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A&M Quiz 3 Goniometry

front 1

Factors that affect ROM

back 1

Gender
age
race
BMI
Occupation
Recreation
Testing factors
-Tester's experience
=Instruments used
=Time of day

front 2

Women tend to have ______ ROM compared to men (adults not children)

back 2

Greater

front 3

these motions below tend to be _______ in children :
Hip flexion, abduction, lateral rotation
Dorsiflexion
Elbow flexion and extension

back 3

Greater

front 4

the motions below tend to be _______ in children;
Hip extension
Knee extension
Plantar flexion

back 4

limited

front 5

Wrist flexion and extension
Hip rotation
Shoulder rotation
Vertebral mobility
are all common areas of _________ Rom in adults

back 5

decreased

front 6

0- ______ degrees of motion is noted for each motion. typically

back 6

0-180 degrees

front 7

What are the 3 main parts of the goniometer

back 7

Body (contains the fulcrum)
Stationary arm
Movement arm

front 8

When determining ROM in the testing position the Joint should be in starting position of ___ degrees

back 8

0

front 9

when Using Goniometer the Fulcrum should be at the ____ ___ _____

back 9

axis of motion

front 10

when Using the Goniometer, Stationary arm parallel to long axis of _______ _________

back 10

proximal segment

front 11

the Moving arm of the goniometer should always be parallel to long axis of ______ _______

back 11

distal segment

front 12

Ideally read goniometer while in place on the patient at ___ _____

back 12

eye level

front 13

when recording the measurement, Record starting and ending position
E.g. knee flexion

back 13

0° - 120°

front 14

If pt is unable to start at 0° then from where started
e.g. knee flexion ...

back 14

15°-120°

front 15

If hyperextend then that degree - 0° to end ROM

back 15

10° - 0° -120°

front 16

12 steps of the testing procedure are?

back 16

1. Pt. in testing position
2. Stabilize proximally
3. Distal segment to 0o; take part through ROM and get end-feel
4. Visually estimate ROM
5. Return to start position
6. Palpate bony landmarks
7. Align goniometer
8. Read & record start position
9. Stabilize proximal segment
10. Move distal through full ROM
11. Replace and realign goniometer
12. Read and record ROM

front 17

The measurement of a joint angle and the amount of motion

back 17

Goniometry

front 18

Movement of the shafts of the bones around an axis
Gross movement of shafts of bones
Occurs around a fixed axis of motion
Takes place in 1 of the 3 cardinal planes and around corresponding axis

back 18

Osteokinematics

front 19

Movement of the joint surfaces with respect to each other

back 19

Arthrokinematics

front 20

ROM

back 20

The arc of motion that occurs at a joint or a series of joints

front 21

the feeling experienced by an examiner as a barrier to further motion at the end of PROM.

back 21

end-feel

front 22

Excessive range of motion
Poor stability and control
Injury and repetitive stress
Pain?

back 22

hypermobility

front 23

Beighton Scale

back 23

this test for Excessive Hypermobility measures the ROM of the joints below:

Thumb
5th MCP joint
Elbow
Knee
Forward flexion

front 24

If you want to improve rectus femoris length, what position will you place the hip and knee in?

back 24

flexion

front 25

If you want to improve hip extension, what position will you place the knee in?

back 25

knee extension

front 26

If trying to improve length of a muscle that crosses two joints, how should that muscle be positioned?

back 26

end range

front 27

If trying to improve ROM at a joint where a two joint muscle crosses, how should the joints and be positioned?

back 27

end range

front 28

When trying to measure ROM at a joint, where should you position the muscle that crosses that joint and another?

