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JOINT MOBS > quiz #1 (intro - shoulder) > Flashcards

quiz #1 (intro - shoulder) Flashcards

1
Q

joint mobs definition

A

skilled passive movement by therapist on articular surfaces to decrease pain / increase joint mobility or ROM

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2
Q

physiological effects of joint mobilization

A

-fires articular mechanoreceptors
-fires cutaneous & muscular receptors
-abates or stops nociceptors (pain receptors)
-decreases or relaxes mm guarding
-causes synovial fluid movement & improves
nutrient exchange
-improves mobility & flexibility at joint
-maintains tensile strength of articular tissues

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3
Q

arthrokinematics

A

-motions you can feel
-movement that occurs INSIDE joint
(roll, spin, slide/ glide)

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4
Q

osteokinematics

A

-motions you can see
-movement of body parts OUTSIDE joint
(flex, ext, ADD, ABD, rotate)

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5
Q

close packed position

A

-articular bones have MAX area of contact
-joint stability = greatest
-max mobility
*injury: fracture / dislocation

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6
Q

open / loose packed position

A

-joint surfaces become separated
-little congruity & minimal surface contact
-joint stability = minimal
*injury: sprains, strains, swelling

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7
Q

capsular pattern of restriction

A

-predictable pattern of movement restriction
-when entire joint capsule is injured / affected
-order: most restricted to least

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7
Q

CONCAVE / CONVEX RULE

A

when concave surface moves on convex surface

roll & slide must occur in SAME direction

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7
Q

CONVEX / CONCAVE RULE

A

when convex surface moves on concave surface

roll & slide occur in OPPOSITE directions

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8
Q

joint distraction

A

two opposing joint surfaces separated from each other, moving toward loose/ open packed position

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8
Q

axial distraction

A

through long axis of joint

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9
Q

lateral distraction

A

perpendicular to long axis of joint

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10
Q

compression / approximation

A

two opposing joint surfaces move toward each other / approximated - toward close packed position

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11
Q

joint play

A

motion available between two articular surfaces in one direction

not under voluntary control

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12
Q

rules of joint play (pt.1)

A

-patient must be relaxed
-therapist must be relaxed & comfortable
-mobilize one joint, in one direction, & at one time

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13
Q

rules of joint play (pt.2)

A

-assessment of joint play should always be in loose packed position
-do not lever joint
-watch for patient discomfort
-always re-assess prior & after Tx

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14
Q

causes for joint dysfunction

A

-intra articular adhesions / pericapsular stiffness
-shortened mm groups around joint
-mm weakness & imbalance around joint
-pain
-nerve root adhesions
-soft tissue restrictions

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15
Q

indications for joint play

A

-most commonly associated with restoring ROM for peripheral & axial skeleton joints
-primary indication: decreased ROM due to immobilization, usually from fractures, ligamentous sprains, tendonitis, or adhesive capsulitis
-any condition involving fibrosis or pseudo-fibrosis (relative capsular fibrosis) of joint capsule is indicated for mobilization

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16
Q

CI’s joint play

A

hypermobility
joint effusion
inflammation

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17
Q

precautions joint play

A

-malignancy
-bone disease
-unhealed fracture
-excessive pain
-total joint replacements
-newly formed/ weakened CT
-systemic CT disease
-elderly (weakened CT)

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18
Q

methods of joint examination

A

-inspection
-palpation
-ROM (active vs passive)
-radiography (x-ray)
-CT scan
-MRI
-conventional & contrast Arthrography
-ultrasound Arthrography

19
Q

inspection & palpation - looking for…

A

-swelling
-skin changes
-mm, above & below joint (wasting) compared to non injured side
-deformity, bones misaligned, valgus / varus

20
Q

ROM

A

measurement of amount of movement around a specific joint

21
Q

passive (relaxed) ROM

A

therapist makes motions of joint while patient is relaxed through unrestricted range
-patient does not contract mm
-anatomic barrier = end of PROM

