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129 Cards in this Set
- Front
- Back
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What is contractibility? |
The ability of the skeletal muscle to shorten with force |
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What is excitability? |
The capacity to respond to a stimulus |
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What is extensibilty |
Ability of a muscle and its associated fascia to do lengthening deformation during movement of a joint through its anatomic range |
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Elasticity |
Ability of skeletal muscle recoil to their original resting length after being stretched |
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What is muscle integrity |
How much the muscle conforms to the expected anatomical and biological norms |
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What is tone? |
The resting tension and responsiveness of a muscle to passive elongation or strech |
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AKA tone |
Muscle tone |
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What is impairment |
Any loss or abnormality ofpsychological, physiological or anatomical structure or function |
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What is muscle power |
The force generated by muscle contraction |
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What is muscle endurance |
The ability to sustain a contraction |
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What is mobility |
The ease of movement and range of motion of the joint |
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What is stability |
The ability to maintain of the structural integrity of the joints |
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What are the common musculoskeletal impairments |
- tissue/ joint mobility - tissue/joint integrity - muscle function/ performance - muscle spasms - poor posture - swelling/ edema - increased MRT |
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What is hypomobility |
restricted motion of a joint or body part |
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What is Hypertonicity the result in? and where does it happen |
- Happens in the CNS - results of: - brain lesions UNM - brainstem lesions - basil ganglia lesions |
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what is are 2 types of barriers? |
- restrictive - pathological |
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Where are soft tissue dysfunctions located? |
Anywhere between the normal physiological barriers |
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What are restrictive and pathological barriers? And what do they do? |
- it's when soft tissue dysfunction is presents - limits available ROM and can change the quality of movement |
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What is stretch weakness? |
Is when a muscle is being stretched beyond its normal length but not beyond normal ROM |
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prolonged muscle elongation causing muscle muscle spindle inhibition and the creation of more sarcomeres is ________ |
Stretch weakness |
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AKA stretch weakness |
Positional weakness |
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What is tightness weakness |
Overused muscle shortens over time, changing its length-tension curve making it more readily activated and weaker after time |
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What is impairment |
Any loss or abnormality of psychological or/and anatomical sturcture |
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What is wellness |
The self perception of an individual that combines a balance of mind, body, spirit |
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T/F can you have aspects of wellness and then impairments based massage |
Ture |
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T/F wellness massage is a form of treatment? |
True |
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What can cause a decrease in elasticity and an increase in non-contractile tissues, which eventually leads to ischemia and changes to muscle fibers |
Muscle tightness |
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What are the 4 biomechanical contributors of MRT |
1) Water a. Free b. Bonded 2) Connective tissue 3) Myofibrils 4) Adipose |
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What are the 3 Contractile contributors |
1) Spasm 2) Trigger points 3) Unnecessary muscle tension |
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name 4 factors that could contribute to repetitive strain injury |
overuse of joint contractures or poor mobility scar tissue trauma |
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what symptoms would you suspeck that your patient has myositis ossifican |
return of inflammation hardness of hematoma (lesion site) |
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describe the subacute stage of injury |
decreased inflammation or has disappeared fibroblasts produce collagen pain may be experienced synchronous with tissue resistance increase of pain = increase of active resistance |
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name one way chronic inflammation is different than acute inflammation |
no signs of inflammation chronic inflammation is progressively slow |
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true or false - the primary goal of treatment for tendonitis is to challenge the tissue and realign tissue fibres to effectively deal with imposed stres |
false |
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what type of functional testing could differentiate between a tendonopathy and bursitis/bursa irritation |
active resisted |
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your client presents with pain and decrease of ROM from grade 3 strain/sprain injury 3wk ago to the quadraceps and mcl there is no inflammation 1. name 3 impairments that are likely contributing to the pain 2. what passive ROM range is primarily limited 3. what are your primary goals of treatment |
1. near-complete tear or avulsion contracture joint dysfunction 2. flexion 3. decrease of pain, increase of ROM, decrease of MRT |
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1. a marathon runner has a spasm in the left hamstring, what type of muscle spasm 2. what would be the goal of treatment |
1. intrinsic muscle spasm 2. eliminate muscle spasm |
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what are 3 findings from a physical assessment that will indicate the presence of Trp |
twitching response nodule in a taut band autonomic phenomina |
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describe 3 mechanisms that could cause a trigger point to occur in a muscle |
adaptive shortening (contracture) muscular overload poor posture emotional stress |
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list 4 muscles that would be places in a shorten position with an anterior pelvic tilt |
psoas rectus femoris quadratus lumborum iliacus |
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you find an active trigger point in QL. name 2 range of motion that would be retricted |
lateral flexion flexion |
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what is the trigger point referral pattern for glute med |
pain along posterior iliac crest, sacrum, posterior lateral buttocks and upper thigh |
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what is the trigger point referral pattern for iliopoas |
along l-spine, upper gluteal anterior thigh |
