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164 Cards in this Set

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Energy Systems

ATP-PC or Phosphagen System


Anaerobic Glycolysis or Lactic Acid System-


Aerobic or Oxygen System

ATP-PC or Phosphagen System

uses APT during high intensity short duration exercise


Does not depend on long series of chemical reactions


Does not depend on transporting the O2 we breathe to working muscles


Both ATP and PC are stored directly within the contractile

Anaerobic Glycolysis or Lactic Acid System

major supplier of ATP during high intensity short duration activities. Stored glycogen split into gluclose thru glycolysis, split again into pyruvic acidDoes not require O2

Uses carbs (glycogen and glucose)


Releases enough energy for the resynthesis of only small amounts of ATP.

Aerobic Metabolism

used predominantly during low intensity, long duration exercise.


Provides energy through the oxidation of food. The combo of fatty acids, amino acids, and glucose with oxygen releases energy that forms ATP




This system will provide energy as long as there are nutrients to utilize.

Free Nerve Endings (Location, sensitivity, primary distribution)

Location: Joint Capsule, ligaments, sunovium, fat pads


Sensitivity: one type is sensitive to non-noxious mechanical stress; other type is sensitive to noxious mechanical or biochemical stimuli


Distribution: All joints

Golgi Ligament Endings (Location, sensitivity, primary distribution)

Location: ligaments, adjacent to ligaments' bony attachment


Sensitivity: Tension or stretch on ligaments


Distribution: Majority of joints

Golgi-Mazzoni Corpuscles (Location, sensitivity, primary distribution)

Location: Jt capsule


Sensitivity: Compression of jt capsule


Distribution: Knee jt, jt capsule

Pancinian Corpuscles (Location, sensitivity, primary distribution)

Location: Fibrous layer of jt capsule


Sensitivity: High freq vibration, acceleration and high velocity changes in jt position


Distribution: all joints

Ruffini Endings (Location, sensitivity, primary distribution)

Location: fibrous layer of jt capsule


Sensitivity: stretching of jt capsule; amplitude, and greater velocity of jt position


Distribution: Greater density in proximal jts, particularly in capsular regions

Classification and functional characteristics of Type I muscle fibers

Classification: Aerobic, red, tonic, slow-twitch, slow-oxidative


Function: low fatiguability, high capillary density, high myoglobin content, small fibers, extensive blood supply, Lg amounts of mitochondria

Classification and functional characteristics of Type II muscle fibers

Classification: anaerobic, white, phasic, fast-twitch, fast-glycolytic


Function: high fatiguability, low capillary density, low myoglobin content, large fibers, less blood supply, fewer mitochondria

Glenohumeral Joint (Open pack, closed pack, capsular pattern)

Open: 55 degrees abd, 30 degrees horse add


Closed: abd, ER


Capsular: ER, ABD, IR

Sternoclavicular Joint (open pack, closed pack, capsular pattern)

Open: arm resting by side


Closed: max shoulder elevation


Capsular: pain at extremes of ROM

Acromioclavicular Joint (open pack, closed pack, capsular pattern)

Open: arm resting by side


Closed: arm ABD 90 degrees


Capsular: pain at extremes of ROM

Muscles that cause shoulder flexion

Anterior deltoid


coracobrachialis


pectoralis major


biceps brachii

Muscles that cause shoulder extension

latissimus dorsi


posterior deltoid


teres major

Muscles that cause shoulder ABD

middle deltoid


supraspinatus

Muscles that cause shoulder ADD

Pectoralis major


latissimus dorsi


teres major

Muscles that cause shoulder ER

Teres minor


infraspinatus


posterior deltoid

Muscles that cause shoulder IR

Subscapularis


teres major


pectoralis major


latissimus dorsi


anterior deltoid

Muscles that cause scapular elevation

Upper traps


Levator scapulae

Muscles that cause scapular depression

latissimus dorsi


pectoralis major


pectoralis minor


lower traps

Muscles that cause scapular protraction

serratus anterior


pectoralis minor

Muscles that cause scapular retraction

Trapezius


rhomboids

Muscles that cause scapular upward rotation

trapezius


serratus anterior

Muscles that cause scapular downward rotation

rhomboids


levator scapulae


pectoralis minor

Radiohumeral Joint (open pack, closed pack, capsular pattern)

Open: full extension, supintation


Closed: 90 degrees flexion, 5 degrees supination


Capsule: flexion, extension, supination, pronation

Ulnohumeral Joint (open pack, closed pack, capsular pattern)

Open: 70 degrees flexion, 10 degrees supination


Closed: extension


Capsular: flexion, extension

proximal radioulnar joint (open pack, closed pack, capsular pattern)

