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Movement and Structure > Exam 2 > Flashcards

Exam 2 Flashcards

1
Q

Differentiate between OT and PT’s role in functional ambulation

A

PT focuses on restoring or improving movement, strength, and range of motion
OT focuses on way to improve motor skills needed to do everyday occupations

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2
Q

Identify factors affecting functional ambulation

A
  1. Strength
  2. Cognition
  3. Range of motion
  4. Attention
  5. Endurance
  6. Vision
  7. Balance
  8. Motivation
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3
Q

Sagittal Plane/ Frontal Axis

A

a. Hip flexion/ extension
b. Knee flexion/ extension
c. Dorsiflexion/ Plantar Flexion
d. Toe flexion/ extension

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4
Q

Frontal Plane/ sagittal Axis

A

a. Hip abduction/ adduction
b. Ankle inversion/ eversion

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5
Q

Transverse Plane/ vertical axis

A

a. Lateral rotation
b. Medial rotation
c. Toe abduction/ adduction

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6
Q

hip flexion

A

0 -120

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7
Q

knee ROM

A

flexion: 0-135

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8
Q

hip extension

A

0-30

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9
Q

hip abduction

A

0-40

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10
Q

hip adduction

A

0-35

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11
Q

hip internal/ external rotation

A

0-45

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12
Q

plantar flexion

A

0-50

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13
Q

dorsiflexion

A

0-15

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14
Q

inversion

A

0-35

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15
Q

eversion

A

0-20

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16
Q

occupations for hip extension

A
  • Laying on stomach
  • Full standing
  • Walking
  • Reaching overhead
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17
Q

occupations for hip flexion

A
  • Putting on socks
  • Sitting and standing from chair
  • Climbing stairs
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18
Q

joint functions

A
  • Connection between bones
  • Bind skeletal system together
  • Lever system make movement possible
  • Make bone growth possible
  • Proprioception
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19
Q

types of joints

A
  1. Fibrous joints
    - Stability: dense connective tissue
    - Sutures of skull, interosseous membranes
  2. Cartilaginous joints
    - Slightly moveable
    - Pubic symphysis, sternocostal joint
  3. Synovial Joints
    - Mobile joints
    - Allow purposeful movement
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20
Q

anatomy of synovial joint

A
  • Bones
  • Cartilage
  • Joint capsule
  • Synovial membrane
  • Synovial fluid:
  • Muscle:
  • Nerves: sensory and motor
  • Blood vessels
  • Ligaments and tendons
    1. Ligaments: connect bone to bone
    2. Tendons: connect muscle to bone
    3. Limited ability to heal
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21
Q

ball and socket joint

A
  • Spherical surface fits into concave depression
  • Most mobile
  • Movement in all 3 axes
  • Ex: glenohumeral joint
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22
Q

ellipsoid joint

A
  • Oval shaped convex end articulates with concave basin of another
  • Motion around 2 axes
  • Ex: radiocarpal joint
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23
Q

saddle joint

A
  • Convex and concave articulating surfaces
  • Motion in 2 axes
  • Ex: CMC joint of thumb
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24
Q

hinge joint

A
  • Motion in single axis
  • Only flexion and extension
  • Ex: elbow joint
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25
Q

pivot joint

A
  • Motion in 1 axis
  • Bones rotating around another
  • Ex: atlantoaxial joint
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26
Q

gliding joint

A
  • Two flat surfaces of adjacent bones
  • Least movement
  • Ex: carpal bones of wrist
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27
Q

arthro vs osteokinematics

A
  • Osteokinematics: what you see
  • Arthrokinematics: what you do not see
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28
Q

normal joint end feel

A
  1. Soft: soft tissue approximates
  2. Firm: feel tension/ stretch of muscle
  3. Hard: bone one bone
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29
Q

abnormal joint end feel

A
  • Soft: caused by edema, synovitis
  • Firm: caused by increased muscle tone, tight tissue
  • Hard: caused by osteoarthritis, hypertrophic ossification
  • Empty: No end feel beause pain comes first
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30
Q

open pack position

A
  • Position with least amount of joint congruency
  • Capsule and ligaments are lax
  • Point of greatest mobility
  • EX: knee in full partial flexion
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31
Q

closed pack position

A
  • Position with maximum joint congruency
  • Capsule and ligaments taught
  • Point of greatest stability
  • EX: knee in full flexion
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32
Q

stance phase of gait

A
  1. initial contact: heel strike
  2. loading response: flat foot
  3. midstance
  4. terminal stance: heel off
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33
Q

preswing phase of gait

A

toe off

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34
Q

swing phase of gait

A
  1. initial swing: toe off
  2. mid-swing
  3. terminal swing: heel strike
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35
Q

