Chapter 7 - Functional Assessments Flashcards

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1
Q

The alignment and balance of the musculoskeletal system. Allows for joints, muscles, and nerves to function efficiently together.

A

Functional Integrity

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2
Q

What are the 4 Postural Deviations

A

Kyphosis
Lordosis
Flat Back
Sway Back

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3
Q

What is Kyphosis?

A

Increased posterior thoracic curve from neutral.

Excessive posterior curvature of the spine typically in the thoracic region.

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4
Q

What is Lordosis?

A

Increased anterior lumbar curve from neutral.

Excessive anterior curvature of the spine that typically occurs at the low back.

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5
Q

What is Flat Back Posture?

A

decreased anterior lumbar curve

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6
Q

What is Sway Back ?

A

decreased anterior lumbar curve and increased posterior thoracic curve from neutral.

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7
Q

Tightened/Shortened muscles in Kyphosis/Lordosis?

A
Hip Flexors
Lumbar Extensors
Anterior Ches/Shoulders
Latissimus Dorsi
Neck Entenstors
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8
Q

Weak/Lengthened muscles in Kyphosis/Lordosis?

A
Hip Extensors 
External Obliques
Upper Back extensors
Scapular Stabilizers
Neck Flexors
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9
Q

Tightened/Shortened muscles in Flat Back Posture?

A

Rectus abdominus
Upper Back Extensors
Neck Extensors
Ankle Plantar Flexors

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10
Q

Tightened/Shortened muscles in Sway Back Posture?

A

Hamstrings
Upper Fibers of Posterior Obliques
Lumbar Extensors
Neck Extensors

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11
Q

Weak/Lengthened muscles in Flat Back Posture?

A

Iliacus/psoas major
Internal Oblique
Lumbar Exensors
Neck Flexors

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12
Q

Weak/Lengthened muscles in Sway Back Posture?

A
Illiacus/Psoas major
Rectus Femoris
External Oblique
Uppber Back extensors 
Neck flexors
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13
Q

Correctable Muscle Imbalances?

A
Repetitive Movements
habitually poor posture
side dominance
lack of joint stability/mobility
imbalanced strength programs
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14
Q

Non-Correctable Muscle Imbalance?

A

Scoliosis
Rheumatoid Arthritis
Structural Deviations
Surgeries/Amputations

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15
Q

What are the 5 deviations?

A
Ankle Pronation/Supination
Hip Adduction
Pelvic Tilting
Shoulder Position/Thoracic Spine
Head Position
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16
Q

What is ankle pronation?

A
Arch Flattening
Foot - Eversion
Tibia(Knee) - Internal Rotation
Femoral - Internal
Plane of View - Front
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17
Q

What is ankle supination?

A
High Arches
Foot - Inversion
Tibia(Knee) - External Rotation
Femoral - External Rotation
Plane of View - Front
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18
Q

What is Hip Adduction deviation?

A

Lateral tilt of pelvis that elevates one hip
Lengthened(Weakened) Leg Hip Abductors
View from back

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19
Q

Deviation: Anterior Pelvic Tilt?

A

Pelvis Tilted down and forward
Associated with Tight Hip flexors, sedentary lifestyle and lots of time sitting
Plane of View - Saggital

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20
Q

Deviation: Posterior Pelvic Tilt?

A

Pelvis tilted down and backwards
Associated with Tight rectus abdominus and hamstrings
Plane of View Saggital View

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21
Q

Shoulder Deviation: Shoulders not level

A

Upper trapezius
levator scapula
rhomboids
Plane of View: Frontal

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22
Q

Shoulder Deviation: Asymmetry to midline

A

Lateral trunk flexors

Plane of View: Frontal

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23
Q

Shoulder Deviation: Protracted (forward, rounded)

A

Serratus anterior
anterior scapulo-humeral muscles
upper trapezius
Plane of View: Sagittal

