Reading...
Play button
Play button
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;
136 Cards in this Set
- Front
- Back
|
- Remove the load and elongation is reversed
- Temporary change in length |
Elastic Deformation
|
|
|
- Remove the load, no reversal
- Extensible, but not retractable - Permanent change in length |
Plastic Deformation
|
|
|
What tissues are said to be viscoelastic?
|
Connective tissues
|
|
|
Extensibility and retractability
|
Elasticity
|
|
|
Extensibility only
|
Viscosity
|
|
|
How does tissue failure occur?
|
High-amplitude, rapidly applied force
This can cause not just non-recoverable changes but tissue failure (complete tearing or rupture) |
|
|
(3) Factors that influence whether elastic or plastic properties predominate
|
1. Amplitude of the force
2. Speed of application 3. Duration of application |
|
|
Low amplitude, slow application and short duration favors what kind of response?
|
Elastic response
|
|
|
High amplitude, rapid application and long duration favors what kind of response?
|
Plastic response
|
|
|
Even if tearing doesn't occur when connective tissues are permanently lengthened, what can occur?
|
MECHANICAL weakening
|
|
|
Rapid, high-force stretching procedures can result in what kind of weakening?
|
STRUCTURAL weakening
|
|
|
Creep will cause loss of tissue extensibility due to what (2) causes?
|
1. Loss of turgor
2. Adhesion formation |
|
|
What is sometimes needed to break cross-linkages?
|
Rapidly applied, high-amplitude force
|
|
|
Gradual re-arrangement of collagen proteoglycans and loss of water describes what?
|
Creep
|
|
|
Creep is commonly seen in what?
|
- ADLS of various occupational groups (drivers, prolonged standing, sustained positions, engaging in repetitive motion over time)
- Abnormal postural syndromes (UCS, LCS) - Lifestyle habits (obesity, sedentary life style, lack of variety of activity) |
|
|
Loss of energy that occurs to a viscoelastic tissue that has undergone creep
|
Hysteresis
|
|
|
Change in behavior of a tissue (mechanical behavior after creep has occurred)
|
Hysteresis
|
|
|
Is deformation from hysteresis permanent?
|
Yes! Even if the forces are removed.
We do have an opportunity to reverse some amounts though. |
|
|
The difference or change in length or shape of a tissue from it's original
|
Set
(This occurs after creep and hysteresis has occurred) |
|
|
(4) Functions of skeletal muscle
|
- Movement at joints
- Protection of the joints they are responsible for moving - Maintenance of posture - Heat production |
|
|
Injury to muscle often results in what (3) things?
|
1. Fibrosis
2. Loss of elasticity and strength (viscous properties) 3. Joint dysfunction |
|
|
We observe the "functional layer" of soft tissue to assess what?
|
Contour and symmetry
|
|
|
We palpate the "functional layer" of soft tissue to assess what (5) things?
|
1. Internal derangement
2. Consistency 3. Flexibility 4. Responsiveness to pressure 5. Tone Tone = consistency, flexibility and responsiveness to pressure |
|
|
What is the leading indicators of joint assessment in the body?
|
Asymmetric tone
|
|
|
Ropey muscles become hyper or hypotonic?
|
HYPOtonic
|
|
|
A single alpha motor neuron and all of the skeletal muscle fibers it innervates
|
Motor unit
|
|
|
All of the muscles involved in a specific movement across a given joint including the agonist, synergist and antagonist
|
Myotactic unit
|
|
|
(2) Types of Synergy
|
1. A synergist may extend the line of pull of a prime mover
2. May stabilize the prime mover |
|
|
A muscle's tone is the result of what?
|
Continous, random stream of nerve impulses from the spinal cord
|
|
|
Sustained partial contraction of skeletal muscle is controlled by what?
|
Cortex and Muscle Spindles
|
|
|
Muscle spindles detect what?
