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OCTH 712 exam 1
| Question | Answer |
|---|---|
| everyday activities that people do to bring meaning and purpose to life, umbrella term that task and activity fall under | occupations |
| completion of meaningful activities by a person, group(s), or population(s) | occupational performance |
| goal-directed actions that contribute to occupational performance; support occupational performance in environment; ex. motor, process, and social interaction skills | performance skills |
| physical; occupation to occupation; biomechanic focus; ex. reaching, stabilizing, manipulating, and walking | motor skills |
| cognitive, emotional, and psychosocial function essential; ex. navigating and organizing | process skills |
| social interaction skill | speaking |
| underlying body structures that contribute to movements involved in daily function, relates to motor performance skills, how structures work together, primary movers | functional anatomy |
| moving from 1 position or place to another; ex. changing positions in bed, transferring, walking, gait, adaptive equipment | functional mobility |
| emphasizes meaning behind motion, recognizing movement as an outflow of individual volition/will | purposeful movement |
| habits, routines, roles, rituals | performance patterns |
| identifies performance skills and patterns that facilitate or inhibit occupational performance, looking at strength level for movement, what's used, contexts | activity analysis |
| standing upright, feet apart, head forward, arms at sides, palms forward | anatomical position |
| attachment point that moves the least, usually proximal, typically bigger, more secure | origin |
| attachment point that is more moveable, usually distal, smaller | insertion |
| use of physical touch to identify structures | palpation |
| features that are palpable or visible on surface of the skin | surface anatomy |
| component of bone that protrudes beneath skin | bony landmark |
| study of anatomy and mechanics in relation to human movement | kinesiology |
| involves analysis of occupational performance and interventions to improve participation; typically applied when there is a fundamental problem in tissue integrity, range of motion, strength, coordination, and/or endurance | biomechanics |
| focuses on addressing orthopedic and MSK deficits that impact ROM and strength, usually used when there's an issue with an actual structure | biomechanics |
| plane, midline in center of body, divides into left and right sides, flexion and extension | sagittal plane |
| plane, also called coronal plane, anterior and posterior portions, abduction and adduction | frontal plane |
| plane, inferior and superior portions, rotating/twisting motions | transverse plane |
| axis, medial to lateral | frontal axis |
| axis, anterior to posterior | sagittal axis |
| axis, inferior to superior | vertical axis |
| joint's center around axes of motion | axis |
| cooperative, interdependent movement of segments and joints of body | kinetic chains |
| functional movement, promotes stabilization (heavy work patterns), proximal joints move in relation to distal segment moving a fixed joint proximally, examples: pushing a grocery cart or squatting to pick up a box | closed chains |
| free movement of distal segment in space, promotes mobility, allows joints to move together or independent of others, involves reaching and mobility, more independent and fine motor, less strength and stability, example: conducting an orchestra | open chains |
| OTs try to go from a ____ chain to a ____ chain | open; closed |
| example of moving from an open chain to a closed chain | brushing teeth by moving shoulder instead of wrist |
| any push or pull of matter, not just objects but bodies too | force |
| pulling, ex. Nursemaid's elbow | tensile force |
| pushing, ex. pushing to sit up | compressive force |
| turning effect of force, ability to rotate an object around an axis, synonymous with torque | moment |
| specific motion a m. can generate at a joint, synonymous with moment | action |
| determines how strong the m. is, actions, and how much movement; lever arm; distance from joint to m. | moment arm |
| mechanical advantage, tries to change distance of moment arm to improve this | leverage |
| pulley systems, think about how movement occurs at a joint, provides mechanical advantage, generate functional motion | levers |
| type of lever, exerted force and resistive force on opposite sides of axis; few in body; examples: seesaw and human neck | first class lever |
| type of lever, resistive force closer to axis than exerted force and on same side, not many in body, examples: using a wheelbarrow and human ankle | second class lever |
| type of lever, effort and resistance are near each other, most common in human body, allows for higher-velocity movements, example: digging | third class lever |
| what percent of levers in the human body are third class | 90% |
| force generated within a joint in response to external forces acting upon it; based on positioning of arm (changes moment arm and amount of effort), load, and where the load is located related to the axis | joint reaction force |
