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Practice Topics Exam 4 > MFR 1 > Flashcards

MFR 1 Flashcards

1
Q

What is MFR - Grounded in….

A

Grounded in the theories of osteopathic methods - “structure governs function”
“body’s innate ability to heal itself”

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2
Q

What is MFR

A

A graded stretch to soft tissue that is guided entirely by feedback from the recipients body to the therapist’s hands
Requires skill set to get this perception

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3
Q

A little history of manual medicine - 40s and 50s

A

Cyriax - termed the words “end feel”

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4
Q

A little history of manual medicine - 60s and 70s

A

Mennell, Maitland, Paris, Kaltenborn discussed joint mobility

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5
Q

A little history of manual medicine - 80s

A

More focus to connective tissue

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6
Q

A little history of manual medicine - 2000s

A

Integrated model

Use of manual therapy to correct dysfunction

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7
Q

Techniques that work on soft tissue can be ___ or ___

A

Mechanical

Neurological

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8
Q

Techniques that work on soft tissue - Mechanical

A

Massage (STM) - Connective tissue massage, Swedish massage
Rolfing
Myofascial release
Deep tissue release
Instrument assisted soft tissue mobilization

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9
Q

Techniques that work on soft tissue - Neurologic

A

Positional release
SCS
Shiatsu
Trager

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10
Q

Types of tissue in the body

A 
Mm
Nerve
Epithelium
Connective tissue:
 - Cartilage
 - Bone
 - Connective tissue proper 
       - Loose irregular
       - Dense irregular
       - Dense regular
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11
Q

Make up of connective tissue

A

Cells

Extracellular Matrix

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12
Q

Make up of connective tissue - Cells include

A

Fibroblasts/Fibrocytes
Adipocytes
Mobile cells - Macrophages, Lymphocytes, Plasma cells, Mast cells

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13
Q

Make up of connective tissue - Extracellular matrix includes

A

Water (60-70%)
Proteoglycans (bind water)
Glycosaminoglycans (GAGs)

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14
Q

Make up of connective tissue - most common GAGs

A 
Chrondoitin Sulphate (collagen precursor)
Dermatin Sulphate
Hyaluronic Acid (assists with turnover of collagen cells)
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15
Q

Loose irregular CT - made up of

A

Delicate, loosely arranged collagen with abundant ground substance and cells of all types

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16
Q

Loose irregular CT - Collagen and elastin

A

Fewer collagen and elastin fibers with more fibroblasts and macrophages

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17
Q

Loose irregular CT - vascularization

A

Is well vascularized

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18
Q

Loose irregular CT - Designed for

A

flexibility and is not very resistant to stress
HIGH POTENTIAL FOR CHANGE
fluid moves!

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19
Q

Dense Regular CT - located where

A

Tendons and ligaments

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20
Q

Dense regular CT - description

A

Predominantly collagen fibers
Collagen fibers are all arranged in ONE direction
This provides protection against stress exerted in one direction and allows for more efficient movement

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21
Q

Dense regular CT - changing it

A

Require a lot more force to change this type of tissue!

There is also less fluid

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22
Q

Steps to become a fiber

A 
tropo collagen
micro fibril
sub fibril
fibril
fiber
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23
Q

What happens before there is tissue damage to dense regular CT

A

When we put traction or pull on a tendon, part of it is untwisting
If the force is high enough to have tissue damage, there will be some untwisting before there is any tissue damage

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24
Q

Dense irregular CT - found where

A 
joint capsules
periosteum
epineurium
perichondrium
dermis of the skin
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25
Q

Dense irregular CT - content

A

Very high collagen - collagen fibers predominate!

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26
Q

Dense irregular CT - fiber arrangement

A

Fibers are arranged in bundles oriented in two or more directions and without definite structure

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27
Q

Dense irregular CT - change

A

Compared with loose CT, this type of CT is less flexible and is also more resistant to stress!!!

28
Q

When we are doing joint mobilizations, grades 3 and 4, what CT are we trying to effect?

A

Dense irregular CT

29
Q

Superficial fascia - is where

A

right beneath the dermis

30
Q

Superficial fascia consists of

A

Loose irregular CT and adipose tissue

31
Q

Superficial fascia functions to

A

provide storage for water and fat
provide insulation
prevent mechanical deformation
provide pathway for nerves and blood vessels

32
Q

Superficial fascia - adhesions can affect

A

circulation
lymph drainage
nerve conduction
Scar adhesions may also be a source of chronic pain

33
Q

Deep fascia is what

A

Dense sheet of fibrous CT mainly made up of dense regular and dense irregular CT that penetrates and surrounds mm, bones, nerves, and blood vessels

34
Q

Deep fascia provides:

A

Connection in the form of aponeuroses, ligaments, tendons, retinacula, joint capsules, and septa

35
Q

Deep fascia and manual therapy

A

Not doing a lot of change to the deep fascia with manual therapy

36
Q

Deep fascia function:

A

Allows free mvmnts of mm
Fills space btw mm and other organs
Provides passageways for nerves and blood vessels
May provide attachments for mm

