Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
186 Cards in this Set
- Front
- Back
this is a manual therapy technique comprising a continuum of skilled passive movements to the joints and/or related soft tissues that are applied at varying speeds and amplitudes
|
joint mobilization/manipulation
|
|
this is a passive joint movement for increasing ROM or decreasing pain; applied to joints at varying speeds using physiologic or accessory motions
|
mobilization
|
|
this is a passive joint movement for increasing joint mobility that incorporates a sudden, forceful thrust that is beyond the patient's control
|
manipulation
|
|
these are self-stretching techniques that specifically use joint traction or glides that direct that stretch force to the joint capsule
|
self-mobilization (automobilization)
|
|
these are concurrent application of a sustained accessory mobilization applied by a clinican and an active physiologic movement to end range applied by the patient
|
mobilization with movement (MWM)
|
|
what are three uses of joint mobilizations?
|
(1) modulate pain
(2) increase ROM (3) treat joint dysfunctions that limit ROM by specifically addressing altered joint mechanics |
|
what are five factors that may alter joint mechanics?
|
(1) pain and muscle guarding
(2) joint hypomobility (3) joint effusion (4) contractures or adhesions in the joint capsules or supporting ligaments (5) malalignment or subluxation of bony surfaces |
|
what are the two things that you are looking for during a joint mobilization?
|
(1) changes in tissue tension
(2) patient's response |
|
careful observation of a joint's PICR includes what three things?
|
(1) observation of skeletal/bone motion during AROM
(2) changes in the muscle can affect joint motion (3) the muscle impairment may cause poor joint tracking, particularly when it is at the end range |
|
motions of the bones
|
osteokinematics
|
|
motions that are performed voluntarily, such as flexion, extension, abduction, etc.
|
physiological movements
|
|
these are the different directions of motion of which each joint is capable
|
degrees of freedom
|
|
refers to motions of the bone surfaces within the joint; accessory motions
|
arthrokinematics
|
|
use an active contraction of deep muscles that attach near the joint and whose line of pull can cause the desired accessory motion (joint play)
|
muscle energy techniques
|
|
what are the five arthrokinematic motions?
|
slide, roll, spin, compression, distractin
|
|
this is a high-velocity, short amplitude motion that the patient can not prevent; used to snap adhesions and stimulate joint receptors
|
thrust
|
|
this arthrokinematic movement occurs when one bone rotates around a stationary longitudinal mechanical axis (i.e. shoulder flexion/extension, hip flexion/extension)
|
spin
|
|
this arthrokinematic motion is when a series of points on one articulating surface come into contact with a series of points on another surface (i.e. femoral condyles on tibial plateau)
|
roll
|
|
this arthrokinematic motion is when a specific point on one surface comes into contact with a series of points on another surface
|
slide
|
|
the treatment plane of a joint follows which surface, convex or concave?
|
concave
|
|
this arthrokinematic movement is when two surfaes are pulled apart, and are often used to increase stretch fo the capsule, alleviate compression on related tissues
|
traction/distraction
|
|
this arthrokinematic motion is when two surfaces are pressed together; used to add stability to a joint
|
compression
|
|
what arthrokinematic motion is a normal reaction of a joint to muscle contraction?
|
compression
|
|
in what portion of the spine is rotation of the atlas coupled with slight lateral flexion ot th eother side?
|
Craniocervical spine (C0/1/2)
|
|
in this section of the spine, lateral flexion and rotation occur ipsilaterally
|
cervical spine (C2-C7)
|
|
in this section of the spine, lateral flexion and ipsilateral rotation occur together, in that the spinous processes move toward the convexity of the lateral curvature
|
thoracic spine
|
|
research suggests there is an overall contralateral pattern in the couple movements of which part of the spine?
|
lumbar spine
|
|
this is the position of the joint where the articulating surfaces are maximally separated, and there are minimal compression forces; joint exhibits greatest amount of excursion here
|
open-packed
|
|
in what position is joint mobility assessed, and do joint mobilizations often begin in?
