PT Final Flashcards
Three systems that integrate afferent input to efferent output
vision, peripheral vestibular system(semi circ. canals), somatosensory system (propricoeption, cerebellum)
gaze stabilization is
walking while keeping eyes fixed
cervico ocular reflex
fixation of eyes while moving neck
optokinetic reflex
maintains eye position with movements of the head
movement within the labyrinth causes:
eye moevements and postural adjustments
what is the NS goal in standing biomechanics?
keep the center of gravity centered between the base of support
Semicircular canals detect BLANKK acceleration
angular
Angular acceleration=
head rotation or change in velocity along a curve
Utricle and Saccule detect BLANKK acceleration
linear
Linear acceleration =
head velocity along a straight line
main purpose of vestibular mechanism is to
maintain visual eye fixation
Doll’s Head Response
Eyes fixated on a spot and will move in a direction opposite to head movement
Utricle and saccule togethere detect
the direction of gravity
visual input travels through what tract?
medial fasciculus tract
Perception of Motion is the
ability to differentiate the movement in the environment from one’s self
INput from 6 things allows smooth pursuit to occur
cerebellul, extra ocular eye muscles, cervico-mechano receptors, vestibular apparatus, retina, cervical muscles
saccade allows
the ability to focus the eye on an object of interest
explain the effect whip lash has on blurry vision
whip lash affects the cervical spine, and the CNS uses cervical muscles to intitiate and brake the head/neck movements
cervico occular reflex
maintains eye fixation with neck movement
Vistibulo occular reflex
maintains eye posi tion with movement of the head
Unilateral or bilateral have increase dizziness?
unilateral due to an imbalance b/t the two vestibular systems.
Proprioception
the sense of position, posture, and movement
Largest abundance of mechanoreceptors in the spine located?
upper cervical vertebrae
The highest concentration of mechanoreceptors is located in what area of a muscle spindle?
belly
Muscle mechanoreceptors respond to what changes within the tissue
muscle lengthening
Golgi Tendon Organs are located ?
in the junctions of muscles and their tendons
mUscle spindles action=
maintain tone and tension in muscles on oppo sides of a joint
golgi tendon action=
exert inhibitory effect on contraction of the muscle fibers
Type I mechanoreceptors located in what joints?
proximal jts
What is the job of type 1 mechanoreceptors?
signal the angle of joint throughout ROM and provide info to determine postural tonic mscl contractions
What is the job of type 2 nerve endings?
Provide info about the position of the joint and provide info to activate the phasic muscle actions
Where are type 2 nerve endings located?
distal mscls
Job of Type III mechanoreceptors
high threshold receptors that are only activated when a high joint stress occurs at end range and provide protection function like GTO
JOb of type IV receptors
free nerve endings in ligaments, capsules, fat pads that respond to pain stimuli and generate intense, motor responses in all muscles, protecting and restricting ROM
Engram
an appropriate neurologic programming facilitating optimal motor patterns
Motor Moron is someone who
has difficulty performing neutral pelvis and lumbar stabilization iexercises
Purpose of pertrubations
to increase the speed of contraction and body’s reflex response
Describe the muscles responsible for static stability
postural muscles composed of red fibers that are found in the deep layers of the neck, spoine, ribs, pelvis
How are red muscle fibers (core stabilizers) related to white phasic muscles?
they offere stablity so that the white fiber torque muscles can provide power thorughout movelment
INtrinsic stabilizer muscles
muscles that attach directly to the lumbar vertebrae and provide structural stability a segment
Examples of intrinsic stabilizer mscls include
psoas, QL, oblique, rapezius, Lats, Transversus,
Torque Producers
muscles that produce enought torque to produce movement
torque producer muscles include:
ERector spoinae, Recut abdominis, external obliques, mid and lower traps, and QL
What area of the body has a high level of proprioceptor receptors?
upper cervical
What area of the muscle spindle has the highest concentration of mechanoreceptors?
belly
muscle spindle mechanoreceptors respond to
change in mscl length.
Concentric = BLANKKK, Isometric=BLANKKK,
Eccentric=BLANKKK
Concentric=acceleration
Isometric=stabilization
Eccentric=Deceleration
WHat is the goal of sensorimotor training?
The goal is to integrate peripheral function with central nervous system programming
Posture
position of the body, relative arrangement of body parts, or charactertistic manner of bearing one’s body
Good Posture
state of muscular and skeletal balance that protects sturcture of body against injury while working and muscles functiona nd visceral organs function most efficiently
Postural fault
body parts position that produces increased strain on supporting structures and less efficent balance of body over its base of support
Adaptive shortness
tendency for shortened muscle to remain in shortened position
stretch weakness
weakness of muscle from remaining in a lengethened condition beyond their neurtal physiolgocial resting position
tight weakness
muscles kept in a habitually shortened position lose their elasticity and test strong only in shortened position, not lengthened!
