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CP 2 > Midterm > Flashcards

Midterm Flashcards

1
Q

what is ankylosis? Is passive movement possible?

A

fusion of the joint

no

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2
Q

What are the absolute contraindications for joint mobilizations? (8)

A
  • malignancy in area
  • active inflammation and/or infectious joint
  • ankylosis of joint
  • fracture at the joint
  • practitioner lack of ability
  • neurological deterioration
  • diseases with affect integrity of ligaments
  • arterial insufficiency
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3
Q

What are relative contraindications for joint mobilizations? (6)

A
  • excessive pain or swelling
  • arthroplasty (joint replacement)
  • hypermobility
  • metabolic bone disease
  • pregnancy
  • spondylolisthesis
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4
Q

What direction are you assessing with Grade 3 distraction?

A

general mobility

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5
Q

What is the dosage for joint mobilization oscillations?

A
  • 1-3 seconds each

- 1-5 sets for 15-30 seconds each

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6
Q

What is the dosage for joint mobilization sustained holds

A

1-5 sets for 15-30 seconds each

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7
Q

What direction will you do grade 1 and 2 joint mobilizations?

A

the direction doesn’t matter; must be done in open packed positions

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8
Q

How many times should joint mobilizations with movements be done before reassessing joint motion?

A

10 times

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9
Q

What is the ability of contractile tissue to produce tension and a resultant force based on demand placed on the muscle

A

muscle strength

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10
Q

What is the ability of the neuromuscular system to produce, reduce, or control forces during functional activities in a smooth coordinated manner

A

muscle functional strength

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11
Q

What is the ability of related to the strength and speed of a movement; the amount of work produced by a muscle in a given amount of time

A

muscle power

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12
Q

What is the ability to perform low-intensity, repetitive, or sustained activities over a prolonged period of time

A

muscle endurance

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13
Q

Which muscle fibers atrophy fastest?

A

type 1 fibers - endurance fibers

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14
Q

Which type of muscle fibers shows the greatest hypertrophy?

A

type 2 fibers - strength/power fibers

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15
Q

What occurs at the capillary beds during hypertrophy?

A

there is no change because there is no extra demand for O2 for strength and power - they are anaerobic

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16
Q

What are resistance training guidelines for children under 7

A
  • no “formal” training
  • encourage daily physical activity and bodyweight exercises
  • emphasize multi-joint, functional movements
  • increase weight by no more than 5% at a time
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17
Q

What muscle performance training would have some sort of time/speed component to it combined with strength?

A

TUG test

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18
Q

What does FITT stand for?

A

Frequency
Intensity
Time
Type

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19
Q

Training zone of 1 RM for sedentary/untrained patients

A

30 -40% of 1 RM

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20
Q

Training zone of 1 RM for highly trained patients

A

over 80% of 1 RM

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21
Q

Training zone of 1 RM for normal patients

A

60 - 80% of 1 RM

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22
Q

________ recovery leads to more rapid recovery than _______

A

active is more rapid than passive

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23
Q

What type of exercise has an analgesic effect based on research?

A

isometric exercise

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24
Q

At a minimum, how long should a static isometric muscle contraction hold last

A

6-10 seconds

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25
Q

When can patients progress to the mobility phase of their exercise prescription?

A

when signs of inflammation have disappeared

- some patients can skip tissue healing phase and go right to mobility phase

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26
Q

What kind of exercises would you do during the tissue healing phase?

A

ROM and isometrics

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27
Q

What kind of exercises would you do during the mobility phase?

A

ROM and stretching exercises

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28
Q

What is required for the patient to progress from the mobility phase to the performance initiation/stabilization and motor control phase?

A

pain free ROM

- they do not have to have full mobility, just has to be pain free

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29
Q

What type of exercises can be used in the performance initiation/stabilization and motor control phase

A

concentric, eccentric, and isometric

- apply the SAID principle

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30
Q

What is required for the performance improvement phase?

