Term
|
Definition
| deduction is a thought process where conclusions are made based on the assessment of data in light of a previously stated hypothesis or diagnosis |
|
|
Term
|
Definition
| induction is a thought process where conclusions are made based on the gathering and assessment of data without influence by any preconceived thoughts or notions. |
|
|
Term
| when using induction, what must one do to make a conclusion? |
|
Definition
| use the process of triangulation where many sources of information point to one conclusion. Put aside the physician's diagnosis and do my own research. Take data to see if the patient is getting better. If the data supports my original hypothesis, continue. If not, go back to the drawing board and do more inductive thinking by interviewing and examining the patient |
|
|
Term
| should we use inductive or deductive thinking in clinical care? |
|
Definition
|
|
Term
| why is deductive thinking bad in clinical care? |
|
Definition
| deductive thinking allows someone else's diagnosis to bias the information. |
|
|
Term
| what are the components of a working diagnosis/hypothesis |
|
Definition
| MOI, injured tissues, severity of injury, contributors to overuse, mechanisms that may sustain the injury |
|
|
Term
| give an example of a mechanism that could sustain an injury |
|
Definition
| foot pronation may not be involved with a knee injury, but it can affect healing by putting valgus stress on an injured medial collateral ligament |
|
|
Term
| what to do after we make a working hypothesis/diagnosis? |
|
Definition
| intervene and get into deduction |
|
|
Term
| why is it important to know the MOI? |
|
Definition
| to work on injury prevention and limit injury recurrence |
|
|
Term
| how to facilitate healing? |
|
Definition
| protect injured tissue during rehabilitation, address issues that hasten healing, promote optimal mechanical properties in the healed tissue |
|
|
Term
| How to protect injured tissues? |
|
Definition
| try new activities, modify activity, external support such as braces or splints |
|
|
Term
| describe return to strength in an injured tissue |
|
Definition
| when tissue is injured, it takes a long time for it to regain normal strength (if ever) |
|
|
Term
| what happens if you give too much protection to injured tissue |
|
Definition
| it decreases the strength of the tissue |
|
|
Term
| why is mobilization necessary for injured tissues |
|
Definition
| mobilization is needed to facilitate the proliferative and remodeling phases of healing. Mobilization is needed to strengthen. |
|
|
Term
| what is the one type of tissue that should not be mobilized during healing and why |
|
Definition
| bone: if you do not protect and immobilize bone, it will form a mal-union |
|
|
Term
|
Definition
| force crossing a plane of tissue = internal force in the tissue divided by cross sectional area = load inside the tissue = internal reaction to an externally applied load |
|
|
Term
|
Definition
| forces that are external to the tissue |
|
|
Term
| how is stress affected by cross sectional area |
|
Definition
| stress is internal force in the tissue divided by cross sectional area, so the larger the cross sectional area, the lower the stress |
|
|
Term
| why is it dangerous when tissues atrophy, stress-wise? |
|
Definition
| when tissues atrophy and lose cross sectional area, they lose protection and will experience greater stress and greater risk for injury. |
|
|
Term
| why is it good to hypertrophy a tissue? |
|
Definition
| if you can hypertrophy the tissue, it will experience decreased stress and be at less risk for injury |
|
|
Term
|
Definition
| pounds/square inch, Newtons/square meter |
|
|
Term
| how many types of stress are there |
|
Definition
|
|
Term
| what are the 3 types of stress |
|
Definition
| tensile, compressive, shear |
|
|
Term
| what are the 2 normal forces |
|
Definition
|
|
Term
| why are tensile and compressive stresses "normal" |
|
Definition
| they are perpendicular to the cross sectional area of the tissue |
|
|
Term
| what does tensile stress do? |
|
Definition
|
|
Term
| what does compressive stress do? |
|
Definition
|
|
Term
| are external load forces distributed equally throughout the inside of a material? |
|
Definition
| no, but we tend to assume that it is for our purposes |
|
|
Term
|
Definition
| stress in which internal force vectors are parallel to the cross sectional area of interest. |
|
|
Term
| are tissues more likely to fail with shear or normal stress? |
|
Definition
|
|
Term
| what is our job as the clinician when evaluating stress? |
|
Definition
| our job is to look at external loading, determine what the stress pattern is, and do stress shielding to reduce the stress that is within the tissue so that it can heal and so that it does not become reinjured |
|
|
Term
|
Definition
