Term
| first degree muscular strains- 1) size of tear? 2) activity allowed? |
|
Definition
1) Tear of a few fibers
2) Minimal strength loss, little (if any) LOM
3) Minimal restriction of activity |
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Term
| Second degree muscle strains- 1) size of tear? 2) activity? 3) healing? |
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Definition
1) Greater number of fibers torn
2) Activity is often restricted by pain
3) Some loss of function
4) Usually require 3-28 days of rehabilitation |
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Term
| third degree muscle strain- 1) size of tear? 2) when is pain present? 3)treatment? 4) how long does it take to heal? |
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Definition
1) Tear extends across entire muscle belly
2) Whether px is present on resistance depends upon resultant injury to the tissue
3) Surgical intervention often necessary
4) Healing takes from 3 wks to 3 mos |
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Term
|
Definition
| inflammatory disorder of tissues around the tendon |
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Term
|
Definition
| degeneration of the tendon accompanied by pain. tendon often thickened |
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Term
|
Definition
| inflammation of tendon. rarely seen histologically |
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Term
|
Definition
| abnormal reparative process that causes benign hypertrophic ossification (formation of bone around muscle) in the soft tissue |
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Term
| two types of myositis ossificans |
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Definition
1) myositis ossifican circumscripta
2) myositis ossifican progressive |
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Term
| How and where does myositis ossifican circumscripta develop? |
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Definition
| 1) can be traumatic or atraumatic (nondocumented trauma, repeated small mechanical injuries, and non mechanical injuries caused by ischemia or inflammation) 2) 80% occurs in thigh or arm |
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Term
| What is the cause of myositis ossifican progressive? |
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Definition
| autosomal dominant genetic disorder |
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Term
| First degree ligamentous sprain- 1) size 2)signs 3)implications |
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Definition
1) Size- Tearing of a few fibers, minimal loss of structural integrity
2) Signs- Little or no swelling, Local tenderness, Minimal bruising
5) Implications- Minimal functional loss, early return to training |
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Term
| Second degree ligament tear (signs, implications) |
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Definition
1) signs-
significant structural weakening
some abnormal motion
solid end-feel to stress
more bruising and swelling, often associated hemarthrosis and effusion
2) implications-
tendency to recurrence
need protection from risk of further injury
may need modified immobilization
may stretch out further with time |
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Term
| Third degree ligament sprains (signs, implications) |
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Definition
1) signs:
loss of structural integrity
marked abnormal motion
significant bruising
hemarthrosis
2) IMPLICATIONS:
needs prolonged protection
surgery may be considered
often permanent functional instability |
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Term
|
Definition
| A defect in mineralization that results in a large amount of unmineralized osteoid. bone mineral density that is lower than normal |
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|
Term
| bone density T score that defines osteopenia |
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Definition
| standard deviation between -1 and -2.5 below peak bone mass from the young adult mean (25 y/o male) |
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Term
|
Definition
| bone density mass of at least 2.5 SD below the mean young adult (25 y/o) |
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|
Term
| osteoporosis is responsible for how many fx? most common fx? |
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Definition
| more then 1 million per year (vertebra is most common) |
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|
Term
| population at high risk of osteoporosis fx |
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Definition
| lifetime risk 75% of women > 50 y/o. 15-20% at risk for hip fx |
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|
Term
|
Definition
1) Type I (postmenopausal)
2) type II (age related) |
|
|
Term
| Type I of osteoporosis (postmenopausal)- bone affected? most common fx? |
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Definition
| primarily affects trabecular bone. vertebral and distal radial fx most common |
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Term
| Type II osteoporosis (age related) |
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Definition
seen in pts > 70 y/o.
related to poor calcium absorption.
