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53 Cards in this Set
- Front
- Back
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What is hypomobility?
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Less than expected ROM
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What are the six causes of hypomobility?
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1. Inflammation
2. Age 3. Capsuloligamentous shortening 4. Muscular shortening 5. Joint malposition 6. 'Subluxed' joint |
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How does mobility change with age?
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-Increased mobility in children
-Mobility decreases with age |
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How is subluxation different than a subluxed joint?
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-Subluxation: Joint moves out and comes back in
-Subluxed joint: Chronically malaligned |
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What is a capsular pattern? What does it indicate?
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-Pattern of PASSIVE loss of movement in a synovial joint
-Indicates involvement of TOTAL joint |
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What are the six causes of a capsular pattern?
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1. Systemic disease
2. CA 3. Fx 4. Local inflammation 5. Acute trauma 6. Overload to an aging joint |
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Why is a capsular pattern important to recognize?
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Could indicate problem or disorder that must be referred to a physician or specialty other than PT
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What is a non-capsular pattern? What are the causes?
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-Any loss of passive movement other than a capsular pattern
-Causes can be multifactoral |
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What are the interventions used to treat hypomobility?
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1. Manual therapy
2. Exercise |
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What type of manual therapy is used to treat hypomobility? What is the purpose of using manual therapy?
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-Types: Mobilization, manipulation
-Purpose: Pain relief, stretch inert tissues |
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What is the purpose of using exercise to improve hypomobility?
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-Improve motor control
-Maintain gains of treatment |
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What is hypermobilty? What are the two types?
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-Greater than expected ROM
-Types: Generalized, localized |
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What are the two causes of generalized hypermobility?
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1. Systemic disease
2. Congenital condition |
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What is Ehlers-Danlos syndrome? Does it cause hyper- or hypomobility?
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-Rare, hereditary disorder
-Collagen manufacturing defect -Causes hypermobility of joints and stretchy skin |
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What is Marfan syndrome? What are some signs of the syndrome? Does it cause hyper- or hypomobility?
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-Rare, hereditary disorder
-Connective tissue defect -Signs: Pectus excavatusm, arachnodactyly, dilation of aorta -Causes hypermoblity of joints |
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What is localized hypermobility? Is it related to systemic disease?
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-Increased normal mobility in one or more joints
-Unrelated to systemic disease |
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What are some causes of localized hypermobility?
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-Soft tissue overload
-OA changes -Muscle support -Breakdown of normal support |
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What soft tissue structures can cause hypermobility?
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-Capsule
-Ligaments -Muscle -Tendon |
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How does muscle support cause hypermobility?
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-Loss of static tone
-Loss of motor control |
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Breakdown of what four normal support structures can cause hypermobility?
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1. Bony architecture
2. Elastic support 3. Passive restraint 4. Muscular tone |
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Is joint instability easy or difficult to diagnose? Why?
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-Difficult
-Inconsistent findings |
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What are the three causes of instability?
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-Articular
-Ligamentous -Loss of motor control |
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What are three interventions for treating joint instability?
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1. External support-Bracing, cast, crutches
2. Internal support-Muscular training, collagen building 3. Surgical correction |
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What are the five categories of mobility grading?
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1. Ankylosed
2. Hypomobile 3. Normal 4. Hypermobile 5. Instability |
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During what category of mobility grading do PT's use mobilization?
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Hypomobile
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What are the three stages of the healing process?
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1. Inflammation
2. Proliferation 3. Remodeling |
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What are the four cardinal signs of inflammation?
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1. Redness (rubor)
2. Heat (calor) 3. Pain 4. Edema (tumor) |
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What does PRICEMEM stand for?
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Protection
Rest Ice Compression Elevation Manual therapy Early mobility Medication |
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What is the timing for the inflammatory stage of healing? What interventions are used during this stage?
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-Days
-PRICEMEM |
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What is the timing for the proliferative stage of healing? What interventions are using during this stage?
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-Days to weeks (~5-15 days)
-Interventions: General movements, rest, submaximal isometrics |
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What is the timing for the remodeling phase of the healing process?
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-Weeks to months
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What are the injury mechanisms for a muscle injury?
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1. Excessive strain
2. Excessive tension 3. Contusions 4. Lacerations 5. Myotoxic agents (ex: Botulism) |
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What are the key findings for a muscle injury?
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-Contractile tissue
-Pain w/ stretching -Pain/weakness w/ resistance |
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What is a 1st degree muscle strain? What are the S/S?
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-Microtear
-Local tenderness -Minor swelling -Minimal strength loss or movement restriction *Strong and painful |
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What is a 2nd degree muscle strain? What are the S/S?
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-Micro- & macrotear
-Moderate to severe pain -Swelling -Loss of strength -Functional deficit *Weak and painful |
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What is a 3rd degree muscle strain? What are the S/S?
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-Macroscopic tear (complete)
-Possible less pain -Severe swelling -Significant weakness -Significant functional loss *Surgery to fix |
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What are the interventions used to treat a muscle injury?
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-PRICE (injury grade will dictate amount of rest)
-Pain relief -Gentle movement (stimulus for cellular repair) -Surgery for 3rd degree injury |
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What are the injury mechanisms for a tendon injury?
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-Repetitive overuse-->microtrauma
-Failure-->macrotrauma (rupture) -Predisposition: Age, vascular supply, use patterns |
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Are there more chronic problems with muscles or tendons?
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Tendons
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What are the key findings for a tendon injury?
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-Contractile tissue
-Pain w/ stretching -Pain/weakness with resisted testing -Pain w/ active movement only (tenosynovitis) |
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What is the difference between tendonitis and tendonosis?
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-Tendonitis: Inflammation of tendon, can occur acutely
-Tendonosis: Degeneration of tendon, chronic overuse |
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What is tenosynovitis?
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Inflammation between tendon and sheath
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What are the interventions used to treat tendon injury?
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-Same as for muscle
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What are the injury mechanisms for ligament injury?
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-Macrotrauma
-Chronic overload or stress (creep) |
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What are the key findings for a ligament injury?
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-Hx of trauma (always)
-Joint effusion -Stress tests -Point tenderness |
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What is a 1st degree ligament sprain? What are the S/S?
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-Microscopic tear
-Pain -No swelling -No instabiliity/laxity |
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What is a 2nd degree ligament sprain? What are the S/S?
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-Micro- and macroscopic tearing
-Pain -Swelling -Mild laxity, but end-feel -Decreased strength |
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What is a 3rd degree ligament sprain? What are the S/S?
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-Macroscopic tear (complete), injury to other structures
-Pain (or not) -Swelling -Significant laxity with no end-feel |
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What are the healing times for the three types of ligament strains?
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-Grade I: Return to sport in 1-2 wks, complete healing in 4-6 wks
-Grade II: Return to sport in 8-12 wks -Grade III: Need surgery to repair, stabilize joint if no surgery |
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What are the injury mechanisms for a cartilage injury?
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-Degeneration (microtrauma)
-Macrotrauma -Inflammatory process |
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What are the key findings for a cartilage injury?
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-Pain with compression and shearing (special tests)
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What are the injury mechanisms for a bursa injury?
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-Macrotrauma
-Chronic overload |
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What are the key findings for a bursa injury?
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-Pain with compression and shearing (special tests)
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