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Manual Therapy Exam 1 > Into to Mobilization > Flashcards

Into to Mobilization Flashcards

1
Q

What techniques are used to modulate pain and treat joint impairments that limit ROM by addressing altered mechanics of the joint?

A

Manual Therapy

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2
Q

5 reasons we would alter the mechanics of a joint?

A
  • pain
  • muscle guarding
  • joint effusion
  • contractures
  • adhesions
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3
Q

What type of technique is applied to joints and soft tissue?

A

skilled and passive

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4
Q

a manual therapy technique comprising of continuum of skilled passive movements to the joints and or soft tissue that are applied at various speeds and amps

A

mobilization/manipulation

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5
Q

manipulations that do not involve thrust

A

non-thrust manipulation

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6
Q

a high velocity, low amp movement within or at end of ROM

A

thrust manipulation

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7
Q

What are the 4 indications of manipulation?

A
  • safe and effective means to restore joint play
  • to decrease pain
  • **must be part of comprehensive exam of joint
  • **must be part of comprehensive POC
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8
Q

What is osteopathy?

A
  • body as a unit
  • structure and function are reciprocally interrelated
  • self-regulatory mechanisms
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9
Q

What is joint play?

A

quality of motion in joint (Mennell)

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10
Q

What is the study of motion?

A

Kinematics

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11
Q

What is osteokinematics?

A

voluntary movement of body part around the joint or fixed axis

  • measurable with goni (active and passive)
  • gross movements of body parts
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12
Q

What two types of movement make up kinematics?

A
  • osteokinematics

- arthrokinematics

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13
Q

What are two types of movements within osteokinematics (sub of kinematics)?

A
  • Active joint motion

- Passive joint motion

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14
Q

Describe end feel?

A

“feel” of tissues when passive motion is extended to the end of the joints ROM through overpressure

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15
Q

what is the quality of resistance at the end range of joint motion?

A

End Feel

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16
Q

What type of barrier is found in the end movement of ACTIVE motion in a joint?

A

physiological barrier

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17
Q

What are the three main uses of active ROM

A
  • determine joint range
  • determine flexibility
  • determine muscle function
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18
Q

What type of barrier is found in end range of PROM?

A

anatomical barrier

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19
Q

what are the two main uses of PROM?

A
  • contrast with AROM

- determine nature of end feel

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20
Q

Three types of NORMAL end ranges?

A
  • soft tissue approx. (knee flexion)
  • tissue stretch (dorsiflex)
  • bone to bone (elbow ext)
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21
Q

7 Abnormal End Ranges

A
  • empty
  • early or late muscle spasm
  • capsular
  • bone to bone
  • springy
  • muscle spasticity
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22
Q

patterns of limitation in ROM or restriction of movement which is a result of total joint reaction and involves specific limitations in motion?

A

Capsular Pattern

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23
Q

Two types of limitation in motion at the joint?

A

Capsular and Non capsular

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24
Q

ROM limitations that do not correspond to the classic capsular pattern for the joint?

A

Non capsular pattern

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25
Q

Extension more limited than flexion at elbow?

A

non capsular

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26
Q

Flexion more limited than extension at elbow?

A

capsular

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27
Q

what are motions that occur WITHIN the joint at the joint?

also, naturally occurring to allow movements and maintain integrity of joint and CANNOT be measured with goni

A

Arthrokinematics

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28
Q

What makes up arthrokinematics? (2 subtypes)

A
  • Component motions (rolls, slides, spins)

- Mobilization/Manipulation (distraction grades 1-3 and glides 1-5)

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29
Q

Joint play and accessory motions (compression and distraction) make up what type or motions)

A

component motions (slides, rolls, spins)

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30
Q

Distractions and glides make up with type of movement?

A

Manipulation/Mobilization

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31
Q

-Incongruent joint surface

A

Rolling

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32
Q

Characteristics of Rolling?

A
  • incongruent joint surface
  • new surface meets new surface of opposing
  • always occur in the same direction of “swinging” bone
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33
Q

Which direction does a roll occur?

