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Soft Tissue Mobilization Flashcards

1
Q

CT is considered what type of substance

A

Colloidal

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2
Q

What is heat or pressure that changes ground substance from a dense gel to o more liquid state

A

Thixotropy

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3
Q

What is the piezoelectric effect

A

The ability of an object to produce a voltage after a mechanical compression stress

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4
Q

True or False:

Piezo electricity exists in crystals

A

True

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5
Q

What does CT behave as in the piezoelectric model

A

A crystal

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6
Q

What influences fibroblast and fibroclast activity

A

Charge

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7
Q

What is the ability of a substance to resist flow

A

Viscosity

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8
Q

What is the ability of a substance to rebound from deformation

A

Elasticity

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9
Q

What is the region that represents “setting” of the structure being tested including taking up slack

A

Toe region

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10
Q

Which zone does the deformation usually result in permanent deformation

A

Plastic zone

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11
Q

Which zone is deformation reversible

A

Elastic zone

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12
Q

What is the point of the stress strain curve called where after attaining ultimate stress, the tissue begins to fail

A

Neck

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13
Q

What is the point of the stress strain curve where sudden decrease in stress while strain continues to rise

A

Failure point

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14
Q

What is happening at the neck point of the stress strain curve

A

Initially microfailure and tissues narrow (necking)

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15
Q

What does the sudden decrease at the failure point mean

A

Substance of the material has begun to fail (tear)

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16
Q

What is the stress being lower during unloading for any given strain that occurs during loading

A

Discrepancy

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17
Q

What ia the difference in strain between loading and unloading called

A

Hysteresis

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18
Q

What does hysteresis represent

A

Energy lost during the test

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19
Q

True or False:

After repeated loading the stress strain curve looks identical yet starts at a new point

A

True

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20
Q

What is creep

A

Applying a constant load to a structure to lengthen it

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21
Q

How do you achieve a greater length increase in tissue using creep

A

Longer duration and less load

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22
Q

How is energy lost in a hysteresis loop

A

In the form of heat

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23
Q

What will cause a stiffer substance with higher loading rates to fail

A

Higher stresses and lower strains

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24
Q

What will cause a less stiff substance at higher temperatures to fail

A

Lower stresses and higher strains

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25
Q

Does heating tissue make it easier or harder to induce plastic elongation

A

Easier

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26
Q

What is the response of myofascial tissue to immobilization

A

Loss of ground substance

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27
Q

What are the 3 things that cause ground substance to be lost

A
  1. Loss of glycosaminoglycans and water
  2. Loss of interfiber lubrication
  3. Loss of interfiber distance
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28
Q

What does the loss of ground substance result in

A

New crosslinks that adhere adjacent collagen fibers together

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29
Q

What is the half life of collagen

A

300-500 days

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30
Q

What is the half life of ground substance

A

1.7-7 days

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31
Q

What does nontraumatized CT damage result in

A

Fibrosis

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32
Q

What does traumatized CT damage result in

A

Scar tissue formation and contracture

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33
Q

What did Threlkeld determine

A

Permanent elongation of collagen fibers requires a force to achieve 3-8% fiber elongation

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34
Q

How long does it take for elongation without fiber tearing of 1-1.5% to occur

A

60 minutes

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35
Q

Where are type Ia muscle spindles located

A

Within muscle parallel to muscle fibers

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36
Q

Where are type Ib golgi receptors located (4)

A
  1. Myotendinous junctions
  2. Attachment sites of aponeurosis
  3. Ligaments of peripheral joints
  4. Joint capsules
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37
Q

Where are type II pacini and paciniform receptors located (3)

A
  1. Myotendonous junctions
  2. Deep layers of joint capsule
  3. Spinal ligaments
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38
Q

Where are type II ruffini receptors located (3)

A
  1. Ligaments of peripheral joints
  2. Dura mater
  3. Outer layers of joint capsules
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39
Q