Open: 70 degrees elbow flexion, 35 degrees supination


Closed: 5 degrees supination


Capsular: supination, pronation

Muscles that cause elbow flexion

Biceps brachii


brachialis


brachioradialis

Muscles that cause Elbow extension

triceps brachii


anconeus

Muscles that cause supination

biceps brachii


supinator

Muscles that cause pronation

pronator teres


pronator quadratus

Radiocarpal joint (open pack, closed pack, capsular pattern)

Open: neutral with slight ulnar deviation


Closed: extension with radial deviation


Capsular: flexion and extension equally limited

Muscles that cause wrist flexion

flexor carpi radialis


flexor carpi ulnaris


palmaris longus

Muscles that cause wrist extension

Extensor carpi radialis longus


extensor carpi radialis brevis


extensor carpi ulnaris

Muscles that cause radial deviation

extensor carpi radialis


flexor carpi radialis


extensor pollicis longus


extensor pollicis brevis

Muscles that cause ulnar deviation

extensor carpi ulnaris


flexor carpi ulnaris

Hip (iliofemoral) joint (open pack, closed pack, capsular pattern)

Open: 30 degrees flexion, 30 degrees ABD, slight ER


Closed: full extension, IR


Capsular: flexion, abd, IR (sometimes IR is most limited)

Muscles that cause hip flexion

iliopsoas


sartorius


rectus femoris


pectineus

Muscles that cause hip extension

gluteus maximus


gluteus medius


semitendinosus


semimebranosus


biceps femoris

Muscles that cause hip ABD

gluteus medius


gluteus minimus


piriformis


obturator internus


tensor fasciae latae

Muscles that cause hip ADD

adductor magnus


adductor longus


adductor brevis


gracilis

Muscles that cause hip IR

TFL


gluteus medius


gluteus minimus


pectineus


adductor longus

Muscles that cause hip ER

Gluteus maximus


obturator externus


obturator internus


piriformis


gemelli


sartorius

Knee (tibiofemoral) joint (open pack, closed pack, capsular pattern)

Open: 25 degrees flexion


Closed: full extension, tibial ER


Capsular: flexion, extension

Muscles that cause knee flexion

Biceps femoris


semitendinosus


sartorius


semimebranosus

Muscles that cause knee extension

rectus femoris


vastus lateralis


vastus intermedius


vastus medialis

Talocrural joint (open pack, closed pack, capsular pattern)

Open:10 degrees plantar flexion, midway between max inversion/eversion


Closed: Max dorsiflexion


Capsular: plantar flexion, dorsiflexion

Subtalar Joint (open pack, closed pack, capsular pattern)

Open: midway between extremes of ROM


Closed: supination


Capsular: Limitation of varus ROM

Midtarsal Joint (open pack, closed pack, capsular pattern)

Open: Midway between extremes of ROM


Closed: supination


Capsular: dorsiflexion, plantar flexion, adduction, IR

Muscles that cause plantar flexion

tibialis posterior


gastrocnemius


soleus


peroneus longus


peroneus brevis


plantaris


flexor hallucis

Muscles that cause dorsiflexion

Tibialis anterior


extensor hallucis longus


extensor digitorum longus


peroneus tertius

Muscles that cause inversion

tibialis posterior


tibialis anterior


flexor digitorum longus

Muscles that cause eversion

Peroneus longus


peroneus brevis


peroneus tertius

Cervical spine (open pack, closed pack, capsular pattern)

Open: midway between flexion/extension


Closed: extension


Capsular: lateral flexion and rotation equally limited, extension

Muscles that cause cervical flexion

SCM


longus colli


scalenus muscles



Muscles that cause cervical extension

Splenius cervicis


semispinalis cervicis


iliocostalis cervicis


longissimus cervicis


mulifidus


trapezius

Muscles that cause cervical rotation and lateral flexion

SCM


Scalenus muscles


Splenius cervicis


Longissimus cervicis


Iliocostalis cervicis


Levator scapulae


multifidus

Thoracic Spine (open pack, closed pack, capsular pattern)

Open: Midway between flexion/extension


Closed: extension


Capsular: lateral flexion and rotation are equally limited, extension

Muscles that cause thoracolumbar flexion

rectus abdominis


Internal oblique


external oblique

Muscles that cause thoracolumbar extension

erector spinae


quadratus lumborsum


multifidus

Muscles that cause thoracolumbar rotation and lateral flexion

posts major


quadratus lumborum


external oblique


internal oblique


multifidus


longissimus thoracis


Iliocostalis thoracis


rotatores

Muscle Spindle

In muscle belly.


