Midterm Theory Review Flashcards
Do you think Passive Relaxed ROM is used to increase joint nutrition?
Yes
Someone is having a painful joint, what grade of joint mob is appropriate/safe for this without doing any further assessment?
Grade one, oscillatory. To help reduce SNS firing in the joint.
(Grade 2 is also used for assesment)
In regards to stretching and strengthening, the force is applied to the distal end of the moving segment?
True!
Writing with a pen is an example of what? When it comes to the hand
A precision movement/ pattern
At what level of lumbar flexion do your extensor muscles start to relax? What degree?
45 degrees
Proximal segment needs to be stabilized?
Yes, true
T or F, the client is encouraged to continue breathing during stretching and strengthening??
TRUE strengthening is more important.
Comparing strengthening and stretching, would you say that the amount of time you hold the stretch or a strengthen is the same?
Different! Stretch is 30 seconds. Unless it’s painful. An AIT is ten seconds then 30 seconds.
Strengthening is 2-3 sets 8-10reps for 10 seconds
T or F: Flexion and extension are examples of accessory movements??
FALSE
T or F: accessory movements are necessary for physiological movement?
TRUE
EX: GH joint! The scapula rotation during abduction to allow full rotation
Accessory movements are sometimes unnecessary?
True!
Is joint play an example of physiological movement?
- No because physiological movement is natural, and joint play is what we do.
- Slide vs a Glide: glide is what we do and a slide is the equivalent of it.
When you are considering resistance exercise for a client what are some things you need to keep in mind other than their condition?
Blood pressure, heart rate, medications, capability, comprehension, age related factors, meaning extensibility of tissue, maybe rather than resistance you would get them to go through a range of motion
EX: if someone has a right side hip hike, what is the physiological movement of the hip that’s occurring?
ADDuction of the leg.
Pelvis is rotating on the head of femur.
When you have a lateral pelvic tilt, which iliac crest does the lumbar spine bend towards?
The elevated one
If you were doing agonist contraction to rectus femoris, what muscle is contracting?
Glute max and hamstrings, same in the reverse.
In context of GH joint mobilizations: a posterior glide would increase?
Flexion
In context of GH joint mobilizations: a anterior glide would increase?
Extension
In the first carpometacarpal joint, how would you increase extension? Radial glide Flexion?
Ulnar glide
Mobilizing the medial end of the clavicle at the SC joint inferiorly would increase what scapular movement?
Elevation
How do you stretch the biceps brachii vs the coracobrachialis?
- Action of coracobrachialis: assist in flexion and adduction at the GH joint.
- Action of biceps: flexion of the elbow and flexion of the shoulder.
What’s unique about their attachments when it comes to the joints they cross?
- Coracobrachialis: cross the shoulder
- Biceps brachii: cross the shoulder and the elbow.
What other muscle in that area has a similar stretch position to the above muscles but is different?
Brachialis! Only the elbow.
The humeroulnar joint: what direction would the glide be to increase extension?
ULNARLY extension of the elbow also means VALGUS.
Know glides of joints!!
!!
There are three different muscles that come from three different groupings of the body…
What is an attachment that sartorius as well as other muscles in the thigh attach to?? And what are the other muscles?
Pes Anserine! The other muscles are Gracilis and semitendinous, and Sartorius.
What is pes anserine? Where is it located?
Medial tibial condyle
What is a unique feature of sartorius in comparison of other muscles in the body?
It’s the longest muscle in the body? Its origin is ASIS.
Know the O’s and I’s of sartorius
- Origin: ASIS
- Insertion: medial tibial condyle
-Action: flexes, lat rot, abducts the thigh, flexes knee
Innervation: femoral
Know the ligaments at the AC joint and what movements they limit.
Acromioclavicular, joins acromion to clavicle and strengthens the superior aspect of joint
Coracoclavicular ligament:
- Conoid attaches coracoid process to conoid tubercle of clavicle
- Trapezoid attaches superior coracoid process to the trapezoid line on inferior clavicle.
