Lecture 1 Flashcards
What is flexibility?
The range of motion available in a joint or series of joints
What is Total Flexibility dependent on?
Joint’s ROM
Muscle Flexibility
What are other important aspects of flexibility?
Mobility
Stability
Control mobility
Skill
What should you look at when two joints are fused together?
The hypermobile joints proximal and distal to the fused area
What occurs from a upper motor lesion?
Spastic muscles
What occurs from a lower motor lesion?
Flaccid muscles
What is considered the mechanical component of Total flexibility?
Joint’s ROM
What is considered the Neuro component of Total Flexibility?
Muscle Flexibility
What should occur if there is no joint/mechanical problem of the joint?
Linear movement
What makes up Joint’s ROM of Total Flexibility?
Ability of Periarticular connective tissue to deform.
Joint Arthrokinematics
What makes up Muscle Flexibility of Total Flexibility?
Ability of muscle to lengthen
Neuromuscular component-GTO and Muscle Spindle (Gamma Bias)
Why is total flexibility important?
Accommodates stress
Dissipate the Forces/Impact
Improves the efficiency of movement
Improves the effectiveness of movement
Collectively, why is total flexibility important?
Will assist in the prevention or minimization of injury
What is static Flexibility?
The MEASURED ROM available about a joint or a series of joints
How do you measure Static Flexibility?
Linear or Rotary Measurements- (Ruler or Goniometer)
What is dynamic flexibility?
The MEASURE OF RESISTANCE to active motion about a joint or series of joints.
How do you measure dynamic flexibility?
Biodex
Where does the limitation lie? JROM and its static flexibility or MF and its dynamic flexibility?
JROM and its static flexibility-Time component
What are the primary limiting factors of JROM?
Arthrokinematics of joint
Alignment of articular surfaces
What are the grades of joint mobility testing?
0-Ankylosis 1-Moderate hypomobility 2-Hypomobile 3-Normal 4-Hypermobile 5-Moderate hypermobility 6-Pathologically hypermoble
What must be done to determine a person’s joint mobility?
Test both sides if possible
If Grade 3 of Joint mobility is found, then the fault to decreased total flexibility is due to what?
Periarticular connective tissue about the joint
How can you tell connective tissue was torn rather than muscle in a tear?
Connective tissue has no blood flow, so the area will not bruise, unlike muscle tissue which does have blood flow and will bruise.
What is another name for muscle tear?
Rent
What is considered accessory motion?
Non-rotary slide
Joint mobility test
Periarticular connective tissue
What is considered Physiological motion?
Rotary physiological movement
Goniometric measurement
Periarticular Connective tissue plus muscle flexibility
Which population scars greater than others?
Dark skin compared to European Descent
What are the two main components of Connective Tissue?
Collagen
Elastin
What makes up collagen?
Fibrous Protein
Provide the skeletal structure that holds connective tissue together
Enables the tissue to resist mechanical forces and deformation.
What makes up Elastin?
Assist the recovery of tissue from deformation
More elastin in tissue equals greater recovery from deformation
If no Elastin then it would be brittle and break
What are the types of collagen?
Type I
Type II
Type III
Where are types I and III collagen often found?
In connective tissue
What happens to type III collagen?
It matures to Type I
Which collagen demonstrates greater tensile strength?
Type I
Though Type III also has some Tensile strength
Type II is compression tolerant not tensile tolerant
What is the ground substance of Collagen?
Made of glucoaminoglycans (GAG-Sugar, Protein, Sugar)
This is the substance the collagen fibrils are embedded
What does GAG have an affinity for?
Hydration
When you get older you lose water and flexibility
What are four GAGs?
Chondrotin 4-Sulfate
Chondrotin 6-Sulfate
Hyaluronic Acid
Dermatin Sulfate
What is the importance of the ground substance?
It’s a viscous gel that serves to provide lubrication between collagen fibers where they cross. Causes the fibers to not stick together.
What is the synthesis of collagen intracellularly?
Protocollagen to Procollagen
What is the synthesis of collagen extracellularly?
Procollagen to Tropocollagen to Pentafibril quarter stagger to Extracellular maturation
How can collagen be described?
