Day One Lecture-Goinometry Flashcards
When do you assess sensation?
patients is MSK and/or neurological conditions
How do you document sensation?
intact, abnormal, numbness or tingling; picture of mapped area
Types of sensation (4)
light touch, vibration, cold/hot, painful stimuli
Brief description of how sensory information is perceived?
skin receptors, to peripheral nerves, spinal cord, brainstem, thalamus and sensory cortex.
Deep Tendon Reflexes
the simplest reflex response that involves an afferent (sensory), efferent (motor) and one synapse called a monosynaptic reflex
What makes a normal response?
presents bilaterally and symmetrically
hyper response indicates
upper motor neuron lesion
hypo response indicates
lower motor neuron lesion
How to induce a deep tendon reflex?
tap the tendon, stretches the muscle, muscle spindles feel stretch, sensory fibers (1a) send the signal, a motor neuron connects the spinal cord to the muscle and tells it to contract.
A simple reflex response does not…
travel to the brain
Usually when testing the muscle is positioned in…
mid-range
Sometimes a gentle … of the target muscle will facilitate reflex testing
stretch
Grade scale for reflexes: 0 1+ 2+ 3+ 4+
0- no response 1+-present, but depressed; low normal 2+-average; normal 3+-increased, brisker than average; possibly but not necessarily abnormal 4+- very brisk; abnormal
What information does palpation give us?
temperature; skin: moist/dry, sensation; tissue density; deformities; posture
Always compare… if able.
bilaterally
What do we use goniometry for?
determining absence or presence of dysfunction
establishing a diagnosis
developing treatment goals
evaluating progress or lack therof
modifying treatment
patient motivation
researching the effectiveness of treatment
as a guide for fabrication of an orthosis or other piece of adaptive equipment
What does AROM indicate?
status of inert tissue, muscle’s contractile ability against gravity, patients ability or willingness to move.
What does PROM indicate?
joint integrity, joint capsule flexibility and the extensibility of the ligaments and muscles.
Sagittal plane axis
medial-lateral
Medial-lateral movement
front to back
Where does the medial-lateral axis lie?
frontal plane
Frontal plane axis
anterior-posterior
Anterior-posterior movement
side to side
Where does the anterior-posterior axis lie?
sagittal plane
Transverse axis
vertical
End-feel soft, normal category
limited by soft tissue (muscle or soft tissue); knee and elbow flexion
End-feel soft, abnormal category
as normal but feels boggy. Limited by edema, inflammation etc
End-feel firm, normal category
limited by tendon, capsule or ligament; knee extension, forearm supination
End-feel firm, abnormal category
as normal but there is a lack of give; elbow extension with biceps contracture
End-feel hard, normal category
limited by bony category; no give or bounce; elbow extension
End-feel hard, abnormal category
like normal but feels like there is a body blockage or fracture
End-feel empty category is always abnormal
unable to achieve end range, pain is the limiting factor
Capsular pattern of restriction definition
limitation of motion in a particular pattern caused by restriction of the joint capsule
In CPR, the loss of motion ….a fixed degree of ROM or in just one plane.
is not
In CPR, the loss of motion … a fixed proportion of motion loss in more than one plane.
is
In CPR, loss of rotation is ….present in joints with 3 degrees of freedom.
always
What causes CPR?
Trauma, joint lesion or arthritis, conditions that cause capsular fibrosis (immobilization or low grade inflammation)