back 28

midrange

front 29

Passive Insufficiency

back 29

Muscles can prevent full ROM from occurring at a joint if it is being lengthened over multiple joints

front 30

If a _______ ________ ________ is limited, PROM may not pick that up because PROM is measured in a position that does not fully elongate a two-joint muscle

back 30

two joint muscle

front 31

If a one joint muscle is limited,________ at that joint will be limited

back 31

PROM

front 32

Muscke Length Testing

back 32

Looks individually at a muscle's ability to elongate and is Mostly used for two-joint muscles

front 33

Empty End Feel

back 33

No real end feel due to pain. No resistance is felt except patient has muscle splinting or spasm
Acute joint inflammation; bursitis, fracture,

front 34

Abnormal Hard End Feel

back 34

Occurs sooner or later in the ROM or in a joint that is not typical to have hard end-feel.
Chondromalcia, osteoarthritis, fracture, loose joint bodies, heterotrophic ossification

front 35

Nomal Hard End Feel

back 35

Bone on Bone
(e.g. elbow extension)

front 36

Abnormal Firm End Feel

back 36

Occurs sooner or later in the ROM or in a joint that is not typical to have firm end-feel.
Increased muscle tone; tight/shortened capsule, muscle, ligaments or fascial

front 37

Normal Firm End Feel

back 37

Muscular (e.g. 90/90)
Capsule (e.g. ext. of MCP)
Ligament (e.g. forearm supination)
Nerve (e.g. SLR)

front 38

Abnormal Soft End Feel

back 38

Occurs sooner or later in the ROM or in a joint that is not typical to have soft end-feel.
Edema; Adipose, Muscle bulk

front 39

Normal Soft End Feel

back 39

Soft tissue approximation
(e.g. knee , elbow flexion)

front 40

Abnormal End Feel

back 40

an end feel not typical for the given structures; indicative of a problem at the system level (impairment or pathology)

front 41

Normal End Feel

back 41

an end feel expected given the anatomical structures

front 42

End Feel

back 42

Limitations/barriers to ROM at the end of the range

front 43

ROM Assessment

back 43

Determine active ROM
Determine PROM
Determine End feel
Determine Muscle length
Assessment
Normal motion
Hyper or hypo mobility
Capsular pattern

front 44

Minimal Detectable Change

back 44

the minimum amount of change in a patient's score/measurement that ensures the change isn't the result of measurement error.

front 45

Concave on Convex

back 45

Roll and glide in the same direction as movement of shaft

front 46

Convex on Concave

back 46

Roll in same direction as movement of shaft but glide in opposite direction

front 47

PROM

back 47

the arc of motion attained at a joint by an examiner without assistance from the subject. The subject remains relaxed and plays no active roll in producing movement.

front 48

AROM

back 48

The arc of motion attained at a joint by a subject during unassisted voluntary joint motion

front 49

Hypomobility

back 49

this term refers to an decrease in PROM that exceeds normal values for a joint, given the subjects age, gender. The end-feel occurs early in the ROM and may be different in quality from what is expected.

front 50

Which axis of motion is oriented vertically when in the anatomical position. This axis runs through the shaft of the bone. Motion on this axis occurs in the transverse plane. Typically called rotational movements. Ex. Rotation of the trunk, oe internal/external rotation of the shoulder.

back 50

Vertical

front 51

Which axis of rotation allows movement to occur along the sagittal plane, such as flexion or extension of the elbow.

back 51

Medial-Lateral

front 52

Which axis oriented in a direction, which allows movement to occur along the frontal plane, Such as Abduction or adduction of the hip.

back 52

Anterior-Posterior

front 53

These movements take place along which plane?
• Internal and external rotation
• Axial rotation

back 53

Transverse

front 54

These movements take place along which plane?
• Adduction
• Abduction
• Lateral flexion
• Ulnar and radial deviation
• Eversion
• Inversion

back 54

Frontal

front 55

These movements take place along which plane?
• Flexion
• Extension
• Dorsiflexion
• Plantar flexion
• Forward and backward bending

back 55

Sagital

front 56

pathological conditions involving the entire joint capsule that cause a particular pattern of restriction involving all or most of the passive motions of the joint.

back 56

Capsular Pattern

front 57

Knee Flexion

back 57

130-140

front 58

Knee Extnsion

back 58

0 degrees

>5 is hyperextension

front 59

Hip Flexion

back 59

120-140

front 60

Hip extension

back 60

18-30Hip extension

front 61

Hip Abduction

back 61

40-55

front 62

Hip Adduction

back 62

20-25

front 63

Hip Internal ROtation

back 63

30-45

front 64

Hip External Rotaton

back 64

32-50

front 65

Dorsiflxion (Talocrural joint)

back 65

15-20

front 66

Plantar Flexion

back 66

45-55

front 67

Inversion at the Tarsal Joint

back 67

30-35

front 68

Eversion at the Tarsal Joint

back 68

15-20

front 69

Inversion/Supination (subtalar inversion)

back 69

5 degrees

front 70

Eversion/Pronation (subtalar eversion)

back 70

5-12 degrees

front 71

MTP Joint Flexion

back 71

30-45 degrees

front 72

MTP JOint Extension

back 72

70-80 degrees

front 73

What muscle test tests the length of the rectus femoris and a positive test is anything less than 90 degrees of knee flexion?

