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physiological movement

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movement of the joint in a direction in which the patient can voluntarily move

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Anatomical limit

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of joint range of motion is the cessation of normal motion because of the shape of the articular sufaces, the influence of ligamnets and muscles, and the contract or tension produced by extra-articular structures

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A Category I test is one in which

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you must apply forces with your hands

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A category II test is one in whic

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You do not apply forces on the patient (eg Observational data, circumference, etc)

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To tell the difference in tissue turgor you would use

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Palpation Test

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Dryness or excessive moisture of the skin could indicate

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an ANS dysfunction

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Radiculopathy means

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Nerve root injury

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AROM is a Category __ test

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II

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5 cardinal signs of inflammation

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Redness, Swelling, Heat, Pain, Inhibited function

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3 palpable signs of inflamation

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Swelling, Heat, pain

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Functio lasa means

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Inhibited function

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Turgor, in physical therapy, means

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Firmness

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MMT means

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Manual Muscle Testing

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Founders of Manual Muscle Testing were these three:

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Lovett, the Kendalls

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Examination procedure designed to assess the force production capability of a muscle or muscle group

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Manual Muscle Test

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Polio affects the ___ neurons

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alpha motor neurons

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Three factors in MMT measurement scales

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1. Extent of the arc of movement, 2. Gravity, 3. Magnitude of force applied by examiner

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Two most common MMT scales

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Daniels and Worthingham scale...Kendall scale

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Daniels and Worthingham scale score of 5 indicates

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Normal: Motion through full range against gravity and max applied forces

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Motion through full range and max applied forces is...

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The "Normal" #5, top rating in the Daniels and Worthingham scale. It is not an operational definition

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Tolerance of slightly less than the maximum applied force implies this score on the D+ W scale

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5- ("Normal -")

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Good+ would be scored as __ on the D+W scale

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4+, i.e. slightly more than moderate amount of force

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3 bases of operational definitions

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1. Universally understood, 2. Sound theoretical basis

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In the Daniels and WOrthingham scale, there will always be ___ in grades above ___

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Error in grades above Fair (3)

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Toleration of slightly less than moderate amount of force indicates

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4- in D+W scale. "Good -"

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Tolerance of slight resistance at end of the range of motion against gravity means

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The patient has a score of "Fair +" or 3+ on the D+W scale

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3 or Fair score on D+W scale indicates the patient

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has Motion through the full range against gravity and can hold

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Kendall scale is from 0 to

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10, (also a zero to normal scale like D+W)

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D+W is a ___ type of scale

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ORDINAL

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THe scores on the D+W scale that are operationally well defined include

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0-Fair(3)

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A poor score on the D+W indicates

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Motion through full range of with gravity diminished (because it can never be "eliminated")

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"Poor -" or 2- indicates this on the D+W

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More than half of the range with gravity diminished

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"Poor +" on the D+W is a scale of

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2+, meaning less than half of the range against gravity

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Fair - on the D+W scale indivates

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More than half of the range against gravity, and is noted as 3-

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Zero indicates on both the Kendall and D+W Scales:

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No contraction felt in the muscle/No palpable contraction

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The Kendall scale has both numerical values of ___ to ___ and this value

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0-10 and "t" for trace

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"trace" or "t" on the Kendall scale indicates

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Tendon becomes prominent or contraction felt in muscle but no visible movement

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On the Kendall scale, 1 corresponds with __

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Poor-

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On the D+W scale, 1 corresponds with

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Trace

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On the Kendall scale, P+ indicates

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Moves through complete range of motion with gravity minimized and holds against resistance

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Cyriax is known for his method of

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determining the lesion (pathology) that is present

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Menell is known for identifying

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joint movements that are abnormal

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Maitland identifies...

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activities and exam procedures that alter the patient's signs and symptoms

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Maitland's approach is driven by

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Symptom behavior change (i.e. alleviation) during treatment

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Comparable signs and use of the body diagram are aspect's of __'s approach

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Maitland's

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Determination of severity, irritability, nature and stage of condition are aspects's of ___'s approach

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Maitland

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PPIVM and PAIVM are aspect's of ___'s apprach to examination

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Maitland

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comparable signs are

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the patient's report of symptoms that are comparable to the symptoms associated with the chief complaint, and are elicited during any exam procedure

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Severity means

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the Intensity of symptoms related to a functional activity -- a self-report

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Irritability is

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related to the amount of activity needed to provoke symptoms and the amount of time needed for symptoms to subside

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Nature of impairment is

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Most closely aligned with the type of pathology present

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Stage of impairment is

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Prognosis of the condition, i.e. recurring, chronic, comorbidities

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Irritability guides your __ during exam

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agressiveness

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Menell believed that abnormal joint play...

