Therex 2 Exam 1

Front 1

CAPTE says it is "not inappropriate" to teach what level of joint mobs to PTA students?

Back 1

1 and 2 because they do not stretch the capsule

Front 2

APTA says PTA's can perform which level of joint mobs?

Back 2

none

Front 3

manual therapy techniques address what general type of dysfunction?

Back 3

Somatic dysfunction

Front 4

what structures are included in/with the Somatic system?

Back 4

skeletal, arthrodial, myofacial structures, related vascular, lymphatic, and neural elements

Front 5

component motions

Back 5

glides, rolls, and spins

Front 6

joint play

Back 6

facilitation of movement in joint not voluntarily controlled

Front 7

distraction

Back 7

application of a force w/ joint seperation

Front 8

traction

Back 8

application of a force w/out joint seperation

Front 9

thrust

Back 9

a sudden high velocity, short amplitude motion is delivered at the pathological limit of an accessory motion to alter positional relationships

Front 10

MWM

developed by?

Back 10

mobilization w/ movement

Brian Mulligan

Front 11

MUA

Back 11

manipulation under anesthesia

Front 12

goals of manipulation

Back 12

to restore normal, pain free movement of the musculoskeletal system in postural balance, restoration of joint play, even distribution of loads.

Front 13

improves the plasticity and elasticity of shortened or thickened soft tissue by:

stretching tight capsules, snapping adhesions, alter positional relationships, improve fluid dynamics(blood), release sensitive structures

Back 13

biomechanical manipulation

Front 14

reduces muscle tone and pain by firing mechanoreceptors

Back 14

neurophysiological manipulation

Front 15

type____ mechanoreceptors gate pain and are stimulated by oscillation

Back 15

type 2

Front 16

type ____ mechanoreceptors in capsule and ligaments are used to inhibit mm tone for relaxation and are stimulated by ____, ____ ____, and thrust.

Back 16

type 3

stretch, sustained pressure, thrust

Front 17

effects of manipulation release of endorphins and lipoprotein

Back 17

chemical

Front 18

manipulation effects of manipulation relate to effects of touch, pt's confidence in us, and also stimulated by the "pop" or cavitation that occurs with thrust manipulation.

Back 18

Psychological

Front 19

manipulation contraindications

Back 19

hypermobility

joint effusion

inflammation

Front 20

precautions for contraindications

Back 20

malignancy

bone disease

unheald fx

excessive pain

hypermobility in associated joints

total joint replacement

systemic connective tissue disease (RA)

Front 21

grades of mobility

Back 21

6-unstable

5-considerable hypermobility

4- slight hypermobility

3-normal

2-slight hypomobility

1- considerable hypomobility

0- ankylosed(no movement/fused)

Front 22

when joint surfaces have maximum contact with each other, are tightly compressed and difficult to seperate.

Back 22

joint congruency

ligaments are taut

closed pack position

Front 23

when joint surfaces do not have maximum contact w/ each other and are easily separated

Back 23

joint incongruency

open packed position

ligaments are lax

resting position

best place for mobilization techniques

accessory motion and joint play are demonstrated

Front 24

passive angular stretching

Back 24

may cause increased pain and joint trauma

lever magnifies forces at the joint

excessive compression in the direction of the rollling bone

a roll without glide does not replicate normal joint mechanics

Front 25

joint glide stretching

Back 25

safer and more selective than passive angular stretching

forces are applied close to the joint surface and are controlled at an intensity compatible with the pathology

replicates gliding component/does not compress the cartilage

Front 26

who is credited for joint mobilization grades

Back 26

jeffrey maitland

Front 27

mob grades

Back 27

1-small amplitude rhythmic oscillations at the beginning of ROM

2-large amplitude oscillations performed in ROM prior to tissue resistance

3-large amplitude oscillations performed just beyond the limit of tissue resistance

4-small amplitude ascillations performed into resistance of capsule

Front 28

who is credited for joint distraction grades?

Back 28

Freddy Kaltenborn

Front 29

joint distraction grades

Back 29

1-bunching of skin

2-take up the slack

3-distraction(stretch of capsule)

Front 30

superior angle @ ___, root of spine of scap @ ____, inf angle @____.

Back 30

T2

T3

T7

Front 31

what is the scapulohumeral rhythm?

Back 31

GH:ST

2:1 ratio

120 deg GH

30 deg SC w/elevation

30 deg AC after SC elevation/rotation

Front 32

referred pain in shoulder region

cervical spine:___ and ___ nerve roots.

