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Foundations of PT 2 > Quiz 2 > Flashcards

Quiz 2 Flashcards

1
Q

List the 3 types of muscle tissues, the nervous system they control, and their function

A

Skeletal (Striated): Voluntary, exerts force on bones to create movement at a joint

Smooth (Non-striated): Involuntary, regulates movement of material through the hollow organs of the body

Cardiac (Striated): Involuntary, specialized tissue that regulates the pumping action of the heart

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2
Q

Differentiate between epimysium, perimysium, and endomysium

A

Epimysium: Fascia that encases the entire muscle (outermost layer)

Perimysium: Bundles of muscle fibers that are grouped together by fascia, and located within the epimysium

Endomysium: Individual muscle fibers wrapped in fascia, located within the perimysium (innermost layer)

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3
Q

What is a sarcomere?

A

The individual contractile unit of a muscle fiber

The length is from one Z band to another

I Bands: Light area, thin filament, made up of actin

A Bands: Dark area, thick filament, made up of myosin

[Note: Myofilaments (actin and myosin) form the zone and bands within the sarcomere]

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4
Q

What is connective tissue?

A

Made up of dozens of proteins including collagen

Two major physical properties:
- Tensile strength
- Relative inextensibility

Connective tissue within the muscle is made up of elastic fibers

Elastic fibers are almost found with collagen fibers

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5
Q

T or F? Structures with large amounts of collagen tend to limit motion and resist stretch

A

True

(think ligaments and tendons)

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6
Q

The ability for skeletal muscle to contract depends on what?

A
  • Maximal force production
  • Speed of contraction
  • Muscle fiber efficiency
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7
Q

What is the sliding filament theory?

A

Once binging site is exposed, myosin heads from the thick filament attach to
the exposed binding sites on the thin filament and cross-bridges are formed

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8
Q

T or F? Abnormal movement typically begins with neurological changes that control movement, followed by structural changes

A

True

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9
Q

T or F? Muscles can shorten in as little as 4-6 week when held in passively shortened positions

A

False, 2-4 weeks

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10
Q

What are the two types of musculotendinous receptors?

A

Golgi tendon organs (GTO) and muscle spindle

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11
Q

Describe Golgi Tendon Organs (GTO)

A
  • Connects approximately 15-20 muscle fibers
  • Located between the muscle belly and it’s tendon
  • Can sense increased muscle tension when contracted or stretched
  • INHIBITS antagonist muscle
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12
Q

Describe a muscle spindle

A
  • Located in the muscle belly and lies parallel with muscle fibers
  • Inhibits antagonist and facilitates agonist
  • Causes a stretch reflex contraction
  • Has both a static and dynamic component
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13
Q

Describe the static and dynamic components of a muscle spindle

A

Static Component:
- Fires all the time
- Provides structural info, fires more rapidly as the muscle becomes stretched

Dynamic Component:
- Fires with sudden changes in position
- Provides movement inro like velocity and direction

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14
Q

T or F? GTOs and muscle spindles work together through their reflexive actions to regulate muscle stiffness

A

True

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15
Q

Chronic hypertrophy is associated with what?

A
  • Structural changes in the size of existing individual muscle fibers
  • Number of muscle fibers
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16
Q

What is muscle fiber hyperplasia?

A

Defined as the increase of muscle fibers

  • Individual muscle fibers can split into two daughter cells, which then develop into new muscle fibers
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17
Q

What is muscle atrophy?

A

The loss of muscle size and strength

reasons for atrophy:
- disuse
- aging

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18
Q

What is sarcopenia?

A

Atrophy caused by the aging process

  • May also be related to decreased ability for the motor unit end plate to continuously repair and reconstruct with advancing age
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19
Q

What do the following abbreviations mean?

PROM
AAROM
AROM

A
  • Passive range of motion
  • Active assisted range of motion
  • Active range of motion
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20
Q

What are the two types of contraction?

A

Open Kinetic Chain and Closed Kinetic Chain

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21
Q

What does isokinetic mean?

A

“same speed”

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22
Q

What does “isotonic” mean?

A

“same resistance”

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23
Q

What is myostatic contracture (stretching)?

A

Permanent shortening

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24
Q

What does FITT stand for?

