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57 Cards in this Set
- Front
- Back
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Rotatory/Angular |
motion that happens on an angle (measured with goniometer) |
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Translatory/Linear |
motion that goes in a straight line (not measured with a goniometer) |
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Curvilinear |
Combination of rotary and translatory |
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Sagittal Plane |
divides body into left and right halves (axis of motion is medial/lateral) |
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Transverse Plane |
divides the body into top and bottom (vertical axis) |
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Coronal (Frontal) Plane |
divides the body into front and back (anterior to posterior axis) |
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Flexion/Extension |
occurs in the sagittal plane through a medial-lateral axis |
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Abduction/Adduction |
occurs in the coronal plane through an anterior-posterior axis (can occur in the frontal plane via shoulder and hip when at a 90 deg angle) |
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Medial/Lateral Rotation |
occurs in the transverse plane through a vertical plane |
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Scaption of the shoulder |
45 deg angle abduction in plane of scapula (multiplanar movement) |
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Supination and Pronation |
multiplanar movement |
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Center of Gravity (COG) |
Point at which mass is most concentrated. Lies just anterior to the S2 vertebrae. Women typically have lower COG |
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Line of Gravity (LOG) |
Vertical force of gravity acting upon the body. Will always go through the COG. Center of the ear->center of the shoulder->slightly posterior to the center of the hip->slightly anterior to the knee->slightly anterior to malleoli |
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Lordosis or Lordotic
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inward curve of the spine; found in cervical spine and lumbar spine
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Kyphosis or Kyphotic
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outward curve of the spine; found in thoracic and sacral spine
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2 major components of connective tissue |
1. cellular-fibroblasts are the basic cell of most connective tissue
2. Extracellular matrix- a. interfibrillar component/ground substance b.fibrillar component |
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Structural Proteins of the extracellular matrix |
Collagen-most abundant protein in the human body
Elastin-flexible substance that deforms under stress and returns to its original state once the stress is taken away |
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Interfibrillar component of extracellular matrix |
ground substance-occupies space between collagen (shock absorber)
hydrophillic
made up of proteoglycans, glycoproteins, and glycosaminoglycans (GAGs) |
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Collagen |
has strong tensile strength; can stretch and resist a long way; most abundant protein in the human body; helps muscle to not fail under normal tensile strength |
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Fibrous component of extracellular matrix |
-Composted of collagen and elastin -12 types of collagen in the body |
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Stress-Strain concept |
-tension, compression, or shearing -stress-load applied to material -strain-deformation of change in material; can be reversible or permanent |
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Ligament |
connects bone to bone; composed of primarily one type of collagen; arrangement of collagen is in different directions |
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Tendon |
connects muscle to bone; composed of one type of collagen; parallel fibers; osteotendinous junction - where the tendon attaches to the bone; mineralization similar to that of the bone myotendinous junction - composed of 2 different tissues; joining area between is weaker (area of gradual change)
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Tendon Unit |
-Paratenon-outer capsule/sheath of tendon(creates nice place for tendon to slide along bone via tenosynovium-lubrication for the tendon) -Epitenon-sheath that encloses individual tendon units -Endotenon-groups of tendon fibers -Fascicle->fibril->microfibril **may also see paratenon and epitendon called the peritendon (outer sheath that encloses the inner parts)
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Bursae |
*Provides cushion between structures that are approximated *synovial fluid/membrane -tendon and bone-subtendinous -bone and skin-subcutaneous -muscle and bone-submuscular -ligament and bone |
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Cartilage |
*Fibrocartilage-found in joints where little motion occurs (invertebral joints) *Elastic cartilage-flexible structures (ears) *Hyaline articular cartilage-joint cartilage |
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Bone |
*gives structure -cellular components: osteoclasts and osteoblasts
-2 layers of bone: Cancellous (inner layer: Tribecular; spongy) and Compact/cortical (outer layer: periosteum) |
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Microscopic level of bone |
-Woven bone-new bone (found in newborns and healing stages of fracture
-Lamellar-predominant in healthy adult
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Muscle |
*Creates movement about a joint and moves bone around bone *muscle->fascicle->fiber->myofibril->myofilament -Sarcolema-cell membrane that encloses the muscle fiber -Sarcoplasm-substance within which the muscle cell/myofibril is housed
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Sarcomere |
considered "contractile unit"
-contains 2 proteins: actin(tripomyosin; thin) and myosin(thick and beefy; has head groups)
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Types of Muscle Contractions |
*Concentric - shortening *Eccentric - lengthening (most difficult; ex:going down stairs) *Isometric - does not change length (ex:putting hands together, palms facing, and push) *Isotonic - series of concentric and eccentric (typical weight lifting contraction)
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Synarthritic Joints |
*Bones are connected with either fibrous or cartilaginous tissue (non-synovial) *Fibrous -sutures (in head) -gomphoses (teeth) -syndesmoses (interosseous ligement; ex: middle of tibia and fibula) *Cartilaginous -symphyses (bones brought together with articular cartilage (pubic symphyses) -synchondroses (costal cartilage)
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Diarthritic Joints |
