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STI 1 > Final Exam Review > Flashcards

Final Exam Review Flashcards

1
Q

What are the characteristics of muscle pain?

A

Aching, cramping pain, difficult to localize, and can be referred to deep somatic structures.

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2
Q

What are the two types of trigger points?

A

Active & latent

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3
Q

What is an active trigger point?

A

Produces pain familiar to the patient upon palpation

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4
Q

What is a latent trigger point?

A

Produces an unfamiliar pain to patient upon palpation.

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5
Q

What can onset a trigger point?

A
  • Muscle overload from unaccustomed concentric or eccentric exercise
  • Prolonged shortened or lengthened position
  • radicular pain / radiculopathy
  • gross trauma
  • systemic perpetuating factors
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6
Q

How can a muscle with a trigger point present ?

A
  • motor dysfunction
  • weakness of involved muscle
  • altered sequence of recruitment of patterns
  • decreased work tolerance of muscle
  • weakness occurs from reflex inhibition
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7
Q

When finding a trigger point on a patient they may feel?

A

Local tenderness
Referral of pain to a distant site
Peripheral sensitization
Central sensitization

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8
Q

What do you feel when finding a trigger point on a patient?

A
  • palpable taut band
  • exquisitely tender spot in the taut band (latent)
  • patient recognizes referred pain / symptoms (symptoms)
  • unrecognized referred pain / symptoms (latent)
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9
Q

In what direction do you go when palpating a muscle for trigger points?

A
  • Perpendicular to the muscle fibers
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10
Q

What technique would you use when looking for trigger points in the Biceps Brachii muscle?

A

Cross-fiber PINCER palpation

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11
Q

What technique do you use when palpating for a trigger point in the deltoid muscle?

A

Cross- fiber FLAT palpation

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12
Q

When palpating for a trigger point, you need to assess what area of the muscle/

A
  • attachment to attachment
  • ex: biceps brachii, use cross-fiber pincer technique going from radial head to coracoid process and supraglenoid tubercle to assess both heads of the muscle.
    -ex: ant. Deltoid, use cross-fiber flat technique going from lateral 1/3 of clavicle to acromion process going perpendicular to the muscle
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13
Q

Once a trigger point is found, what are the steps to releasing it?

A
  1. Ask patient to rate pain 0-10 (10 being worst)
    • keep pain below a 5
    • if pain with pressure is above 5: lighten pressure, DO NOT CHANGE LOCATION
  2. Make sure you stay on the trigger point when moving pt into position of release
    • keep in mind muscle fibers will move with pt’s movements
  3. Have pt resist muscle’s PRIMARY action for ~10-15 secs 3-5x
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14
Q

What should a PT consider when looking for trigger points?

A
  • referred pain pattern
  • pt reported sx
  • pt examination
  • trigger point examination
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15
Q

When palpating for a trigger point you should remember:

A

Muscle actions
Nerve innervations
Attachments
Muscle fiber directions
Type of muscle

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16
Q

Where are lymph capillaries located?

A

Interstitial spaces of the subendothelial layers of the skin
Mucous membranes

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17
Q

Function of the lymphatic system

A

Drain substances the Blood system cannot

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18
Q

What is lymphedema?

A

Abnormal accumulation of protein and water in the interstitial space
Protein-rich swelling
Disease process

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19
Q

What are the 2 types of lymphedema and what differentiates them?

A
  1. Primary: congenital (present at birth)
  2. Secondary: post-trauma
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20
Q

What is primary lymphedema?

A

Congenital malformation of the lymphatic system
- hypoplasia
-hyperplasia
- aplasia
-present at birth (Milroy’s disease)
- lymphedema praecox- develop in childhood
- lymphedema tarda- develop in adulthood

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21
Q

What is secondary lymphedema?

A

Caused by trauma to the lymphatic system

22
Q

What are some causes of trauma to the lymphatic system?

A

Trauma
Infection
Filariasis
Surgery
Radiation
Malignant tumors
CVI

23
Q

Secondary lymphedema is caused by trauma to the lymphatic system. What is the highest incidence of secondary lymphedema in the U.S.?

A

S/p breast cancer surgery. Especially pts that underwent radiation therapy, following the removal of axillary lymph nodes

24
Q

What are the 4 stages of lymphedema:

A

0: latency (preclinical)
1: reversible
2: spontaneously irreversible
3: lymphostatic elephantiasis

25
Q

Who created CDT tx program for lymphedema?

A

Dr. Michael Foldi

26
Q

What is CDT? What does it consist of?

A

Complete Decongestive Therapy
Gold standard tx for lymphedema
Manual lymph drainage
Compression bandaging/garments
Exercise

27
Q

When practicing CDT in a tx session, what are 3 things needed to be effective?

A
  1. Manual lymph drainage
  2. Compression bandaging/garment
  3. ROM exercises performed WITH compression on
28
Q

When draining the UE what should be the direction of drainage? What is the drainage site?

