Final Flashcards
Indications for massage?
Relive pain Relax Inc circulation Dec edema Inc mobility
Contraindications of massage?
Conditions spread by massage Internal bleeding Acute inflam- RA exacerbate Circulatory condition Pitting edema
Precautions of massage?
Abnl sensation
Instability
Hygiene
Psychological effects of massage?
Build trust
Relax
Convey feeling
Mechanical effects of massage?
Assist venous return Encourage lymphatic flow Dec edema Dec scar Stretch tissue
Physiological effects of massage?
Metabolic balance
Prevent venous statsis- prevent edema
Reflex effects of massage?
Vasodilation/ vasoconstrict General relaxation or general stimulation Goose bumps Stim endorphins and endogenous Psychoneuroimmunological
What is the function of effleurage?
Glide over skin over subcutaneous and mm as a whole
Assessment, begin and end massage, mobilize skin, transitional stroke
Types of effleurage
Long or vertical
Horizontal
Shingling
NeuromuscuLar techniques are
Compression - constant pressure
Petrissage- c kneading
Stripping or knuckling-
CT technique are
skin rolling- lift, wave like normalize particular area
Friction-circular ( spiral inc in depth), transvere ( on adhesions), cross friction( itis, Inc release of histamine)
MFR
What does MFR do to surrounding area?
Relax surrounding area to allow full joint motion
Goals of mfr are?
Restore functional balance
Dec symptoms
Inc tissue rom store quality and quantity
Normalize show absorption
What is the superifical or subcutaneous layer of skin?
Undersurface of skin, loose, fat Cells, blood vessels
What is the deep layer of the skin?
Compartmentilze mm
Seperate and contour filled to allow movement of one layer to another
What is the subserous layer of skin?
Lubricants viscera
The function of MFR includes
Support Mvmt Stability Fluids Receptors
The pathway of injury to tissues
Inflam change tissue texture
Bio mechanical changes
Immunological change were scars interfere with function
Direct technique is
Push in direction of restrictions.
For acute injuries
Indirect technique is
Find restrictions push in opposite directions
Chronic injury
What a intrinsic forces?
What the pt puts out
What are extrinsic forces?
What PT puts out
What is the release phenomenon technique?
Move in or away from restrictions.
What is the testing hand.
Hand doing the work
What is the assisting hand?
Support from distance away from pt
What is ease technique?
Direction of least resistance
Indirect
What is bind technique?
Direction of resistance
Direct
What is pathway of treatment ?
Assessment- locate restriction, end feel, fine tune, clock method
Application of load
pt enhanced
Exercise to reinforce release, strengthen in new rom
What is the stroke techniques for treatment pathway ?
Skin glide/ finger glide Bony contours with finger glide Sustain pressure for 30 secs Sustain pressure by lengthening/ shortening Unlock spiral Direct oscillation Indirect oscillation
Indications for hand wrist finger massage
Carpal tunnel Tendonitis - golfer and tennis elbow, duquerivers Adhesion or contracture Amputation OA and RA Overuse Fx
Contraindications for hand wrist finger massage
Open wound Unsealed fx Tendon repair Tumor Infection RA
Forearm wrist flexors
Flexor capri radialis and ulnaris
Forearm wrist extension
Extensor carpi radialis longus/ brevis, and ulnaris
Forearm finger flexors
Flexor digitorium, superficials, profundus
Forearm finger extensors
Extensor digitorium
Intrinsic hand mm
Thenar, hypothenar
Dorsal and palmar interossie
Lumbricals
Positing for hand, wrist, forearm massage
Sitting with hand supported by pillow, don’t jab shoulder
Supine pillow under head and knee, arm straight in air, Dec edema
Hand wrist, forearm massage intervention
1 pulse
2 open
3 middle
4 close
What is in the opening of the hand, wrist, forearm massage?
Below elbow to shoulder- effleurage and petrissage of biceps and triceps
Finger tip to elbow- effleurage distal to prox
What is in the middle of the hand, wrist, forearm massage?
Forearm to wrist to hand
MFR- finger glide
Effleurage- wrist to elbow, finger to elbow, finger to wrist
Petrissage- midforearm up ext and flexors
Friction- medial lateral and ant post each finger, tendons, bellies, webspace, Mtc
Webspace
Rom
Stretch and close arches
Mobilize mcp
Radius
Ulnar
What is in the closing of the hand, wrist, forearm massage?
Elbow to shoulder, finger tips to elbow
Fingertips to shoulder
MFR provides?
Mechanical and elastic Tension regulator Support and protect restraint Lubrication and spaces Continuum
If the fascia is injured result in?
Scarring
Neuro flexible response
Functional loss
What is a trigger point?
Hyper irritable spot
What is a primary trigger point?m
Causes pain when palpation or pass over it
What is the secondary trigger point?
All of a sudden find it and cause pain,
Need to find primary cause
What is treatment for increase mm tone?
MFR strumming or constant pressure
How to treat mm play?
