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MS II > Trigger Points/ Tender Points > Flashcards

Trigger Points/ Tender Points Flashcards

1
Q

What is a trigger point?

A
  • Hyperirritable locus within a taut band of skeletal muscle located in the muscular tissue or its associated fascia
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2
Q

What are the 2 types of trigger points?

A
  • Active (Pain without palpation)

- Latent (Clinically silet, but restricts, weakens muscle, and predisposes it to acute attacks of pain)

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3
Q

Upon who is trigger point mapping based?

A

JFK

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4
Q

Is a Trigger Point a primary or secondary condition?

A

Can be either

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5
Q

What are 4 direct causes of trigger points?

A
  • Acute overload (a specific event or movement)
  • Overwork/ overuse fatigue
  • Direct trauma
  • Chilling
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6
Q

What are the 2 causes of overwork fatigue?

A
  • Repetitive contractions

- Sustained contractions

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7
Q

What are 4 indirect causes of trigger points?

A
  • Overloaded synergistic muscles from primary muscle dysfunction
  • Visceral disease
  • Arthritic joints
  • Emotional distress
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8
Q

How much do trigger points vary?

A
  • Extremely variable due to activity

- Latent can turn into active

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9
Q

How do TrPs limit the movement of muscle?

A
  • Develop guarding habits that limit movement
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10
Q

What type of autonomic changes may appear in the presence of Trigger Points?

A
  • Diaphoresis
  • Vascontriction
  • Changes in proprioception
  • Hair loss
  • etc…
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11
Q

What are the 6 clinical signs used to diagnose a trigger point?

A
  • Weakness and restriction in the stretch of an affected muscle
  • A palpable taut band in the affected muscle
  • Severe focal tenderness to digital pressure
  • Twitch response following snapping or dry needling
  • Reproduction of pain
  • Elimination of symptoms targeting specific muscle
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12
Q

What is the goal of trigger point therapy?

A
  • Inactivate trigger point decreasing referred pain
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13
Q

What are 3 methods of trigger point treatment?

A
  • Manual technique
  • Needling w/ or w/o medicaiton
  • Dry needling
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14
Q

How much pressure should be applied through digital palpation to assess trigger points?

A
  • Approximately 4 kg
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15
Q

How many tender points need to be present for a diagnosis of fibromyalgia?

A
  • 11 of 18 sites
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16
Q

What are the 18 sites of tender points?

A
  • Bilateral at suboccipital muscle insertions
  • Bilateral anterior aspects of the intertransverse spaces at C5 - C7
  • Bilateral trapezius at midpoints and upper boarders
  • Bilateral medial supraspinaltus
  • Bilateral second rib at the 2nd costochondral junctions lateral to junctions of upper surfaces
  • Bilaterally 2 cm distal to humeral epicondyles
  • Bilateral outer quadrants of buttocks in anterior fold of muscle
  • Bilateral greater trochanter near trochanteric prominence
  • Bilateral medial fat pad proximal to the joint line of knee
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17
Q

Are tender or trigger points exclusively muscle?

A
  • Trigger points
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18
Q

Who developed the counterstrain/ positional release method?

A
  • Jones
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19
Q

What is the theory behind positional release?

A
  • Decreases sensitivity of the muscle spindle to stretch, which decreases the excitability of extrafusal muscle fibers
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20
Q

Does a trigger point or tender point illicit a local twitch response?

A
  • Trigger points
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21
Q

Does a trigger point or tender point illicit a local tenderness on palpation?

A
  • Both
22
Q

Can a trigger point or tender point be singular?

A

Only a trigger point

23
Q

Does a tender point or trigger point occur in specific locations?

A

Tender point

24
Q

Does a trigger point or tender point cause a specific referred pain pattern?

A

Trigger point

25
Q

Does a trigger point or tender point increase the body’s overall sensitivity to pain?

A

Tender point

26
Q

What is the referred pain pattern of the SCM?

