Musculoskeletal System
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92 terms
Terms | Definitions |
|---|---|
 Anatalgic | -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 | -staggering, unsteady and exaggerated -usually a wide base of support |
| Cerebellar | -staggering seen with cerebellar disease |
| Circumduction | -circular motion to advance leg -during swing phase -insufficient hip or knee flexion or DF |
| Double step | -alternate steps are of different length or rate |
| Equine | -high step -prance like -excessive gastroc activity |
| Festinating | -walk on toes -starts slow than increases like falling forward |
| Hemiplegic gait | -patient abducts affected limb |
| Parkinsonian gait | -increased forward flexion of trunk and knees -shuffling with quick and small steps -festinating may occur |
| Scissor gait | -legs cross midline upon advancement |
| Spastic gait | -stiff movement -toes seem to catch and drag -legs held together -hip and knee slightly flexed |
| Steppage | -feet and toes are lifted through hip and knee flexion to excessive heights -secondary to DF weakness -foot slaps at initial contact |
| Tabetic | -high stepping ataxic which feet slap the ground |
| Trendelenburg | -denotes gluteus medius weakness -excessive lateral trunk flexion and weight shifting over stance leg |
| Vaulting | -swing leg advances by compensating through combination of elevation of pelvis and PF of stance leg |
| Sternoclavicular joint | -composed of clavicle articulating with the manubrium of sternum |
| Acromioclavicular joint | -composed to the lateral end of the clavicle articulating with the acromion of the scapula |
| Glenohumeral joint | -ball and sock joint -round head of humerus articulates with the shallow glenoid cavity of the scapula -reinforced by the superior glenohumeral ligament, middle glenohumeral ligament, inferior glenohumeral ligament and the coracohumeral ligament |
| Scapulothoracic articulation | -articulation between the scapula and the posterior rib cage -articulation no considered to be a joint since it lacks connection by fibrous, cartilaginous or synovial tissue |
| Elbow | -hinge joint -composed of humerus, ulna and radius -flexion and extension occur at the articulation of the trochlea with the semilunar notch of the ulna -joint capsule reinforced by the ulnar collateral ligament and radial collateral ligament |
| Wrist and Hand | -consists of radiocarpal and midcarpal joints -flexion, extension, radial and ulnar deviation -hand consists of metacarpophalangeal joints, proximal and distal interphalangeal joints and carpometacarpal joints |
| Hip | -ball and socket joint -formed by the articulation of femur with the innominate bone -head of femur inserts into acetabulum |
| Stability of hip | -acetabulum -iliofemoral ligament -pubofemoral ligament -ischiofemoral ligament |
| Knee | -hinge joint -formed by articulation of the tibia with the femur -weak in terms of bony arrangement |
| Stability of knee | -anterior/posterior cruciate ligament -medial/lateral collateral ligament -deep medial capsular ligament |
| Ankle | -hinge joint -articulation of the tibia and fibula with the talus -distal ends of the tib/fib form a mortise that borders the talus -structurally strong secondary to the bony and ligamentous arrangement |
| Stability of ankle | -bony arrangement provides the ankle with good lateral stability -medial ligaments: deltoid -lateral ligaments: anterior tibiofibular, anterior talofibular, calcaneofibular, lateral talocalcaneal, posterior talofibular |
| Normal end feel | -type of resistance that is felt when passively moving a joint through the end range of motion -certain tissues and joints have a consistent end-feel and are described as firm, hard or soft |
| Firm end feel | -stretch -DF, finger extension, hip medial rotation, forearm supination, etc. |
| Hard end feel | -bone to bone -elbow extention, etc. |
| Soft end feel | -soft tissue apporximation -elbow flexion, knee flexion |
| Abnormal end feel | -any end feel that is felt at an abnormal or inconsistent point in the ROM -in a joint that normally presents with a different end feel |
| Empty | -cannot reach end feel usually due to pain -joint inflammation, fracture, bursitis, etc. |
| Abnormally Firm | -increased tone, tightening of capsule, ligament shortening, etc. |
