treatments Flashcards
what is periostitis?
inflammation of the periosteum
occurs at the site of insertion
what occurs from untreated periostitis?
stress fracture
what are shin splints?
pain on the medial border or lateral tibia
what activity is common to develop shin splints?
running
what some causes of shin splints?
overuse
tight calf mms
predisposing tramua
what are some common symptoms of shin splints / periostitis?
flat feet
inflammation
adhesions
achiness in the morning
tight cramp with activity
what is compartment syndrome?
increase in pressure within a compartment of the lower leg
where is compartment syndrome most common?
anterior
if compartment syndrome is present in the anterior leg, what should you treat?
posterior muscles
is compartment syndrome a medical emergency?
yes
what is patella femoral syndrome?
tracking laterally of the patella
what director does the patella glide during flexion ad extension of the knee?
flexion (inferior)
extension (superior)
where is the normal Q angle?
ASIS
mid patella
tibial tuberosity
what contributes to patella femoral?
abnormal biomechanics
tight lateral thigh
tight ant. or pos. structures
weakness in medial thigh
overuse of knee
what are some signs of patella femoral?
difficulty standing and sitting for long times
pain on knee compression
swelling
walking down stairs, squatting or running downhill are painful
what are some postural abnormality with patella femoral?
flat feet
valgus knee stress
medial patella
hyperextended knees
what range is most painful for patella femoral?
flexion of the knee
what is IT band syndrome?
contracture or shortening of the IT band
where is most of the pain with IT band?
lateral knee
what TP can contribute to IT band?
TFL
what causes IT band?
sitting at a desk for long hours
wheelchair users or bed rest clients
running or cycling
what is a common complication of IT band?
trochanteric burse
what is hyperlordosis?
increase in normal lumbar curve (anterior pelvic tilt increased)
what structures are tight with hyperlordosis?
iliopsoas
rectus femoris
QL
piriformis
what structures are lengthed with hyperlordosis?
abdominals
hamstrings
gluteal max
what causes hyperlordosis?
poor posture
pregnancy
weak abdominals
obesity
what are some postural findings with hyperlordosis?
plantar flexion
hyperextended knees
reduces hip extension
what is hyperkyphosis?
increase in normal kyphotic cure of the spine with an anterior head carriage
What’s the difference between functional and structural?
functional (due to poot posture or voluntary changes)
structural (due to changes in the body’s bone structure)
what is common to develop from hyperkyphosis?
TOS
frozen shoulder
facet joint irretation
breathing changes
shoulder protraction
what is scoliosis named after?
the convexity
what test determines if scoliosis is functional or structural?
flex the trunk forward to see if the spine realigns
how do you record scoliosis?
span (distance)
apex (furthest point from midline)
s or c cure (c has one curve s has two)
major and minor curve
what range of motion is limited with thoracic right-sided scoliosis?
flexion towards the affected side
lateral flexion towards the afffected side
where does rip humping occur?
on convex side of ribs
what direction does the SP point with scoliosis?
towards concave side
what direction does the vertebral bodies point with scoliosis?
towards convexity
what is counternutation?
anterior pelvic tilt
what is nutation?
posterior pelvic tilt
what is an upslip?
ASIS and PSIS on one side is higher then the ASIS on the other side
what is a torsion of the pelvis?
ASIS is higher then the PSIS on the same side
when the trunk flexes forward, in what way does the ASIS move? PSIS? ischium?
asis moves lateral
psis moves medial
ischium moves lateral
opposite directions with extension
what are the types of torticollis?
acute
congenital
spasmodic
In what way does the neck rotate with torticollis?
towards the effected side
what muscles are mainly involved with torticollis?
extension of the neck (levator scapula)
flexion of the neck (scm)
when would you test AR range of motion with torticollis?
when the spasm is reduced
what is acute acquired torticollis?
a painful unilateral shortening or spasm of the neck muscles resulting in abnormal head positioning
what is psuedotoricollis?
when any movement causes pain and all ranges are limited due to idiopathic muscle spasms
what is congenital toricollis?
a contracture of one scm muscle present at infancy
can congenital torticollis be corrected?