back 73

Ely test

front 74

What test tests the tightness of the IT band and anything greater than 10 degrees is a negative test

back 74

Ober test

front 75

Normal ROM for Hip flexion of the SLR test is what>

back 75

68-80 degrees

front 76

What are the 4 joints of the shoulder complex

back 76

  • Glenohumeral Joint
  • Sternoclavicular Joint
  • Acromioclavicular Joint
  • Scapulo-thoracic Joint

front 77

What are the rotator coff mucles and where do they insert?

back 77

Supraspinatus- greater tubercle of the humerus

Infraspinatus- greater tubercle of the humerus

Teres Minor- greater tubercle of the humerus

Subscapularis- lesser tubercle of thee humerus

front 78

what is the main rols of the rotator cuff muscles?

back 78

provides dynamic stabilzation to the humeral head

front 79

What muscles function as a group to control the active arthrokinematics of the GHJ by stabilizing the head of the humerus within the glenoid fossa during abduction?

back 79

The rotator cuff

front 80

Describe the degrees of freedom at the Shoulder

back 80

flexion-0extensio n

abduction-adduction

internal-external rotation

front 81

In order to achieve 90 degrees of ABD there must be 60 degrees of GH motion and ____ degrees of Scapulothoracic motion

back 81

30

front 82

What should you stabilize when measuring shoulder motion

back 82

the scapula

front 83

CapsulaR Pattern for the GHJ of limited ROM is>

back 83

External rotation>abduction>internal rotation

front 84

Frozen shoulder

back 84

joint capsule of the GHJ is inflammed adhering to the joint structure, limitations will follow a capsular pattern

front 85

what are the 3 stages of frozen shoulder

back 85

Freezing, frozen, thawing

front 86

What stage of frozen shoulder presents as constant pain ( especially at night), and gradual loss of ROM in 2-9 months

back 86

freezing

front 87

what stage of frozen shoulder presents with stiffening of joint structures with continues loss of ROM (4-12 months)

back 87

frozen

front 88

What stage of frozen shoulder presents as restoration of motion and function (5-26 months)

back 88

Thawing

front 89

Describe the loss of ROM you would expect to find after 5-6 months of adhesive capsulitis? which motions are the most? which are the least?

back 89

Flexion limited to: 85-90

abduction limited to 85-90

ER limited to 50

front 90

which side is considered the "normal side" when the differences in ROM between R&L in the general population are noted?

dominant or nondominant

back 90

Non-Dominant

front 91

AS we age, elderly start to lose internal rotation at the shoulders? T or F?

back 91

True

front 92

Combing hair requires ___ degrees of flexion and ____-____ degrees of ERT at the shoulder

back 92

110

60-80

front 93

Toileting requires ___-___ degrees extension and ___ degrees IR at the shoulder

back 93

35-50

100

front 94

Feeding calls for ___-___ degrees of flexion and ___-___ of IR at the shoulder

back 94

35-85

20-60

front 95

Sternoclavicular joint

back 95

  • medial clavicle with menubrium and 1st rib cartilage
  • strong joint capsule
  • reinforced by
    • anterior and posterior SC ligaments
    • costoclavicular ligaments
    • interclavicular ligament

front 96

Sternoclavicular Motion

back 96

  • 3 degrees of freedom
  • clavicle on the sternum
  • elevation/depression
  • protraction/retraction
  • anterior/posterior

front 97

The sternal end of the clavical is convex/concave in cephalad-caudal direction and convex/concave in the anterior-posterior direction

back 97

convex

concave

front 98

Why are the capsule and ligaments so strong and thick at the SC joint with little motion?

