NPTE

5 Characteristics of Synovial joints

synovial fluid, synovial membrane, joint cavity, articular cartilage, fibrous capsule.

Name the 5 Joint receptors

Free nerve endings, golgi ligament endings, golgi-mazzoni corpsucles, pacinian corpsucles and ruffini endings.

Class 1 lever

Axis of rotation (fulcrum) between the effort (force) and the resistance (load). Examples: seesaw, triceps brachii force on olecranon with force pushing on forearm.

Class 2 lever

Load between fulcrum and force. Wheelbarrow is an example. Length of effort arm always longer than resistance arm.

Class 3 lever

force between fulcrum and load. length of effor arm is always shorter than resistance arm. Shoulder abduction with weight at wrist is an example.

Free Nerve Endings

one type is sensitive to non-noxious mechanical stress, other type sensitive to noxious mechanical or biochemical stimuli

golgi ligament endings

located at ligaments and adjacent to ligaments' bony attachment, senses tension or stretch on ligaments

golgi-mazzoni corpsucles

located at joint capsule, senses compression of joint capsule

pacinian corpsucles

located at fibrous layer of joint capsule, senses high frequency vibration, acceleertaion and high velocity changes in joint position

ruffini endings

located at fibrous layer of joint capsule, senses stretching of joint capsule, amplitude and joint velocity of joint poisiton

Energy systems: ATP-PC System

used for high intensity, short duration (sprinting 100 meters). Phosphocreatine decomposes and releases a large amt of energy that is used to construct ATP.

ATP con't

Occurs almost instantaneously allowing for ready energy needed my muscles. provides energy for muscle cxn for up to 15 seconds.

ATP aka phosphagen system does not....

depend on a long series of chem rxns, on transporting of O2, and both ATP and PC are stored directly in contractile mechanisms of the muscle.

Anaerobic Glycolysis

Major supplier of ATP during high intensity, short duration. Stored glycogen is split into glucose, and thru glycolysis, split again into pyruvic acid. This forms ATP.

Anaerobic glycolysis con't

This system is nearly 50% slower than the PC system and provides 30-40 sec's of cxn. Uses only carbs (glycogen and glucose)

Lactic acid

forms from anaerobic glycolysis = mm fatigue

Aerobic metabolism

Used for low intensity, long duration (marathon running). Yields the most ATP but requires several series of complex chem rxns.

Aerobic metabolism con't

The combo of fatty acids, amino acids, and glucose with O2 releases energy that forms ATP and will provide energy as long as there are nutrients available.

Type 1 muscle fibers

aerobic, red, tonic, slow twitch, slow-oxidative

Type II muscle fibers

anaerobic, white, phasic, fast twitch, fast-glycolytic

Gly (glycolysis)

Fly (it goes fast)

Funtional characteristics of Type I mm fibers

low fatigability, high capillary density, high myoglobin content, smaller fibers, extensive blood supply, large amt of mitochondria. (marathone and swimming are examples)

characteristics of Type II mm fibers

high fatigability, llow capillary density, low myoglobin content, larger fibers, less blood supply, fewer mitochondria, (high jump, sprinting are examples)

Muscle receptors: muscle spindle

distributed throughout the mm belly. They send info to the nervous system about muscle length and/or the rate of change of its length. Helps w/control of posture and the gamma system, involuntary movements.

Golgi tendon organ

very sensitive to tension. They transmit info about tension or rate of change of tension within the mm.

Golgi tendon organ con't

An avg of 10-15 mm fibers connected to each golgi tendon organ.

Open chain activities

involve the distal segment, usually the hand or foot, moving freely in space. (kicking a ball w/ the LE)

Closed chain activities

involve the body moving over a fixed distal segment. (squat lift)

Resistive Testing

innervation level

Pronation

ankle rolls in

supination

ankle rolls out

hallux valgus

Big toe slants inward toward the midline of the foot. "Bunion" often resulting from wearing shoes that are too narrow

Right handed people

a tendency toward a slightly low R shoulder and slightly high R hip

Left handed people

a tendency toward a slightly low L shoulder and slightly high L hip

Body composition

the relative % of body weight that is comprised of fat and fat-free tissue

12-18%

healthy range of body fat for males

18-23%

healthy range of body fat for females

Hydrostatic weighing

most widely used lab procedure to determine body density

Plethysmography

this method calculates body density with means of a chamber measuring change in air pressure.

Anthropometry

Skinfold measurement. Measures overall % body fat thru 9 standardized sites.

Loose packed position

point in the ROM of a jt where the articulating surfaces are the least congruent and supporting structures are the most lax

Closed packed position

the point where a jt's articulating surfaces are at maximum congruency resulting in greatest mechanical stability

Cadence

The average number of steps an individual will walk over a period of time. Average 110-120 steps per minute.

Base of support

Average for an adult is 2-4 inches

Step length

Average for an adult is 13-26 inches

Hawkins-Kennedy impingement test

pt's arm brought to 90 degrees flexion and passively internally rotated impinging the structures between the head of the humerous and acromion process.

Neers sign

stabalize the pt's scap with one hand, pronate the effected arm and bring up to 90 degrees passively. a positive sign is any pain reported by pt.

Allen Test/ Wright Test (hyperabduction test)

Tests for thoracic outlet syndrome

Tinel's Sign

a way to test for irrtated nerves. Lightly tapping on the nerve, a positive sign is pins and needles or prickling.

Ober's test

a way to identify contracture of the ITB. If patient can't adduct passed the exam table, they test positive.

Homan's sign

a test for DVT. Pt knee extended, examiner DF's the foot and squeezes the calf. pain = positive

phalen's test

Pt is asked to fully flex wrist and hold 60 seconds. Any tingling in thumb, index finger, middle finger, or half of ring finger may be indicative of carpal tunnel d/t compression of median n.

Piriformis test

pt's hip flexed to 60 degrees in sidelying. PT applies downward pressure (adduction) to knee while stabalizing pelvis. Positive test is pain or tightness. May be indicative of sciatic n compression.

Muscle insufficiency

a muscle contraction that is less than optimal due to an extremely lengthened or shortened position of the muscle. There are two types.

Active insufficiency

when a two-joint muscle contracts across both joints simultaneously

passive insufficiency

when a two-joint muscle is lengthened over both joints simultaneously.

Make test

an evaluation procedure where a patient is asked to apply a force against the dynamometer

break test

patient is asked to hold a contraction against pressure that is applied in the opposite direction to the contraction. "hold, don't let me move you.