Trigger Points

Front 1

the superficial fascia that invests muscle is also known as...

Back 1

connective tissue

Front 2

trigger points are nodules under the skin...true or false

Back 2

true

Front 3

trigger points tend to manifest within the epimyisum, perimysum or endomyosum

Back 3

epimyisum

Front 4

__________ supports organs, wraps around muscles and condenses to form ligaments, aponeuroses and even bones.

Back 4

fascia

Front 5

fascia has neither a beginning nor an end. t or f

Back 5

true

Front 6

where do trigger points develop

Back 6

in the myofascia

Front 7

define a trigger point

Back 7

a deeply irritable localized spot of exquisite tenderness in a nodule in a palpable taut band of skeletal muscle

Front 8

trigger points develop where in the muscle belly

Back 8

center - where the motor end plate enters

Front 9

what characteristics play a role in trigger point manifestations and genesis

Back 9

ageing, body morphology, posture, weight gain, and congenital malformation

Front 10

when a small part of the muscle goes into contracture, as with a trigger point, it causes...

Back 10

a small localized spike in electrical activity

Front 11

what is localized, nodular and discrete and characteristically painful patterns of referred pain

Back 11

trigger points

Front 12

a widespread diffuse musculo-skeletal pain and fitigue?

Back 12

fibromyalgia

Front 13

fibromyalgia does not involve the joints, ligaments, bones, or muscles

Back 13

joints

Front 14

who is more affected by fibromyalgia..men or women

Back 14

women

Front 15

what is the defining symptom of a myofascial trigger point

Back 15

referred pain

Front 16

name the hamstring muscles

Back 16

semitendinosous
semimembranosus
biceps femoris

Front 17

name the quadriceps muscles

Back 17

vastus medialis
vastus intermedius
vastus lateralis
rectus femoris

Front 18

what is the origin for the rectus femoris muscle

Back 18

anterior inferior iliac spine

Front 19

what is the origin for the biceps femoris

Back 19

ishial tuberosity

Front 20

what is the action of the rectus femoris

Back 20

flex the thigh at the hip and extend the leg at the knee

Front 21

what is sacro-sternal release?

Back 21

loosens the fascia in the abdominal, ribs, and sternum

Front 22

whenever any part of the quads harbor trigger points, ,the __________ usually have at least latent trigger points that restrict movement.

Back 22

hamstrings

Front 23

muscle contraction occurs at the same level as the..................

Back 23

sarcomere

Front 24

TrP's in the anterior gluteus minimus tend to activate satellite TrP's in the ................

Back 24

vastus lateralis

Front 25

The TrP's are ususally multiple where...............

Back 25

vastus intermedius

Front 26

if you are having trouble going upstairs, the muscle affected is......

Back 26

vastus intermedius - extends the leg at the knee

Front 27

what muscle has TrP's most frequently in children

Back 27

vastus lateralis

Front 28

if you are having trouble going down the stairs the affected muscle is...........

Back 28

rectus femoris

Front 29

any TrP's in the quads will compromise what?

Back 29

knee extension

Front 30

when sitting for long periods of time, TrP's can be perpetuated with what muscle

Back 30

rectus femoris

Front 31

what is PIMR

Back 31

post isometric muscle release

Front 32

what is the concept behind PIMR?

Back 32

the use of an isometric contraction followed by taking up the slack in the muscle being stretched.

Front 33

take the muscle to be stretched until the client feels a comfortable resistance is part of what technique

Back 33

PIMR protocol

Front 34

name some associated trps with the hamstrings

Back 34

adductor magnus
gastroc
quads

Front 35

the vastus ......... has the largest bulk of the four heads of the quadriceps femors and the trps are most frequently found in children

Back 35

lateralis

Front 36

fascial lengthening is very helpful when working with the .......

Back 36

quads

Front 37

what is the law of facilitation

Back 37

car example - when a nerve impulse has once traveled a given route within the body, that route is then easier for future impulses to travel

Front 38

law of symmetry

Back 38

with sufficient nerve stimulation, impulses from one side of the body will tend to generate motor reaction in the same muscles on the opposite side of the body

Front 39

law of radiation

Back 39

where impulses continue to increase, they are propagated upward and will radiate outward from the nerves higher up the spinal cord

Front 40

law of generalization

Back 40

when nerve impulses are sufficiently intense, they are propagated by the brain and radiate to all muscles of the body.

Front 41

Every muscle fiber in the body is either totally relaxed or totally contracted. t or f

Back 41

true

Front 42

The varying degrees of movement are the result of the number of muscle fibers contracted. t or f

Back 42

true

Front 43

night time calf cramping is a symptom of trps in the ....

