Objective Exam (Physiologic ROM) - Musculoskeletal

Question 1

physiological movements

Answer 1

ROM

use of a goni

Question 2

what are physiological movements

Answer 2

normal movements we perform during our daily activities

Question 3

how can physiological movements be performed

Answer 3

active or passively

Question 4

AROM

Answer 4

performed voluntarily

Question 5

what does AROM show

Answer 5

pt’s combined willingness to move

joint ROM

location of pain

muscle power

Question 6

what do contractile tissues experience during ROM

Answer 6

tension placed on them

by stretching or contracting them

Question 7

what do inert tissues experience during AROM

Answer 7

tension placed on them by stretching or pinching

Question 8

inert tissues

Answer 8

all structures other than contractile tissues

Question 9

determination of a problem…

Answer 9

should not be made by the first positive sign

Question 10

when should we determine the problem

Answer 10

when all other contradictory signs have been eliminated

Question 11

what should we note when testing active movements (1)

Answer 11

when and where in the movement the onset of pain occurs

if movement increases the intensity +/or quality of the pain

pts rxn to pain

amount of observable restriction

pattern of movement

Question 12

what should we note when testing active movements (2)

Answer 12

movement of associated joints

willingness to move

quality of the movement

any limitation of movement

nature of limitation

Question 13

when and where in the movement the onset of pain occurs

Answer 13

w/ pain at start, middle and end

Question 14

if movement increases the intensity +/or quality of the pain

Answer 14

should be suspicious of contractile tissue pathology

but dont jump to conclusion

Question 15

dont jump to conclusion

Answer 15

it could be vascular or the joint may be very irritated

Question 16

pattern of movement

Answer 16

beware of subs

Question 17

movement of associated joints

Answer 17

look at what occurs at surrounding joints

Question 18

quality of movement

Answer 18

is the motion smooth and controlled

is it coordinated

Question 19

PROM

Answer 19

pt must be completely relaxed

PT brings pt through the motion

Question 20

what should the PT do as they take the pt through the motion –> PROM

Answer 20

continuously talk to the pt

Question 21

movement must be –> PROM

Answer 21

proceeded through as must ROM as possible

through discomfort and up to the pain

Question 22

what is PROM done to determine

Answer 22

amount of movement

sequence of pain and resistance

end feel

painful arc

Question 23

sequence of pain and resistance

Answer 23

as we take the pt through the ROM, something will stop you

indicates the suitability of the area to be stretched

Question 24

if there is pain before resistence

Answer 24

interpreted as an acute lesion

unsuitable for stretching

Question 25

if pain occurs synchronously

Answer 25

lesion is subacute may not tolerate gentle stretching

Question 26

resistance before pain

Answer 26

chronic lesion suitable for stretching

Question 27

painful arc

Answer 27

when taking a pt through motion starts pain free --then pain --> then goes away

Question 28

PROM will also determine

Answer 28

capsular patterns non capsular patterns joint end feel

Question 29

capsular patterns

Answer 29

directly related to passive physiological ROM

Question 30

what is capsular pattern

Answer 30

when looking at the inert components of a joint restriction of motion presents w/ consistent pattern of limitation for that respective joint limitation = capsular pattern

Question 31

what can the capsular contracture be the result of

Answer 31

many primary causes

Question 32

primary causes of capsular contracture

Answer 32

non-use following a minor injury strain or sprain that went unattended any insult to a joint that will cause the capsule to fibrose

Question 33

how do limitations occur --> capsular pattern

Answer 33

proportional pattern of restriction NOT JUST THE DEGREE OF LOSS

Question 34

what does the capsular pattern NOT indicate

Answer 34

pathology extend of the joint involvement

Question 35

non-capsular pattern

Answer 35

reveals capsular irritation is not present

Question 36

what does the presence of a non-capsular pattern mean

Answer 36

irritation of the entire joint capsule is not contributing to the limitation of movement another tissue type must be at fault

Question 37

3 possible causes of non-capsular patterns

Answer 37

ligamentous adhesions internal derangement extra-articular lesions

Question 38

ligamentous lesions --> non capsular pattern

Answer 38

usually occurs after an injury when adhesions occur

Question 39

internal derangement --> non capsular pattern

Answer 39

occurs in joints where there is the possibility of having an intra-articular fragment of cartilage or bone ex: meniscus in the knee

Question 40

extra-articular lesions --> non capsular pattern

Answer 40

resisting structure is outside of the joint

Question 41

if a capsule pattern isnt present

Answer 41

capsule could still be involved

Question 42

joint end feel

Answer 42

important for determining the nature of the restriction that causes the end of motion

Question 43

3 normal end feels

Answer 43

bone to bone soft tissue approximation tissue stretch

Question 44

which normal end feel is most common

Answer 44

tissue stretch

Question 45

5 abnormal end feels

Answer 45

muscle spasm empty end feel capsular end feel bone to bone springy