| strain = magnitude of tissue deformation = deformation or change in shape that takes place in regard to the stress that has been imposed. |
|
|
Term
| how many types of strain are there |
|
Definition
|
|
Term
| what are the 3 types of strain |
|
Definition
| shear, tensile, compressive |
|
|
Term
| define longitudinal strain |
|
Definition
| deformation in response to normal stress = tensile or compressive strain |
|
|
Term
| how to calculate % tensile strain |
|
Definition
| (change in length/original length)x100% |
|
|
Term
| what does % tensile strain indicate |
|
Definition
| percentage change in length = deformation |
|
|
Term
| how to calculate % compressive strain |
|
Definition
| (change in length/original length)x100% |
|
|
Term
| what happens before you have a complete separation from shear strain |
|
Definition
|
|
Term
| describe angular deformation |
|
Definition
| if you had a right (90 deg angle) in the tissue and impose shear stress, you will see the right angle become a smaller angle. |
|
|
Term
| define angular deformation |
|
Definition
| change in the angle in radians |
|
|
Term
| how many degrees in a radian |
|
Definition
|
|
Term
| how do we measure internal angular deformation? |
|
Definition
| internal deformation is represented by external angular deformation |
|
|
Term
| how was it determined that a radian is 57.3 degrees? |
|
Definition
| radian = angular displacement such that the arc length is equal to the radius of the arc. Circumference of a circle = 2πr = 360°. Therefore, 1 rad = r = 360°/2π = 57.3° |
|
|
Term
| on the stress strain curve, which variable is on the y axis |
|
Definition
|
|
Term
| remind me again in 2 words what stress is |
|
Definition
|
|
Term
| on the stress strain curve, which variable is on the x axis |
|
Definition
|
|
Term
| remind me again in 1 word what strain is |
|
Definition
|
|
Term
| on the stress strain curve, is the peak of injured tissue higher or lower than the peak of normal tissue, and what does this mean. |
|
Definition
| On the stress strain curve, the peak of injured tissue is lower than the peak of normal tissue. This means that injured tissue cannot withstand as much stress as normal tissue. |
|
|
Term
| on the stress strain curve, what is the x distance of injured tissue compared to normal tissue, and what does this mean? |
|
Definition
| On the stress strain curve, the injured tissue doesn't go as far on x axis, meaning it can't withstand as much strain (stretch) before injury. |
|
|
Term
| what does the stress strain generally mean for injured tissues |
|
Definition
| we have to be careful with injured tissues and protect them (but not too protective) |
|
|
Term
| what is the peak on the y axis called on a stress strain curve? |
|
Definition
| ultimate strength of the material = peak stress that can be withstood |
|
|
Term
| what is the area under the curve in a stress strain curve? |
|
Definition
| the energy the material has absorbed prior to failure. |
|
|
Term
| what happens to the energy the material absorbs prior to failure when it does fail? |
|
Definition
| all of the energy is released. This is called energy at failure |
|
|
Term
| what is the indication of energy at failure |
|
Definition
| release of energy can be dangerous to surrounding tissues, especially in bone (and especially in cancellous bone) |
|
|
Term
| what does the slope of the stress strain curve indicate? |
|
Definition
|
|
Term
| what does stiffness (or slope of the stress strain curve) imply? |
|
Definition
| the steeper the slope, the stiffer the tissue, the more stress that can be applied with less strain, the less deformation occurs in response to the stress |
|
|
Term
| what are some tissues that we want to be stiff? |
|
Definition
|
|
Term
| what is a tissue that we do not want to be stiff? |
|
Definition
|
|
Term
| why do we want bone to be stiff |
|
Definition
| we don’t want it to deform under stress because we want it to support the structural framework of the body. |
|
|
Term
| why do we want tendon to be stiff? |
|
Definition
| the job of the tendon is to deliver force from the muscle to the bony target. If the tendon is not stiff, then when the muscle yanks on the tendon, it will not be able to deliver the strong force going from the muscle to the bone. |
|
|
Term
| explain this analogy: finger:fingerprint::tissue:stress-strain-curve |
|
Definition
| every tissue has its own stress strain curve |
|
|
Term
| what things can change the stress strain relationship |
|
Definition
| temperature, frequency of loading |
|
|
Term
| what is the purpose of the inflammatory response |
|
Definition
| begin healing process and lay down tissue that will be incorporated into the healing tissue |
|
|
Term
| is it desirable to have a big inflammatory response in muscle? |
|
Definition
|
|
Term
| what is the inflammatory response a response to? |
|
Definition
|
|
Term
| what are the types of injuries that cause an inflammatory response |
