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MSK T3 > Intro To MSK > Flashcards

Intro To MSK Flashcards

1
Q

What is the (Massage Therapy Act, 1991) Scope of Practice?

A

The assessment of soft tissues & joints of body & treatment & prevention of physical dysfunction & pain of soft tissues & joints by manipulation to develop, maintain, rehabilitate or augment physical function, or relieve pain.

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2
Q

What are the 3 main treatment priorities?

A
  1. Decrease pain
  2. Normalize ROM
  3. Improve function (Strength/Endurance)
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3
Q

What are Causes (Specific impairment) for Pain?

A

• Mechanical (stretch or compression)
• Inflammation
• Referral (TrP, Neurological)
• Psychosomatic

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4
Q

What is the Assessment for Mechanical (stretch or compression) Pain?

A

Postural assessment, AF, PR, mm length testing, palpation

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5
Q

What is the Assessment for Inflammation pain?

A

Case history, observation, palpation

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6
Q

What is the Assessment for Referral (TrP, Neurological) Pain?

A

TrP: referral patterns, palpation, mm length strength tests Neurological: Dermatomes, Nerve tension tests, tinnel’s, TOS tests, palpation

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7
Q

What is the Assessment for Psychosomatic Pain?

A

Physical findings don’t match

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8
Q

What is the Treatment Option for Mechanical (stretch or compression) Pain?

A

Massage, heat, stretch

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9
Q

What is the Treatment Option for Inflammation Pain?

A

Lymph drainage/superficial fluid techs, rhythmich techs (gentle), low grade join play, hydrotherapy, positioning

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10
Q

What is the Treatment Option for Referral (TrP, Neurological) Pain?

A

TrP: Petrissage, heat, stretch, PIR, acupuncture

Neurological: Massage, MF techs (Nerve mobilization), acupuncture, spine joint mobes if nerve root implicated

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11
Q

What are the Causes (Specific impairment) for Hypomobility?

A

• 5MRT (tone/TrP)
• Myofascial (muscular) extensibility
• Adhesions/ Scarring
• Periarticular adhesions/ contracture
• Swelling
• Pain
• Weakness/ Inhibition

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12
Q

What is the Assessment for 5MRT (tone/TrP) Hypomobility?

A

Passive ROM, mm length testing, palpation, visual observation, ‘stiffness’ may be described

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13
Q

What is the Assessment for Myofascial (muscular) extensibility Hypomobility?

A

Passive ROM, mm length testing, palpation, visual observation, ‘stiffness’ may be described

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14
Q

What is the Assessment for Adhesions/ Scarring Hypomobility?

A

Passive ROM, mm length testing, palpation, visual observation, ‘stiffness’ may be described

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15
Q

What is the Assessment for Periarticular adhesions/ contracture Hypomobility?

A

ROM (active/passive), early capsular end feel, postural deviation

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16
Q

What is the Assessment for Swelling Hypomobility?

A

Observation, palpation

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17
Q

What is the Assessment for Pain Hypomobility?

A

Subjective data, provocation tests

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18
Q

What is the Assessment for Weakness/ Inhibition Hypomobility?

A

Postural observation confirmed with mm strength testing

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19
Q

What is the Treatment Option for 5MRT (tone/TrP) Hypomobility?

A

Neuromuscular techniques, heat, joint play, stretch, PIR

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20
Q

What is the Treatment Option for Myofascial (muscular) extensibility Hypomobility?

A

Myofascial techs, heat, stretch

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21
Q

What is the Treatment Option for Adhesions/ Scarring Hypomobility?

A

Myofascial techniques (including frictions*), heat, stretch

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22
Q

What is the Treatment Option for Periarticular adhesions/contracture Hypomobility?

A

High grade joint play

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23
Q

What is the Treatment Option for Swelling Hypomobility?

A

Superficial fluid techniques, LD, hydrotherapy, low grade joint play, positioning

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24
Q

What is the Treatment Option for Pain Hypomobility?

A

Treat primary dysfunction

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25
Q

What is the Treatment Option for Weakness/ Inhibition Hypomobility?

A

Weakness: Therapeutic exercise
Inhibition: Tapotement, TherEx, Electroacupuncture

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26
Q

What are Causes (Specific impairment) for Hypermobility?

A

• Trauma/ Pathology
• Tissue laxity
• Weakness/ Inhibition

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27
Q

What is the Assessment for Trauma/Pathology Hypermobility?

A

Diagnosis/Clinical impression

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28
Q

What is the Assessment for Tissue laxity Hypermobility?

A

Postural assessment, ROM (active/passive), mm length tests, special tests

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29
Q

What is the Assessment for Weakness/Inhibition Hypermobility?

A

Postural observation confirmed with mm strength testing

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30
Q

What is the Treatments for Trauma/Pathology Hypermobility?

A

Treat presenting impairments (modify as needed)

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31
Q

What is the Treatment for Tissue laxity Hypermobility?

