Module 2 - Principles Of Positioning

Front 1

True or False:
work related muculoskelatal disorder (WMD) is an injury

Back 1

True

Front 2

WMD afftects the

Back 2

musculoskeletal, peripheral nervous, and nuerovascular systems

Front 3

WMD is caused or aggravated by

Back 3

prolonged repetitive forceful or awkward movements, poor posture, ill-fitting chairs and equipment or fast-paced workload

Front 4

musculoskeletal disorders result in more than ____ percent of all newly reported occupational injuries

Back 4

- 60

Front 5

a __________ is a task that involves the same fundamental movement for more than 50 percent of the work cycle

Back 5

repetitive task

Front 6

A painful disorder of the wrist and hand caused by compression of the median nerve within the carpal tunnel of the wrist

Back 6

Carpal Tunnel Syndrome (CTS)

Front 7

Causes of Carpal Tunnel Syndrome (CTS)

Back 7

- poor posture
- repeatedly bending the hand up, down or from side to side at the wrist
- continuously pinching gripping an instrament without resting muscles

Front 8

Symptoms of Carpal Tunnel Syndrome (CTS)

Back 8

- numbness, pain, tingling in the thumb, index and middle fingers

Front 9

The nerve fibers of the median nerve originate in the

Back 9

spinal cord in the neck

Front 10

a painful disorder of the lower arm and wrist caused by compression of the unlar nerve of the arm as it passes through the wrist

Back 10

Ulnar Nerve Entrapment

Front 11

Causes of Ulnar Nerve Entrapment

Back 11

- bending the hand up, down or from side to side at the wrist
- holding the little finger a full span away from hand

Front 12

Symptoms of Ulnar Nerve Entrapment

Back 12

- Numbness, tingling, and/or loss of strength in the lower arm or wrist

Front 13

A painful disorder of the wrist and hand caused by compression of the median nerve between the two heads of the pronator teres muscle

Back 13

Pronator Syndrome

Front 14

Causes of Pronator Syndrome

Back 14

holding lower arm away from body

Front 15

Symptoms of Pronator Syndrome

Back 15

Similar to those of carpal tunnel syndrome:
Numbness, pain, tingling in the thumb, index and middle fingers

Front 16

a painful inflammation of the tendons of the wrist resulting from strain

Back 16

Tendinitis

Front 17

Causes of Tendinitis

Back 17

Repeatedly extending the hand up or down at the wrist

Front 18

Symptoms of Tendinitis

Back 18

Pain in the wrist, expecially on the outer edges of the hand, rather than through the center of the wrist

Front 19

A painful inflammation of the tendons on the side of the wrist and at the base of the thumb

Back 19

Tenosynovitis

Front 20

Causes of Tenosynovitis

Back 20

hand twisting, forceful gripping, bending the hand back or to the side

Front 21

symptoms of Tenosynovitis

Back 21

pain on the side of the wrist and at eh tbase of the thumb; sometimes movement of the wrist yields a crackling noise

Front 22

a painful disorder of the fingers as a result of injury of the extensor muscles of the thumb

Back 22

Extensor Wad Strain

Front 23

Causes of Extensor Wad Strain

Back 23

Extending the fingers independently of each other

Front 24

symptoms of Extensor Wad Strain

Back 24

Numbness, pain, and loss of strength in the fingers

Front 25

a painful disorder of the fingers, hand and/or wrist as a result of the compression of the brachial nerve plexus and vessels between the neck and shoulder

Back 25

Thoracic Outlet Syndrome

Front 26

Causes of Thoracic Outlet Syndrome

Back 26

Tilting the head forward, hunching the shoulders forward, and coninuously reaching overhead

