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Quiz 4
Mckenzie, Upper, Lower extremities
91
Anatomy
Professional
08/30/2012

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Term
____physical therapy and exercise used to extend the spine can help "centralize" the patient’s pain by moving it away from the extremities (leg or arm) to the back. Back pain is usually better tolerated than leg pain or arm pain, and the theory of the approach is that centralizing the pain allows the source of the pain to be treated rather than the symptoms.
Definition
McKenzie approach
Term
____self-healing and self-treatment are important for the patient’s pain relief and rehabilitation.
Definition
Central tenant of the mckenzie approach
Term
passive modalities of the mckenzie method are
Definition
NONE—such as heat, cold, ultrasound, medicine or needles—are used in the treatment.
Term
What is the long term goal of the McKenzie method
Definition
teach patients suffering from neck pain and/or back pain how to treat themselves and manage their own pain for life using exercise and other strategies.
Term
The McKenzie method's goal is to ___ the patients visit
Definition
minimize
Term
In order for the McKenzie method to work with its design to help patients you need the pain to
Definition
centralize
Term
What are some patients where pain would not centralize
Definition
lumbar spinal stenosis, facet joint osteoarthritis, extending the spine may actually increase their pain
Term
What is the highest clinical categories of back pain
Definition
simple back pain (90%)
Term
What is the second highest category of back pain
Definition
nerve root pathology (<10%)
Term
Serious spinal pathology incidence is in about ___%
Definition
2%
Term
What are the 3 syndromes in the mckenzie method
Definition
postural, dysfunction, derangement
Term
____characterized by intermittent pain brought on only by prolonged static loading of normal tissues.
Definition
Postural Syndrome
Term
What is essential in a postural syndrome?
Definition
time is causative component in prolonged loading
Term
Patients with postural syndrome experience how much pain and movement with activity
Definition
no pain and full rom
Term
To provoke pain in what syndrome is slumped sitting which results in prolonged end-range positioning of the joint capsules or adjacent supportive ligaments?
Definition
Postural Syndrome
Term
In this syndrome Pain is never constant and appears only as the affected structures are mechanically loaded. Pain will stop almost immediately on cessation of loading.
Definition
Dysfunction Syndrome
Term
In dysfunction syndrome where is the pain caused from?
Definition
mechanical deformation of structurally impaired tissues from either previous trauma or inflammatory degeneration process
Term
Previous trauma or inflammatory degenerative processes will result in what deformation of tissue
Definition
contraction, scarring, adherance, adaptive shortening, or imperfect repair (pain felt when loaded)
Term
In dysfunction syndrome end range stress of ___ shortened structures
Definition
adaptively
Term
In dysfunction syndromeMechanical deformation ___ produces pain at end of range
Definition
immediately
Term
In dysfunction syndrome what 5 areas could be the cause
Definition
discogenic, zygopophyseal, ligamentous, muscular, apenurosis
Term
This is the most common mechanical syndrome. Signs and symptoms may include back pain only, back and leg pain, or leg pain only.
Definition
Derangement syndrome
Term
___causes a disturbance in the normal resting position of the affected joint surfaces.
Definition
Internal derangement
Term
Internal displacement of articular tissue of whatever origin will cause pain to remain constant until
Definition
the displacement is reduced
Term
What tissue obstructs movement in derangement syndrome
Definition
displacement of articular tissue
Term
___derangement is the model used to explain the dramatic and long-lasting detrimental or beneficial responses to movement and positioning.
Definition
Intradiscal
Term
___ is no loading strategies decrease, abolish or centratise symptoms
Definition
derangement syndrome irreducible
Term
___ is loading strategies decrease, abolish, or centralize symptoms
Definition
derangement reducible
Term
___Pain only at limited end range
Definition
dysfunction adherent nerve root
Term
___ is pain only on static loading, physical exam normal
Definition
postural
Term
If a person fails to meet a spinal mechanical classification then consider
Definition
stenosis, hip, SIJ, mechanical inconclusive, spondylo, chronic pain state
Term
Derrangement and dysfunction use what three principles
Definition
extension, flexion, and lateral
Term
Postural uses what principle
Definition
postural (skips by extension, flexion and lateral)
Term
___phenomenon in which limb pain emanating from the spine is progressively abolished in a distal to proximal direction in response to therapeutic loading strategies….. indicates a good prognosis.
