrotic contractures)

51
Q

PNF stretching procedures:

A
  • hold-relax or contract-relax
  • agonist contraction
  • hold-relax with agonist contraction