|
1. Change in length
2. Rate of change |
|
|
Action potential is generated and muscle contracts all the way; there is no partial contraction. Fires to full capacity or not at all
|
All or Non Principle
|
|
|
Muscles should be barely overlapping. If not enough or too much overlap, muscles weaken
|
Length/Strength Relationship
|
|
|
State of readiness to contract; default or steady state condition of a muscle
|
Resting tone
|
|
|
Resting tone is influenced by what?
|
- Nature of the joints it moves
- Resting tone of all the other muscles in it's myotactic unit (synergists, antagonists) |
|
|
When does muscle imbalance occur?
|
When muscles of opposing function develop altered levels of resting tone relative to each other
|
|
|
Muscle imbalance is an example of what?
|
Functional hypertonicity
|
|
|
Pyramidal System Dysfunction is an example of what?
|
Structural hypertonicity
|
|
|
Pyramidal System Dysfunction includes what?
|
- Strokes, head and spinal cord injuries
- Increased tone of predictable muscle groups - Term spasticity is often used |
|
|
Extrapyramidal System Dysfunction is an example of what?
|
Structural hypertonicity
|
|
|
Extrapyramidal System Dysfunction includes what?
|
- Parkinson's disease, focal dystonias (writer's cramp), spasmodic dysphonia
- Increased tone in both sides of the joint - Often referred to as "rigidity" |
|
|
Limbic System Dysfunction is an example of what?
|
Functional hypertonicity
|
|
|
Limbic System Dysfunction can be caused by what?
|
Psychological distress
|
|
|
- Diffuses hypertonicity throughout a region of the body; diffuse headache, dysmenorrhea
- Affected muscles tender to the touch |
Limbic System Dysfunction
|
|
|
Interneuron Dysfunction (Spinal) is an example of what?
|
Functional Hypertonicity
|
|
|
Interneurons can be inhibitory (GABA, glycine) or excitatory (glutamate) and do what?
|
Focus attention on relevant sensory input, and block out behaviorally irrelevant or unchanging input
|
|
|
Aberrant information can lead to what?
|
(Interneuron Dysfunction)
Hypertonicity of segmentally related muscles |
|
|
Hyper or Hypotonic muscles are more susceptible to trigger point formation?
|
HYPER
|
|
|
Trigger points that develop in HYPOtonic muscles is usually brought on by what?
|
Metabolic components- oxidative stress
|
|
|
Antagonists will become what?
|
Inhibited and hypotonic
|
|
|
Faulty movement patterns can occur as a result of what?
|
CNS overactivates the hypertonic muscles and under uses the hypotonic muscles
|
|
|
Most imbalances begin as what?
|
Predictable responses to the stressful demands of our environment
- Sustained loading of a muscle Constrained postures held over time - Repetitive tasks - Lack of activity - Lack of variety of activity - Gravity |
|
|
What is the most important factor in the development of muscle imbalance?
|
TIME
|
|
|
When a muscle develops increased resting tone, it is what?
|
HYPERtonic
|
|
|
HYPERtonic muscles lose what?
|
Extensibility
|
|
|
HYPERtonic muscles over time will lose what?
|
Strength
- Fatigue more quickly |
|
|
Antagonists will become what?
|
HYPOtonic and lengthened
|
|
|
The joint controlled by an antagonist will develop what?
|
A compromised ROM and increased stress
|
|
|
Facilitation = What?
|
Hypertonicity
|
|
|
Chronic facilitation leads to what?
|
Adaptive shortening
|
|
|
Adaptive short muscles develop what?
|
Adhesions
|
|
|
Hypotonicity = What?
|
Inhibition
|
|
|
Chronic inhibition leads to what?
|
Stretch weakening (sometimes)
|
|
|
Altered "Relative" Tone results in what?
|
HYPERtonic muscles lose some extensibility
HYPOtonic muscles loose some retractability |
|
|
Tight muscles head in a contracted state
|
HYPERtonic
|
|
|
Taut muscles held in an elongated state
|
HYPOtonic
|
|
|
Speed and magnitude of the stretch is dependent on what?
|
Chronicity of the problem
|
|
|
Confirmation of muscle imbalance is made by what?
