Lecture 1 Flashcards

Intro

1
Q

what are mobilizations?

A

passive manual techniques applied to joints + related soft tissues @ varying speed + amplitude

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2
Q

what is joint play?

A

amount of movement available between joint surfaces @ capsular level

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3
Q

what are physiologic movements?*osteokinematics

A

movements px can do voluntarily

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4
Q

what are accessory movements? *Also known as component movements

A

movements within the joint and surrounding tissues that are necessary for ROM but can not be actively controlled

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5
Q

what are arthrokinematics?

A

study of the movements that occur between the articular surfaces, inside
the joint (accessory movements)

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6
Q

what is congruency?

A

max achieved when articular surfaces have the tightest fit

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7
Q

what are normal end feels?

A

bone on bone
STA
tissue stretch/ ligamentous
muscular
capsular/firm

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8
Q

What are abnormal end feels?

A

muscle spasm
empty
springy
early bone on bone
boggy
muscular
capsular - before end range

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9
Q

what is subluxation?

A

incomplete or partial dislocation- often involves secondary trauma to surrounding soft tissue

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10
Q

what is manipulation?

A

thrust- high velocity, short amplitude-( patient cannot prevent)

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11
Q

what are the 2 shapes of joint surfaces?

A

ovoid + sellar

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12
Q

what is ovoid?

A

one surface convex
one surface concave

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13
Q

what is a sellar surface?

A

one surface convex in one direction - concave in the opposite ex. thumb/saddle

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14
Q

what is distraction?

A

joint surfaces pulled apart- require specific angle

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15
Q

what is compression?

A

joint surfaces approximated

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16
Q

what is roll?

A

one articular surfaces rolls on another
- always in same direc. as bone in motion+ associated with glide

17
Q

what is spin?

A

accessory movement- bone moves in circular fashion around stationary imaginary axis

18
Q

what is glide?

A

one articular surface glides on another

19
Q

what are the benefits of joint mobilizations?

A

pain control
joint lubrication
improves tissue health

20
Q

what are indications for joint mobilozations?

A
  1. pain + mm guarding
  2. reversible joint hypomobility
  3. positional faults/subluxations
  4. progressive limitation
  5. functional immobility
  6. poor proprioception
21
Q

list absolute contraindications of joint mob./assessment

A

hypermobility + instability
acute inflammation
bone lesions
CT lesions
bacterial infection/ sepsis
excessive pain
spinal cord lesion
joint replacement

22
Q

what are precautions in joint mobs.?

A

joint effusion?
prolonged corticosteroid
history neoplasm/radiation
osteoporosis
neurological signs
pregnancy- relaxin

23
Q

what are the two systems for grading?

A

graded oscillation technique(maitland)
Sustained translatory techniques (kaltenborn)

24
Q

what is grade 1 sustained?

A

small-amplitude distraction or glide applied where no stress is placed on capsule.
pain relief, non-corrective grade of mobilization.

25
what is grade 2 sustained ?
enough distraction or glide is applied to tighten the tissues around the joint to tissue resistance. This is also a non-corrective grade and can be used to decrease pain and maintain ROM.
26
what is grade 3 sustained?
distraction or glide is enough to put a stretch on the joint capsule and on periarticular structures. Movement is through the tissue resistance. This is a corrective grade used to stretch the joint structures and increase ROM and joint play
27
what is grade 1 oscillation?
small amplitude rhythmic oscillations performed at beginning of the range, before tissue resistance. Performed at approximately 3-5 cycles per second.
28
what are grade 2 oscillations?
: large amplitude oscillations performed within the range, before tissue resistance. Performed at 2 cycles per second.
29
what are grade 3 oscillations?
: large amplitude oscillations performed within tissue resistance (in and out), but before the joint limit. Performed at 2 cycles per second
30
what are grade 4 oscillations?
small amplitude oscillations performed just beyond tissue resistance but before the joint limit. Performed at approximately 3-5 cycles per second.
31
what are grade 5 oscillations?
small amplitude, high velocity movement (not oscillatory) that begins at the tissue resistance and ends up at the anatomical limit of the joint (manipulation). This is not in our scope of practice
32
what is the goal of grade 1 + 2 oscillations?
reduce pain (oscillations have an inhibitory effect on perception of painful stimuli by repetitively stimulating mechanoreceptors to block nociceptors).
33
what are the uses of grade 3 + 4 oscillations?
improve ROM
34
what grades can cause irritation due to higher frequency?
1+4
35
how long can grade 1 + 4 oscillations be done for?
15- 30 seconds with few seconds rest up to 5 sets (rapid and may cause irritation)
36
how long can grade 2+3 oscillations be done for?
up to 1 minute
37
what grade would you do for a first appointment joint mobilizations?
grade 1 or 2 oscillation
38
what should be taught to px after increasing ROM
ROM exercises in newly gained range p-free