Back 43

gastroc

Front 44

pain often felt in the long arch of the foot is a symptom of the ......... muscles

Back 44

gastroc

Front 45

activation of trps from the gastroc are...

Back 45

physical overload
malpositioning of the foot
slimbing steep slopes
jogging uphill
riding a bike with the seat too low
wearing a leg cast

Front 46

leaving the foot in the plantar flexed position for prolonged periods can perpeputate trps in the gastroc. t or f

Back 46

true

Front 47

associated trps from the gastroc are

Back 47

soleus
hams
long flexors of the toes
tib posterior
tib anterior
long extensors of the toes

Front 48

...... muscle has been referred to as the second heart

Back 48

soleus

Front 49

the soleus muscle contracts when shortenting and lengthening t or f

Back 49

true

Front 50

joggers heel is often soleus trps. t or f

Back 50

true

Front 51

it is good to use a bolster under the ankles during treatment for the ...... and the ......

Back 51

gastroc and the soleus

Front 52

the client is prone with the feet well of the end of the table describes what treatment

Back 52

stretch and spray for the gastrocs

Front 53

one muscle should never be strengthened in isolation t or f

Back 53

true

Front 54

the central trigger point always exist in the center of the muscle belly. t or f

Back 54

true

Front 55

...... trigger points may be created as a response to the central trigger point in neighboring muscles that lie within the referred pain zone.

Back 55

satellite (or secondary)

Front 56

........... can cause dragging of the toes or tripping or falling when walking

Back 56

tibialis anterior

Front 57

what are the associated trps with the tibialis anterior

Back 57

peroneus longus
extensor hallicus longus
extensor digitorum longus

Front 58

sitting in a cross-legged position may affect a range of muscles such as the .............., the buttock muscles and the thigh muscles

Back 58

hip flexors

Front 59

heavy smokers may develop trigger points in the shoulder (deltoid) and arm (biceps brachii) muscles t or f

Back 59

true

Front 60

how you sleep may activate a trigger point t or f

Back 60

true

Front 61

trigger points manifest where sarcomeres and extrafusal motor end plates become over active t or f

Back 61

true

Front 62

how do i know its a trigger point

Back 62

stiffness int he affected muscle
spot tenderness (exquisite pain)
a palpable taught nodule or band
presence of referred pain
reproduction of the patients symptoms
may be hotter or colder than the surrounding tissues
may be more moist than the surrounding tissues
may be a loss of skin elasticity in the region of the trigger point

Front 63

what is the origin of the tibialis anterior?

Back 63

lateral condyle of tibia. upper half of later surface of tibia

Front 64

what is the action of the tib anterior

Back 64

dorsiflexes the ankle joint and inverts the foot

Front 65

what is the action of the tibalis anterior

Back 65

walking and running, lifts the foot clear off the ground as the leg swings forward

Front 66

problems in the tib anterior what should you do/avoid

Back 66

avoid prolonged cr journeys and use of pedals
change running surface and running shoes
avoid walking prolonged on sloping surfaces
adjust car seat
use wedge under heel of foot for driving pedal

Front 67

what is the referred pain pattern of the tibialis anterior

Back 67

vague pain along the shin
pain culminating in the big toe

Front 68

what is the origin of the fibularis longus

Back 68

upper two thirds of lateral surface of fibula lateral condyle of tibia

Front 69

what is the insertion of the fibularis longus

Back 69

lateral side of medial cuneiform base of first metatarsal

Front 70

what is the referred pain pattern of the fibularis longus

Back 70

mainly over lateral malleolus anteriorly and posteriorly in a linear distribution.
laterally along foot, occasionally vague pain in middle third of lateral aspect of lower leg.

Front 71

avoid high heeled and lat shoes is advice that you would give to someone having pain in what muscle....

Back 71

fibularis longus

Front 72

what is the best technique to use on an active central trigger point?

Back 72

inhibition-ischaemic compression technique

Front 73

what method of trigger point release directly involve the patient, asking them to actively contract the affect/host muscle and then to relax it.

Back 73

stretch and release techniques

Front 74

situations when to use the spray and stretch techniques include:

Back 74

young children
needle shy patient
immediately after trigger point injection
post hemiplegic
immediately following major trauma
after whiplash
myofascial trigger points and hyperuricaemia (excess uric acid)

Front 75

how do i know its a trigger point

Back 75

stiffness in the afected muscle
spot tenderness
a palpable taut nodule
presence of referred pain

Front 76

what is a diffuse trigger point

Back 76

develop along lines of altered stress and or strain patterns

scoliosis

multiple satellite trigger points exist secondary to multiple central trigger points

Front 77

attachment trigger points

Back 77

no nerves running through tendon...much more avascular so harder to find