Sends information to CNS about muscle length and/or rate of change of its length


Controls posture and with help of gamma system involuntary movements

Golgi Tendon Organ

Encapsulated sensory receptors through which muscle tendons pass immediately beyond their attachment to the muscle fibers.


Function to transmit info about tension or rate of change within tension of muscle.

Types of Muscular Contractions

Concentric


Eccentric


Isometric


Isotonic


Isokinetic

Concentric contractions

muscle shortens while developing tension

Eccentric Contraction

Muscle lengthens while developing tension

Isometric Contraction

Tension developed but there is no change in the length of the muscle

Isotonic Contraction

The muscle shortens or lengthens while resisting a constant load

Isokinetic Contraction

Tension developed by the muscle, while shortening or lengthening at a constant speed, is maximal over the full ROM

Open-chain

The distal segment (usually the hand or foot) moving freely in space.

Closed-chain

The body moves over a fixed distal segment.

Upper Quarter Myotomes

Cervical Rotation: C1


Shoulder Elevation: C2-C4


Shoulder Abduction: C5


Elbow Flexion: C5-C6


Wrist Extension: C6


Elbow Extension: C7


Wrist Flexion: C7


Thumb Extension: C8


Finger Abduction: T1

Upper Quarter Reflexes

Biceps: C5


Brachioradialis: C6


Triceps: C7

Upper Quarter Dermatomes

C2: posterior head


C3: Posterior-lateral neck


C4: Acromioclavicular jt


C5: Lateral Arm


C6: Lateral forearm and thumb


C7: Palmar distal phalanx-middle finger


C8: Littler finger and ulnar border of the hand


T1: Medial forearm

Heel Walking Functionally tests what innervation level?

L4-L5

Toe Walking Functionally tests what innervation level?

S1

SLR Functionally tests what innervation level?

L4-S1

Lower Quarter Myotomes

Hip flexion: L1-L2


Knee extension: L3-L4


Ankle Dorsiflexion: L4-L5


Great Toe Extension: L5


Ankle Plantar Flexion: S1

Lower Quarter Reflexes

Patella tendon: L4


Achilles Tendon: S1

Lower Quarter Dermatomes

L2: Anterior Thigh


L3: Middle 1/3 of anterior thigh


L4: Patella and medial malleolus


L5: Fibular Head and dorsum of foot


S1: Lateral and plantar aspect of foot


S2: Medial aspect of posterior thigh


S3-S5: Perianal area

Where does the plumb line align?

Slightly post. to coronal suture


Thru external auditory meatus


Thru axis of the odontoid process


Midway thru the tip of the shoulder


Thru the bodies of the lumbar vert


Slightly posterior to hip jt


Slightly anterior to axis of knee jt


Slightly anterior to lateral malleolus


Thru calcaneocuboid

Stance phases of the gait cycle

Initial contact


Loading response


Midstance


Terminal Stance


Per-swing


(60% of the gait cycle)

Swing phases of the gait cycle

Initialswing


Midswing


Terminal swing


(40% of the gait cycle)

Peak muscle activity during the gait cycle

Tibialis anterior: just after heel strike, responsible for eccentric lowering of the foot into PF


Gastroc-soleus: During late stance, responsible for concentric raising of the heel during toe off


Quads: In periods of single support, during early stance and before toe off to initiate swing phase


Hamstrings: During late swing phase, responsible for decelerating the unsupported limb

How much hip flexion is required for gait?

0-30 degrees

How much hip extension is required for gait?

0-10 degrees

How much knee flexion is required for gait?

0-60 degrees

How much knee extension is required for gait?

0 degrees

How much ankle dorsiflexion is required for gait?

0-10 degrees

How much ankle plantar flexion is required for gait?

0-20 degrees

Cadence

the number of steps an individual will walk over a period of time.


The average adult cadence= 110-120 steps/min

Step length

The distance measured between right heel strike and left heel strike.


Average= 28 inches

Stride length

The distance between right heel strike and right heel strike.


Average= 56 inches

Antalgic Gait

A protective gait pattern where the involved step length is decreased in order to avoid weight bearing on the involved side usually secondary to pain.

Ataxic Gait

A gait pattern characterized by staggering and unsteadiness. There is usually a wide BOS and movements are exaggerated.

Steppage Gait

A gait pattern in which the feet and toes are lifted through hip and knee flexion to excessive heights; usually secondary to dorsiflexion weakness. The foot will slap at initial contact with the ground secondary to decreased control.

Trendelenburg Gait

A gait pattern that denotes glut med weakness; excessive lateral trunk flexion and weight shifting over the stance leg.

Vaulting Gait

A gait pattern where the swing leg advances by compensating through the combination of elevation of the pelvis and plantar flexion of the stance leg.