- TOGETHER they support the acromioclavicular joint. A passive attachment of scapula & upper limb from clavicle.
- These ligaments contribute to horizontal stability, making them crucial for preventing superior dislocation of the AC Joint. Both portions also limit rotation of the scapula.
What is the action of infraspinatus?
External rotation
Which of the four gluteal muscles?
1) Piriformis
2) Gluteus maximus
3) Medius
4) Minimus
How would you stretch Piriformis?
Internal Rotation
How would you stretch glute max?
Internal Rotation
What muscles are being streatch when the Hip externally rotated and adduction
Medius and Minimums (Both abduct the thigh and internally rotate)
T or F: Supraspinatus minimizes the inferior slide of the humeral head when the deltoid contracts.
True
T or F the biceps long head tendon helps stabilize the anterior portion of the GH joint:
True
Attaches to supraglenoid tubercle and the Short head goes to the coracoid process
T or F: the orientation of the glenoid fossa and the glenoid labrum, provide some stability to the GH joint?
TRUE glenoid fossa is angled towards your acromion
How do you stretch the levator scapula?
Smelling your armpit: Contra lat flexion, contralateral rotation, flexion
When it comes to the shoulder abduction what does a large percentage of movement come from? GH or scap?
GH joint
What range does posterior glide improve in the GH joint?
What range does anterior glide improve?
Posterior improves: internal rotation and flexion
Anterior improves External rotation and extension
Action of Teres minor:
External Rotation
What is scaption? Movement of the humerus in the scapular plane. Which ROM moves through the scapular plane?
Abduction
What are the Os and Is of pectoralis minor?
- O: Ribs 3-5 anterior surface
- I : Coracoid process
- Action: protraction and stabilizing of the scapula.
What type of a joint is the radioulnar joint?
Pivot joint
Action of extensor digitorum
Extension of wrist and digits
Know various glides to the proximal radio ulnar joint do
Abduction/ Supination: Volar glide.
Adduction/ Pronation: Dorsal glide
What is the open pact (resting position) for the humeroulnar joint?
70 degrees of flexion and 10 degrees supination
When doing a lumbar spine traction what is the position of the hips?
(closed pact at hip) Open pact is 30 flexion 30 abduction
What’s the action of adductor pollicis?
Adduction of the thumb
What is the action of flexor digitorum superficialis?
flexion of wrist, MCP joint, PIP joint, and weak elbow flexion
What is the action of Profundis
flexion of the MCP, PIP, DIP, weak wrist flexion. (Only muscle to flex DIPS)
What is the action of the interossei muscles?
palmar group- adduction of digits. Dorsal group: abduction of digits PAD DAB
What do Adductor Pollicus, Flexor Digitorum Superficials, Profundis, Interossei Muscle do collectively?
They let you pick things up precisely like a pincient grip!
The PSIS moves posteriorly and inferiorly during which pelvic tilt?
Posterior
In a neutral pelvis the ASIS is higher or lower than PSIS?
Higher
In an anterior pelvic tilt, are ASIS higher or lower than PSIS?
They are level
What is the clinical significance of a weak glute med?
Trendelenburg hip drops
The lateral collateral ligament of the elbow protects you against?
Varus Stress
What is the transverse humeral ligament?
Keeps the biceps tendon in the bicipital groove (intrat vicular notch)
What is the annular ligament?
Keeps the radial head seated in its notch
Considering the humeral radial joint which bone of this bone is concave and which is convex?
Concave= Radius Convex= Humerus
Out of your four digits, which does not adduct or abduct?
The third
What is the resting position for the SC joint?
Relaxed posture arms by your side
Know which carpals move during ulnar and radial deviation.
- Convex- capitate and hamate
- Concave- scaphoid, lunate, triquetrum
- (Slide opposite direction with flexion and extension, radio and owner deviation)
- Concave-trapezium and trapezoid
- Slide same direction with flexion and extension
- Trapezoid is bound to capitate - cannot slide in different directions during radial and ulnar deviation.