A

pain free ROM

- does not have to have full mobility, just has to have pain free ROM

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31
Q

What is the goal of BFR?

A

mimic the effects of high intensity exercise by recreating a hypoxic environment using a cuff while performing low intensity exercises

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32
Q

Does PROM increase strength and endurance?

A

No

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33
Q

reciprocal inhibition

A

When the stretch reflex is activated in a muscle being lengthened (antagonist), inhibition in the muscle on the opposite side of the joint may occur

  • relaxation of muscles on 1 side of a joint to accommodate contraction on the other side of the joint
  • activating the agonist to get the antagonist to relax
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34
Q

What part of the muscle control reciprocal inhibition?

A

muscle spindles

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35
Q

What part of the muscle controls autogenic inhibition?

A

golgi tendon organs

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36
Q

autogenic inhibition

A

When tension develops, the GTO fires and decreases tension in the muscle-tendon unit being stretched, enabling a muscle to be elongated against less muscle tension

  • ability for a muscle to relax when it experiences increased tension
  • activating the antagonist to get the antagonist the relax
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37
Q

When is PNF stretching more appropriate?

A

when muscle spasm limits motion

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38
Q

When is PNF stretching less appropriate?

A

for stretching long-standing, fibrotic contractures

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39
Q

antagonist contraction

A
  • hold-relax
  • using autogenic inhibition
  • stretch range limiting (antagonist) muscle to end range, then have patient contract muscle, then stretch farther
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40
Q

agonist contraction

A
  • contract relax
  • using reciprocal inhibition
  • stretch range limiting (antagonist) muscle to end range, then have patient contract agonist (opposite) muscle, then stretch antagonist
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41
Q

When is agonist contraction useful?

A
  • when muscle guarding restricts muscle lengthening and joint movement
  • when the patient can’t generate a strong, pain-free contraction of antagonist
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42
Q

What does SBAR stand for?

A

Situation
Background
Assessment
Recommendation

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43
Q

nociceptive vs neuropathic pain

A

nociceptive - increased sensitivity to a peripheral nerve, usually from an injury

neuropathic - injury to a nerve

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44
Q

What are the 5 moments for hand hygiene?

A

1) BEFORE touching the patient
2) BEFORE clean/aseptic procedures
3) AFTER a body fluid exposure risk
4) AFTER touching the patient
5) AFTER touching a patient’s surroundings

45
Q

What PPE should be worn with contact precautions?

A

gloves and gown

46
Q

What PPE should be worn with droplet precautions?

A

gloves and mask

47
Q

What PPE should be worn with airborne precautions?

A

masks and respirators

48
Q

PNF overflow (irradation)

A

Spread of a muscle response from stronger to weaker muscles – the more resistance you apply, the more muscles recruited

49
Q

What does PNF manual contact do?

A

stimulates the muscle to reinforce the movement AND guide the direction of the movement

50
Q

Where is the therapist position during PNF stretching?

A

directly in line with the desired motion and should be facing the direction of the desired movement

51
Q

What is applied manually during PNF patterns to facilitate muscle contraction?

A

traction

52
Q

D1 Flexion UE pattern

A
  • the most important motion is eating
  • shoulder flexion, adduction, ER
  • forearm supination
  • wrist radial deviation
  • fingers flexed
53
Q

D1 Extension UE pattern

A
  • throw away the trash
  • shoulder extension, abduction, IR
  • forearm pronation
  • wrist ulnar deviation
  • fingers extended
54
Q

D2 Flexion UE pattern

A
  • drawing the sword and throwing it behind you
  • shoulder flexion, abduction, ER
  • forearm supination
  • wrist radial deviation
  • fingers extended
55
Q

D2 Extension UE pattern

A
  • putting the sword back
  • shoulder extension, adduction, IR
  • forearm pronation
  • wrist ulnar deviation
  • fingers flexed
56
Q

What pattern is the involved and non-involved side doing during lift and reverse lift?