A

TherE to strengthen supporting structures

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32
Q

What is the Treatment for Weakness/ Inhibition Hypermobility?

A

Weakness: TherEx
Inhibition: Tapotement, TherEx, Electroacupuncture

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33
Q

What are the 4 Big/Common Modifiers?

A
  1. Compromised Cardiovascular Health
  2. Diabetes
  3. CT disorders
  4. Medications
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34
Q

What are modifications for Compromised Cardiovascular Health?

A

• consider positioning (limiting time in prone, tx in sidelying or semifowler’s)
• hydro modifications (ie. modifying temperature, duration of tx, local instead of general applications)
• shorter/local strokes instead of sweeping fluid techniques to limit stress on CV system
• delayed/compromised healing - consider impact on stages of healing & response to treatment

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35
Q

What are modifications for Diabetes?

A

• tissue fragility
• altered sensation
• delayed/compromised healing
• with long term patients, cardiovascular health needs to be considered

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36
Q

What are modifications for CT disorders?

A

• tissue fragility

37
Q

What are modifications for Medications?

A

• implications for patient feedback, tissue fragility

38
Q

What are Treatment Planning Considerations for Functional presentations and the aging body?

A

• Tissues can be altered with manual therapy & remedial exercise to improve function/mechanics.
• When patients present with functional impairments, treatment goals should be to normalize tissues & optimize function. There can & should be defined treatment plan resulting in full resolution & discharge of patient.

39
Q

What are Treatment Planning Considerations for Structural presentations and the aging body?

A

• There are permanent changes to tissues that cannot be altered with manual therapy.
• Treatment goals shift to managing symptoms & maintaining tissue health/mobility. Treatment planning for structural presentations tend to be long term/ongoing ‘maintenance’ treatments as opposed to ‘fixing’ functional problem.

40
Q

What happens to soft tissues and joints as we age?

A

Soft tissues & joints slowly degenerate, often presenting as osteoarthritis (OA), disc degenerations, tendinopathies, etc.

41
Q

What are conditions like osteoarthritis & tendinopathies considered to be?

A

They are considered chronic & sometimes structural impairments.

42
Q

Can conditions like OA & tendinopathies typically be ‘fixed’?

A

No, they often cannot be ‘fixed’ & require long-term management.

43
Q

What is the focus of long-term treatment plans for patients with degenerative conditions?

A

The focus is on managing symptoms & maintaining functionality as much as possible.

44
Q

Why is it important to have conversations about degenerative conditions with patients?

A

Helps manage patient expectations & makes treatment planning discussions easier.

45
Q

Can massage therapy still benefit patients with chronic degenerative conditions?

A

Yes, massage therapy can play significant role in their long-term health, wellness, & functionality, even if conditions cannot be fixed.

46
Q

What is the traditional way we learn a muscle’s action in anatomy?

A

Based on a proximal attachment fixed joint position.

47
Q

What is the functional reality of muscle actions in the lower extremity?

A

We live in a distal attachment fixed scenario, such as when our feet are on the ground during standing or gait.

48
Q

Why is it important to consider the interdependent nature of joints in the body?

A

No joint functions in isolation, especially in a distal attachment fixed scenario like during gait.

49
Q

What is an example of joint interdependence in the lower extremity?

A

During a squat, hip flexion, knee flexion, & dorsiflexion of the talocrural joint cannot be isolated; the joints function as a chain.

50
Q

What should be considered when assessing impaired function at one joint?

A

The impact on the rest of the chain – particularly the joints above & below.

51
Q

What balance does every joint require to allow for efficient movement?

A

Every joint requires a balance of stability & mobility.

52
Q

What determines a joint’s primary need for stability or mobility?

A

Factors like the number of planes it moves in, its articulation, & its static/dynamic stabilizers (ligaments, muscles).

53
Q

How do joints alternate in their primary needs to allow efficient movement?

A

Joints typically alternate between mobility & stability to allow a large range of motion (ROM) while maintaining control.

54
Q

What happens if a joint’s primary need (stability or mobility) is not fulfilled?

A

It can lead to inefficiency in movement or dysfunction in the joints above & below it.

55
Q

What happens if a mobile joint loses mobility due to postural dysfunction, injury, etc.?

A

The brain will compensate by gaining mobility at another joint, often a stable joint, above or below.

56
Q

Why is compensatory movement at a stable joint problematic when a mobile joint loses mobility?

A

Stable joints are not designed for mobility, so compensatory movement can lead to dysfunction & stress on those joints.

57
Q

hat happens if a stable joint lacks stability?

A

There will be a lack of control during movement, & compensatory actions may occur at the affected joint or at a joint above or below.

58
Q

What can be stressed if a stable joint experiences excessive movement?

A

Inert structures, like ligaments or menisci, are likely to be stressed, which can lead to injury.