-Articular cartilage is covered with joint capsule (synovial) -Often contain structures that increase stability, absorb shock, or facilitate motion -Synovial fluid -Types - based on number of axes and planes in which motion can occur *uniaxial - 2 motions/1 plane *biaxial - 4 motions/2 plane *triaxial - 6 motions/3 plane |
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Uniaxial |
*hinge (elbow joint, knee, phalanges)
*pivot (C1-C2 joint, proximal radioulnar joint)
*1 plane/2 motions |
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Biaxial |
*Condyloid (metacarpal joints or MCP joints)
*Saddle (Carpometacarpal joint of thumb or CMC joint)
*2 planes/4 motions
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Triaxial |
*Plane (carpal bones; joints slide and glide along each other)
*Ball and socket
*3 planes/6 motions |
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Osteokinematic Movement |
occurs between two bones (one joint) and is visible to the observing eye **what is measured with goniometer |
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Arthrokinematic Movement (accessory motion) |
movement that occurs between joint surfaces that is not typically visible to the eye
-Roll -Slide/glide -Spin **convex/concave rule** |
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Kinetic Chain |
**Describes movement that occurs at different joints in a series *Upper kinetic chain: shoulder, elbow, wrist *Lower kinetic chain: hip, knee, foot -Open-proximal end is fixed -Closed-distal end is fixed (walking, weight bearing)
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Convex/Concave Rule |
1. Concave surface moving on a convex surface, roll and glide occur in the same direction
2. Convex surface moves on a concave surface, roll and glide occur in the opposite direction |
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Closed packed joint position |
joint surfaces are most congruent with one another and the joint is most stable |
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Open packed joint position |
joint surfaces are least congruent and the joint is most mobile |
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Range Of Motion |
amount of motion available at a specific joint |
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Functional ROM |
*motion necessary to complete a task/ADL -cervical rotation necessary to turn head to drive -shoulder elevation necessary to reach into cabinet -hip flexion necessary to sit in a chair
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Goniometry |
*the measurement of joint ROM -Purpose: to track patient progress, write goals and plan of care, and compare to norms |
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Indications |
*what you're doing -when an objective data is needed -to assess progress toward goals -if a patient can maintain position to complete measurement |
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Contraindications |
*beware of what you're doing and the position -very old or very young -difficulty holding position to obtain measurement -when limitations at other joints prohibits accurate measurement (ex:muscle tightness) -post-operative movement precautions -incision or wound that could open -suspect hypermobility, subluxation, dislocation -myositis occificans or heterotrophic ossification (bone growth where you shouldn't have it; mostly middle of muscle) |
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Precautions |
*Osteoporosis or other pathology that causes brittle joints -hypermobility -hemophilia (bleeding into joint; chronic & congenital disorder) -ankylosing joints (affects spine oftenly, joint line becomes hard) -post injury - edema, tissue rupture -recently healed fracture -after prolonged immobilization -be mindful of muscle tightness vs. joint restriction *Age and Gender -children and women tend to be more hypermobile |
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Goniometric Principles and Techniques |
*Typically measured through a 180 deg arch of motion with anatomical position referenced as zero/neutral |
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ROM Concepts |
Active Range of Motion (AROM)-movement of joint segment without assistance from another body part, object, or person
Passive Range of Motion (PROM)-movement completed by an external source (ex:therapist, machine, etc.)
Active Assistive Range of Motion (AAROM)-movement completed by the patient with assistance from an external source |
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Other Goniometric Terms |
-Accessory motion (happens at jointline itself) -Joint play - free motion that occurs at a joint when the joint is relaxed -Joint mobilization - an active or passive attempt to increase the available joint ROM |
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Measurement Precautions |
-proper patient position -stabilize body segments to prevent substitution -Don't read the wrong side of the body of the goniometer!! -Always use the same technique for same joint on same patient -Don't read a higher measurement than is actually there |
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Normal Joint End Feels |
*Soft - approximation of two soft tissue structures (elbow flexion)
*Firm - springy sensation when contractile tissue is put on stretch (hip flexion, hamstring gets tight)
*Hard - abrupt stop to motion because of boney approximation (elbow extension |
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Pathological End Feels |
a) Soft - boggy, thick sensation in a joint (indicative of inflammatory process; feels spongy and odd) b) Firm - springy sensation indicating abnormal soft tissue shortening (abnormally tight muscle) c) Hard - abrupt stop to motion when rough joint surfaces contact one another (osteoarthritis, osteophytes present, fracture, dislocated joint) d) Springy block - rebound effect is felt indicating soft tissue derangement (tear or abnormality); very painful (ex: when pt has torn maniscus) e) Empty - pt's pain causes motion to cease before the true joint end feel is acheived |
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Capsular & Non-capsular Patterns |
* Description of joint motion limitations based on injury or pathology
- capsular pattern - pathology limits all or most joint motion directions (frozen shoulder)
- non-capsular pattern - limitations in motion only occur in one or two directions instead of all directions available at the involved joint |
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Correct Documentation of Joint ROM Measurements |
-need to indicate joint measured -whether measurement is active, passive, active-assistive -report based on 0-180 deg system -note any end feels or capsular patterns present -indicate if measurement is normal or abnormal |
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Sliding Filament Theory |
How a muscle contraction is produced
Action potential->chemical reaction release Ca2+ions->tripomyosin+triponin open and make actin available->head groups on myosin grab actin and pull it toward->contraction of muscle |
