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CATA 263 > lecture 2: ROM, Flexibility and Manual Muscle Testing > Flashcards

lecture 2: ROM, Flexibility and Manual Muscle Testing Flashcards

1
Q

what is a diagnostic sign

A

objective and measrable

see, feel, hear, assess

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2
Q

what is a symptom

A

subjective and provided by perception of injured athelte

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3
Q

what is an acute injurt

A

sudden onset of symptoms

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4
Q

what is an acute injurt

A

sudden onset of symptoms

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5
Q

what is a chornic injury

A

slow onset of symptoms

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6
Q

what is microtrauma

A

multiple small stim that culminate to a painful reaction

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7
Q

what is a macrotrauma

A

LARGE stimular that lead to instantaeaous painful reaction

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8
Q

give an example of an acute and macrotrauma

A

ankle sprain

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9
Q

give an example of a chronic and microtrauma

A

stress fracture

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10
Q

what are the 2 reasons its important to evaluate the uninjured side

A

1) serves as a baseline

2) serves as a goal to what we want to get back to

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11
Q

what is the acronym for evaluopton process

A

HOPS

(history, observation, palpation, special/stress tests/physical assessment

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12
Q

explain history of hops

A

primary compain, MOI, signs and symtpoms, past injuries, any changes

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13
Q

explain observation of hops

A

posture, gait, deformtiies, brising, swelling wtc

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14
Q

explain palplation of hops

A

looking for deformities, tenderness, heat

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15
Q

explain stress tests/ physical assessment

A

doing AROM, PRom, RROM, flexibility, lig testing, neurological exain

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16
Q

what side do you always start on and why

A

uninjured to establish a baseline

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17
Q

what is important to remmeber in terms of joints when doing physycial tests

A

some muscles cross more than one joint so you may noeed to evaluate multiple joints

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18
Q

in neuromulscular injuries/pathlogies, what can be the source of the pain and why

A

nerve

can cause neuralgia/reffered pain

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19
Q

where shiuld you assess if you suspect the pain is coming from a nerve

A

spine

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20
Q

what does osteokinetic mean

A

movement that is visible from the outisde

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21
Q

give examples of osteokinetic movement

A

abduction, rotation, flexion, extension, supination, etc

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22
Q

in ROM what type of movements are we assessing

A

osteokinetic movements

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23
Q

what are the 2 thigns that affect ROM

A

affected by

1) joint arthrokineamties (bony structures)
2) soft tissue (muscle. ligs, capsules(

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24
Q

what is arthrokinetic movement

A

movement resulting from the bone movement inside

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25
Q

what is another nsme for flexibility

A

mobility

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26
Q

what is the defintion of m=flexibility

A

ability to move freely wihtout restriction

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27
Q

true or false: flexiblity will not fffect ROM

A

false, it will

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28
Q

what are the 2 types of flexibility

A

passive and active

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29
Q

in order to measure JOINT ROM in a joint with 2 joint muscles involved, the first muscle must be BLANK and the second must be BLANK

A

first muscle be elongated

second joint should be in a shorted position

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30
Q

give an example of how the muscles should be when assessing knee joint ROM

A

While looking at knee flexion, since gastroc also affects the joint, the ankle must be in a shorted postion

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31
Q

in order to measure MUSCLE LENGTH of flex of a 2 joint muscle, how should the muscle be placed

A

the muscle should be placed in an elongated position across all joints

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32
Q

give an example of how joints shouodnbe for testing muscle length

A

if looking at the hamstring musxle length:

the hip muscle be in full flexion and the knee in full extension

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33
Q

what is active ROM

A

perform voluntary movemetn

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34
Q

what does active ROM assess

A

assess muscle function

total amplitude, willingness, fludiity of movement

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35
Q

what is passive ROM

A

performed by the professional without participation from the patient

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36
Q

what does passive ROM assess

A

assess non contractratile strcutires (joints, ligs)

assess for end fell sensations and amplituedes

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37
Q

what is resisted ROM

A

muscle contraction against a ressitance

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38
Q

what does RROM assess

A

assess for muscle function at specific ROM

assess strength and endurance

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39
Q

if someone has pain on PROM, what is it most likely do to

A

injury to non contractule strengthes

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40
Q

if someone has pain on RROM or AROM what is ut most likely due to

A

muscle function injury

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41
Q

what is required to stretch

A

rewquires a segment to go to a point of resistance in the ROM

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42
Q

when does active stretching occur

A

when a person stretching supplies the force of the stretch

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43
Q

when does passive stretcching occur

A

occurs when a extersnal force causes increases a stretch

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44
Q

what are the two proprioceptors for strecthing

A

golgi tendon organs and muscle spindles

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45
Q

where are msucle spindles located

A

intrafusal muscle fibers

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46
Q

what do muscle spindles monitor changes in

A

monitor changes in msucle length (and speed)