| assessing muscle strength (putting it in strongest position or isolating tested m.) and ergonomics (tool use, repetitive tool use, force to generate movement) | joint reaction force implications for OT |
| amount of applied force/area; all muscles need to be under a certain amount or muscle mass will reduce; example: astronauts lose muscle mass in space because of a lack of this | stress |
| amount of material displacement under specific amount of stress, the stress pulls on the muscles | strain |
| ability to stretch and return to original shape, varies with age | elasticity |
| stiffness of a material, stress-strain diagram | Young's modulus |
| ability to return to normal shape after strain, how far it can go before it doesn't bounce back | elastic deformation |
| maximal stress that can be sustained before tissue failure | yield point |
| permanent deformation of tissue but retains continuity | plastic deformation/strain |
| made up of collagen and calcium | bone |
| found in the shaft of long bones, greater mineral content than collagen, rigid support | cortical bone |
| found in marrow cavity of bones and end of long bones, higher collagen content | cancellous (spongy) bone |
| covers ends of long bones, dense connective tissue to absorb force between bones, multiple layers | articular (hyaline) cartilage |
| degeneration of cartilage within a joint | osteoarthritis |
| connects bone to bone and provides joint stability | ligaments |
| connect muscle to bone | tendons |
| from muscle contraction to the bone to allow for movement | transfer force |
| dense fibrous sleeve around synovial joint, provides passive stability to hold the joint together but is not good under pressure, contains synovial fluid to allow the joint to move slowly and freely | joint capsule |
| fibrous insertion that connects adjacent muscles, example: forms rectus sheath | aponeurosis |
| connection between 2 bones | joint |
| types: synovial, fibrous, cartilaginous | joints |
| type of joint, mobile joints, typical joints used in OT, allows for purposeful movements, ex. shoulders and elbow | synovial joints |
| type of joint, little/no mobility, provides stability, ex. sutures of skull | fibrous joints |
| type of joint, little/no mobility, provides stability, ex. pubic symphysis | cartilaginous joints |
| maximal contact between articular surfaces, maximal tension on surrounding ligaments, often with extension, ex. knee in full extension | close-pack position |
| least surface contact, increased mobility of joint, laxity/looseness of surrounding ligaments, allows for more movement | open-pack position |
| structural, functional, and degrees of freedom | classifications of joints |
| number of axes around which a joint moves | degrees of freedom |
| ball and socket, ellipsoid, hinge, saddle, gliding, pivot | types of synovial joints |
| type of synovial joint, spherical surface fits into concave depression, most mobile, rotates around 3 axes (flex and extend, ab and adduct, internal and external rotation), ex. shoulder and hip | ball and socket joint |
| type of synovial joint, oval-shaped convex end articulates with elliptical concave basin of another, 2 axes (flex and extend and ab and adduct), ex. radiocarpal joint and MCP | ellipsoid joint |
| type of synovial joint, collateral ligaments limit medial and lateral movement, one axis (flex and extend), ex. elbow joint | hinge joint |
| type of synovial joint, modified ellipsoid joint, two axes (flex and extend and ab and adduct), convex and concave articulating surfaces, ex. CMC joint of thumb | saddle joint |
| type of synovial joint, 2 flat surfaces of adjacent bones, translation movements between surfaces, least mobile, ex. carpal bones | gliding joint |
| type of synovial joint, one axis (internal and external rotation), bones rotate around one another, ex. atlantoaxial joint | pivot joint |
| gross movement of bones in relation to one another | osteokinematics |
| internal joint patterns, involves accessory motions that cannot be achieved by voluntary muscle force | arthrokinematics |
| movement of joint surfaces in same direction | translation |
| joint surfaces come together | compress |
| joint surfaces pull away | distract |
| joint surfaces move parallel to one another | glide |
| joint surfaces do axial rotation | spin |
| every point of the bone moves around a center of rotation (joint), primary motion | rotational movement |
| used in the place of the term rotation when talking about joint movement | roll |
| describes movement of distal and proximal parts of bone at the same time, distal moves 1 way and proximal moves the other | convex-on-concave rule |
| distal bone glides in opposite direction of rotational movement, ex. wrist | convex-on-concave surface |
| determines position of a joint and available range of motion of the joint | goniometry |
| medical and occupational histories, routines and habits, roles and valued occupations | occupational profile |
| instrument used to measure ROM | goniometer |
| body: 1/2 circle (0-180) or full circle (0-36), alignment: anatomical landmark, stationary arm: aligned parallel to proximal segment, moving arm: aligned parallel to distal segment, fulcrum: point over axis of motion at joint being measured | goniometer |
