Comprehensive Test Study Guide Flashcards
1
Q
What is the earliest point when you should suspect that a patient with a fracture might be in the remodeling phase?
A
3 weeks
2
Q
Which cell produces collagen?
A
Fibroblasts
3
Q
Which of the following is not a type of drug that can delay fracture healing?
A
Antihypertensives
4
Q
How long does each healing phase last for a fracture?
A
Inflammation: Up to 7 days
Repair/Regeneration: 8-12 weeks
Remodeling: Up to 2 years
5
Q
What is a type of chronic injury?
A
Neuroma
6
Q
What is not a function of macrophages during the inflammatory response?
A
Release of chemicals that cause vasodilation. This is caused by mast cells.
7
Q
What is a function of Schwann cells following peripheral nerve injury?
A
They divide to increase the likelihood that an injured neuron will contact them and regenerate.
8
Q
What are a list of nutrients needed for fracture healing?
A
Vitamin C and D, phosphorus, protein, calcium
9
Q
Where does osteoblastic activity begin and end?
A
Begins outside the fracture site then moves inward.
10
Q
Is woven bone deposited at the fracture site before or after soft callus formation?
A
Before
11
Q
At most, how long can the remodeling/maturation phase of tissue healing typically take?
A
24 months
12
Q
T or F: Nerve injuries closer to the cell bodies (Spinal cord) result in greater losses.
A
True
13
Q
What does the acute phase of fracture healing entail?
A
Hematoma formation, inflammation, angiogenesis, and initial develop of fibrous soft callus.
14
Q
What is woven bone eventually replaced with?
A
Cortical/trabecular bone, and they are remodeled by osteoclasts and blasts
15
Q
What is a weakness of Williams and Anderson’s revised stress and injury model?
A
There is little research investigating the implementation and assessment of preinjury interventions associated with this model.
16
Q
What percentage of patients have clinical levels of psychological stress and need to be referred to a mental health professional?
A
5-13%
17
Q
Clinicians should keep in mind that it is normal for injury rehabilitation time that lasts for ____ or longer to provoke emotional responses of grief and anger.
A
4 months
18
Q
How should a clinician respond when a patient asks how long the recovery process will take?
A
Give the patient a range of time to allow for flexibility and to avoid causing stress and anxiety.
19
Q
What is a typical characteristic of bad pain?
A
It is chronic
20
Q
What’s the purpose of Williams and Anderson’s revised stress and injury model?
A
It can be used to determine when an individual is at greatest risk for injury.
21
Q
How can a clinician demonstrate active listening?
A
The clinician should regularly restate what the patient says to make sure that the clinician correctly understands the patient.
22
Q
T or F: The response to an injury is more likely to be intense when the injury is more severe.
A
True
23
Q
Define Passive Range of Motion
A
Using an external force to move a body part through an arc of motion
24
Q
Which of the following is not an example of an inert tissue?
-Ligament
-Tendon
-Bone
-Fascia
A
Tendon (this would be contractile)
25
What is inert tissue and give 6 examples.
Tissue that does not contract.
Bone, bursae, cartilage, capsule, fascia, ligament
26
When should resistance be applied during RROM?
Near the midrange, to avoid impinging structures at the end range
27
According to the Cyriax Classification for muscular lesions, a major injury that affects both the muscle and tendon will result in what quality contraction?
Weak and painful
28
Summarize the Cyriax Classification for muscular lesions
-Stong & painful: First or second degree muscular strain (injury to muscle or tendon)
-Weak & painless: Third-degree strain/complete rupture of muscle or tendon (neuromuscular dysfunction)
-Weak & painful: Major injury to muscle and /or tendon (neuromuscular dysfunction)
29
What structure's normal end-feel is described as stretching a leather belt because it has a firm end-feel with slight give?
Ligament
30
What structures normal end-feel is described as stretchy or rubbery?
Muscle
31
What is considered contractile tissue?
Nerve, muscle, tendon
32
Which of the following is not a specific indication for resisted range of motion?
-Determination of muscular control
-Increase of total range of motion
-Strength assessment
- Strength increase
Increased total range of motion
33
What is resisted range of motion used to determine?
General muscle weakness or pain in the muscle performing the motion.
34
What are indications for the use of resisted range of motion?
Assessing muscle strength, increasing muscle strength, determining muscular control, and assessing muscular injury
35
What joint contractures is most likely to occur in a person who is paralyzed from the waist down?
Irreversible contracture
36
What are the three contracture types?
-Myostatic: Musculotendinous unit adpatively shortens and ROM is significantly altered.
-Scar: After trauma or sugerical intervention: Can result in limitations of of joint ROM
-Irreverable: More commonly found in persons confined to wheelchairs or bedridden
37
What best describes ballistic stretching in terms of intensity and duration?