Front 27

symptoms of Thoracic Outlet Syndrome

Back 27

Numbness, tingling, and/or pain in the fingers, hand or wrist

Front 28

a painful inflammation of the muscle tendons in the shoulder region

Back 28

Rotator Cuff Tendinitis

Front 29

Causes of Rotator cuff Tendinitis

Back 29

holding the elbow above waist level and holding the upper arm away from body

Front 30

symptoms of rotator cuff tendinitis

Back 30

severe pain and impaired funtion of the shoulder joint

Front 31

the ideal position of the body while performing work activities and is associated with decreased risk of musculoskeletal injury

Back 31

Neutral postition

Front 32

Nuetral Seated position:

Back 32

- Forearms parallel to floor
- Weight evenly balanced
- Thighs parallel to the floor
- Hip angle of 90 degrees
- Seat height positioned low enough so that you are able to rest the heels of your feet on the floor

Front 33

Goals for Neutral Neck Position

Back 33

- head tilt of 0 - 15 degrees
- the line from eyes to the treatment are should be as near to vertical as possible

Front 34

Things to avoid for Neutral Neck Position

Back 34

- head tipped too far foward
- head titled to one side

Front 35

Goals for Neutral Back Position

Back 35

- Leaning forward slightly from the waist or hips
- trunk flexion of 0 - 20 degrees

Front 36

Things to avoid for Neutral Back Position

Back 36

- Overflexion of the spine (curved back)

Front 37

Goals for Neutral shoulder position

Back 37

- shoulders in horizontal line
- weight evenly balanced when seated

Front 38

Things to avoid for Neutral shoulder postion

Back 38

- shoulders lifted up toward ears
- shoulders hunched forward
- sitting with weight on one hip

Front 39

Goals for Neutral Upper Arm Position

Back 39

- Upper arms hang parallel to th long axis of torso
- Elbows at waist level held slightly away from body

Front 40

Things to avoid for Neutral Upper Arm postition

Back 40

- greater than 20 degrees of elbow abduction away from body
- elbows held above waist level

Front 41

Goals for Neutral Forearm Positon

Back 41

- Parallel to the floor
- Raised or lowered, if necessary, by pivoting at the elbow joint

Front 42

things to avoid for Neutral Forearm position

Back 42

- angle between forearm and upper arm of less than 60 degrees

Front 43

Goals for Neutral hand position

Back 43

- little finger-side of palm slightly lower than thumbside of palm
- wrist aligned with forearm

Front 44

Things to avoid for neutral hand position

Back 44

- thumb-side of palm rotated down so that palm is parallel to the floor
- hand and wrist bent up or down

Front 45

the position of the patient during dental treatment

Back 45

supine

Front 46

supine position is

Back 46

the patient lying on his or her back in a horizontal position an the chair back nearly parallel to the floor

Front 47

The recommended body position of the patient

Back 47

heels should be slightly higher than the tip of the nose

Front 48

what is the purpose of placing the heels slightly higher than the tip of the nose

Back 48

maintains good blood flow to the head and the more apprehensive patient is less likely to faint

Front 49

the chair back should be nearly parallel to the floor for _________ treatment areas

Back 49

maxillary

Front 50

the chair back may be raised slightly for ________ treatment areas

Back 50

mandibular

Front 51

the recommended head position of the patient during treatment

Back 51

the top of the patients head should be even with the upper edge of the headrest. If necessary ask the patient to slide up in the chair to assume position

Front 52

the recommended headrest position

Back 52

if adjustable raise or lower it so that the patient's neck and head are aligned with the torso

Front 53

True or false:
The patient should be asked to adjust his or her head position to provide the clinician with the best view of the treatment area

Back 53

True

Front 54

asking the patient to open their mouth and tilt their head down is termed the

Back 54

chin-down position

Front 55

the chin down position is used on the

Back 55

Mandibular areas

Front 56

asking your patient to open their mouth and position the head in a neutral position is termed

Back 56

the chin-up position

Front 57

the chin up position is used on the

Back 57

Maxillary areas

Front 58

_________ is the science of adjusting the desing of tools, equipment, tasks, and environment for safe, comfortable and effective human use.