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47
Q

what happens when sensory neuron from a muscle spindke innervates a motor neuton in muscle spindles

A

create the stretch reflex

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48
Q

when there is a rapid msucle lengthening, what happens to the muscle and why

A

muscle contraction

to avoid injury

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49
Q

true or false: you waNT TO avoid activation of the msucle spindles in stretching

A

true

50
Q

why wouldny you want the muscle spindles activated in stretching

A

cause it will contract the muscle

51
Q

where are GTos locatied

A

nesar the musculortendinous junctions

52
Q

what are GTO sensitive to

A

cahnges in muscle tension

53
Q

what happens to a muscle when GTO are activatied,

A

causes the muscle to relax

54
Q

relaxation that occurs in the SAME muscle experiences tension is called

A

autogenic inhibition

55
Q

relaxation that occurs in the muscle opposite the muscle experiences tension is called

A

reciprocal inhibition

56
Q

How is autogenic inhibitor accomplised

A

accomplished via active contraction of the miuscle immediated before passive strecth of that same muscle

57
Q

what is happening at a physiological level f=during autogenic inhibition

A

tension built up during active contracion stimulates GTO cause a reflexive relation of the muscle during the subsequent passive stretching

58
Q

what is happening at a physiological level during recripocal inhibition

A

tension in contracting muscle stimulates GTO and caauses reflexive relaxion of the stretched muscle

59
Q

true or false: in static strecthing, you want to activat muscle spindles and why

A

false, you do not want to because the stretch reflex will happeen and cannot stretch properly if the muscle is being contracted

60
Q

what is static strecthing

A

slow constant stretch that holds at the end of ROM for 15-30 sec
repeat multiple times

61
Q

what is dynamic stretching

A

functionally based stretching

uses spirt ad activity specific movement to prepare the body for warm up

62
Q

what does dynamic stretching promote

A

dynamic flexibility

63
Q

what is dynamic flexibility

A

ability to actively move throug hROM needs for activity with proper muscle activation

64
Q

what us ballistic strecthign

A

inolves active msucle effort andf uses a bouncing type movement

65
Q

in ballistirc strethching, the end postiion is held?

A

false.

66
Q

is ballistic used more pre or post exercuse

A

pre exercise

67
Q

what is the issue with ballisitc stretching

A

if not controlled it can lead to injurt of the muscles/coonnetcive tissue since pushing the limits of ROM

68
Q

what type of stretching usually triggesrs the strech reflex

A

ballistic

69
Q

what does PNF stand for

A

prioprioceptive neuromusuclar facilitation strech

70
Q

what was PNF orriginally created for

A

designed to relax muscles with icnreased tone or activity

to get rid of soreness

71
Q

true ir falseL PNF facilitiates muscular activation

A

false

mscular inhibition

72
Q

explain autogenic inhibition in PNF strecthign

A

either an isometic or concentric muscle contaaction of the antagonist muscle (the one being streched) is used prior to a passive strech of the antagonist

73
Q

explain receprical inhibiton in PNF

A

use agonist muscle contraction

74
Q

true or false: eccentric contraction is not used in PNF

A

truw

75
Q

explain the hold relax strecth method

A

1) passive stretch (10s)
2) isometic cntatction (causes autogenic inhibition)
3) athetlete relate=ex and passive stretch is perfromed in new ROM for 30 s

repeat 3-6 or until no furhter gain in ROM

76
Q

explain the contract relax

A

1) passive stretch (10s)
2) concentric contraction through full ROM
3) athltee relaxes and passive stretch is perfomed in new ROM for 30 sec

repeat

77
Q

which is the most effective PNF strecth and why

A

HOLD RElax with with agonist contaction
slow reversal hold relax

because of autogenic and reciprocal inhibition

78
Q

explain the slow reversal hold relax method

A

1) passive stretch(10s)
2) isometric contraction (6 sec)
3) Athlete relaxed and then contracts agonist muscle to bring through new rom

repeat

79
Q

why is manual muscle testing imporatnt (3)

A

1) part of our assessment to determine the integrity of the muscular tissues
2) imporatnt for determining ability to RTP
3) important to know for prescribing exercises

80
Q

what are the 3 reasons we get msucle wealkness

A

1) muscle imbalances (posture or repetiive movements)
2) fatigue
3) injury (lig injury, muscular injury, nerve injury,joint injury)

81
Q

expkain how repetitive movements can cause msucle imbalances and waekness

A

in tennis for example

unilateral, other msucle gets negletcted

82
Q

weakness may due to

A 
nerve involvement 
disuse atrophy
strecth weakness
pain
fatigue
83
Q

what are some examples of return of muscle strength (5)

A

1) recovery after disease/trauma/repair
2) return of nerve impulse
3) hypertrophy of unaffected muscle fibers
4) muscualr development resulting from exrceises
5) return of strength after tightness has been relived

