FINAL EXAM

Question 1

when do you need to use joint play?

Answer 1

decreased ROM

Question 2

swing phase

Answer 2

35-40% of walking cycle

Question 3

stance phase

Answer 3

60-65% of walking cycle

Question 4

gate cycle - how many times do you get double leg stance

Answer 4

2x
-initial contact
-terminal stance & pre-swing

Question 5

capsular pattern GH joint

Answer 5

external rotation
ABDuction
internal rotation

Question 6

what is a myotome?

Answer 6

group of muscles supplied by single nerve root

Question 7

rules of joint play

Answer 7

-patient relaxed & fully supported
-therapist relaxed, firm but comfortable grasp
-one joint & movement examined at a time
-unaffected side first
-one articular surface stabilized, other surface moved
-movements normal, not forced
-movements should not cause undue discomfort

Question 8

lateral hip stability - what part of gait do you need it the most?

Answer 8

during load response
mid swing

Question 9

CI’s for joint play

Answer 9

hypermobility
inflammation
joint effusion
neoplasm / cancer
recent fracture
excessive pain

Question 10

joint play - absolute CI

Answer 10

cancer

Question 11

causes of joint dysfunction

Answer 11

-intra articular adhesions / pericapsular stiffness
-shortened muscle groups around joint
-muscle weakness & imbalance
-pain
-nerve root compression
-soft tissue restrictions

Question 12

dermatome definition

Answer 12

area of skin that connect to specific nerve roots on spine
-developed within first 3-5 weeks of fetal life

Question 13

reflex of achilles tendon

Answer 13

plantar flexion of foot

Question 14

what way would you NOT want to use a special test?

Answer 14

cannot use as diagnosis (not definitive)
cannot help understand a difficult sign / symptom

Question 15

gait stance - which points have double leg stance

Answer 15

initial contact stage
terminal stance & pre-swing stage

Question 16

ATAXIC GAIT

Answer 16

if patient has poor sensation / lacks muscle coordination - tendency toward poor balance & broad base
(irregular, jerky & weaving)

Question 17

TRENDELENBURG

Answer 17

if hip ABDuctors (glute med & min) are weak
-stabilizing effect of muscles during stance phase is lost
-patient exhibits excessive lateral list
-thorax thrusts laterally to keep center of gravity over stance leg

Question 18

close packed position - ankle (talocrural)

Answer 18

maximum dorsiflexion

Question 19

jaw reflex

Answer 19

normal response = closing mouth

Question 20

peripheral sensitization

Answer 20

local phenomenon that occurs when tissue has been damaged & inflammation occurs resulting in localized pain
“primary hyperalgesia”

Question 21

different parts of stance phase

Answer 21

initial contact (heel strike)
load response (foot flat)
midstance (single-leg stance)
terminal stance (heel off)
preswing (toe off)

Question 22

full ROM shoulder flexion

Answer 22

160-180

Question 23

positions for empty can (supraspinatus) test

Answer 23

patients arm ABDucted to 90 degrees in neutral: resistance applied
shoulder then medially rotated & angled toward forward 30 degrees (empty can) -> patients thumbs pointing toward floor: resistance applied

Question 24

myotome for shoulder ABDuction

Answer 24

C5

Question 25

range of dorsiflexion for ankle

Answer 25

20 degrees

Question 26

what would you see if someone had a weak glute medius & minimus

Answer 26

= trendelenburg gait (gluteus medius gait)

Question 27

myotome for dorsiflexion

Answer 27

L4

Question 28

STEPPAGE

Answer 28

-patient has weak / paralyzed dorsiflexor muscles, resulting in a drop foot
-to compensate & avoid dragging toe against ground, patient lifts knee higher than normal → at initial contact, foot slaps on ground because of loss of control of dorsiflexor muscles

Question 29

central sensitization

Answer 29

more central process involving brain & spinal cord that occurs if injury does not follow a normal healing pathway & becomes chronic
“secondary hyperalgesia”