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Kines Exam 2 > Joint Mobs > Flashcards

Joint Mobs Flashcards

1
Q

What type of CT is joint capsule made of?

A

Dense fibrous CT

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2
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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3
Q

What are the 3 roles of a joint capsule?

A
  1. Seals joint space
  2. Provides passive stability by limiting movements
  3. Provides active stability via its proprioceptive nerve endings
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4
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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5
Q

What does injury to the joint capsule often lead to?

A

 Pain
 Loss of motion
 Excessive motion

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6
Q

Why do we test at the open pack position?

A
  1. Maximal incongruency
  2. Intracapsular space is as large as possible
  3. Maximal amount of joint play available
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7
Q

Why do we not test in the closed pack position?

A
  1. Joint positions where joint is most congruent
  2. Surrounding tissue (capsules and ligaments) under maximal tension
  3. Maximal stability of the joint
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8
Q

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

A
  1. Gross (quantity of movement) - hypomobile, normal, hypermobile
  2. End-feel (quality of movement) - firm, hard, empty
  3. Provocation
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9
Q

What is the difference between hypomobility and hypermobility?

A
  1. Hypomobile - Motion stops short of anatomical limit instead stops at pathological point of limitation (Pain, spasm, adhesions, inflammation)
  2. Hypermobile - Joint moves beyond its anatomical limit because of laxity of surrounding structures
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10
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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11
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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12
Q

What are the proposed nutritional effects of joint mobilizations?

A

o Synovial fluid movement

o Improve nutrient exchange

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13
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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14
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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15
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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16
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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17
Q

Choose absolute or relative contraindication:

Malignancy in area of treatment

A

Absolute

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18
Q

Choose absolute or relative contraindication:

Arthroplasty

A

Relative

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19
Q

Choose absolute or relative contraindication:

Cervical arterial dysfunction

A

absolute

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20
Q

Choose absolute or relative contraindication:

Spondylolisthesis

A

relative

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21
Q

Choose absolute or relative contraindication:

Hypermobility

A

relative

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22
Q

Choose absolute or relative contraindication:

Infectious arthritis

A

absolute

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23
Q

Choose absolute or relative contraindication:

Upper cervical spine instability

24
Q

Choose absolute or relative contraindication:

Practitioner lack of ability

25
Choose absolute or relative contraindication: | Fusion of the joint
absolute
26
Choose absolute or relative contraindication: | Excessive pain or swelling
relative
27
Choose absolute or relative contraindication: | Fracture at the joint
absolute
28
Choose absolute or relative contraindication: | Osteoporosis
relative
29
Choose absolute or relative contraindication: | Neurological deterioration
absolute
30
The joint play movement compression is what? (parallel or perpendicular)
Approximation of joint surfaces | Force perpendicular to joint plane
31
The joint play movement traction/distraction is what? | parallel or perpendicular
Separation of joint surfaces | Force perpendicular to joint plane
32
The joint play movement gliding is what? | parallel or perpendicular
Force direction parallel to joint surface
33
The joint play movement gliding is what? | parallel or perpendicular
Force direction parallel to joint surface
34
Distraction joint mobs are what to joint surface?
Perpendicular
35
Oscillation joint mobs are what to joint surface?
Parallel
36
Sustained hold mobilizations can be what 3 ranges?
1. Beginning range 2. Mid range 3. End range
37
Kaltenborn Distraction Grades are what type of mobs? | What are three grades called?
Perpendicular mobs Grade 1 - piccolo (loose) Grade 2 - Slack (take up slack) Grade 3 - Stretch
38
Describe the grade 1; where in the range it falls and its purpose for joint distractions.
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
39
Describe the grade 2; where in the range it falls and its purpose for joint distractions.
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
40
Describe the grade 3; where in the range it falls and its purpose for joint distractions.
Grade III – stretch | o Designed to stretch joint capsule and soft tissues surrounding the joint to increase mobility
41
Maitland Oscillation Joint Mob Grades are what type of mobs? How many grades?
Parallel Glides | 5 Grades
42
Maitland Oscillation Joint Mob Grade 1: where in the range it falls and its purpose for joint distractions
o Small amplitude technique performed at beginning of available ROM (first 25%) o Primary goal: pain and spasm reduction
43
Maitland Oscillation Joint Mob Grade 2: where in the range it falls and its purpose for joint distractions
o Large amplitude technique performed in middle of available ROM (middle 50%) o Primary goal: pain and spasm reduction
44
What is theory of Maitland Oscillation Joint Mob Grade 1 & 2?
 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
45
T/F Maitland Oscillation Joint Mob Grade 1 & 2 are for pain relief and muscle guarding
True
46
T/F Maitland Oscillation Joint Mob Grade 1 & 2 have a direct mechanical effect on restrictions
False, no direct mechanical effect on restrictions
47
T/F Maitland Oscillation Joint Mob Grade 1 & 2 influences mechanical nociception
True
48
T/F Maitland Oscillation Joint Mob Grade 1 & 2 are often used before and after grade 3 and 4
True
49
Maitland Oscillation Joint Mob Grade 3: where in the range it falls and its purpose for joint distractions
o Large amplitude technique performed at end of available ROM (last 50%) o Primary goal: stretching joint capsule and associated structures
50
Maitland Oscillation Joint Mob Grade 4: where in the range it falls and its purpose for joint distractions
o Small amplitude technique performed at end of available ROM (last 25%) o Primary goal: stretching joint capsule and associated structures
51
Maitland Oscillation Joint Mob Grade 5: where in the range it falls and its purpose for joint distractions
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
52
T/F Maitland Oscillation Joint Mob Grade 3/4 are primarily for pain relief and muscles guarding
False, primarily stretching technique
53
T/F Maitland Oscillation Joint Mob Grade 3/4 have mechanical and neurophys effect
True
54
Maitland Oscillation Joint Mob Grade 3/4 may activate what two receptors to aid in reducing restriction of movement?
Inhibitory joint and muscle spindle receptors
55
T/F Maitland Oscillation Joint Mob Grade 3/4 are used on patients who are normal
False, would make them hypermobile

Kines Exam 2 (6 decks)

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