A

Drainage should be performed distally -> proximally
Drainage site is the axilla

29
Q

When draining the LE, what is the order of drainage? What is the drainage site?

A

Distal -> proximal
Drainage site is inguinal fold

30
Q

What is the difference between acute pain and chronic pain?

A

Acute pain is pain lasting < 3 months. Often a result from surgery, injury, and/or disease
- warning sign to stop movement and seek medical help
chronic pain is pain lasting > 3 months. Persists beyond the normal healing time and includes peripheral and central sensitization and psychological components.

31
Q

What is somatic pain? What are the two types of somatic pain?

A

Somatic pain: caused by a stimulus to tissue to a person with INTACT nervous system Inflammatory and Nociceptive

32
Q

Inflammatory pain is what type of pain?

A

Caused by a tissue response to an injury or irritant and should resolve when the irritant ceases with healing

33
Q

What is nociceptive pain?

A

Caused by noxious stimuli of nociceptive receptors in the skin or muscles
- touch, pressure, temperature
Sensitization of peripheral nociceptors as a result of injury that causes an increased release of neurotransmitters in the dorsal horn of the spinal cord.

34
Q

What is neuropathic pain?

A

Caused by injury, dysfunction or change within the sensory nervous system, with the presence of neurological signs tat can include motor and autonomic changes.

35
Q

What are the different types of neuropathic pain?

A

Central Pain Syndrome
Complex Regional pain syndrome
Fibromyalgia
Phantom pain
Radiculopathy
Phantom Pain
Radicular pain
Referred pain
Visceral pain
Dermatomal pain
Myotomal pain
Sclerotomal pain
Referred trigger point pain

36
Q

what is Psychological Pain? What are the two types?

A

Physical pain that is caused, prolonged, or increased by mental, emotional, or behavioral factors
Chronic pain syndrome/ Somatization disorder
Pain disorders

37
Q

Characteristic responses to palpations of a trigger point include?

A

A local twitch response of the taut muscle fibers, and referred sensation in a specific pattern for that specific muscle. This sensation occurs or increases when pressure is applied to the trigger point.

38
Q

What is Specific Compression used for? How is it done?

A

A nongliding technique that therapists apply with a specific contact surface to muscle, tendon, or connective tissue.
Compression and release is applied in a direction that is perpendicular to the target tissue.
Therapist keeps pressure on trigger point even when pt relaxes from contraction.

39
Q

What is the positioning of the patient for cross friction to be performed?

A

Patient is supine leg being treated is exposed, foot is in Dorsi flexion

40
Q

What are 3 outcomes expected after trigger point or myofascial pain is treated?

A

Decreased trigger point activity
Decreased myofascial pain
Increased range of motion

41
Q

What are 3 outcomes expected after treatment to chronic pain or chronic pain syndromes?

A

Increased functional activity
Analgesia
Decreased depression

42
Q

What is another name for specific compression?

A

Trigger Point release

43
Q

What are the 6 types of trigger points?

A

Active- produces a familiar pain to pt
Latent- produces an unfamiliar pain to pt
Primary- in response to trauma oracute or chronic overload
Key- responsible for activating satellites
Satellite- activated by a key trigger point, by being in the area of referral, or by being its antagonist or synergist
Central- located near center of muscle fibers
Attachment- located in a muscle’s tendon or aponeurosis

44
Q

What parts of your arm are acceptable to use when performing trigger point release?

A

Finger tips
Olecranon
Knuckles

45
Q

What is one of the most important concepts when performing trigger point release?

A

Speak to the patient. Ask them how it feels (“when I pass over this area do you feel pain? Can you rate your pain on a scale 0-10”). Verbalize how much you want your patient to contract the muscle treated. Ask them if the pain they feel if familiar or not.

46
Q

What are some common errors when performing Specific compression?

A

Pressure applied too quickly
Pressure is too much for pt
Pressure is not maintained on trigger point (slides off)
Insufficient depth
Too few repetitions
Sustained accurate pressure does not diminish referral
Perpetuating factors not addressed
Satellite and secondary trigger points not addressed

47
Q

After performing specific compression, what massage techniques can be useful?

A

Petrissage
Stripping
Skin rolling

48
Q

What are the components of effleurage?

A

Whole relaxed palmar surface of the hand (full hand contact)
Light pressure
Direction is towards the primary drainage sites (axilla and inguinal fold)
Duration 2 min or longer

49
Q

Contraindications for effleurage are?

A

Acute systemic
Local inflammatory due to infection
Untreated metastatic disease
Allergic reactions
Recent thrombosis
Edema due to R sided heart failure

50
Q

Precautions for effleurage?

A

Cardiac insufficiency
Congestive heart failure
Thyroid hyperactivity
Only treat a pt with asthma between attacks
Pregnancy
Low blood pressure
Traumatic edema
Chronic inflammation

STI 1 (1 decks)

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