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JOINT MOBS > WRITTEN FINAL - HINTS > Flashcards

WRITTEN FINAL - HINTS Flashcards

1
Q

joint mob definition

A

skilled passive movement by therapist on articular surfaces to decrease pain or increase joint mobility or ROM

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2
Q

physiological effects of joint mobs

A

-fires articular mechanoreceptors
-fires cutaneous & muscular receptors
-abates or stops nociceptors (pain receptors)
-decreases or relaxes mm guarding
-causes synovial fluid movement & improves nutrient exchange
-improves mobility & flexibility at joint
-maintains tensile strength of articular tissues

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3
Q

arthrokinematics

A

motions you can feel, movement that occurs inside a joint

roll, spin, slide/glide

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4
Q

osteokinematics

A

motions you can see, movement of body parts that occurs outside a joint

flexion/extension, ABD/ADD, rotation

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5
Q

closed packed position

A

-max area of contact
-max stability
-min mobility

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6
Q

capsular pattern of restriction

A

predictable pattern of movement restriction that occurs in a synovial joint when entire joint capsule is injured or affected

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7
Q

CONCAVE / CONVEX RULE

A

when a concave surface moves on a convex surface, roll & slide must occur in SAME direction

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8
Q

CONVEX / CONCAVE RULE

A

when a convex surface moves on a concave surface, roll & slide occur in OPPOSITE directions

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9
Q

joint distraction (axial & lateral distraction)

A

two opposing joint surfaces separated from each other, moving towards a loose or open packed position

axial distraction: through long axis of joint
lateral distraction: perpendicular to long axis of joint

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10
Q

compression / approximation

A

two opposing joint surfaces moved towards each other or approximated
towards a close packed position

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11
Q

indications for joint play

A

-restoring ROM for peripheral & axial skeleton joints
-primary indication = decreased ROM due to immobilization, usually from fractures, sprains, tendonitis, or adhesive capsulitis
-any condition involving fibrosis or pseudo-fibrosis (relative capsular fibrosis) of joint capsule

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12
Q

contraindications

A

hypermobility
joint effusion
inflammation

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13
Q

grading joint play

A

-always start with least stress on joint & go to more & more stress
-use grading system for both sustained glides or distractions & oscillations

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14
Q

GRADE 1 - SUSTAINED

A

-initiation of movement
-stop before first tissue stop

non-corrective - P.M.

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15
Q

GRADE 2 - SUSTAINED

A

-up to first tissue stop, not going past

non-corrective - P.M.

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16
Q

GRADE 3 - SUSTAINED

A

-up past first tissue stop until anatomical limit

corrective - stretched joint capsule, restore ROM

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17
Q

GRADE 1 - OSCILLATIONS

A

small amplitude

between initiation of movement & tissue resistance

5 cycles per second

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18
Q

GRADE 2 - OSCILLATIONS

A

large amplitude

between initiation of movement & tissue resistance

2-3 cycles per second

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19
Q

GRADE 3 - OSCILLATIONS

A

large amplitude

within tissue resistance & backing out again

2-3 cycles per second

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20
Q

GRADE 4 - OSCILLATIONS

A

small amplitude

within tissue resistance to end of limited ROM

5 cycles per second

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21
Q

normal end feels

A

-bony: “hard” unyielding sensation, painless
-soft tissue approximation: yielding compression, or “mushy” feel
-tissue stretch: firm springy type of movement with slight give, elastic resistance, may be hard (capsular) or soft (elastic)

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22
Q

abnormal end feels

A

-early spasm: caused by mm/ligament tear, often acute
-late spasm: caused by instability
-capsular: hard (chronic) & soft or boggy (acute), caused by capsule damage
-empty: caused by ligament rupture or tear, very painful
-bone to bone: caused by osteophyte, early restriction in ROM
-springy block: caused by internal derangement inside joint, common in meniscus, early restriction