-Therefore, trapezium and trapezoid slide in a posterior direction with radial deviation and an anterior direction with ulnar deviation
Lumbo pelvic rhythm! Your erector spinae contract until about 45 degrees, then they relax. What happens is what order?
Coordinated movement of the lumbar spine and pelvis occur during maximum forward bending of the trunk.
1) Head and upper trunk initiate flexion
2) Pelvis shifts posteriorly to maintain centre of gravity
3) Trunk continues to forward bend- eccentric contraction of extensor muscle of spine until 45°
4) Posterior lateral ligaments becomes taut, Facet joints approximate (stability at enter vertebral joints, and muscles relax)
5) Pelvis begins to rotate forward - anterior pelvic tilt - eccentric contraction of hamstrings and gluteus maximus.
6) Pelvic rotation continues until muscles reach full length
7) Limited by flexibility of various back extensors.
- Returning to upright position:
- Hip extensor muscle rotating the pelvis posterior.
- Back extensors contracting extending the spine from the lumbar region upward.
Agonist Contraction is a technique that involves contraction of which muscle group?
The opposite, opposing
Does concave bone moving on convex slide in opposite or same direction to its swing?
Same!
Stretch that you stay in one position for a set time. You are able to relax your body while partner, asccessory or prop intensifies the stretch by putting external pressure on your body.
Passive Stretch
Does Convex bone moving on Concave bone slide in the same or opposite direction to swing?
Opposite
Do you think AF ROM can increase muscle strength?
It maintains strength
Can AF ROM help prevent or lessen muscle Atrophy
Prevent Atrophy
Can PR ROM prevent or lessen muscle atrophy?
No it deals with fluid of the joint not muscle
Can PR ROM help decrease pain?
Muscle spindles control the what of a muscle?
Length (stretch receptor)
If a cx has muscle spasm what type of stretch is appropriate
Agonist Contraction
In which direction will the radius slide in the distal radioulnar joint during pronation
Anteriorly
If client has a painful shoulder joint what technique is safe?
Joint Distraction
What peripheral joint mobilization is used to assess the joint?
Grade 2 Distraction
How would you stretch Gracillis
Hip Abduction and Knee Extension
How would you stretch Tibialis Anterior
Evert the foot and plantar flex
Hold-relax uses what type of contraction?
Isometric
Contract-relax uses what type of contraction?
Isotonic
If your stretching a muscle and it has a soft tissue stretch what end feel could you perform on client?
Hold relax ROM
Voluntary contraction and relaxation skeletal muscles without changing the muscle length or moving the associated part of the body
Muscle Setting
Amount of tension or force that can be developed in a muscle. Ability of contractile tissue to produce tension
Strength
Your back feels relief when you bend forward or round you back like if you had facet joint irritation or spinal stenosis
Flexion Bias
ROM is insufficient due to limitation in muscle length
Passive insufficiency
Contraction is insufficient due to limitation in muscle length
Active insufficiency
Science of movement
Kinesiology
Science of movement
Kinesiology
Where is your tibiofemoral joint located?
On tibial and femur joint (knee)
What muscle would you strengthen if you need to maintain muscle strength in flexion of the tibiofemoral joint
What muscle would you strengthen if you need to maintain muscle strength in flexion of tibiofemoral joint
Hamstring
How can you isometically strengthen rhomboids
Pinch your shoulders
In protective phase for inflammatory conditions What is beneficial for healing
Pain free movement
Do not want to restore full ROM in maximum protection phase
No
GH impingement, bursitis , tendinitis, protective phase What exercise can you do?
Pendulum swings no weight
What can friction tecnhiques do to the tissue for the healing process
Help break up scar tissue
If a client has steppage Gait what muscle is weak? What is action to strengthen this muscle?