|
- Palpation of muscles
- Lengthen testing of muscles - Functional Testing (movement patterns) |
|
|
Recurring patterns of imbalance
|
- Handedness
- Repetitive activities - Occupational activities - Recreational activities - Familial modeling |
|
|
Postural muscles tend to be what?
|
Overused, facilitated and adaptively shortened (HYPERtonic)
|
|
|
What is layered syndrome?
|
Lumbar erectors are not what become hypertonic; instead, the thoracoerector intrinsic muscles start to atrophy
|
|
|
Hypertrophy is what?
|
An increase in
- Size (diameter) of muscle fibers - Number of myofibrils within each muscle fiber/cell |
|
|
Increased strength and increased muscle size are developed more rapidly with what kind of exercise?
|
Resistive type
|
|
|
No new myofibrils develop unless muscle reaches 75% of MCV
|
Training effect
|
|
|
Decrease size of fibers and decrease number of myofibrils
|
Atrophy
|
|
|
Involuntary contraction of a muscle in response to nerve irritation, injury or other compromise
|
Muscle spasm
|
|
|
Key to defining true muscle spasm
|
Involuntary, irritation
|
|
|
Primary muscle spasm is caused by what?
|
Direct trauma to the muscle itself
|
|
|
Relief of primary muscle spasm is dependent on what?
|
Relief of nerve irritation
|
|
|
Secondary (protective) muscle spasm is caused by what?
|
Irritation of nerve root, plexus of peripheral nerve
Can also occur in response to injury of other nearby structures (ligament, tendon, joint, disc, bone, etc) |
|
|
Immobilization can be used as treatment for which muscle spasms?
|
Primary and secondary
|
|
|
Ice can be used as treatment for which muscle spasms?
|
Primary and secondary
|
|
|
Compression can be used as a treatment for which muscle spasms?
|
Secondary only
|
|
|
Fibrous netting that permeates, interweaves, connects and covers all other tissues and organs in a body-wide tensional network
|
Fascia
|
|
|
Fascia contains what?
|
- Nervous system tissue
- Vascular and lymphatic tissue All within its elastic matrix; and fat deposition |
|
|
Ligaments and tendons are regarded anatomically as local thickenings of fascial sheets which have adapted to increase local tension with what?
|
Dense and more parallel fiber arrangement
|
|
|
Functions of fascia
|
- Maintain structural integrity
- Support and protect organs and muscles - Shock absorption - Provide matrix for intercellular communication - Provide defense against pathogens - Create environment for tissue repair |
|
|
Fascia responds to what?
|
Actively to stimuli
|
|
|
What is the largest organ in the body for interoception?
|
Fascia
|
|
|
How does fascial influence biomechanical behavior?
|
It contracts and relaxes
|
|
|
Fascia can add to, reduce, or change its composition via what?
|
Fascial Remodeling
|
|
|
Fascial contraction results in what?
|
Stiffening
|
|
|
Prolonged contraction of fascia results in what?
|
New (more) collagen being laid down
|
|
|
How does fascia reduce friction?
|
Facilitates movement between adjacent structures
|
|
|
Fascia functions to limit what?
|
Muscle elongation and joint range of motion; including vertebral motion
|
|
|
What layer wraps around individual muscles?
|
Epimysium
|
|
|
Which layer is a continuity of fibers with deep fascia?
|
Epimysium
|
|
|
Each muscle epimysium forms one layer of rhwat?
|
Intermuscular septum
|
|
|
Two layers of epimysium connecting two contiguous muscles
|
Intermuscular septum
|
|
|
Which layer is specialized for the structures they support or surround?
|
Deep fascial
|
|
|
Tendons are an extension of what?
|
Epimysium, perimysium and endomysium
|
|
|
Which layer separates fascicles and individual fibers
|
Perimysium/endomysium
|
|
|
Perimysium/Endomysium have a high density of what?
|
Collagen for strength and elastin for extensibility
|
|
|
Which layer is found in higher concentrations in postural (tonic) muscles than phasic muscles?
