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musculoskeletal quiz 1 Flashcards

1
Q

Model of Human Occupation (MOHO)

components:

A

Volition - Willingness to act
Habituation - Habits
Performance - Actions
Environment – Location of the Activity

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2
Q

Model of Human Occupation (MOHO): Premises

A

Human is an open system. Volition drives the system. Clinician role is to understand the client in terms of these systems and intervene to facilitate engagement in occupation.

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3
Q

Canadian Model of Occupational Performance and Engagement: Components

A

Spirituality
Occupation
Context (Institutional included)

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4
Q

Canadian Model of Occupational Performance and Engagement: Premises

A

Worth of individual is central to this model. Spirituality is core of a person. OT’s must understand client’s spirituality to facilitate engagement in occupations. Performance of occupations takes place within social, physical and cultural environments.

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5
Q

Occupational Adaptation (OA): Components

A

Occupations
Physical and emotional strengths and weaknesses
Examination of available support systems (physical and emotional)

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6
Q

Occupational Adaptation (OA): Premises

A

Help people participate in their desired occupations by adapting or modifying the occupations or using other methods to perform the occupation.

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7
Q

Person Environment Occupation (PEO): Components

A

Person
Environment
Occupation

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8
Q

Person Environment Occupation (PEO): Premises

A

Occupations are the everyday things that people do PEO looks at the person in terms of physical, social and emotional factors. The environment (context) influences the person and occupations. The environment includes culture and political institutions.

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9
Q

Biomechanical

Frame of Reference (FOR): Components

A

Strength
Range of Motion (ROM)
Endurance

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10
Q

Biomechanical

Frame of Reference (FOR): Premises

A

Applies kinetic (forces acting on the body). Uses the principals of physics related to forces, levers and torque.

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11
Q

Manual Muscle Grades

Manual Muscle Test Grading Criteria

A 
ROM = range of motion
AG = against gravity (holding muscle/ limb up with NO support)
GM = gravity minimized (not elevated, sitting on surface 
5
Complete ROM AG MAX resistance
4 +
Complete ROM AG nearly MAX resistance
4
Complete ROM AG MOD resistance
4 -
Complete ROM AG < MOD resistance
3 +
Complete ROM AG MIN resistance
3
Complete ROM AG NO resistance
3 - 
Completes MORE THAN HALF ROM AG
2 + 
Initiates ROM AG –OR- Completes ROM GM, slight resistance
2 
Completes ROM GM
2 - 
Does not complete ROM GM
1 
Palpable contraction, no ROM
0- No palpable contraction
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12
Q

Reflex scale

A

0 = No response
1+ = Sluggish or diminished
2+ = Active or expected response
3+ = More brisk than expected, slightly hyperactive
4+ =Brisk, hyperactive, with intermittent or transient clonus

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13
Q

Subjective client information

A

General Patient Profile

  • date/time of examination
  • Identifying data (age, gender, race, place of birth, marital status, occupation, religion)
  • Source of referral
  • Sources of subjective examination information (patient, relative, friend, medical record, referral letter)
  • History of OT for their current condition (required by Medicare)
  • Awareness of diagnosis and prognosis (required by Medicare)

Chief complaint
-Pain, stiffness, weakness, other

Behavior and symptoms

Performance in Areas of Occupation (Functional Limitations)

  • ADL
  • Instrumental ADL
  • Rest and sleep
  • Education
  • Work
  • Play
  • Leisure
  • Social participation

Adjustment to disability or adaption

Medication review

Review of symptoms

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14
Q

Objective measures

A
  1. ADL (bathing, dressing, etc)
  2. IADL (meal prep, care of pets, etc)
  3. AROM
  4. PROM
  5. Edema
  6. Pain
  7. Muscle strength
  8. Endurance
  9. Muscle tone
  10. Motor Reflexes
  11. Sensation
  12. Proprioception
  13. Coordination
  14. Cognition (memory, attention, etc)
  15. Perception
  16. Vision
  17. Balance
  18. Communication
  19. Pain
  20. Gait patterns
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15
Q

Synovial Joint:

A

the type of joint found between bones that move against each other, very mobile

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16
Q

Hinge joint

A

uniaxial (has 1 degree of motion, moves in one plane)

Examples include elbow, knee, ankle, & interphalangeal joints

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17
Q

Pivot joint

A

uniaxial (has 1 degree of motion, moves in one plane)
Rotation around a single axis

Examples include atlantoaxial joint & proximal radioulnar joint

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18
Q

Saddle joint

A

biaxial (has 2 degrees of motion, moves in two planes)
More flexibility than hinge joint

Examples include thumb (CMC joints) & sternoclavicular joint

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19
Q

Condyloid joint

A

biaxial (has 2 degrees of motion, moves in two planes)
Concave surface slides over convex surface

Example includes MCP joints (radial and carpal bones)

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20
Q

Ball & socket joint

A

triaxial, multiaxial (allows for flex, ext, abd, add, & rotation)
Most flexibility & freedom of movement, easily injured

Examples include shoulder & hip joints

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21
Q

Plane joint

A

triaxial, multiaxial (allows for flex, ext, abd, add, & rotation)
Allow gliding to occur between 2 or more bones