A

Frequency, Intensity, Timing, Type

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25
Q

Differentiate between strain and sprain

A

Musculotendinous (strain), ligament (sprain)

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26
Q

Differentiate between the 3 classes of tissue injury

A

Grade 1:
- Mild pain at the time of injury
- Mild swelling
- Minimal tearing

Grade 2:
- Moderate pain that requires stopping of the activity
- Stress and palpation of tissue will increase pain
- Moderate tearing

Grade 3:
- Near or complete tear
- Stress to the torn tissue is usually painless

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27
Q

What are the 3 phases of healing and their time frames

A

Inflammation: 4-6 days
Proliferation: 4-24 days
Remodeling: 21 days to 2 years

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28
Q

Describe the inflammatory phase

A
  • 0-6 days
  • vascular changes (vasoconstriction to vasodilation)
  • hemostasis occurs

Signs:
- pain at rest
- redness
- swelling
- warmth
- loss of function
- muscle guarding

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29
Q

How do you treat a patient during the inflammatory phase? (use POLICE)

A

P: Protect
OL: Optimal Loading
I: Ice
C: Compression
E: Elevation

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30
Q

Describe the proliferative phase

A

Granulation tissue formation

Signs:
- decreased inflammation
- pain with tissue resistance

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31
Q

Describe the remodeling phase

A
  • 21 days to 2 years
  • Maturation of connective tissue
  • Scar remodeling

Clinical Signs:
- Absence of inflammation
- Pain after tissue resistance

Intervention:
- Stretching
- Strengthening
- Mobility

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32
Q

List the normal healing times for the following injuries and their stages

A

Muscle
- Grade 1: 1-4 weeks
- Grade 2: 3-12 weeks
- Grade 3: 1-6 months

Tendon
- Tendonitis: 3-7 weeks
- Tendonosis: 3-6 months

Ligament
- Grade 1: 1-4 weeks
- Grade 2: 4 weeks to 6 months
- Grade 3: 6-12 months

Meniscus/Labrum: 3-12 months

Bone: 6-12 weeks

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33
Q

Differentiate between the different grades of a muscle injury

A

Grade 1: Small tears (extend to <10% muscle thickness)

Grade 2: Moderate tears (extend to 10-50% muscle thickness)

Grade 3: Significant tears (extending to >50% muscle thickness)

Grade 4: Complete tears

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34
Q

T or F? Healing requires approximately 20% more calories than normal, and protein intake should be higher

A

True

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35
Q

List the vitamins and their role in healing

A

Glucose:
- Energy

Vitamin C:
- Wound healing
- Tissue repair
- Immune function

Vitamin D:
- Bone health and immune function

Vitamin A:
- Cell growth and immune function

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36
Q

Which factors impact healing?

A
  • Aging
  • Diabetes
  • Infections
  • Stress
  • Medications
  • Lifestyle (alcohol, smoking, obesity)
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37
Q

What are the causes of mobility impairments?

A

prolonged immobilization, pain, swelling/inflammation, joint effusion, sedentary lifestyle, postural changes

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38
Q

List the affects of immobilization on muscle

A
  • Atrophy
  • Decreased muscle tone
  • Increased fatigue
  • Increase connective tissue
  • Muscle fibers are replaced with fatty tissue
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39
Q

List the affects of immobilization on tendons and ligaments

A
  • Changes in collagen cross linking
  • Collagen weakness
  • Bone-tendon insertional site weakness
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40
Q

List the affects of immobilization on articular cartilage

A
  • Decreased thickness
  • Chondral softening
  • Decreased chondrocytes
  • Irregular articular cartilage surface
  • Decreased synovial fluid
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41
Q

List the affects of immobilization on bone and joint capsule

A
  • Bone resorption as a loss of loading
  • Disuse osteoporosis
  • Decreased joint capsule size
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42
Q

Differentiate between the three different extents of soft tissue change

A

Elastic: Back to resting length

Plastic: New and greater length after stretch

Viscoelastic: Time dependent, slowly lengthens (goes back to resting length after stretch)

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43
Q

Differentiate between contractile and non-contractile

A

Contractile: Has the ability to contract (muscle)

Non-contractile: Does not have the ability to contract (tendons and ligaments)

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44
Q

What is connective tissue made up of?