back 98

it is the only attachment to the axial skeleton for the UE

front 99

Tibial femoral joint

back 99

femoral condyles on the tibia's condyles

reinforced by anterior and piosterior cruciate ligaments and the MCL and LCL

front 100

Patellofemoral joint

back 100

posterior patella and the femoral patellar surface

front 101

joint capsule

back 101

large, loose posterior

reinforced by ligaments, tendons, and muscles

front 102

Anterior Knee Stabilization

back 102

  • Quadriceps Tendon
  • Patellar Tendon
  • Expansion from knee extensors
  • ACL & PCL

front 103

What ligament is tested with the varus stress test?

back 103

LCL

front 104

What component of the Knee is tested with the Ober's test?

back 104

IT Band

front 105

What ligament of the knee is tested with the Valgus Stress Test *with pain?

back 105

Medial Collateral Ligament

front 106

what muscles share a common insertion at the knee at the Pes Anserine

back 106

Semitendonosis, Sartorius, and Gracilis insertion

front 107

What muscles posteriorly stabilize the knee?

back 107

The knee flexors

front 108

Which ligament of the Knee

  • resists anterior translation of the tibia relative to a fixed femur (open chain)
  • resists posterior translation of the femur relative to a fixed tibia (closed chain)
  • resists varus and valgus deformations and excessive horizontal plane rotations

back 108

Anterior Cruciate ligament

front 109

Meiniscal Tear

back 109

MOI usually involves weight bearing during trauma (slip and fall) or external force

sx= joint line tenderness

front 110

this type of pain is caused by the patella not moving well in the intercondylar groove

back 110

Patellofemoral Pain

front 111

Bike

back 111

1/2 x BW or 100 lbs of compressive forces on the knee

front 112

The _________ ligament does the following:
• Limits eversion
• A triangular shaped ligament originating off of the medial malleolus.
• The ligament has 3 sets of fibers;
o tibionavicular
o tibiocalcaneal
o tibiotalar

back 112

Deltoid Ligament

front 113

The _________ ligament does the following:
• Limits inversion
• Consists of 3 different ligaments
o Anterior talofibular
o Calcaneofibular
o Posterior talofibular
o The most frequently injured ligament is the anterior talofibular ligament, typically as a result of excessive inversion and plantar flexion

back 113

LCL

front 114

name the ligaments of the ankle going clockwise

back 114

Anterior talofibular
Calcaneofibular
Posterior talofibular

front 115

What are the lateral ligaments of the ankle?

back 115

Anterior and posterior talofibular ligaments
Calcaneofibular ligaments

front 116

What are the medial ligaments of the ankle

back 116

Deltoid Ligaments

Anterior & Posterior Talotibial

Tibionavicular

tibiocalcaneal

front 117

the ___________ joint is Formed by the articulations between the convex head of the more proximal phalanx and the concave base of the more distal phalanx

back 117

interphalngeal

front 118

the __________ joint Formed by the articulation between the convex metatarsal head and the concave base of each corresponding phalanx

back 118

metatarsal-phalangeal

front 119

the _____________ joint is formed by the articulation between the distal surfaces of the 3 cuneiforms and the cuboid with the base of all 5 metatarsals

back 119

Tarsometatarsal joint

front 120

The _______ _______ joint Consists of 2 articulations, the talonavicular joint and calcaneocuboid joint

back 120

Transverse tarsal

front 121

Between the 3 inferior facets of the talus and the matching superior facets of the calcaneus describes which joint?

back 121

Subtalar

front 122

Trochlea of the talus articulates with the rigid concavity formed by the distal tibia and the fibula describes which joint?

back 122

Talocrural joint

front 123

Which ligament of the knee,

o Resists posterior translation of the tibia relative to a fixed femur (open chain)
o Resists anterior translation of the of the femur relative to a fixed tibia (closed chain)
o Resist extremes of knee flexion
o Resist valgus or varus deformations and excessive horizontal plane rotations

Mech of injury
-Hyperflexion
-Dashboard injuries
-Sever hyperextension
-Large valgus or varus producing force with a planted foot
-Any of t

back 123

PCL

front 124

Which ligament of the knee,
Resist valgus deformation of the knee
Resist excessive knee extension