|
open-packed
|
|
this joint position is the position of maximal congruency of the articular surfaces; ligamentous structures are on maximal stretch and this may be used when you progress the vigor of a joint mob technique
|
close-packed position
|
|
this is a characteristic pattern oflimitation of certain movements for a joint, and is specific for each joint. Limited in a fixed proportion, not a fixed degree, and indicates that the entire joint capsule is restricted
|
capsular pattern of restriction
|
|
this is an objective finding found on examination that reproduces the pain or demonstrates the abnormality relevant to why the patient is seeking treatment
|
comparable sign
|
|
this is the motion you assess before and after performing a joint mobilization technique to assess any improvement in the joint condition
|
comparable sign
|
|
this is the point in movement where the therapist feels something pushing back
|
resistance
|
|
this is the resistance point where there is an ONSET of resistance
|
R1
|
|
this is the resistance point where there is an anatomical barrie
|
R2
|
|
this is the soft tissue limit that has a soft to hard endfeel and is the end of active range of motion
|
physiological barrier
|
|
this is the final limit to motion and has a firm endfeel, and further movement would cause damage. This is R2, the end of passive joint motion
|
anatomical barrier
|
|
this is a tissue sensation at the end of passive range of motion assessed by the therapist
|
endfeel
|
|
in the Maitland technique, this grade is a small amplitude within resistance free range of motion
|
Grade I
|
|
in the Maitland technique, this grade is a large amplitude within resistance free range of motion
|
Grade II
|
|
in the Maitland technique, this grade is a large amplitude into resistance
|
Grade III
|
|
in the Maitland technique, this grade is a small amplitude into resistance
|
Grade IV
|
|
what are the three nutritional effects of joint mobilization?
|
(1) small gliding motions cause synovial fluid movement
(2) distributes synovial fluid to atrophied or avascular articular cartilage (3) movement can improve nutrient exchange due to joint swelling and immobilization |
|
what are two mechanical effects of joint mobilization?
|
(1) maintains extensibility and tensile strength of articular and periarticular tissues
(2) improves mobility of hypomobile joints (adhesions and thickened CT from immobilization loosens) |
|
what is the neurophysiological effect of joint mobilization?
|
provides sensory/afferent input to joint receptors for regulation of muscle tone, static position, speed of movement, change of speed, sense of direction and alter nociceptive stimuli
|
|
what are the five principles of assessment from a joint perspective?
|
(1) determine need for mobilization
(2) relate to diagnosis (3) establish relationship of pain and resistance (4) determine choice of technique, dosage, progression and effect of treatment (5) performed at initial exam, during and betwen treatment techniques and at the end of te treatment session |
|
what are 6 indications for joint mobilization?
|
(1) joint hypomobility
(2) joint pain (3) muscle spasm/guarding (4) correct position faults (5) prevent loss of motion and maintain joint play (6) joint nutrition |
|
in theory, this is a positional fault of a joint that exists with joint stiffness, preventing that joint from returning to its neutral or rest position
|
mechanical dysfunction of a joint
|
|
what are the five possible causes of mechanical dysfunction of a joint?
|
(1) lack of tracking of opposing joint surfaces
(2) Hitching within the joint, roughened surface (3) thixotripic property of the synovial fluid-get sticky (4) fringe of synovium caught between joint surface (5) meniscoids in the zygapophyseal joints entrapped |
|
what are five contraindications to joint mobilization?
|
(1) evidence of vertebrobasilar insufficiency
(2) serious pathology such as bone disease, malignancy of the spine, infection (3) post-surgical fusions (4) spinal cord signs (5) new total joint replacements |
|
the earliest signs of joint dysfunction are often abnormalities in what type of motions?
|
accessory
|
|
what are the duration parameters for a joint mobilization technique treating pain?
|
10-30 seconds, 1-3 bouts
|
|
what are the duration parameters for a joint mobilization technique treating stiffness?
|
30-60 second bouts, 3-6 bouts
|
|
what are the concave-convex surfaces at the hip joint?
|
concave acetabulum, receives convex femoral head
|
|
what are the concave-convex surfaces at the tibiofemoral joint?
|
concave tibial plateaus articulate with convex femoral condyles
|
|
what are the concave-convex surfaces at the talocrural joint?