59
Q

How does the brain compensate for a lack of stability in a joint?

A

The brain may use the muscular system to create stability, leading to muscle & fascia shortening to limit excessive movement.

60
Q

What is an example of a compensatory pattern due to glute med weakness?

A

A patient may develop a Trendelenburg gait with contralateral hip drop, resulting in pelvic instability.

61
Q

How can pelvic instability due to glute med weakness affect the knee?

A

Pelvic instability can cause excessive movement at the knee (a stable joint), potentially damaging inert structures or predisposing them to injury.

62
Q

What muscle is often recruited by the nervous system to compensate for glute med weakness?

A

The iliopsoas is commonly recruited to stabilize the hip, which can lead to trigger points, strain, & mechanical pain in the lumbar spine.

63
Q

Why is it important to look beyond the location of pain in patients?

A

Pain is not always located where the dysfunction or the root cause of the dysfunction is.

64
Q

What is the primary treatment goal for patients experiencing pain?

A

The number one priority is to alleviate pain.

65
Q

Why is treating only the tissue impairments at the location of pain often insufficient for long-term relief?

A

If there is an underlying stability or mobility issue causing dysfunction, treating the pain alone won’t address the root cause & may not lead to long-term relief.

66
Q

What types of assessments should be used to identify the root cause of dysfunction?

A

Regional postural scan, movement screening, length testing, strength testing, & functional/special tests.

67
Q

What does a comprehensive assessment help with when creating a treatment plan?

A

It helps form both short- & long-term goals & creates an effective treatment plan.

68
Q

How can assessments influence active care programs?

A

They provide insight into the type of active care program that should be implemented, either under supervision or in collaboration with other healthcare professionals.

69
Q

How can we achieve efficient movement in one plane of motion?

A

By controlling movement in the other two planes of motion.

70
Q

What is an example of a sagittal plane movement, & which planes must be controlled for efficiency?

A

Gait is a sagittal plane movement (flexion & extension), & the transverse and coronal planes (rotation, abduction/adduction) must be controlled.

71
Q

What forces act on the body during single-limb stance?

A

Gravity pulls us into flexion, adduction, & internal rotation.

72
Q

Which muscles are important for maintaining an upright posture during single-limb stance?

A

The trunk & lower limb musculature, especially the posterior chain, resist flexion, adduction, & internal rotation.

73
Q

What are examples of coronal or transverse plane deviations at different joints in the lower extremity?

A

Hip: Lateral pelvic shift or contralateral hip drop
Knee: Valgus stress
Lower extremity: Internal rotation
Ankle: Overpronation

74
Q

Why are movement inefficiencies in the coronal & transverse planes particularly damaging for certain joints?

A

The more stable a joint needs to be & the fewer planes it allows movement in, the more damaging inefficiencies in movement can be.

75
Q

What approach should be taken in treatment planning for patients with movement inefficiencies?

A

A local, regional, & spinal segmental approach, with thorough intake & assessment to identify contributing factors.

76
Q

Why is specificity important in treatment planning?

A

Specificity in assessment & intake leads to successful treatment planning & helps achieve the patient’s goals & desired clinical outcomes.

77
Q

How does massage therapy contribute to the healing process?

A

Massage therapy can affect multiple levels of the healing process, touching on local, regional, & systemic factors.

78
Q

What does local treatment focus on?

A

Local treatment focuses on specific tissues, including inert and contractile tissues, nerve pathways, & circulatory pathways.

79
Q

What tissues are involved in regional treatment?

A

Regional treatment includes joints above & below the local treatment site, agonist-antagonist muscles, synergists, & associated nerve & circulatory pathways.

80
Q

What is spinal segmental treatment?

A

Spinal segmental treatment involves addressing the spinal segments related to the local & regional tissues, stimulating the circulatory & nervous system pathways (dermatome, myotome, sclerotome) to enhance treatment effectiveness.

81
Q

Which spinal segments correspond to the head, neck, shoulder, & upper extremity in the paravertebral reflex sympathetic vascular areas?

A

T1-T6.

82
Q

Which spinal segments correspond to the middle trunk somatic tissues & all visceral territory?

A

T1-L2.

83
Q

Which spinal segments correspond to the pelvic girdle & lower extremity?

A

T10-L2.

84
Q

Which spinal segments correspond to the heart, lungs, & upper respiratory airways in the paravertebral reflex sympathetic visceral areas?

A

T1-T5.

85
Q

Which spinal segments correspond to the liver, gallbladder, stomach, spleen, and pancreas?

A

T6-T10.

86
Q

Which spinal segments correspond to the adrenal medulla?

A

T8-L1.

87
Q

Which spinal segments correspond to the kidneys?

A

T10-T11.

88
Q

Which spinal segments correspond to the adrenal glands, small intestine, ascending & transverse colon, & bladder?

A

T10-L2.

MSK T3 (5 decks)

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