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T2 MSK > Topic 3 - Posture > Flashcards

Topic 3 - Posture Flashcards

1
Q

A debated subject among health professionals that holds strong cultural, political and societal meanings, but these beliefs are often unsupported by evidence.

A

Posture

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2
Q

“____” posture is generally overemphasized and is referred to as being “straight” and “aligned.” “___” posture is associated with slouching.

A

“Good”
“Bad”

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3
Q

Physiologically, all postures or movements load _______ differently, so context becomes an important consideration.

A

Tissues

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4
Q

The total force through particular musculoskeletal tissue.

A

Tissue Loading

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5
Q

The configuration of the body’s head, trunk and limbs in space. It includes position and relative relationships of the bony skeleton and supporting soft tissues.

A

Posture

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6
Q

Posture is in part the relative ___________ of the parts of the body to each other, however what needs to be considered is the particular _______ in which it is used.

A

Arrangement
Context

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7
Q

Posture is a shifting pattern of righting and ___________ reflexes, habits and adaptive responses to things such as _______, ADL’s, psychological states and personal anatomical limitations.

A

Stabilizing
Gravity

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8
Q

Functional and _____________ considerations are integral to the concept of posture as are the consequences of various postures to performance and _______.

A

Biomechanical
Comfort

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9
Q

identifying and describing the relationships between various factors which influence posture is integral to the analysis needed to identify ___________, treat them with the appropriate massage techniques and provide the _________ necessary to help with postural complaints.

A

Impairments
Self-Care

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10
Q

T/F - Many MSK complaints are attributed to the narrative of muscle imbalances, which research can back up with evidence.

A

False - Many MSK complaints are attributed to the narrative of muscle imbalances, BUT research CANNOT back THIS up with evidence.

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11
Q

There is evidence that posture can shape ____ and that there are emotional dimensions of posture including links to __________.

A

Mood
Depression

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12
Q

T/F - Individuals suffering from depression often show greater anterior head inclination, thoracic kyphosis and a slumped posture.

A

True

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13
Q

Some ____ ____ posture suggestions include:
- Frequent movement
- Avoid prolonged sitting
- Minimal use of muscular effort/problematic loading for sustained periods
- Efficient use of muscles to avoid fatigue
- Efficient movement at a joint

A

Pain Free

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14
Q

________ ( ________ ) curves are normally present in the lumbar and cervical regions.

A

Lordotic (Anterior)

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15
Q

________ ( _________ ) curves are normally present in the thoracic and sacral regions.

A

Kyphotic (Posterior)

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16
Q

Normal curvature and flexibility of the spine allow for distribution of ______ and efficient use of the associated muscles and joints.

A

Forces

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17
Q

The weight bearing and shock absorbing portion of the spine.

A

Anterior Pillars (aka. Vertebral Bodies) & Intervertebral Discs

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18
Q

Made up of the articular processes and facets. They provide the gliding mechanism for movement.

A

Posterior Pillars (aka. Vertebral Arches)

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19
Q

The posterior pillars also include bony ______ (e.g. TVPs & SPs) to which the muscles attach and function to allow for ________ and control. They also provide spinal stability.

A

Levers
Movement

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20
Q

When it comes to ________ postural alignment, the list of landmarks that should align from a _______ view are:
- Anterior ankle
- Head of fibula
- Greater trochanter
- Bodies of lumbar spine
- Middle of acromion
- Cervical spine
- External auditory meatus

A

Standing
Lateral

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21
Q

T/F - For athletes, imbalances between agonist and antagonist muscles is something we want to correct.

A

False - For athletes, imbalances between agonist and antagonist muscles is something we DON’T ALWAYS want to correct.

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22
Q

The pelvic tilt from ASIS to PSIS should be ____ or PSIS is slightly ______. The average is 0-15 degrees.

A

Even
Higher

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23
Q

ASIS and the pubic bone should be aligned __________.

A

Vertically

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24
Q

A line through pubic symphysis and PSIS in the transverse plane.

A

Pelvic Angle

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25
Q

How many degrees is the pelvic angle?

A

30 degrees

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26
Q

The following are part of ________ posture:
- Medial border on rib cage
- 3-4 patient’s finger widths from midline
- Stretch weakness of scapular retractors
- Inferior angle sits on thorax
- Spine of scapula at T3
- Spine of scapula at 15 degrees of inclination

A

Scapular

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27
Q

_______ stresses the structures that help to maintain upright posture.

A

Gravity

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28
Q

The point in the center of an object, where the objects mass behaves as if it were concentrated. It will change in different postures.

A

Center of Gravity

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29
Q

In anatomical position, the center of gravity of the upright adult human is anterior to the ___.

A

S2

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30
Q

The basic level of tension required to brace our joints and maintain cellular activity. It is unlike resting tone because constant muscle activation is needed.