| when do you record motion in goniometry | beginning and end |
| recorded as 10-0-150 or +10-150 for example | hyperextension |
| type of range of motion; client-controlled; movement of client; may be predictive of functional activity; substitution possible; observe coordination, attention span, following directions, pain | active range of motion (AROM) |
| type of range of motion, how much motion is available at the joint, often greater than other type because of assistance from therapist, tells more about joint structure, decreased strength/muscle weakness may be present, ex. range past point of pain | passive range of motion (PROM) |
| due to moving, stretching, or pinching non-contractile structures; muscles is not often stretched; something is wrong with the joint | pain during PROM |
| caused by stretching of contractile structures and non-contractile structures | pain at end of PROM |
| how far can a client move the joint with a little assistance | active assistive ROM |
| degree of motion used, less than total | functional ROM |
| how many degrees are capable in a joint | total active motion and total passive motion |
| limiting factor, soft tissue restriction, ex. elbow flexion | soft |
| limiting factor, muscle stretch (ex. hip flexion with straight knee), capsular stretch (ex. MCP extension), ligament stretch (ex. forearm supination) | firm |
| limiting factor, bone on bone, ex. elbow extension | hard |
| limiting factor, unable to establish end feel | empty |
| gender, age, active vs. passive, occupations, activities, pain, disease and pathology, testing positions | factors affecting ROM |
| ROM less than normal values | hypomobility |
| ROM beyond normal values, typically due to loose ligaments | hypermobility |
| typical degrees of active ROM for joints of human body based on empirical research, established norm | typical movement |
| amount of active motion necessary to complete a specific functional task, such as drinking from a cup, how much motion is needed for the task | functional movement |
| specific pattern of restriction involving all or most passive motions of the joint due to pathological conditions | capsular patterns |
| conditions with significant joint effusion or synovial inflammation (ex. gout) and conditions with fibrosis (ex. immobilization of joint, chronic low-grade capsular inflammation) | conditions that lead to capsular patterns |
| passive movement restricted by structures other than joint capsule (ex. muscle strain), one movement and not all | non-capsular patterns |
| soft tissue injuries or fractures, joint instability, post-op restrictions, ossification | contradictions for ROM |
| joints infected or inflamed, joints with osteoporosis, hypermobility or subluxation, stiffened/hardened joints, post-op restrictions, painful conditions, pain meds or muscle relaxants, hemophilia, hematomas, soft tissue damage | precautions for ROM |
| determines presence, absence, or changes; establishes diagnoses; develops prognosis, goals, and plan of care; evaluates progress; modifies treatment; motivates individuals, researches therapeutic techniques | how goniometry data is used |
| radiograph vs. goniometry, strong correlation | criterion validity of goniometry |
| correlation between decreased ROM and projected functional limitations | construct validity of goniometry |
| consistency, good to excellent in reproducing consistent results | reliability of goniometry |
| what provides force for functional movements | muscle |
| type of muscle, moves bones, supplies force for purposeful movement, striated and alternating bands of fibers, mostly voluntary | skeletal muscle |
| type of muscle, forms muscular components of heart, striated and in segments, involuntary | cardiac muscle |
| type of muscle, involuntary, internal organs, nonstriated, contracts slowly and automatically | smooth muscle |
| microscopic study of body tissue (chemical composition and design) and how they work | histology |
| surrounds each individual muscle fiber | endomysium |
| surrounds fascicles (group of muscle fibers) | perimysium |
| surrounds group of fascicles | epimysium |
| long cylindrical strands of contractile proteins | myofibrils |
| contractile units of a muscle | sarcomeres |
| protein composing filaments, thin | actin |
| protein composing filaments, thick, forms central shaft of each sarcomere | myosin |
| stabilizes border around myosin, limits excursion | titin filaments |
| connects actin filaments, divides sarcomeres | z discs |
| a single motor neuron and the muscle fibers it innervates, increase strength by using more motor units, commands are all-or-none (fires or it doesn't, no partial) | motor unit |
| what position are muscles the strongest in | midrange |
| area of a cross section of a muscle at its widest point, this and length are proportional to muscle strength | physiological cross-sectional area |
| ____ and ____ muscles are the strongest | wide; long |
| type of muscle, fibers are oriented obliquely, three kinds | pennate muscles |
| type of muscle, fibers are oriented parallel to the line of force | fusiform muscles |
| a single ____ is made up of multiple motor units that send separate signals to sarcomeres | muscle |
