MSK Weak Points Flashcards
1
Q
ATP-PC System
A
sprinting 100 meters
enough energy for 15 seconds
2
Q
Phosphagen system represents…
A
the most rapidly available source of ATP for muscle use
3
Q
ATP and PC are stored directly in
A
contractile mechanisms of muscle
4
Q
Anaerobic glycolysis
A
sprinting 400-800 meters
glycogen used and split into glucose and then again into pyruvic acid
formulates lactic acid
5
Q
Anaerobic is __% slower than phophocreatine system.
A
50
6
Q
Anaerobic can provide a person with __-___seconds of muscle contraction
A
30-40
7
Q
Anaerobic only uses what fuel source?
A
carbs
8
Q
Which energy system yields the most ATP?
A
aerobic
9
Q
frontal plane has what axis?
A
anterior-posterior axis
abduction and adduction
10
Q
sagittal plan has what axis?
A
medial-lateral axis
flexion and extension
11
Q
transverse plane has what axis?
A
vertical
12
Q
Class 1 lever: how many in the body?
A
very few
13
Q
Example of class 1 lever?
A
triceps extension
(Seesaw)
14
Q
Class 2 lever: length of effort arm is always ______ than resistance arm.
A
longer
15
Q
In most instances in a class 2 lever arm, what acts as effort and resistance?
A
gravity as effort
muscle as resistance
16
Q
Class 2 lever example?
A
hand on table and weight bearing through it
(wheelbarrow)
17
Q
Class 3 lever: length of effort arm is always ______ than resistance arm
A
shorter.
18
Q
With a class 3 lever shoulder abduction has weight where?
A
at wrist
19
Q
Class 3 levers allow ___ movements at rapid speeds and are the most ____.
A
large
common
20
Q
example of class 3 lever in body
A
elbow flexion
21
Q
Synarthroses joints are…
A
fibrous
22
Q
Synarthroses (fibrous) joints are ….
A
nonsynovial
23
Q
Movement in fibrous joints
A
minimal to none
24
Q
Fibrous joints
A
suture (skull)
syndesmosis (interosseous membrane of tib/fib)
gomphosis (tooth in socket)
25
Do suture joints move?
no
26
Syndesmosis joints' connection and motion
bone to bone with fibrous membrane or cord
very little motion
27
Amphiarthroses are known as
cartilaginous joints
28
Amphiarthroses (Cartilaginous) joints have what kind of cartilage, and connect what structures and what is their movement like?
hyaline or fibrocartilage
bone to bone
slightly moveable
29
types of cartilaginous joints
synchondrosis
symphysis
30
synchondrosis joints examples in body. They have what kind of cartilage?
sternum and true rib articulations
hyaline cartilage
31
Symphysis example in body, cartilage type.
pubic
two bones covered in hyaline cartilage and connected by fibrocartilage
32
Synovial joints aka
diarthroses
33
Synovial (diarthroses) joints have 5 distinguishing characteristics, what are they?
joint cavity, articular cartilage, synovial membrane, synovial fluid and fibrous capsule
34
3 types of joints in synovial joints
uniaxial
biaxial
multiaxial
35
Uniaxial joints include which ones and have what kind of motion around an axis?
hinge and pivot
elbow and atlantoaxial
one motion around a single axis in one plane
36
Biaxial joints include which ones and have what kind of motion around an axis?
condyloid- MCP
saddle-CMC
two planes and 2 axes through convex/concave
37
Multi axial joints include which ones and have what kind of movement around an axis?
plane (gliding)-carpal
ball and socket
three planes and around three axes
38
Gogli tendon organs are located where
in most joints
39
golgi-mazzoni corpuscles are located where?
they are sensitive to?
primarily distributed where?
joint capsule
compression of joint capsule
knee joint
40
Pacinian corpuscles are usually where?
What are they sensitive to?
where are they distributed?
fibrous layer of joint capsule
high frequency vibration, acceleration, and high velocity changes in joint position.
all joints
41
ruffini endings are where?
what are they sensitive to?
and where are they distributed?
fibrous layer of joint capsule
stretching of capsule, amplitude and velocity of joint position
greater density in proximal joints, particularly in capsular regions.
42
Type IIa muscle fibers are what color? Type IIb?
red
white
43
Muscle spindle sends info about....