A

Postural Tone

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31
Q

What are the 3 subsystems that need to be considered for postural stability?

A

1) Passive (e.g. inert structures/bones & ligaments)
2) Active (e.g. muscles)
3) Neural Control (e.g. PNS/CNS)

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32
Q

T/F - Self-care should incorporate all 3 subsystems of postural stability.

A

True

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33
Q

___________ and muscular _________ are often a combination of inert tissue damage, insufficient muscular strength or endurance and poor neuromuscular control.

A

Instability
Imbalance

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34
Q

The inability to maintain equilibrium under dynamic and static conditions, such as preparation of movements, perturbations (e.g. uneven surfaces) and quiet stance (e.g. standing still).

A

Postural Instability

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35
Q

For weight bearing joints to remain stable, there must be a force to __________ the force that is created by greavity.

A

Counteract

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36
Q

____________ to gravity is provided by:
- Muscular activity and inert tissue
- Bones, muscles and joints from body levers
- Resistance further from axis leads to increased use of muscles
- Neural control coordinates response of muscle

A

Counterforce

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37
Q

When the gravitational force is posterior, the hip _______ are involved and passive support by the iliofemoral ligament. When gravitational force is anterior, the hip _________ assume more responsibility to maintain posture.

A

Flexors
Extensors

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38
Q

Center of gravity falls ________ to the atlanto-occipital joints. The cervical ________ muscles counteract this force into flexion.

A

Anterior
Extensor

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39
Q

T/F - When postural deviations are extreme, there is more dependence on active structures to maintain stability.

A

False - When postural deviations are extreme, there is more dependence on INERT structures to maintain stability.

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40
Q

T/F - Muscular endurance is promoted more than strength to maintain posture.

A

True

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41
Q

T/F - Many MSK complaints can be attributed to the stresses from prolonged postures and movement patterns.

A

True

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42
Q

Impairments of the joints, muscles or connective tissues can lead to postural ______. Prolonged postures can result in the feeling of discomfort and ____.

A

Stress
Pain

43
Q

Pain resulting from the stretching or compression of pain sensitive structures/tissues, which contain nociceptors and when they are stressed, pain is felt.

A

Mechanical Pain

44
Q

Muscles, ligaments, joint capsules and periosteum are __________ and can cause pain when mechanically stressed.

A

Innervated

45
Q

T/F - Mechanical pain is pathological in nature.

A

False - Mechanical pain is NOT pathological in nature.

46
Q

_______ _____________ provides an evidence-based explanation for many cases of “unexplained” chronic musculoskeletal pain.

A

Central Sensitization

47
Q

A strategy that changes maladaptive illness perceptions to reconceptualise ideas of pain by patient education about central sensitization and its role in chronic pain.

A

Pain Physiology Education

48
Q

If pain occurs for __ to __ months, it is considered chronic in nature and is often considered to be “centralized.”

A

3-6 months

49
Q

Posture that deviates from normal and there are no adaptive changes.

A

Postural Fault (aka. Faulty Posture)

50
Q

Adaptive shortening and/or muscle weakness are involved with postural ___________.

A

Dysfunction

51
Q

Pain from mechanical stresses of poor/prolonged posture, which is likely due to postural stress.

A

Postural Pain Syndrome

52
Q

Any habitual, self-imposed positioning that causes physical stress, especially coping poorly with postural challenges (e.g. ADLs that are difficult to do comfortably).

A

Poor Posture

53
Q

A challenge to your posture that is imposed on you, as opposed to something you’re doing to yourself out of laziness (e.g. sleeping on a plane).

A

Postural Stress

54
Q

T/F - Postural stresses overtime are not associated with degenerative changes.

A

False - Postural stresses overtime CAN BE associated with degenerative changes.

55
Q

Connective tissue layers may adhere to each other and with palpation there is an inability to differentiate tissues.

A

Fascial Adhesions

56
Q

Increased demands will result in more muscular tension.

A

Increased Resting Tension

57
Q

Myofascial _______ ______ result from an overload of the muscles.

A

Trigger Points

58
Q

Reduced weakness and _________, along with fatigue result in the inability to _______ a posture.

A

Endurance
Sustain

59
Q

_____ is more likely to occur when muscles are fatigued, weak or lack normal flexibility.

A

Spasm

60
Q

____________ can occur through increased abdominal pressure and there is usually urinary leaking. It is also linked to heartburn and constipation.

A

Incontinence

61
Q

Assessment findings and characteristics of _____________ include:
- Decreased ROM
- Reduced quality of movement
- Muscle attachments are closer together
- Inability of someone to assume a corrected posture
- Increased resistance to active & passive elongation
- Possible associated weakness

A

Hypomobility

62
Q

The adaptive shortening of a muscle or other soft tissue (e.g. joint capsule, fascia, skin) that prevents normal extensibility of the involved structures and is mostly associated with trauma.