Examples include intercarpal, intertarsal, & acromioclavicular joints

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22
Q

Kinematics refers to

A

the study of the motions of joint and limb segments

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23
Q

Kinematic chains are

A

a combo of several joints uniting successive segments

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24
Q

Closed Kinematic Chains

A

Motion at one joint is accompanied by motion at adjacent joint (picture of the individual in with both feet on ground in the squat)

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25
Open Kinematic Chains
Distal joint is free to move in any direction; distal end is free to move in space (picture of individual on balancing on one foot, with other foot free to move around)
26
Closed packed position
More stable Maximum congruency of joint surface Joint capsule is taut
27
Open packed position
Less stable Position of incongruency of joint surfaces Joint capsule lax
28
closed (tight)
maximum area of joint surface contact, ligaments are stretched and under tension, capsule is taut, joint is compressed and hard to separate. Extension of elbow, hip, knee, and flexion of MCP's. Stability in a closed pack position is a therapy consideration
29
open (loose)
joint surface is minimal contact, ligaments are slack, capsule is slack, joint can be distracted. Joint mobilizations are done in the open packed position
30
What's in the middle for first, second, and third class
1st- fulcrum is in the middle 2nd- load is in the middle 3rd- effort is in the middle
31
Draw first, second, and third class fulcrums
(see study guide)
32
``` Mechanical Advantage (MA) of Levers MA = ```
(force arm length)/(weight arm length)
33
Fulcrum:
the point at which a lever rotates
34
Effort:
the force applied to the lever (input force)
35
Load:
the force applied to the lever (output force)
36
First Class of Levers
fulcrum/axis is between the force and resistance E.g. crowbar, scissors, teeter-totter, splint Example in humans = atlanto-occipital joint (axis) =ankle standing on one foot
37
Second Class of Levers
Resistance is between the fulcrum/axis and the force E.g. wheelbarrow, nutcracker Example in humans: = rare, opening mouth against resistance Forces on pelvis when standing on both feet
38
``` Second class of levers continued "A lever operates at a mechanical disadvantage when the___________ and ____________. The force exerted must be greater than the load in order for it to be moved or supported. ```
load is farther from the fulcrum and the effort is closer to the fulcrum
39
In a second class order of levers it IS true to say:
The fulcrum is between the force and resistance This order of levers occurs commonly in the body Resistance (weight) is between the fulcrum (axis) and the force An example of this order of levers is the biceps flexing the elbow
40
Third Order of Levers
Force is between the fulcrum and the resistance E.g. spring close to a screen door Example in humans = biceps (3rd are common in the body)
41
Isometric:
to hold still
42
Isometric contraction:
contractile mechanisms are activated, but no change in length of fibers or motion occurs. (Eg Quads, elbow flexion) We can hold (isometric) more than we can lift (concentric) but less than we can lower (eccentric)
43
Concentric:
to lift Contractile tissue activated and shortens We can lift (concentric) less than we can hold (isometric)
44
Eccentric:
to lower with control Contractile tissue activated and lengthens We can lower (eccentric) more than we can hold (isometric) or lift (concentric)
45
Compression:
forces pull together
46
Tensile:
forces pull apart
47
Shearing or tangential forces:
act parallel Shear forces are parallel to the surfaces Friction is dependent on surface material
48
Scalar measures
MAGNITUDE -Measures of space -Quantities ~Time, volume, speed, mass, temperature, distance, energy, work~
49
Vector measures
VELOCITY and DIRECTION (start to finish) | Muscles have magnitude, velocity, and direction
50
Think of muscles as vectors: | Length of vector is
proportional to the specific amount of the muscle pull, in effect it is to scale.
51
Think of muscles as vectors | Line of pull represents
the pull from the attachment (insertion) in the direction of the other attachment (origin). So, the line of pull is the insertion towards the origin.
52
Think of muscles as vectors: | There is a tendency towards movement in
that direction.
53
Think of muscles as vectors: Vectors can be from the ___ or ____ dependent upon the direction the force is moving, the arrow follows the direction of the muscle fibers.
origin or insertion
54
Think of muscles as vectors: | A muscle force has
magnitude, direction, point of application and line of pull & angle of pull.
55
OT profile contents
The initial step in the evaluation process that provides understanding of the client’s occupational history and experiences, patterns of daily living, interests, values and needs. The client’s problems and concerns about performing occupations and daily life activities are identified, and the client’s priorities are determined.
56
Agonists (prime movers)
Muscle contractile units shorten to produce a specific joint motion. Prime mover or controller of the joint motion.
57
Antagonists
Oppose agonists and must relax to allow agonists to move | Protect joints; stops motion at the end of ROM (e.g. wrist flexion)
58
Synergy
Muscles acting together. Muscles contribute to joint motion, but not the primary joint movement If a muscle performs more than one action another muscle must neutralize one of the actions by stabilization (e.g. wrist extension and finger flexion)
59
Agonist for grasp
finger flexors
60
Synergists (stabilizers) for grasp
Wrist extensors
61
Antagonists to grasp
Finger extensors

musculoskeletal (3 decks)

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