A
  • involved side doing D2 pattern

- non-involved side doing D1 pattern

57
Q

What pattern is the involved and non-involved side doing during chop and reverse chop?

A
  • involved side doing D1 pattern

- non-involved side doing D2 pattern

58
Q

rhythmic initiation steps

A

1) therapists performs PROM
2) therapist has patient perform AAROM
3) patient performs AROM
4) patient performs AROM against resistance

59
Q

alternating isometrics

A

Patient performs isometric contraction while resistance is applied to agonist and antagonist – very little joint movement occurs
- best for core strength

60
Q

dynamic reversals

A

Apply resistance through the pattern on both sides

- ex: resist D2 flexion then resist D2 extension

61
Q

fast/quick stretch

A
  • Provide a quick stretch of the agonist when changing directions
  • Produces a relatively short-lived contraction of the agonist’s muscle and short-lived inhibition of the antagonist muscle which facilitates a muscle contraction (muscle spindle)
62
Q

Repeated contraction/stretch

A
  • Move through a pattern pausing and applying a quick stretch, press through more motion, pause, quick stretch, push
  • Emphasizes strengthening in specific ranges throughout the motion
63
Q

dynamic reversal hold

A

Same as dynamic reversals but with an isometric hold at end of the motion prior to changing directions

64
Q

agonist reversal

A

Reversing the type of contraction you are eliciting from your patient, working concentrically, isometrically, then eccentrically

65
Q

Antalgic Gait

A

Short, choppy steps because they don’t want to bear weight on the involved side

66
Q

What hip deviation will cause forward trunk lean?

A
  • weak quads
  • hip flexure contracture
  • weak lumbar or hip extensors
  • hypomobile anterior hip capsule - they can’t get into extension
67
Q

What hip deviation will cause decreased hip extension? What will this do to their steps?

A
  • Tight hip flexors
  • Decreased anterior joint mobility
  • Weak glutes
  • shorten their steps
68
Q

If glute max is weak how will my body compensate?

A

Rock themselves back and use their trunk to create hip extension

69
Q

What might you see with weak gluteus medius?

A

Hip drop on contralateral side

70
Q

What can cause knee hyperextension during gait?

A
  • Quadriceps weakness – doesn’t control the knee eccentrically so the sling it back to lock out the knee
  • Hamstring weakness
  • Increased tone of quadriceps
  • Compensation for plantarflexion contracture or spasticity
  • hypermobile posterior capsule
71
Q

What can cause decreased knee extension during gait?

A
  • Quadriceps weakness (unable to straighten knee) – tight anterior joint capsule
  • Knee joint hypomobility
  • Hamstring contracture or stiffness
  • Strategy to avoid heel rocker
72
Q

What is equinus gait? What may cause this?

A

excessive plantarflexion during gait

  • Tib ant weakness
  • Plantarflexion contracture
  • Hypomobility of talocrural joint – posterior capsule hypomobile
  • Compensation for short leg/short stride length
  • Painful heel/avoiding heel rocker
73
Q

What is calcaneal gait? What may cause this?

A
  • increased dorsiflexion
  • tib anterior contracture
  • weak gastroc
  • hypomobility talocruel joint
74
Q

What is Equinovarus gait?

A
  • club foot

- Ankle plantar flexion and subtalar inversion

75
Q

What often causes foot drop? What muscles would you MMT? What muscles would be tight?

A
  • Often due to dorsiflexor weakness caused by paralysis of common peroneal nerve
  • tib anterior MMT
  • tight gastroc soleus (PF)
76
Q

What might cause foot flat?

A
  • Weak dorsiflexors
  • limited ROM
  • hypomobility
  • normal immature gait pattern (neonatal)
77
Q

What position is the foot in during excessive supination?

A

varus

78
Q

What position is the foot in during excessive pronation?

A

valgus

79
Q

What might cause inadequate push off?

A
  • Result of weak plantar flexors
  • Tight/spastic dorsiflexors
  • Hypomobile talocrural joint – anterior (convex on concave)
  • Pain in forefoot
80
Q

What causes excessive anterior pelvic tilt?