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24
Q

Shoulder Deviation: Medially Rotated humerus

A

Pectoralis major and latissimus dorsi (Shoulder adductors)
internal obliques
Plane of View: Frontal

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25
Q

Shoulder Deviation: Kyphosis and depressed chest

A
Shoulder Adductors
Pectoralis minor
rectus abdominus
internal oblique
Plane of View: Sagittal
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26
Q

bend and lift screen: lack of foot stability: ankles collapse inward/feet turn outward: tight muscles

A

soleus
lateral gastrocemius
peroneals

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27
Q

bend and lift screen: knees move inward: tight & underactive

A

tight:
hip adductors
tensor fascia latae

underactive:
gluteus medius and maximus

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28
Q

bend and lift screen: unable to keep heels in contact with floor: tight

A

plantarflexors

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29
Q

bend and lift screen: hip and knee initiation of movement:

A

movement initiated at knees may indicate quadriceps and hip flexor dominance, as well as insufficient activation in glutes

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30
Q

bend and lift screen: unable to achieve parallel between tibia and torso

A

poor mechanics; lack of dorsiflexion due to tight plantarflexors (which normally allow the tibia to move forward)

31
Q

bend and lift screen: hamstrings contact back of calves

A

muscle weakness and poor mechanics; inability to stabilize and control the lowering phase

32
Q

bend and lift screen: back excessively arches: tight & undercactive

A

tight:
hip flexors
back extensors
latissimus dorsi

underactive:
core
rectus abdominus
glutes
hamstrings
33
Q

bend and lift screen: back rounds forward: tight & underactive

A

tight:
lat dorsi
teres major
pec major and minor

underactive:
upper back extensors

34
Q

Bend and lift screen: Head Upward

A

compression and tightness in the cervical extensor region

35
Q

bend and lift screen: head downward

A

increased hip and trunk flexion

36
Q

hurdle step screen: lateral tilt, forward lean, rotation:

A

lack of core stability

37
Q

hurdle step screen: anterior tilt with forward torso lean: tight & overactive

A

tight: stance leg hip flexors
overactive: rectus abdominis and hip extensors

38
Q

Shoulder Push Stabilization Screen: “Winging” during push-up movement

A

Inability of parascapular muscles to stabilize the scapulae against the rib cage
Can also be due to a flat thoracic spine.

39
Q

Shoulder Push Stabilization Screen: Hyperextension (collapsing) of the low back

A

Lack of core, abdominal, and low back strength

40
Q

Thoracic Spine Mobility Screen: how far should the trunk rotate in each direction?

A

45 degrees

41
Q

Thoracic Spine Mobility Screen: bilateral discrepancy

A

Side Dominance

42
Q

lack of thoracic mobility will negatively impact…

A

glenohumeral joint mobility

43
Q

What are the 5 primary movements?

A

1) Bending/raising and lifting/lowering movements (squatting)
2) Single-Leg Movements
3) Pushing Movements
4) Pulling Movements
5) Rotational Movements

44
Q

Thomas Test: Objective

A

To assess the length of the muscles involved in hip flexion. (Do not use on clients with low back pain)

45
Q

Thomas Test: with the back and sacrum flat, the back of the lowered thigh does not touch the table and the knee does not flex to 80 degrees: muscle tightness?

A

primary hip flexor muscles

46
Q

Thomas Test: with the back and sacrum flat, the back of the lowered thigh does not touch the table but the knee does flex to 80 degrees: muscle tightness?

A

iliopsoas, which is preventing the hip from rotating posteriorly and inhibiting the thigh from being able to touch the table

47
Q

Thomas Test: with the back and sacrum flat, the back of the lowered thigh does touch the table but the knee does not flex to 80 degrees. muscle tightness?

