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Flashcards in Joint Mobs Deck (55)
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1
Q

What type of CT is joint capsule made of?

A

Dense fibrous CT

2
Q

T/F Joint capsule thickness is equal all the way around

A

False, varies in thickness according to stresses placed on it

3
Q

What are the 3 roles of a joint capsule?

A
  1. Seals joint space
  2. Provides passive stability by limiting movements
  3. Provides active stability via its proprioceptive nerve endings
4
Q

What impact will a tight joint capsule have on motion?

A

cause early and excessive accessory motion in the opposite direction of the tightness

5
Q

What does injury to the joint capsule often lead to?

A

 Pain
 Loss of motion
 Excessive motion

6
Q

Why do we test at the open pack position?

A
  1. Maximal incongruency
  2. Intracapsular space is as large as possible
  3. Maximal amount of joint play available
7
Q

Why do we not test in the closed pack position?

A
  1. Joint positions where joint is most congruent
  2. Surrounding tissue (capsules and ligaments) under maximal tension
  3. Maximal stability of the joint
8
Q

What are you trying to determine with the joint mobility assessment? (3 things)

A
  1. Gross (quantity of movement) - hypomobile, normal, hypermobile
  2. End-feel (quality of movement) - firm, hard, empty
  3. Provocation
9
Q

What is the difference between hypomobility and hypermobility?

A
  1. Hypomobile - Motion stops short of anatomical limit instead stops at pathological point of limitation (Pain, spasm, adhesions, inflammation)
  2. Hypermobile - Joint moves beyond its anatomical limit because of laxity of surrounding structures
10
Q

What are indications for joint mobilizations?

A
  • Break pain cycle
  • Increase joint extensibility
  • Increase extensibility of tendons, muscles, fascia
  • Increase joint ROM
  • Promote muscle relaxation
  • Improve muscle performance
11
Q

What are the proposed biomechanical effects of joint mobilizations?

A

o Motion improvement
o Positional improvement
o Increase joint capsule extensibility

12
Q

What are the proposed nutritional effects of joint mobilizations?

A

o Synovial fluid movement

o Improve nutrient exchange

13
Q

Describe neurophysiological effect of mechanoreceptor stimulation of joint mobilizations

A

o Stimulates mechanoreceptors to inhibit pain impulses – distraction from other pain (hit elbow -> rub the area to decrease pain)

14
Q

Describe neurophysiological effect of gate control theory of joint mobilizations

A

o Gate control theory (joint capsule nerves)– chronic pain unmyelinated C fibers, stimulate large myelinated fibers which stops slow pain from reaching brain

15
Q

Describe neurophysiological effect of Descending pathway inhibition theory of joint mobilizations

A

o Descending pathway inhibition theory (brain stimulation) – grade 5 mobilizations, stimulating periaqueductal gray area, release serotonin, bind to opioid receptors and block incoming pain signals

16
Q

Describe neurophysiological effect of peripheral inflammatory modulation of joint mobilizations

A

o Peripheral inflammatory modulation – inflammation joint capsule, stimulate and flush out inflammation

17
Q

Choose absolute or relative contraindication:

Malignancy in area of treatment

A

Absolute

18
Q

Choose absolute or relative contraindication:

Arthroplasty

A

Relative

19
Q

Choose absolute or relative contraindication:

Cervical arterial dysfunction

A

absolute

20
Q

Choose absolute or relative contraindication:

Spondylolisthesis

A

relative

21
Q

Choose absolute or relative contraindication:

Hypermobility

A

relative

22
Q

Choose absolute or relative contraindication:

Infectious arthritis

A

absolute

23
Q

Choose absolute or relative contraindication:

Upper cervical spine instability

A

absolute

24
Q

Choose absolute or relative contraindication:

Practitioner lack of ability

A

absolute

25
Q

Choose absolute or relative contraindication:

Fusion of the joint

A

absolute

26
Q

Choose absolute or relative contraindication:

Excessive pain or swelling

A

relative

27
Q

Choose absolute or relative contraindication:

Fracture at the joint

A

absolute

28
Q

Choose absolute or relative contraindication:

Osteoporosis

A

relative

29
Q

Choose absolute or relative contraindication:

Neurological deterioration

A

absolute

30
Q

The joint play movement compression is what? (parallel or perpendicular)

A

Approximation of joint surfaces

Force perpendicular to joint plane

31
Q

The joint play movement traction/distraction is what?

parallel or perpendicular

A

Separation of joint surfaces

Force perpendicular to joint plane

32
Q

The joint play movement gliding is what?

parallel or perpendicular

A

Force direction parallel to joint surface

33
Q

The joint play movement gliding is what?

parallel or perpendicular

A

Force direction parallel to joint surface

34
Q

Distraction joint mobs are what to joint surface?