|
convex talus articulates with concave mortise (tibia and fibula)
|
|
what are the concave-convex surfaces at the subtalar joint?
|
convex calcaneus articulates with concave talus
|
|
what are the concave-convex surfaces at the GH joint?
|
concave glenoid fossa receives the convex humeral head
|
|
what are the concave-convex surfaces at the humeroulnar joint
|
convex trochlea (humerus) articulates with concave olecranon (ulna)
|
|
what are the concave-convex surfaces at the humeroradial joint?
|
convex capitulum (humerus) articulates with concave radial head
|
|
what are the concave-convex surfaces at the proximal radioulnar joint?
|
convex rim of radial head articulates with concave radial notch on ulna
|
|
what are the concave-convex surfaces at the distal radioulnar joint?
|
concave ulnar notch of the radius articulates with the convex head of ulna
|
|
what are the concave-convex surfaces at the radiocarpal joint?
|
concave distal radius articulates with convex proximal row of carpals (scaphoid, lunate, triquetrium)
|
|
what is the resting position of the hip?
|
30 degrees flexion and abduction, slight ER
|
|
what are three mobilizations that can increase flexion at the hip?
|
(1) caudal glide resting
(2) caudal glide in flexion (3) physiological flexion |
|
what are the arthrokinematics of hip flexion?
|
anterior roll, posterior glide
|
|
what is the resting position of the tibiofemoral joint of the knee?
|
25 degrees flexion
|
|
what is the resting position of the proximal tibiofibular joint?
|
25 degrees flexion at knee, 10 degrees PF
|
|
what is the resting position of the patellofemoral joint of the knee?
|
0 degrees extension
|
|
what are three mobilizations that can increase knee flexion?
|
(1) patellofemoral caudal glide
(2) patellofemoral medial and lateral glides (3) tibiofemoral posterior glide (tibia on femur) |
|
what are the arthrokinematics of knee flexion?
|
posterior roll, posterior glide)
|
|
what are four mobilizations that can increase knee extension?
|
(1) patellofemoral cephalad glide
(2) patellofemoral medial and lateral glide (3) tibiofemoral anterior glide (tibia on femur) (or posterior glide of femur on tibia) (4) physiological extension |
|
what is the resting position of the distal tibiofibular joint?
|
10 degrees talocrural plantarflexion
|
|
what is the resting position of the talocrural joint?
|
10 degrees talocrural plantarflexion, neutral inversion/eversion
|
|
what is the resting position of the subtalar joint?
|
10 degrees talocrural plantarflexion, neutral inversion/eversion
|
|
what are three mobilizations that increase dorsiflexion in the ankle?
|
(1) distal tib/fib posterior glide
(2) talocrural posterior glide (3) talocrural caudal glide |
|
what are the arthrokinematics of dorsiflexion at the ankle?
|
anterior roll, posterior glide
|
|
what are two mobilizations that can incrase plantarflexion at the ankle?
|
(1) talocrural anterior glide
(2) talocrural caudal glide |
|
what are the arthrokinematics of plantarflexion at the ankle?
|
posterior roll, anterior glide
|
|
what are two mobilizations that increase eversion at the ankle?
|
(1) subtalar medial glide
(2) talocrural caudal glide |
|
what are the arthrokinematics of ankle eversion?
|
lateral roll, medial glide
|
|
what are two mobilizations that increase inversion at the ankle?
|
(1) subtalar lateral glide
(2) talocrural caudal glide |
|
what are the arthrokinematics of ankle inversion?
|
medial roll, lateral glide
|
|
what are five mobilizations that can increase GH joint flexion?
|
(1) lateral distraction at neutral
(2) lateral distraction at 90 (3) posterior glide (4) posterior glide in 90 (5) physiological flexion |
|
what are the arthrokinematics of GH joint flexion?
|
spinning of humeral head on glenoid fossa
|
|
what are three mobilizations that can increase horizontal adduction at the GH joint?
|
(1) lateral distraction in neutral
(2) lateral distraction at 90 (3) posterior glide in 90 |
|
what are the arthrokinematics of humeral horizontal adduction?