Important in....
muscle length and/or the rate of change in its length
control of posture and help of gamma sys, involuntary movements
44
Golgi tendon organs have an average of ___-____muscle fibers connected. and send ____information.
10-15
instataneous
45
Nociceptors are
free nerve endings
46
Nociceptors activated by
thermal, mechanical or chemical stimuli
47
Nociceptors have two types of afferent neurons
A delta and C
48
A-delta fibers transmit
quickly
49
C fibers transmit
slowly and from deeper tissues
50
A-delta are more ___pain
sharp
51
C-fibers are more ___pain
dull
52
nociceptors transmit to what part of spinal cord and up which tracts?
dorsal horn
thalamus via spinothalamic tract
53
Gate control theory
says that the a-delta and c fibers also synapse with an inhibitory interneuron A-alpha and A-beat that help inhibit pain naturally.
54
What do we use for gate control theory as therapists?
e-stim and massage
55
Endogenous opioids are aka
endorphins
56
How do endogenous opioids work?
by controlling the amount of calcium and potassium that are moving in and out of the cell in depolarization and also inhibiting GABA
57
What is viscerogenic pain?
internal organ pain
58
Viscerogenic pain does not ___ based on movement.
change
59
Common sites of viscerogenic pain that will refer are
shoulder, scap, back, chest, pelvis, SI joint, groin, hip
60
Heart is innervated by ___-____ and can cause pain on/in
C3-T4
left side of body in chest, mid-back, jaw, shoulder, arm, neck
61
Kehr's sign is positive when?
What is it testing? What is happening?
pressure too upper abdomen or supine positioning results in L shoulder pain.
blood accumulating in abdominal cavity, secondary often to rupture in spleen and can cause irritation of diaphragm and refer pain to left shoulder. due to irritation of diaphragm's nerves C3-C5
62
Gallstones can refer pain to
R upper abdomen and interscapular region because they are innervated by mid-thoracic spinal segments. Can also irritate diaphragm which will refer pain to R shoulder
63
Cutaneous/ superficial somatic pain is caused by...
It feels like....
within skin or subcutaneous tissue
well-localized, sharp/stabbing
dull ache at rest
64
Deep somatic pain is caused by....
type of pain felt....
associated with...
bone, muscle, fascia, tendons, ligaments, joint capsules and blood vessels.
diffuse and may be referred to other areas
onset of muscle spasm or trigger points
65
Visceral pain is....
associated with...
internal organs
autonomic symptoms (perspiration, changes in BP)
66
Neuropathic pain is...
Symptoms provocation is with....
Associated with...
sharp, burning, shooting, tingling or electrical that follows a peripheral and/or dermatomal pattern.
Tests that move, load or compress neural tissues will evoke symptoms.
Evoked by things that dont normally evoke pain.
sensory or motor changes
67
Referred pain can be from what sources?
It is usually ...
Does not have ....
Localized tenderness and .... are common.
somatic or visceral source
well-localized
well defined borders
muscle hypertonicity
68
3 types of classifications of pain
nociceptive
neuropathic
nociplastic
69
Nociceptive
injury, inflammation, or mechanical irritation to non-neural tissue. usually in proportion to level of stimulus
70
Neuropathic
nerve pain in dermatomal distribution. Sensory signs like tingling, numbness, burning as well as changes in color, temp, and trophic changes
71
Nociplastic
abnormal pain processing
disproportional to stimulus applied.
Diffuse and not related to a specific structure
72
Vascular pain
throbbing, pulsing, beating, pounding
73
Body fat percentage for males.... females
12-18%
18-23%
74
Skinfold measuring sites
abd
tris
bis
chest
medial calf
midaxillary
subscap
suprailiac
thigh
75
If you have a low metatarsal arch, what can you see under the ball of the foot?
calluses
76
Empty end feels (Abnormal) meanings
joint inflammation
fracture
bursitis
77
Firm end feels (abnormal) meanings
increased tone
tightening of capsule
ligament shortening
78
Hard end feel (abnormal) meanings
fracture
OA
osteophyte formation
79
Soft end feel (abnormal) meanings
edema
synovitis
ligament instability/tear
80
MMT 2-/5
does not complete ROM in gravity-eliminated
81
MMT 2/5
completes ROM in gravity-eliminated
82
MMT 2+/5
able to initiate movement against gravity
83
MMT 3-/5
does not complete full ROM against gravity but more than half
84
MMT 3/5
against gravity without resistance
85
MMT 3+/5
minimal resistance
86
MMT 4-/5
minimal-moderate resistance
87
MMT 4/5
moderate resistance
88
What is muscle insufficiency?