MFR strumming or perpendicular mobilization
What is the technique for MFR stroke of strumming?
Finger with heal of hand Apply perpendicular pressure Stay in contact as glide Horizontal( superifical) vs vertical( deep) Respiration assist from pt
What is the function of strumming?
Assessing restriction identification of mm tone
What is the function of perpendicular mobilization?
Assess mm play and edges in relation to surrounding tissue
What is the technique for perpendicular mobilization?
Perpendicular pressure Identify restriction Assist hand places tissue on slack Continuous pressure Respiration assist
What are indications for CS and TS massage?
Upper cross syndrome CS pain Facet joint problem Healed fx Post op Lig sprain OA Rib dysfunction Whip lash Mm strain FHP H/A Herniation Scolosis TMJ
What are contraindications for CS and TS massage?
Acute whiplash Unhealed fx Active Potts disease- Tb Anklyosing spondylitis Mi Cancer
What are the mm for CS and TS massage?
Subocciptial
Intertransveri,
Semi spinalis, thoracis, cerivus, capitus, rotators, thoracis
Erector spinae
Serratus posterior superior
Levator scap, mid trap, upper trap, scalene, Scm
Lower trap, rhomboid, latts, rtc
What is the primary position for CS and TS massage?
Prone with pillows in neutral LS, under ankles, towel roll under acromion
Sheets over sacrum to CS, over legs
What is the secondary position for CS and TS massage?
Seated in 45 pillow under face and knees
Sit over table and head comfortable on table with pillow for support
What is the opening for CS and TS massage?
Sacrum to base of occiput
Superifical to deep figure 8
Up center down and out
Atleast three
What is the middle for CS and TS massage?
MFR- finger glides
Effleurage- shingles, long effleurage, figure 8, horizontal
Petrissage- erector spinae and traps different fibers
Friction- around scapula, base of occiput, paraspinalis cervical and thoracic, traps, rhomboidas, btwn ribs
Mfr- constant pressure, strumming, perpendicular mob, skin rolling, stripping, stretching
What is the closing for CS and TS massage?
Whole back: sacrum to occiput
What is the definition of massage?
Manipulation of soft tissue
NS, MM, circulation
What is lymphedema?
Abnormal accumulation of protein rich fluid I’m interstitum
What is lymphedema fluid made of?
Protein Water Rbc, wbc Lymphocytes Waste products Foreign substances Fat
What is the function of the nodes?
Filter station for noxious material
Produce lymphocytes
Regulate amount of protein
What does the sub mental water shed drain?
Under chin
Drain lower lip, gums, tip of tongue,chin
What does the submandibular water shed drain?
Under mandible
Drain lips, external cheeks, medial eyelid, teeth, gum,tongue, floor of mouth, cheek mucosa
What does the perauricular water shed drain?
Front of ear Parotid gland Front ear Nasal root Lateral eye lid
What does the retroauricular water shed drain?
Behind ear Ear Posterior surface Scalp Middle ear
What does the occiput water shed drain?
In trap
Posterior and base of neck
What does the cervical water shed drain?
In Scm Ear Parotid gland Jack angle Neck Base of head Tonsils
What does the axillary water shed drain?
In armpit
Ue
Upper trunk quadrant
Mammary gland
What does the pectoral water shed drain?
Mammary gland
Lateral quadrant
What does the cubital water shed drain?
Forearm
Hand
What does the lumbar water shed drain?
Testicles/ ovaries
Uterus
Kidney
Adrenal gland
What does the iliac water shed drain?
Inguninal Bladder Prostate Uterus Upper vagina
What does the superifical inguinal water shed drain?
Below naval Lumbar Glutes Perineum External genetial Low extremity
What does the popliteal water shed drain?
Lower leg
How does the body transport the lymph?
Intrinsic contraction
Respiration
Venous and arterial pulse
Skeletal mm movement
What is primary lymphedema caused by?
Mechanical insufficiency of lymphatic system
Female
What does praecox mean?
Before 35
What does tarda mean?
After 35
What is hypoplasia?
Most common
Less than normal number of lymph node or insufficient
What is hyperplasia?
Vessel excessively dilated causing to be less function
D/t vascular dysfunction
What is aplasia?
Absence of lymph nodes or lymph node capillary
Combo with hypoplasia
What is inguinal nodes fibrosis ( kinmoutn syndrome)?
Fibrosis, fibrosclerosis, fatty degeneration or morphological changes to iliac and inguinal lymph nodes
Always LE
What is milroys disease( type 1 congenital)?
Affect at birth
Male
One LE
What is meiges syndrome ( type 2 no congenital)?
During puberty
Female
LE
Fusion of two toes, 2 rows of eyelashes, nearsighted, yellow nails, vertebral abnormalities, cerebrovascualr malformations, cleft palate, sensory loss
What is secondary lymphedema?
Surgery Radiation Trauma Cancer Parasite Infection Obesity Self induced Benign Malignant
What are the symptoms of lymphedema?