High intensity, short duration
38
Based on current evidence, what type of stretching should be performed before activity that requires high muscular force?
Dynamic stretching
39
What factors limit soft tissue flexibility?
-Muscle/tendon tightness
-Connective tissue contractures
-Abnormal bony structure
-Soft tissue approximation
-Scar tissue
40
Which of the following is not considered a factor that can affect the stress-strain curve resulting in an increased risk of tissue failure?
-Chronic disease
-Increased activity
-Increased chronological age
-Prolonged immobilization
Increased activity
41
What tissue property describes a tissue’s ability to stretch and return to its original resting length?
Elasticity
42
What stretching techniques involve actively moving a joint quickly through its normal range of motion to slightly elongate muscles?
Dynamic
43
What stretching technique is most frequently utilized during rehabilitation of the knee, shoulder, hip, and ankle?
PNF
44
Which of the following is not a possible reason for limited ankle dorsiflexion range of motion?
-Weak gastrocnemius soleus complex
-Weak tibialis anterior
-Tight gastrocnemius soleus complex
-Talocrural capsular tightness
Weak gastrocnemius soleus complex
45
Describe the hold-relax technique when it comes to stretching.
1. Lengthen the muscle
2. Hold and isometrically contract the same muscle for several seconds
3. After contraction, clinician lengthens the muscle further.
46
What motion occurs when one point on one surface meets a new point on the opposing surface?
Roll
47
Which type of joint mechanoreceptor is responsible for nociception?
Type IV
48
What is joint mobilization?
It involves the passive movement of a joint through the application of manual therapy techniques
49
What is osteokinematics vs. arthrokinematics?
Osteo: Active or passive movement of a bones around a joint
Arthro: Passive movement performed by the clinician, includes distraction, compression, sliding, rolling, and spinning
50
Factors contributing to joint hypomobolization.
Immobilization
Tissue trauma
Muscle imbalance
Neuromuscular disease
Limited mobility
Postural malalignment
Deformities
Sedentary lifestyle
I T M N L P D S
51
Name, locate and describe the response of the four type of mechanoreceptors.
-Type I: Superficial joint capsule-Regulation of muscle tone, sense of direction of movement, speed of movement
-Type II: Deep joint capsule-Change of speed and regulation of muscle tone
-Type III: Ligaments-Sense of direction of movement and regulation of muscle tone
-Type IV: Joint capsule, ligaments, fat pads, blood vessels: nociception
52
How would you classify the five grades of oscillation? P. 118
Grade I, reduce pain, small amplitude and beginning of range of joint play
Grade II, reduce pain, large amplitude and mid-range of joint play
Grade III, increase tissue mobility, large amplitude, mid-end range of joint play
Grade IV, increase tissue mobility, small amplitude, end range of joint play
Grade V, Joint manipulation, small amplitude, beyond end of joint play
53
When considering the Concave-Convex Rule, direction of the ____ is determined by whether the moving surface is convex or concave.
Slide
54
How long is the stretching window?
3.3 minutes or less (if deep heat is applied).
55
Describe the effects of superficial heating on on joint capsules?
Limited direct thermal effects
56
When applying the Concave-Convex Rule, which of the following is not true when examining open-kinetic chain knee extension?
-The slide occurs in the posterior direction.
-The roll occurs in the anterior direction.
-Spin does not occur.
-The swing is in the anterior direction.
The slide occurs in the posterior direction
57
The roll is always in the same direction as what?
Swing
58
Describe how slide is determined.
Based on whether the moving surface is convex or concave.
If it is convex, it moves in the opposite direction of the swing
If it is concave, it moves in the same direction as the swing
59
What motion is defined as the same point of one surface contacting new points on the opposing surface?
Slide
60
Which of the following describes motions that accompany active range of motion but are not under voluntary control?
-Osteokinematics
-Manipulations
-Accessory movements
-Arthrokinematics
Accessory movements
61
What term is used to describe the movement that occurs between joint surfaces during voluntary joint movement?
Arthrokinematics??
62
What strength movements best mimic functional activities in athletics?
Eccentric exercises
63
According to the DAPRE protocol, a patient’s working weight is based on what?
Percentage of the patient’s 6RM
64
Contrast the DeLorme-Watkins and Oxford protocol?
DLW:
10 reps @ 50% 10 RM
10 reps @ 75% 10 RM
10 reos @ 100% 10 RM
Oxford:
Opposite in percentages: 100% to 75% to 50%
65
Describe the Daily Adjustable Progressive Resistance Exercise.