yes with gentle stretching and surgical treatment
is pain present with congenital torticollis?
no only decreases movement is present
what is spasmodic torticollis?
a localized dystonia resulting in involuntary spasms of the cervical muscles or incontrollable rhythmic spasms of the neck muscles
would you stretch SCM if a client is positive for a vertebral artery test?
no its contradincated
would you perform a joint play on someone with spasmodic torticollis?m
no its contradincated
what are tension headaches?
headaches due to a muscle contraction
what type of headache is unilateral and frontal arising form the lateral neck?
cervicogenic headaches
what are spinally mediated headaches?
caused by trigger points in the neck or thorax, cervical facet joints, ligaments, or disc of the joints
what are chronic daily headaches?
can be daily or near-daily headaches that are constant but fluctuations of pain levels
if headaches are new at age _____. client should be referred to a physician.
age 50
how are most tension headaches described as?
a rubber band around the forehead
what essentail oils are helpful for headaches?
lavender
peppermint
blue chamomile
where does the upper trapezius muscle refer?
above the eye, around the ear and down the lateral neck (question mark)
where do occipital muscle refer?
back of the neck
where does the SCM muscles refer?
occiput, around eye, into the ear and across the forehead
what is the cause of migraines?
unknown
genetic
trigger factors (stress, hunger, medication, weather, allergies)
aggravating factors (movement, TP, postural dysfunctions)
what is an aura in relation to migraines?
auras is a set number of signs and symptoms someone feels before having a migraine
what is more common mirgaines with an aura or without?
without
what are some symptoms of migraines?
mood changes
zig zag lines or visual distotrion
rumbling noises
pins and needle feeling around hands
everyone tends to have different side effects
what is the most common symptom of child migraines?
stomach pain or nausea
what are cluster headaches?
grouping of headaches, often once a day for several weeks
how would cluster headaches be described?
unilateral
jaw, nose and teeth pain
sharp, burning pain
exceeds for 12 months
what ae drug-associated headaches?
related to medications or drug use
what is drug associated headaches most common?
mornings when blood levels of drugs or medication are lowest
during withdrawal
what kind of headache is common with coccyx trauma or falls on the coccyx?
trauma-related headaches
what is resting position for TMJ?
mouth slightly open, lips together, teeth not touching
what are the two movements in order of the jaw opening?
rotation the glide
what shape is the TMJ joint?
biconcave
what three components must be present to have TMJ dysfunction?
predisposition
tissue alteration
stress
what can cause TMJ dysfunction?
muscle imbalances
muscle overuse (chewing gym)
postural
direct tramua
whiplash
infections
what is bruxism?
grinding of the teeth
what are some signs of TMJ?
clicking or popping noise
headaches
decreased jaw depression
ear stuffiness
TP in muscles of mastication
what would cause the jaw to have an s-shaped movement?
muscle source
what would cause the jaw to have a c-shaped movement?
capsular source (open towards effected side)
what movement would be present with an anterior disc displacement?
towards opposite side during opening of the jaw
what movement would be present with edema in the joint of the jaw?
towards the unaffected side when closed and towards effected side when opening
what are the types of whiplash?
hyperextension (head on)
hyperflexion (back on)
mixed (side impact)
what are the grades of whiplash?
grade 0: no complaints of pain or physical symptoms
grade 1: neck pain and tenderness but no physical symptoms
grade 2: neck pain and musculoskeletal injury
grade 3: neck pain, musculoskeletal and neurological injury
grade 4: neck pain, musculoskeletal nad neurological and fracture or dislocation
what phases of a car accident would you get TMJ?
phase two
what vertebral levels are mostly effected by car accidents?
C5-C6
what are some factors in a car accident?
head position
seatbelt
headrest
seatback
stature
how long after an accident should you not feel pain?
before the 24hr mark
should you decrease a muscle spasm in the acute stage of healing?
no
should you passively stretch a spasmodic muscle?
no
should you relax muscles surrounding a hypermobile joint?
no
what is the difference between a dislocation and a subluxation?
dislocation is a complete dissociation of the joint
subluxation is a partial dissociation of the joint
what is the most common joint to disslocate?
