manipulatio nand mobilization Flashcards
what can be used to explain joint dysfunction?
biomechanical principles
What can be explained by combining biomechanical info with neurophysiology?
the role of joint dysfucntion in pain and altered physiological function
What are the two bimechanical approaches to joint assessment?
static model and dynamic model
the static model of joint assesment is based on what fundamental?
that structure detemines function
what can create changes in the mechanical and neurological function of a joint?
alterations in the position of adjacent bones
what three things is malposition determined by?
static palpation, x rays, special instruments like thermograpy and electromyography
what could limit static assesment?
bony anomalies, bad function with good alignment, joint compensating for problem elsewhere
what are the advantages of satic assessment?
good for acute conditons with painful movement, and where there is limited motion
what is the emphysis of the static model?
structural , bone out of place causes problems
What is the emphasis of the dynamic model?
functional, loss of motion is the problem
What is the dynamic model based on?
function is often more signifigant thatn structure, mobile means healthy
according to the dynamic model, what do alteration in motion of adjacent bones create?
altered mechanical and neurological function of a joint
what contributes to the altered motion of a joint?
muscles and ligaments
How can restrictions be determined?
motion palpation, posture/gait analysis and motion x rays
what are the main limitations of the dynamic model?
all examiners see something different, not as good if motion is limited, may overlook poor posture if joints are ok, disease may be limited by disease.
what are the main advantages of the dynamic assessment?
identifies componenets that become dysfunctional like joint or soft tissues
what does malposition of bone refer to?
static finding
what does restriction of joint motion refer to?
dynamic finding
what model does the naturopathic manipulative therapeurtic approace uses?
combo of structural/static and functional/dynamic analysis
what is joint fixation?
temporaly immobilized , either in position of movment or at rest when in movement.
what does joint restriction describe?
direction of limited movement in a dysfunctional joint
what are the three main causes of joint dysfunction
mechanical, chemical and phychological stress
Example of mechanical cause of joint dysfunction
macrotrauma, microtrauma (repetitive) and postural
example of chemical cause of joint dysfunction
environmental toxyns, hormonal, reflex interaction
example of psychooical stress causing joint dysfunction
psycho somato visceral reflexes
what does parts stand for?
Pain, Asymmetry, range of motion, tone, special tests
what is parts used for?
to identify joint dysfunction
how is pain and tenderness identifeid
palpation both static and motion
ow is asymmetry detected?
static palpation of bony landmarks and muscle tine
How is range of motion determined?
motion palpation or range of motion, active, passive etc.
how is tone determined?
palpation of soft tissues
what are some special tests?
orthopedic and challenges
when assesing joint dysfunction what 3 things are you doing?
Plapation both static and motion, Range of motion inclucing end feel and Naming the dysfunction both static and motion listings
first part of inspectionand observation?
superficial like shape, posture and gate, scars cuts, etc
what does static palpation include?
Assessment of neutral muscles, ligaments bones skin
What does motion palpation include?
quality of movement, quality, joint play, end feel and symptioms
what is ment by joint play?
what is the quality of resistance?
what is the goniometry used for?
extremity joint global range of motion
What is the inclinometry used for?
spinal measurements global range of motion
what is AROM?
active range of motion that patient does for self, physiological osteokinematic movement
What is PROM?
Passive range of motion without patien assistance.
what is the physicological barrier?
end point of ACTIVE joint movement
What is joint paly?
movement of joint, independent of voluntary muscle action, felt from a neutral position
What is end feel?
movement independent of voluntary muscles: springing bone at the limit of its passive range of motion.
What is the elastic barrier
resistance felt at end of passive range of motion, can still go a bit further
Paraphysiological space?
increased movement beyond elastic barrier
Anatomic limit
limit of motion imposed by anatomic structures, beyond this point is trauma
Are all joint end feels the same?
no, what is normal for one may be pathological for another
What is capsular end feel like?
firm but giving, resistance builds with lengthening
example of normal casular
external rotation of shoulder
example of abnormal capsular?
cabsular fibrosis and adhesions
Ligamentous movement?
slightly firmer that capsular
normal ligamentous movement?
knee extension
abnormal ligametous movement
resisantace a result of ligament shortening
Soft tissue approximation is what?
giving squeezing quality, results from approximation of soft tissue,
Nomal soft tissue approximation?
elbow flexion
abnormal ligamentous approximation
muscle hypertrophy and soft tissue swelling
in what conditions can end feel be palpated?
normal or abnormal conditions
Bony end feel?
hard, non giving
normal bony end feel
elbow extension
abnormal bony end feel
bony exostosis , aarticular hypertrophic changes
Muscular end feel?
firm but giving but it builds with elongation, not as stiff a capsular
Normal muscular end feel?
hip flextion
what are the end feels that can only be assesed in abnormal condtions?
muscle spasm, interarticular, and empty
when can end feel not be assesed due to guarding?
during muscle spasm.
interarticular end feel - abnormal is what?
bouncy, springy like in a joint mice or meniscal tear
what is empty end feel?
normal resistance is missing, unusual give or deformation lke in joint injury,
what does listing refer to?
description of the manner in which the joint is dysfunctional by naming and recording the joint abnormalities
how are peripheral joints listed?
position of the most moveable bone
How are vertebrae joints listed?
name the upper vertebra relative to lower one of the motion sement.
is listing static or dynamic?
listing can be either static or dynamic
what is used at the ending of a static listing?
the term malposition is used at end of static listing.
in static listing what termonology is used to describe position of joint?
standard motion termonology.
how would I lable a static malposition?
determine the anatomical position (flexion, extension etc) of the bone then add malposition.
what are motion listings based on?
motion palpation or dyamic x ray.
what does motion listin describe?
the direction the joint will NOT move or has lack of springy feel.
what term is at the end of motion listing?
restriction
how do I lable motion listing?
determine the direction the joint will not move and then add the term restricted.
what would extension restriction mean?
not moving into extension