Tib anterior
Dorsiflexion and inversion of foot
Would you stretch a swollen and inflamed muscle
No
What action are involved in supination of the foot
1, Plantarflexion
- Adductor
- Evert
What muscle causes shin splints
Tib posterior
When do you not do pendulum exercise in shoulder
Dislocated shoulder
How do you stretch triceps
Flex elbow and gh joint
What direction do humerus slide when gh extension is performed
Ant- head
Post - bone
In which direction would you mobilize the 1st CMC joint increase extension
Radial
What direction would you mobilize the 1st CMC joint increase flexion
Ulnar
Isomeric does what?
Maintain mm strength
Isotonic does what?
More stability, balance, increase strength
Negative reaction to strengthening
DOMS and soreness
When stretching and strengthening you stabilize at the proximal end and where would the force be applied of the moving segement
Distal end
If your client has tight GL and is hiked up on right side would your hip also be adducted on right or abducted on right
Pelvis hike and hip adduct on right side
GH joint rule?
Convex on cancave
What way do the humerus slide when GH joint extension is performed
Anteriorly
How to increase General mobility to AC joint
Anterior glide
To increase flexion of humeroulnar joint you would do what glide
Distal (scoop)
Humeroulnar joint increase valgus (extension)
Ulnar
Humeroulnar increase varus flexion
Radial
Proximal radioulnar joint rule
Convex on cancave
Increase dorsal and volatility glide prox radiaoulnar
Dorsal: post-pronate
Volar: ant-sup
Distal radioulnar joint rule
Increase dorsal glide
Increase volar glide
Concave on convex
Dorsal glide: supinate
Volar glide: pronate
Radiocarpal joint: wrist joint
Increase dorsal: ant flex
Volar: post ext
Radial : ulnar dev
Ulnar: radial dev
Radiocarpal joint does flexion and extension, ulnar and radial dev
Is distal radioulnar joint considered part of wrist
No
Outer end of clavicle is held in alignment with the acromion by the ?
Acrominoclavicular ligament
Coraclavicular ligament
*restricts vertical or elevation of lateral clavicle
How would you strengthen glute medius
Abduct leg and medially rotate
Long head of bicep stablizes against humeral?
Elevation (ant portion)
When arm is in resting position the inferior and anterior portion of joint capsule are lax and superior position is taut rotator cuff mm reinforce the joint capsule superior, posterior, anterior
Just know this
GH joint joint rule
Convex on concave Increase: Flexion: Post glide Extension: Ant glide Abduction: inferior External: anterior Internal: posterior
What is scaption
30* horizontal abduction and ratio is 2:1
To strengthen pec major what would you do
Internal rotation and adduction
Deltoid mm causes what kind of translation of humerus I unopposed
Upward translation
Rotator cuff mm stabilize compressive forces a ————- translation of GH
Downward
What type of joint is the humeroulnar joint
Modified hinge
What type of joint are proximal/distal radioulnar
Pivot
What type of joint is the GH
Ball and socket
Why do the humerus externally rotate with elevation
For clearance of greater tubercle
How do you stretch extensor digitorum
Flex 2-5 MCP digits
How would you stretch subcap
Lateral rotation of GH
Proximal radioulnar joint rule
Convex on concave
Distal radioulnar joint rule
Concave on convex
Increase wrist flexion of wrist at Radiocarpal joint What glide would you do
Dorsal
What joint of the wrist/hand do ulnar/radial dev occur
Radiocarpal
Radiocarpal joint rule
Convex on concave
What joint is considered your wrist joint
Radiocarpal
What mm do you use pinch grip
Add pollicus, flex digit, supination an pronation, interosssi, lumbar, thenar emminence
Cup shaped rim of cartilage that lines and reinforces ball and socket such as hip and shoulder
Labrum
What elbow lig supports valgus stress
MLC
What elbow ligament supports elbow against varus stress
LCL
Is surface of radius in humeroradial joint concave or convex
Radius is concave
Humerus is convex
Which digit has most movement
5th
What glide to improve extension/external rotation of Gh joint
Anterior
Which digit has second most movement
4th
Why do trapezoid move with capitate during radial and ulnar devi
Trap is bound to capitate
What digit has least movement
3rd
Know muscles LP 7-8 pg 8
bony structures, ligaments, glenoid labrum, capsule (adhesive and cohesive forces in the joint)
Static
tendons of the rotator cuff aid in tightening static structures, when the muscles contract it provides?