GH
what position would cause an anterior dislocation?
abduction
external rotation
what position would cause a posteriorodislocation?
adduction
medial rotation
what would cause a lunate dislocation?
fall on outstretched hand
what is common to see with an elbow dislocation?
fracture
should AF range of motion be pain-free in the acute phase?
yes
is distal circulation CI in acute and early subacute stages of healing?
yes to prevent congestion
should range of motion or strength come first?
range of motion
(q)what is the main goal for a client with early ankylosing spondylitis?
maintain thoracolumbar mobility
(q)what benefits are a client with lupus going to experience with massage?
relieving joint pain which is a common symptom
(q)ankylosing spondylitis lead to what kind of fusion?
spinal fusion from ossification of the intervertebral discs and ligaments
(q)what deformity of the hands is common with RA?
ulnar deviation of wrist and fingers
(q)during an acute flare-up of RA, what hydro is best to use?
submerge hands or feet in cool water NOT cold
(q)what is RA?
chronic systemic inflammatory disease with acute flare-ups
(q)what condition begins at the sacroiliac region and is known as the bamboo spine?
ankylosing spondylitits
(q)what condition causes degenerative changes in the joint in a later stage?
RA
(q)what are the triggers for fibromyagia?
stress, lack of sleep, and lack of execrise
(q)do all 18 tender points need to be present with fibromyalgia?
no just 11 / 18
(q)what is the insertion of the deltoid considered with fibromyalgia?
controlled site of pain
(q)how is one diagnosed with fibromyalgia?
collection of symptoms including tender points
(q)what is the most common symptom of fibromyalgia?
headaches
skin sensitive
fatigue
IBS
(q)what is the reason for headaches and personality changes in systolic lupus?
lupus is often cause by inflammation of connective tissue in the central nervous system
(q)what neurotransmitter is decreased in Parkinson?
dopamine
(q)is chest expansion common with ankylosing spondylitis?
no
hip and knee flexion is
decreases lordotic curve
fusion of the spine
(q)what is a common cause of constipation?
stress
(q)what comes first, the hepatic flexure or the splenic flexure?
hepatic is found first on the right side after the ascending colon
(q)what is the best position for a client undergoing a stomach massage?
supine with a pillow under the knees
(q)what postural changes are common with pregnancy?
pes planus
scapular protraction
femoral external rotation
(q)why would joint mobs be avoided with pregnant clients?
due to the amount of relaxin hormone causing the joints and ligaments to be lax
(q)is hyperlordosis common with pregnancy in the first trimester?
no
(q)what hydro therapy is best for a client who is pregnant?
thermosphere to upper back
(q)In what direction should you lay a pregnant client on the table?
left side
(q)what is always appropriate to perform on a client in the acute stage of healing?
grade 1 oscillation
(q)what causes constipation?
bust, stressful life
fetal growth during pregnancy
poor hydration
lack of fibre in diet
(q)what is good to recommend a client with a frozen shoulder?
pendulum swings
(q)what is always avoided when treating a dislocation?
placing the client in the position which cause injury
(q)what muscle is likely strained with hyperkyphosis and protracted shoulder?
suprepsinatus
(q)what is always present in a dislocation of the GH?
GH sprain
(q)what dislocation is caused by being tackled from behind while throwing a ball?
anterior
what ranges are most limited with a frozen shoulder?
abduction and external rotation
what are the three stages of frozen shoulder?
acute (freezing)
subacute (frozen)
chronic (thawing)
what are some causes of frozen shoulder?
idiopathic (primary)
musculoskeletal trams or disorders
a trigger point in subscap
postural abnormalities
disuse after injury
what joints are involved with the shoulder?