Injury caused by;
Valgus producing force with foot planted
-Sever hyperextension

back 124

MCL

front 125

Which ligament of the knee,

Resist varus deformation of the knee
Resist excessive knee extension

Injury caused by;
Varus producing force with foot planted
-Sever ehyperextension

back 125

LCL

front 126

Donning socks: ___- ___ degrees of knee flexion

back 126

115-120

front 127

Sit to stand: _____ - ______ degrees of knee flexion

back 127

90-95

front 128

Descending stairs: ____ - ______ degrees of knee flexion

back 128

85-100

front 129

Ascending stairs: _____ - _____ degrees of knee flexion

back 129

85-100

front 130

Walking on level surfaces: Requires ____ - ____ degrees of knee flexion

back 130

60-65

front 131

Obesity is often associated with loss of knee ROM and pain

As much as _____ degree of loss of flexion for each unit of increase to BMI

back 131

1

front 132

standing = _____ BW at the knee?

back 132

1xBW

front 133

Squatting =~ ___ x BW or 1400 lbs of compressive force on the knee

back 133

7

front 134

Stair Descend ___ x BW 0r 1000 lbs of compressive force on the knee

back 134

5

front 135

Stair Ascend= ___ x BW or 660lbs

back 135

3.3

front 136

Bike = ____ x BW or 100 lbs of compressive force on the knee

back 136

1/2

front 137

this type of knee pain is caused by the patella not moving well in the intercondyler groove

back 137

Patellofemoral Pain

front 138

MOI usually weight bearing during trauma i.e. slip and fall, or external force

sx = Joint Line Tenderness

back 138

meniscal tear

front 139

Which ligament of the knee,

o Resists anterior translation of the tibia relative to a fixed femur (open chain)
o Resists posterior translation of the femur relative to a fixed tibia (closed chain)
o Resist valgus and varus deformations and excessive horizontal plane rotations

Mech of injury
Hyper extension

Large valgus or varus producing force with a planted foot

Either of the above combined with torsion

back 139

ACL

front 140

function of the meniscus

back 140

to absorb compressive forces across the knee caused by muscular contraction and body weight

front 141

When the knee is flexed at 120 degrees and the patella is liding distally, where on the patella is the femur making contact

back 141

on the posterior superior aspect

front 142

- palpable bony projections on the medial and lateral femoral condyles. Respectively these serve as the attachments for the MCL and LCL

back 142

medial and lateral epicondyles

front 143

the large rounded projections of the distal femur that articulate with the medial and lateral condyles of the tibia

back 143

medial and lateral condyles

front 144

Which ligament of the knee,

o Resists posterior translation of the tibia relative to a fixed femur (open chain)
o Resists anterior translation of the of the femur relative to a fixed tibia (closed chain)
o Resist extremes of knee flexion
o Resist valgus or varus deformations and excessive horizontal plane rotations

Mech of injury
-Hyperflexion
-Dashboard injuries
-Sever hyperextension
-Large valgus or varus producing force with a planted foot
-Any of the above combined with torsion

back 144

PCL

front 145

- the smooth rounded area between the femoral condyles that articulates with the posterior surface of the patella.

back 145

• Intercondylar groove

front 146

Compared to the 2 non-weight-bearing exercises, the squat exercise produced significantly higher PFJ stress at ____, _____, and ____ of knee flexion.

back 146

90°, 75°, and 60°

front 147

as you extend the knee, patellar femoral joint compression increase during which type of movement

back 147

OKC

front 148

greater compression of the patellar femoral joint during knee flexion on decent ( increased flexion= increase pressure) occurs during which type of movement?

back 148

CKC

front 149

What are the osteokinematic motions of the tibiofemoral (KNEE) joint?

back 149

• 2° of freedom;
-flexion/extension
-internal/external rotation

front 150

Describe the vascularity of the meniscus

back 150

Inner one third = Essentially avascular

Middle third = Poor blood supply

Outer third = Good blood supply

front 151

_____________ ______ __________ ____________ are crescent shaped fibro cartilaginous discs located at the top of the medial and lateral condyles of the tibia.

back 151

• medial and lateral menisci

front 152

-Improve overall congruency of the tibiofemoral joint
-Dissipate compression and shear forces across the knee