|
anterior roll, posterior glide
|
|
what are three mobilizations that can increase abduction at the GH joint?
|
(1) lateral distraction neutral
(2) caudal glide (3) caudal glide in 90 abduction |
|
what are the arthrokinematics of internal rotation at the GH joint? (with arm down by side)
|
anterior roll, posterior glide
|
|
what are two mobilizations that can increase internal rotation at the GH joint?
|
(1) lateral distraction neutral
(2) posterior glide |
|
what are two mobilizations that can increase external rotation at the GH joint?
|
(1) lateral distraction neutral
(2) physiological lateral rotation |
|
what are the arthrokinematics of external rotation at the GH joint? (with arm down by side)
|
posterior roll, anterior glide
|
|
what is the resting position of the humeroulnar joint?
|
70 degrees flexion, 10 degrees supination
|
|
what is the resting position of the humeroradial joint?
|
elbow extension, forearm supination
|
|
what is the resting position of the proximal radioulnar joint?
|
70 degrees elbow flexion, 35 degrees supination
|
|
what are three mobilizations that increase elbow flexion?
|
(1) humeroulnar distraction
(2) humeroulnar distraction progressiom (3) humeroradial volar glide |
|
what are the arthrokinematics of elbow joint flexion?
|
anterior roll, anterior glide
|
|
what are three mobilizations that increase elbow extension?
|
(1) humeroulnar distraction
(2) humeroulnar distraction progression (3) humeroulnar dorsal glide |
|
what are the arthrokinematics of elbow joint extension?
|
posterior roll, posterior glide
|
|
what is a mobilization that can increase forearm supination?
|
proximal radioulnar volar glide
|
|
what is a mobilization that can increase fororearm pronation?
|
proximal radioulnar dorsal glide
|
|
what are the arthrokinematics of forearm supination?
|
anterior roll, posterior glide
|
|
what are the arthrokinematics of forearm pronation?
|
posterior roll, anterior glide
|
|
what is the resting position of the distal radioulnar joint?
|
10 degrees supination
|
|
what is the resting position of the radiocarpal joint?
|
neutral to slight wrist extension
|
|
what are 8 mobilizations that can increase wrist flexion?
|
(1) radiocarpal distraction
(2) radiocarpal dorsal glide (3) scaphoid on radius dorsal glide (4) lunate on radius dorsal glide (5) triquetrium on disc dorsal glide (6) trapezium on scaphoid volar glide (7) triquetrium on hamate volar glide (8) lunate on capitate volar glide |
|
what are the arthrokinematics of wrist flexion?
|
volar roll, dorsal glide
|
|
what are nine mobilizations that can increase wrist extension?
|
(1) radiocarpal distraction
(2) radiocarpal volar glide (3) scaphoid on radius volar glide (4) lunate on radius volar glide (5) triquetrium on disc volar glide (6) scaphoid on trapezium/trapezoid volar glide (7) hamate on triquetrium volar glide (8) capitate on lunate volar glide (9) trapezoid on capitate volar glide |
|
what are the arthrokinematics of wrist extension?
|
dorsal roll, volar glide
|
|
what are two mobilizations that increase supination of the forearm at the DRUJ?
|
(1) distal radioulnar joint dorsal glide
(2) radiocarpal distraction |
|
what are two mobilizations that increase pronation of the forearm at the DRUJ?
|
(1) distal radioulnar joint volar glide
(2) radiocarpal distraction |
|
what is the resting position of the MCP joint?
|
slight flexion
|
|
what is the resting position of the MTP joints?
|
10 degrees extension
|
|
what are two mobilizations that will increase flexion of the MCP joint?
|
(1) MP distraction
(2) MP volar glide |
|
what are the arthrokinematics of MCP flexion?
|
volar roll, volar glide
|
|
what are two mobilizations that will increase extension of the MCP joint?
|
(1) MP distraction
(2) MP dorsal glide |
|
what are the arthrokinematics of MCP extension?
|
dorsal roll, dorsal glide
|
|
what is a mobilization that can increase flexion at the MTP joint?
|
plantar glide
|
|
what are the arthrokinematics of MTP flexion?
