Soft Tissue Mobilization Flashcards
1
Q
CT is considered what type of substance
A
Colloidal
2
Q
What is heat or pressure that changes ground substance from a dense gel to o more liquid state
A
Thixotropy
3
Q
What is the piezoelectric effect
A
The ability of an object to produce a voltage after a mechanical compression stress
4
Q
True or False:
Piezo electricity exists in crystals
A
True
5
Q
What does CT behave as in the piezoelectric model
A
A crystal
6
Q
What influences fibroblast and fibroclast activity
A
Charge
7
Q
What is the ability of a substance to resist flow
A
Viscosity
8
Q
What is the ability of a substance to rebound from deformation
A
Elasticity
9
Q
What is the region that represents “setting” of the structure being tested including taking up slack
A
Toe region
10
Q
Which zone does the deformation usually result in permanent deformation
A
Plastic zone
11
Q
Which zone is deformation reversible
A
Elastic zone
12
Q
What is the point of the stress strain curve called where after attaining ultimate stress, the tissue begins to fail
A
Neck
13
Q
What is the point of the stress strain curve where sudden decrease in stress while strain continues to rise
A
Failure point
14
Q
What is happening at the neck point of the stress strain curve
A
Initially microfailure and tissues narrow (necking)
15
Q
What does the sudden decrease at the failure point mean
A
Substance of the material has begun to fail (tear)
16
Q
What is the stress being lower during unloading for any given strain that occurs during loading
A
Discrepancy
17
Q
What ia the difference in strain between loading and unloading called
A
Hysteresis
18
Q
What does hysteresis represent
A
Energy lost during the test
19
Q
True or False:
After repeated loading the stress strain curve looks identical yet starts at a new point
A
True
20
Q
What is creep
A
Applying a constant load to a structure to lengthen it
21
Q
How do you achieve a greater length increase in tissue using creep
A
Longer duration and less load
22
Q
How is energy lost in a hysteresis loop
A
In the form of heat
23
Q
What will cause a stiffer substance with higher loading rates to fail
A
Higher stresses and lower strains
24
Q
What will cause a less stiff substance at higher temperatures to fail
A
Lower stresses and higher strains
25
Does heating tissue make it easier or harder to induce plastic elongation
Easier
26
What is the response of myofascial tissue to immobilization
Loss of ground substance
27
What are the 3 things that cause ground substance to be lost
1. Loss of glycosaminoglycans and water
2. Loss of interfiber lubrication
3. Loss of interfiber distance
28
What does the loss of ground substance result in
New crosslinks that adhere adjacent collagen fibers together
29
What is the half life of collagen
300-500 days
30
What is the half life of ground substance
1.7-7 days
31
What does nontraumatized CT damage result in
Fibrosis
32
What does traumatized CT damage result in
Scar tissue formation and contracture
33
What did Threlkeld determine
Permanent elongation of collagen fibers requires a force to achieve 3-8% fiber elongation
34
How long does it take for elongation without fiber tearing of 1-1.5% to occur
60 minutes
35
Where are type Ia muscle spindles located
Within muscle parallel to muscle fibers
36
Where are type Ib golgi receptors located (4)
1. Myotendinous junctions
2. Attachment sites of aponeurosis
3. Ligaments of peripheral joints
4. Joint capsules
37
Where are type II pacini and paciniform receptors located (3)
1. Myotendonous junctions
2. Deep layers of joint capsule
3. Spinal ligaments
38
Where are type II ruffini receptors located (3)
1. Ligaments of peripheral joints
2. Dura mater
3. Outer layers of joint capsules
39
What do type Ia muscle spindles respond to
Muscle stretch
40
What do type Ib GTO and GEO respond to
GTO: Muscular contraction
GEO: To strong stretch only
41
What do type II pacini and paciniforms respond to
Rapid pressure changes and vibrations
42
What do type II ruffinis respond to (3)
1. Rapid pressure
2. Sustained pressure
3. Tangential forces (lateral stretches)
43
Where are interstitial type III and IV 50% high threshold and 50% low threshold receptors located
Almost everywhere
44
True or False:
| Interstitial type III and IV 50% high threshold and 50% low threshold receptors are the most abundant in the body
True
45
What do interstitial type III and IV 50% high threshold and 50% low threshold receptors respond to (3)
1. Rapid as well as sustained pressure changes
2. HPT
3. LPT
46
What is the result of type Ia muscle spindle activation
Reduction in tone of antagonist, increased tone in agonist
47
What is the result of type Ib golgi receptor activation
Tone is decreased in associated motor units
48
What is the result of type II pacini and pacinform receptor activation
Proprioceptive feedback for movement control
49
What is the result of type II ruffini receptor activation
Inhibition of sympathetic activity
50
What is the result of type III and IV interstitial receptor activation
Changes in vasodilation and plasma extravasation
51
What are the types of mechanoreceptors that have an effect on local fluid dynamics (2)
1. Type III and IV interstitial receptors
| 2. Type II ruffini receptors
52
What was determined by Staubesand et al when it comes to fascial contractions (2)
