Joint dysfunction Flashcards
What are the components of Joint dysfunction/subluxation?
P.A.R.T.S. -pain (location, quality and intensity) -asymmetry -range of motion abnormality -tone, texture, temperature abnormality -special tests
What are the 3 causes of joint dysfunction/subluxation?
macrotrauma (ex: MVA) microtrauma (ex: carpal tunnel) posture (anterior head carriage)
What is a complex clinical syndrome with potential mechanical, inflammatory, vascular and neurobiologic pathologic effects?
subluxation syndrome
What are subtle mechanical joint alterations affecting quality and range of motion?
joint dysfunction
What is the state whereby an articulation has become temporarily immobilized in a position that it may normally occupy during any phase of physiologic movement?
joint fixation
What is a limitation in movement called?
joint restriction
What does a subluxation mean in orthopedics/medicine?
partial or incomplete dislocation
What are the two different meanings of subluxation in chiropractic?
-traditional meaning is a joint causing nervous system compromise producing suboptimal health -modern meaning is a local biomechanics effect
What are the classic components of the physical exam?
-observation -palpation -percussion -auscultation
What are the components of the physical exam of the NMS?
-observation (superficial, posture and gait) -range of motion (goniometry and inclinometry) -palpation (static and motion palpation) -muscle testing (resisting movement on a scale of 0-5) -orthopedic testing -neurologic testing -percussion and auscultation
What is the diagnosis when there is the presence of joint dysfunction without any further pathophysiologic process?
primary joint dysfunction
When a primary somatic problem causes a secondary somatic problem?
somatosomatic reflex ex: muscle hypertonicity secondary to spinal joint dysfunction
When a primary somatic problem causes a secondary visceral problem?
somatovisceral reflex ex: constipation secondary to lumbopelvic joint dysfunction
When a primary visceral problem causes a secondary somatic problem?
viscerosomatic reflex ex: thoracic dysfunction secondary to GI disease
Palpatory diagnosis of somatic structures in a neutral position?
static palpation -evaluates soft tissue and bone/cartilage
Palpatory diagnosis of passive and active segmental joint range of motion
motion palpation
Discrete, short range movements of a joint independent of the action of voluntary muscles, determined by springing each vertebrae in the neutral position?
joint play
Movement accomplished without outside assistance - patient does the movement?
Active ROM
Movement which is carried through by the operator without conscious assistance or resistance by the patient?
Passive ROM
The end point of active joint movement?
Physiological Barrier
Discrete, short range movements of the joint independent of the action of voluntary muscles, determined by springing each vertebrae at the limit of its passive range of motion?
end play
The elastic resistance that is felt at the end of passive range of movement - further motion toward the anatomic barrier limit can be induced?
elastic barrier
Area of increased movement beyond the elastic barrier available after cavitation within the joint’s elastic range?
paraphysiological space
The limit of motion imposed by anatomic structures where movement beyond it would cause tissue damage?
anatomic limit
What is #1?
joint play
What is #2, from neutral position to physiological barrier?
active range of motion
What is #3, from neutral to elastic barrier?
passive range of motion
What is #4?
physiological barrier
What is #5?
End Play Zone
What is #6?
Elastic barrier
What is #7?
paraphysiological space
What is #8?
anatomic line
What is #9?
range where joint trauma/tissue damage occurs
What are the different types of end play?
- capsular (firm but giving)
- ligamentous (firmer and also giving)
- soft tissue approximation (giving with squeezing quality)
- bony (hard, nongiving stop)
- muscular (not as stiff as capsular or ligamentous)
- muscle spasm (protective muscle splinting due to injury)
- interarticular (bouncy, springy quality)
- empty (unusual give and deformation)
No muscle contraction detected would be what grade in muscle testing?
0
Trace muscle contraction would be what grade in muscle testing?
1
Movement without force of gravity applied would be what grade in muscle testing?
2
Movement that is able to resist gravity is what grade in muscle testing?
3
Movement that is able to resist gravity against some additional resistance is what grade in muscle testing?
4
Movement that is able to resist gravity and full resistance is what grade in muscle testing?
5
A minor musculotendinous lesion of less than 20% would have what symptoms and classification?
- strong and painful
- 1º or 2º strain
A partial musculotendinous rupture with 20-80% tear would have what symptoms and classification?
- weak and painful
- 2º strain
A complete musculotendinous rupture with more than 80% torn would have what symptoms and classification?
- weak and (initially) painless during “golden period”
- 3º strain