A

Collagen, Elastin/retaculin, and nonfibrous ground substance

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45
Q

Collagen fibers are responsible for…

A

strength and stiffness of tissue

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46
Q

T or F? Collagen fibers withstand high tensile loads while proteoglycans withstand high compressive loads

A

True

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47
Q

List the affects of inactivity on collagen strength

A
  • Decreased size and number of collagen fibers
  • Increased percent of elastin to collagen = increased tissue compliance
  • Collagen fiber weakness = decreased stiffness
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48
Q

List the affects of corticosteroid on collagen strength

A
  • Decreased organization of collagen fibers
  • Decreased collagen fiber synthesis
  • Decreased strength of collagen fibers
  • Necrosis of collagen near the injection site
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49
Q

List the affect of age on collagen strength

A
  • Decreased stiffness and strength of collagen fibers
  • Slower adaptation to loads placed on tissues
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50
Q

Describe the collagen fiber orientation of tendons, skin, ligaments/jointcapsules/fascia

A

Tendons:
- Collagen fibers are parallel
- Resists greatest tensile load

Skin:
- Collagen fibers are random
- Limited resistance to tensile load

Ligaments/jointcapsules/fascia:
- Collagen fibers vary
- Resists multidirectional forces

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51
Q

What is “creep”?

A

Long stretch, low load (if a person holds a stretch for an extended period of time, it will lengthen very slowly)

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52
Q

What are the three types of stretching?

A

Static (good for increasing length)
- Long duration
- Low load

Ballistic (tissue trauma, greater residual soreness)
- Short duration
- High velocity (and rapid)

Dynamic (before activities, enhances performance)
- Short duration
- Low velocity

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53
Q

What are the phases of a dynamic warmup?

A

Phase 1: Gradual increase in HR and breathing
Phase 2: Joint mobilization to increase temp
Phase 3: Short dynamic, active stretches

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54
Q

T or F? Most injuries occur in the eccentric phase of activity?

A

True

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55
Q

What are the functions of glucose, vitamin a, vitamin c, and vitamin d?

A

Glucose: Energy

Vitamin A: Cell growth and development/immune function

Vitamin C: Wound healing, tissue repair, immune function

Vitamin D: Bone health and immune function

56
Q

What are the functions of magnesium, copper, zinc, and iron?

A

Magnesium: Protein/collagen synthesis

Copper: Collagen cross-linking

Zinc: Wound healing, protein synthesis

Iron: Collagen production

57
Q

Which vitamins/minerals are recommended after a bone injury?

A
  • Calcium
  • Vitamin D
  • Vitamin K2
58
Q

T or F? Elderly males heal slower than elderly females

A

True, because wound healing is largely affected by estrogen

59
Q

Which factors affect healing?

A

Diabetes, infection, stress, medications, lifestyle (smoking, alcohol, obesity)

60
Q

List the indications and contraindications of stretching

A

Indications:
- Scar tissue formation
- Adhesions
- Contractures
- Muscle weakness

Contraindications:
- Bony end feel
- Recent fracture
- Osteoporosis
- Acute inflammation or infection
- Hypermobility

61
Q

Describe the 4 parts of the stress-strain curve

A

Toe region
- Collagen fibers straighten out
- Most activity occurs in this range

Elastic range (goal of dynamic stretching)
- Muscle returns to resting position after load is removed

Plastic range (goal of static stretching)
- Permanent tissue deformation
- Doesn’t return to resting position after release
- Collagen fibers rupture

Failure point
- Tissue ruptures

62
Q

When is a 5 minute warmup without a recovery interval ideal?
When is a 15 minute warmup with a 5 minute recovery interval ideal?

A

5 min warmup, no recovery: Better power output if anaerobic exercise is done right after

15 min warmup, 5 min recovery: Better for improving mean and peak power in anaerobic exercise

63
Q

T or F? 6-10% of bodyweight resistance with dynamic warmup is ideal

A

True

64
Q

What are the 4 signs of overload?

A
  • Pain
  • Tenderness
  • Swelling
  • Warmth
65
Q

List the parameters for stretching

A
  • 2-3 sets, 30-60 seconds each
  • 2-5x per week
66
Q

List the types of manual, mechanical, and self stretches

A

Manual: Static, PNF

Self Stretch: Static, Ballistic, Dynamic, PNF

Mechanical: Device/brace/cast

67
Q

What are the 3 types of PNF stretching?

A

Contract-Relax (CR), Agonist Contraction (AC), Contract-Relax Agonist Contract (CR-AC)

68
Q

T or F? When the length of the moment arm increases, the leverage increases

A

True

69
Q

T or F? Estrogen is better for healing while testosterone is better for building muscle

A

True

70
Q

Humans can lose up to _____ to _____ of muscle mass between the ages of 25 to 80 years of age

A

1/3, 1/2

71
Q

What is sarcopenia?

A

Muscle atrophy caused by age

72
Q

CDC suggests that adults partake in at least _______ minutes of moderate exercise every week, with at least ____ days of strength training

A

150, 2

73
Q

What are the 4 training principles?