Slow onset, progressive Pitting Distally Limb feel heavy, tight, fatigue Inc risk of infection Hyper keratosis( thickening of skin) Papilloma ( extra growth) Inc fatty tissue Fibrotic changes
What are the stages of lymphedema?
0- latent
1- reversible
2- spontaneously reversible
3- lymphostais elephantiasis
What is the latent stage of lymphedema?
No visible palpable edema
What is reversible lymphedema?
Pitting edema
Dec with elevation
No fibrosis
What is spontaneously reversible lymphedema?
Pit it g becomes progressive
Fibrosis sets in
What is lymphostais elephantiasis?
No pitting
Significant skin changes
Severe fibrosis
What are complications of lymphedema?
Progressive Inc risk of infection Inc risk of open wounds Hyperkeratosis Fungal infection Lymph fistulas Lymph cysts Lymph varicosity Radiation fibrosis
What is lipedema?
Women (B) symmetric swelling from iliac crest to ankle Streamers positive No cellulitis Painful palpation Easily bruise
What are the characteristics of venous edema,?
Hemosiden staining
Fibrous of subcutaneous tissue
Atrophic skin
What is phase one ( daily) of lymphedema treatment?
Manual lymphatic draining Compression bandage Skincare Remedial exercises Pt educate on self care
What is phase two ( maintenance) phase of lymphedema?m
Compression garment during day
Self bandage at night
Skin care- low ph
Daily remedial exercise- inc mm pump, inc venous return
Self mld daily- inc resorption of protein, re route to healthy, diuretic effect, breakdown fibrotic area
What are the goals of lymphedema treatment?
Volume reduction Improve integ Infection prevention Improve psychosocial Improve functional mobility
What are contraindication of lymphedema treatment?
Acute infection Cardiac edema Malignant disease Renal dysfunction Acute dvt Arterial disorders Acute chf Htn
What are indications of anterior trunk massages?
Postural dysfunction Whiplash Open heart surgery Pulmonary disease Breast cancer Scolosis Shoulder injury Healed rib fracture Thoracic outlet syndrome
What are contraindications for anterior trunk massage?
Costochondritis
Rib fx unhealed
Positional for pregnancy
Mi
Muscles of the neck involved in an anterior trunk massage include
Longus colli
Scm
All scale es
Muscles of the trunk involved in an anterior trunk massage include
Pec major and minor Coricobrachialis Internal and external obliques Levator costae Abdominal Internal and external intercostals Diaphragm Ilicostalis
Mm of the shoulder that are involved in an anterior trunk massage include
Subscap
Serratus anterior
What this the position for an anterior trunk massage?
Supine Less amount of pillows Pillow under knees towel over legs Cover chest when needed
What strokes are involved in an anterior trunk massage?
Raking Friction Effleurage Skin slides Finger glide Bony contours
What are some indications for foot and ankle?
Sprain Plantar fasciitis Fractures Tendinitis Surgery Shin splints Compartment syndrome Osteomyelitis Crushing injuries AChilles rupture Bursitis Heel spur
What are contraindications of foot and ankle?
CHF
Phlebitis-> dvt
Tumor
Open wound
Anterior mm of ankle and foot
Quad
Hamstring
Adductors
Tfl
Posterior foot and ankle mm
Gastroc Soleus Post tib Flexor hallicus longus Flexor digitorium longus
Anterior calf mm for foot and ankle massage
Ant tib
Extensor hallicus longus
Extensor digitorium longus and brevis
Lateral mm for foot and ankle.
Perineal longus and brevis
Intrinsic mm of foot and ankle
Flexor digitorum brevis Abductor digiti minimi Abductor hallicus Adductor hallicus Interossi Lumbricals
What is the primary position of the foot and ankle massage
Supine
Pillow under foot, head and heel off table
What is the secondary position of foot and ankle massage
Under ankle and stomach
What is skin rolling?
Walk finger up back and drag thumbs behind
What is skin pulling?
Pinch and move in all directions
What are indications for thoracic lumbar massage?
Post surgery LBP Facet joint fracture Postural dysfunction Degenerative disc disease Nerve impingement
What are contraindications of thoracic lumbar massage
Tumor Chf Fracture Cancer Internal bleeding
What are the deep segmental mm for the thoracic lumbar massage
Interspinalis
Intertransversi
What are the deep transverse mm for the thoracic lumbar massage
Semispinalis
Rotators
Multifidis
What are the intermediate mm for the thoracic lumbar massage
Erector spinae
Ilicostalis
Longissimus
Spinalis
What are the extrinsic intermediate mm for the thoracic lumbar massage
Serratus posterior
What are the extrinsic superficial mm for the thoracic lumbar massage
Quadratus lumborum
Abductors
Latts
What are the hip and pelvis mm for the thoracic lumbar massage
Glute max
Piriformis
Iliopsoas
What is the primary position for the thoracic lumbar massage
Pillow under abs, ankle, acromion, horse shoe for head
What is the secondary position for the thoracic lumbar massage
Pillows under the knee, belly, neutral head, hug pillow