SC
AC
GH
scapulothoracic
what stage of a frozen shoulder is the most painful?
acute or freezing
where is most of the pain located with a frozen shoulder?
lateral biceps
Would you perform a joint play with frozen shoulder?
no high grades
when is the joint most in pain with frozen shoulder?
at night in the acute stage or on capsule stretch in the subacute stage
would you overtreat frozen shoulder?
no
would you mobilize an osteophyte?
no
what homecare is beneficial for a client with a frozen shoulder?
pendulum swings
wall crawls
wand exercise
what can cause constipation?
lack of hydration
lack of fibre
stress or busy lifestyle
pregnancy
medical side effect
post surgery effect
what are some common symptoms of constipation?
straining or pain while passing stool
infrequent bowel movements
IBS
low back pain
bad taste in mouth etc
what hydro would you avoid with constipation?
heat on abdomen
what muscle TP can contribute to bowel irritation?
iliopsoas
what direction should you treat the abdomen?
clockwise direction starting at the sigmoid colon and workings distal to proxmial
what are some symptoms of a first trimester pregnancy?
nausea/vomiting
polyurea
blood pressure falls
relaxin hormone produced
mood swings
tender and increases breast size
what are some symptoms of the second trimester?
edema
hypertension
dyspnea
varicose veins
headaches
18-21 week movement is felt
pain in stomach etc
how does pregnancy affect the cardio vascular system?
increases heartbeat
dizziness/lightheaded
hypertension is common
hypotension in first stage of pregnancy
how does pregnancy affect breathing?
diaphragm is compressed and elevated
why would you avoid high-grade joint mobs with pregnant clients?
due to production of relaxin
what is pre-eclampisa?
medical emergency
due to elevated blood pressure
due to toxemia related condition
what are the three signs of preeclampsia?
spiked blood pressure
weight gain over 2lbs/wk
proteinuria
what is eclampisa?
fatal condition if not treated asap
what are things to look out for in a pregnant client?
vaginal bleeding
severe abdominal pain
water breaking
swelling
upper right stomach pain
how does posture change with pregnancy?
hyperlordosis
head carriage
internal rotation of shoudlers
flat feet
external rotation of hips
what essential oils are not permitted to use with pregnant clients?
rosemary
lavender
tangerine
jasmine
basil
what are the borders of the breast tissue?
the lower edge of the clavicle
an inch below breast contour over rectus abdominus
sternal midline
anterior edge of latissimus doors
when would you not perform breast massage?
mastitis present
undiagnosed lump present
breast abscess present
direct pressure over the ruptured implant
no boundaries established
no open communication
what nerve innervates the nipples?
T4
(q) does the joint become hypermobile or hypermobile with a dislocation?
both
(q)what range is mostly limited with right thoracic scoliosis?
lateral flexion to the right
(q)what side would you treat first with scoliosis?
concave side to stretch
convex side second to stimulate
(q) what structure rotates towards the convexity?
vertebral bodies
(q) what allows us to know if scoliosis is functional or strutrual?
disappears when the client flexes forward
(q)when should you avoid frictions?
when the client is on antiinflammatories
(q)would you ice the dorsal foot for a client with chronic plantar fasciitis?
no
(q)what direction does the talar head and navicular bone move with pes planus?
talar head (medial)
navicular (inferior)
(q)what is an avulsion fracture?
break of the bone from a violent pull of the ligament or tendon
(q)what is the mechanism of injury with potts fracture?
foot planted on the ground and a forceful eversion is applies at the ankle
(q) how many grades of injury does tendonitis have?
4 based on signs and symptoms
(q)what ligament is damaged with LCL injury of the eblow?
annular ligament
(q) would you see a bakers cyst with pes planus?
not likely
(q) how can you determine if pain is from a bursa or tendon?
tendon pain increased on movement/contracture
bursa is constant
(q) does foot supination cause patellar femoral syndrome?
no
(q) what is a compound fracture?
bone is broken and broken through skin
(q)what bones are associated with Dupuytren fracture?
tibia
fibula
talus
(q) what movement is effective for stretching pes planus?
inversion
(q)what hydro is best for plantar fasciitis?
deep moist heat to posterior leg
(q)what ligament is damaged with potts fracture?
deltoid ligaments
(q)how do you determine the stage of healing?
based on inflammatory signs and symptoms shown
(q) what are the signs of inflammation?
swelling
rubor
pain
immobilty
heat
(q) what hydro is recommended for subacute healing?
contrast
(q) how do adhesions develop?
untreated chronic inflammation
(q) how do you prevent scar tissue formation?
active free range in pain free plain
(q)do you treat distal to inflammation?