Injury caused by

Extreme valgus or varus producing forces at the knee
Extreme rotations of the knee especially under large compression forces

back 152

Medial and lateral menisci

front 153

-Resist excessive knee extension

Injury caused by severe hyper extension

back 153

Posterior Capsule

front 154

Which ligament of the knee,

Resist varus deformation of the knee
Resist excessive knee extension

Injury caused by;
Varus producing force with foot planted
-Sever hyperextension

back 154

LCL

front 155

Which ligament of the knee,
Resist valgus deformation of the knee
Resist excessive knee extension

Injury caused by;
Valgus producing force

back 155

MCL

front 156

Conversely, the 2 non-weight-bearing exercises produced significantly higher PFJ stress at ____, _____, and _____ of knee flexion when compared to the squat exercise

back 156

30°, 15°, and 0°

front 157

Which ligament of the knee,

o Resists anterior translation of the tibia relative to a fixed femur (open chain)
o Resists posterior translation of the femur relative to a fixed tibia (closed chain)
o Resist valgus and varus deformations and excessive horizontal plane rotations

Mech of injury
Hyper extension

Large valgus or varus producing force with a planted foot

Either of the above combined with torsion

back 157

ACL

front 158

• While a lateral angle greater than 175° is called genu varum or the term genu ____________ is to say that the shaft of the tibia is positioned (tilts) medially towards midline, making the knees bow apart

back 158

Varum

front 159

A lateral angle of less than 175° is called excessive genu____________. Or to say that the shaft of the tibia is positioned (tilts) laterally away from midline, making the knees knock together.

back 159

Valgum

front 160

• During normal patellar femoral joint motion the Patella glides _____________ as knee is extended

back 160

Proximally

front 161

• During normal patellar femoral joint motion the Patella glides___________ as the knee is flexed

back 161

Distally

front 162

• Function of the patellar

back 162

o Act as a transmitter of quadriceps force across the knee
o Enhancing the leverage (internal moment arm) of the quad muscle

front 163

-protrusion of bone located on the anterior aspect of the proximal tibia, serves as an attachment for the quad muscle.

back 163

Tibial tuberosity

front 164

• Intercondylar eminence

back 164

-dbl pointed projection of bone separating the medial and lateral condyles of the tibia. Serves as an attachment for the ACL and PCL

front 165

smooth and shallow for articulation with the condyles of the femur

back 165

• Medial and lateral condyles of the tibia-

front 166

Intercondylar Notch

back 166

- located on the posterior/inferior aspect of the distal femur separating the medial and lateral condyles

front 167

Proximal joint surface of the hip is the ?

back 167

acetabulum

front 168

Distal joint surface of the hip is the _______ ________

back 168

femoral head

front 169

Axis of motion of the hip joint is the is the ______ _______

back 169

femoral head

front 170

the hip joint is enclosed anteriorly by __________ and the _________ ligaments

back 170

iliofemoral (Y Ligament) & pubofemoral

front 171

the hip is Enclosed posteriorly by __________ ligaments

back 171

ischiofemoral

front 172

capsular pattern of the hip follows what motions?

back 172

Restricted:
*Medial/Internal rotation
Limited:
*Flexion
*Abduction

front 173

what are the 3 degrees of freedom at the hip?

back 173

flexion/extension
add/abduction
int/external rotation

front 174

Can occur anywhere in the labrum but __________ / _______ most common tear

back 174

anterior/superior

front 175

a labral tear can be Accompanied by clicking, slipping
Often due to repetitive twisting, cutting, and pivoting movements in addition to repetitive ______ at the hip

back 175

flexion

front 176

a labral tear can be associated with Pain with Flexion/Adduction and with axial loading
Often associated with _____ __________

back 176

hip impingement

front 177

avascular necrosis

back 177

Painful weightbearing
Restricted motion typically due to pain
Due to impaired blood supply from the lateral circumflex branches off the femoral artery
Often results in need for THR

front 178

Slipped Capital Femoral Epiphysis (SCFE)

back 178

Lower Extremity held in lateral/external rotation
Limb is shorter
Pain
Sometimes in knee
Decreased medial/internal rotation and flexion

front 179

antiversion/retroversion

back 179

Torsional Rotations of the femoral neck or the acetabulum

Extreme amounts of IR vs. ER

Extreme amounts of ER vs. IR