A

-always in direction of swinging bone

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34
Q

Congruent joint surface (or flat or curved)

A

Sliding

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35
Q

Characteristics of Sliding?

A
  • congruent surface
  • same pt on one surface contacts different point on opposing side
  • direction of slide depends on concave or context surface
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36
Q

When the concave portion of a bone is moved on a convex surface what direction is the slide?

A

same direction as the motion

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37
Q

When the convex portion of a bone is moved on a concave surface what direction is the slide?

A

opposite direction of motion

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38
Q

Concave-Convex Rule

A

Concave motion=same slide

Convex motion=opposite slide

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39
Q

If the surface is more congruent is there more sliding or rolling?

A

sliding

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40
Q

if the surface is more INCONGRUENT is there more sliding or rolling?

A

Rolling

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41
Q

What controls sliding movements?

A

muscles

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42
Q

What type of component motion is a rotation about a stationary mechanical axis?

A

Spin, arc is created as it spin

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43
Q

What component motion occurs at the shoulder and hip during flexion and extension?

A

Spin

44
Q

Sliding component motion of joint mobilization is used to:

A
  • restore joint play

- reverse joint hyper mobility

45
Q

What is a small amount of movement that can only be assessed by an external force passively?

A

joint play

46
Q

What is necessary for normal, tpainfree ROM and normal end feel?

A

joint play

47
Q

A position of joint with maximum congruity and efficient for load bearing, and very dangerous to do joint play?

A

Closed pack position

48
Q

Resting position of joint, low capsular tension, inefficient for load bearing, least congruity, and best for joint play assessment?

A

Open pack position

49
Q

What manipulation is perpendicular to the treatment plane?

A

distraction

50
Q

What manipulation is parallel to the treatment plane?

A

glides

51
Q

When should you assess joint play?

A
  • when AROM and PROM is limited

- Abnormal End Feel

52
Q

When are arthrokinematics considered normal and not need to be assessed?

A

-AROM and PROM and ENDFEELS are normal

53
Q

What is it when joint surfaces are distracted and moved in a translatory fashion?

A

Glide mobilization

54
Q

use of translatoric glide to stretch tight capsule, replicates a slide, PROM can compress joint and this minimizes joint surface contact

A

Joint-glide stretch

55
Q

what is a plane that passes through the joint and lies at the right angle to a line running from the axis of rotation to the middle of the contacting articular surface

A

Treatment plane

56
Q

what is a 2 dimensional approximation on the articular surface of concave bone

A

treatment plane

57
Q

What is a distraction? Grades?

A

when articular surfaces are separated, perpendicular to treatment plane

58
Q

Joint surfaces are “unweighted”; no appreciable joint separation; only enough force to nullify joint compression forces
ex: removing tight skin

A

Distraction Grade 1

59
Q

slack in the capsule is taken up; other periarticular tissues tighten

A

Distraction Grade 2

60
Q

Capsule and ligaments are stretched

A

Distraction Grade 3

61
Q

What grade distraction goes through available joint play range and to the tissue resistance but does no proceed to the anatomical limit?

A

Grade 2 distraction

62
Q

What grade distraction goes through complete available joint play range, past tissue resistance, and almost to anatomical limit?

A

Grade 3 distraction

63
Q

What grade glides are done only if there is a restriction?

A

3,4,5

64
Q

Grade 1 Slide

A

small amplitude at beginning of range

65
Q

Grade II slide

A

large amplitude within range which does not extend to the end of available range

66
Q

Grade III slide

A

large amplitude up to a pushing into limit of range

67
Q

Grade IV slide

A

small amplitude up to and pushing into limit of range

68
Q

Grade V slide

A

thrust; small amplitude, high velocity at or beyond limit of range

69
Q

Statics and dynamics are two components of what?