____ dermatome is lateral humeral region.

Back 32

C4

C5

C5

Front 33

carrying a heavy back pack over the shoulder would most likely cause pain from what nerve?

Back 33

suprascapular nerve in the suprascapular notch

Front 34

adhesive capsilitis characterized by dense adhesions capsular thickening and capsular restrictions in shoulder.

usually occurs b/w 40-60yo

idiopathic

Back 34

frozen shoulder

Front 35

adhesive capsilitis frozen shoulder stages

Back 35

1. "chillin" <3mo: gradual pain increases w/ motion and present at night, loss of ER

2. "freezing" 3-9mo: intense pain at rest w/ motion limited in all directions

3. "frozen" 9-15mo: pain only in movement w/ adhesions, limited GH motion, scapula substitutions

4. "thawing" 15-24 mo: minimal pain w/ motion gradually improving, significant capsular restrictions

Front 36

4 conditions to be adhesive capsilitis

Back 36

AROM limited capsular pattern

PROM limited capsular pattern

loss of jt play in capsular pattern

capsular end-feel in capsular pattern

Front 37

maximum protection phase

Back 37

1. control inflammation using splint/sling for protection, anti inflammatory med, Cryotherapy(CP)

2. pain free PROM, grade 1 and 2 mobs to decrease pain/increase jt nutrition

3. may be able to begin submax mm setting (light isometrics:should be 4-6wks after surgery)

Front 38

moderate protection controlled motion phase

Back 38

1. w/ attention to healing, may begin AAROM-AROM

2. grade 3 and 4 mobs if needed for stretching

3. pt ed. "not to over do it"

4. resolve mm imbalances

5. work on lower level to moderate function

Front 39

shoulder capsular pattern

Back 39

ER-abd-IR

Front 40

minimum protection return to function phase

Back 40

1. cont w/ jt mobs if ROM still impaired

2. progress activities to restore necessary functional activities

Front 41

TSA

Back 41

total shoulder arthroplasty

standard alignment of Gh jt with prosthetic

Front 42

rTSA

Back 42

reverse total shoulder arthroplasty

ball and socket components reversed in their orientation.

Front 43

GHA ROM goal

Back 43

glenohumeral arthroplasty

ROM goal: 0-140 or 150 deg elevation

0-45 or 50 deg ER

Front 44

tissue healing basic time frames

Back 44

50% healed at 2 weeks

80% healed at 6 weeks

100% healed at 12 weeks

healed does not mean matured!

Front 45

types of acromions

Back 45

normal

curved

hooked

Front 46

primary impingements

Back 46

due to anatomical structure-curved/hooked acromions bring tip of acromion lower so more likely to impinge

may also be due to tight post capsule driving humerus anteriorly

Front 47

acromioplasty

Back 47

removal of anterior, inferior surface of acromion

Front 48

subacromial decompression

Back 48

to increase space for tendons to glide

Front 49

secondary subacromial impingment

Back 49

due to hypermobility of humerus- free to move outside constraints of jt. unidirectional: only unstable in one direction, multi directional: unstable in more than one direction.

Front 50

SLAP

Back 50

Superior Labrum Anterior to Posterior

lesion is at long head of biceps tendon blending into superior labrum at supraglenoid tubercle.

surgery screws or anchors to hold back into glenoid.

Front 51

hill sachs lesion

Back 51

causes fracture/indentation on head of humerus when humeral head dislocates anteriorly and post aspect slams against ant glenoid

Front 52

bankart lesion

Back 52

anterior inferior labrum peels away from glenoid from anterior dislocation.

Front 53

w/ increased thoracic kyphosis, the scapula is protracted and tilted forward and the GH posture is IR.

what muscles are tight and what are weak?

Back 53

tight-pec minor, levator scapulae, IR's

weak- ER's of shoulder and scapular upward rotators

Front 54

factors that influence therapy progression

Back 54

chronic vs acute injury

size/location

associated pathology(fracture/GH instability)

med hx(smoking)

steroid

age

level of activity

surgery

pt's compliance

Front 55

Rotator cuff repair

size of tear

Back 55

small <1cm:shorter immob time

medium 1cm-5cm: 3-6 wks immob

massive >5cm: 4-8wks immob

Front 56

ex techniques during acute and subacute stages of shoulder rehab

Back 56

wand exercises

ball rolling or table top dusting

wall(window) washing

pendulum codmans ex.

gear shift