|
Perimysium/endomysium
|
|
|
Which layer greatly influences passive muscle stiffness?
|
Perimysium/endomysium
(Resistance to elongation) |
|
|
Which layer plays a role in muscle imbalances? (Functional hypertonicity)
|
Perimysium/endomysium
|
|
|
Which layer is responsive to mechanical stimulation
|
Perimysium/endomysium
|
|
|
Increased myofibroblast activity can lead to what?
|
Collagen deposition
|
|
|
What is the most common cause of musculoskeletal pain for the general population?
|
Chronic myofascial pain
|
|
|
Healthy myofascial allows for what?
|
Compression
- Absorbs forces and maintains distance between collagen fibers - Prevents adhesions and keeps soft tissues supple and elastic |
|
|
Disruption of fascia leads to what?
|
- Altered distance between fibers
- Cross-linking of fibers - Overgeneration of new fibers - Altered (haphazard) arrangement of fibers |
|
|
Pain and/or phenomena referred from active myofascial trigger points, with associated muscular dysfunction. The trigger point is the pain generator
|
Myofascial Pain Syndrome
|
|
|
A focus of hyperirritability in muscular or fascial tissue that when compressed, is locally tender, and gives rise to referred pain and tenderness, and sometimes autonomic phenomena, and distortion of proprioception, remote from its source, with or without external stimulation
|
Myofascial trigger points
|
|
|
Area of pain referral of a myofascial TP is known as what?
|
Reference Zone - Essential (solid) and Spill Over (stippled)
|
|
|
Referral patterns of specific muscles are what?
|
Predictable and reproducible
|
|
|
Are trigger points motor points?
|
NO. But they may be found near them
|
|
|
Active trigger points refer to what?
|
Whether a muscle is at rest or in motion
|
|
|
Are active trigger points tender to palpation?
|
Always
|
|
|
Active trigger points prevent what?
|
Full lengthening oft he muscle because lengthening process increases the pain
(Do length test later) |
|
|
Active trigger point pain worsens with what?
|
Compression
Referral pain worsens and trigger point pain worsens |
|
|
Are latent trigger points painful?
|
Only when compressed
|
|
|
Do latent trigger points refer?
|
Only when compressed
|
|
|
Becomes active because its muscle is located within the zone of reference of another active trigger point
|
Satellite Trigger Points
|
|
|
Because active because its muscle is part of the same myotactic unit of another active trigger point
|
Secondary trigger point
|
|
|
Active pain syndromes occur more commonly during what age?
|
Productive years- those who are most active!
|
|
|
Latent trigger points are more common than what kind of trigger points?
|
Active trigger points
|
|
|
Most myofascial trigger points are located where?
|
Within a palpable, taut, fibrous band within a muscle
- Palpation is variable depending on its location |
|
|
What is the "Local Twitch Response"?
|
- Transient contraction of muscle fibers of the taut band only. Typically elicited by a snapping palpation
- Only elicited to muscles close to the surface of the body and palpable - Reflex activation of motor units within the taut band. trigger point has no electricity or background current |
|
|
How can tenderness and referral can be increased in a myofascial trigger point?
|
Lengthening the muscle passively
|
|
|
How is the pain described with a myofascial trigger point?
|
Dull, achy, deep
|
|
|
Examples of trigger points that can produce a sharp pain referral
|
- Infraspinatus to anterior GHJ
- Subscapularis to posterior GHJ - Tibialis anterior to big toe with crushing pain |
|
|
Physiologic signs of a myofascial trigger point are a result of what?
|
Oxidative stress (inadequate ATP supply)
|
|
|
Referral of a trigger point usually projects in which direction?
|
Distally
|
|
|
Which muscle has referral pain proximally?
|
Medial hamstrings- refers to gluteal muscle proximally
|
|
|
Example of referral pain to a joint
|
Gastroc refers to proximal SI joint which can refer to the jaw
|
|
|
Does severity and extent of referral pattern correlate with size?
|
No!
Scalenes produce a lot of pain, especially middle and anterior. And latissimus produces a small pain referral pattern |
