Intro to MSK Flashcards
What are two parts of the Canadian approach to manual therapy?
- Differential diagnosis
2. Biomechanical examination
_______ ________ = assessments of movement dysfunction by looking at the joint kinematics
biomechanical examination
What are 3 manual therapy articular techniques
- joint mobilization
- joint manipulation
- traction
What are 3 manual therapy soft tissue techniques ?
- deep transverse friction massage
- trigger point release
- myofascial techniques
_____ is a strategy used to teach people in chronic pain the neurobiology and neurophysiology involved in their pain experience
PNE
______ focuses less on anatomical and pathoanatomical models and is more hands off
PNE
______ _____ position = position in which the greatest degree of mobility between articular surfaces is available
open pack
_____ _____ position = position in which the least degree of mobility between articular surfaces is available
close pack
_________ movement = gross movement of limb or body parts relative to one another that the pt can perform voluntarily
osteokinematic
_________ movement = relative motion that occurs between joint surfaces
arthokinematic
Arthrokinematic movement also known as ________ movements
accessory
Is arthrokinematic movement necessary for full motion to be achieved?
YES
What are 3 arthrokinematic movements?
- roll
- slide/glide
- spin
When the convex joint surface moves on a fixed concave surface, the direction of the joint glide is _______ the direction of bone displacement
opposite
When the concave joint surface moves on a fixed convex surface, the direction the joint glides is in the ____ direction as the bone displacement
same
Joint mobilization may include a combo of both _______ and _________ movements
physiologic; accessory
When joint motion is usually restricted, joint ______ and ______ is usually impaired
rolling; gliding
What do we use when joint motion is restricted?
distractions and glides
_________ _____ = the plane where the joint glide normally occurs during movement
treatment plane
Treatment plane = located at a _____ angle to a line drawn from the axis of rotation to the center of the concave articulating surface
right
________ = force is applied in a direction that is perpendicular and away from the treatment plane
distraction/traction
____ = force is applied in a direction parallel to the treatment plane
glide
Grade __ = before R1, small amplitude
1
Grade __ = before R 1, large amplitude
2
Grade ___ = between R1 and R2, large amplitude
3
Grade __ = at end near R2, small amplitude
4
Grade __ = small amplitude, high speed, thrust at R2 and beyond
5
What grades do you choose for pain relief?
1 and 2
What grades do you choose for stiff and non-irritable joints ?
3 and 4
What are the 3 effects of joint mobilizations?
- neurophysiological
- mechanical
- psychological
What are 3 neurophysiological effects of grades 1-5 joint mobs?
- firing or articular mechanoreceptors, proprioceptors
- firing of cutaneous and muscular receptors
- altered nociception
What are 4 mechanical effects of grade 3-5 joint mobs?
- stretching of joint restrictions
- breaking of adhesions
- alter positional relationships
- reduce/eliminate barriers to normal motio
What are 3 psychological effects of grades 1-5 joint mobs?
- confidence gained through improvement
- effects from manual contact
- response to joint sounds
What are 6 examples of indications for manual therapy?
- to improve accessory or physiological movement
- to reduce positional faults/subluxation and restore normal articular relationship
- to relieve pain
- enhance motor function via neurophysiological effects
- to improve nutrition to intra-articular structures by promoting mobility
- to reduce muscle guarding
When assessing joint play and joint motion barriers, what 3 things should you assess for?
- quantity of movement
- end feel
- presence of pain
What is the rate of oscillations in the Maitland grading system?
2-3 Hz
In the Maitland grading system, oscillate in __ - __ s intervals until desired effect is reached in grade I or II mobs
10-30
In the Maitland grading system, oscillate in __ - __ s intervals until desired effect is reached in grade III or IV mobs
30-60
Kaltenborn grading system = sustained for cycles of __-__ s holds
6-10
Kaltenborn grade __ = small amplitude distraction
1
Kaltenborn grade __ = distraction to take up the slack
2
Kaltenborn grade __ = distraction to glide or stretch tissue
3
When mobilization involves joint glides, the _______ grading system is most commonly used
Maitland
When choosing to provide separation between joint surfaces the ________ grading system is often used
Kaltenborn
When P>R, what treatment and what grade?
traction; grade I
When P = R, what treatment and what grade?
traction OR glides from neutral - midrange; grade I - II
When R>P, what treatment and what grade?
glides into barrier; grade III - IV
When no pain, just R, what treatment and what grade?
glides OR constant stretch into barrier OR manipulation; grade IV or V
What are 3 purposes of a deep transverse friction massage?
- prevent or destroy abnormal fibrous adhesions
- optimize quality of scar
- enhance normal healing
Indication for DTFM for muscle?
subacute or chronic
Indication for DTFM for tendon?
acute or chronic
Indication for DTFM for ligament?
acute or chronic
Position of muscle in DTFM?
muscle belly relaxed
Position of tendon in DTFM?
tendon on pain free stretch
Position of ligament in DTFM?
ligament on pain free stretch
Analgesic effects of DTFM within __-__ mins; can then go deeper if indicated and tolerated by pt
2-3
DTFM should include steady, rhythmical movements (__-__ Hz per second)
2-3
Duration of DTFM for acute?
gentle, up to 10 min
Duration of DTFM for chronic ?
up to 15 mins
Frequency of DTFM ?
every other day
_______ ______ = longitudinal force applied in an effort to separate the vertebrae
spinal traction
What are 8 effects of spinal traction?
- separation of vertebral bodies
- increase IVF area
- mechanoreceptor stimulation / pain inhibition
- disc related changes
- decreased muscle spasm
- mobilization of zygopophyhseal joints
- mobilization of muscles and connective tissue
- improved circulation
