Fundamentals of PTA Week 1&2 Lecture Flashcards
What are the stages of trauma?
- Initial shock
- Denial: days to weeks
- Grief: mourning, self blame
- Anger: eternalizing blame, non compliance
- Resolution: acceptance
What is a linear motion?
Moves at same time, same direction and same distance (aka translatory)
- Rectilinear and Curvilinear
What is angular motion?
Moves at same time, same direction but not same distance (aka rotatory) e.g. knee extension while sitting on a chair
What is an example of combination of angular and linear movement?
Person on a skateboard
Synarthrosis -
Motion?
Structure?
Example?
Has a thin layer of fibrous periosteum between two bones.
Motion - No
Structure - Fibrous-suture joint
Example - Skull
Syndesmosis -
Motion?
Structure?
Example?
A fibrous joint that connects two adjacent bones with ligaments or a strong membrane.
Motion - Slight amount of twisting/stretching
Example - Distal tibiofibular joint (in the ankle) and distal radioulnar joint
Gomphosis
Motion?
Structure?
Example?
Motion - No
Structure - Fibrous peg in socket
Example - Between teeth and mandible
Amphiarthrosis
Motion?
Structure?
Example?
Has either hyaline or fibrocartilage
Motion - Little; bending/twisting; compression; provide stability
Structure - Cartilagenous
Example - Symphysis pubis, vertebral discs, ribs
Diarthrosis
Motion?
Structure?
Example?
Most common; further classified into movement and degrees of freedom
Motion - Free
Structure - Synovial
Example - Hip, elbow, knee
Kinetics vs kinematics
Kinetics- Forces and motion only and reveals how forces affect motion.
Kinematics- Motion only–or how an object moves through space–without reference to any associated force.
What is osteokinematics?
Joint motion.
Movement of bones around a joint axis; one bone moving on another
- Flexion and extension
- Abduction and adduction
- Lateral and medial rotation
E.g. Humerus moving on the scapula
What is arthrokinematics?
Joint surface motion
- Roll, spin, glide.
E.g. Humeral head’s movement within glenoid fossa of scapula
What are component movements?
Motions that accompany active motion but are not under voluntary control.
Superior is also called?
Cephalad
Inferior is also called?
Caudal
What do bones consist of?
- Organic and inorganic material
- Comprised of compact and cancellous
What are long bones?
Diaphysis with 2 epiphysis
E.g. femur, tibia
What are short bones?
Carpals, tarsals - usually articulate with more than one bone
What are flat bones?
Broad, thin surface
E.g. scapula, sternum, ilium
What are irregular bones?
Mixed shapes
E.g. vertebra, sacrum
What are sesamoid bones?
Patella, pisiform
What is diaphysis
Main shaft; center is medullary cavity
What is medullary canal
Hollow; decreases the weight of the bone
- Contains marrow and provides passage for nutrient arteries
What is endosteum
The membrane that lines the medullary canal
For bone resorption
What is osteoclasts responsible for?
Responsible for bone resorption
What is epiphysis
Each end of a long bone
- In adult, it is osseous; in children, it is cartilaginous (epiphyseal plate: manufactures new bone)
What is metaphysis
- Flared part at each end of the diaphysis
- Made up of cancellous (spongy) bone
- Functions to support the epiphysis
What is periosteum and its functions?
- Tough fibrous membrane covering all of the bone except the articular surfaces
- Contains nerve and blood vessels to provide nourishment, prompt growth and repair
Function:
- Nourishment
- Growth in diameter of immature bone
- Repair of the bone
- Attachment for tendons and ligaments
During flexion, what happens to the angle of body parts and the movement occurs in what plane and around what axis?
↓ Angle
Sagittal plane around the frontal axis
During extension, what happens to the angle of body parts and the movement occurs in what plane and around what axis?
↑ Angle
Sagittal plane around the frontal axis
Abduction/adduction occurs in what plane and around what axis?
Frontal plane around sagittal axis
ER and IR are what movements in what plane through what axis?
Lateral/medial movement
Transverse plane
Vertical axis
Thumb flexion/extension (thumb moving side to side; parallel to the palm) occurs in what plane and axis?
Frontal plane; sagittal axis
Thumb abduction/adduction (thumb moving up and down, perpendicular to the palm) occurs in what plane and axis?
Sagittal plane; frontal axis
What are the joint motions in sagittal plane around frontal axis?
Flexion/extension
What are the joint motions in frontal plane around sagittal axis?
Abduction/adduction
Radial/ulnar deviation
Eversion/inversion
What are the joint motions in transverse plane around vertical axis?
Medial/lateral rotation
Supination/pronation
Right/left rotation
Horizontal abduction/adduction
How many bones are in axial skeleton? What is their function?
80 of the skull, hyoid, vertebral, ribs, sternum, coccyx
- Support, protection, hemopoiesis
How many bones are in appendicular skeleton? What is their function?
126 bones of the extremities; clavicle, scapula, humerus, radius, ulna, carpals, mcps, phalanges, tarsals, mtps, pelvic girdle, femur, patella, tibia, fibula
- Locomotion
What is joint capsule in synovial joints made of?
fibrous cartilage
What does synovial membrane do and what does it secrete?