Active insufficiency
muscle which shortens over 2+ joints reaches a length at which it can no longer generate useful force
Active insufficiency applies to what muscles
muscles that cross 2 joints ONLY
Passive insufficiency
When full ROM is limited by muscles length more than ligaments
Postural pain syndrome
is pain due to mechanical stress when maintaining faulty posture for prolonged time
Postural dysfunction
adaptive shortening and muscle weakness form prolonged poor posture, contracutre, or adhesions during tissue healing
How does the gravitational line lie in relation to the ankle
anterior to ankle joint
ankle gains stability through
soleus and plantar flexors
how does gravitation line lie in relation to knee?
anterior, keeps knee in extension
With knee fully extended, what muscles keep knee stable?
NONE!
with knee flexed what muscles keep knee stable?
quads, line moves posterior ot knee joint
when gravitational line passes posterior to hip AOM, what happens?
pelvic tilt
When line passes posteriorly, what is provided to keep the hip joint stable?
iliofemoral ligament
when line passes anteriorly what is requrired to maintain stability?
glutes/hip extensors
what muscles provide stability when gravity line shifts to sides of a vertebral body?
contralateral muscles
gravitational line should travel through what area of the upper cervical/skull?
anterior to CO -C1
what muscles contract to keep the head balanced?
posterior cervical muscles
what structure keeps the motion of the head in control in full FLEXION
ligamentum nuchae
Differences b/t phasic and postural muscles (8 differences)
capillary network, treatment, responses to dysfunction, energy metabolism, fuel source, fatigueability, metabolic processes, and speed of contraction
signs of transverse abdominis being lengthened or inhibited
navel out
overactivity of hamstrings in distal 1/3=
weak glutes
shoulder stabilizers weak=
abduction, elvation, winging of scap
Adductor notch” may suggest what pathology?
hypertonicity of short adductors distally and a hip dysfunction/pathology
external rotation of the leg suggest what muscle is tightended?
piriformis
scapular protraction of the medial border or winging suggests?
weak SA, tight pecs, tight upper traps, and levator,
Very prominent TL erectors=
weak abs, weak glutes, tight psoas, tight erectors
rotation of pelvis could be assoc. w what mscls?
QL, hamstrings, jt dysfunction, tight iliopsosas
palm facing posteriorly may indicate what dysfun.
tight interanal rotators
positive test in the trunk curl up=
feet come off the ground indicating a tight ilipsoas and abs
what is a posititve test for push up
scapula winging to test shoulder girdle stability
hip abduction positive test
looking for hip hiking, extern rotation, pelvis shaking,
purpose of hip abduction test
hip joint mobility, pelvis stability, glut med weakness, QL hyperactivity, TFL, psoas, adductor piriformis too active
Head flexion purpose/pos test
chin juts forward/shakes, helps ID weak neck flexors and tight SCM
shoulder abduction positive test
shoulder hiking, upper trap contraction before 60 degrees of abduction indicating abnormal G/H translation
layered syndrome
alternating hypertrophy then hypotrophy as you move superior to inferior
Describe the effect exercise can have on stopping the progression of scoliosis
Exercise alone will not halt the progression of or correct moderate/severe scoliosis but may help with mild idiopathic scolisos
How do you exercise a scoliosis curve?
stretch the short concave muscles, and strengthen the elongated convex side
spinal bracing should be used for curves that are greater than BLANKK degrees
40 degrees
Spinal bracing can also be used for curves that are BLANKK degrees and if progression is blank in one year and there is at lest one year of growth remaining
curves 25-40 if progression is >5 degrees in one year and there is at least one year of growth remaining
THe major goal of bracing is to
prevent progression of a curve or give some permanent correction and stabilization
Most common form of treatment for scolisosis is a combo of
millwaukee brace and daily exercises for mild to moderate scolisosis with 2 years of growth remaining
Which type of brace uses a concept of dynamic correction?
milwaukee brace
The milwaukee brace is worn for how long?
23-24 hrs a day for several years until full skeletal maturity
milwaukee brace is recommended for curves located in the BLANKK spine where as boston is good for BLANKK curves
milwaukee=upper thoracic
boston= below T8, lumbar
components of copes brace
brace, exercise, manipulation, electrical stimulation, heel lifts, nutrition, oculovestibular training
main afferent proprioceptive influence of sensorimotor training ocmes from what receptors (3 areas)
foot, SI, and deep neck muscles
Poor balance is associated with
low back pain
prupose of a functional capacity evaluation
gives objective info for prescribing treatment and monitioring results
indications for FCE
subacute, 6-8 weeks since injury, treatment plateaus, difficulty returning to employment,
normal ROM for knee flexion flexibility test
140-150 degrees of knee flexion