1 set: 10 reps at 50% of 6 RM
2 set: 6 reps at 75% of 6 RM
3 set: AMRAP with 6 RM
4 set: AMRAP with adjusted working weight
66
T or F. A motor unit is comprised of either a slow or fast twitch fibers.
True
67
What is defined as the ability to move a force a given distance?
Work
68
Which of the following is not a guideline that should be considered when performing PNF exercise?
-The patient should look at the moving limb.
-Resistance should be given to facilitate maximal response.
-For protection, rotation should be avoided.
-Verbal cues should coordinate with desired movement.
For protection, rotation should be avoided
69
What aspect of muscular performance is directly related to the cross-sectional area of a particular muscle?
Muscle Strength
70
What is the contractile unit of a muscle called?
Sarcomere
71
What is a bundle of muscle fibers called?
Fascicle
72
What are sarcomeres made up of?
Thin and thick myofibrils, (myosin, actin)
73
What lower extremity PNF pattern begins with the knee flexed, the ankle dorsiflexed, and the hip flexed, abducted, and internally rotated?
D2 Extension
74
What type of exercise is indicated for a patient with a contracture of soft tissue joint capsule?
Joint mobilization
75
According to the Cyriax Classification for muscular lesions, a major injury that affects both the muscle and tendon will result in what quality contraction?
-Weak and painful
-Strong and painless
-Strong and painful
-Weak and painless
Weak and painful
76
What structures normal end-feel is described as stretchy or rubbery?
Muscle
77
An athlete who has suffered an open joint dislocation has most likely suffered which type of open wound?
-Puncture
-Avulsion
-Laceration
-Abrasion
Laceration
78
What is soft callus composed of?
Avascular fibrous tissue
79
How are strains and sprains graded?
Based on the amount of damage to the injured tissue.
80
Is distraction crucial to the production and movement of synovial fluid?
No
81
What specifically addresses intra-articular tissues that are causing limitations in joint range of motion or normal joint mobility?
Joint mobilizations
82
If there is pain in the active and passive movement in the same direction, what type of tissue injury is most likely causing the pain?
Inert
83
If there is pain with active movement in one direction and pain with passive movement in the opposite direction, what type of tissue injury is most likely causing the pain?
Contractile
84
What overrides the muscle spindles after 8 seconds of stretching?
Golgi Tendon Organ
85
Which kind of injury usually results in a patient becoming impatient because of their eagerness to return to their sport?
Chronic injury
86
When should clinicians begin challenging a patient’s negative self-talk?
When a patient has begun to accept the injury
87
What are the elastic and contractile components of a muscle?
Elastic: Perimysium, epimysium
Contractile: Actin, myosin
88
In which phase of the stretch shortening cycle does the alpha motor neuron increase activation of the muscle?
Concentric
89
What plane of movement should plyometric exercises begin in before progression?
Sagittal
90
Which of the following is not an example of a preparatory phase plyometric exercise for the core?
-Crunch with medicine ball off wall
-Cable chops
-Side plank
-Weighted crunch
Crunch with medicine ball off wall
91
The neurophysiological model of plyometrics is based on what kind of energy?
Kinetic
92
The stretch reflex occurs by stimulation of what?
Muscle spindles that are located parallel with the muscle fibers.
93
What is the general strength criteria for initiating normal plyometric exercise?
-Back squat 1.5xbodyweight or squat 60% of 1 RM 5 x in 5 seconds
-Bench press 1xbodyweight or 5 clap push-ups
94
What plyometric phase is not typically found within a rehabilitation program?
Maximal
95
During the ground contact time of jump training, it is important to enhance what 3 aspects?
Proprioception, posture, kinesthetic awareness
96
Which phase of plyometric training is characterized by all the exercises having a longer transition time from eccentric to concentric muscle action?
Preparatory
97
What Plyometric Exercise Category focuses on low-intensity rebound activities and longer contact time?
Low-intensity submaximal plyometrics
98
Summarize the plyometric exercise categories.
-Preparatory: Strength training/balance training/technique
-Submaximal: Low/medium intensity, longer to shorter contact times
-Maximal: High intensity, short duration
99
Which of the following plyometric exercises involves the patient jumping off one platform or box, landing on the floor, and jumping onto another box?
Box jump
100
When using an isokinetic testing device, what calculation provides the best overall indicator for a patient’s readiness for activity?
Total work
101
What does an isokinetic dynamometer measure? And what speed is it always set at?
Force or power
90 degrees/second
102
The resistance provided by isokinetic equipment is called what?
Accommodating resistance
103
What is the equation for power?
Force x Distance / Time
104
What is the recommended slow concentric isokinetic test speed for the shoulder?