Back 58

Ergonomics

Front 59

design characteristics for choosing a chair

Back 59

- legs
- height
- seat
- backrest

Front 60

the legs of the clinician chair shoud have

Back 60

- five legs for stability
- casters for easy movement

Front 61

the height of the of the clinician chair should

Back 61

- allow clinician to sit with thighs parallel to the floor. A seat range of 14 - 20 inches accommodates both tall and short clinicians
- be easily adjustable from a seated position

Front 62

a seat range of ____ to _____ inches accomodates both tall and short clinicians

Back 62

14 - 20

Front 63

the seat of the clinician chair should have the following characteristics

Back 63

- front edge of seat should have a waterfall shape (rounded front edge)
- should not be too heavily padded; thick padding requires constant minor readjustments to maintain balance
- when seated with the back against the backrest, the seat length should not impinge on the back of the clinicians knees. A seat length of 15 - 16 inches fits most clinicians

Front 64

a seat length of ____ to ____ inches fits most clinicians

Back 64

15 -16

Front 65

the backrest of the clinician chair should

Back 65

- be adjustable in both vertical and horizontal directions so that it can be positioned to touch the lumbar region of the back when comfortably seated
- angle between the seat and the chair back should be between 85 and 100 degrees

Front 66

the first component in avoiding fatigue and injury is

Back 66

proper positioning of the patient in relation to the seated clinician

Front 67

while working the clinician must be able to gain acces to the patient's mouth and dental unit without

Back 67

bending, stretching, or holding his or her elbows above waist level

Front 68

the first step is establishing neutral position in relation to the patient is

Back 68

adjust the height of the clinician chair to establish a hip angle of 90 degrees

Front 69

the 2nd step in establishing neutral position in relation to the patient is

Back 69

lower the patient chair until the tip of the patient's nose is below the clinician's waist level. Your elbow angle should be at 90 degrees when your fingers are touching the teeth in the treatment room

Front 70

Your elbow angle should be at ____ degrees when your fingers are touching the teeth in the treatment room.

Back 70

90

Front 71

What shoud you avoid when establishing neutral position in relation to the patient

Back 71

- placing your legs under the back of the patient chair - in this position the patient will be too high and you will need to raise your arms to reach the patients mouth. It is acceptable to place your legs under the headrest of the chair

Front 72

The most common positioning error made by clinicians during periodontal instrumentation is

Back 72

positioning the patient too high in relation to the clinician

Front 73

True or False
The clinician can see better if the patient is higher/closer.

Back 73

False
- the clinician has improved vision of the mouth when the patient is in a lower position

Front 74

To establish proper positioning for the patient

Back 74

sit beside the patient with your arms against your sides and crossed at your waist. The patients open mouth should be below the point of your elbow

Front 75

having the patient in proper position, you will be able to reach the mouth without

Back 75

placing stress on the muscles of your shoulders or arms

Front 76

The second component in avoiding fatigue and injury is

Back 76

proper positioning of the dental equipment in relation to the clinician

Front 77

It is important that the clinician not have to bend over or rach to access

Back 77

dental instruments or equipment

Front 78

Position of the Dental light for the Mandibular teeth

Back 78

position the dental light directly above the patient's head. The light should be as far above the patient as possible while still remaining within easy reach. In this position the light beams will shine directly down into the patient's mouth

Front 79

Position of the Bracket table for the mandibular teeth

Back 79

if the dental unit has a bracket table it should be positioned as low as possible so that the clinician can easily view the instruments resting on it. Instruments should be within easy reach

Front 80

Position of the patient chair for Mandibular teeth

Back 80

position the patient chair so that your elbo angle is at 90 degree anlge when your fingers rest on the mandibular teeth

Front 81

Light position for Maxillary teeth

Back 81

Position the dental light above the patient's chest. tilt the light so that the light beams shine into the patient's mouth at an angle. Position the light as far way from the patient's face as possible while still keeping it within easy reach

