HVLA

Question 1

What is the mechanism of action of HVLA

Answer 1

Resets aberrant mechanoreceptors in a dysfunctional joint

Question 2

How is articulatory technique different from HVLA technique

Answer 2

No high velocity thrust/impulse

Question 3

When does the therapeutic effect take place during an articulatory technique treatment procedure

Answer 3

When all the slack in the joint is taken up

Question 4

While treating the hip using articulatory technique, what motion is performed

Answer 4

Circumduction

Question 5

What best classifies articulatory technique

Answer 5

Passive & Direct

Question 6

What are the 5 key points of articulatory techniques

Answer 6

Firm, protective, painless grasp
Mobilize one joint at a time, one plane at a time
One side of joint is stabilized, the other is moved
No forceful abnormal movement
Therapeutic movement occurs when all the “slack” in the joint has been taken up

Question 7

Signs of articular restriction

Answer 7

Decreased ROM
Harder end-feel of passive ROM
Tisssue texture changes

Question 8

What is a type 1 afferent neuron

Answer 8

Ruffini

Question 9

What is a type 2 afferent neuron

Answer 9

Pacinian

Question 10

What is a type 3 afferent neuron

Answer 10

Golgi tendon organ

Question 11

What is a type 4 afferent neuron

Answer 11

Free nerve endings

Question 12

What is a Ruffini receptor

Answer 12

Mechanoreceptors in the outer layer of the fibrous joint capsule

Question 13

Function of a Ruffini receptor

Answer 13

Slow adapting tension control
Inhibition of pain impulses

Question 14

What is a Pacinian receptor

Answer 14

Mechanoreceptors in the deep layers of the fibrous joint capsule

Question 15

Function of Pacinian receptors

Answer 15

Rapid adapting low threshold tension sensor
Transitory inhibition of nociceptor activity

Question 16

What is a Golgi tendon body

Answer 16

Single mechanoreceptors embedded in the terminal ligaments near the joint capsule or muscle tendon junction

Question 17

Function of Golgi tendon bodies

Answer 17

Inhibitory reflexogenic effect on motor neurons

Question 18

What is a free nerve ending

Answer 18

Nociceptors sensitive to noxious substances in fibrous joint capsule
Activated by depolarization

Question 19

Function of free nerve endings

Answer 19

Pain

Question 20

Route of afferent neurologic info from mechanoreceptors to spinal cord

Answer 20

Medial branch of dorsal rami

Question 21

Absolute contraindications of cervical HVLA

Answer 21

RA
Down syndrome
Achondroplastic dwarfism
Chiari malformation

Question 22

Absolute contraindications of regional/segmental HVLA

Answer 22

Fracture/dislocation
Joint fusion
Klippel-Feil syndrome
Vertebrobasilar/carotid pathology
Inflammatory arthritidies (acute)
Infection
Malignancy
Myelopathy

Question 23

Relative contraindications of regional/segmental HVLA

Answer 23

Herniated disc
Radiculopathy
Whiplash
Osteopenia/perosis
Spondylolisthesis
Metabolic bone disease
Hypermobility
Pregnancy
Implanted devices
History of inflammatory arthritidies

Question 24

What is considered joint dysfunction

Answer 24

Loss of ROM that cannot be restored through voluntary contraction

Question 25

What is articulatory technique

Answer 25

Moving the synovial joint in a way that voluntary movement cannot reproduce

Question 26

What is the amplitude produced in HVLA

Answer 26

1/8 inch