|
Definition
| mechcanical, temperature, light, chemical, infection |
|
|
Term
| what determines whether an injury will cause hemorrhage into interstitial spaces? |
|
Definition
|
|
Term
| what happens initially with the inflammatory response |
|
Definition
| influx of tissue and cellular debris, possibly blood |
|
|
Term
|
Definition
| formation of cellular debris and red blood cells after tissue injury |
|
|
Term
| through what mechanism do injured cells release histamine and form prostaglandins after tissue injury? |
|
Definition
|
|
Term
| what causes edema in inflammation? |
|
Definition
| histamine and prostaglandins increase capillary permeability. Because of increased permeability, constituents of the blood (plasma proteins, colloids, water) leak out into the area. The increase of these particles draws fluid into the area to maintain osmotic pressure, and this causes edema. |
|
|
Term
| what is the trouble with edema? |
|
Definition
| edema is the medium in which scar tissue/adhesions form, causes uncomfortable pressure, causes muscle inhibition |
|
|
Term
| how much inflammatory response do we want in a muscle injury? |
|
Definition
|
|
Term
| what turns on the arachidonic Cascade |
|
Definition
| with injury, phospholipids in the cell membrane release phospholipase. This starts the arachidonic Cascade |
|
|
Term
| in the arachidonic cascade, what does the phospholipase from the cell membrane form/cause? |
|
Definition
|
|
Term
| in the Arachidonic cascade, what medication can inhibit phospholipase? |
|
Definition
|
|
Term
| Once arachidonic acid is formed, what two branches does the arachidonic cascade take? |
|
Definition
| cyclooxygenase, lipoxygenase |
|
|
Term
| which side of the Arachidonic Cascade has a lot of prostaglandins? |
|
Definition
|
|
Term
| remind me again what prostaglandins do following injury |
|
Definition
| phospholipids increase cell membrane permeability and cause vasodilation of vascular smooth muscle and result in edema |
|
|
Term
| what are some things that prostaglandins are needed for |
|
Definition
| platelet aggregation to stop bleeding, protection of GI mucous membrane and inhibition of gastric acid secretion, maintenance of renal blood flow |
|
|
Term
| how do steroids affect the Arachidonic cascade |
|
Definition
| they inhibit the formation of phospholipase, thereby inhibiting the entire cascade |
|
|
Term
| in the arachadonic cascade, what medications can inhibit the cyclooxygenase branch of the metabolic process? |
|
Definition
|
|
Term
| what is the affect on the arachidonic cascade of taking NSAIDs |
|
Definition
| NSAIDs inhibit the cyclooxygenase branch of the metabolic process and therefore drive the arachidonic cascade into lipoxygenase, which increases formation of leukotrienes |
|
|
Term
| what is the problem with too many leukotrienes? |
|
Definition
| leukotrienes can act as bronchoconstrictors. |
|
|
Term
| if you have a patient with asthma, what concerns might you have with prescribing what type of medication for inflammation and why? |
|
Definition
| use caution with applying NSAIDs for inflammation because NSAIDs inhibit the cyclooxygenase branch of the metabolic process and therefore drive the arachidonic cascade into lipoxygenase, which increase the formation of leukotrienes, which can cause bronchoconstriction |
|
|
Term
| what are other adverse side effects of using NSAIDs for inflammation (other than bronchoconstriction)? |
|
Definition
| because NSAIDs inhibit the cyclooxygenase branch, they inhibit the formation of prostaglandins. Therefore, adverse side effects of NSAIDs are: increased clotting time, GI distress, decreased renal blood flow, CNS issues such as tinnitus |
|
|
Term
|
Definition
|
|
Term
| what are the 3 major determinants of mechanical properties of tissue |
|
Definition
| consituents of the material, percent contribution of each constituent, structural architecture |
|
|
Term
| what are some examples of the constituents of a tissue |
|
Definition
| collagen, ground substances, water, inorganic materials |
|
|
Term
|
Definition
| no, it fails very quickly |
|
|
Term
| why is the structural architecture of a tissue a major determinant for the mechanical properties of the tissue? |
|
Definition
| Orientation of collagen fibers in relation to applied load makes a difference. If stress is applied along the orientation of the collagen fibers, the tissue will withstand strongly and stiffly. If stress is applied against the orientation, the tissue will respond in a weak way with a great amount of deformation. |
|
|
Term
| describe tissue adaptation to decreased use |
|
Definition
| with decreased loading of tissues, the tissue atrophies. This means fewer numbers of collagen fibers and the ones that are there have a smaller cross sectional area. This leads to decrease in strength and stiffness. The same external loads will cause increased stress, and the tissue will fail at a lower magnitude of loading. |
