OCC 501 Block 2 Review

3 structural joint classifications

fubrous, cartilagenous, synovial

fibrous joint

immovable connective tissue, sutures of skull

cartilagenous joint

slighlty moveable, pubis symphysis or sternocostal

synovial joint

moveable, most joints

joint capsule purpose

surrounds joint cavity to stabilize joint

synovial joint bone role

stable moving pieces

synovial joint cartilage role

protective covering that reduces friction

cartilage blood supply

non vascularized, heals slowly

synovial joint capsule role

surrounds joint cavity and stabilizes joint

joint capsule blood supply

poorly vascularized

synovial joint synovial membrane role

lines joint capsule and secretes synovial fluid

synovial fluid blood supply

highly vascularized

synovial joint synovial fluid role

nourishes cartilage by moving in via tensile force and out via compression

synovial joint muscle role

contractile tissue, crosses joints to move bones

muscle blood supply

highly vascularized

synovvial joint nerves role

proprioceptive and pain input, control motor output

synovial joint blood vessels role

supplying muscles and bones around the joint

ligaments

connect bone to bone, stabilization

tendons

connect muscle to bone, transmit force

ball and socket joint

mobility, 3 axes

identify

ball and socket joint

ellipsoid joint

2 spoons, 2 axes

identify

ellipsoid joint

saddle joint

convex and concave aticulating surfaces, 2 axes

identify

saddle joint

hinge joint

flexion/extension, 1 axis

identify

hinge joint

pivot joint

rotating, one axis

identify

pivot joint

gliding joint

flat surfaces gliding, least movement but most stable joint

identify

gliding joint

open pack joint congruency

least

open pack ligaments

lax

open pack has greatest

mobility

open pack example

partial flexion

closed pack joint congruency

highest

closed back ligaments

taut

closed pack has greatest

stability

closed pack position

full extension

identify position

open pack

identify position

closed pack

end feel

quality of reistance felt when joint stops moving

end feel tells

what structure is stopping the motion

end feel common limiting structures

ligaments, capsule, tendon tension, bony contact, soft tissue

soft end feel cause

tissue approximation

firm end feel cause

stretch of muscle, capsule, or ligament

hard end feel cause

bone to bone contact

unexpected soft end feel cause

edema, synovitis

unexpected firm end feel cause

increased muscle tone, tight tissue

unexpected hard end feel cause

OA, hypertrophic ossification, SCI, burn injury complications

unexpected empty end feel cause

pain

elastic deformation

region where tissue will return to original shape after stress is removed

identify 1

elastic deformation

yield point

elastic limit and boundary between elastic and plastic region

identify 2

yield point

plastic deformation

permanent change in shape by bending and folding

identify 3

plastic deformation

ultimate strength

tissue's maximum capacity

identify 4

ultimate strength

before ulitmate strength

tissue is intact but permanently damaged

after ultimate strength

tissue damage starts, decreased strength, rupture may occur

degrees of freedom

how many axes a joint can move in

contraindications to not complete ROM assessment (2)

joint dislocation or unheald fracture OR immediately post-surgery on soft tissue structures surrounding joints

ROM assessment precautions

hypermobility, recently healed injuries, active pain or inflammation, on pain meds or muscle relaxers, post-op precautions, osteoporosis

client factors limiting ROM

muscle weakness, scar tissue, arthritis, fractures, spasticity, pain, edema, soft tissue contracture

screening ROM assessment purpose

quick check for potential limitations

screening ROM categories

WFL, WNL, or full ROM assessment

occupation based ROM assessment

observing functional activity to see if formal ROM assessment is required

formal ROM assessment purpose

detailed measurement necessary to claify reason, extent, or cause of movement limitations

3 steps of ROM evaluation

explain and position pt, measure with goniometer, record measurement

explain and position patient

ask name + DOB, explain what you're doing and why, ask for permission to touch, position pt safely, move clothing, hand hygiene

measure active ROM

dmeonstrate motion and ask pt to peform, measure with gioniometer, measure PROM if AROM is limited

measure passive ROM

passively move limb until resistance or pain felt, measure final position with goniometer

record measurement

record starting position dash end position, PROM in ()

PROM

limb relaxed, if client cannot do enough AROM

PROM goal

maintain ROM and prevent adhesions

how many joints can PROM move

more than one

how many joints can AROM measure

1

AAROM

initiates movements but uses unaffected limb or device to move it through ROM

AAROM goal

maintain or improve joint mobility for those who can partially move a joint but not reach full range without help

static stretching

end range held for 15-30 seconds

static stretching most effective when

tissue is warm

static stretching goal

promote elastic deformation to increase ROM

no strain strain level

tissue maintained in position for long period of time with no force applied

no strain con contracile tissue behavior

increased connective tissue density

elastic deformation non contractile tissue behavior

collagen fibers stretch but return to resting length after force removed

plastic range non contracile tissue behavior

micro failure of collagen fibers with tissue remodeling/adaptation

ultimate strength non contractile tissue behavior

macrofailure of collagen fibers, tissue tearing

intervention priority with at trick of losing PROM or limited AROM

PROM, positioning, splinting, AROM

intervention priority permanent limited ROM

rehabilitative FOR strategies

internvetion for limited PROM

stretching

intervention for limited AROM

increase strength and endurance

WFL/WNL ROM intervention focus

ROM not a goal area

3 types of muscle tissue

cardiac, smooth, skeletal

skeletal muscle functions (5)

force production, protection, fluid circulation, heat production, emotional expression

excitability

ability to respond to stimuli for contraction

4 characterisitcs of skeletal muscle

excitability, contractility, extensibility, elasticity

contractility

ability to contract and generate force

extensibility

ability to stretch or lengthen when force applied

elasticity

ability to return to resting length when stretching or shortening force is removed