A
  • Overload: To improve a system, it needs to be exercised beyond normal loads
  • Specificity: Selecting a specific exercise to improve on a particular task
  • Reversibility: Training effects begin to be lost as soon as training stops
  • Individuality: Variation in response to a training program between individuals
74
Q

T or F? A longer lever arm makes an exercise more difficult while a shorter lever arm makes an exercise easier

A

True

75
Q

Differentiate between inertia and momentum

A

Inertia: Resistance of a body to change in velocity

Momentum: Body in motion stays in motion unless acted on by an outside force

76
Q

A body with a relative density (RD) <1 will _______, while a body with a relative density (RD) >1 will _______

A

Float, Sink

77
Q

External pressure of water causes a _______ increase in blood volume, and increasing the work needed for breathing by ______

A

60%, 60%

78
Q

What is hydrostatic pressure (HP)?

A

The pressure the fluid exerts on an object

79
Q

T or F? Increased central blood volume combined with a more forceful contraction increases stroke volume by an average of 35% with immersion to neck level

A

True

80
Q

What is PNF?

A

Definition: Hands on treatment used to facilitate effective patterns of movement in patients with both neurologic and MSK impairments

81
Q

What type of grip is used for PNF?

A

Lumbrical grip

82
Q

T or F? Resistance during PNF can elicit isotonic, isometric, or eccentric contractions

A

True

83
Q

Differentiate between traction and approximation

A

Traction: Separation of joint surfaces (pulling)

Approximation/Compression: Compression of joint surfaces (pushing)

84
Q

List and describe the different PNF patterns?

A

UE: D1 and D2 (flexion and extension)
LE: D1 and D2 (flexion and extension)

Chopping/Lifting: With head and trunk movement

85
Q

Describe D1 UE Flexion

A

Shoulder: Flexion, Adduction, ER
Forearm: Supination
Wrist: Radial deviation
Fingers: Flexion

86
Q

Describe D1 UE Extension

A

Shoulder: Extension, Abduction, IR
Forearm: Pronation
Wrist: Ulnar deviation
Fingers: Extension

87
Q

Describe D2 UE Flexion

A

Shoulder: Flexion, Abduction. ER
Forearm: Supination
Wrist: Radial deviation
Fingers: Extension

88
Q

Describe D2 UE Extension

A

Shoulder: Extension, Adduction, IR
Forearm: Pronation
Wrist: Ulnar deviation
Fingers: Flexion

89
Q

Describe D1 LE Flexion

A

Hip: Flexion, Adduction, ER
Ankle: DF, Inversion

90
Q

Describe D1 LE Extension

A

Hip: Extension, Abduction, IR
Ankle: Plantarflexion, Eversion

91
Q

Describe D2 LE Flexion

A

Hip: Flexion, Abduction, IR
Ankle: Dorsiflexion, Eversion
Toes: Extension

92
Q

Describe D2 LE Extension

A

Hip: Extension, Adduction, ER
Ankle: Plantarflexion, Inversion
Toes: Flexion

93
Q

What is a chop? What is a reverse chop?

A

Chop: Bilateral asymmetrical UE extension with neck and trunk flexion

Reverse Chop: Bilateral asymmetrical UE flexion with neck and trunk extension

94
Q

What is a lift? What is a reverse lift?

A

Lift: Bilateral asymmetrical UE flexion

Reverse Lift: Bilateral asymmetrical UE extension

95
Q

How do PNF techniques differ with different goals?

A

Strengthening: Rhythmic initiation (teaches the pattern)

Stretching: Increases mobility/stretching (contract relax)

96
Q

What is rhythmic initiation of PNF?

A

Promotes learning of a new movement, muscular coordination, and independent movement

Occurs in 4 phases
- Passive
- Active assisted
- Active
- Resisted

97
Q

What is rhythmic stabilization?

A

Alternating isometric contractions against resistance with a goal of increasing strength and stability

98
Q

What is facilitated stretching (hold relax)?

A

Limb is moved to end range of motion, performs sub-maximal contraction (5 seconds), patient then relaxes, then clinician helps patient move further into the movement

99
Q

What does Wolff’s Law state?

A

Bones adapt to the mechanical stress placed on them

100
Q

Define and describe “Plyometrics”

A

Definition: Exercise involving repeated rapid stretching and contracting of muscles to increase muscle power

Uses elastic properties of connective tissues and the stretch reflex of the neuromuscular unit

Stored elastic energy is used during the shortening phase

101
Q

What are the contraindications of plyometrics

A
  • Pain, inflammation, joint stability
  • Post op patients
  • Inadequate flexibility and strength

Precautions include children or elderly individuals

102
Q

How many off days/hours between two plyometric workouts?