|
|
Term
| describe tissue adaptation to increased use |
|
Definition
| If you progressively (not aggressively) increase intensity, frequency, duration of loadingand allow the tissue to have time to react, it will hypertrophy. This means the tissue will have more collagen fibers and that the collagen fibers will have a greater cross sectional area. Internal forces will be divided by a larger cross sectional area so that stress is decreased. |
|
|
Term
| describe tissue adaptation to aging |
|
Definition
| with aging, tissue has a reduced ability to adapt to increased use secondary to decreased vascularity and reparative cells. There is also increased stiffness because of increase in cross linkage between adjacent collagen fibers, which reduces the ability to stretch |
|
|
Term
| If a pateint has a musculoskeletal injury and she can't change jobs and we can't change anything about the loading required in the job, what is our only option? |
|
Definition
| strengthen the tissue: cause it to hypertrophy and gain cross sectional area to decrease stress |
|
|
Term
| why is it difficult to stretch an older person? |
|
Definition
| increase in cross linkage between adjacent collagen fibers |
|
|
Term
| what to do if you take 2 weeks to stretch an older adult and you just can't |
|
Definition
| accommodate: add a heel lift for an older adult with tight posterior muscles who tends to fall backwards |
|
|
Term
| what are some factors that influence mechanical properties of tissues? |
|
Definition
| temperature, loading rate loading frequency |
|
|
Term
| does warm or cold collagenous tissue have a greater ultimate strength at failure? |
|
Definition
|
|
Term
| does warm or cold collagenous tissue have a greater strain at failure? |
|
Definition
|
|
Term
| what to do before participation in PT to prevent injury? |
|
Definition
| low intensity physiologic warm-up or heat modalities: ultrasound or hot pack |
|
|
Term
|
Definition
| loading rate = strain rate = how quickly the tissue is loaded |
|
|
Term
| is a 10%/second strain rate fast or slow |
|
Definition
|
|
Term
| what does a 10%/second strain rate mean? |
|
Definition
| every second, the tissue gets 10% longer |
|
|
Term
| is a 100%/second strain rate fast or slow? |
|
Definition
|
|
Term
| if the strain rate is 100%/second, does it take a full second to injure the tissue? |
|
Definition
|
|
Term
| how does increasing the speed of loading affect the strength and stiffness of tissue? |
|
Definition
| increasing the speed of loading increases the strength and stiffness of tissue |
|
|
Term
| for what type of tissue is increased stiffness bad and why |
|
Definition
| articular cartilage: repetitive impact loaders have stiffer articular cartilage. This is a slamming of articular cartilage between subchondral bone, which will destroy articular cartilage and cause OA. |
|
|
Term
| how do strain rates explain why ligaments are more likely to rupture than to produce avulsion fractures? |
|
Definition
| If we have a bone-ligament-bone complex and the complex is loaded with a fast strain rate, both the soft tissues and the bone will get stiffer, but the bone will become stiffer to a greater degree than the soft tissues. Bone gets stronger and stiffer more than ligamen because bone is a more metabolically reactive tissue. This means that the ligament is the weak link and we are likely to see a mid-ligament rupture |
|
|
Term
| describe what would happen in the same bone-ligament-bone complex to cause an avulsion fracture |
|
Definition
| if the bone-ligament-bone complex is loaded with a lower strain rate (because of a less violent MOI), both the bone and the ligament are not as strong and are not as stiff as they are for a fast strain rate. If the bone has less strength and stiffens less than the ligament, this is when we would see an avulsion fracture |
|
|
Term
| would you rather have an avulsion fracture or a mid-substance ligament fracture? |
|
Definition
| avulsion: it can be surgically repaired. The integrity of the joint is maintained because the bone will heal. If the ligament ruptures, you have to worry about whether the ligament can heal on its own or needs surgery. If the ligament heals on its own, it might be hypermobile. If it surgically repaired, it is likely to be hypomobile. you will get increased/changed contact pressure, which will lead to OA. |
|
|
Term
| define frequency of loading |
|
Definition
|
|
Term
| how does frequency of loading affect ultimate strength of the material |
|
Definition
| as the frequency of loading increases, the ultimate strength of the material (peak of the curve) decreases |
|
|
Term
| what is the result of increased frequency of loading |
|
Definition
| it takes an injury of lesser magnitude to injure the tissue. Causes repetitive loading injury. |
|
|
Term
