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Biomechanics > Evaluation of Joint dysfunction > Flashcards

Evaluation of Joint dysfunction Flashcards

1
Q

What are the four components of a standard physical exam?

A

Look (observe), Touch (palpation), Tap (percussion), Listen (auscultation)

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2
Q

What are the 7 components of a physical exam of the NMS system?

A

Observe, ROM, Palpation, Muscle testing, Orthopedic testing, Neurologic testing, Percussion and Auscultation

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3
Q

What is the medical definition of subluxation?

A

A partial or incomplete dislocation.

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4
Q

What is the (basic) definition for subluxation in Chiropractic?

A

A dysfunctional joint (not just the spine) that can/ does affect the biomechanics.

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5
Q

What is subluxation syndrome?

A

A complex clinical syndrome with potential mechanical, inflammatory- vascular, and neurobiologic pathologic effects.

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6
Q

What are the 3 types of joint dysfunction?

A

Hypomobolity, Hypermobility, and Clinical joint instability

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7
Q

What is joint dysfunction?

A

Joint mechanics that show disturbances of function without structural or positional change- subtle mechanical joint alterations affecting quality and range of joint motions

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8
Q

What is joint fixation?

A

The state whereby an articulation has become temporarily immobilized in a position that it may normally occupy during any phase of physiologic movement.

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9
Q

What is joint restriction?

A

limitation of movement; or describes the direction oflimited movement in dysfunctional joints

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10
Q

What are the components of joint dysfunction/ subuxation?

A

P.A.R.T.S.

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11
Q

What does P.A.R.T.S. stand for?

A

Pain, Asymmetry, Range of motion abnormality, Tone/texture/temperature, and Special tests

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12
Q

What are the 3 (of the many) causes of joint dysfunction as seen in the clinical presentation?

A

Macrotrauma, Microtrauma, or Posture

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13
Q

What is an example of a macrotrauma?

A

Motor vehicle accident

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14
Q

What is an example of a microtrauma?

A

Repeated stress injury (carpal tunnel syndrome)

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15
Q

What is an example of poor posture for joint dysfunction?

A

Anterior head carriage

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16
Q

What is primary joint dysfunction?

A

The presence ofjoint pathomechanics without any further

pathophysiologic process.

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17
Q

What are the two examples of Joint dysfunction and disease being related?

A

Somatosomatic reflexes and Somatovisceral reflexes

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18
Q

What is a somatosomatic reflex?

A

When a primary somatic problem causes a secondary somatic problem

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19
Q

What is a somatovisceral reflex?

A

When a primary somatic problem causes a secondary visceral problem; or when a primary visceral problem causes a secondary somatic problem

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20
Q

What are two examples of joint dysfunction and disease occurring separately?

A

Diabetes and Hypertension

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21
Q

What are the four steps for physical assessment of joint dysfunction/subluxation?

A

Inspection/observation, Global ROM, Palpation- Static and Motion, and Muscle testing

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22
Q

On inspection/observation, what are you looking at?

A

Superficial stuff (skin, moles, etc), Posture, Gait

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23
Q

What is Global ROM?

A

The evaluation of a joint or spinal regional movement in all its ranges o f movement.

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24
Q

What do you compare Global ROM against?

A

Standards (with goniometers and Inclinometry)

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25
Q

What is Static palpation?

A

Palpatory diagnosis of somatic structures in a neutral static position.

26
Q

What is palpation?

A

The act of feeling with the hands. The application of variable manual pressure through the surface ofthe body for the purpose ofdetermining the shape, size, consistency, position, inherent motility, and health ofthe tissues beneath.

27
Q

What is motion palpation?

A

(segmental motion assessment)- Palpatory diagnosis of

passive and active segmental joint range o f motion.

28
Q

What two structures are you looking for with static palpation?

A

Soft tissue (skin and muscle), and Bone/cartliage

29
Q

What are the objectives of motion palpation?

A

Quantity of movement, Quality of movement, Joint play, End feel, and Symptoms

30
Q

What is joint play?