Front 82

Patient chair position for Maxillary teeth

Back 82

when instrumentation moves from the mandibular to the maxillary teeth, lower teh entire patient chair (not just chair back) until your elbow angle is at 90 degree angle when your fingers rest on the maxillary teeth

Front 83

True or False
You should not raise your elbows above waist level when working in the patient's mouth

Back 83

True

Front 84

Your legs and the stool base should form a

Back 84

tripod

Front 85

Your lower arms should be in a ________ position or raised slightly so that the angle formed between your lower and upper arm is slightly less than _____ degrees

Back 85

- horizontal
- 90

Front 86

There are ____ basic clinician positions.

Back 86

4

Front 87

The 4 basic clinician postitions are

Back 87

- 8 o'clock
- 9 o'clock
- 10 - 11 o'clock
- 12 o'clock

Front 88

the 8 o'clock position is located

Back 88

to the front of the patient's head

Front 89

the 9 o'clock position is located

Back 89

to the side of the patient's head

Front 90

the 10-11 o'clock position is located

Back 90

near the corner of the patient headrest

Front 91

the 12 o'clock position is located

Back 91

behind the patient's head

Front 92

the torso position of the 8 o'clock (to the front) position

Back 92

-sit facing the patient with your hip in line with the patient's upper arm

Front 93

the leg position of the 8 o'clock (to the front) position

Back 93

your thighs shoud rest against the side of the patient's chair

Front 94

the arm position of the 8 o'clock (to the front) position

Back 94

to reach the patient's mouth, hold your arms slightly away from your sides. Hold your lower right arm over the patient's chair. DO NOT rest your arm on the patient's head or chest.

Front 95

True or False:
It is sometimes necessary to rest your arm on the patient's head or chest to maintain neutral position.

Back 95

FALSE
- DO NOT rest your arm on the patient's head or chest

Front 96

hand position of the 8 o'clock (to the front) position

Back 96

rest the sider of you left hand in the area of teh patient's right cheek bne and upper lip. Rest the finger tips of your right hand on the anterior teeth in the patient's maxillary left quadrant

Front 97

line of vision of the 8 o'clock (to the front) position

Back 97

your line of vision is straight ahead, into the patient's mouth

Front 98

True or False
It is difficult to maintain neutral position when seated in the 8 o'clock position, therefore use of this position should be limited

Back 98

True

Front 99

Torso position of the 9 o'clock (to the side) position

Back 99

sit facing the side of the patient's head. The midline of your torso is even with the patient's mouth

Front 100

leg position of the 9 o'clock (to the side) position

Back 100

your legs may be in either of two acceptible positions
1) straddling the patient chair
2)underneath the headrest of the patient chair

Front 101

True or False
Neutral postion is best achieved in the 9 o'clock postition by straddling the chair

Back 101

True
-however use the alternate position if straddling is uncomfortable

Front 102

Arm position of the 9 o'clock (to the side) position

Back 102

to reach the patient's mouth, hold the lower half of your right arm in approximate alignment with the patient's shoulder. Hold your left hand and wrist over the region of the patient's right eye

Front 103

hand position of the 9 o'clock (to the side) position

Back 103

rest your left hand in the area of the patient's right cheekbone. Rest the fingertips of your right hand on the premolar teeth of the mandibular righ posterior sextant

Front 104

line of vision of the 9 o'clock (to the side) position

Back 104

your line of vision is striaght down into the patient's mouth

Front 105

torso position for the 10 - 11 o'clock (near corner of headrest) position

Back 105

sit at top right corner of the headrest; the midline of your torso is even with the temple region of the patient's head

Front 106

leg position for the 10 - 11 o'clock (near corner of headrest) position

Back 106

your legs should straddle the corner of the headrest

Front 107

arm position of the 10-11 o'clock (near corner of headrest) position

Back 107

to reach the patient's mouth, hold your right hand directly across the corner of the patient's mouth. hold your left hand and wrist above the patient's nose and forehead