hip and pelvic fx are common |
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|
Term
| treatment of osteoporosis |
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Definition
1) physical activity
2)estrogen- progesterone (type I)
3) calcium supplementation (type II)
4) vitamin D
5) various other drugs |
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Term
|
Definition
1) xrays (only detect if bone loss is more than 30%)
2)CT scans,
2) DEXA (dual energy xray aborption)- BMD test |
|
|
Term
| estrogen- progesterone treatment for type I is most effective when? |
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Definition
| when given within 6 years of menopause |
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|
Term
|
Definition
Gathering of info from the chart, other care-givers, pt, pts family, caretakers & friends in order to identify and define the pts problem(s)
Ongoing process
Purpose is to obtain information that identifies and measures a change from normal |
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Term
|
Definition
| Level of judgment necessary to make sense of the findings in order to identify a relationship |
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|
Term
| main reason pts come to PT |
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Definition
|
|
Term
| examination and evaluation should focus on? |
|
Definition
| cause of pain- mechanical, chemical, thermal |
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Term
|
Definition
| both chemical and mechanical source |
|
|
Term
| which pain is less effected by movement or positions and more constant? |
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Definition
|
|
Term
| what kind of pain is caused by collagen deformation? |
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Definition
| mechanical pain that is constant |
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|
Term
|
Definition
| location, onset, duration, etiology, syndrome |
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Term
|
Definition
| intesity, quality, pattern |
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Term
|
Definition
| mood, anxiety, depression, well being |
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Term
|
Definition
| meaning of pain, view of self, coping skills and strategies, previous treatment, attitudes and beliefs, factors influencing pain |
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Term
|
Definition
| communication, interpersonal interaction, physical activity, pain behaviors, medication, intervention, sleep |
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Term
| Pain- sociocultural, ethnocultural |
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Definition
| family and social life, work and home responsibilities, recreation and leisure, environmental factors, attidues and beliefs, social influences |
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|
Term
|
Definition
| dull, aching, sometimes hard to localize |
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|
Term
| ligament (capsule) pain description |
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Definition
|
|
Term
| nerve root pain description |
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Definition
| sharp, shooting, burning, radiating |
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|
Term
|
Definition
| sharp, bright, lightening like |
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|
Term
| sympathetic nerve pain description |
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Definition
| burning, pressure like, sting, aching |
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Term
|
Definition
| deep, nagging, dull, localized |
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|
Term
| components of examination |
|
Definition
Pt History
Observation
Palpation
Systems Review
Tests & Measures/Joint Play Movements
Reflexes & Cutaneous Distribution
Special Tests
Diagnostic Testing |
|
|
Term
| key component of assessment |
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Definition
| history- good history provides 80% or more of information necessary to explain presenting problem |
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Term
| what do you do during history? |
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Definition
| active listening, r/o contraindications and other possible medical complications (ROS), formulation of your hypothesis |
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Term
| key components of observation |
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Definition