no
(q) what position would a client be in with acute iliopsoas strain?
weight on unaffected leg
affected hip is flexed
abduction and external rotation of hip
(q) with a chronic rectus femoris strain, would there be decreased active free knee extension?
no
(q) following the rule proximal distal proxmial, how would it apply to treating the low leg? (what would you treat first)
low back
hamstring
low leg
foot
(q)what are the signs of a third degree strain?
loud pop at injury time
loss of strengthen
depression in skin
(q) can friction work cause an inflammatory response?
yes
(q)what area of the brain is responsible for parkinsons?
basal ganglia
(q) what would you see in the acute stage of a strain?
a) adhesions
b) TP
c) hypertonicity
d) contratures
c) hypertonicity
(q) would you passively stretch in the acute stage of healing?
no
(q) what is the mechanism of injury for a illopsoas strain?
hyperextenion of the hip
(q) what hydrotherapy is best for a dupuytrens contracture?
parrifin wax
(q) how is a dupuytrens contracture described?
flexion deformity of the ring and baby finger
(q) after youve performed friction techniques, what is the next step?
apply a stretch to the area to realine the muscle fibers and then apply ice (cban)
(q) would you remove a muscle spasm in the acute stage of an injury?
no
(q) what is friction used to treat?
adhesions
(q) what is a common symptom seen with muscle spasm?
pain with stretch to the muscle
(q) what area is a grade 3 burn affecting the most?
epidermis
dermis
subcutaneous tissue
(q) is nuclear a category of burns?
no
(q) what age group and age is it common to see muiltple sclerosis?
females 20-40
(q) what condition is an example of upper motor neuron lesion?
muiltple sclerosis
(q) what is MS characterized by?
patches of demyelination in the CNS
(q) if the right side of the brain is injured, what side of the body is effected?
the left side
(q)describe cerebral palsy?
non progressive disorder impairing voluntary movement
(q)full body relaxation to reduce tremors is appropriate towards what condition?
parkinsons
(q) what is a treatment goal for a client with cerebral palsy?
minimze contracture formation
(q) is multiple sclerosis progression predictable?
no
(q) describe parkinsons?
difficult movementy
resting tremors
muscular rigidity
(q) what is a malignant neoplasm?
invades blood and lymph system
(q) is MS a progressive condition?
yes
(q) what condition is associated with resting tremors?
parkinsons
(q) what condition is associated with intension tremors?
MS
(q) would abduction be seen with a extensor pattern of the lower body?
no
(q) would internal rotation be seen in a flexor pattern of the lower body?
no
(q) what is a common posture with hemiplegia?
flexor pattern of the upper body
extensor pattern of the lower body
(q) where is most of the edema found in a client with hemiplegia?
ankle
what is the leading cause of adhesions?
chronic inflammation
what are some signs of inflammation?
redness
swelling
heat
pain
loss of function
muscle spasm
muscle guarding
would you treat distal to swelling?
no
would the presence of edema affected range?
yes it would reducd when movement compressed the edema
what is the purpose of a muscle spasm?
an internal splint to the injured site
reduces movement and prevents further injury
what are cause of spasms?
pain
circulatory stasis
increased neuron firing
chilling in the muscle
lack of vitamin D
what are some contraindications for muscle spasm?
do not attempt to remove or completey elimate spasm
avoid passive stretching when acute
hot hydro
massage if DVT is present
what is the most common spasm?
calf cramp
what is a contusion?
crush injury to a muscle
what is a hematome?
large local hemorrhage following tramua
what things can lead to scar tissue formation?
inflammation
prolonged immobilization
paralysis or paresis
what are some types of burns?
thermal
corrosive
electrical
radiation
what are some contrandication for burns?
infection risk is high, wash hands often
wearing gloves to prevent infection
no oils to the area
avoid contact with burns
modifcations to hydro
active resisted in acute stage
direction of pressure is towards injury site
what are the causes of strains?
sudden overstretch of the muscle
extreme contraction of the muscle agasint heavy resistance
describe a grade 1 strain?
minor stretch and tear
minmal loss of strength
mild discomfort with activity
describe a grade 2 strain?