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what is the trigger point referral pattern for QL |
lateral sacrum to lateral gluteal fold |
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where are the lordotic curves are present in what regions of the spine |
c-spine l-spine |
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what is the degree varience of a pelvic tilt |
even or PSIS is slightly higher 7 - 15 degrees |
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what thoracic vertebrae is the landmark for the spine of the scapula |
T3 |
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what part of the spine are the kyphotic curve located |
thoracic and sacral regions |
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what is mechanical pain |
a pain resulting from the stretching or compression of pain sensitive of structures/tissue which contain nociceptors when they are stressed, pain is felt |
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what are the assessment finding with someone with hypomobility |
decreased range of motion muscle attachments are closer together inability of someone to assume correct posture increased resistance to active and passive elongation |
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what is contracture |
the adaptive shortening of muscle or other soft tissue |
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what massage techniques can you use for someone with contracture |
myofascial techniques |
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what does contracture prevent within the body |
prevents normal extensibility of the involved structures which can occur muscles, joint capsule, fascia and skin |
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what are possible soft tissue impairments (there are 11) |
hypo-mobility tightness weakness contracture hyper-mobility adaptive lengthening stretch weakness fascial adhesions increased resting tension myofascial trigger points reduced endurance/fatigue spasm |
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what is the most severe form of muscles tightness |
tightness weakness |
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define what it tightness weakness |
overused muscle shortens over time changing the muscles length-tension curve and becoming more readily activated and weaker over time an increase in the non contractile tissue and a decrease in elasticity, leading to hypertrophy overuse leads to ischemia and degeneration of muscle fibres, which weakens the muscle |
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define hypermobility |
increased rom |
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define adaptive lengthening |
when muscles, ligament and joint capsules are in a state of continual stretch, they can lengthen, ligament laxity results in hyper-mobility of a joint muscle attachments are further apart |
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define stretch weakness |
when muscles and fascia adaptively lengthen, they must function in a lengthened posistion |
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what is stretch weakness can be subject to in a muscle |
fatigue trigger points muscle spasm muscle may test weak or have reduced endurance. may be hypermpbile muscle attachments are further apart |
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what are fascial adhesions |
connective tissue layers may adhere to each other. |
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what does the therapist feel when palpating fascial adhesions |
there is an inability to differentiate tissues |
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how does myofascial trigger points occur |
due to an overload of muscles |
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what soft tissue impairment results in the inability to sustain a posture |
reduced endurance/fatigue |
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when is a spasm most likely to occur |
when muscles are fatigues, weak or lack of normal flexibility |
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define postural fault/faulty posture |
posture that deviates from normal no adaptive change |
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define postural dysfunction |
adaptive shortening and or muscle weakness are involved |
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define postural pain syndrome |
pain from mechanical stresses of poor/prolonged posture |
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what is the aka for lordotic posture |
hyperlordosis |
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what is hyerlordsis (lordotic posture) |
it is increased lordotic curvature of the lumbar spine ....it looks like this ' ) ' ...faces anteriorly |
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what is often accompanied with hyperlordosis |
an increase thoracic kyphosis and forward head posture |
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what can you observe in the pelvic region as a therapist when a patient has a hyperlordosis |
an anterior pelvic tilt |
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what position is the hip in when in an anterior pelvic tilt |
hip flexion |
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what muscles may limit mobility due to a lack of extensibility could include when a client has an anterior pelvic tilt |
Hip Flexors - Iliopsoas rotates frwrd when tight. Quadriceps - front thighs muscle Erector Spinae - lower back muscles |
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what muscles may be weakened or over-lengthened could include when a client has an anterior pelvic tilt |
Glute - your butt muscles Lower - Abs Hamstring - back thighs muscle |
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what are some impairments with a lordotic posture |
decreased extensibility increased resting muscle resting tension joint mobility stretch weakness fascial restrictions |
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what are some common causes for an anterior pelvic tilt |
sustained faulty posture pregnancy obesity weak abdominal muscles trauma |
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what are some symptoms associated with a patient with an anterior pelvic tilt |
muscular ache/pain - mechanical - fatigue/overuse trigger points narrowing of posterior disc spaces and IVF's that can cause compression of neurovascular structure exiting the spine approximation of articular facets leading to inflammation and synovial irritation
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what are some orthopedic testing that can be used for a patient with an anterior pelvic test |
modified thomas test ober's ely's |
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what muscles are modified thomas, ober's, ely's testing for |
modified thomas test - iliopoas, rec fem (supine)
ober's - tensor fascia lattae (side lying) ely's - rectus femoris (prone) |
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where are trigger points located with someone with lordotic posture |
gluteus maximus and medius quadratus lumborum illiopsoas |
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what is the referral pattern for iliopsoas |
Lumbar spine
Anterior thigh Upper half of thigh |
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what is the referral pattern for quadratus lumborum |
Lower abdomen
Sacroiliac joint Lower buttock upper Greater trochanter |
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what is the referral pattern for pectoralis major |
