misc

Question 1

joint surfaces

Ovoids

Answer 1

Pure ovoids -(ball and socket) equal curvature in all directions and 3DOF

Modified ovoids - unequal curvature and only 2DOF

Complex modified ovoid - AC joint (3 DOF. F/E, Abd/Add, IR/ER)

Question 2

Joint surfaces

Sellars

Answer 2

Pure sellar (saddle) - unmodified. convexity perpendicular to concavity so 2 DoF

modified sellar - not perpendicular so only 1 DoF

Question 3

Mechanical model

Answer 3

most common used. Describes a mechanical block to movement.

Caused by diabetes on articular surface, catches on contours of surfaces, fibrocartilaginous inclusions into joint, minor subluxations, non-specific.

Question 4

Neurophysiological model

Answer 4

common version holds that increased muscle tone prevents movement at the end of range.

• more sophisticated version is that hypertonicity produces a second axis of rotation around which the bone much move during normal motions. Cannot have 2 axis at one time so bone does not move.

Question 5

Combined model

Answer 5

combination of mechanical and neurophys models within same patient and even the same joint at different times.

Question 6

Myofascial hypo mobility end feel

Answer 6

elastic

muscle in-extensibility -scars, contractures, adaptive shortening, hypertonus

Question 7

pericapsular hypo mobility end feel

Answer 7

hard capsular, early capsular or spasm/boggy if arthritis present

(is capsular or ligamentous in-extensibility)

Question 8

biomechanical hypo mobility end feel

Answer 8

pathomechanical (hard and jammed)

is a jammed joint

Question 9

locking vs focusing concept with manipulation

Answer 9

locking - using combined motions above and below

focusing - increasing tension in system without using physiologic motion (use body not hands)

spectrum (marfans ankylosing) pt on one end will need more of focusing than the other.

examples

• long level lock.
• short level lock ( no locking of adjacent segments)
• minimal level (high speed needed building -tension without physiologic range)
• no lever focusing

Question 10

Selective tissue testing elements (how to test)

Inert
contractile
neurological
vascular

Answer 10

Inert - passive stretch (capsule, ligament, bone, synovium, cartilage, skin, bursa, dural sleeve, fascia)

contractile - isometrics (muscle, tendon, tenoperiosteal jct, submuscular or subtendinous bursa)

Neuro - dermatome, myotome, reflexes, clonus, babinski, oppenheim, hoffman. (afferent and efferent pathways)

Vascular - sustained or repeated contractions for claudication or passive stretch for DVT (arteries and veins)