A

Contracture

63
Q

Most severe form of muscle weakness that is often overlooked clinically. The overused muscle shortens over time, changing the muscle’s length-tension curve and becoming more readily activated and weaker after time.

A

Tightness Weakness

64
Q

With _________ weakness, there is an increase in non-contractile tissue and a decrease in elasticity, which leads to ___________. Overuse leads to ischemia and degeneration of muscle fibres, which further weakens the muscle.

A

Tightness
Hypertrophy

65
Q

Assessment findings and characteristics of _____________ include:
- Increased ROM
- Muscle may test weak or have reduced endurance
- Muscle attachments are further apart
- Possible associated weakness
- Often congenital and poses no issues

A

Hypermobility

66
Q

When muscles, ligaments and joint capsules are in a state of continual stretch. They can lengthen and ligament laxity results in hypermobility of a joint.

A

Adaptive Lengthening

67
Q

Habitually lengthened muscles may become over-lengthened and exhibit stretch ________. When muscles and fascia adaptively lengthen, they must function in a lengthened position, which is considered a mechanical ____________.

A

Weakness
Disadvantage

68
Q

Some risk factors for ________ pain include:
- Prolonged poor postures
- Age
- Changes in tissue tolerance
- Systemic pathologies
- Previous trauma
- Arthritis
- Generally deconditioned
- Depression
- Spondylolisthesis
- Fractures (e.g. broken/crushed vertebrae)
- Osteoporosis
- Disc degeneration
- Scheuermann’s disease
- Spinae Bifita
- Ankylosing spondylitis
- Muscular dystrophy

A

Postural

69
Q

When treating postural pain:
- Address where the pain is ___________ from first (e.g. CNS, referred, mechanical)
- Movement stretching and strengthening to treat adaptive __________
- Connective tissue techniques to treat myofascial tissue
- Neuromuscular techniques for CNS
- Do not increase instability by increasing mobility in hypermobile joints

A

Originating
Shortening

70
Q

T/F - Massage does not improve weakness.

A

True

71
Q

_____________ modalities for treating postural pain include:
- Heat
- Stretching
- Exercise with full ROM

A

Complementary

72
Q

Some goals of treatment when treating postural pain include:
- Improve body _________
- Identify sustained faulty posture
- Address lack of strength/endurance
- Identify ____________ factors
- Improve work area ergonomics

A

Awareness
Contributing

73
Q

Increase in the lordotic curve of the lumbar spine and is often seen with increased pelvic tilt.

A

Lordotic Posture (aka. Hyperlordosis)

74
Q

With an anterior pelvic tilt the hip is in _______.

A

Flexion

75
Q

With ________ posture, muscles that may limit mobility due to weakness or a lack of extensibility could include:
- Rectus femoris
- Hip flexors (e.g. iliopsoas, TFL, anterior fibres of gluteus medius)
- Hip adductors

A

Lordotic

76
Q

With ________ posture, antagonist muscles that are prone to be weakened and lack qualities to stabilize include:
- Hamstrings
- Hip extensors (e.g. gluteus maximus, posterior fibres of gluteus medius)

A

Lordotic

77
Q

Possible associated impairments with ________ posture include:
- Decreased tissue extensibility
- Increased resting muscle tension
- Joint mobility issues
- Weakness
- Fascial restrictions
- Pain

A

Lordotic

78
Q

Sources of symptoms with ________ posture include:
- Muscular ache/pain (e.g. mechanical, fatigue/overuse)
- Trigger points
- Narrowing of posterior disc spaces and IVF’s that can cause compression of neurovascular structures exiting the spine
- Approximation of articular facets leading to inflammation and synovial irritation

A

Lordotic

79
Q

Common causes of ________ posture include:
- Comfortable position for patient
- Sustained faulty posture
- Lack of strength/endurance
- Pregnancy
- Obesity
- Weak/surgically adhered abdominal muscles
- Trauma

A

Lordotic

80
Q

Common trigger points the can be experienced with ________ posture include:
- Gluteus maximus
- Gluteus medius
- Quadratus lumborum
- Iliopsoas

A

Lordotic

81
Q

Some useful orthopaedic tests for ________ posture include:
- ROM testing for the hip and lumbar spine
- Modified Thomas test
- Ober’s
- Ely’s
- Schober’s

A

Lordotic

82
Q

General management of lordotic posture includes:
- Treat _____ symptoms when present
- Treat tissue impairments that limit mobility
- Improve postural awareness and encourage _______
- Improve strength/endurance of muscles that maintain correct posture

A

Acute
Changes

83
Q

Characterized by increased thoracic curve (rounded back) and protracted shoulders (round shoulders).

A

Kyphotic Posture (aka. Hyperkyphosis)

84
Q

Involves increased flexion of lower cervical and upper thoracic regions, as well as increased extension of the occiput on C1.