anterior deltoid long head of biceps brachaii acute back pain into the anterior chest wall medial border of upper extremity to 4&5 digits intense breast pain into the axilla |
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whatis the referral pattern for pectoralis minor |
pain along the mucle chest, shoulder and medial arm pain |
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what is the referral pattern for levator scapula |
triangular pattern from top of the scapula to the angle of the neck posterior glenohumeral joint |
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what is the referral pattern for rhomboid |
medial border of the scapula superior aspect of the spine of scapula toward acromion |
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what is the referral pattern for lower/middle trapezius |
upper: pain and tenderness post lateral neck, temporal region and angle of mandible middle: local pain radiating medially toward spine lower: post cervical spine, mastoid area above spine of scapula |
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what is the referral pattern for gluteus maximus |
pain in buttock just below gluteal fold |
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what is the referral pattern for gluteus medius |
low back medial buttock sacral and lateral hip radiating somewhat into upper thigh |
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when a muscle is in a ________ position it is likely to fatigue easily |
lengthened or shortened |
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the type of trigger point that is activated by a key trigger point is called |
satellite |
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when you perform stripping to reduce trigger point activity, apply the technique to |
the entire taut band, from end to end |
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what results with reffered pain |
trigger point |
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pain, edema, myofascial adhesion and reduced voluntary range of motion are examples of what |
impairment |
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what are some componnets of muscle resting tension |
trigger point muscle spasm holding patteren |
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what is protocol prior to treating a trigger point |
communicate about acceptable levels of pain |
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when are fascial techniques are contraindicated |
with unstable joints |
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what is the preffered exercise modality to treat adaptive lengthening in postural dysfunction is |
resistance exercise PIR |
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after massage treatment of a trigger point what do you apply |
heat 10mins and stretch 3x30sec |
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what is the intervention and primary goal of a treatment of postural dysfunction, |
treatment recovery prevention of secondary impairments |
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what are some techniques and or modalities that can help to reduce a trigger point |
specific compressions muscle stripping dry needling |
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what type of functional testing could differentiate between a tendonopathy and bursitis/ bursa |
active resistance |
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what are some key characteristics of tendonopathy |
vulnerable of repetative strain tendons no vascularized decreased perfusion increased healing time |
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what is the grade 2 MCL sprain recover time |
2-8 weeks |
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what are 3 physical findings what will indicate at trigger point |
local twitching nodule in a taut band autonomic phenomina |
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describe 3 mechanisims that could cause a trigger point to occur in a muscle |
adaptive shortening muscular overload poor posture emotional stress |
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what are 4 muscles that would be placed i a shortened position with an anterior pelvic tilt |
psoas rec fem ql iliacus |
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an acute trigger point in QL what are 2 ROM that would be restricted |
lateral flexion flexion |
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name 4 factors that could contribute to RSI |
overuse of joint contractures or poor mobility scar tissue trauma |
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what would you suspect that when your patient has myositis ossifican |
return of inflammation hardness of hematoma @ lesion site |
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describe subacute stage of injury |
decrease of inflammation fibroblast produce collagen pain may be experienced synchronous with tissue resistance |
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what muscle has a referral pattern in the temple, jaw and neck |
temporalis |
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what are the 4 clinical decision making phases |
evaluating phase treatment planning phase treatment phase discharge phase |
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what is the order of treatment generally used by massage therapist in most cases |
remove inflammation:pain/swelling range of motion strength or proprioception return of function |
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chronic swelling may not cause pain, true or false |
true |
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when is strengthening of a muscle needed |
when a muscle imbalanced, often caused by injury or re-injury |
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what can cause a decrease of muscle strength |
disuse trigger point soft tissue restriction injury |
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what is rheumatoid arthritis |
chronic systemic inflammation disease of joints and connective tissue swollen and inflamed synovium |
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does rheumatoid arthritis happen more in men or women |
women |
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what are the 4 stages of rheumatoid arthritis |
synovitis pannus formation fibrosis bony ankylosis |
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what is pannus formation |
enzymes released that destroy articular cartilage and bone. extends to the joint margins abnormal form granulation tissue degradation of bone and tissue fragility |
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bony ankylosis |
calcifaction of the panno and fibrous tissue- this leads to joint fusion deformity, disuse atrophy no joint movement |
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what boutonniere deformity |
PIP flexion DIP hyperextension |
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what is Swan Neck Deformity |
PIP hyperextension DIP flexion |
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what is ZIGZAG deformity |
MCP ulnar deviation PIP radial deviation |
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what is rheumatoid nodules |
not painful non-functional tissue not everyone with RA has them formed by collagenous tissue, adhered to tendon & fascia and reduces ROM common places heel and elbow |
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what is reynauds phenomenon |
reduces circulation of fingers, toes with cold exposure |
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what is systemic lupus |
chronic inflammation, can affect organ system idiopathic butterfly rash reduced circulation - reynauds phenomenon |