| Abnormally Hard | -fracture, osteoarthritis, osteophyte formation, etc. |
| Abnormally Soft | -edema, synovitis, ligament instability/tear |
| ATP-PC system | -high intensity, short duration exercise (100 meters) -Phosphocreatine decomposed and releases a large amount of energy -occurs almost instantaneously allowing for ready and available energy -provides energy for up to 15 seconds -represents most rapidly available source of ATP for muscle use |
| Reasons for rapid availability of ATP | -does not depend on long series of chemical reactions -does not depend on transporting the oxygen we breathe to working muscles -Both ATP and PC are stored directly within muscles |
| Anaerobic Glycolsis | -major supplier of ATP -high intensity, short duration exercise (400-800 meters) -stored glycogen is split into glucose and through glycolysis, split again into pyruvic acid -does not require oxygen -nearly 50% slower than the PC system -can provide 30-40 seconds of muscle contraction -formation of lactic acid which causes muscle fatigue -uses only carbs -releases enough energy for resynthesis of small amounts of ATP |
| Aerobic Metabolism | -predominantly during low intensity, long duration exercise such running a marathon -oxygen system yields most ATP -requires several series of complex chemical reactions -provides energy through the oxidation of food -combination of fatty acids, amino acids and glucose with oxygen releases energy that forms ATP -will provide energy as long as there are nutrients to utilize |
| Base of support | -distance between left and right foot during progression of gait -distance decreases as cadence increases -average for adult: 2-4 inches |
| Cadence | -number of steps -average adult: 110-120 steps per minute |
| Degree of toe out | -angled formed by each foot's line of progression and a line intersecting the center of the heel and second toe -average adult: 7* |
| Double support base | -two times during a gait cycle when both feet are on the ground -time of double support increases as speed of gait decreases -does not exist with running |
| Gait cycle | -sequence of motions that occur from one initial contact of heel to next consecutive initial contact with same heel |
| Pelvic rotation | -rotation of pelvis opposite the thorax in order to maintain balance and regulate speed -adult: 8 (4 forward with the swing leg and 4* backward with the stance leg) |
| Single support phase | -when only one foot is on the ground -occurs twice during single gait cycle |
| Step length | -distance measured between right heel strike and left heel strike -average adult: 28 inches |
| Stride length | -distance measured between right heel strike and the following right heel strike -average adult stride length: 56 inches |
| Free nerve ending location | -joint capsule, ligaments, synovium, fat pads |
| Free nerve ending sensitivity | -one type sensitive to non-noxious mechanical stress -other type sensitive to noxious mechanical or biochemical stimuli |
| Free nerve ending distribution | -all joints |
| Golgi ligament ending location | -ligaments, adjacent to ligaments' bony attachment |
| Golgi ligament ending sensitivity | -tension or stretch on ligaments |
| Golgi ligament ending distribution | -majority of joints |
| Golgi-Mazzoni corpuscles location | -joint capsule |
| Golgi-Mozzoni corpuscles sensitivity | -compression of joint capsule |
| Golgi-Mozzoni corpuscles distribution | -knee joint, joint capsule |
| Pacinian corpuscles location | -fibrous layer of joint capsule |
| Pacinian corpuscles sensitivity | -high frequency vibration, acceleration and high velocity changes in joint position |
| Pacinian corpuscles distribution | -every joint |
| Ruffini ending location | -fibrous labyer of joint capsules |
| Ruffini ending sensitivity | -stretching of joint capsule, amplitude and velocity of joint position |
| Ruffini ending distribution | -greater density in proximal joints in capsular regions |
| Type I muscle fiber | -aerobic -red -tonic -slow twitch -slow-oxidative |
| Type II muscle fiber | -anaerobic -white -phasic -fast twitch -fast-glycolytic |
| Functional characteristics of Type I | -low fatigability -high capillary density -high myoglobin content -smaller fibers -extensive blood supply -large amount of mitochondria -marathon, swimming, etc. |