A

48-72 hours (2-3 days)

103
Q

How do you know whether or not a patient is suitable for plyometrics?

A
  • 80-85% muscle strength
  • 90% pain free ROM
  • Must exhibit strength and stability of proximal regions of the body
104
Q

How should you progress plyos?

A
  • Speed
  • Intensity
  • Recovery (more reps in set)
105
Q

Which tests can assess whether or not an athlete is ready to “return to sport”

A
  • Triple hop
  • Depth jump
  • Shoulder tap test
  • Hand held dynamometry
106
Q

T or F? An athlete can have input on whether or not they believe they are ready to return to sport, but should not make the final decision

A

True

107
Q

Define “strength”

A

The ability to generate the required force for a specific movement pattern/task

108
Q

Define “stability”

A

The ability to maintain control of a joint movement or position via the coordinated actions of surrounding tissues and the neuromuscular system

(broken into either “active” or “passive” stability)

109
Q

What is the “SAID” principle?

A

S - Specific
A - Adaptations
I - Imposed
D - Demands

110
Q

The majority of patients partake in a physical therapy program between ____ and ____ weeks

A

6, 12

110
Q

What are the 3 stages of the general adaptation syndrome (GAS)?

A
  • Alarm reaction (Body’s initial response to stress)
  • Stage of resistance (Body strives towards restoring hemostasis after initial stress)
  • Stage of exhaustion (Body is no longer able to cope)
111
Q

Youth should participate in at least ___ mins of exercise per day

A

60

112
Q

What age is considered child/pre-adolescent?

A

Female: 11 years old
Male: 13 years old

113
Q

What age is considered adolescent?

A

Female: 12-18
Male: 14-18

114
Q

T or F? When training youth individuals, begin each training session with a 5-10 minute dynamic warmup, followed by 1-3 sets of 6-15 repetitions (upper and lower body exercises)

(2-3x per week)

A

True

115
Q

At what age can an individual begin lifting?

A

7 years old

116
Q

T or F? Healing and muscle building requires increased metabolic activity

A

True

117
Q

T or F? Skeletal muscle contractile protein is the largest protein reservoir

A

True

118
Q

What is the optimal protein intake?

A

1.0-1.2g per kg of bodyweight

119
Q

How much sleep is recommended for adolescents, children, and adults?

A

Children (3-5 years old): 10-13 hrs
Children (6-12 years old): 9-12 hrs
Adults/Adolescents (10-19 years old): 7-9 hrs

120
Q

What is sleep apnea?

A

Breathing will start and stop while sleeping (often associated with obesity)

121
Q

What is sleep insomnia?

A

The inability to fall and stay asleep

122
Q

How much rest should a patient get after doing plyos?

A

3 days

123
Q

Which principle states that a load applied with the tissue kept at a constant length will result in decreased internal tension until equilibrium is reached?

A

Stress relaxation

124
Q

Which PNF pattern would be used to help a fisherman cast a line

A

Chop

125
Q

Which PNF pattern would be used to help a passenger buckle their seat belt (using right hand? Lift or Reverse lift?

A

Reverse lift

126
Q

What is the innermost layer of the skeletal muscle tissue?

A

Endomysium

127
Q

Which type of injury impacts a muscle tendon?

A

Strain

128
Q

Loading, Ice, and Elevation may be utilized during which phase of tissue healing?

A

Inflammatory

129
Q

Pain occurring after the onset of tissue resistance is most consistent with which phase of tissue healing?

A

Remodeling phase

130
Q

Treatment in which phase might involve single plane motion, low intensity exercise, and isometrics?

A

Proliferative phase

131
Q

Which principle states that a load applied with the tissue kept at a constant length will result in decreased internal tension until equilibrium is reached?

A

Stress-relaxation

132
Q

T or F? It is appropriate to use aquatic therapy when you are trying to combat the effects of osteoporosis to increase bone growth

A

False, you want to load the bone to strengthen it (Wolff’s law)

133
Q

When doing plyos, which phase stores potential energy?

A

Eccentric

134
Q

T or F? An infected wound is an absolute contraindication to aquatic therapy

A

True

135
Q

A patient is only permitted to partially weight bear <25% of their weight through their right LE. Should the patient immerge into the water up to the ASIS or C7?

A

C7 (the more immerged you are in water, the less stress placed on your legs)

Foundations of PT 2 (4 decks)

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