Module 4: Joint Mobility

Question 1

What is a joint?

Answer 1

They are the junctions between bones that compose the skeleton and allow movement to occur.

Question 2

What is the difference between passive and active range of motion?

Answer 2

Active is when the person being tested is doing the movement themselves and passive is when someone esle is taking them through the range

Question 3

If a client showed poor range of motion in an active movement but good range in a passive movement what would that imply?

Answer 3

According to the video that would mean the client requires strength. If there is a limit in both tests then there is something wrong in the joints

Question 4

What is a contraindication

Answer 4

A contraindication is a specific situation, symptom, or medical condition that makes a particular drug, procedure, or surgery inadvisable because it may cause harmful, dangerous, or fatal consequences to a patient

Question 5

Joints are formed by what 5 main things? Describe them.

Answer 5

Bones - form the articular surface
Cartilage - covers the bones forming the articular cartilage
Joint capsule - tissue that recovers the joints
Synovial membrane - is the inner lining of the capsule responsible for producing synovial fluid
Ligaments - provides stability by connecting structures

Question 6

Joints can have other structures such as meniscus, what is a meniscus? [Bonus]

Answer 6

A meniscus is a tough, rubbery, C-shaped piece of fibrocartilage that acts as a shock absorber and stabilizer between the thighbone (femur) and shinbone (tibia) in the knee

Question 7

Joints can have other structures suchs as bursa, what is a bursa? [Bonus]

Answer 7

A bursa is a small, fluid-filled sac that acts as a cushion between bones, muscles, tendons, and skin near joints, reducing friction and allowing smooth movement; there are over 150 bursae in the body

Question 8

Joints can have other structures suchs as a labrum. What is a labrum? [Bonus]

Answer 8

A labrum is a ring of tough, fibrous cartilage that lines the outer rim of the socket in ball-and-socket joints, primarily the shoulder (glenoid) and hip (acetabulum

Question 9

What are the three types of joints? (6)

Answer 9

Question 10

Name the 6 types of synovial joints

Answer 10

Question 11

List and describe the three main planes of movement

Answer 11

Question 12

What does a degree of freedom refer to? Describe each category of freedom? (1+3)

Answer 12

The different directions a joint can travel

1) Uniaxial – only one degree of freedom: flexion/extension of elbow

2) Biaxial – two degrees of freedom: flexion/extension, ulnar/radial deviation wrist

3) Multiaxial – more than 2 degrees of freedom: flexion/extension, abduction/adduction, internal/external rotation of the shoulder.

Question 13

Name each movement axis and where they intersect

Answer 13

Question 14

A joint ROM is formed by two types of movements. What are they?

Answer 14

physiological and accessory movements
Physiological movement: flexion, extension, rotation
Accessory movement: spin, roll, glide

Question 15

What is the difference between closed-pack and loose packed positions?

Question 16

Distinguish between full, inner and outer ROM

Answer 16

Question 17

Describe the 5 main causes of hypermobility

Answer 17

1) tearing or displacement of intracapsular structures
* Meniscus tear
* Soft tissue lesions
2) Formation of scar tissue – frozen shoulder
3) Immobilization
* Changes in the joint
* Shortening of muscles surrounding the joint
4) Neurological impairment – change in muscle control
* Spasticity or flaccidity
5) Pain
* May lead to lack of movement and shortening of muscles

I get the sense the textbook will have a better answer

Question 18

What are some of the causes and problems associated with hypermobility

Answer 18

Causes:
1) Pathology (disease)
2) genetics (probably)
Problems:
1) Risk of injury
2) Excessive overuse of joints leading to degenerative changes

Question 19

What is Goniometry and what is end feel?

Answer 19

goniometry is the type of measuring physios do to assess mobility. End feel is the feeling of the joint during PRM and physios should be familiar with that feeling in order to assess possible pathologies

Question 20

There are 5 ways to treat limited ROM according to the PP. What are they?

Answer 20

Passive ROM
Active ROM
Stretches
Mobilizations (accessory movements)
Manipulation

Question 21

When is PRM useful to help ROM

Answer 21

Indication: when full active ROM is not possible due to weak muscle, neurological problem, pain

Question 22

What are the effects and contraindications of PRM?

Answer 22

Maintain or increase ROM
Prevent muscle contractures
Increase circulation
Increase synovial fluid production and cartilage nutrition
Decrease pain
Maintain function

Contraindications
Acute injury to the joint, ligament or muscles
Early fractures

This is probably for people who are wheelchair bound etc.

