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O Exam 1

Goni, mmt, posture, biomechanics, tissue heal, stretch

what is the purpose of goni & mmt? communicate with other health professionals & document progress
goniometry is... the measuring of angles of joints
most common source used in goni norkin & white
what is more precise... goni or incliometer? goni
stationary arm proximal arm
moving arm distal arm
fulcrum joint
factors that determine ROM age, gender, BMI, recreation, genetics
reliability- to what extent is the measurement accurate when different examiners perform the measurement (intertester) or when the same examiner repeats the test (intratester)
factors that affect reliability and validity same tester, same position, same device, same technique, repeated 3x
alternate methods to mmt isokinetic equip & dynameters
mmt stabilization can be accomplished by: mm tension of subject, gravity, external pressure of examiner, positioning
screening quick tests to conserve the examiners time and prevent pt fatigue check both sides at the same time, give resistance in test position first, do all tests in on position 1st before changing- so be organized and plan test
mm performance quality of how mm works-encompasses strength, power and endurance
neuromuscular control ability to control mm
Wolfe's law states that bone is laid down according to stress
muscular disuse leads to atrophy... fewer mitochondria, decrease in myofibrils present in the cells
pt management model to provide ex management examination, evaluation, diagnosis, prognosis, interventions
intervention by the PTA review POC:coordination, communication & documentation, procedural intervention, patient-related instruction, monitoring, progression
functional outcomes must be: meaningful, practical, sustainable (pt satisfaction important)
discharge: anticipated goals and expected outcomes have been attained
discontinuation: ending of services before goals met, due to pt decision to stop, change in medical stat, or need for further service not justified to payer
motor learning cognitive (figure it out), associative (refining the mvmt), autonomous (mvmt automatic)
blocked same task, same conditions, same order
random slight variations in an unpredictable order, variations change with each rep
random-blocked variations of the same task in random order, but each variation is performed more than once
function excursion difference between max length & max shortening
active insufficiency when mm is max shortened, it can't generate much power (1 or 2 jt mm)
passive insufficiency when mm is fully elongated (only 2 jt mm)
ROM for acute state of healing PROM & AAROM
ROM for subacute state of healing AAROM & AROM (3-10 days)
ROM for chronic state of healing stretching & RROM
precautions to ROM when motion disrupts healing, other health issues are life threatening (after trauma or surgery)
longer mm generally have ____ force potential than short mm less
very tight mm have ____ force potential reduced
posture-lateral view: ear, shd, slightly post to hip (thru greater trochanter), ant to knee jt, ant to lat malleolus, normal pelvic tilt
posture-posterior view: look for lateral curve (scoliosis), shd height symmetry, scap inferior angle symmetry, trochanter height symmetry, crest height syymetry, PSIS asymmetry, genu valgum/varum, calcaneal valgum (line of Achilles)
posture-anterior view: shd height & rotation, nipple line, ASIS, iliac crest height, patellas (height & rotation), hands (palms to back means pec tightness)
stability in standing posture is created by: mm and ligaments
stability at the ankle is created by: soleus mm
stability at the knee is created by: knee ligaments, gastrocnemius & hamstrings
stability at the hip is created by: no mm stability needed if hip is in alignment
stability in the spine is created by: abdominal & erector spinae (superficial), deep mm (segmental) & posterior longitudinal ligament
normal COG is: anterior to S2
superficial mm stabilizing spine rectus abdominus, inter & external obliques, erector spinae, scales, levator-main function to respond to external loading (stressed w/bad posture)
deep mm stabilizing spine transverse abdominus, multifidis, rotatores, rectus capitus, longus coli- main function is reflexive segmental control to maintain upright stability balance & posture (not much stress)
trapezius & semispinalis capitus keep head... from falling fwd
scalene & levator: stabilize vertebrae
become weak & stretched w/FHP supra & infra hyoids- also balance during chewing
lordotic posture increased LS angle more than 30 degrees, ant pelvic tilt w/tight hip flexors, compression of post facet jts, narrow IV foramen & post disc space (will pinch nerve), stretched & weak transvers abdominus & other abdominals, tight erector spinae & post lig
flat low back posture decreased LS angle, ASIS almost level with PSIS, post pelvic tilt, reduced shock absorption due to loss of curve, stretched/weak erector spinae, stretched post lig, tight hamstrings, 90% of back pn pt, disc probs
increased thoracic kyphosis stretched/weak thoracic ext, often occurs w/FHP, occurs w/fwd-internally rotated shd, stretched/weak rhomboid & middle/lower traps, stretched posterior ligaments of thoracic spine
fwd head increased cervical lordosis, tight cervical ext & post lig, tight pecs & scalenes, increased stress on C-4 thru C-6 facet jts & discs, tight upper trap, stretched cervical flexors, post facet jt compression, narrow IV foramen
flat upper back & neck posture stretched post cv ext & post cv lig, tight cv flexors, loss of curve so increased jt stress, more common in ectomorphs
genu recurvatum back knee
genu varum bow leg
genu valgum knock knees
pes cavus high arch in foot
pes planus flat foot
CT such as ligaments & tendons: made of elastin, can elongate 70% w/o disruption
collagen more abundant than elastin & many different types (12-19), designed for stability and strength
ground substance jello- gel like substance that provides support and is related to cellular exchanges of gasses & water
fibroblasts are: the unique cells that form the collagen threads
cartilage important to PT: hyaline & fibrocartilage
cell in matrix of cartilage... chondrocyte
ligaments are considered: hypovascular, do have microvascularity, take longer to heal
type I collagen: very strong in mature scars
type II collagen: more elastic in immature scars
strains happen to mm
sprains happen to ligament
grade I microscopic tearing w/no joint laxity, heal spontaneously pretty well w/o PT
grade II tearing of some fibers with moderate joint laxity, pt will say doesn't feel normal
grade III complete rupture of the ligament w/profound instability and laxity-surgical treatment-almost always other damage as well
ACL treatment leans toward surgery
MCL treatment leans toward nonsurgical
articular cartilage is avascular
fibrocartilage found in synovial joints of shd, hip, knee
Created by: jessigirrl4
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