A
  • Occiput/ occipital headaches
  • Ear
  • Eye
  • Cheek
  • Frontal area/ frontal headaches
  • Throat
  • Sternum
27
Q

What are 3 autogenic symptoms of the SCM?

A
  • Tinnitus
  • Blurred vision
  • Postural dizziness
28
Q

What type of grip is used when performing TrP therapy on the SCM?

A
  • Pincer
29
Q

What should be avoided when performing TrP therapy on the SCM?

A
  • The carotid artery and jugular vein
30
Q

What are the stretch positions that follow TrP therapy of the SCM?

A

Clavicular head: Neck extension, side bending, and rotation to the opposite side
Sternal: Neck extension, side-bending to the opposite side, rotation to the same side of the stretched muscle

31
Q

What is the positive stretch sign of the SCM?

A
  • Pain at occipital base and upper c-spine of side opposite stretch
32
Q

What muscle is usually involved in TrPs of the SCM?

A
  • The scalenes
33
Q

What postural imbalance is typically present if the Scalenes and TrPs develop trigger points?

A

T-spine/ forward neck posture

34
Q

Besides posture, what else may lead to TrPs of the SCM?

A
  • Whiplash injury
35
Q

What occupations may lead to development of SCM trigger points?

A
  • Those that require constant or repetitive forward neck bending
36
Q

What sleeping modification can be made to prevent SCM TrPs?

A
  • Pillow positioning
37
Q

What is a common HEP for SCM TrPs?

A
  • Maintain shoulder in depression (hold onto table

- Use MFS positions

38
Q

What is the referred pain pattern for the Scalenes?

A
  • Neck
  • Pectoral region
  • Medial border of scapula
  • Front and back of arm
  • Radial surface of the forearm
  • Index finger and thumb
39
Q

What grip is used for TrPs in the Scalenes?

A
  • Thumb or four fingesr

- Palpated against transverse processes

40
Q

What is the stretch for the Scalenes following TrP treatment?

A
  • Neck side-bending with moderate extension

- Stabilize scapula by holding onto chair

41
Q

What is the positive stretch sign for the scalenes?

A
  • Pain on ipsilateral cervical spine
42
Q

What are 3 mechanisms of injury for the Scalenes?

A
  • Whiplash
  • Over respiration
  • Muscular imbalance between the SCM and scalenes causing forward neck posture
43
Q

What is the referred pain pattern for the suboccipitals?

A
  • Occipital headaches
  • Deep headaches
  • Pain behind the eye
44
Q

What stretch technique is coupled with TrP of the suboccipitals?

A
  • Suboccipital decompression technique

- Chin tuck with upper cervical traction

45
Q

What is the positive stretch sign for the suboccipitals?

A
  • There is none
46
Q

What are 3 mechanisms of injury for the suboccipitals?

A
  • Forward head posture with posterior rotation of the occiput
  • Prone position for a prolonged period with hands support the head (watching TV or reading a book)
  • Excessive use of binoculars or eye glasses that require adjustment may cause a short hyperextension of the neck
47
Q

What is the referred pain pattern of the upper trapezius?

A
  • Posterolateral neck
  • Behind ear
  • Temporal area/ temporal headaches
  • To zygomatic arches
48
Q

What is the stretch coupled with TrP therapy of the upper trapezius?

A
  • Neck flexion
  • Side-bending towards opposite side
  • Slight rotation to ipsilateral side
49
Q

What is the positive stretch sign of the upper trapezius?

A
  • Pain at the opposite side during a stretch
50
Q

What is the HEP stretch for the patient for an upper trapezius TrP?

A
  • Pt sitting and holding ipsilateral shoulder in depression by gripping under the table with their hand
  • Use other hand to flex, contralaterally sidebend, and ipsilaterally rotate the neck to the same side
51
Q

What are 3 mechanisms of injury of the upper trapezius muscle?

A
  • Stabilizing phone between head and shoulder
  • Carrying heavy bags with strap over shoulder
  • Armchairs or wheelchairs with high arm supports or no supports

MS II (20 decks)

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