when a muscle contraction is less than optimal due to extremely lengthened or shortened position
89
Active insufficiency
incapable of shortening to produce full ROM
90
Passive insufficiency
incapable of lengthening to produce full ROM
91
Power grip
fingers in flexion, wrist in ulnar deviation and slight extension
92
cylindrical grip holds
soda can
93
fist grasp holds
hammer
94
spherical grip holds
baseball
95
hook grasp controlled by and holds
forearm flexors and extensors
pail handle
96
precision grip
MCP and IP joints on radial side of hand
97
3 types of precision grip
digital prehension
lateral prehension
tip prehension
98
digital prehension grip
pencil
99
lateral prehension grip
key
100
tip prehension grip
needle
101
Intrarater reliability of dynamometry
>.94
102
Handheld dynamomter grip strength is ___-___lbs greater in dominant hand
5-10
103
Isometric dynamometry is contraindicated for
those with fxs
and significant HTN
104
Isokinetic dynamometry
constant speed
alters resistance
speeds of motion include: 60, 120, 180 degrees per second
105
What is a make test?
patient is asked to apply force through dynamometer
106
Break test?
patient holds a contraction
107
Movement of pelvis during initial swing
backward rotatino 4-5*
108
Movement of pelvis during midswing
neutral
109
Movement of pelvis during terminal swing
forward rotation 4-5*
110
Movement of pelvis during initial contact
forward rotation maintained
111
Movement of pelvis during loading response
less forward rotation
112
Movement of pelvis during midstance
neutral
113
Movement of pelvis during terminal stance
backward rotation 4-5*
114
Movement of pelvis during pre-swing
backward rotation 4-5*
115
Hip flexion during initial swing and midswing
20*
116
Hip flexion during terminal swing, initial contact and loading response
30*
117
Hip flexion during midstance
extending to neutral
118
Hip flexion during terminal stance
apparent hyperextension 10*
119
Hip flexion during preswing
neutral extension
120
knee movement during initial swing
flexed to 60*
121
knee movement during midswing
60-30* flexion
122
knee movement during terminal swing
extension -0*
123
knee movement during initial contact
full extension
124
knee movement during loading response
flexion 15*
125
knee movement during midstance
extending to neutral
126
knee movement during terminal stance
full extension
127
knee movement during pre-swing
35*
128
ankle movement during initial swing
PF 10*
129
ankle movement during midswing and terminal swing
neutral
130
ankle movement during initial contact
neutral, heel first
131
ankle movement during loading response
PF 15*
132
ankle movement during midstance
PF -10* DF
133
ankle movement during terminal stance
neutral with tibia stable and heel off prior to IC of opposite foot
134
ankle movement during pre swing
PF 20*
135
Toes are neutral during gait except when?
terminal stance and pre swing where MP are extended
136
ROM requirements for normal gait: Hip flexion
hip extension
knee flexion
knee extension
ankle DF
ankle PF
0-30*
0-10*
0-60*
0*
0-10*
0-20*
137
Average base of support during gait (distance between the left and right foot during progression of gait)
2-4 in
138
Average cadence for a walking adult
110-120 steps per minute
139
Average degree of toeing out during gait
7*
140
Average pelvic rotation during gait
8*
4* forward with swing leg and 4* backward with stance
141
Step length is
measured between R heel strike and L heel strik
142
Average step length
28 in
143
Stride length is
R heel strike to R heel strike
144
Average stride length
56 in
145
Antalgic gait is where stance time is____. There is rapid and shorter swing phase of the ____limb. Causes of this gait....
decreased
uninvolved limb
bone or joint disease, joint inflammation, injuries to muscles, tendons or ligaments
146
Ataxic gait usually involves...