trendelenburg gait

A
  • weak hip abductors
  • compensated by contralateral side bending
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36
Q

foot drop gait

A
  • weak dorsiflexion
  • compensated with hip or knee flexion
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37
Q

antalgic gait

A
  • abnormally short stance phase on one leg
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38
Q

hemiplegic gait

A
  • extensor spasticity from a stroke
  • reduced knee flexion during swing phase
  • compensated by contralateral side bend
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39
Q

ataxic gait

A

unsteady, staggering, uncoordinated, wider base of support

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40
Q

parkisonial gait

A
  • forward flexed posture
  • decreased trunk rotation and arm swing
  • short shuffled steps, losing balance
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41
Q

use of walking aids for functional ambulation

A

increase the base of support

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42
Q

when are crutches used?

A

non weight bearing precautions

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43
Q

posterior leaf spring AFO

A

provide assist with dorsiflexion
least supportive

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44
Q

semi-solid AFO

A

provide dorsiflexion assist, some ankle stability, some control at knee

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45
Q

solid AFO

A

limits all foot and ankle motion
provides dorsiflexion assist and prevent knee hyperextension

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46
Q

KAFO

A

little to no voluntary control at the knee and foot with some voluntary control of the hip and trunk

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47
Q

HKAFO

A

complete or partial loss of voluntary control of trunk and lower extremities

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48
Q

RGO

A

assists with advancing LE in patients with weak muscles

49
Q

ROM contraindications

A

rom should not be completed to avoid injury
joint dislocation or unhealed fracture
immediately after surgery any soft tissue surrounding joints

50
Q

ROM precautions

A
  • joint hypermobility
  • recently healed fractures
  • active inflammation at joint
  • using pain meds or muscle relaxants
51
Q

types of ROM evaluations

A
  1. screening
  2. occupation based
  3. formal
52
Q

OTPF intervention types

A
  1. interventions to support occupations
  2. occupations and activities
  3. education and training
  4. advocacy
  5. group
  6. virtual
53
Q

why does a client not have full ROM

A
  1. muscle weakness
  2. scar tissue
  3. arthritis
  4. soft tissue contracture
54
Q

PROM

A
  1. limb relaxed
  2. therapist moves body part completely
55
Q

why to do PROM

A
  • maintain range of motion
  • prevent adhesions or contractures
  • maintain joint mobility
56
Q

why do stretching

A

increase range of motion

57
Q

why do Joint mobilization

A
  • increase joint mobility and maintain joint play
  • joint capsule tightness
58
Q

A/AROM

A

client actively begins movement, assistance from external force to complete motion

59
Q

why do A/AROM

A
  • increase AROM
  • build strength
60
Q

AROM

A
  • client moves independently
  • therapist may may change gravity resistance
61
Q

why do AROM

A
  • maintain full range of motion
  • have full ROM but needs to strengthen
62
Q

What to do to maintain PROM

A

PROM
AROM

63
Q

what to do to increase PROM

A

stretching
joint mobilization
splinting

64
Q

what to do to increase AROM

A

AROM
resistance training

65
Q

skeletal muscle characteristics

A

excitability: respond to stimulus
contractility: contract, generate force
extensibility: stretch
elasticity: return to resting length

66
Q

skeletal muscle fiber types

A

slow twitch
fast twitch

67
Q

slow twitch fibers

A
  • low force
  • long duration
  • resistance to fatigue
  • rely on oxygen
  • postural muscles
68
Q

fast twitch fibers

A
  • higher velocity
  • more force and mobility
  • fatigue quickly
  • superficial muscles
69
Q

strength of muscle contraction depends on

A
  1. number of fibers in motor unit
  2. number of motor units recruited
70
Q

parallel muscle shape

A

greater ROM, less strength
- biceps
- triceps
- rhomboids

71
Q

pennate muscle shape

A

greater strength, less ROM
- deltoid
- lumbricals

72
Q

passive insufficiency

A
  • multi-joint muscle can’t fully lengthen to allow full ROM at all joints it spans
  • agonist muscle contraction is inhibited because antagonist muscle is maximally lengthened
73
Q

passive insufficiency example

A

the hip extensors are maximally stretched when the knee is extended, limiting further hip flexion

74
Q

tenodesis

A

closing of the fingers through tendon action rather than muscle contraction

75
Q

C6 SCI

A
  • weak innervation of wrist extensors but no innervation wrist and finger flexors
  • use passive wrist flexion to extend fingers to grasp
76
Q

active insufficiency

A

agonist muscle action is inhibited due to its excessive shortness
- muscles reduced ability to produce force at the end range
- tendons are maximally short limiting ability to contract

77
Q

active vs passive insufficiency

A

Passive: decrease ability to produce full ROM
active: decreased ability to produced full strength