A

Perpendicular

35
Q

Oscillation joint mobs are what to joint surface?

A

Parallel

36
Q

Sustained hold mobilizations can be what 3 ranges?

A
  1. Beginning range
  2. Mid range
  3. End range
37
Q

Kaltenborn Distraction Grades are what type of mobs?

What are three grades called?

A

Perpendicular mobs
Grade 1 - piccolo (loose)
Grade 2 - Slack (take up slack)
Grade 3 - Stretch

38
Q

Describe the grade 1; where in the range it falls and its purpose for joint distractions.

A

Grade I – piccolo (loosen)
o Distraction force that neutralizes pressure in the joint without producing actual separation of the joint surfaces
o No stress on the joint capsule
o Can be used with gliding mobilizations to reduce compressive forces on articular surfaces and thereby pain

39
Q

Describe the grade 2; where in the range it falls and its purpose for joint distractions.

A

Grade II – slack (take up the slack)
o Slack in joint capsule is reduced through sustained distraction
o Separates the articulating surfaces and eliminates the play in the joint capsule
o Can help to determine the sensitivity of the joint

40
Q

Describe the grade 3; where in the range it falls and its purpose for joint distractions.

A

Grade III – stretch

o Designed to stretch joint capsule and soft tissues surrounding the joint to increase mobility

41
Q

Maitland Oscillation Joint Mob Grades are what type of mobs? How many grades?

A

Parallel Glides

5 Grades

42
Q

Maitland Oscillation Joint Mob Grade 1: where in the range it falls and its purpose for joint distractions

A

o Small amplitude technique performed at beginning of available ROM (first 25%)
o Primary goal: pain and spasm reduction

43
Q

Maitland Oscillation Joint Mob Grade 2: where in the range it falls and its purpose for joint distractions

A

o Large amplitude technique performed in middle of available ROM (middle 50%)
o Primary goal: pain and spasm reduction

44
Q

What is theory of Maitland Oscillation Joint Mob Grade 1 & 2?

A

 Reduces pain by improving joint lubrication and circulation to tissues related to the joint
 Rhythmic oscillations possibly activate articular and skin mechanoreceptors which play role in pain reduction

45
Q

T/F Maitland Oscillation Joint Mob Grade 1 & 2 are for pain relief and muscle guarding

A

True

46
Q

T/F Maitland Oscillation Joint Mob Grade 1 & 2 have a direct mechanical effect on restrictions

A

False, no direct mechanical effect on restrictions

47
Q

T/F Maitland Oscillation Joint Mob Grade 1 & 2 influences mechanical nociception

A

True

48
Q

T/F Maitland Oscillation Joint Mob Grade 1 & 2 are often used before and after grade 3 and 4

A

True

49
Q

Maitland Oscillation Joint Mob Grade 3: where in the range it falls and its purpose for joint distractions

A

o Large amplitude technique performed at end of available ROM (last 50%)
o Primary goal: stretching joint capsule and associated structures

50
Q

Maitland Oscillation Joint Mob Grade 4: where in the range it falls and its purpose for joint distractions

A

o Small amplitude technique performed at end of available ROM (last 25%)
o Primary goal: stretching joint capsule and associated structures

51
Q

Maitland Oscillation Joint Mob Grade 5: where in the range it falls and its purpose for joint distractions

A

o High velocity thrust of small amplitude at end of available range but within its anatomical range
o Movement that exceeds the resistance barrier
o Commonly referred to as high velocity thrust technique or joint manipulation

52
Q

T/F Maitland Oscillation Joint Mob Grade 3/4 are primarily for pain relief and muscles guarding

A

False, primarily stretching technique

53
Q

T/F Maitland Oscillation Joint Mob Grade 3/4 have mechanical and neurophys effect

A

True

54
Q

Maitland Oscillation Joint Mob Grade 3/4 may activate what two receptors to aid in reducing restriction of movement?

A

Inhibitory joint and muscle spindle receptors

55
Q

T/F Maitland Oscillation Joint Mob Grade 3/4 are used on patients who are normal

A

False, would make them hypermobile