Joint Integrity (9/11a)

Question 1

Joint integrity

Answer 1

describing if the joint is anatomically and biomechanically normal

Considers more than just mobility

Question 2

Joint mobility

Answer 2

the ability of the joint to be moved passively

Question 3

Accessory motion/joint play

Answer 3

small, isolated motions normally present at a joint that must be performed passively by an examiner or external force

can’t be done actively

Question 4

Force production issues (AROM is less than PROM)

Answer 4

nerve recruitment (PNS/CNS)

low muscle mass

muscle is tethered or inferior

lack of motivation

Question 5

Reduced PROM can be due to

Answer 5

Shortened internal joint structures (ligaments and joint capsules)

Fat tissue adhered to structures around joint

Muscles are too tight

Patient is afraid or in pain

Question 6

Assessment of joint play considers what

Answer 6

anatomical issues causing reduced ROM and also overstretching injuries

Question 7

Sprain

Answer 7

overstretched ligaments and capsules

Question 8

Strain

Answer 8

overstretched muscles and tendons

Question 9

Grades of sprains

Answer 9

Grade 1: overstretching, majority of fibers intact
Generally pain, normal motion, normal end feel

Grade 2: partial tear
Generally pain, slightly abnormal, softer end feel

Grade 3: complete tear
Generally no pain, abnormal amount of motion, soft end feel

Question 10

Swelling

Answer 10

general term for extra fluid in an area

Question 11

Edema

Answer 11

fluid between tissue layers; joint was violated and fluid got out or something else going on

Question 12

Effusion

Answer 12

fluid encapsulated within the joint, usually needs a needle to remove the fluid

Question 13

Hypermobile

Answer 13

more than normal mobility

Question 14

Hypomobile

Answer 14

less than normal mobility

Question 15

Generally expect more mobility from

Answer 15

women and younger age groups

Question 16

Laxity vs Instability

Answer 16

Laxity - more motion than normal, loose motion, CT longer than normal

Instability - symptomatic manifestation

Question 17

End feel

Answer 17

the sensation the PT can feel at the end of ROM

Question 18

Types of End Feel (PT terms)

Answer 18

Tissue approximation
Capsular end feel
Bony end feel
Spasm end feel
Empty end feel

Question 19

End Feel - Tissue approximation

Answer 19

subcutaneous tissues pushing against each other and limiting ROM

EX: elbow flexion

Question 20

End Feel - Capsular

Answer 20

joint capsule is limiting the ROM

Feels like stretching a leather belt

EX: shoulder lateral rotation

Question 21

End Feel - Bony

Answer 21

bone touching bone is limiting the ROM

hard, clear stop

EX: elbow extension

Question 22

End Feel - Spasm

Answer 22

muscles abruptly halt motion due to intense pain and guarding

Question 23

End Feel - Empty

Answer 23

patient may be in pain but nothing physically stops you from going farther into ROM