60 degrees / second
105
When determining work fatigue, you measure the decline in work between the first ____ of repetitions of a set and the final ____ of repetitions of that set.
33%, 33%
106
Which of the following is not a true statement about isokinetic testing?
-Eccentric training does not increase concentric strength.
-Eccentric training best prepares a muscle for the activities of sport.
-Eccentric/concentric is effective at increasing the functional capacity of a muscle group.
-Concentric training does not increase eccentric strength.
Eccentric training best prepares a muscle for the activities of sport
107
What year was the isokinetic concept first described?
1967
108
A straight leg raise with a 5-pound weight at the ankle is an example of what type of exercise?
-Isotonic
-Isometric
-Eccentric
-Isokinetic
Isotonic
109
What variable remains constant with isokinetic exercise?
Velocity
110
How much carry over is there between specific training velocities?
15 degrees / second above and below
111
What does maximum work repetition measure in isokinetic training?
The total work in the repetition with the highest torque.
112
What is the most widely used method for determining intensity of aerobic training?
Heart rate
113
Which of the body’s energy systems utilizes the Krebs cycle for energy production?
Oxidative system
114
What is stroke volume?
The amount of blood ejected by the heart with each beat.
115
What is heart rate influenced by?
The parasympathetic nervous system at rest and the sympathetic nervous system during exercise.
116
During activity, what is released to influence the sympathetic nervous system?
Norepinephrine
117
Which aerobic exercise does the ACSM classify as a Group II activity?
-Jogging
-Hiking
-Walking
-Biking
Hiking
118
Does minute ventilation increase linearly with work rate during high-intensity exercise?
No
119
Which of the following is not a muscle response to aerobic training?
-Mitochondrial size increases.
-Muscle fibers store more glycogen.
-New capillaries form in the muscle.
-Type II fibers receive the greatest effect from training.
Type II fibers receive the greatest effect from training.
120
At what rate does cardiac output increase during exercise?
Initially quickly, then it slows down as exercise is sustained.
121
T or F: The increase in output is closely related to an increase in VO2 and exercise intensity.
True
122
What is the most widely accepted method for measuring cardiorespiratory fitness?
VO2 Max
123
When maximal stroke volume is achieved, what is responsible for an increase in cardiac output?
Heart rate
124
What is minute ventilation?
The volume of air breathed per minute
125
What 5 changes occur at rest from aerobic training?
-Lower heart rate
-Increased stroke volume
-Increased size of left ventricle
-Increased blood volume and hemoglobin
-Increased skeletal muscle capillarization
126
Glycolysis is the breakdown of glucose to what?
Pyruvic acid
127
What happens to pyruvic acid when oxygen is sufficient?
It converts to acetyl-coenzyme, which then enters the Krebs cycle.
128
What happens to pyruvic acid when oxygen isn't present?
It turns into lactic acid and enters anaerobic/nonoxidative glycolysis.
129
What is a major role of the oxidative system?
To prevent the accumulation of lactate in the blood.
130
What is the Karvonen method for determining target heart rate?
(Maximum HR-Resting HR x Training Intensity) + Resting HR
131
____ are located in muscles and they relay information to the central nervous system regarding muscle ____.
Muscle spindles, stretch
132
Which of the following systems primarily provides feedback regarding the patient’s position in space?
Visual
133
In general, which strategy will be used to maintain balance when there is a relatively small displacing force on a familiar task?
Ankle
134
Which of the following systems primarily provides feedback regarding the body’s position in space relative to other body parts?
Somatosensory
135
The feed forward mechanism of the somatosensory system incorporates ____ experience in the production of a motor response for ____ muscle activity.
Past, preparatory
136
Which of the following is not a joint receptor located within the ligaments and capsule surrounding joints?
-Free nerve endings
-Merkel cells
-Pacinian corpuscles
-Ruffini receptors
Merkel cells
137
What is the unconscious recognition of a joint position in space?
proprioception
138
What is the detection of joint movement?
Kinesthesia
139
What does the vestibular system provide?
Feedback regarding the position of the head
140
What are sensorimotor structures that help regulate neuromuscular control?
Mechanoreceptors
141
Sensory information is sent through what pathways, and where does the information get sent to?
Monosynaptic (spinal cord) and polysynaptic (spinal cord and brain)
142
Where are joint receptors located?
Soft tissue structures (ligaments and joint capsules)
143
What do GTOs monitor, and where are they located?
Muscle tension, musculotendinous junction
144
What do muscle spindles monitor, and where are they located?
They monitor the muscle length change and rate of muscle length change. Located in the muscle.
145
What kind of fibers do muscle spindles consist of?
Intrafusal
146
What is the Balance Error Scoring System (BESS) used for?
To assess static and dynamic balance