Definition
centralization
Term
occurs when distal symptoms are produced and remain or distal symptoms are made more severe by loading strategies without centralisation…. the prognosis is poor.
Definition
peripheralisation
Term
What are the 4 principles of managment of derangement syndrome
Definition
achive reduction, maintain reduction, recover function, train the patient in prophylaxis
Term
___ is achieved when the pain is centralized, the obstruction to motion is removed, and the condition remains better
Definition
reduction
Term
What syndrome is the intention of the treatment procedures is to produce the symptoms at end range in order to initiate a remodeling effect upon the adaptively shortened, scarred and/or fibrosed tissues. This is the “no pain, no gain” group.
Definition
Dysfunction syndrome
Term
what is the emphasis of treatment of dysfunction syndrome
Definition
to regain lost function due to the loss of tissue extensibility, and ultimately prophylactic training is emphasized
Term
What is the intent of treatment of postural syndromes
Definition
to educate the patient in the mechanism of pain production, and train the patient to correct the postural habits at fault. This includes correct postures when sitting, standing, and lying.
Term
What are 6 prerequisites to doing a good orthopedic evaluation?
Definition
1. Take a good history
2. Understand the neuro/orho overlaps
3.Knowledge of the musculoskeletal system
4. Knowledge of Imaging studies and how to order them
5. Good clinical lab test in differential diagnosis
6. Understand ortho eval and its relation to diagnosis/treatment
Term
What are the parts to an ortho evaluation?
Definition
Inspection/Observation
Soft Tissue Palpation
Bony Palpation
Neurological Exam
ROM Studies
Orthopedic Testing
Examination of Related Areas
Diagnostic Imaging
Clinical Laboratory
Establishing Base Line to Measure Progress
Term
if a doctors goal is to promote anatomical rest, diminish muscular spasm, reduce inflammation, and alleviate pain they are in the ___ intervention stage of passive care
Definition
acute
Term
The __ stage of treatment is to increase pain free ROM, and minimize deconditioning
Definition
remobilization active care
Term
The __ stage of treatment is to restore strength and endurance and to increase physical work capacity
Definition
rehabilitation active care
Term
The ___ stage is to modify social and recreational activities, diminish risk factors, and to adapt psychological factors
Definition
Life style adaptions active care
Term
Pain will decrease after ___ weeks
Definition
3
Term
Tissue healing will be almost complete after ___ weeks
Definition
6
Term
If a patient has a NMS condition that has pain through a portion of its ROM, what types of exercise can a provider do that will provide 15 degrees of strength overflow to each side of the exercised which will add 30 degrees of improvement
Definition
Isokinetic
Term
If a patient has a one sided extremity disorder that the provider can treat/exercise the opposite side and gain 15 degrees of ROM and improvement in proprioception
Definition
neurological crossover
Term
what describes these syndromes: tendonitis, impingement syndrome, rotator cuff, epicondylitis, dequervains, and trigger finger
Definition
Overuse syndromes
Term
What are 4 modalities a provider can use to treat overuse syndromes
Definition
ice, interferential current, iontophoresis, and micro current
Term
What are 4 short term DME/Supports one can use to treat over use injuries
Definition
kinesio taping, shoulder sling, epicondyle support, and wrist/hand support
Term
How long at most would someone use supports or DME
Definition
one month
Term
What types of nutritional supports would be helpful with patients with overuse syndromes
Definition
proteolytic enzymes
Antiox + Anti inflammatory
Nerve support (neuro ease)
Magnesium Salicylate (Ultra cal-M)
White Willow Bark + Bromelain (Salizan) (aspirin)
Term
Do not give a patient white willow bark or salicylate if they are already on ___
Definition
coumadin or other blood thinners
have history of peptic ulcers
Term
What types of proproceptive training could you do with a person with overuse syndromes?