| Functional characteristics of Type II | -high fatigability -low capillary density -low myoglobin content -larger fibers -less blood supply -fewer mitochondria -high jump, sprinting, etc. |
| Muscle spindle | -distributed throughout belly of muscle -send info to nervous system about muscle length, and rate of change of its length -important in the control of posture and with the help of gamma system -involuntary mvmts |
| Golgi tendon organ | -GTO -encapsulated sensory receptors -very sensitive to tension, especially when produced from an active muscle contraction -transmit info about tension or rate of change in tension -10-15 muscle fibers are usually connected -stimulated through the tension produced by muscle fibers -provide the nervous system with instantaneous info on the degree of tension in each small muscle segment |
| Nonopioid agents: actions | -provide analgesia and pain relief -produce anti-inflammatory effects and antipyretic (reduce fever) -promote reduction of prostaglandin formation that decreases the inflammatory process, decrease uterine contractions, lowers fever and minimizes impulse formation of pain fibers |
| Nonopioid agents: indications | -mild to moderate pain of various orgins, fever, headaches,muscle ache, inflammation (except acetaminophen), primary dysmenorrhea, reduction of risk of myocardial infarction (aspirin only) |
| Nonopioid agents: side effects | -nausea, vomiting, vertigo, abdominal pain, gastrointestinal distress or bleeding, ulcers, potential for Reye syndrome in children (aspirin only) |
| Nonopioid agents: PT implications | -patients are at increased risk of masked pain that would allow for mvmt beyond limitation or false understanding of their level of mobility -stomach pain should be taken seriously with referral to doctor |
| Opioid agents(narcotics): action | -provide analgesia for acute severe pain management -stimulates opioid receptors within the CNS to prevent pain impulses from reaching their destination -some used to assist with dependency and withdrawal symptoms |
| Opioid agents: indications | -moderate to severe pain of various origins -induction of conscious sedation prior to a diagnostic procedure -relief of severe and persistent cough(codeine) |
| Opioid agents: side effects | -mood swings, sedation, confusion, vertigo, dulled cognitive function, orthostatic hypotension, constipation, incoordination, physical dependence, tolerance |
| Opioid agents: PT implications | -therapist must monitor the patient for potential side effects of respiratory depression -treatment two hours after administration to maximize benefit -patient may not accurately report if treatment is painful |
| Open chain | -involve distal segment, usually hand or foot, moving freely in space -example: kicking a ball |
| Closed chain | -involve the body moving over a fixed distal segment -example: squats |
| Cardinal plane | -occurs around three corresponding axes (ant/post, medial/lateral and vertical) |
| Frontal plane | -coronal -divides the body into anterior and posterior sections -abduction, adduction, etc. -occur around anterior-posterior axis |
| Sagittal plane | -divides the body into left and right sections - flexion, extension occur around a medial-lateral axis |
| Transverse plane | -divides body into upper and lower sections -medial and lateral rotation occur around a vertical axis |
| Isometric exercises | -muscular force is generated without a change in muscle length -often performed against an immovable object -submax are traditionally used in rehab programs |
| Isotonic exercises | -muscular contraction in which the muscle exerts a constant tension -muscle mvmt with a constant load -performed against resistance often employing equipment such as hand weights |
| Isokinetic exercise | -exercise with a constant maximal speed and variable load -reaction force is identical to force applied to the equipment -cybex, biodex and lido |
| Concentric | -when the muscle shortens while developing tension -raising |
| Eccentric | -when muscle lengthens while developing tension -lowering |
| Isometric | -when tension develops but there is no change in the length of the muscle |
| Isotonic | -when the muscle shortens or lengthens while resisting a constant load |
| Isokinetic | -when the tension developed by the muscle, while shortening or lengthening at a constant speed, is maximal over the full ROM |
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