Exam 2 Flashcards
what is manual muscle testing?
a means of objectively grading the max contraction of a muscle/muscle group
what is the purpose of mmt?
1)determine extent of muscle power available
2)id muscle weakness which interferes w/client funct
3)prevent deformities from occurring by locating poss prob areas due to muscle imbalance
4)aid therapist in:
a) setting baseline for treatment
b)assessing need for and practicality of adaptive devices c)determining level of acts the client is capableof performing
d)eval the effectiveness of treatment techniques
indications for muscle testing
1) lower motor neuron disease (diseases which cause flaccid paralysis: polio, guillain-barre synd)
2)spinal cord injuries (quadriplegics and paraplegics will demo lower mot neu clinical pic above lvl of lesion)
3)neurological diseases that cause primary muscle weakness (multiple sclerosis, amyotrophic lat sclerosis, myasthenia gravis, muscular dystrophy)
contraindications for muscle testing
-for clients who primarily demonstrate an upper mot neu lesion (diseases that result in spasticity, hyperactive deep reflexes, pathological reflexes) such as:
-cerebral palsy
-cerebral vascular accident(if they still move in synergistic patterns of motion)
-spinal cord injuries
-parkinson’s disease
types of disabilities that may be tested with limitations considered
-arthritis: pain may inhibit client from moving part or accepting mac resistance
-parkinson’s: during early stages, prior to or in the absence of rigidity
-cerebral vascular accident: as synergy patterns break up, client may demo isolated muscle control in various joints if spasticity isn’t an inhibiting factor
-cerebral palsy: if hypertonicity or hypotonicity arent severe and incoordination not a prob, a form of muscle testing may be done w/adaptations
limitations of muscle testing
1)doesn’t show endurance and ability to do work
2)doesn’t show ability to combine muscles into smooth harmonious mvt
3)doesn’t show pic of gross/partial muscle control
4)doesn’t show ability to use muscle power: for funct, motivation, muscle sense (motor control and coord)
5)doesn’t show how much joint range the kind muscle is working through
skills needed by tester
1)know how to position part being tested
2)know to stabilize to rule out substitution and give a firm base
3) must know poss substitution patterns and how to look out for them
4) know how to palpate to feel contraction
5) know how and where to apply resistance
6)know how to set “normal” in muscle power
7) knowledge of origins, insertions, direction of fibers and pos of muscle layers
procedure for mmt
1)introduce self
2)position
3)stabilize
4)observe
**5) palpate
6) resist
7) grade
0/zero
no contraction of muscle, no mvt of the part
t(1) trace
slight cont can be palpated; no mvt of part
p-(2-) poor minus
prt moves through incomp ROM w/g min
p(2) poor
prt moves through com ROM w/g min
p+ (+2) poor plus
prt moves through com ROM w/g min, slight res
f-(3-) fair minus
moves through incom ROM vs g
f (3) fair
moves through com ROM vs g
f+ (3+) fair plus
moves through com ROM vs g, slight res
g(4) good
moves through com ROM vs g, mod res
n(5) normal
moves through com ROM vs g, normal res
funct capacity of a muscle indicates
ability of muscle to contract in a controlled setting. muscle grade will also give the therapist some info on how the client might be expected to perf funct acts
funct cap: good to normal
should perform all funct acts involving those muscles w/out undue fatigue providing endurance lvl is also good to normal
funct cap: fair plus
-should be able to perf most funct acts inde
-lower endurance lvl and easily tired
-work short periods, then rest needed
-may be protected by therapist, especially if muscle strength is expected to improve
-said to represent a definite funct threshold
funct cap: fair
-will be able to performmin task vs g, but no real work
-low endurance, client tires when attempting funct acts
-could prob do light work but w/frequent rest
-in lower extremities: not enough strength for walking
funct cap: poor
-below funct range
-should be able to maintain own ROM vs g min w/ no inhibiting factors
-could help stabilize joint, in terms of funct
funct cap: zero to trace
-completely dependent
-not able to perform funct acts w/out external power source(therapist, electric hand splint, electric wheelchair)
glenohumeral joint
true anatomical joint- diarthrosis- ball and socket
scapulothoracic joint
-not a true anatomical joint
-physiological joint mechanically linked to acromioclavicular and sternoclavicular joints
acromioclavicular joint
true anatomical joint
-plane synovial
-allows for additional range of rotation on the thorax in latter stages of elevation
-maintains relationship b/t clavicle and scapula in early stages of elevation
sternoclavicular joint
true anatomical joint
-plane synovial
-attaches clavicle to sternum
-serves as only bony connection of the upper extremity to trunk
subdeltoid joint
not anatomical joint, but a physiological joint
-2 surfaces moving w/respect to each other (humerus vs coracoacromial arch)
-mechanically lined to glenohumeral joint (mvt in one joint influences mvt in the other)
what bones makes up shoulder girdle
the clavicle and scapula
why are mvts of the shoulder girdle also called mvts of the spacula or scapulathoracic joint?
since position of clavicle doesnt permit its moving independently
translatory mvts
scapula moves as a whole
scapula: elevation
upward mvt of the scapula w/vertebral border remaining parallel to spinal column
scapula: depression
return from the position of elevation