Lines joint capsules
Secretes synovial fluid
Synovial joint bone ends are covered in what?
Articulating cartilage aka cushions for bone surfaces
What are examples of plane/ gliding joint (a type of synovial joint)?
The joints between the metacarpal bones of the hand and those between the cuneiform bones of the foot.
Uniaxial
What are examples of sellar joint (aka saddle joint)?
The carpometacarpal joint at the base of the thumb
What are examples of hinge joint?
Knee, elbow
What are examples of pivot joint?
AA joint, proximal radioulnar joint
What are examples of condyloid joint (aka ellipsoid joint)?
MCP, MTP, AO joint, distal radiocarpal joint (wrist)
What are examples of ball and socket joint?
Glenohumeral, acetabular
What are characteristics of nonaxial joint?
- Linear movement
- Gliding motion
- Flat joint surface
- e.g. intercarpal
What are characteristics of uniaxial joint?
- 1 axis, 1 plane
- 1 degree of freedom
- Hinge or pivot
- e.g. Elbow and interphalangeal (fingers) joint
What are characteristics of biaxial joint?
- 2 axes/ 2 planes
- 2 degree of freedom
- Condyloid or saddle
- e.g. MCP (knuckles) and radiocarpal
What are characteristics of triaxial joint?
- 3 axes/ 3 planes
- 3 degrees of freedom
- Ball and socket
- e.g. hip and shoulder
What is “degrees of freedom”?
Motion around axis and planes
What is the degree of freedom for the talocrural joint?
- 1 degree (df/pf)
- Formed by the distal ends of the tibia and fibula, and the talus bone
What is the degree of freedom for subtalar joint?
1 degree (inv/ev)
Formed by the talus and calcaneus
What is the degree of freedom for midtarsal joint?
2 degrees (df/ pf/ add/ abd/ in/ ev)
Formed by talonavicular and calcaneocuboid
What is a bursa?
A small pad-like sacs
- In areas of excessive friction
- Under tendons/ bony promiences
- e.g. olecranon bursa, student’s bursa
What is an aponeurosis?
Broad, flat sheet of dense fibrous connective tissue that connects muscles to each other or to bones
What is fascia?
Sheath of stringy connective tissue that surrounds every part of your body. It provides support to your muscles, tendons, ligaments, tissues, organs, nerves, joints and bones
What are three types of cartilages?
- Hyaline
- Fibrocartilage
- Elastic
What are characteristics of hyaline cartilage?
- Ends of opposing bones
- Smooth articular surface
- No blood/ nerve supply
- Nutrition from synovial fluid
What are characteristics of fibrocartilage?
Shock absorption, important in weight bearing joints
- e.g. menisci knee, labrum, intervertebral discs
What are elastic cartilage and where can you find them?
Allow certain amount of motion
- e.g. symphysis pubis, larynx
What are different classifications of fractures?
- Simple: bone break w/o protrusion
- Compound: bone breaks with protrusion
- Greenstick: young bone
- Comminuted: several pieces
- Impacted: end of one bone pushed up into remainder of other bone
- Double: break in 2 places
- Multi
- Spiral
What is osteoporosis and what does it lead to?
Loss of bone density that can lead to pathological fracture
What is osteomyelitis?
Bacterial infection of bone
What are the types of fracture reduction?
- Closed reduction: push pieces back into place
- Open reduction: requires surgical intervention
- Internal fixation: internal with rods, screws; may be permanent
- External fixation: temporary
What is power?
Measure of muscle performance and is work/time
What is strength?
Ability of muscle groups to produce tension and results in maximal effort either dynamically or statically in relation to the demand placed on it
What is endurance?
Necessary to perform repeated motor tasks in activities of daily living.
- Total body endurance: Low intensity exercise/time
- Muscle endurance: Isolated muscle group performance/time
What is flexibility and mobility?
Necessary for performance of normal functional activities.
Mobility exercises will restore lengths of muscles.
What is relaxation?
Conscious effort to relieve tension in muscle through therapeutic exercise
What is coordination?
Ability to use the right muscle at the right time with appropriate sequencing and intensity which requires an intact motor system
What is fatigue?
Affects functional performance
What is local muscle fatigue?
- Diminished response of a muscle to repeated stimulus.
- It’s a normal physiological response characterized by a decrease in amplitude of motor unit potentials.
What is recovery from fatigue?
Time to restore body to pre-existing state
What is overwork?
Causes temporary of permanent deterioration of strength as a result of exercise
What is substitution?
May occur with much resistance or with weak muscle
What is muscle soreness?
Develops during or directly after strenuous exercise performed to a point of fatigue; occurs because of lack of oxygen, usually transcient.
What is DOMS?
Develops 24-48hrs after exercise and slowly diminishes within a week
What is contractures and fibrosis?
Conditions that can affect the body’s muscles, tendons, and ligaments, and can cause a loss of movement in joints
What is open kinematic chain?
Movement that occurs in chain where distal segment moves freely in space; specific muscle isolation
E.g. chest presses, biceps curls, leg curls and leg extensions
What is closed kinematic chain?