37
Q

What types of CT are we trying to affect with MFR

A

Superficial fascia

Loose irregular CT

38
Q

What types of CT are we trying to affect with joint mobilization

A

Deep fascia

Dense irregular CT

39
Q

What types of CT are we trying to affect with Soft tissue mobilization

A 
Loose irregular (fascia)
Dense irregular (muscle)
40
Q

What types of CT are we trying to affect with passive stretching

A 
Superficial irregular (fascia surrounding mm)
Dense regular (tendon)
Dense irregular (mm)
41
Q

Fascial lines

A

Theory that there are anterior, posterior, and lateral fascial lines
Need to consider the fascia when working with high level athletes

42
Q

Normal healing - scar formation

A

Inflammatory
Granulation
Fibroblastic
Remodeling

43
Q

Normal healing - scar formation - Inflammatory phase

A

Histamine reaction

Cells coming in a getting rid of debris

44
Q

Normal healing - scar formation - Granulation phase

A

Fibroblasts coming in

Slowly healing the wound - might see wound edges come in, or scab coming on

45
Q

Normal healing - scar formation - Fibroblastic

A

Put down the good stuff

Fibers are coming in

46
Q

Normal healing - scar formation - Remodeling

A

Wound is closed and healed
Scar will still change though - devascularization so see change in color and there is a change in collagen type as well - change from type 3 to type 1 - stronger

47
Q

Normal healing - scar formation - when in the tissue healing process would MFR, joint mobs, passive stretching, STM be most effective

A

Fibroblastic and Remodeling!

This is when the tissue can take the stress of it

48
Q

Inflammatory reaction and mobility - chronic irritant

A

Leads to the inflammatory process being activated every time the person is exposed to the irritant
Inflammatory process leads to increase in fibroblasts laying down - shrinkage of CT - and then abnormal movements and the cycle continues

49
Q

Theoretical mechanisms of soft tissue dysfunction

A

Intermolecular crosslinking
Lymphatic stasis
Immobilization
Ground substance dehydration/dec GAGS and proteoglycans
Neuroreflexive triggerpoints/ afferent nerve ending - inc sensitivity

50
Q

Theoretical mechanisms of soft tissue dysfunction - Intermolecular cross linking leading to

A 
Excessive fibrosis (from the rep. trauma)
Immbolization which then leads to inc in cross links and a dec in water
51
Q

Theoretical mechanisms of soft tissue dysfunction - lymphatic stasis leads to

A

fibrosis and adhesion formation

52
Q

Theoretical mechanisms of soft tissue dysfunction - immobilization leads to

A

Inc rate of degeneration of mature collagen and inc in new immature collagen

53
Q

Stress/Strain curve - Elastic vs. Plastic

A

Elastic region and then the yield point before going into plastic region
At the end of plastic region is failure point and ultimate strain (X) and ultimate stress (Y)

54
Q

Elastic and plastic behavior - elastic behavior is what

A

Stretching it and then come back, stretch and then come back
Ex - stretch hamstrings once and feel better but then run again and feel tight again
This is only stretching in the elastic region - is okay, but will not give prolonged change

55
Q

Elastic and plastic behavior - plastic behavior is what

A

Where you will get prolonged change - the goal is that you load it with force and then it doesn’t go back all the way down - need frequency though!!!
Repetition is key

56
Q

Material failure summary - what is the difference among materials

A

All materials will break if the strain is high enough

The difference is in what will happen first

57
Q

Material failure summary - If a material completely recovers from strain, it shows

A

Elastic deformation

58
Q

Material failure summary - f a material shows permanent deformation following strain, it shows

A

plastic deformation

59
Q

Material failure summary - Most materials are ____ at low strains

A

Elastic

60
Q

Material failure summary - At higher strains…

A

A brittle material will continue to deform elastically until it breaks
A malleable or ductile material will deform plastically before it breaks

61
Q

Material failure summary - The stress at which a material’s deformation changes from elastic to plastic is known as

A

the yield stress or elastic limit

62
Q

Material failure summary - The toughness of a material is

A

the amount of energy it can absorb before it breaks

63
Q

Material failure summary - Changes with age

A

Dec elastin and dec water
Dec water leads to cells being closer together and forming cross-links that then form fibrous tissue
Also less ground substance (less water)

64
Q

Using the stress-strain diagram, what are we doing when we apply myofascial release to fascial tissue?
With MFR -

A

We take fascia through elasticity and release and repeat with hopes of dec how much stress has to be applied each time
We hope to move into the elastic limit and yield point - so start with elastic and hope to get to early plastic

65
Q

Using the stress-strain diagram, what are we doing when we apply myofascial release to capulse in joint mobilization

A

Same but the capsule is less compliant so we need to apply higher stress to get strain

66
Q

Using the stress-strain diagram - The greater the viscoelasticity of a substance the

A

more likely we will get deformation in a shorter period of time!

With dec fluid viscosity, elasticity dec and get more stiff

67
Q

What technique would be most effective to gain motion, 1 year post surgery in a pt who had a lung lobectomy with a large transverse scar ant to pos on the lateral chest and difficulty with inspiration from chest wall tightness

A

MFR
Slow long pressures would most likely get into the plastic phase

Next would be AROM that allows elongation of the scar

Practice Topics Exam 4 (9 decks)

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