Chap 1
to have something that is considered a true (clinically important) difference it must change at last how many points on a visual analog scale?
2 points
how many nerve root pairs do you have?
31 pairs
what is tissue shock?
time period where you don't have muscle guarding yet
when is the head the highest during the gait cycle?
midstance
explain primary vs secondary curves - what is forward in each and which cruves are primary vs secondary?
primary curves are curves present at birth (thoracic and sacral) ; entire spine is concave forward
secondary curves are curves that develop as growth occurs (cervical and lumbar) ; convex forward
what is the cut off for acute, subacute, and chronic pain?
acute = 7-10 days
subactue = 10 days - 7 weeks
chronic = >7 weeks
what is a sclerotome?
area of bone or fascia primarily supplied by a single nerve root
explain intrareliability vs interreliability.
intrareliability = i do the test multiple times and come up with the same outcome
interreliability = multiple people do the test and come up with the same outcome
what is stride length and what is the average stride length?
distance between two successive heel strikes of the same foot
average = 57 inches
What are 2 advantages and 2 disadvantages to bipedal posture?
advantages: enables hands to be free, eyes father from ground to see farther ahead
disadvantages: greater stress on spine, pelvis, and lower limbs
reduced stability
difficulty in respiration and blood transport to the brain - increased work for heart
explain peripheralsensitization vs centralsensitization.
peripheralsensitization = peripheral nocioceptors become more sensitive which could cause hyperalgia
centralsensitization = brain and spinal cord are receiving too many signals and they get sensitized
explain radiculopathy vs myelopathy.
radiculopathy = damage to nerve root out - lower motor neuron lesion (causes radiating pain)
myeloptahy = neurogenic disorder involving spinal cord or brain - upper motor neuron lesion
give 2 examples of clinical outcomes and 2 examples of functional outcomes.
clinical = strength and ROM
functional = power, agility, and kinesthetic awareness
what are the stages of stance phase and when is it single vs double leg support?
initial contact - double leg
load response - single leg
midstance - single leg
terminal stance - double leg
pre-swing - double leg
explain the difference between lumbarization and sacralization.
lumbarization = S1 not connected to sacrum
sacralization = L5 is connected to sacrum
explain three differences between musculoskeletal and systemic pain.
musculoskeletal pain = sharp/superficial, associated with movement, aggravated by mechanical stress, associated with trauma or overuse, generally lessens at night
systemic pain = deep/aching throb, reduced by pressure, constant waves of pain & spasm, not affected by movement, progressive symptoms, disturbs sleep
what are 3 things hypermobile people are susceptible to? what about hypomobile people?
hypermobile = ligament sprains, joint effusion, chronic pain, recurrent injury, paratenonitis from lack of control, early osteoarthritis
hypomobile = muscle strains, pinched nerves, paratenonitis from overstress, myofascial hypomobility, pericapsular hypomobility, pathomechanical hypomobility
What are the 3 types of reflexes and give an example of each.
deep tendon = patellar
superficial = abdominal
pathological = babinski
which gait do you often see with stroke patients?
hemiplegic gait
when is puberty in males vs females and how long do each take?
males = 9.5 - 16 years lasting up to 5 years
females = 8 - 14 years lasting up to 3 years
give 3 red flags.
severe unremitting pain, pain unaffected by position, severe night pain, severe pain with no history of injury, severe spasm, inability to urinate or hold urine, elevated temp, psychological overlay
what are 3 differences between phasic and tonic muscles and give an example of each.
phasic = includes almost all other muscles, tend to become weak and inhibited, primarily 1 joint muscles (glutes)
what are the deep tendon reflex grades and what is likely wrong at each grade?
0 - absent (areflexia) ; issue with anterior nerve root out
1 - diminished (hyporeflexia) ; issue with anterior nerve root out
2 - normal
3 - exaggerated (brisk) ; cns issue
4 - clonus (hyperreflexia) ; cns issue
which gait stems from something being wrong in the brain whether it be poor sensation or lack of muscle coordination?
ataxic
What is tight & weak in both upper and lower crossed syndrome?
upper tight = upper traps, levator scapula & pec major and minor
upper weak = anterior deep neck flexors & rhomboids, serratus anterior, lower traps
lower tight = thoracolumbar extensors & iliopsoas, rectus femoris
lower weak = deep anterior abdominal muscles & glute max and med