Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
79 Cards in this Set
- Front
- Back
POSTURE
general definition? |
a position or attitude or the body
The relative arrangement of body parts for a specific activity A characteristic manner of bearing one’s body |
|
POSTURE
how is it assesed? |
Posture is assessed in anatomic position, with hands relaxed at sides
|
|
POSTURE
where do they gravitational force lines fall? |
The gravitational force line falls through the center of mass.
Behind the hip joint In front of the knee joint In front of the ankle joint |
|
POSTURE
in general, where is the center of gravity? |
The center or gravity (COG) is about S2.
Varies between individuals and body types. |
|
POSTURE
why is the center of gravity different for men? |
Men- increased upper body mass- higher COG
|
|
POSTURE
why is the center of gravity different for women? |
Women- increased lower body mass- lower COG
|
|
Factors that cause us to move out of a posture
JOINT COMPRESSION main idea? |
spine, decreased height of discs
|
|
Factors that cause us to move out of a posture
LIGAMENTOUS TENSION main idea? |
leaning on Y lig
|
|
Factors that cause us to move out of a posture
CONTINUOUS MUSCLE CONTRACTION main idea? |
fatigue
|
|
Factors that cause us to move out of a posture
CIRCULATION main idea? |
pooling of blood in legs or insufficient sensation causing tissue damage
|
|
Materials Required when assessing posture
PLUMBLINE use? |
string hanging from ceiling, weight on the end
|
|
Materials Required when assessing posture
WALL GRID main idea? |
clear film with gridlines, hanging from ceiling
|
|
Posture
STATIC POSTURE main idea? |
Static- assume and hold posture
|
|
Posture
DYNAMIC POSTURE main idea? |
movement patterns to change from one position to another
|
|
Posture
should it be assessed in both sitting and standing positions? |
Assess posture of spine and pelvis in standing and sitting- LE length may play a role in posture
|
|
Posture
how many planes should it be assessed in? |
Asses posture in 2 planes
Frontal- front and back halves Sagittal- side to side, comparing bony prominences |
|
Procedure- frontal plane
where should patient be instructed to stand? |
Have pt stand on opposite side of plumbline- centered or greatest mass
|
|
Procedure- frontal plane
what should be measured? |
Measure out of norms for all spinal curves and joints
|
|
Procedure- sagittal plane
where should patient be instructed to stand? |
Pt standing on opposite side of the plumbline
|
|
Procedure- sagittal plane
what should be assessed? |
Assess bilateral bony landmarks, spinal scoliosis, and head righting
|
|
SCOLIOSIS
what is the difference between FUNCTION and STRUCTURAL |
Functional or Structural- Have pt bend forward
If functional- curve is flexible and disappears If structural- vertebrae deviate laterally from midline and rotate, causing ribs to rotate and vert and ribs to protrude |
|
SCOLIOSIS
what can be concluded if when sitting there is no scoliosis? |
If no scoliosis then curve is functional and due to leg length discrepancy
|
|
Naming the Curve with Scoliosis
how is it named? |
to the side of their convexity (right of left)
with the vertebrae number |
|
Naming the Curve with Scoliosis
when forward bending, what side will the ribs protrude on? |
Ribs will protrude on the side of the convexity in forward bending.
|
|
Naming the Curve with Scoliosis
is determining if COMPENSATED or UNCOMPENSATED the same as naming the curve? |
May be compensated or uncompensated but this is not a NAME
|
|
Protective Shift
is this considered Scoliosis? |
Not a scoliosis
|
|
Protective Shift
what is this due to? |
Due to protective shortening on one side of paraspinals and reactive lengthening on the other side
|
|
Protective Shift
are these patients considered ACUTE? |
These pts are very acute
|
|
Protective Shift
what is this the possible result of? |
Could be result of pulled muscle or HNP to keep disc off nerve root
Shift hips toward PT and check for increased pain level |
|
Leg Length
when is this kind of testing used? |
Leg Length testing is used when an asymmetry occurs during postural examination.
|
|
Leg Length
what might cause a leg length asymmetry? |
Leg length asymmetry may be caused by actual bony asymmetry or may be caused by pelvic obliquity or muscular imbalances.