tearing
snapping sensation
gap apperance
hard time with activity
describe a grade 3 strain?
complete rupture
sound at injury
unable to continue activity
what are some CI’s for strain?
avoid testing grade 2 and 3 in acute stage
avoid removing spams around acute strain
distal circulation
(q) what is considered deep sensory testing?
dermatomes
deep pressure
temperature perception
(q) what muscle is being tested with wrights hyperabduction?
pec minor
(q) what nerve is compressed with carpal tunnel syndrome?
median
(q) in a prolapsed cervical disc, the pressure from the disc is usually against what structure?
posterior longitudinal ligament
(q) a client with a disc herniation at C4/C5 and resultant nerve root irritation will have what type of weakness?
shoulder abduction
(q) a disc herniation at C5-C6 will compress what nerve root?
C6
(q) what is the mjost common disc herniation?
posterior lateral
(q) what position would relieve compression at L4/L5 facet joint irritation?
flexion and contralateral side bending
(q) what is a common trigger for a client with Raynaud’s disease?
exposure to cold
(q) what nerve is affected with weakness in the tricep muscle?
radial nerve
(q) what nerve is involved with wrist drop?
radial nerve
(q) what test would differentiate pronator teres from carpal tunnel?
pronator teres test
(q) what nerve is peroneus longus innervated by?
superficial fibular
(q) what nerve innervates soleus?
tibial nerve
(q) what test is used to determine the regeneratin of the ulnar nerve?
tinel tap at the elbow
(q) what nerve is effected by bells palsy?
VII
(q) your client has sharp shooting, searing pain, short and shallow breaths and pain in the area of the lateral axillary, sternum, and spine. what condition would they have?
intercostal neuralgia
(q) what condition is due to traction of the upper brachial plexus, affecting the deltoid, bicep and brachialis muscles?
erbs duchenne
(q) when treating a client with hypertension it is important to closely monitor them for warnings of cardiac distress
what is a good sign to look for?
heart rate of 100 BPM
(q) what is heart pain due to reduced blood supply to the heart?
angina pectoris
(q) what is a good homecare for a client with hypertension?
mild aerobic activity
(q) what is the safest way to treat a client in with congestive heart failure?
lateral strokes
(q) what is another name for DVT?
thrombophlebitis
(q) what hydro is best for clients with DVT or varicose veins?
cool hydro to the legs
(q) is sharp intense bilateral leg pain a symptom of varicose veins?
no
(q) what occupation would you see high rates of Raynaud’s disease?
food prep workers
(q) what does COPD stand for?
chronic obstructive pulmonary disease
(q)what is the following technique:
a middle finger placed flat on the back/chest within an intercostal space, then tap the finger with the other middle finger and index finger to listen for different sounds
mediate percussion
(q) what position for postural drainage is used for addressing the middle lobe?
supine with 1/4 turn superior, affected lobe superior
(q) what is the benefit for a facial steam prior to sinusitis treatment?
loosens mucous
(q) which of the following is common to see in post partum depression:
euphoria
anxiety about the future
cant wait to go to work
thought of hurting your husband
anxiety about the future
(q) what joint mob is safe to use on a client with acute frozen shoulder
grade one oscillation to the shoulder
(q) what muscle depresses the jaw?
lateral pterygoid
(q) what is an ominous sign when treating the breast?
clear, greyish-green or bloody discharge
(q) where does a trigger point in the suboccipital muscles typically refer to?
occiput around the head to the orbit of the eye
(q) is having a mammogram within 24 hours of treatment CI’d?
yes
(q) what is injured with hyperflexion of the C-spine?
posterior neck
(q) what is a positive rebound test indicate?
appendicitis (refer to MD)
(q) is vastus medialis weakness common with patellofemoral syndrome?
no
(q) what is important when treating a client with AIDS?
do not over fatigue
(q) what is appropriate for treating a client with an incomplete L2 spinal cord injury
cool wash
running vibrations
isometric strengthening of knee extensors
(q) how long after radiation can you treat a client?
4 weeks
(q) non-paralytic polio presents with what symptoms?
flu-like sympotoms
(q) what cervical spine damage would lead to a complete loss of diaphragm function?
C3 above