What do type Ia muscle spindles respond to

A

Muscle stretch

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40
Q

What do type Ib GTO and GEO respond to

A

GTO: Muscular contraction
GEO: To strong stretch only

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41
Q

What do type II pacini and paciniforms respond to

A

Rapid pressure changes and vibrations

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42
Q

What do type II ruffinis respond to (3)

A
  1. Rapid pressure
  2. Sustained pressure
  3. Tangential forces (lateral stretches)
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43
Q

Where are interstitial type III and IV 50% high threshold and 50% low threshold receptors located

A

Almost everywhere

44
Q

True or False:

Interstitial type III and IV 50% high threshold and 50% low threshold receptors are the most abundant in the body

45
Q

What do interstitial type III and IV 50% high threshold and 50% low threshold receptors respond to (3)

A
  1. Rapid as well as sustained pressure changes
  2. HPT
  3. LPT
46
Q

What is the result of type Ia muscle spindle activation

A

Reduction in tone of antagonist, increased tone in agonist

47
Q

What is the result of type Ib golgi receptor activation

A

Tone is decreased in associated motor units

48
Q

What is the result of type II pacini and pacinform receptor activation

A

Proprioceptive feedback for movement control

49
Q

What is the result of type II ruffini receptor activation

A

Inhibition of sympathetic activity

50
Q

What is the result of type III and IV interstitial receptor activation

A

Changes in vasodilation and plasma extravasation

51
Q

What are the types of mechanoreceptors that have an effect on local fluid dynamics (2)

A
  1. Type III and IV interstitial receptors

2. Type II ruffini receptors

52
Q

What was determined by Staubesand et al when it comes to fascial contractions (2)

A
  1. There are smooth muscle cells embedded within the collagen fibers
  2. Intrafascial capillaries, autonomic nerves, and sensory endings
53
Q

What did Straubesand et al conclude based on their findings

A

Autonomic nervous system regulated fascial pre tension

54
Q

What form myofibroblasts

A

Fibroblasts

55
Q

What do myofibroblasts contain

A

Smooth muscle actin fibers

56
Q

Can myofibroblasts actively contract

57
Q

How long do you hold a passive stretch for a muscle and DCT

A

Muscle: 30 seconds
DCT: 5 minutes

58
Q

What is the purpose of myofascial release

A

To relieve soft tissue from the abnormal “grip” of tight fascia

59
Q

What is fascia

A

CT that surrounds all bodily tissue

60
Q

What is fascia composed of

A

Primarily collagen with some elastic fibers

61
Q

When doing myofascial release do you pull in the direction of the muscle of across the grain of the muscle

A

In the direction of the muscle

62
Q

Do you start deep or superficial with myofascial release

A

Superficial

63
Q

How long do you hold the stretch position for

A

Until the soft tissue is felt to relax (release) which takes about 3-5 minutes

64
Q

How do you stretch deeper restrictions

A

Stretch further to take up the slack

65
Q

Where are your fingers located for cranial base release

A

Right under the occipital condyles

66
Q

What does the release indicate

A

You can stretch to a new barrier

67
Q

What do spray and stretch techniques deactivate

A

Gamma spindle response

68
Q

What do spray and stretch techniques use to deactivate gamma spindles

A

Vapocoolant spray

69
Q

How should the patient and their muscle be positioned for spray and stretch techniques

A

Patient should be relaxed and the muscle should be slightly tensioned

70
Q

How far away should the spray bottle be for spray and stretch techniques

A

12-18 inches above skin

71
Q

What angle should you spray at for spray and stretch techniques

A

30 angle to the skin

72
Q

How do you spray the patient when using spray and stretch techniques

A

Spray in parallel sweeps covering the mm from TP to RPP area

73
Q

After the vapocoolant spray is applied what do you do next

A

Apply gentle stretch to elongate the muscle

74
Q

How many times can the spray and stretch technique be repeated

A

Up to 3 times

75
Q

What is is active release techniques

A

Pinning the muscle to be elongated and moving the muscle into a lengthened position

