Musculoskeletal II- Dynamometry, End-Feel, Description of joints, Dermatome testing, resistive testing, Types of contraction, and muscle physiology Flashcards
1
Q
Type I vs Type II Muscle fiber classifications
A
- Type I- aerobic, red, tonic, slow twitch, slow oxidative
- Type II- anaerobic, white, phasic, fast twitch, gast glycolytic
2
Q
Type I vs Type II- Functional characteistics of muscle fibers
A
- Type I- low fatigue, high capillary density, high myoglobin content, smaller fibers, extensive blood supply, large amount of mitochondria (ex marathon, swimming)
- Type II- high fatiguability, low capillary density, low myoglobin content, large fibers, less blood supply, fewer mitochondria (ex high jump, sprinting)
3
Q
Muscle receptors- Muscle spindle
A
- distributed throughout belly of muscle
- function to send info to the nervous system about muscle length and/or rate of change of its change
- spindle if important in the control of posture, and with the help of the gamma system, involuntary movements
4
Q
Muscle receptors- Golgi tendon organ
A
- encapsulated sensory receptors through which muscle tendons pass immediately beyond their attachment to the muscle fibers
- very sensitive to tension especially when produced from an active muscle contraction
- the function to transmit info about tension or the rate of change of tension within the muscle
- average of 10-15 muscle fibers usually connected in series with each golgi tenson organ
- stimulated through the tension produced by muscle fibers
- GTO provide the nervous system with instantaneous information on the degree of tension in each small muscle segment
5
Q
Concentric
A
- muscle shortens and develops tension
6
Q
Eccentric
A
- muscle lengthens and develops tension
7
Q
Isometric
A
- occurs when tension develops, but there is no change in the length of the muscle
- often against immovable objects
8
Q
Isotonic
A
- occurs when muscle shortens or lengthens while resisting a constant load
9
Q
Isokinetic
A
- occurs when the tension developed by the muscle, while shortening or lengthening at a constant speed, is maximal over the full range of motion
- ex biodex
10
Q
Resistive testing- Upper extremity (C1-T1)
A
- Cervical rotation (C1)
- Shoulder elevation (C2-C4)
- Shoulder abduction (C5)
- Elbow flexion (C5-C6)
- Wrist extension (C6)
- Elbow extension (C7)
- Wrist flexion (C7)
- Thumb extension (C8)
- Finger adduction (T1)
11
Q
Reflex testing- Upper extremity (C5-C7)
A
- Biceps (C5)
- Brachioradialis (C6)
- Triceps (C7)
12
Q
Dermatome testing- Upper extremity (C2-T1)
A
- Posterior head (C2)
- Posterior lateral neck (C3)
- Acromioclavicular joint (C4)
- Lateral arm (C5)
- Lateral forearm and thumb (C6)
- Radial distal phalanx, middle finger (C7)
- Little finger and ulnar border of the hand (C8)
- Medial forearm (T1)
13
Q
Functional testing (L4-S1)
A
- heel walking (L4-L5)
- toe walking (S1)
- SLR (L4-S1)
14
Q
Resistive testing- Lower extremity (L4-S1)
A
- hip flexion (L1-L2)
- knee extension (L3-L4)
- ankle dorsiflexion (L4-L5)
- great toe extension (L5)
- ankle plantar flexion (S1)
15
Q
Reflex testing- Lower extremity (L4-S1)
A
- patella (L4)
- achilles (S1)
16
Q
Dermatome testing- Lower extremity (L2-S5)
A
- anterior thigh (L2)
- middle third of anterior thigh (L3)
- patella and medial malleolus (L4)
- fibular head and dorsum of foot (L5)
- lateral and plantar aspect of foot (S1)
- medial aspect of posterior thigh (S2)
- perianal area (S3-S5)
17
Q
Ideal plumb line alignment (pg70)
A
- slightly posterior to coronal suture
- through the external auditory meatus
- through the axis of the odontoid process
- midway through the tip of the shoulder
- through the bodies of the lumbar vertebrae
- slightly posterior to the hip joint
- slightly anterior to the axis of the knee joint
- sightly anterior to the lateral malleolus
- through the calcaneocuboid joint
18
Q
Loose packed position
A
- stress on joint- minimal
- congruency of joint- minimal
- ligament position- great laxity
- joint surface- no volitional seperation
19
Q
Close packed position (pg 71)
A
- stress on joint- maximal
- congruency of joint- full
- ligament position- full tightness
- joint surface- compressed
20
Q
Normal end feel
A
-
firm (stretch)
- ankle df, finger ext, hip ir, forearm supination
-
hard (bone to bone)
- elbow extension
-
soft (soft tissue approximation)
- elbow flx, knee flx
21
Q
Abnormal end-feel
A
-
empty (cannot reach end-feel, usually due to pain)
- joint inflammation, fracture, bursitis
-
firm
- increased tone, tightness of capsule, ligament shortening
-
hard
- fracture, OA, osteophyte formation
-
soft
- edema, synovitis, ligament instability/tear
22
Q
Dynamometry basics
A
- measuring forces thata re doing work
- measures strength through the use of a load cell or spring loaded gauge
23
Q
Handheld dynamometry (pg 76)
A
- can be used to assess the grip strength of a patient
- normaly, dominant grip strength 5-10 pounds greater than non-dominant grip strength
- also used to measure muscle group strength by having patient exert maximal force against dynamometer
24
Q
Isometric dynamometry (pg 76)
A
- measures static strength of a muscle group without any movement
- extremity restrained by stabilization straps or stabilized with only verbal instruction
- conraindicated for acute orthopedic injury, fractures, or significant hypertension
- inability to convert data to functional activities
25
**Isokinetic dynamometry** (pg 76)
* measures strength of a muscle group during a movement with constant, predetermined speed
* alters tension to accomodate for the change on length-tension ratio and lever arm throughout the entire arc of motion
* therefore, muscle group contracts maximally throughout motion
* common speeds are 60, 120, 180 deg per sec
* does not correlate to function since same velovity throughout
* patient will never have more resistance than they can handle throughout