Question 23

When is it good to use assissted or unassissted ARM on a client?

Answer 23

when there is full or near full PROM, to increase muscle strength

Question 24

What are the effects and contraindications of ARM

Answer 24

Maintain or increase ROM
Prevent muscle contractures
Increase circulation
Increase synovial fluid production and cartilage nutrition
Increase strength
Improve function

Contraindications
Acute injury to the joint, ligament or muscles
Early fractures

Question 25

What is the definition and indication of stretches?

Answer 25

Definition: performed by the individual or external person taking the joint beyond the available ROM, resulting in change in soft tissue length Indication: to increase or maintain ROM

Question 26

What are the effects and contraindations of stretching?

Answer 26

Maintain or increase ROM Prevent muscle contractures – increase soft tissue length Increase circulation Decrease muscle spasm – effect on pain Increase tissue compliance / flexibility Decrease pain Contraindications Acute injury to the joint, ligament or muscles Early fractures Joint hypermobility

Question 27

When is mobilization used on a client and what is the definition of accessory movements?

Answer 27

Performed when there is decrease in accessory movements Accessory movements: movements that a person can not actively perform but are part of normal joint ROM. It is a type of passive movement performed by an external person

Question 28

What are the effects and contraindications of mobilization?

Answer 28

Effects Increase ROM Regain normal physiological ROM – hypomobile, adhesions Decrease pain Increase synovial fluid production and cartilage nutrition Contraindications Acute injury to the joint, ligament or muscles Early fractures Joint hypermobility

Question 29

What is the definition and indications of manipulations

Answer 29

Definition: small-amplitude forceful movements to the joint past the physiological available range Indication: to increase ROM due to end-range blockage

Question 30

What are the effects and contraindications of manipulations?

Answer 30

Effects Increase ROM Regain normal physiological ROM – hypomobile, adhesions Decrease pain Increase synovial fluid production and cartilage nutrition Contraindications Acute injury to the joint, ligament or muscles Early fractures Joint hypermobility

Question 31

For every kind of interventiion for ROM, which fit under PRM and ARM?

Answer 31

PROM: Relaxed passive movement Stretching Accessory movement (mobilizations) Manipulations AROM: AAROM (assisted) AROM

Question 32

Gotta make practice questions with this table somehow

Question 33

Provide examples of each kind of synovial joint

Question 34

Differentiate between closed-packed and loose-packed joint positions.

Answer 34

Closed packed is when the joints are at their most optimal fit between both sides of the joint (congruency) and it's when the joint is most stable and the ligaments are often taut

Question 35

Define the movement of glide. Describe one joint in the body where this accessory movement occurs.

Answer 35

Gliding is a pure translatory movement, one fixed point sliding over the other joint surface.

Question 36

Define the movement of spin. Describe one joint in the body where this accessory movement occurs.

Answer 36

Spin is like a top spinning, a pure rotatory motion. Apparently this happens a little in the spine during flexion/extension

Question 37

Define the movement of roll. Describe one joint in the body where this accessory movement occurs.

Answer 37

A roll refers to one surface rolling over another, like a ball rolling over a surface. An example of roll is seen when the femoral condyle rolls over a fixed tibial plateau during knee extension.

Question 38

Give 4 factors that contribute to normal ROM. Describe how they facilitate ROM.

Answer 38

1) capsule supporting synovial membrane 2) Intact neuromuscular and musculoskeletal systems 3) Muscle strength 4) Bony Shape or hyaline Cartilage

Question 39

Normal limitation of ROM is brought about by:

Answer 39

* articular surface contact * limit of ligament extensibility * limit of tendon and muscle extensibility * apposition of soft tissue. (bicep being in the way of further flexion of the bicep)

Question 40

What are some examples of things that can limit range of motion? (That are beyond obvious things like fractures)

Answer 40

Soft tissue lesion Muscle atrophy Neurological impariment (paralysis) Hypertrophy (body builder)

Question 41

What is the difference between stretching and passive ROM?

Answer 41

Stretching differs from relaxed passive movement in that it takes the movement beyond the available range

Question 42

What is the difference between accessory movements and manipulations?

Answer 42

Manipulations are forecful and take something beyond available range and are potentially dangerous. "accessory movements as those movements of the joints that a person cannot perform actively but that can be performed on that person by an external force"