|
plantar roll, plantar glide
|
|
what is a mobilization that can increase extension at the MTP joint?
|
dorsal glide
|
|
what are the arthrokinematics of MTP extension?
|
dorsal roll, dorsal glide
|
|
what is the resting position of the lumbar spine?
|
slight flexion
|
|
what is the closepacked position of the lumbar spine?
|
extension and ipsilateral side bending
|
|
what is the capsular pattern of the lumbar spine?
|
equal limitation of ipsilateral side bending, and extension greater than flexion
|
|
what are three things that you are assessing with PPIVMS of the spine?
|
(1) quantity of movement
(2) quality of movement (3) end range |
|
what are four mobilizations for central symptoms in the lumbar spine?
|
(1) central PA (increase overall ROM, extension esp.)
(2) unilateral PA (performed bilaterally to increase overall ROM, extension) (3) rotation mob performed bilaterally (4) passive flexion or extension PPIVM |
|
what are three mobilizations for unilateral symptoms in the lumbar spine?
|
(1) unilateral PAs to increase rotation and sidebending
(2) rotation to one direction (3) sidebending as a PPIVM to one direction |
|
what spinal mobilizations would you use for someone with a flexion impairment of the lumbar spine?
|
central and unilateral PAs bilaterally to increase accessory glide for extension
|
|
what spinal mobilizations would you use for someone with an extension impairment of the lumbar spine?
|
flexion PPIVMS or rotation mob performed in both directions to gap facets and improve flexion
|
|
what spinal mobilizations would you use for someone with a rotation impairment of the lumbar spine?
|
rotation mob in the direction that may correct impairment; sidebending PPIVM
|
|
what four thoracic vertebrae have spinous processes that are in the same plane as the transverse processes and vertebral bodies?
|
T1-T3, T12
|
|
what are the four thoracic vertebrae whose spinous processes project downward halfway between its own TPs and the one below it?
|
T4-T6, T11
|
|
what are the four vertebrae whose spinous process projects downward in the plane a full level below its own transverse processes?
|
T7-T9, T10
|
|
what are six mobilizations used in the thoracic spine for central symptoms?
|
(1) central PA to increase overall ROM esp ext
(2) unilateral PA bilaterally (3) unilateral PA on costovertebral joints/ribs bilaterally (4) rotation mob bilaterally (5) sidebending mob bilaterally (6) passive flexion or extension PPIVM |
|
what are the five mobilizations used in the thoracic spine for unilateral symptoms?
|
(1) unilateral PAs to increase rotation and sidebending
(2) unilateral PA on costovertebral joints/ribs (3) rotation to one direction (4) sidebending mob to one direction (5) sidebending as a PPIVM to one direction |
|
what are five mobilizations used in the cervical spine for central symptoms?
|
(1) central PA
(2) unilateral PA performed bilaterally (3) rotation mob performed bilaterally (4) cervical distraction (5) flexion or extension PPIVM |
|
what are six mobilizations used in the cervical spine for unilateral symptoms?
|
(1) unilateral PAs for rotation and sidebending
(2) unilateral PA on costovertebral joints and along ribs (3) Rotation to one direction (4) cervical distraction (5) sidebending as a PPIVM to one direction (6) SNAGs |
|
how would you differentiate between vertebrobasilar insufficiency and vestibular issues?
|
perform standing test (holding head in full rotation for 10 seconds)
|
|
what is the comparable sign for hip caudal glide in neutral?
|
any limited movement (flexion is easiest)
|
|
what is the comparable sign for hip caudal glide in 90 flexion?
|
hip flexion
|
|
what is the comparable sign for physiological flexion?
|
hip flexion
|
|
which way does the patella glide during knee flexion?
|
inferiorly
|
|
which way does the patella glide during knee extension?
|
superiorly
|
|
what is the comparable sign for patellofemoral caudal glide?
|
knee flexion
|
|
what is the comparable sign for patellofemoral cephalad glide?
|
extension
|
|
what are the comparable signs for patellofemoral medial/lateral glides?
|
knee flexion or extension
|
|
what is the comparable sign for posterior glide of tibia on the femur at the tibiofemoral joint?