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23
Q

capsular pattern of restriction of GH

A

1: lateral (external) rotation
2: ABD
3: medial (internal) rotation

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24
Q

GH - lateral distraction: hand placement

A

stabilizing hand: distal humerus at lateral supracondylar crest

mobilizing hand: grasp proximal humerus near axilla & mobilize laterally

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25
GH - convex/ concave rule
convex head of humerus in concave glenoid cavity of scapula = CONVEX on CONCAVE
26
GH - loose & closed packed position
LOOSE: 40-55º ABD, 30º of horizontal ADD (in scapular plane) CLOSE: full horizontal ABD with lateral (external) rotation
27
humeroulnar/ trochlear - loose & closed packed position
LOOSE: 70º of elbow flexion, 10º of supination CLOSE: extension & supination
28
humeroradial - loose & close packed position
LOOSE: full extension & supination CLOSE: elbow flex 90º, forearm supinated 5º
29
proximal radioulnar - loose & closed packed position
LOOSE: 35º supination, 70º flexion CLOSE: forearm supinated 5º
30
radiocarpal (wrist) - loose & closed packed position
LOOSE: neutral (halfway between flex & ext) with slight ulnar deviation CLOSE: extension with radial deviation
31
midcarpal - loose & closed packed position
LOOSE: neutral or slight flexion with ulnar deviation CLOSE: extension with ulnar deviation
32
intercarpal - loose & closed packed position
LOOSE: neutral / slight flexion CLOSE: extension
33
carpometacarpal (CMC) - loose & closed packed position
LOOSE: -thumb:midway between ABD & ADD, midway between flex & ext -fingers: midway between flex & ext CLOSE: -thumb: full opposition -fingers: full flexion
34
metacarpophalangeal (MCP) - loose & closed packed position
LOOSE: slight flexion CLOSE: -thumb: full opposition -fingers: full flexion
35
interphalangeal (IP) - loose & closed packed position
LOOSE: slight flexion CLOSE: full extension
36
AF - loose & closed packed position
LOOSE: 30º flexion, 30º ABD, slight lateral rotation CLOSE: full extension, medial rotation, ABD
37
AF - capsular pattern of restriction
flexion, ABD, medial rotation
38
SI - loose & closed packed position
LOOSE: neutral CLOSE: full nutation
39
tibiofemoral (knee) - loose & closed packed position
LOOSE: 25º flexion CLOSE: full extension, lateral rotation tibia
40
talocrural (ankle, mortise) - loose & closed packed position
LOOSE: 10º plantar flexion, midway between inversion & eversion CLOSE: max dorsiflexion
41
patellofemoral - loose & closed packed position
LOOSE: full extension CLOSE: full flexion
42
subtalar/ talocalcaneal - loose & close packed position
LOOSE: midway between extremes of ROM CLOSE: supination
43
talocalcaneonavicular, cuboideonavicular, alcaneocuboid, distal Intertarsal - loose & closed packed position, capsular pattern of restriction
LOOSE: midway between extremes of ROM CLOSE: supination (inversion) CAPSULAR PATTERN: dorsiflexion, plantar flexion, ADD, medial rotation
44
metatarsophalangeal - loose & closed packed position
LOOSE: 10º extension CLOSE: full extension
45
interphalangeal (foot) - loose & closed packed position
LOOSE: slight flexion CLOSE: full extension
46
TMJ - loose & closed packed position
LOOSE: mouth slightly open, lips together, teeth not in contact CLOSE: teeth tightly clenches
47
spine - loose & close packed position
LOOSE: midway between flexion & extension CLOSE: full extension
48
proximal radioulnar joint
synovial, pivot, diarthrosis, uniaxial -convex radial head & slightly concave radial notch of ulna -annular ligament, quadrate ligament -pronation & supination
49
proximal radioulnar joint - anterior glide (radius on ulna)
E: increase supination of forearm P: soft hand not to compress deep branch of -stabilizing hand: on proximal ulna, posterior & medial surfaces -mobilizing hand: on proximal radius, anterior (towards cubital fossa) may use thumb or palm to do mobilization -place towel in patient’s hand to control degree of supination
50
proximal radioulnar joint - posterior glide (radius on ulna)
E: increase pronation of forearm P: median nerve & brachial artery sit lateral to biceps tendon, soft hand approach not to compress them -stabilizing hand: on proximal ulna with inside hand placed over olecranon -mobilizing hand: on proximal radius, anterior aspect, glide proximal radius posteriorly -stand & use body weight
51
distal radioulnar joint
synovial, pivot, diarthrosis, uniaxial -head of ulnar & ulnar notch of distal radius -articular disc (triangular fibrocartilage TFCC), dorsal & palmar radioulnar ligaments -supination & pronation
52
triangular fibrocartilage complex (TFCC)
cartilage helps stabilize radius & ulna with hand or forearm movements has a superficial & deep portion
53
distal radioulnar joint - posterior glide (radius on ulna)
E: increase supination of wrist & forearm, P.M. P: do not compress radial & ulnar arteries -stabilizing hand: on distal ulna & carpal bones -mobilizing hand: on distal radius in posterior direction -use rolled up towel or pillow to support wrist
54
distal radioulnar joint - anterior glide (radius on ulna)
E: increase pronation of wrist & forearm P: do not compress radial & ulnar arteries -stabilizing hand: stabilize distal ulna & carpal bones -mobilizing hand: mobilize distal radius in anterior direction -use rolled up towel or pillow to support wrist
55
tibiofemoral (knee) - anterior & posterior glide of tibia on femur: CI's
anterior: CI'd for ACL injury/ damage posterior: CI'd for PCL injury/ damage
56
tibiofemoral (knee) - medial & lateral gap: CI's
medial: do not lever joint, do not let femur rotate medially lateral: not in full extension, do not lever joint
57
tibiofemoral (knee) - medial & lateral glide of tibia: CI's
do not allow femur to rotate medially
58
patellofemoral - superior & inferior glide: CI's
do not compress patella/ force knee into extension/ hyper extension
59
patellofemoral - medial & lateral glide: CI's
CI'd if previous dislocations, do not force knee into hyperextension, discontinue if painful
60
proximal tibiofibular - posterior & anterior glide of fibula: CI's
do not apply too much pressure to fibular head due to common peroneal nerve nearby
61
distal tibiofibular - posterior glide of fibula: CI's
do not apply too much dorsiflexion, relax achilles tendon

JOINT MOBS (18 decks)

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