Normal shoulder flexion ROM

0-180

Normal shoulder extension ROM

0-60

Normal shoulder ABDuction ROM

0-180

Normal shoulder IR ROM

0-70

Normal shoulder ER ROM

0-90

Normal elbow extension ROM

0

Normal Elbow Flexion ROM

0-150

Normal Pronation ROM

0-80

Normal Supination ROM

0-80

Normal Wrist Flexion ROM

0-80

Normal Wrist Extension ROM

0-70

Normal Radial Deviation ROM

0-20

Normal Ulnar Deviation ROM

0-30

Normal Metacarpophalangeal Flexion ROM

0-90

Normal Metacarpophalangeal Extension ROM

0-45

Normal PIP Flexion ROM

0-100

Normal DIP Flexion ROM

0-90

Normal DIP Extension ROM

0-10

1st MCP Flexion ROM

0-50

1st IP Flexion ROM

0-80

Normal Hip flexion ROM

0-120

Normal Hip Extension ROM

0-30 (20)

Normal Hip Abduction ROM

0-45

Normal Hip Adduction ROM

0-30

Normal Hip IR ROM

0-45

Normal Hip ER ROM

0-45

Normal Knee Flexion ROM

0-135

Normal Ankle DF ROM

0-20

Normal Ankle PF ROM

0-50

Normal Ankle inversion ROM

0-35

Normal Ankle eversion ROM

0-15 (20)

Normal subtalar inversion ROM

0-5 (10-12)

Normal Subtalar eversion ROM

0-5

Normal Cervical Spine Flexion ROM

0-45

Normal Cervical Spine Extension ROM

0-45

Normal Cervical Spine Lateral Flexion ROM

0-45

Normal Cervical Spine Rotation ROM

0-60

Normal Thoracolumbar Spine Flexion ROM

0-80

Normal Thoracolumbar Spine Extension ROM

0-25

Normal Thoracolumbar Spine Lateral Flexion ROM

0-35

Normal Thoracolumbar Spine Rotation ROM

0-45

Special tests used for: shoulder dislocation

apprehension test for anterior dislocation

Special tests used for: Biceps tendon patho

speed's test


yergason's test

Special tests used for: rotator cuff patho/impingement

Drop arm


supraspinatus test





Special tests used for: Thoracic outlet syndrome

ROOS


Costoclavicular


Hyperabduction


Adson

Special tests used for: Knee ligamentous instability

anterior drawer


lachman


pivot shift


posterior drawer


valgus stress test


varus stress test


AMRI test


ALRI test

Special tests used for: Meniscal Patho

Apley's compression


McMurray's


joint line palpation


Thesslay

Special tests used for: Ankle ligamentous instability


Anterior drawer for ATFL


Talar tilt for calcaneofibularligament

Grades for Joint Mobilization

I: Sm amp at beginning of range


II: Lg amp within range, but not reaching


III: Lg amp up to limit of range


IV: Sm amp at limit of range


V: Sm amp high velocity thrust at limit of range

Rule for Convex surface moving on concave surface

Roll and slide occur in opposite direction




mob force should be applied in the opposite direction of the bone movement

Rule for concave surface moving on convex surface

Roll and slide occur in same direction




mob force should be applied in the same direction as the bone movement

Contra's to Joint Mobs (8)

1. active disease


2. Infection


3. advanced osteoporosis


4. articular hypermobility


5. fracture


6. acute inflammation


7. muscle gaurding


8. joint replacement

Effusion

increased fluid volume within the jt capsule

Q angle

The degree of angulation present when meaning the patella to the ASIS to the tib. tub.




Normal: 13 males; 18 females

Strain

injury involving the musculotendinous unit that involves muscle, tendon or their attachment to bone

Sprain

An acute injury involving a ligament

Muscles that cause TMJ Depression (3)

Lateral pterygoid


Suprahyoid


Infrahyoid

Muscles that cause TMJ Elevation (3)

Temporalis


Masseter


Medial pterygoig

Muscles that cause TMJ Protrusion (3)

Masseter


Lateral and Medial Pterygoid

Muscles that cause TMJ Retrussion (3)

Temporalis


Masseter


Diagastric

Muscles that cause TMJ lateral movements (4)

medial and lateral pterygoid


Masseter


Temporalis

Class 1 lever

fulcrum between the effort and resistance load“seesaw”

Class 2 lever

Class 2- the resistance between the fulcrum andeffort force “wheelbarrow”


The effort arm is ALWAYS longer than theresistance arm

Class 3 Lever

the effort force is between the fulcrum and theresistance load


The effort arm is ALWAYS shorter than theresistance arm.