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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
Q

GH - convex/ concave rule

A

convex head of humerus in concave glenoid cavity of scapula

= CONVEX on CONCAVE

26
Q

GH - loose & closed packed position

A

LOOSE: 40-55º ABD, 30º of horizontal ADD (in scapular plane)

CLOSE: full horizontal ABD with lateral (external) rotation

27
Q

humeroulnar/ trochlear - loose & closed packed position

A

LOOSE: 70º of elbow flexion, 10º of supination

CLOSE: extension & supination

28
Q

humeroradial - loose & close packed position

A

LOOSE: full extension & supination

CLOSE: elbow flex 90º, forearm supinated 5º

29
Q

proximal radioulnar - loose & closed packed position

A

LOOSE: 35º supination, 70º flexion

CLOSE: forearm supinated 5º

30
Q

radiocarpal (wrist) - loose & closed packed position

A

LOOSE: neutral (halfway between flex & ext) with slight ulnar deviation

CLOSE: extension with radial deviation

31
Q

midcarpal - loose & closed packed position

A

LOOSE: neutral or slight flexion with ulnar deviation

CLOSE: extension with ulnar deviation

32
Q

intercarpal - loose & closed packed position

A

LOOSE: neutral / slight flexion

CLOSE: extension

33
Q

carpometacarpal (CMC) - loose & closed packed position

A

LOOSE:
-thumb:midway between ABD & ADD, midway between flex & ext
-fingers: midway between flex & ext

CLOSE:
-thumb: full opposition
-fingers: full flexion

34
Q

metacarpophalangeal (MCP) - loose & closed packed position

A

LOOSE: slight flexion

CLOSE:
-thumb: full opposition
-fingers: full flexion

35
Q

interphalangeal (IP) - loose & closed packed position

A

LOOSE: slight flexion

CLOSE: full extension

36
Q

AF - loose & closed packed position

A

LOOSE: 30º flexion, 30º ABD, slight lateral rotation

CLOSE: full extension, medial rotation, ABD

37
Q

AF - capsular pattern of restriction

A

flexion, ABD, medial rotation

38
Q

SI - loose & closed packed position

A

LOOSE: neutral

CLOSE: full nutation

39
Q

tibiofemoral (knee) - loose & closed packed position

A

LOOSE: 25º flexion

CLOSE: full extension, lateral rotation tibia

40
Q

talocrural (ankle, mortise) - loose & closed packed position

A

LOOSE: 10º plantar flexion, midway between inversion & eversion

CLOSE: max dorsiflexion

41
Q

patellofemoral - loose & closed packed position

A

LOOSE: full extension

CLOSE: full flexion

42
Q

subtalar/ talocalcaneal - loose & close packed position

A

LOOSE: midway between extremes of ROM

CLOSE: supination

43
Q

talocalcaneonavicular, cuboideonavicular, alcaneocuboid, distal Intertarsal - loose & closed packed position, capsular pattern of restriction

A

LOOSE: midway between extremes of ROM

CLOSE: supination (inversion)

CAPSULAR PATTERN: dorsiflexion, plantar flexion, ADD, medial rotation

44
Q

metatarsophalangeal - loose & closed packed position

A

LOOSE: 10º extension

CLOSE: full extension

45
Q

interphalangeal (foot) - loose & closed packed position

A

LOOSE: slight flexion

CLOSE: full extension

46
Q

TMJ - loose & closed packed position

A

LOOSE: mouth slightly open, lips together, teeth not in contact

CLOSE: teeth tightly clenches

47
Q

spine - loose & close packed position

A

LOOSE: midway between flexion & extension

CLOSE: full extension

48
Q

proximal radioulnar joint

A

synovial, pivot, diarthrosis, uniaxial
-convex radial head & slightly concave radial notch of ulna
-annular ligament, quadrate ligament
-pronation & supination

49
Q

proximal radioulnar joint - anterior glide (radius on ulna)

A

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
Q

proximal radioulnar joint - posterior glide (radius on ulna)

A

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
Q

distal radioulnar joint

A

synovial, pivot, diarthrosis, uniaxial
-head of ulnar & ulnar notch of distal radius
-articular disc (triangular fibrocartilage TFCC), dorsal & palmar radioulnar ligaments
-supination & pronation

52
Q

triangular fibrocartilage complex (TFCC)

A

cartilage helps stabilize radius & ulna with hand or forearm movements

has a superficial & deep portion

53
Q

distal radioulnar joint - posterior glide (radius on ulna)

A

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
Q

distal radioulnar joint - anterior glide (radius on ulna)

A

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
Q

tibiofemoral (knee) - anterior & posterior glide of tibia on femur: CI’s

A

anterior: CI’d for ACL injury/ damage
posterior: CI’d for PCL injury/ damage

56
Q

tibiofemoral (knee) - medial & lateral gap: CI’s

A

medial: do not lever joint, do not let femur rotate medially
lateral: not in full extension, do not lever joint

57
Q

tibiofemoral (knee) - medial & lateral glide of tibia: CI’s

A

do not allow femur to rotate medially

58
Q

patellofemoral - superior & inferior glide: CI’s

A

do not compress patella/ force knee into extension/ hyper extension

59
Q

patellofemoral - medial & lateral glide: CI’s

A

CI’d if previous dislocations, do not force knee into hyperextension, discontinue if painful

60
Q

proximal tibiofibular - posterior & anterior glide of fibula: CI’s

A

do not apply too much pressure to fibular head due to common peroneal nerve nearby

61
Q

distal tibiofibular - posterior glide of fibula: CI’s

A

do not apply too much dorsiflexion, relax achilles tendon

JOINT MOBS (18 decks)

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