A

Forward Head Posture

85
Q

Observations with kyphotic posture include:
- Thoracic spine is in _______
- Lower cervical spine is in _______
- Upper cervical spine is in _________
- Scapulae are __________

A

Flexion
Flexion
Extension
Protracted

86
Q

With protracted scapula, look for __ to __ patient’s finger widths from midline and weakness of scapular __________.

A

3-4
Retractors

87
Q

With anterior tilt of scapula, look for ________ angle off of rib cage, possible shortness/weakness in pectoralis _____ and weakness/poor control of serratus ________.

A

Inferior
Minor
Anterior

88
Q

With ________ posture, muscles that may limit mobility due to a lack of extensibility and weakness could include:
- Rhomboids
- Middle trapezius
- Erector spinae muscles
- G-H external rotators (e.g. teres minor, infraspinatus)

A

Kyphotic

89
Q

With ________ posture, weakness in functional movements could be due to:
- Upper trapezius (lengthened in lower c-spine & flexed in upper)
- SCM, scalenes & levator scapulae (shortened due to HFC)

A

Kyphotic

90
Q

Potential impairments with ________ posture include:
- Pain
- Decreased tissue extensibility (e.g. myofascial, joint, capsular)
- Increased resting muscle tension
- Weak muscles/lack of endurance
- Depression

A

Kyphotic

91
Q

Potential sources of pain symptoms with ________ posture include:
- Muscular ache/pain (e.g. mechanical, fatigue/overuse)
- Trigger points
- Narrowing of posterior disc spaces and IVF’s that can cause compression of neurovascular structures exiting the spine
- Stress to anterior ligaments in upper c-spine and posterior ligaments/joint capsules in lower c-spine
- Narrowing of IVF’s in upper c-spine leading to compression of neurovascular structures
- Compression of nerves by muscles in the head/neck region
- Psychoneuroimmunological, mood and central sensitization origins

A

Kyphotic

92
Q

Common causes of ________ posture include:
- Effects of gravity and poor ergonomics
- Prolonged postures
- Faulty prolonged sitting postures (e.g. working at a desk)

A

Kyphotic

93
Q

Some useful orthopaedic tests for ________ posture include:
- Observing posture (e.g. spinal curves, tilt/protraction of scapulae)
- ROM testing for cervical spine, thoracic spine & shoulder girdle
- Pectoralis major/minor length test
- Testing strength of scapular muscles (e.g. rhomboids, middle/lower trapezius)

A

Kyphotic

94
Q

Strategies to reduce _________ posture include:
- Task substitution (e.g. alternate between sitting and standing)
- Task interruption (e.g. short breaks to change position or stretch)
- Increasing incidental exercise (e.g. use stairs instead of elevator)

A

Sedentary

95
Q

___________ related to posture that are significant to massage therapists include:
- Pain from mechanical stress from muscle tension, trigger points & sensitive structures
- Mobility impairments of muscles, joints & fascia
- Impaired muscle performance associated with poor muscular endurance
- Insufficient postural control by increasing strength of stabilizing muscles

A

Impairments

96
Q

T/F - The client’s awareness of posture should be developed as soon as possible and they should be encouraged to adjust their posture throughout the day.

A

True

97
Q

Common trigger points that can be experienced with ________ posture include:
- Pectoralis minor
- Pectoralis major
- Rhomboids
- Middle & lower trapezius
- Levator scapula

A

Kyphotic

98
Q

Referred pain from a trigger point in _______ ______ is:
- Commonly identified as LBP
- Experienced along posterior iliac crest, sacrum & posterior/lateral aspects of the buttock
- Experienced in the upper thigh

A

Gluteus Medius

99
Q

Symptoms of a gluteus medius trigger point would be pain when _______, lying on back/affected side and/or when ________ in a chair.

A

Walking
Slouched

100
Q

What should you rule out before identifying a gluteus medius trigger point?

A

Sacroiliac Joint Dysfunction

101
Q

Referred pain from a trigger point in __________ _____ may:
- Include the anterior chest and breast
- Extend down the ulnar aspect of the arm to the 4th & 5th fingers
- Be easily mistaken for that of ischemic heart disease if experienced on the left side
- Result in shoulders being rounded and head forward posture

A

Pectoralis Major

102
Q

Referred pain from a trigger point in __________ _____ may:
- Cause entrapment of neurovascular structures from the taut fibres
- Be experienced over the anterior shoulder
- Be a big contributor to rounded shoulder posture

A

Pectoralis Minor

103
Q

Referred pain from a trigger point in _______ _______ is:
- Often associated with a stiff neck & usually limits cervical rotation
- Concentrated at the angle of the neck and along the medial border of the scapula

A

Levator Scapula

T2 MSK (12 decks)

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