|
|
Leg Length
what are the 3 common tests for assessing leg length discrepancy? |
True leg length discrepancy
Apparent leg length discrepancy Leg pull test |
|
True Leg Length Procedure
how is the patient positioned? |
Pt in supine
Place legs in similar positions |
|
True Leg Length Procedure
how measured? |
Measure from ASIS to medial malleoli
Distal ASIS border to proximal med mall |
|
True Leg Length Procedure
what might cause asymmetry? |
If unequal, may be due to femur or tibia
Bend knees to 90 degrees, compare height |
|
Apparent Leg Length Procedure
how is pt positioned? |
Pt in supine
Place legs in similar positions |
|
Apparent Leg Length Procedure
how measured? |
Measure from umbilicus to medial malleoli
|
|
Apparent Leg Length Procedure
if unequal, what might this indicate? |
Uneven measures could indicate:
Pelvic obliquity Adductor or flexion deformity of the hip |
|
Leg Pull Procedure
how is pt positioned? |
Pt in supine
Place legs in similar positions |
|
Leg Pull Procedure
how measured? |
Grasp pts legs at the malleoli with thumbs at the most proximal part of the med mall
Flex pts hips and then pull legs while lowering Visually compare thumb level |
|
Leg Pull Procedure
what additional pt positions should this be tested in and how does rotation affect this test? |
Test in supine, long sit and full sit
ER will lengthen leg, IR will shorten |
|
Narrative notes
in what kinds of facilities are these mostly utilized? |
Mostly used in rehab centers where progress will be slower
|
|
Narrative notes
how often are they written and how is the grammar/usage different? |
Can be written once per day, per week
Complete sentences vs fragments |
|
Narrative notes
what kind of motion is emphasized and how written? |
Quality of movement stressed more than quantity
Must be organized, concise and direct Written in paragraph form |
|
Balance
definition? |
the ability to control center of gravity over a base of support in a given sensory environment
|
|
Balance
how determined? |
Determined by sensory input and motor output
|
|
Sensory Input
combination of what systems? |
vision
proprioceptive vesibular somatosensory |
|
Sensory Input
what does VISION include? |
eyes, age, clarity
|
|
Sensory Input
what does PROPRIOCEPTION include? |
positioning of body in space, affected by decreased sensation
|
|
Sensory Input
what does the VESTIBULAR system resolve conflict from? |
resolves conflicts from other 2
Semicircular canals-measure speed & acceleration Vestibular nuclei- vestibulospinal tract |
|
Sensory Input
what does SOMATOSENSORY refer to? |
self to object
|
|
Motor Output
Postural Synergy learned or automatic? |
Automatic Response
Can I correct this movement of COG inside BOS, or do I have to step? Use of a Balance Strategy- small movements of joints |
|
Motor Output
Program Strategy automatic or learned? |
Learned Response
|
|
Motor Output
Program Strategy what kind of mechanism is at work? |
feed forward mechanism, I have been through this before, and _____ is what I did then and it worked. Let’s try it again.
Roller coaster loop- lean backwards of forwards? |
|
Motor Coordination
this is the process of deciding _____? |
Process of deciding motor output
|
|
Motor Coordination
what is the goal of MOTOR COORDINATION? |
maintain COG within BOS- Stability
|
|
Motor Coordination
what is FEEDBACK CONTROL? |
automatic responses triggered by stimulation
|
|
Motor Coordination
what is FEED FORWARD CONTROL? |
control- prior experience and current environmental conditions determine movement strategy
|
|
Motor Coordination
how is NORMAL CONTROL? |
Normal control is automatic and subconscious
|
|
Balance Strategies
what is the CONE OF STABILITY? |
elliptical pattern around the COG
Forward Sway- 8 degrees Backward Sway- 4 degrees |
|
Balance Strategies
ANKLE STRATEGY where is the sway? how is the muscle action? |
Sway about the ankles
Muscle action it distal to proximal |
|
Balance Strategies
ANKLE STRATEGY what muscles active forward and backwards? |
Forward= gastroc- hamstrings- paraspinals
Backward=ant tib- quads- abdominals |
|
Balance Strategies
HIP STRATEGY how is it typified and where is the muscle action? |
Sway about the hips
Muscle action is proximal to distal |
|
Balance Strategies
HIP STRATEGY what muscles active during forward and backward motion? |
Forward= abdominals- quads- ant tib
Backward= paraspinals- hamstrings- gastroc |
|
Balance Strategies
how effective is the SHEARING STRATEGY |
Strategy-Not very effective on slippery surfaces, will cause a fall
|
|
Balance Strategies
STEPPING STRATEGY when is this used? |
Use when movement is too fast or too far to stay within cone of stability
|
|
Balance Strategies
STEPPING STRATEGY what is this a combination of? |
Combination of muscle reactions between both legs brings the feet back under the body when the COG has exceeded the BOS
|
|
how should strategy, sequence, and timing be assessed in older and diseased patients?
|
Assess with:
Eyes open and closed Firm and soft surfaces perturbation |
|
Treatments
if there are SENSORY DEFECITS, what should be worked on? |
work on boosting other systems
|
|
Treatments
if there are STRATEGY DEFECITS, what should be worked on? |
work on other hip or ankle strategies
|
|
Treatments
if there are SEQUENCING DEFICITS, what should be worked on? |
practice slowly and increase speed, could add FES for training
|
|
Treatments
if there are ORGANIC PROBLEMS, will treatment always be successful? |
If organic problems- severing of tracts or obliteration of nuclei, treatment may not be successful
|
|
Tinetti Balance Assessment
what does it measure? |
Measures different postures and gait
|
|
Tinetti Balance Assessment
is it subjective or objective? |
Objective for documentation, improving numbers
|
|
Tinetti Balance Assessment
has its reliability and validity been established? |
Reliability and Validity proven
|
|
Tinetti Balance Assessment
what does it asses and what are its levels? |
Assess’ pts risk of falling
19 and lower, pt at HIGH risk 19-24, could fall but not high risk Validation for PT for balance training |
|
Vertigo
what do CAWTHORNE'S EXERCISES accomplish? |
reproduces vertigo and thereby desensitizes deficient area.
|
|
Vertigo
what does the HALL-PIKE POSITION accomplish? |
45 degree reclined, may increase vertigo due to semi circular canals fluid levels all even.
|
|
Vertigo
what kind of postures to begin with, and how should it progress? |
Begin with static postures and progress as dizziness decreases
|