| how to avoid reinjury in a healing/week tissue (looking for 3 things to avoid) |
|
Definition
| avoid too much magnitude, frequency, or duration of load onto the healing/weak tissue |
|
|
Term
|
Definition
| moment = force x moment arm |
|
|
Term
| what do we know biomechanically about a bouncer runner who heel strikes? |
|
Definition
| she has a high GRF and with a large plantarflexion moment from the ground that must be met with a large internal dorsiflexion moment. |
|
|
Term
| what to do for a bouncer runner who heel strikes and has anterior compartment syndrome |
|
Definition
| ask her to run and land on her forefoot |
|
|
Term
|
Definition
|
|
Term
| what do we know biomechanically and tissue-ly about a little old lady who walks loudly and has her knee extended or hyperextended during the loading phase of walking? |
|
Definition
| She is not flexing her knee to absorb shock and prolong the Δt, so there is a rapid peak of GRF. This quick loading makes articular cartilage stiffen and subchondral bone stiffen. This rapid rise in GRF can cause degradation of articular cartilage over time. |
|
|
Term
| what to do for little old lady with decreasedknee flexion in loading whose knees hurt? |
|
Definition
| teach her to walk with more knee flexion. This way, she will have a gradual rise rather than a sharp peak of GRF. |
|
|
Term
| what to do if a patient has multiple complaints? |
|
Definition
| rank them in order of priority |
|
|
Term
| what are some questions to ask about chief pain complaint? |
|
Definition
| Where is the pain? Point to where it hurts the most. Does the pain stay right there, or does it radiate? Describe the pain. When did the pain begin? How did the pain begin? What other symptoms are associated with the pain? What causes or affects the pain? |
|
|
Term
| describe musculoskeletal pain |
|
Definition
| most musculoskeletal disorders are aggravated by movement and relieved by rest except discogenic LBP, which is aggravated by sitting and relieved by upright movement. OA stiffness/pain might also increase with rest. |
|
|
Term
| what to do if pain does not vary with movement |
|
Definition
|
|
Term
| what to ask about previous history of cc during subjective interview |
|
Definition
| What attempts have been made to treat this episode of symptoms? Has there been a previous episode of similar nature? What precipitating causes might be present? Is the problem getting worse? What is your current medical status? What is your family history? |
|
|
Term
| why ask about current medical status |
|
Definition
| a variety of health conditions can affect the musculoskeletal system |
|
|
Term
| why ask about family history |
|
Definition
| look for inherited neuromuscular diseases or diseases that affect the musculoskeletal system: diabetes, charcot-marie-tooth, RA |
|
|
Term
|
Definition
| VAS, McGill Short Form Questionnaire |
|
|
Term
| Should SOAP be used as a diagnostic framework? |
|
Definition
|
|
Term
| is it ok to mix subjective and objective portions together |
|
Definition
|
|
Term
| when to record data from the S&O portions? |
|
Definition
| while it is obtained. Don't wait til later |
|
|
Term
| Is there always a cause of the pain? |
|
Definition
|
|
Term
| can the patient history tell the clinician what is wrong |
|
Definition
|
|
Term
| is the examiner-directed interview close ended or open ended? |
|
Definition
|
|
Term
| is the patient-directed interview open ended or close ended? |
|
Definition
|
|
Term
| what is the basic outline of the Frisch 5-5 evaluation system |
|
Definition
| Case History, 1. Observation/inspection, 2. function, 3. palpation, 4. neurologic tests, 5. special tests |
|
|
Term
| at what point should you determine how to proceed with the examination process? |
|
Definition
| after obtaining patient history |
|
|
Term
| what should you consider in the examination |
|
Definition
| joints that lie under the painful area, joints that refer to the painful area, mucles that lie under the painful area, what is the cause of the pain? |
|
|
Term
| should you focus on inert or contractile tissues in the area? |
|
Definition
|
|
Term
| what are some other names for a clearing examination |
|
Definition
| screening examination = scanning examination = lower and upper quarter screen |
|
|
Term
| what is the purpose of a clearing examination? |
|
Definition
| to identify major area of involvement and to eliminate confusing information |
|
|
Term
| what are some other good reasons to perform a clearing examination |
|
Definition
| 1. somatic organs can refer to the extremities. 2. pain patterns overlap, and spinal or extremity biomechanical disorders can coexist. 3. DJD of the spine leads to hyperexcitability of the entire sclerotomal segment |
|
|
Term
| what to do if a screening examination is normal? |
|
Definition
| consider nonmusculoskeletal cause for complaint |
|
|
Term
| what are the 5 components of observation/inspection |
|