A

kinematics

70
Q

what is the study of bodies at rest and includes posture, and solid mechanics such as (stress/strain)

A

Statics

71
Q

a static system, minimizes forces acting on the body

A

posture

72
Q

study of mechanical property of materials; stress and strain;

A

Solid Mechanics

73
Q

what is resistance of material to deformation

A

stress

74
Q

Stress is:

A
  • resistance of material to deformation
  • response to an applied load
  • force/area
  • directly related to magnitude of force
  • inversely related to unit area
  • stress=force divided by cross sectional area
75
Q

deformation that occurs in response to applied load; expressed as a percent change

A

strain

76
Q

application of a force, moment, or some combination to a material

A

load

77
Q

Five types of load

A
  • compression
  • tension
  • torsion
  • bending
  • shearing
78
Q

a force that is equal and opposite forces are applied toward the surface

A

compression force

79
Q

a force that is equal and opposite forces are applied away from the surface

A

tension

80
Q

a force opposing forces cause twisting

A

torsion

81
Q

opposing forces parallel to surface

A

shearing

82
Q

a force that is a combination of 3 or more loads causing it to bend around an external axis

A

bending

83
Q

Know the seven levels of stress strain curve

A

1: toe region (slack region)
2: elastic region; no damage; linear
3: elastic limit
4: plastic region (initial failure, loss of mechanical properties)
5: ultimate stress (max stress)
6: necking region (thinning of tissue toward failure)
7: failure point (max strain)

84
Q

What region of the curve is taking up slack and collagen fibers straighten without elongation?

A

Toe Region (1)

85
Q

What region of the curve is: linear; stress is directly proportional to strain (hooks law); and once stress is removed it returns to normal length (slope is stiffness of material(

A

Elastic region 2

86
Q

transition be tween linear portion and where curve flattens; tissues do not return to original length

A

Elastic limit 3

87
Q

region where tissue lengthens disproportionally to stress; permanent deformation; microscopic tearing of fibers

A

Plastic region 4

88
Q

What may allow tissue structures to return to original length after some plastic deformation has occurred below the level of ultimate stress?

A

biological memory

89
Q

peak of curve; maximum load tolerated; beyond this point necking and failure occurs

A

Ultimate stress 5

90
Q

region that follows ultimate stress; in plastic region; micro failure progresses to macro failure; total failure results

A

necking 6

91
Q

absence of stress region, total rupture of tissu

A

Failure point 7

92
Q

what is load that is applied for extended time, tissues stretch and does not return to normal length?

A

Creep

93
Q

what is a load applied to stretch tissue, length of tissue kept constant and decreased force is needed to maintain the stretch for prolonged stretching?

A

Stress-relaxation

94
Q

repetitive loading increase in heat production, may result in failure even if below yield point

A

Cyclic loading

95
Q

What are the variables for mobilization:

A
  • freq/duration
  • force/amplitude
  • speed/rhythm or type
  • location
  • temperature
96
Q

Mobilization: force criteria:

A
  • larger surface area of application=more comfort
  • apply force close to joint like
  • gentle touch
97
Q

What grades of manipulation have a psychological effect?

A

Grade I and II

98
Q

What grades of manipulation have neurophysiological effects?

A

Grades I and II

99
Q

What grade distraction and glides have a mechanical effect?

A

Grade III distraction, Grade III-V glides

100
Q

What type of effect: elongation of connective tissue and contractile tissue

A

physiological effect

101
Q

What type of effect: reducing pain, decreasing muscle guarding, inhibiting stretch reflex and improving kinesthetic awareness

A

neurophysiological effect

102
Q

what type of effect: restoration of joint play which allows for appropriate component motions and subsequent increase in active and passive ROM; decrease joint pain

A

mechanical effect

103
Q

What are the joint classifications? 0-6

A

0: ankylosed (fused)
1: considerable restriction
2: slight restriction
3: normal
4: slight increase hyper mobile
5: considerable increase in hyper mobile
6: path. unstable

104
Q

-reasses, provide exercise/stretching to maintain gains, provide HEP, provide patient education

A

after moblization

105
Q

Structure governs function, but in time…

A

function will modify if not dictate structure

Manual Therapy Exam 1 (8 decks)

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