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Pat asses L3
| Question | Answer |
|---|---|
| What is goniometry? | Measurement of angles created at human joints to assess ROM. |
| What is ROM? | Arc of motion occurring at a joint or series of joints. |
| What notation system is used for ROM? | 0–180° system. |
| Where is 0° for flexion/extension, abduction/adduction, and rotation? | Flexion/extension and abduction/adduction = anatomical position. Rotation = halfway between medial/internal and lateral/external rotation. |
| What is AROM? | ROM attained by the patient during unassisted voluntary motion. |
| What information does AROM provide? | Willingness to move, coordination, awareness/attention span, pain during movement, muscle strength, and ability to follow instructions. |
| What are contractile vs non-contractile tissues? | Contractile = muscles, tendons, and attachments. Non-contractile = ligaments, joint capsules, bursa, fascia, and skin. |
| If AROM is normal, do you need to test PROM for that motion? | no |
| What is PROM? | ROM attained by the therapist without patient assistance. |
| What are the characteristics of PROM? | Patient remains relaxed and PROM is typically slightly greater than AROM. |
| What information does PROM provide? | Amount of movement available, factors limiting movement, and pain during movement. |
| If AROM is painful but PROM is pain-free, what could that tell you? | AROM: the patient's muscles contract → pain PROM: therapist moves them while they stay relaxed → no pain So the muscle/tendon being actively used is more suspicious. |
| What defines a normal end feel? | Full PROM is achieved and normal joint anatomy stops the movement. |
| What defines an abnormal end feel? | PROM may be decreased/increased, or normal/limited PROM occurs but something other than normal anatomy stops movement. |
| What is hypomobility? | Decreased PROM compared with normal values; may result from joint-surface abnormalities, soft-tissue shortening, osteoarthritis, etc. |
| What is hypermobility? | Increased PROM exceeding normal values due to soft-tissue laxity, trauma, or hereditary disorders. |
| What do you need to know about capsular patterns for this exam? | Know the general concept of a capsular pattern; you do NOT need specific capsular patterns for each joint. |
| What additional end-feel information does the study guide say you need to study? | The normal vs abnormal end-feel charts from the PowerPoint. The individual types are not included in this study guide. |
| What is a goniometer? | Device used to measure joint angles. |
| What are the three main parts of a goniometer and where are they positioned? | Stationary/proximal arm = parallel to longitudinal axis of fixed proximal segment/toward proximal bony prominence; movable/distal arm = parallel to longitudinal axis of moving distal segment/toward distal bony prominence; axis/fulcrum = over joint axis. |
| How do you avoid errors when reading a goniometer? | Be at eye level, know both scales (0–180 and 180–0), and visually estimate the angle before reading it. |
| What is the basic goniometric measurement procedure? | Align goniometer at zero if possible → patient actively moves through full AROM → move goniometer with patient OR realign at end of AROM. |
| What MUST be assessed before muscle strength? | Passive/active joint ROM. |
| What becomes the "full available ROM" used for grading muscle strength? | The patient's full available AROM/PROM at that joint |
| How is normal ROM recorded? | NORMAL (N), WITHIN NORMAL LIMITS (WNL), or the amount of movement in degrees. |
| How is abnormal ROM recorded? | Record degrees of movement including both starting and ending joint positions. |
| If movement begins at 0°, how is ROM recorded? | As the degrees the joint moves away from 0°. |
| What are the applications of goniometric data? | Determine impairment presence/absence, establish diagnosis/prognosis, develop rehabilitation goals/plans, evaluate progress, motivate patients, and gather data for research/orthoses. |
| What is the goniometric assessment process IN ORDER? | Explain/demonstrate movement → test uninvolved side → observe patient AROM/correct improper movements → measure PROM → assess end feel. |
| What are the contraindications for AROM/PROM? | Risk of disrupting healing/causing further damage; suspected subluxation, dislocation, or fracture; presence of myositis ossificans or ectopic ossificans. |
| What are the precautions for AROM/PROM? | Very painful conditions, inflammatory processes, pain or muscle-relaxant use, marked osteoporosis, known hypermobile joints, hemophilia, hematomas, suspected ankylosis, and recent acute injury/immobilization. |
| What is MMT? | Evaluation of muscle function/strength based on the ability to move a joint through ROM and maintain the position against resistance. |
| What three factors determine an MMT grade? | Evidence of contraction → ability to move against gravity vs gravity-eliminated → amount of resistance the patient can hold against. |
| What is the MMT procedure IN ORDER? | Explain/demonstrate movement → test uninvolved limb → properly position patient to isolate muscle/group → test against gravity first and correct improper movements → after full ROM, position limb and apply resistance. |
| Where should resistance be applied during MMT? | Near the distal end of the segment to which the muscle attaches |
| How should resistance be applied during MMT? | Slowly, progressively, and gradually — avoid sudden or uneven resistance. |
| In what direction should resistance be applied during MMT? | Opposite the muscle action |
| What segment should be stabilized during MMT? | The proximal segment. |
| If a contracture or fixed joint limitation restricts ROM, what ROM is used for MMT grading? | The patient's available ROM is considered their full ROM at that time and is used to assess MMT. |
| How can you improve the accuracy of MMT? | Know muscle location/function/anatomy, maintain consistent positioning/stabilization, and recognize/correct substitution movements. |
| What patient factors must be considered during MMT? | Patient effort, pain tolerance/willingness to endure discomfort, understanding of the test, and adequate motor planning. |
| What additional MMT material does the study guide specifically say you MUST know? | Contraindications for MMT and the MMT grading scale. The guide says to use the PowerPoint/handout for the grading scale because there will be questions on it. |
| What are the 3 types of normal end feels? | Soft, firm, hard. |
| What is a soft end feel? | Soft-tissue approximation stops the motion. Example: Knee flexion — calf contacts the posterior thigh. |
| What is a firm end feel? | Stretch/tension of muscle, capsule, or ligament stops the motion. Example: Ankle dorsiflexion or shoulder external rotation. |
| What is a hard end feel? | Bone-to-bone contact stops the motion. Example: Elbow extension. |
| What are the common types of abnormal end feels? | Empty, springy block, abnormal soft, abnormal firm, and abnormal hard. |
| What is an empty end feel? | Pain stops the motion before the therapist feels a true mechanical resistance. |
| What is a springy-block end feel? | A rebound or spring-like sensation that prevents the joint from reaching its expected ROM. |
| What does an abnormal soft end feel mean? | A soft end feel occurs where one normally would not be expected, often because of swelling/edema. |
| What does an abnormal firm end feel mean? | A firm end feel occurs earlier than expected or at a joint where that type of end feel isn't normally expected. |
| What does an abnormal hard end feel mean? | A hard/bony stop occurs earlier than expected or where a hard end feel normally shouldn't occur. |
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