Definition
| 1. functional movements (gait patterns, ADLs); 2. posture (habitual postures, compensatory positions for avoiding pain, muscle guarding); 3. shape (deformity, swelling, muscle asymmetry, atrophy); 4. skin (color, scar tissue, callus, cyanosis); 5. assistive devices (canes, crutches, walker, corset, splint, sling, wheelchair, other aids) |
|
|
Term
| what are the 5 components of movement testing |
|
Definition
| 1. active movements, 2. passive movements (look for end feel, capsular pattern), 3. resisted movements, 4. traction/compression to test intra-articular structures, 5. gliding to test intra-articular structures |
|
|
Term
| should you test the involved or uninvolved limb first? |
|
Definition
| uninvolved = to see what their normal is |
|
|
Term
| should you start with distal or proximal movement of involved limb? |
|
Definition
| start distally, move proximally |
|
|
Term
| what are the names of the 3 Cyriax interpretations/causes of AROM vs PROM limitations? |
|
Definition
| arthrogenic lesions, soft tissue/contractile lesion, capsular pattern |
|
|
Term
| define arthrogenic lesion |
|
Definition
| structures belonging to the anatomic joint |
|
|
Term
| what indicates an arthrogenic lesion |
|
Definition
| AROM and PROM restricted or painful in the same direction |
|
|
Term
| what indicates a soft tissue lesion with contractile tissue as the cause (Cyriax AROM and PROM limitations) |
|
Definition
| AROM and PROM restricted or painful in opposite directions |
|
|
Term
| what indicates capsular pattern as the cause (Cyriax AROM and PROM limitations)? |
|
Definition
| relative restriction of PROM in various directions |
|
|
Term
| what is the Cyriax interpretation of a loss of hip AROM flexion and a loss of hip PROM extension |
|
Definition
| soft tissue/contractile lesion: iliopsoas lesion results in loss of active hip flexion because of the tissue's incompetence and loss of passive hip extension as a result of pain with stretching the impaired tissue |
|
|
Term
| Name the 5 types of end feel |
|
Definition
| bony, capsular, springy, tissue approximation, empty |
|
|
Term
|
Definition
|
|
Term
| describe capsular end feel |
|
Definition
| firm, hardish with a slight give at very end range: glenohumeral joint in ER |
|
|
Term
| describe springy end feel |
|
Definition
| pathologic, painful: meniscus lesion in knee |
|
|
Term
| describe tissue approximation end feel |
|
Definition
|
|
Term
|
Definition
| pathologic, extreme hypermobility (side note that we've also been told an empty end feel is patient restricts movement due to pain) |
|
|
Term
| what to look for in peripheral joints? |
|
Definition
| ligamentous laxity, intraarticular cartilaginous lesions |
|
|
Term
| what are the 4 Cyriax Descriptions of Resisted Movements (names only)? |
|
Definition
| painful and strong, painful and weak, painless and weak, painless and strong |
|
|
Term
| what would cause a painful and strong end feel |
|
Definition
| minor lesion of muscle or tendon, possibly irritated bursa |
|
|
Term
| what would cause a painful and weak end feel |
|
Definition
| major lesion of the muscle or tendon, possibly bone fracture |
|
|
Term
| what would cause a painless and weak end feel |
|
Definition
| neurologic injury or complete ruptur of musculotendinous attachment |
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Term
| what would cause a painless and strong end feel |
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Definition
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Term
| what to try next when standard ROM and MMT doesn't elucidate the underlying cause? |
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Definition
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Term
| what does pain relieved by traction usually indicate? |
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Definition
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Term
| what can gliding help you determine? |
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Definition
| specific planes with lost motion |
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Term
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Definition
| near the end once you've established credibility with the patient |
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Term
| what are the neurologic tests to do? |
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Definition
| nerve trunk: neural tension; reflexes; sensation; motor (weakness, ambulation); cranial nerves |
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Term
| what is double crush phenomenon? |
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Definition
| when a patient has compression neuropathy in the periphery (such as carpal tunnel) as well as compression fo cervical nerve roots (that give rise to the median nerve) |
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