| amount of motor units in a single muscle is based on what | size and fine motor control |
| noncontractile (passive) tissues within the muscle | fascia |
| results from loss of innervation to a muscle, no strength | hypotonic muscle |
| muscle with increased tone, constant state of contraction | hypertonic muscle |
| elongated and encapsulated structures, within muscle fibers, signal changes in muscle length, protect muscles to prevent overcontracting | muscle spindles |
| activates agonist muscles | phasic stretch reflex |
| muscle producing desired motion, prime mover, ex. elbow flexion = biceps | agonist |
| muscle going against the agonist, ex. elbow flexion = triceps | antagonist |
| at junction of muscle and tendon, more sensitive than spindles, helps to set tone and resting tone in body, relieves stress between bone and muscle | golgi tendon organs |
| low forces, long period of time, endurance, type 1 fibers, more resistant to fatigue, ex. running a marathon | slow-twitch fibers |
| powerful contractions, type 2 fibers, fatigue quicker, ex. sprinting | fast-twitch fibers |
| learned patterns of motion | motor memory |
| muscles that assist the prime mover, ex. elbow flexion = brachialis and coracobrachialis | synergists |
| provide stability at origin of muscle | fixators |
| muscles that work together, may act in different directions to produce same motion or stabilize a joint, ex. wrist flexion | force couple |
| crossing (less/more) joints makes a muscle stronger | more |
| contraction with no change in length, "hold" contraction, no movement, ex. holding a coffee mug with elbow at a 90 degree angle | isometric contraction |
| contraction with change in muscle length and joint motion, eccentric and concentric are types of this | isotonic contraction |
| isotonic contraction that involves lengthening, can require lots of strength and activation, can be tiring, ex. lowering a cup back down to a table | eccentric contraction |
| type of isotonic contraction that involves shortening, ex. bringing a mug to the mough | concentric contraction |
| how quickly force is applied to tissue | load rate |
| a muscle cannot elongate enough to allow a joint to move through full ROM, ex. standing and trying to touch toes and keep knees extended, tenodesis is another example | passive insufficiency |
| adjacent fibers are maximally shortened, muscle cannot contract further, results in decrease in force produced by muscle, body changes mechanical leverage in JROM to avoid weakness, ex. extend the wrist so the finger flexors are more effective | active insufficiency |
| action in one place causes and action in another; when wrist is flexed, fingers naturally extend due to passive tension in the long finger extensors; when wrist is extended, fingers naturally flex due to passive tension in the long finger flexors | tenodesis |
| age, gender, individual differences, pain, cognitive status and perceptual factors | client factors |
| motivation, fear of pain and injury, ability to understand expectations of movement and discomfort/directions, anxiety | psychological/psychosocial factors |
| noise, number of people in the room, temperature, repetitive motion, excessive force | environmental factors |
| move the body part through the test ROM, then provide resistance against the body part at its end range/strongest point, can they tolerate it or do they break the movement | break test |
| establishes a basis for re-education, helps determine a patient's level of potential function, determines a patient's needs for supportive apparatuses, helps determine a diagnosis, determines a patient's prognosis | purposes of MMT |
| test can be repeated by any therapist with results that vary by no more than 1/2 grade | reliability |
| is MMT or goniometry more reliable | goniometry |
| procedure must test the specific muscles that it purports to test; careful observation, palpation, stabilization, and correct position are essential; need same variables each time | validity of MMT |
| reporting facts without distortion by personal opinion/bias; watch for personal bias about strength and desire to show patients that they are doing well (removes justification for services) | objectivity of MMT |
| measure of MMT, the part moves through full ROM against gravity and takes max. resistance | 5 (normal) |
| measure of MMT, part moves through full ROM against gravity and takes moderate resistance | 4 (good) |
| measure of MMT, part moves through full ROM against gravity and is unable to take any added resistance | 3 (fair) |
| measure of MMT, part moves through full ROM in a gravity-eliminated plane | 2 (poor) |
| measure of MMT, tension is palpated in the muscle or joint but no motion occurs at the joint | 1 (trace) |
| measure of MMT, no activity | 0 |
| type of muscle tone, muscles lack resistance to passive movement, no active movement, feels floppy and heavy when lifted, 0 in MMT, associated with UMN or LMN damage and atrophy | flaccid muscle tone |
| examples: stroke, brain injury, crush injury, disorders, spinal cord injuries can cause this type of muscle tone | flaccid muscle tone |
