Therapeutic Principles

Warmups/flexibility 

- What are the positive effects on performance? 

- Faster muscle contraction and relaxation of both agonist and antagonist

Muscles

- Improvements in the rate of force development and reaction time

- Improvements in muscle strength and power

 -Lowered viscous resistance in muscles

-Increased blood flow to active muscles

- Enhanced metabolic reactions

- An increased psychological preparedness for performance

- How long is a general warmup? 

:total warm up will last 10-20 minutes 

-Slow active and specific parts?  

-  5-10 mins of slow aerobic exercise

Specific, begin doing sport specific related movements and exercising.

- RAMP Protocol for warmup: Raise, Activate, Mobilize, and Potentiate

- Two different flexibility: dynamic and static 

  • Static: range of a possible movement about a joint and its surrounding muscles during a passive movement

  • Dynamic: Available ROM during active movements, requires voluntary muscular actions

- What factors affect flexibility? 

  • Joint structure, Age and Sex, Muscle and Connective Tissue, Stretch tolerance, Neural control, Resistance training, Muscle bulk, Activity level

- What is the range of motion controlled by? 

FREQUENCY, DURATION, AND INTENSITY OF STRETCHING

- Stretch reflex : WHEN MUSCLE SPINDLES ARE STIMULATED DURING A RAPID STRETCHING MOVEMENT

- What is autogenic and reciprocal inhibition? 

  • Autogenic: active contraction before a passive stretch of the same muscle

  • Reciprocal: contracting the muscle opposing the muscle that is being passively stretched

- Types of stretches 

  • Static: slow and constant, with the end position held for 15 to 30 seconds

  • Ballistic: Typically involves active muscular effort and uses a bouncing-type movement in which the end position is not held 

  • dynamic : a type of functionally based stretching exercise that uses sport-specific movements to prepare the body for activity 

Wound healing (categories in the skin integrity)

- Know the chart

- Causes of wounds 

  • Surgical incisions

  •  Trauma

  •  Pressure

  •  Shearing Forces

  •  Friction

  •  Poor Circulation

- Risk factors for developing a wound? 

  • Risk Factors for Developing a

  • Wound

  • Broken Skin

  • Age (young or old)

  • Nutritional Status

  • Stress

  • Hereditary

  • Disease process

  • Medical Therapies (steroids, chemo, radiation,

  • diuretics) 

- What is a break in the skin or mucous membrane called -  OPEN WOUND



- What type of wound is created for a therapy purpose?

 - INTENTIONAL WOUND



What is the center of mass? And center of gravity? - Line of gravity runs which way through the center of the mass? 

Center of gravity is center of mass  they equal each other, 

The line of gravity runs vertically through Center of Mass, used as a point of reference for posture discussion and can be used to determine stability. 

- How do you get rid of chronic tissue? 

Debridement, which is the removal of this type of chronic tissue, through surgery, chemical, or autolytic.

- What are the phases of healing? Inflammatory, Proliferative, maturation phases



  • The inflammatory phase: a clot forms and cells of inflammation debride injured tissue. Immediate to 0-4 days

  • The proliferative phase: epithelialization, fibroplasia, and angiogenesis occur; additionally, granulation tissue forms and the wound begins to contract. 2 days - 6 week

  • The maturation phase: Collagen forms tight cross-links to other collagen and with protein molecules, increasing the tensile strength of the scar. 3 weeks to 2 years



Injury process 

- Look at the chart 


- What is the healing process?  4 distinct phases (Hemostasis phase, inflammatory, fibroblastic repair, maturation remodeling.

- What are the 1st and 2nd line of defense?  

- Neutrophils and Macrophages

- How does collagen heal? Along the lines of what?: Realignment of collagen fibers along lines of Tensile force to increase tensile strength. Type 1 collagen will be replaced by type 3 to form scar tissue. Collagen will lay randomly if no stress is placed. 

Wolff’s Law:  

Bone/soft tissue will respond to  physical demands placed, will align along stresses/tension

  • Critical that bone/soft tissue be exposed to gradually increasing stresses – specific to activities

Nervous and muscles 

- How many muscles do we have in the body

~ 650 

- What is the purpose of the muscles? (locomotion)

Generation of force and movement

- What are the 3 big muscles? 

  • Skeletal 

  • Cardiac

  • Smooth



- Myosin vs. actin (thick/thin, purposes) 

Myosin- thick filament

Actiin- thin filament

- Muscle tissue has little ability to reproduce blood cells? T/F

 - CNS vs PNS (and know their components ANS, SNS)

  • CNS: Brain and spinal cord

  • PNS: Cranial and Spinal nerves

    • SNS: 

 - Synonym for cell body 

  • Soma or perikaryon

- Myelinated vs unmyelinated nerve fibers 

  • Myelinated fiber: large diameter fiber and concentric 

  • Unmyenlinated: small diameter axon, simple envelope by the cytoplasm

- What are schwann cells?