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leads to dysfunction

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in Menell's approach joint manipulation...

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restores normal joint play

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Patient and examiner must be relaxed -- this is part of ___'s exam approach

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Menell

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One joint/movement examined at a time -- part of ___'s approach

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Menell

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Menell thought that the joint surface examined should be ___ on the joint surface __

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moved on the stabilized joint surface

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No forceful or ___ movements should be used in the Menell approach

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abnormal

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Williams believed that most Low Back Pain is caused by

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excessive lordosis and degeneration of intervertebral disc

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William's philosophy resulted in a non-specific...

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treatment approach

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McKenzie's approach looks at these body parts

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Cervical and Lumbar spine only

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McKenzie believed that most LBP is due to

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flexion related activities

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Most patients can be taught to self-manage. This is a belief of

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McKenzie

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McKenzie was influenced by

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Cyriax

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McKenzie believed, somewhat like Williams, that most LBP originates from

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the intervertebral disc

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Patients can be grouped into categories to guide treatment, this is a part of __'s approach

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McKenzie

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McKenzie is opposite of ___ in his approach of LBP

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Williams

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Three important contributions from McKenzie:

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- emphasis on sagital spinal motions during exam/treatment, - concept of classification, - concepts of centralization and peripheralization

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Convex-Concave rule is from ___

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Kaltenborn

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Assessment of end-feel is a contribution of this practitioner:

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Cyriax

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Concepts of centralization and peripheralization of pain are from

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Cyriax

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Arthrosis is a

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fibrous joint

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Inguinal line separates these two dermatomes

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T12 and L1

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Medial knee is this dermatome

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L3

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Medial side of great toe is this dermatome

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L4

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Referred pain does not

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cross the midline

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Three categories of non-capsular pattern are

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-ligamentous shortening or adhesions, internal derangements, - extra-articular lesions (bursitis)

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Pain-Resistance Sequence is a ___ concept

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Cyriax

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Pain-Resistance Sequence defines these three stages of inflammatory process

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Pain prior to resistance, Pain with resistance, Pain after resistance

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Pain prior to resistance indicates

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Acutely inflammed joint

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Pain with resistance indicates

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Mildly inflammed joint

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Pain after resistance is...

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a non-inflammed joint

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The Pain-Resistance Sequence is useful for guiding the

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vigor of examination and treatment

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Selective Tissue Tension Testing does not work with

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Spine or Glenohumeral joint

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Capsular patterns are usually tested with...

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PROM

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Selective Tissue tension Testing (STTT) is a ..

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series of exam procedures designed to aide in determining diagnosis

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Exam procedures of STTT

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active, passive and resistive movements at mid-range. Interpretation is based on pattern of pain, weakness or limitation

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In the Cyriax method, the PT's conclusion is based on

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the combo of test results: PRS, STT, Capsular v. non-Capsular pattern

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Selective Tissue Tension testing helps determine...

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acuity (severity) of injury, and to ID the structure at fault (contractile v. non-contractile)

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The best test to determine whether lesion is in contractile or non-contractile tissue

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Resisted isometric testing

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Pattern 1 of STT is:

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Inert tissue pattern. Active and Passive range of motion in same direction produce pain at end range, but resisted isometric is not painful

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Pattern 2 of STT is:

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Contractive Tissue Pattern - resisted isometric contraction is painful and/or weeak and Passive ROM is painful in the direction that LENGTHENS affected tissue. Active painful or weak when involved mm group is contracted

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Resisted isometric testing is painful and strong indicates

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Minor COntractile injury

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Resisted isometric motion is painless and weak indicates

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complete rupture of contractile tissue

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Pattern 3 of STT is

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Excessive range of motion found -- indicating capsular or ligamentous laxity

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Meniscus tear of knee has this end-feel

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Springy block

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Cyriax claimed that palpation is almost always

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misleading

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___ and ___ are the most common nerve roots involved in radiculopathy

answer

S1, L5

M&A 5: Examination Philosophies – Flashcards

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