A

the rectus femoris, which does not allow the knee to bend

48
Q

passive straight leg raise (PSL) test: purpose

A

to assess the length of the hamstrings

49
Q

passive straight leg raise tes: the raised leg achieves >/ 80 degrees of movement before the pelvis rotates posteriorly

A

normal hamstring length

50
Q

passive straight leg raise: the raises leg achives <80 degrees of movement before the pelvis rotates posteriorly or there are any visible signs in the opposite leg lifting off the mat or table

A

tight hamstrings

51
Q

Shoulder Flexion: Range of Motion?

A

170-180 degrees

52
Q

Shoulder Flexion: How to test?

A

lay supine on floor with back flat and bent knee position.
hold neutral spine
raise both arms at once, moving them overhead, keeping them close to the head, and bringing them down to touch the floor or as close as possible

53
Q

shoulder flexion test: inability to flex the shoulders to 170 degrees or discrepancies between the limbs

A

potential tightness in the pectoralis major/minor, latissimus dorsi, teres major, rhomboids, subscapularis

54
Q

shoulder flexion test: tightness in the latissimus dorsi will force…

A

the low back to arch

55
Q

shoulder flexion test: tightness in the pectoralis minor

A

may tilt scapulae forward (anterior tilt) and prevent arms from touching floor

56
Q

shoulder extension test: how to test?

A

lie prone, extending both legs and arms at sides.

raise both arms simultaneously into extension, lifting them off the mat

57
Q

shoulder extension: Range Of Motion

A

50-60 degrees

58
Q

shoulder extension test: inability to extend the shoulders to 50 degrees or discrepancies between the limbs

A

potential tightness in pectoralis major, abdominals, subscapularis, biceps brachii

59
Q

external/lateral rotation test: ability to externally rotate the forearms 90 degrees to touch the mat

A

good mobility in the internal (medial) rotators, allowing the joint to move through the full range of motion

60
Q

external/lateral rotation test: inability to reach the floor or discrepancies between the limbs

A

potential tightness in internal rotators of the arm (subscapularis)

61
Q

internal/medial rotation test: ability to internally rotate the forearms 70 degrees toward the mat (forearms are 20 degrees of the mat)

A

good mobility in the external rotators, allowing the joint to move through full range

62
Q

internal/medial rotation test: inability to rotate the forearms 70 degrees, or discrepancies between the limbs

A

potential tightness in the external rotators of the arm (infraspinatus and teres minor)

63
Q

where is the arm/shoulder positioned when it is doing shoulder flexion, external rotation, and scapular abduction

A

overhead and behind the head reaching for opposite superior scapula

64
Q

where is the arm/shoulder positioned when it is doing shoulder extension, internal rotation, and scapular adduction

A

under and behind the back reaching up to touch opposite scapula

65
Q

trunk flexor endurance test

A

Assesses muscular endurance of the deep core muscles

66
Q

trunk lateral endurance test

A

assesses muscular endurance of the lateral core muscles

side-bridge test

67
Q

trunk extensor endurance test

A

assesses muscular endurance of the torso extensor muscles (erector spinae, logissimus, and multifidi)

68
Q

flexion:extension ratio should be….

A

less than 1.0

69
Q

right side bridge:left side bridge scores should be…

A

no greater than 0.05 from a balanced score of 1.0

70
Q

side bridge (either side): extension ratio should be…

A

less than 0.75

71
Q

Sharpened Romberg Test: continue to time clients performance until one of the following occurs…

A
Loss of postural control or balance
Client's feet move on the floor
Client's eyes open
Client's arms move from the folded position
Client exceeds 60 seconds
72
Q

Sharpened Romberg Test: The client needs to maintain his or her balance with good postural control for how long?

A

30 or more seconds

73
Q

Stork-Stand Balance Test: Males

A
Excellent: >50 seconds
Good: 41-50 seconds
Average: 31-40 seconds
Fair: 20-30 seconds
Poor: <20 seconds
74
Q

Stork Stand Balance Test: Females

A
Excellent: >30 seconds
Good: 25-30 seconds
Average: 16-24 seconds
Fair: 10-15 seconds
Poor: <10 seconds