Dynamic stability
What muscle help stabilize scapula
upper trapezius
Serratus anterior
rhomboids
middle trapezius.
The first 30 degrees of upward rotation of scapula occurs with elevation of the clavicle
at the SC joint
Clavicle elevation and rotation
stabilizing compressive forces and downward translation of GH
Shortening of rotator cuff mm
compressive and upward translation on the humerus
Supraspinatus
Trapezius
O: medial 1/3 of SNL Inion NL SP C7-T12
I:
Lateral 1/3 clavicle
Acromion
Spine of scapula
A: Sup: Ipsilat flex, rotate scapula sup., contralat rotation Mid: Retract scapula Inf: Depress scapula
Levator scapula
O:
TVP C1-C4
I:
Sup. Med. border of scapula
A: Elevate scapula Inf. rotation scapula Ipsilat lat flex Rotation of neck
Lattismus Dorsi
O:
SP T6-T12
Iliac crest
Rib 8-12
I:
Floor of bicipital groove
A:
Extension
Adduction
Medial rotation
Teres Major
O:
Post inf angle of scapula
I:
Med lip of biciptal groove at ant surface under arm
A:
Adduct and medial rotate shoulder
Teres Minor
O:
Upper 2/3 lat border scapula
I:
Greater tubercle of humerus (inferior facet)
A:
Lat rotate shoulder
Abduct shoulder
Infraspinatus
O:
Infraspinous fossa of scapula
I:
Middle facet of greater tubercle
A:
Lat rotate shoulder
Abduct shoulder
Supraspinatus
O:
Supraspinatus fossa of scapula
I:
Superior facet greater tubercle
A:
Abduct shoulder
Subscapularis
O:
Subscauplar fossa of scapula
I:
Lesser tubercle of humerus
A:
Med rotate shoulder
Pec Major
O:
CH: Ant med half of clavicle
SH: Ant sternum, sup 6 costal cartilage, aponeurosis external obliques
I:
Lat lip bicipital groove
A:
Adduct and medially rotate shoulder
CH: flex shoulder
SH: extend shoulder from flexed position
Pec Minor
O:
Rib 3-5 near costal cartilage
I:
Coracoid process
A: stablize scapula drawing inferior and anterior
Deltoid
O:
Lat 1/3 clavicle
Acromion
Spine of scapula
I:
Deltoid tuberosity
A:
Abduct shoulder
T or F: any condition or injury resulting in elbow dysfunction and a result in loss of ROM
will affect one’s ADL’s.
Is flexion or extension most affected?
True
Flexion is most affected
Biceps brachii
O: SH: Coracoid process LH: Supraglenoid tubercle
I:
Radial tuberosity
A:
Flex elbow
Supinate foresrm
Flex shoulder
Brachialis
O:
Distal 1/2 of ant surface of humerus
I:
Ulner tuberosity
Coronoid process
A:
Flex elbow
Brachioradialis
O:
Prox 2/3 lat supracondylsr ridge of humerus
I:
Stolid process of radius
A:
Flex elbow
Assist pronate and supinate
Triceps
O: LH: Infraglenoid tubercle LatH: Post surface prox half humerus MH: Post surface distal half humerus
I:
Olceranon
A:
Extend elbow
Extend shoulder
Adduct shoulder
Pronator Teres
O:
Common flexor tendon of med epicondlye of humerus
Coronoid process of ulna
I:
Middle lat surface of radius
A:
Pronate forearm
Pronator Quatratus
O:
Med ant surface of distal ulna
I:
Lat ant surface of didtsl radius
A:
Pronate forearm
Supinator
O:
Lat epicondyle of humerus
I:
Ant lat surface proximal 1/3 of radial shaft
A:
Supinate forearm
What is the strongest hip ligament?
Iliofemoral