A

Discrete, short range movements of a joint independent of the action of voluntary muscles, determined by springing each vertebra in the neutral position.

31
Q

What is Active ROM?

A

Movement accomplished without outside assistance; the patient moves the part himself.

32
Q

What is passive ROM?

A

Movement which is carried through by the operator without conscious assistance or resistance by the patient.

33
Q

What is a physiological barrier?

A

The end point of active joint movement.

34
Q

What is end play or end feel?

A

Discrete, short range movements of a joint independent o f the action o f voluntary muscles, determined by springing each vertebra at the limit of its passive range of motion.

35
Q

What is an Elastic barrier?

A

The elastic resistance that is felt at the end ofpassive range of movement; further motion toward the anatomic barrier may be induced passively by the examiner

36
Q

What is a paraphysiological space?

A

Area of increased movement beyond the elastic barrier available after cavitation within the joint’s elastic range.

37
Q

What is Anatomical limit?

A

The limit ofanatomical integrity; the limit ofmotion imposed by anatomic structures. Forcing the movement beyond this barrier would produce tissue damage.

38
Q

What are you looking for when interpreting joint motion?

A

End play, Painful arc, Capsular pattern, Noncapsular pattern, Hypermobility and hypomobility

39
Q

What is the Capsular feeling of end play?

A

Firm but giving; resistance builds with lengthening, like stretching a piece ofleather.

40
Q

What is a ligamentous feeling of end play?

A

Like capsular but may have a slightly firmer

quality.

41
Q

What is the soft tissue approximation of end play?

A

iving, squeezing quality; results from the approximation of the soft tissues; typically painless.

42
Q

What is the bony feeling of end play?

A

Har, nongiving abrupt stop

43
Q

What is the muscular feeling of end play?

A

Firm but givmg, builds with elongation; not as stiff as capsular or ligamentous.

44
Q

What can be palpated in normal and abnormal conditions?

A

Capsular Ligamentous, Soft tissue approximation, Bony, and Muscular

45
Q

What can be palpated only in abnormal conditions?

A

Muscle spasm, Interarticular feeling, and Empty feeling

46
Q

What is a muscle spasm?

A

uarded, resisted by muscle contraction.
The end feel cannot be assessed because of pain and/or
guarding.

47
Q

What is the interarticular feeling?

A

Bouncy, Springy quality

48
Q

What is the empty feeling?

A

Normal end feel resistance is missing; end feel is not encountered at normal point, and/or the joint demonstrates unusual give and deformation.

49
Q

What is painful arc?

A

Pain during the normal arc ofjoint motion

50
Q

What is Capsular pattern?

A

Injuries or disorders of the joint capsule lead to predictable patterns o f end play restrictions

51
Q

What is noncapsular pattern?

A

Injuries to only one part of the joint capsule don’t necessarily follow typical capsular patterns.

52
Q

What is muscle testing?

A

Clinical assessment o f the strength o f a muscle (integrity o f muscle tissue and its nerve supply)

53
Q

What is a grade 0 in muscle testing?

A

No muscular contraction detected

54
Q

What is a grade 1 in muscle testing?

A

A trace of contraction

55
Q

What is a grade 2 in muscle testing?

A

Can move body part without force of gravity applied

56
Q

What is a grade 3 in muscle testing?

A

Able to resist gravity (lift the body part)

57
Q

What is a grade 4 in muscle testing?

A

Able to resist gravity against some resistance

58
Q

What is a grade 5 in muscle testing?

A

Able to resist gravity against full resistance

59
Q

What are the 3 clinical significance of muscle testing?

A

Strong and painful, Weak and painful, and Weak and painless

60
Q

What does strong and painful muscle testing suggest?

A

Minor musculotendinous lesion (1 degree or 2 degree)

61
Q

What does weak and painful muscle testing suggest?

A

Partial musculotendinous rupture (2 degree strain); or painful inhibition associated with pathology

62
Q

What does weak and painless muscle testing suggest?

A

Neurologic lesion; or complete musculotendinous rupture (3 degree)

Biomechanics (3 decks)

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