| 1) begins when pt enters clinic 2) how does pt rise from chair, any guarding? 3) overt pain behavious (grimacing, rubbing, sighing, bracing) 4) pt interaction (eye contact/ answering questions for themselves)5) assitive brace devices 6) deformities (structural, functional, dynamic) 7) atrophy 8) swelling |
|
|
Term
| principles of examination |
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Definition
1) Tell pt what you are doing
2) Vital signs as appropriate
3) Perform tests appropriate to condition/dx
4) Test noninvolved side first
5) Active → Passive (Overpressure) → Isometric
6) Painful movements done last
7) OP done with care, when performed
8) The thumb is not a palpating instrument
9) Repeat/sustain movements as necessary
10)Isometric movements in rest position
11) Passive movements (degree, quality)
12) Ligamentous testing (repeat with stress)
13) Myotome testing – hold contractions 5 sec
14) Warn pt of possible exacerbation
15) Maintain pt dignity |
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|
Term
|
Definition
1) skin
2) subcutaneous tissue
3) peripheral circulation (pulses)
4) muscles
5) ligaments
6) bones |
|
|
Term
|
Definition
| tenderness, color, temperature, moisture, texture |
|
|
Term
| temperature of skin- acute vs chronic |
|
Definition
acute- moist and warm
chronic- cool and dry; smooth and shiny |
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|
Term
|
Definition
| tone, guarding, trigger points, disruption of continuity |
|
|
Term
|
Definition
|
|
Term
|
Definition
| subluxation/dislocation, tenderness, callous |
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|
Term
|
Definition
| Limited examination of anatomic and physiological status of all systems.Scanning examination |
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|
Term
| Reason for scanning examination of systems review? |
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Definition
| to r/o possible symptoms from other areas (spinal cord and nerve roots, peripheral nerves, visceral involvement) |
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Term
|
Definition
| dermatome, myotome, sclerotome |
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Term
| referred pain should always be suspected when? |
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Definition
| pt complains of deep burning or ache along a limb, of pain from the back of trunk to anterior aspect, or deep pain of large extent with no boundaries, pain presents no signs of disorder and no disturbance of function of the painful part |
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|
Term
| types of neural involvement |
|
Definition
Referred px
Radicular px (Radiculopathy)
Myelopathy (UMN lesion)
Poyneuropathy
Neuropraxia
Axonotmesis
Neurotmesis |
|
|
Term
|
Definition
| Pain "radiated" along the dermatome (sensory distribution) of a nerve due to inflammation or other irritation of the nerve root (radiculopathy) at its connection to the spinal column |
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Term
|
Definition
| UMN lesion resulting from sagittal narrowing of the spinal canal. |
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Term
|
Definition
| Nerve is intact but not longer transmitting impulses |
|
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Term
|
Definition
| Several nerves are involved |
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|
Term
|
Definition
| Nerve injury by disruption of the axon and myelin sheath but with preservation of connective tissue fragments, resulting in degeneration of the axon distal to the injury site |
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|
Term
|
Definition
| Complete severance of nerve with disruption of axon, myelin sheath, and connective tissue elements |
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|
Term
| examination of specific joints |
|
Definition
1) Contractile vs inert
2) Active (physiological/osteokinematic movement)
3) Passive movement
4) Acute vs chronic
5) End-feel
6) Capsular vs noncapsular pattern
7) Accessory (arthrokinematic) movement
8) Contractile tissues (isometric resistance) |
|
|
Term
|
Definition
CONTRACTILE- Tension via stretching or contraction.
INERT- Structures not considered contractile or neural. |
|
|
Term
|
Definition
| Joint capsules, ligaments, bursae, blood vessels, cartilage, dura mater |
|
|
Term
|
Definition
| Muscles, their tendons, & attachments to bone |
|
|
Term
| contractile lesions (cyriax) testing |
|
Definition
| strong and painless, strong and painful, weak and painless, weak and painful |
|
|
Term
|
Definition
| contraction indicates a normal finding |
|
|
Term
|
Definition
| Grade I contractile lesion- local lesion of muscle unit |
|
|
Term
|
Definition