84
Q

why would relieving tightness in a muscle return muscle strength

A

since its too tight the actin and myosin is too close together with too much overlap therefore theres not a good amount of stretch

85
Q

muscle weakness should be treated in accordance with…

A

cause of weakness
(ex: if lack of use=exercise
if fatigue=rest
if strain=treat

86
Q

what are the 2 types of manual testing

A

1) break test

2) acttive resistance

87
Q

explain the break test

A

at the end of available ROM

patient is asked to hold that position and do not allow therapist to break the hold with manual resistance

88
Q

explain active resistance

A

therapist graudally applied manual resistance until it reaches maximal resistance they can tolerate
(requires skill and experience)

89
Q

when applying resistance, what are the aviable points of the scale

A

0-5

90
Q

what does a 0 mean on the scale and what is that usually from

A

no visible or palpable contaction

usually from nerve damage

91
Q

what is a 1 on the scale

A

visible or palpable contaction

92
Q

what is a 2 on th scLe

A

full ROM gravity eliminated

93
Q

whaet is a 3 on the scale

A

full ROM aganst graivity (but cannot with resistance (

94
Q

what is a 4 on the scale

A

full ROM against gravity against a mod. resistance

95
Q

what is a 5 on the scale

A

ful lROM against gravity with max resitance for 6 s

96
Q

what is the optimal postiiton fir msucle testing for 1 and 2 joint muscles

A

1 joint muscle: end of availble ROM

2 joint msucle: done at midrange of overall length

97
Q

what are the 8 basic rules for appliying MMT

A

Place subject in a position that offers the best fixation of the body (supine, prone or sidelying)

Stabilize the part proximal to the tested part or adjacent to

Place the part to be tested in precise antigravity test position, whenever appropriate, to help elicit the desired muscle action and aid in grading

Use test movements in horizontal plane when testing muscle that are too weak to function against gravity

Apply pressure directly opposite the line of pull of the muscle

Apply pressure gradually, allowing the patient to “get set and hold”

Use a long lever whenever possible

Use a short lever if the muscles do not provide sufficient fixation for use of a long lever

98
Q

muscles that are excessive in length are usually BLANK and allow BLANK of opposing muscles

A

are usually weak and allow adaptaive shortning of opposing muscles

(ex; back muscle is weak and lenghted which causes pecs to shorten and contract

99
Q

msucles that are too short are usually BLANKS and maintain opposing muscles in BLANK positive

A

too strong and legnthed

100
Q

pain in passive ROM indicates a possible lesion to what type of structure

A

ligs, joints, non contaractile

101
Q

Pain in active and resisted ROM indicates a possible lesion to what type of structure?

A

muscles

102
Q

Pain with the closed pack position may indicate what type of injury?

A

bone or ligament

103
Q

If your patient has a nerve paralysis; what tests do you expect to be normal and what tests do you expect to be abnormal: AROM, PROM, RROM?

A

AROM: abnomral
PROM: norma
RROM: abnomral

104
Q

how do you assess for capsular/ligament limiations

A

use accesary movements

105
Q

what are some examples of accessory movements

A

disatrction, sliding, compression, roll and glide

106
Q

assessing for capsular, ligament limitations is usually done how

A

woth PROM in open back

107
Q

what is open pack

A

ligaments and structures are less tight, not as much contact, allows for accessory movements to occur

108
Q

what is closed pack

A

two strcutures fit preciesley and accesory movements are not possible

109
Q

where does a joint have more ROM and can do more accessory movements, closed or open pack

A

open pack

110
Q

pain in the close pack position is related to what injuries

A

bone or ligmenats injuries

111
Q

a decrased accesorry movement will have a direct impant on what

A

AROM AND PROM

112
Q

what type of stretching is asscoaited to moving through a rom in controlled manner

A

dynamic

113
Q

what type of stretching is associated with bouncing

A

ballistic

114
Q

what type of stretching is associated with slow constant stretch

A

static

115
Q

what type of stretching involved isometric or concentric contraction

A

pnf strectching

116
Q

the hold relax pnf stress uses autogenic or reciprocal

A

autogenic

117
Q

the contractt relax uses autogenic or reciprocal inhibittion

A

autogenic

118
Q

the slow reversal hold relax strtch uses autogenic or reciprocal

A

both

119
Q

what is a 2 joint muscle

A

a muscle that crosses over 2 joints

120
Q

where should you test a 2 joint muscle and give example

A

midrange

ex: since bicep crosses glenoheum and elbow joint =, do not test it at ends of rom but rather mid range for optimal muscle testing position

121
Q

using a long level means AT hands are closer or further from joint

A

furhter

122
Q

is it better to use long or short levers

A

long levers (easier)

CATA 263 (17 decks)

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