Front 108

hand position of the 10-11 o'clock (near the corner of headrest) position

Back 108

rest your left hadn in the area of the patient's left cheekbone. rest your fingertips of your right hand on the premolar teeth of the mandibular left posterior sextant

Front 109

line of visio of the 10-11 o'clock (near the corner of headrest) position

Back 109

your line of vision is straight down into the mouth

Front 110

torso position for 12 o'clock (behind patient) position

Back 110

sit behind the patient's head; you may sit anywhere from the right corner of the headrest o directly behind the headrest

Front 111

leg position for 12 o'clock (behind patient) position

Back 111

your legs shoud straddle the headrest

Front 112

arm position for 12 o'clock (behind patient) position

Back 112

to reach the patient's mouth, hold your wrists and hands above the region of the patient's ears and cheeks

Front 113

hand position for 12 o'clock (behind the patient) position

Back 113

Place fingertips of your left hand on the anterior teeth in the maxillary left quadrant. Rest the fingertips of your right hand on the anterior teeth in the mandibular right quadrant

Front 114

line of vision for the 12 o'clock (behind the patient) position

Back 114

your line of vision is straight down into the patient's mouth

Front 115

Anterior surfaces toward when you sit at 8:00 are instrumented from the

Back 115

8 - 9 o'clock position

Front 116

Anterior surfaces away from you when you sit at 8:00 are instrumented from the

Back 116

12:00 position

Front 117

Posterior aspects facing toward you when seated at 9:00 are instrumentated from the

Back 117

9:00 position

Front 118

Posterior aspects facing away from you when seated at 9:00 are instrumented from the

Back 118

10-11 o'clock position

Front 119

Flow chart for sequence for practicing positioning

Back 119

- me
- my patient
- my equipment
- my nondominant hand
- my dominant hand

Front 120

M-pend

Back 120

-me
-patient
-equipment
-nondominant hand
-dominant hand

Front 121

1st step in sequencing for establishing position

Back 121

me - assume the clock position for the treatment area

Front 122

2nd step in sequencing for establishing postition

Back 122

my patient - establish patient chair and head position

Front 123

3rd step in sequencing for establishing position

Back 123

my equpiment - adjust the unit light. pause and self-check the clinician, patient, and equipment position

Front 124

4th step in sequencing for establishing position

Back 124

my non-dominant hand - place fingertips of my nondominant hand in the correct position for particular clock position

Front 125

5th step in sequencinf for establishing position

Back 125

my dominant hand - place the fingertips of my dominant hand in the correct position for the particular clock position

Front 126

Position of head of patient for treatment area of Mandibular anterior surface toward you when at the 8 - 9 o'clock position

Back 126

turned slightly toward the clinician in chin-down position

Front 127

position of head of patient for treatment area of maxillary anterior surface toward you when at the 8 - 9 o'clock position

Back 127

turned slightly toward clinician in chin-down position

Front 128

position of patient head while treating the Mandibular arch anterior surface away from you when in 12:00 position

Back 128

turned slightly toward you in chin down position

Front 129

position of patient head while treating the Maxillary arch anterior surface away from you when in 12:00 position

Back 129

turned slightly toward you in chin-up

Front 130

position of patient head while treating the Mandibular arch posterior aspects facing toward you in 9:00 position

Back 130

slightly away, chin Down

Front 131

position of patient head while treating the Maxillary Arch posterior aspects facing toward you in 9:00 position

Back 131

slightly away, chin Up

Front 132

position of patient head while treating the mandibular arch posterior aspects facing away from you in 10-11 o'clock position

Back 132

toward you, chin down

Front 133

position of patient head while treating the Maxillary arch posterior aspects facing away from you in 10-11 o'clock position

Back 133

toward you chin UP