| complete rupture of muscle-tendon unit. peripheral nerve involvement |
|
|
Term
|
Definition
| serious pathology such as significant muscle tear or tumor (ex-fx) |
|
|
Term
| inert tissue lesion pattern |
|
Definition
1) pain free- full ROM
2) pain and limited in all directions
3) pain and excessive or limited ROM in some directions
4) pain free limited ROM |
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|
Term
| Pain and ltd in all directions |
|
Definition
| entire joint effected- arthritis or capsulitis |
|
|
Term
| pain and excessive or limited in some directions |
|
Definition
| ligament sprain or capsular adhesion |
|
|
Term
|
Definition
|
|
Term
| What to observe with active movements |
|
Definition
1) When & where px occurs
2) Do movements ↑ or change quality of px
3) Pt reaction
4) Amount of observable restriction
5) Pattern of movement
6) Rhythm & quality of movement
7) Associated joints/compensatory movements
8) Willingness of pt to move/ROM |
|
|
Term
| What to observe with passive movement |
|
Definition
1) When & where px begins
2) Whether movement ↑ or changes quality of px
3) End feel
4) Movement of associated joints
ROM |
|
|
Term
| Sequence of pain- RED light |
|
Definition
|
|
Term
| pain before resistance suggests? whats contraindication |
|
Definition
| active lesion or extraarticular limitation of movement- stretching contraindicated |
|
|
Term
| Sequence of pain- yellow light! |
|
Definition
| pain synonomous with resistance |
|
|
Term
| pain synonomous with resistances indicates? capuslar feel? hard feel? |
|
Definition
| tear in muscle belly (muscle injuury, joint injury). capsular feel- gently stretching may be cautiously attempted.hard feel- postopone stretching a little longer |
|
|
Term
| Sequence of pain- Green light |
|
Definition
| resistance before pain, suggests stretching will be tolerated |
|
|
Term
| osteokinematics vs athrokinematics |
|
Definition
OSTEO- Occurs when an object forms the radius of an imaginary circle around a fixed point. Physiologic motion
ARTHRO- Motions occurring at joint surfaces. Accessory motion/Joint play |
|
|
Term
|
Definition
| 1) bone to bone 2) soft tissue approximation 3)elastic 4) capsular |
|
|
Term
|
Definition
Abrupt, unyielding
Example: Elbow extension |
|
|
Term
| Soft tissue approximation end feel |
|
Definition
Forgiving, gives impression that further motion is possible if enough force supplied
Ex- Knee flexion; elbow flexion in muscular subjects |
|
|
Term
|
Definition
Stretches with elastic recoil, further forcing feels as if something would snap
Wrist flexion with finger flexion |
|
|
Term
|
Definition
Produced by capsule or ligaments
Stretch w/o elasticity
Examples: wrist flexion (soft); knee / (hard) |
|
|
Term
| abnormal end feel classifications |
|
Definition
| springy block, boggy, spasm, empty, facilitation |
|
|
Term
|
Definition
Rebound sensation, as if pushing off from a rubber pad
Example: Meniscal tear of knee |
|
|
Term
|
Definition
Produced by viscous fluid in joint
Squishy sensation as joint moves toward end range
Example: Hemarthrosis of knee |
|
|
Term
|
Definition
Abrupt or “twangy” end to movement produced by reflex or reactive muscle contraction
Examples: grade II muscle tear; significant traumatic arthritis |
|
|
Term
|
Definition
LOM with no tissue resistance, resistance is fr pt being unable to tolerate further motion 2° px
Examples: acute subdeltoid bursitis; sign of the buttock |
|
|
Term
|
Definition
Light resistance t/o latter half of range that does not prevent end range being achieved
Example: spinal facilitation at any level |
|
|
Term
| Capsular vs Noncapsular pattern |
|
Definition
CAPSULAR- limitation in a joint in a joint specific ration. Proportional LOM
Product of total joint reaction
Each joint has a characteristic pattern
Only joints that are controlled by muscles
NONCAPSULAR- limitation in a joint in any pattern other than a capsular one |
|
|
Term
|
Definition
| allows the least amount of distraction of the joint surfaces and reduces the available degrees of freedom to zero (avoided when assesing the accessory motion of a joint |
|
|
Term
|
Definition
| resting, position of the joint used for joint mobilization |
|
|
Term
|
Definition
| Involuntary obligatory joint motion occurring outside the joint accompanies active motion. (screw home mechanism) |
|
|
Term
|
Definition
0: Ankylosis
1: Extremely hypomobile
2: Slightly hypomobile
3: Normal
4: Slightly hypermobile
5: Extremely hypermobile
6: Unstable |
|
|
Term
| deep tendon reflex of jaw |
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
0 Absent
1+ Diminished
2+ Normal
3+ Exaggerated
4+ Clonus, very brisk |
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|