78
Q

MMT purpose

A
  1. determine clients strength
  2. determine neurological involvement
  3. inform treatment plan
  4. assess progress
79
Q

indications for therapeutic exercise

A
  • favorable for diabetes, osteoporosis, cancer
  • increases in bone mineral density, bowel transit,glucose uptake in muscle, improve back pain
80
Q

precautions for therapeutic exercise

A
  • acute illness or injury
  • heart disease, heart conditions
81
Q

muscle strength treatment

A
  • increase strength with higher loads and few repetitions
  • add resistance to get muscle hypertrophy
82
Q

muscle endurance

A

use low load and increase number of repetitions

83
Q

coordination

A

increased by daily high repetition, contextually relevant tasks,, low resistance

84
Q

isometric exercise

A

muscle length is constant while active tension is produced against immoveable resistance
Advantages: easy to perform, tolerated better by inflammation
Disadvantages: don’t easily transfer to function, may increase bp

85
Q

isotonic exercise

A

progressive resistance exercise
- dumbells, resistance bands
- functional and occupation based

86
Q

Strengthening for muscle grade 0/5, 1/5

A
  1. passive ROM
  2. stretch is PROM is limited
  3. work in across gravity planes
87
Q

strengthening for muscle grade 2/5

A
  1. AROM across gravity
  2. work against light resistance
  3. A/AROM against gravity
88
Q

strengthening for muscle grade 3/5

A
  1. build endurance in across gravity
  2. build endurance in against gravity
  3. light resistance
89
Q

strengthening for 4/5

A
  1. gradually increase resistance to movement
  2. various types of muscle contractions
90
Q

primary motions of scapula

A
  1. elevation and depression
  2. protraction and retraction
  3. upward and downward rotation
91
Q

sternoclavicular joint

A
  • triaxial, saddle joint
92
Q

acromioclavicular joint

A

biaxial, gliding joint

93
Q

glenohumeral joint

A

ball and socket joint
- triaxial

94
Q

subacromial space contents

A
  1. rotator cuff tendons
  2. bursa
  3. LH biceps tendon
95
Q

coracoacromial ligament

A

protects structures in the subacromial space
prevents superior translation of the humerus

96
Q

primary motions of glenohumeral joint

A
  1. flexion and extension
  2. abduction and adduction
  3. lateral and medial rotation
  4. horizontal abduction and adduction
97
Q

requirements for smooth overhead motion of the arm

A
  1. clavicle rotation and elevation
  2. scapula upward rotation
  3. humerus abduction
98
Q

scapula elevation

A
  1. trapezius
  2. rhomboid major/ minor
  3. levator scapulae
99
Q

depression of scapula

A
  1. trapezius
  2. serratus anterior
  3. pectoralis minor
100
Q

scapula upward rotation

A
  1. trapezius
  2. serratus anterior
101
Q

scapula downward rotation

A
  1. rhomboid major/ minor
  2. levator scapulae
  3. pectoralis minor
102
Q

scapula protraction

A
  1. serratus anterior
  2. pectoralis minor
103
Q

scapula retraction

A
  1. trapezius
  2. rhomboid major/ minor
104
Q

shoulder flexion

A

ROM: 0-170
end feel: firm

105
Q

shoulder flexion agonists

A
  1. deltoid
  2. pectoralis major
  3. biceps brachii
  4. coracobrachialis
106
Q

shoulder extension

A

ROM: 0-60
end feel: firm

107
Q

shoulder extension agonists

A
  1. deltoid
  2. latissimus dorsi
  3. teres major
  4. pectoralis major
  5. triceps
108
Q

shoulder abduction

A

ROM: 0-170
end feel: firm

109
Q

shoulder abduction agonists

A
  1. deltoid
  2. supraspinatus
110
Q

shoulder adduction agonists

A
  1. latissimus dorsi
  2. teres major
  3. infraspinatus
  4. pectoralis major
  5. triceps
  6. coracobrachialis
111
Q

shoulder horizontal abduction

A

ROM: 0-45
end feel: firm

112
Q

shoulder horizontal abduction agonists

A

deltoid

113
Q

shoulder horizontal adduction

A

ROM: 0-135
end feel: firm
agonists: deltoid

114
Q

shoulder external rotation

A

ROM: 0-90
end feel: firm

115
Q

shoulder external rotation agonists

A
  1. deltoid
  2. infraspinatus
  3. teres minor
116
Q

shoulder internal rotation

A

ROM: 0-70
end feel: firm

117
Q

shoulder internal rotation agonists

A
  1. deltoid
  2. subscapularis
  3. latissimus dorsi
  4. teres major
  5. pectoralis major
118
Q

why document?

A
  1. reimbursement
  2. legal document
  3. communication
  4. justification

Movement and Structure (4 decks)

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