Joint Mobs Flashcards by Lauryn Kobiela | Brainscape

Q

What type of CT is joint capsule made of?

A

Dense fibrous CT

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Q

T/F Joint capsule thickness is equal all the way around

A

False, varies in thickness according to stresses placed on it

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Q

What are the 3 roles of a joint capsule?

A

Seals joint space
Provides passive stability by limiting movements
Provides active stability via its proprioceptive nerve endings

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Q

What impact will a tight joint capsule have on motion?

A

cause early and excessive accessory motion in the opposite direction of the tightness

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Q

What does injury to the joint capsule often lead to?

A

 Pain
 Loss of motion
 Excessive motion

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Q

Why do we test at the open pack position?

A

Maximal incongruency
Intracapsular space is as large as possible
Maximal amount of joint play available

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Q

Why do we not test in the closed pack position?

A

Joint positions where joint is most congruent
Surrounding tissue (capsules and ligaments) under maximal tension
Maximal stability of the joint

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Q

What are you trying to determine with the joint mobility assessment? (3 things)

A

Gross (quantity of movement) - hypomobile, normal, hypermobile
End-feel (quality of movement) - firm, hard, empty
Provocation

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Q

What is the difference between hypomobility and hypermobility?

A

Hypomobile - Motion stops short of anatomical limit instead stops at pathological point of limitation (Pain, spasm, adhesions, inflammation)
Hypermobile - Joint moves beyond its anatomical limit because of laxity of surrounding structures

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Q

What are indications for joint mobilizations?

A

Break pain cycle
Increase joint extensibility
Increase extensibility of tendons, muscles, fascia
Increase joint ROM
Promote muscle relaxation
Improve muscle performance

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Q

What are the proposed biomechanical effects of joint mobilizations?

A

o Motion improvement
o Positional improvement
o Increase joint capsule extensibility

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Q

What are the proposed nutritional effects of joint mobilizations?

A

o Synovial fluid movement

o Improve nutrient exchange

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Q

Describe neurophysiological effect of mechanoreceptor stimulation of joint mobilizations

A

o Stimulates mechanoreceptors to inhibit pain impulses – distraction from other pain (hit elbow -> rub the area to decrease pain)

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Q

Describe neurophysiological effect of gate control theory of joint mobilizations

A

o Gate control theory (joint capsule nerves)– chronic pain unmyelinated C fibers, stimulate large myelinated fibers which stops slow pain from reaching brain

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Q

Describe neurophysiological effect of Descending pathway inhibition theory of joint mobilizations

A

o Descending pathway inhibition theory (brain stimulation) – grade 5 mobilizations, stimulating periaqueductal gray area, release serotonin, bind to opioid receptors and block incoming pain signals

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Q

Describe neurophysiological effect of peripheral inflammatory modulation of joint mobilizations

A

o Peripheral inflammatory modulation – inflammation joint capsule, stimulate and flush out inflammation

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Q

Choose absolute or relative contraindication:

Malignancy in area of treatment

A

Absolute

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Q

Choose absolute or relative contraindication:

Arthroplasty

A

Relative

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Q

Choose absolute or relative contraindication:

Cervical arterial dysfunction

A

absolute

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Q

Choose absolute or relative contraindication:

Spondylolisthesis

A

relative

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Q

Choose absolute or relative contraindication:

Hypermobility

A

relative

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Q

Choose absolute or relative contraindication:

Infectious arthritis

A

absolute

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Q

Choose absolute or relative contraindication:

Upper cervical spine instability

A

absolute

Q

Choose absolute or relative contraindication:

Practitioner lack of ability

A

absolute

Q

Choose absolute or relative contraindication:

Fusion of the joint

A

absolute

Q

Choose absolute or relative contraindication:

Excessive pain or swelling

A

relative

Q

Choose absolute or relative contraindication:

Fracture at the joint

A

absolute

Q

Choose absolute or relative contraindication:

Osteoporosis

A

relative

Q

Choose absolute or relative contraindication:

Neurological deterioration

A

absolute

Q

The joint play movement compression is what? (parallel or perpendicular)

A

Approximation of joint surfaces

Force perpendicular to joint plane

Q

The joint play movement traction/distraction is what?

parallel or perpendicular

A

Separation of joint surfaces

Force perpendicular to joint plane

Q

The joint play movement gliding is what?

parallel or perpendicular

A

Force direction parallel to joint surface

Q

The joint play movement gliding is what?

parallel or perpendicular

A

Force direction parallel to joint surface

Q

Distraction joint mobs are what to joint surface?