Movement occurs over fixed distal segment; involves multiple joints moving against linear resistance; often used to improve coordination, balance, and core strength
E.g. squats and push ups
What is isometric?
Muscle shortens with no appreciable change in length of muscles
Speed - fixed
Resistance - fixed
Joint motion - no
E.g. plank
What is isotonic?
Exercises carried out against constant load as muscle lengthens/shortens through ROM
- Concentric/eccentric
Speed - variable
Resistance - fixed
Joint motion - yes
E.g. squats, pull up, push up
What is isokinetic?
Dynamic exercise where movement occurs at a constant speed and resistance is variable
Speed - fixed
Resistance - variable
Joint motion - yes
E.g. spin bike
What is concentric?
Muscle shortens with a decrease in joint angle (against gravity)
What is eccentric?
Muscle elongates with increased joint angle (with gravity)
What is muscle irritability?
Capacity to respond to a stimulus
What is muscle contractility?
Ability to shorten or elongate
What is muscle extensibility?
Ability to stretch or lengthen when a force is applied
What is muscle elasticity?
Ability to return to normal resting length once force is removed
What is the excursion of a muscle?
Distance from maximum elongation to maximum shortening.
What is a functional excursion of a muscle?
The distance a muscle is capable of shortening after it has been elongated to it’s max
What is muscle length-tension relationship?
Force built up in muscle causing movement and muscles can be shortened and lengthened half of its normal resting length
Muscles are strongest when…?
Put on a slight stretch before contracting
E.g kicking a ball
1. Hyperextend hip and then flex it forcefully
2. Put hip flexors on a stretch before contracting
Muscle insertion move toward…?
The origin
Insertion = more movable bone
Origin = more stable bone
In order to achieve mechanical advantage, the resisting arm should be…?
Decreased
Mechanical advantage is equal to…?
The length of the force arm (distance between the force and axis) divided by the resistant arm (distance between the resistance and the axis) i.e. MA=FA/RA
Law of Inertia
An object at rest, stays at rest. An object in motion, tends to stay in motion.
Law of Acceleration
Force equals mass times acceleration; F=MXA
Law of Action-Reaction
For every action there is an equal and opposite reaction.
Muscle names tell us about..?
- Location
- Shape
- Action
- Number of heads/divisions
- Attachments (origin/insertion)
- Direction of the fibers
- Size of the muscle
What are the characteristics of fibers “parallel” to the long axis of the muscle?
- Longer
- Greater ROM potential
- Strap, fusiform, rhomboidal, triangular
What are the characteristics of fibers “oblique” to the long axis of the muscle?
- Shorter
- Greater strength potential (due to more fiber)
- Small ROM potential
What are examples of muscles with parallel fibers?
- SCM (strap)
- Biceps, brachialis, and brachioradialis
muscles. (fusiform - spindle shaped) - Rhomboids, glutes, (rhomboidal)
- Pectoralis major (triangular)
What are examples of muscles with oblique fibers?
- Tibialis posterior (unipennate)
- Rectus femoris (bipennate)
- Deltoid (multipennate)
What are the mechanical properties of muscle?
- Comprised of many myofibrils made up of sarcomeres
- Sarcomeres are the contractile units comprised of actin and myosin
- The sliding of both cause muscle to shorten
- Requires energy and calcium ions
What’s the purpose of stretching?
To lengthen the resting length of a muscle.
Must avoid overstretching and ballistic movements
What is First Class Lever?
FAR
Balance and posture
e.g. head flex and ext., seesaw
F - Muscles on the opposite side
A - Vertebrae
R - Weight of head
What is Second Class Lever?
ARF
Power (Mechanical advantage)
e.g. Ankle, wheelbarrow
A - MTP joints in the foot
R - Tibia and body weight
F - Plantar flexors
What is Third Class Lever?
AFR
For ROM
Most common in the body
e.g. The elbow joint; screen door with spring
A - Elbow joint
F - Brachioradialis
R - In the hand
R, the resistance is the same as…?
Load
What is cocontraction of muscle
When the antagonist contracts at the same time as
the agonist
What does the neutralizer muscle do?
When a muscle can do two actions, but only one is wanted.
Contracts to prevent unwanted motion.
What does the synergist muscle do?
Group of muscles that works with one or more
other muscles to enhance a particular motion.
What is active insufficiency?
The point at which a muscle cannot shorten any farther
What is passive insufficiency?
When a muscle cannot be elongated any farther without damage to its fibers.
What is autonomy?
The right of a patient to make their own decisions, including their right to privacy and confidentiality.
What is benifience?
The obligation to act in the patient’s best interest, which includes avoiding harm and ensuring equal services.
What is fidelity?
A therapist’s moral obligation to keep promises and commitments to patients.
This includes keeping information confidential and providing services as ordered by a physician.
What is informed consent?
A type of consent that must be obtained to avoid claims of medical negligence.
What is maleficience?
The obligation to avoid harming the patient.
What is justice?
The obligation to treat all people equally and fairly, including the fair distribution of healthcare resources.