A
  • Weak hip extensors
  • Hip flexion contracture
  • Abdominal muscle weakness
  • Limited hip extension ROM
81
Q

What causes excessive posterior pelvic tilt?

A
  • tight hamstrings
  • hip flexor weakness
  • low back pain
  • limited lumbar extension ROM
82
Q

anatomical vs functional leg length discrepancies

A
  • anatomical - one bone is longer than the other

- functional - bones are the same length but something is causing one leg to be longer or shorter than the other

83
Q

What are causes for waddling gait?

A
  • Tight IT band
  • Contralateral hip abductor weakness
  • Limited hip or knee flexion- leans to contralateral side to compensate to clear foot
  • Commonly seen with pain in hip related to arthritis
84
Q

What is Sensory Ataxic Gait?

A
  • abnormal and uncoordinated movements

- often seen with cerebellar disorders

85
Q

What is Festinating Gait?

A
  • flexed forward gait often seen with Parkinson’s

- short, choppy steps

86
Q

A 2 handed device is required for which weight bearing statuses?

A

NWB
TTWB
PWB

87
Q

A 1 handed device can be used with what weight bearing statuses?

A

WBAT

FWB

88
Q

4 point gait weight bearing status

A

no weight bearing restrictions

89
Q

modified 4 point gait weight bearing restrictions

A

no weight bearing restrictions

90
Q

3 point gait weight bearing status

A

NWB

91
Q

modified 3 point gait weight bearing status

A

TTWB, PWB, or WBAT

92
Q

2 point gait weight bearing status

A

no weight bearing restrictions

93
Q

modified 2 point gait weight bearing status

A

no weight bearing restrictions or WBAT

94
Q

consequences of shallow seat depth on wheelchair

A

thighs are not properly supported, affecting weight distribution and comfort, pelvic position

95
Q

consequences of deep seat depth on wheelchair

A

sacral sitting

- Individual slouches, sliding buttocks forward and posteriorly tilting pelvis

96
Q

consequences of side width too wide on wheelchair

A
  • difficult to reach the drive wheels

- Individual may lean to one side to rest on the armrests

97
Q

consequences of side width too narrow on wheelchair

A

excessive pressure on lateral aspects of pelvis and thighs

98
Q

consequences of back height too high in wheelchair

A

restricts movement, skin irritation over inferior angles of scapulae

99
Q

consequences of back height too low in wheelchair

A

decreased trunk stability, postural deviations

100
Q

What is ideal seat to footplate length?

A

set so that the thigh rests parallel to the cushion surface with the foot comfortably placed on the footrest

101
Q

consequences of too high seat to footplate length

A

individual may sacral sit in order to rest feet on footplates

102
Q

consequences of too low seat to footplate length

A

pressure distribution along thigh is uneven

103
Q

What are the areas at risk for pressure while in a wheelchair?

A
  • inferior angle of scapula
  • sacrum/coccyx
  • Ischial tuberosity
  • greater trochanter
  • popliteal fossa
104
Q

What impairments are you targeting with oscillation mobilizations?

A
  • muscle guarding
  • pain
  • joint hypomobility
105
Q

What impairments are you targeting with sustained hold mobilizations?

A
  • joint mobility - end range

- pain - beginning range to mid range

106
Q

D1 Flexion LE pattern

A
  • Hip flex, add, ER
  • Dorsiflexion
  • Inversion
  • Toes extended
107
Q

D1 Extension LE pattern

A
  • Hip ext, abd, IR
  • Plantar flexion
  • Eversion
  • Toes flexed
108
Q

D2 Flexion LE pattern

A
  • Hip flex, abd, IR
  • Dorsiflexion
  • Eversion
  • Toes extended
109
Q

D2 Extension LE pattern

A
  • Hip ext, add, ER
  • Plantar flexion
  • Inversion
  • Toes flexed

CP 2 (4 decks)

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