1. There are smooth muscle cells embedded within the collagen fibers
2. Intrafascial capillaries, autonomic nerves, and sensory endings
53
What did Straubesand et al conclude based on their findings
Autonomic nervous system regulated fascial pre tension
54
What form myofibroblasts
Fibroblasts
55
What do myofibroblasts contain
Smooth muscle actin fibers
56
Can myofibroblasts actively contract
Yes'm
57
How long do you hold a passive stretch for a muscle and DCT
Muscle: 30 seconds
DCT: 5 minutes
58
What is the purpose of myofascial release
To relieve soft tissue from the abnormal "grip" of tight fascia
59
What is fascia
CT that surrounds all bodily tissue
60
What is fascia composed of
Primarily collagen with some elastic fibers
61
When doing myofascial release do you pull in the direction of the muscle of across the grain of the muscle
In the direction of the muscle
62
Do you start deep or superficial with myofascial release
Superficial
63
How long do you hold the stretch position for
Until the soft tissue is felt to relax (release) which takes about 3-5 minutes
64
How do you stretch deeper restrictions
Stretch further to take up the slack
65
Where are your fingers located for cranial base release
Right under the occipital condyles
66
What does the release indicate
You can stretch to a new barrier
67
What do spray and stretch techniques deactivate
Gamma spindle response
68
What do spray and stretch techniques use to deactivate gamma spindles
Vapocoolant spray
69
How should the patient and their muscle be positioned for spray and stretch techniques
Patient should be relaxed and the muscle should be slightly tensioned
70
How far away should the spray bottle be for spray and stretch techniques
12-18 inches above skin
71
What angle should you spray at for spray and stretch techniques
30 angle to the skin
72
How do you spray the patient when using spray and stretch techniques
Spray in parallel sweeps covering the mm from TP to RPP area
73
After the vapocoolant spray is applied what do you do next
Apply gentle stretch to elongate the muscle
74
How many times can the spray and stretch technique be repeated
Up to 3 times
75
What is is active release techniques
Pinning the muscle to be elongated and moving the muscle into a lengthened position
76
What is the direct technique of active release
Move into restriction
77
What is the indirect technique of active release
Move away from restriction
78
True or False:
| GTOs don't fire during passive stretch the muscle needs to contract for firing of GTOs to occur
True
79
What does the gamma spindle do
Reset the muscle spindle
80
What does the muscle spindle do when active
Increase tone in the agonist
81
What is friction massage used for (4)
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
What types of tissues can friction massage be used on (3)
1. Ligaments
2. Tendons
3. Muscle
83
How far should you move back and forth when using friction massage
Only as far as the skin moves
84
What are indications for friction massage for muscular lesions (3)
1. Recent trauma
2. Long-standing scars
3. Lesion at the musculotendinous junction
85
What are the indications for friction massage for tendinous lesions (2)
1. Tendons with a sheath
| 2. Tendons without a sheath
86
What are the indications for ligamentous lesions (2)
1. Recent sprain
| 2. Chronic sprain
87
When doing friction massage should the muscle be taught or slackened
Slackened
88
When doing friction massage should the tendon or ligament be taught or slackened
Taught
89
When doing friction massage which way should the massage be
Across the grain of the fibers
90
Friction massage can be used for what (3)
1. Minor muscle tears
2. Ligamentous tears
3. Tendinous tears
91
What are the contraindications for friction massage (6)
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
What is the purpose of friction massage
Relief of pain
93
How does friction massage relieve pain (3)
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
How long does soft tissue massage occur for
15 minutes
95
What angle is the tool held at for tool assisted STM
30-60 angle with target tissue
96
How do you know which way to do tool assisted STM
By running your fingers along the fiber orientation of the tissue in both directions and determine which is more tight
97
How long do you do tool assisted STM
3-5 minutes
98
True or False:
| You must anchor on side of the soft tissue before starting tool assisted STM
True
99
What is the purpose of tool assisted STM (4)
1. Remove adhesions
2. Reduce tone
3. Enhance fibroblast proliferation
4. Improve circulation
100
When do tool assisted STM why can muscle strength decrease or increase afterwards
Decrease: May be due to activation of GTOs which decrease contractility
Increase: May be due to activation of muscle spindles which increase contractility
101
How do you do strain counterstrain
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
How much do you want to decrease pain for strain counterstrain
From 10/10 to 3/10
103
Where are tender points located (4)
1. Deep within muscle
2. Tendon
3. Ligament
4. Fascia
104
How big do tender points measure
1 cm or less across
105
What is the muscle energy technique (MET)
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
What is stress
Tension
107
What is strain
Length