76
Q

What is the direct technique of active release

A

Move into restriction

77
Q

What is the indirect technique of active release

A

Move away from restriction

78
Q

True or False:

GTOs don’t fire during passive stretch the muscle needs to contract for firing of GTOs to occur

79
Q

What does the gamma spindle do

A

Reset the muscle spindle

80
Q

What does the muscle spindle do when active

A

Increase tone in the agonist

81
Q

What is friction massage used for (4)

A
  1. Loosen adherent fibrous tissue (break up adhesions)
  2. Aid in absorption of local edema or effusion
  3. Reduce local muscle spasm
  4. Treat chronic inflammation in tendon
82
Q

What types of tissues can friction massage be used on (3)

A
  1. Ligaments
  2. Tendons
  3. Muscle
83
Q

How far should you move back and forth when using friction massage

A

Only as far as the skin moves

84
Q

What are indications for friction massage for muscular lesions (3)

A
  1. Recent trauma
  2. Long-standing scars
  3. Lesion at the musculotendinous junction
85
Q

What are the indications for friction massage for tendinous lesions (2)

A
  1. Tendons with a sheath

2. Tendons without a sheath

86
Q

What are the indications for ligamentous lesions (2)

A
  1. Recent sprain

2. Chronic sprain

87
Q

When doing friction massage should the muscle be taught or slackened

88
Q

When doing friction massage should the tendon or ligament be taught or slackened

89
Q

When doing friction massage which way should the massage be

A

Across the grain of the fibers

90
Q

Friction massage can be used for what (3)

A
  1. Minor muscle tears
  2. Ligamentous tears
  3. Tendinous tears
91
Q

What are the contraindications for friction massage (6)

A
  1. Inflammation due to bacterial action
  2. Traumatic arthritis of a joint
  3. Ossification or calcification in soft structures
  4. Bursitis
  5. Rheumatoid arthritis
  6. Pressure on nerves
92
Q

What is the purpose of friction massage

A

Relief of pain

93
Q

How does friction massage relieve pain (3)

A
  1. May be due to modulation of nociceptive impulses at spinal cord level
  2. Due to concurrent activation of mechanoreceptors in tissues closes the gate to painful impulses
  3. May stimulate diffuse noxious stimuli that imparts inhibitory controls
94
Q

How long does soft tissue massage occur for

A

15 minutes

95
Q

What angle is the tool held at for tool assisted STM

A

30-60 angle with target tissue

96
Q

How do you know which way to do tool assisted STM

A

By running your fingers along the fiber orientation of the tissue in both directions and determine which is more tight

97
Q

How long do you do tool assisted STM

A

3-5 minutes

98
Q

True or False:

You must anchor on side of the soft tissue before starting tool assisted STM

99
Q

What is the purpose of tool assisted STM (4)

A
  1. Remove adhesions
  2. Reduce tone
  3. Enhance fibroblast proliferation
  4. Improve circulation
100
Q

When do tool assisted STM why can muscle strength decrease or increase afterwards

A

Decrease: May be due to activation of GTOs which decrease contractility
Increase: May be due to activation of muscle spindles which increase contractility

101
Q

How do you do strain counterstrain

A

Find a tender point in soft tissue then push on it and tell the patient that is a 10 out of 10 pain then passive move the body part shortening the soft tissue and hold for 90 seconds then move body part back to neutral and release pressure slowly and reassess

102
Q

How much do you want to decrease pain for strain counterstrain

A

From 10/10 to 3/10

103
Q

Where are tender points located (4)

A
  1. Deep within muscle
  2. Tendon
  3. Ligament
  4. Fascia
104
Q

How big do tender points measure

A

1 cm or less across

105
Q

What is the muscle energy technique (MET)

A

Passively move the muscle in desired motion then contract isometrically and hold 3 seconds then relax and push the body part further into the motion

106
Q

What is stress

107
Q

What is strain

Phys Agents (19 decks)

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