22
active ROM
patient “actively” contracts voluntary mm crossing joint, moving joint through its ROM -physiologic barrier = end of AROM
23
grading joint play
-when applying joint mobilizations: start with least stress on joint and go to more & more stress -we use grading system for both sustained glides/ distractions & oscillations -each grade has purpose & function within grading system for a therapeutic effect on joints
24
GRADE 1 - sustained glide / traction
-initiation of movement of opposing joint surfaces -perpendicular to joint surfaces for a distraction joint mob/ parallel for a glide joint mob non-corrective grade
25
GRADE 2 - sustained glide / traction
-movement of opposing joint surfaces is up to first tissue stop -perpendicular to joint surfaces (distraction) or parallel (glide) non-corrective grade
26
GRADE 3 - sustained glide / traction
-movement of opposing joint surface is up to & through first tissue stop -stretches joint capsule - perform grade with caution corrective grade
27
GRADE 1-3 purpose
GRADE 1 & 2: pain management, intro assessment to joint play & techniques GRADE 3: corrective, stretch joint capsule, restore glide motions with joint
28
GRADE 1 - oscillations
small amplitude between initiation of movement & tissue resistance - at the start of motion — 5 cycles per second
29
GRADE 2 - oscillations
large amplitude between initiation of movement & tissue resistance, not reaching end of ROM performed at 2-3 cycles per second
30
GRADE 3 - oscillations
large amplitude within tissue resistance & backing out again - to start of limited end of ROM 2-3 cycles per second
31
GRADE 4 - oscillations
small amplitude within tissue resistance to end of limited ROM 5 cycles per second
32
GRADE 5 - oscillations (not in scope)
high velocity, small amplitude, non-oscillatory starts at tissue resistance & follows through in a thrust manipulation - commonly called a thrust, adjustment, or manipulation
33
end feels
-when assessing passive movements, therapist applies overpressure at end of the range to determine quality of end feel -sensation therapist “feels” in joint as it reaches end of ROM of each passive movement
34
normal end feels
bony: “hard” unyielding sensation that is painless soft tissue approximation: yielding compression, or “mushy” feel tissue stretch: firm springy type of movement with slight give, an elastic resistance, may be hard (capsular) or soft (elastic)
35
abnormal end feels
-early spasm: mm/ ligament tear, often acute -late spasm: instability -capsular: hard (chronic) & soft/ boggy (acute), caused by capsule damage -empty: ligament rupture or tear, very painful -bone to bone: osteophyte, early restriction in ROM -springy block: internal derangement inside joint, common in meniscus, early restriction
36
GH mobilizations
1. Anterior glide 2. Long axis traction 3. Posterior glide 4. Inferior glide at 90 degrees of abduction 5. Inferior glide at 90 degrees of flexion 6. Lateral distraction
37
anterior glide - effect & precautions
EFFECT: increase extension, pain management PRECAUTIONS: anterior joint capsule is looser & more lax so don’t over mobilize in this direction
38
long axis traction (axial distraction/ inferior glide) - effect & precautions
EFFECT: increase overall ROM, pain management PRECAUTIONS: do not allow shoulder girdle to move inferiorly as it may compress brachial plexus between clavicle & first rib
39
posterior glide - effect & precautions
EFFECT: increase internal rotation & flexion, pain management PRECAUTIONS: do not allow the humerus to externally rotate
40
inferior Glide at 90º of ABD - effect & precautions
EFFECT: increase ABD & flexion, pain management PRECAUTIONS: with inferior joint instability use caution, may provoke pain
41
inferior Glide at 90º of flexion - effect & precautions
EFFECT: increase flexion & ABD, pain management PRECAUTIONS: do not lever joint as this may damage capsule - take caution for inferior joint instability - try to minimize pain at humeral head while mobilizing
42
lateral distraction - effect & precautions
EFFECT: increase overall ROM, pain management PRECAUTIONS: do not apply pressure to patient’s chest with forearms, may compress ribs, forearm should be just below breast tissue
43
scapulothoracic joint mobilizations
1. Inferior glide/shoulder depression 2. Superior glide/shoulder elevations 3. Lateral rotation/upward glide 4. Medial rotation/downward glide 5. Distraction 6. Compressions to subscapularis muscle
44
superior glide / shoulder elevation - effect & precautions
EFFECT: increase shoulder elevation & stability, pain management PRECAUTIONS: use soft touch & light pressure to prevent mm guarding
45
inferior glide / shoulder depression - effect & precautions
EFFECT: increase shoulder depression & mobility, pain management PRECAUTIONS: if brachial plexus is stretched/ compressed, it may cause symptoms during mobilization, discontinue - perform with care
46
lateral rotation (upward rotation) - effect & precautions
EFFECT: increase lateral rotation & elevation, pain management PRECAUTIONS: use broad & soft contact for numerous bony prominences
47
medial Rotation (downward rotation) - effect & precautions
EFFECT: increase medial rotation & depression, pain management PRECAUTIONS: use broad & soft contact for numerous bony prominences
48
distraction (scapulothoracic) - effect & precautions
EFFECT: increase overall thoracic mobility, pain management PRECAUTIONS: do not perform if patient has winged scapula - too much pressure may cause mm guarding & pain
49
compressions to subscapularis - effect & precautions
EFFECT: increase scapulothoracic mobility, pain management PRECAUTIONS: if painful, discontinue

JOINT MOBS (18 decks)

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