Definition
cross crawl
exercise balls
Body Blade
PNF
Term
What types of manipulation techniques would be indicated for people with overuse injuries
Definition
soft tissue (gua sha, graston, cross friction massage)
osseous adjustments
Term
What types of exercise would be utilized for people with overuse injuries
Definition
stretching, isometric, isokinetic(bands tubing), and small free weights
Term
What instructions would you give a patient with overuse syndrome
Definition
avoidance and/or alteration of precipitating factors
Term
What modalities would be utilized for bursitis?
Definition
heat, ultrasound, iontophoresis
Term
What DME/supports would you use for bursitis
Definition
NONE
Term
What nutritional support would be used for bursitis?
Definition
B6 (B6 plus B complex)
Glucosamine + anti inflammatory (joint support)
Term
What type of proprioception would be used for NMR or sensory for bursitis patients
Definition
ROM into pain and limitations
exercise balls
body blade
PNF
Term
What types of manipulation would be used for bursitis patients?
Definition
soft tissue (gua sha, graston, cross friction massage)
osseous with light mobilization
Term
What types of exercise would be used for bursitis?
Definition
isometric, stretching, isokinetic(bands and tubing, small free weights (codman's)
Term
What instructions do you give bursitis patients?
Definition
keep moving (no pain no gain)
Slow to response time
Term
If trying to treat a bursitis patient and they get worse with treatment rather than getting better than change diagnosis to ___
Definition
tendonitis
Term
What are the modalities for compression neuropathies?
Definition
heat
ultrasound
Term
When do you use DME/Supports for compression neuropathies
Definition
only during acute phase
Term
What nutritional support do you use for compression neuropathies
Definition
botanical/nerve (neuro ease)
B complex (tri-B-plex)
Term
What type of proprioceptive training would be use for NMR or sensory support of compression neuropathies
Definition
pnf
exercise ball
body blade
Term
What type of manipulation procedures would you use for a compression neuropathy
Definition
soft tissue (graston, gua sha, spray stretch)
osseous decompress entrapment
Term
What modalities are used for the treatment of traumatic injuries
Definition
ice, interferential current, micro current
Term
When do you use DME/Supports in a traumatic injury
Definition
during the passive phase only
Term
What nutritional support do you use in a traumatic injury
Definition
proteolytic enzymes (zyamin)
Formula (joint support)
Term
In a traumatic injury what type of proprioceptive training would be necessary
Definition
PNF
Exercise ball
body blade
Term
What type of manipulation would be necessary in a traumatic injury
Definition
soft tissue (prevent chronic residuals)
Osseous (mild in acute stages)
Term
What type of exercise is used in traumatic injuries
Definition
isometric (acute)
ROM stretch
Isokinetic (band and tubing)
Free weights
Term
What type of instructions do you give to a traumatic injury patient
Definition
complete full rehab program to prevent reoccurance and or early DJD
Term
What modalities would you use in the treatment of DJD
Definition
heat, ultrasound, diathermy, paraffin bath
Term
what supports/DME would you use in DJD patients
Definition
only during stressful activities and avoid if possible
Term
What nutritional support could be given for patients with DJD
Definition
glucosamine/MSM (anabolic)
Calcium/Osteoporosis (bone support)
Multi vitamin (aved multi)
Term
What type of proprioceptive training would be helpful in DJD patients
Definition
cross crawl
exercise ball
body blade
pnf
Term
What type of manipulation would be helpful in DJD patients
Definition
soft tissue (stretch, massage)
ossseous (mobilizing)
Term
What type of exercise would be helpful for DJD patients
Definition
isometric, isokinetic, light free weights, water aerobics
Term
What instructions would you give to a DJD patient
Definition
avoid stressful actives and if so use DME
Keep moving
Term
if there is a nerve injury then you need to __
Definition
care immediately
Term
if the nerve is dying then you will have ___ weeks of care
Definition
1-6
Term
if there is nerve death you will have __ weeks of care
Definition
only maintenance care (can't ever help its dead)
Term
if a person can not sleep on an extremity then think towards what condition
Definition
bursitis
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