A

Perpendicular

Q

Oscillation joint mobs are what to joint surface?

A

Parallel

Q

Sustained hold mobilizations can be what 3 ranges?

A

Beginning range
Mid range
End range

Q

Kaltenborn Distraction Grades are what type of mobs?

What are three grades called?

A

Perpendicular mobs
Grade 1 - piccolo (loose)
Grade 2 - Slack (take up slack)
Grade 3 - Stretch

Q

Describe the grade 1; where in the range it falls and its purpose for joint distractions.

A

Grade I – piccolo (loosen)
o Distraction force that neutralizes pressure in the joint without producing actual separation of the joint surfaces
o No stress on the joint capsule
o Can be used with gliding mobilizations to reduce compressive forces on articular surfaces and thereby pain

Q

Describe the grade 2; where in the range it falls and its purpose for joint distractions.

A

Grade II – slack (take up the slack)
o Slack in joint capsule is reduced through sustained distraction
o Separates the articulating surfaces and eliminates the play in the joint capsule
o Can help to determine the sensitivity of the joint

Q

Describe the grade 3; where in the range it falls and its purpose for joint distractions.

A

Grade III – stretch

o Designed to stretch joint capsule and soft tissues surrounding the joint to increase mobility

Q

Maitland Oscillation Joint Mob Grades are what type of mobs? How many grades?

A

Parallel Glides

5 Grades

Q

Maitland Oscillation Joint Mob Grade 1: where in the range it falls and its purpose for joint distractions

A

o Small amplitude technique performed at beginning of available ROM (first 25%)
o Primary goal: pain and spasm reduction

Q

Maitland Oscillation Joint Mob Grade 2: where in the range it falls and its purpose for joint distractions

A

o Large amplitude technique performed in middle of available ROM (middle 50%)
o Primary goal: pain and spasm reduction

Q

What is theory of Maitland Oscillation Joint Mob Grade 1 & 2?

A

 Reduces pain by improving joint lubrication and circulation to tissues related to the joint
 Rhythmic oscillations possibly activate articular and skin mechanoreceptors which play role in pain reduction

Q

T/F Maitland Oscillation Joint Mob Grade 1 & 2 are for pain relief and muscle guarding

A

True

Q

T/F Maitland Oscillation Joint Mob Grade 1 & 2 have a direct mechanical effect on restrictions

A

False, no direct mechanical effect on restrictions

Q

T/F Maitland Oscillation Joint Mob Grade 1 & 2 influences mechanical nociception

A

True

Q

T/F Maitland Oscillation Joint Mob Grade 1 & 2 are often used before and after grade 3 and 4

A

True

Q

Maitland Oscillation Joint Mob Grade 3: where in the range it falls and its purpose for joint distractions

A

o Large amplitude technique performed at end of available ROM (last 50%)
o Primary goal: stretching joint capsule and associated structures

Q

Maitland Oscillation Joint Mob Grade 4: where in the range it falls and its purpose for joint distractions

A

o Small amplitude technique performed at end of available ROM (last 25%)
o Primary goal: stretching joint capsule and associated structures

Q

Maitland Oscillation Joint Mob Grade 5: where in the range it falls and its purpose for joint distractions

A

o High velocity thrust of small amplitude at end of available range but within its anatomical range
o Movement that exceeds the resistance barrier
o Commonly referred to as high velocity thrust technique or joint manipulation

Q

T/F Maitland Oscillation Joint Mob Grade 3/4 are primarily for pain relief and muscles guarding

A

False, primarily stretching technique

Q

T/F Maitland Oscillation Joint Mob Grade 3/4 have mechanical and neurophys effect

A

True

Q

Maitland Oscillation Joint Mob Grade 3/4 may activate what two receptors to aid in reducing restriction of movement?

A

Inhibitory joint and muscle spindle receptors

Q

T/F Maitland Oscillation Joint Mob Grade 3/4 are used on patients who are normal

A

False, would make them hypermobile