WBOS
movements that are exaggerated
147
Circumduction may be used to compensate for
insufficient hip and knee flexion or DF
148
Double step
alternate steps are of a different length or rate
149
Equine gait pattern
high steps from over activity of gastroc
150
hemiplegic gait pattern
abducts paralyzed limb, swings it around to bring it forward
151
spastic gait pattern
toes seeming to catch and drag, legs held together, hip and knee joints slightly flexed
152
Steppage gait pattern
feet and toes are lifted through hip and knee flexion to excessive heights
usually secondary to DF weakness
foot slap at IC
153
Tabetic gait pattern
high stepping ataxic gait where the feet are slapping the ground
154
Mobilizations are contraindicated for
joint replacement
155
Grade I mobilization is what size amplitude?
small
156
Grade II mobilization is what size amplitude?
large
157
Grade III mobilization is what size amplitude?
large
158
Grade IV mobilization is what size amplitude?
small
159
Convex moving on concave will be
opposite directions
160
Any movement beyond end range is considered
stretching
161
Stress-strain curve: toe region
initial stress that results in the wavy collagen fibers becoming straight and aligning with one another
162
Stress-strain curve: elastic region
added stress to the tissue results in greater deformation, though the tissue returns to its resting length if the stretch is not maintained. Tissues with greater stiffness will have a steeper slope in this portion of the curve.S
163
Stress-strain curve: plastic region
addition of more stress results in permanent deformation even after the stretch force is no longer applied due to the failure of bonds between the collagen fibers.
163
What is the principle for the basis of stretching?
creep
163
What is creep?
soft tissue that is stretched for a sustained duration will elongate and not return to its original length after the load is removed due to viscoelastic property
163
Middle layer of muscle fibers that wraps muscle fibers into groups called fasciculus
perimysium
163
Innermost connective tissue of muscle that enwraps the individual muscle fibers
endomysium
163
Myofibrils make up
sarcomeres
163
Outermost connective tissue layer of muscle that surrounds the entire muscle.
epimysium
163
Subunits of muscle
myofibrils
164
Sarcomeres are made up of....
actin and myosin
165
Isometric
without a change in muscle length
166
Isotonic
constant load
concentric and eccentric
167
Isokinetic
constant speed and variable load.
equipment
168
Power training reps and sets
low reps very high intensity
169
Volume in strength training is calculated by
of reps x intensity
170
Exercise sequence
large muscles first then small
multi-joint before single joint
high intensity before low intensity
171
DeLorne exercise programming
1st: 50% (of 10 rep max) @10 reps
2nd: 75% (of 10 rep max) @10 reps
3rd: 100% (of 10 rep max) @10 reps
172
Oxford exercise programming
1st: 100% (of 10 rep max) @10reps
2nd: 75% (of 10 rep max) @10 reps
3rd: 50% (of 10 rep max) @ 10reps
173
SAID
specific adaptation to imposed demands
174
Reversibility principle
reversible effects can begin within 1-2 weeks of stopping an exercise program
175
length-tension relationship
muscle can produce maximal force near its normal resting length. If it lengthened or shortened it will likely produce less force.
176
force-velocity relationship
speed of muscle contraction affects the force
concentric= as speed increases, force decreases
eccentric= as speed increases the force also increases
177
Moment arm
linear distance from the axis of rotation to the site of the external load
178
power
rate at which work is performed
work/time
179
torque
ability of external load to produce rotation around an axis, calculated by multiplying the magnitude of the load by the moment arm
180
work
magnitude of load multiplied by the distance the load is moved
weight x ROM
181
During strength training muscle fibers IIB turn into
IIA
182
During strength training what happens to capillary bed density?
decreases or there is no change
183
During strength training what happens to mitochondria?
decreased density
184
What happens to ATP during strength training?
increases stores
185
Which type of muscle fibers are resistant to fatigue?
I
186
DOMS characterized by
tenderness to palpation in the muscle belly or at the muscle-tendon junction
187
What types of exercises reduce the likelihood of DOMS?
concentric and isometric
188
Edema vs effusion
edema: outside joint capsule
effusion: inside joint capsule
189
Normal Q angle in supine with knee straight: females vs males
females:18 degrees
males: 13 degrees
190
Sprain grades
I: little to no tear
II: minimal to moderate tearing
III: total tear
191
Strain grades
I: pain, minimal swelling and tenderness
II: moderate swelling, tenderness and impaired motor function
III: palpable defect of muscle, severe pain and poor motor function
192