As a Fiber Suspension Bridge
What is the strength of the Fiber suspension bridge dependent on?
It’s structural properties
What do the structural properties of collagen consist of?
Material Properties (Mechanical and Physical) Size (Area and Length) Organization (Tropocollagen to microfibirl to subfibirl to fibril to fascicle to tendon)
Where do strong fibers align/ how is orientation affected?
Along the area of stress
What are the three factors that contribute to homeostasis?
Cellular remodeling
Ground substance/Collagen Response
Tissue Response
What is cellular remodeling?
Fibroblastic modulation of collagen and GAG synthesis by the force/stresses imposed (usually by motion)
What is Ground substance/collagen response?
Motion will prevent anomalous (fibers sticking together) crosslinks of collagen fibers
Role of GAG is to keep/maintain fibril distance-this lubrication is a result of its affinity for hydration (min. cross linking)
Stress/motion influences the orientation of the newly formed collagen
What is tissue response?
Strength and mobility
Prohibit injury/reinjury
Wolff’s law applicable to soft tissue
What are the non permanent mechanical properties of collagen?
Elasticity
Viscoelasticity
What is the permanent mechanical property of collagen?
Plasticity
What is elasticity?
A spring like behavior where elongation is:
Produced by tension load
Recoverable after the load is removed
(Recovery like rubber-band)
What is viscoelasticity?
Allows slow deformation
Presents with an imperfect recovery
The change is not permanent
(Recovery like Screen door)
What is plasticity?
Residual or permanent change occurs
This change occurs because of viscous properties of the tissue
What is viscosity?
The resistance offered by fluid to change form or relative position of its particles due to attraction of molecules to one another.
Which Mechanical property of collagen is viscosity associated with?
Plasticity
What is another name for Force Relaxation?
Stress relaxation
What is force relaxation?
The decrease in the amount of force required to maintain a tissue at a set amount of displacement or dis0placement over time.
What is force relaxation related to?
The rate of force application and dynamic flexibility where the denominator is time
What is another name for creep?
Creep response
What is creep?
The ability of tissue to deform over time while a constant force is being applied
The tissue lengthens over time
What is creep related to?
Static flexibility
What is another name for hysteresis?
Hysteretic response
What is hysteresis?
The amount of relaxation a tissue has under gone during any single cycle of deformation and relaxation
What is hysteresis related to?
Dynamic Flexibility-Stretch, Relax, Stretch, Relax, etc.
What is muscle?
The associated connective tissue organization
What are the three levels of muscle?
Endomysium
Perimysium
Epimysium
What is the Endomysium?
Connective tissue associated with the individual muscle cells.
Interconnects to the perimysium (slice)
Greater % of elastin in continuously active muscles (Eye and diaphragm)
For Endomysium, what is the arrangement of connective tissue fibrils dependent on?
The degree of stretch or contraction of the muscle
Could be an important factor in the parallel series elastic component
What are the three components of composition in Endomysium?
Myocyte-myocyte
Myocyte-Capillary
Basil lamina network of the myocyte
What is the perimysium?
Surrounds groups of 10-20 muscle fibrils
Collectively called form fascicle
A major component of the parallel elastic components of muscle
What is the perimysium composed of?
Collagenous,
Elastic,
Reticular fibers
Fat cells
What is the importance of the perimysium?
Maintains position of muscle bundles
Distributes stress associated with passive stretch
What is Epimysium?
Surrounds the fascicle of individual muscle
Amount of collagen/elastin varies with the muscle’s function
For muscle stiffness, what is the portion of passive resting tension due to?
The parallel arrangement of the invested connective tissue.
What can a small portion of the tension of muscle stiffness be due to?
The actin and myosin cross bridges.
The tension provided by the cross bridges is velocity dependent.
What contributes to resist deformation?
Contractile and non-contractile elements
What is contractile elements related to?
Velocity of deformation
When is non-contractile elements affected?
The further a muscle is stretched
What do eccentric and concentric actions both have?
A force development which shortens or lengthens the muscle
What is isotonic?
The tone of the muscle remains the same
What occurs when actin and myocin are hyperactive?
You cannot lengthen the muscle which causes stiffness.