  • responsible for myelination of axon

  • Wraps itself as spirally around a short segment of axon

  • Myelinate single axon

- What are satellite cells?

  •  Flat cell that surrounds the cell bodies of neuron of PNS gangla

  • Regulate exchange of material between neuron cell bodies and interstitial fluid

- Body tissue order in which therapeutic energy passes effects? 

 - Ex. ultrasounds: 

- epidermis,  adipose, muscular, nervous, connective

Tissue 

- What type of tissue covers body surfaces? Lines major organs

  EPITHELIAL TISSUE

- What is a 1 layered thin black epithelial tissue called? 

- simple squamous

- What can cells do to respond to stress?: 

Adapts, becomes injured, but recovers, dies 

- What are the major categories of modalities?

 Electrical, thermal, mechanical, light, manual, exercise

- What are connective tissue components?

 GROUND SUBSTANCE, FIBERS, CELLS

  •  And its matrix?

    • White fibers – contain collagen which gives the fibers flexibility and strength

    •  Yellow fibers – contain elastin more elastic than collagen but not as strong

    •  Reticular fibers – thin, highly branched collagenous fibers that provide support

- What are the inflammatory response phases? Time etc 

- This phases of healing shunts the blood flow initially in the first secs to mins protecting healing 

- What is general adaptation syndrome? (A.R.E)

  • Alarm Stage

    •  “Flight or fight” body fights for homeostasis- “Flight or fight” body fights for homeostasis

    • Increased BF, HR, SV

    • shunting occurs

    • Cortisol released

  •  Resistance Stage 

    • Plateau in the bodies adaptation 

      •  Body continues to adapt to the stressor by using homeostatic resources to maintain its integrity

      • Longest phase of the general adaptation syndrome, lasting many days, months, or years

  •  Exhaustion StageExhaustion Stage

    • Body can no longer withstand the stressorBody can no longer withstand the stressor

      •  Occurs when the body cannot withstand 

      •  Clinical—this stage may present as traumatic or overuse injuries

- What is fight or flight response? BODY fights for homeostasis by increasing blood flow, heart rate, stroke volume

- What is maturation remodeling? 

-  3 weeks to 2 years, a process in which new collagen forms which increases tensile strength to wounds, scar tissue is only 80% as strong as original tissue

- What are the 5 cardinal signs of inflammation? 

  • Pain

    • release of prostaglandin/bradykinin, damage to nerve receptors

  • Heat/Increased tissue temp.

    •  vasodilation

  • Redness

    • vasodilation

  • Swelling

    • Increased capillary membrane permeability

  • Loss of function

    • Body’s response to pain, swelling

- Inflammation can only occur in what types of areas? 

- AREAS WHERE DAMAGED AND DEAD CELLS RELEASE THEIR CONTENTS INTO THE ADJACENT SITES

- When dealing with inflammation how long would it take to declassify the subcutaneous situation? 

- How do you form a clot? 

Aggregation and coagulation of platelets form a clot, 

- Two substances released by platelets following the..

  • Thrombin and fibrinogen

- What is fascia? 3D WEB Consisting of a watery extra cellular matrix (ground substance), elastin, and collagen fibers densely woven in all directions, and fibroblast cells



- What kind of network is fascia? THREE WHOLE-BODY NETWORK (FASCIA, MYOFASCIAL, MUSCLE FIBERS)

- What layer of epithelial tissue does lymphatic tissue run through? 

Simple squamous epithelium

- In Parkinson's diseases what nerve transmitter is decreased?  Dopamine neurotransmitter

- What is the ECM in fascia anatomy made of?- (EXTRACELLULAR MATRIX) FIBER PROTEINS AND A FLUID PART, THE GROUP SUBSTANCE. 

- What are the 3 traditional layers of fascia made of? SUPERFICIAL, DEEP, SUBSERIOUS

- What are the fascia lines we covered in class? Front, back, superficial front, superficial back line, lateral, spiral, deep frontal, ipsilateral functional, arm,

 - What muscles make up the arm lines? 

- pec minor, 

- What are different types of collagen fibers? 

- What is type 3 collagen? 

Reticular connective tissue

  • Aid in healing, and is seen in skin, lungs and other hollow organs.

- What is cartilage? 

- tough flexible tissue, lines joints.

- What is fibrous connective tissue? 

Tissue made up of tough protein fibers called collagen, fibroblast, found in tendons and ligaments

- What is meningeal fascia? 

- What is the golgi tendon organ? 

- What is the most common cause of chronic inflammation? 

- What does PRICE stand for? 

- Protection

- Rest

- Ice

- Compression

- Elevation

- What is the blood content and know the % of each RBC, WBC, Plasma, Platelets