|
knee flexion
|
|
what is the comparable sign for anterior glide of tibia on the femur at the tibiofemoral joint?
|
knee extension
|
|
what is the normal way for the fibula to move on the tibia during knee flexion?
|
anterior glide of fibula on tibia with knee flexion
|
|
when the person is moving from neutral to dorsiflexion, what is the normal motion of the fibula in relation to the tibia at the distal tibiofibular joint?
|
(1) fibula medially rotates
(2) lateral displacement (widening) (3) posterior and superior glide |
|
during plantarflexion, what is the normal motion of the fibula in relation to the tibia at the distal tibiofibular joint?
|
narrowing
|
|
what can you use an anterior glide mobilization with movement at the proximal tibiofibular joint to correct?
|
posterior positional fault of fibula
|
|
what is the comparable sign for the anterior glide mobilization with movement at the proximal tibiofibular joint?
|
painful ankle motion, pain with weightbaring in knee flexion, posterior lateral knee pain
|
|
what is the comparable sign for posterior glide at the distal tibiofibular joint?
|
dorsiflexion
|
|
what is the comparable sign for posterior glide of the talocrural joint?
|
dorsiflexion
|
|
what is the comparable sign for talocrural anterior glide?
|
plantarflexion
|
|
what is the comparable sign for caudal glide at the talocrural joint?
|
any limited movement (pick most limited)
|
|
what is the comparable sign for lateral glide at the subtalar joint?
|
inversion
|
|
what is the comparable sign for medial glide at the subtalar joint?
|
eversion
|
|
what is the comparable sign for dorsal glide at the MTP joint?
|
MTP extension
|
|
what is the comparable sign for plantar glide at the MTP joint?
|
MTP flexion
|
|
what is the capsular pattern of the thoracic spine?
|
equal limitation in all directions
|
|
what is the capsular pattern of the cervical spine?
|
approximately equal limitation of side bending, rotation, and extension greater than flexion
|
|
what is the comparable sign for dorsal glide at the distal radioulnar joint?
|
supination
|
|
what is the comparable sign for volar glide at the distal radioulnar joint?
|
pronation
|
|
what is the comparable sign for dorsal glide at the radiocarpal joint?
|
wrist flexion
|
|
what is the comparable sign for volar glide at the radiocarpal joint?
|
wrist extension
|
|
what part of the shoulder joint capsule is stretched during GH flexion?
|
posterior and inferior
|
|
what part of the shoulder joint capsule is stretched during ER at the side?
|
anterior
|
|
what part of the shoulder joint capsule is stretched during ER at 90 degrees?
|
anterior, posterior, and inferior
|
|
what is the resting position of the GH joint?
|
40-45 degrees abduction
|
|
what is the comparable sign for GJ joint lateral distraction in neutral?
|
any limited movement (pick most limited)
|
|
what is the comparable sign for lateral distraction of the GH joint at 90 flexion?
|
GH flexion and horizontal adduction
|
|
what is the comparable sign for GH joint caudal glide in neutral?
|
abduction, reposition superiorly displaced humeral head
|
|
what is the comparable sign for GH joint caudal glide in 90 degrees abduction?
|
abduction
|
|
what are the comparable signs for GH joint posterior glide at side?
|
glenohumeral flexion and internal rotation
|
|
what are the comparable signs for GH joint posterior glide in 90 degrees flexion?
|
glenohumeral flexion and horizontal adduction
|
|
what is the comparable sign for GH joint physiological flexion?
|
shoulder flexion
|
|
what is the comparable sign for distraction at the humeroulnar joint?
|
elbow flexion or extension
|
|
what is the comparable sign for humeroulnar distraction progression?
|
elbow flexion or extension
|
|
what is the comparable sign for volar glide of the humeroradial joint?
|
elbow flexion
|
|
what is the comparable sign for dorsal glide of the humeroradial joint?
|
elbow extension
|
|
what is the comparable sign for dorsal glide at the proximal radioulnar joint?
|
pronation
|
|
what is the comparable sign for volar glide at the proximal radioulnar joint?
|
supination
|
|
what does SNAG stand for?
|
sustained natural apophyseal glides
|