| type of muscle tone, reduced tone, muscle feels floppy and person has trouble controlling it, associated with reduced muscle strength, 2 or 2- in MMT, very common in childhood disorders (muscular dystrophy, cerebral palsy, and developmental disorders) | hypotonic muscle tone |
| type of muscle tone, tension or resistance is present in a relaxed muscle; resting muscle tone; involved in ability to maintain a constant posture and co-contraction between muscle groups; affected by muscle strength, exercise, age, and genetics | typical muscle tone |
| type of muscle tone, muscle has too much resistance to tension or movement at rest, muscles are stiff or tight and hard to move, can occur following intensive exercise, common in neurological disorders (UMN particularly) | hypertonic muscle tone |
| examples: brain injury, spinal cord injury, stroke can cause this type of muscle tone | hypertonic muscle tone |
| type of muscle tone, a hypertonic state characterized by constant resistance throughout ROM, common in Parkinson's, occurs following UMN impairment, impacts postural mm. and mm. of gait, lead pipe and cogwheel types, movement is painful | rigidity |
| type of muscle tone, disruption in muscle movement patterns that cause certain muscles to contract all at once in an area, can be with movement or rest, muscles remain contracted and resist stretch, associated with UMN disorders | spasticity |
| which type of muscle tone can be increased by physiological changes such as yawning or dehydration | spasticity |
| type of muscle tone, permanent contraction of the muscle and tendon due to severe lasting stiffness and spasms over a long period of time, no stretch, shortening of muscle and tendon, tightening of ligaments, neurological disorders, prevention is key | contracture |
| abnormal muscle movement, loss of conscious control over movement, typically the inability to start a movement, freezing, commonly seen in gait and Parkinson's | akinesia |
| abnormal muscle movement; slowed movements and movement patterns; affects voluntary movements and automatic and repetitive movements; tested with repetitive movements; seen in trouble standing, reduced arm swing with walking, clapping and tapping fingers | bradykinesia |
| abnormal muscle movement, involuntary, erratic movements and movement patterns, can happen anywhere, fluid movements, slow or fast, may look like a "tic", may cause jerking or slow muscle spasms | dyskinesia |
| Huntington's, Parkinson's, and Tourette's are examples of the movement | dyskinesia |
| abnormal m. movement; sudden irregular movements of limbs, head, and face; often occurs on one side of the body at once; brief, abrupt, irregular, unpredictable, dance-like; changes in grip; often in face (tongue or mouth); mild case may appear purposeful | chorea |
| abnormal muscle movement, poor muscle control and coordination, clumsy movements, m. strength and tone are normal, organization of movements affected, damage to cerebellum, impacts daily occupations and manipulation of tools, drunk movements | ataxia |
| abnormal muscle movement, involuntary m. contractions and spasms, causes uncomfortable and prolonged postures, twisting or other repetitive motions, can be in one place or affect multiple, can be very painful (like a bad Charlie horse) | dystonia |
| abnormal muscle movement, unintentional and uncontrollable rhythmic movements, motor system overfires, occurs at repetitive frequency, can be resting or intentional | tremor |
| further movement is limited by anatomical structures | end feel |
| normal end feel type, due to bone contacting bone, results in an abrupt unyielding sensation of stopping with no pain to client, example is elbow extension | hard |
| normal end feel type; due to tissue stretch; a firm springy movement with slight give at end of ROM; normal elastic resistance; common; 3 types: muscular stretch (hip flexion), capsular stretch (MCP extension), and ligamentous stretch (supination) | firm |
| normal end feel type, full ROM is restricted by muscle bulk, where tissue meets tissue, painless, examples are knee and elbow flexion | soft |
| abnormal end feel type; hard and unyielding in a joint that isn't expected; restriction occurs before normal end of ROM due to joint changes, fracture, osteophytes, or other changes in the joint | bony end feel |
| abnormal end feel type, sudden and hard dramatic arrest of movement, has pain which is caused by movement, springy rebound feeling, due to reflexive (protective) muscle guarding to prevent further injury | muscle spasm end feel |
| abnormal end feel type; no physical restriction to movement; significant pain; no actual end feel; can be due to acute bursitis, joint inflammation, fracture, of psychological disorder that prevents tolerance of full movement | empty end feel |
| abnormal end feel type, increased muscle tone, shortening in the capsule, muscle or ligament, will occur in contracture development following prolonged spasticity and tone increase, not necessarily permanently firm but becomes more difficult to move | firm end feel |
| abnormal end feel type, mushy soft feel, can indicate acute inflammation, due to tissue edema in a sprain or other cause | soft end feel |
Created by:
emma.scarmon-coyotes
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