Quiz 2 Kinesiology

A normal soft end feel refers to a situation where there is full range of motion (ROM) at a joint, but the motion is stopped by the presence of soft tissue. This means that the joint can move freely until it reaches a point where the soft tissue, such as muscles or ligaments, restrict further movement. This is a normal and expected end feel for many joints in the body.

A Normal Hard End feel refers to the feeling of a hard stop or barrier at the end of the joint's range of motion (ROM) caused by a bony structure. This means that when the joint is moved to its maximum extent, it encounters a solid, unyielding blockage due to the contact between two bones. This can be felt as a hard and abrupt halt in movement, indicating the normal anatomical limitation of the joint's motion.

When there is a decreased range of motion (ROM) at a joint and the motion is stopped due to pain, it is considered an example of an abnormal end feel that is empty. In this case, the joint does not reach its full range of motion due to pain, rather than any physical obstruction or limitation.

Based on the given information, the client is able to fully move their elbow against gravity and can also tolerate moderate resistance. According to the Manual Muscle Testing (MMT) scale, a score of 4 is given when the client demonstrates good strength and can move against moderate resistance. Therefore, the MMT score for this client would be 4.

In this scenario, the client was asked to perform elbow flexion in a gravity eliminated position, but no joint motion was observed. However, a muscle palpation was felt, indicating that there is a trace or flicker of contraction in the muscle. According to the Manual Muscle Testing (MMT) scale, a score of 1 is given when there is a palpable or visible contraction, but no joint motion is observed.

If a patient is able to move a joint in full active range of motion against gravity, a number grade of 3 is automatically given before applying resistance. This indicates that the patient can perform the movement fully and without any assistance or compensation.

An abnormal end feel refers to the sensation felt when a joint reaches its end range of motion. A soft end feel typically occurs when there is swelling or edema in the joint, which restricts further movement. In this case, the decreased range of motion at a joint where joint edema stops the motion would result in a soft end feel.

ROM (Range of Motion) assessment involves measuring the amount of movement that a joint can achieve. By assessing ROM first, we can determine the extent of joint mobility and integrity. This information is crucial in understanding muscle strength because it helps us identify any limitations or restrictions in joint movement that may affect muscle function. MMT (Manual Muscle Testing) assessment, on the other hand, evaluates the strength of specific muscles. Therefore, assessing ROM before MMT allows us to have a comprehensive understanding of both joint mobility/integrity and muscle strength, which are interconnected.

The completion of MMT assessment is contraindicated in patients who have joint pain and inflammation. This is because performing the assessment may exacerbate their pain and inflammation, potentially causing further harm or discomfort. It is important to prioritize the patient's comfort and well-being in such cases and consider alternative assessment methods or wait until the pain and inflammation subside before conducting the MMT assessment.

A normal firm end feel occurs when there is full range of motion (ROM) at a joint, but the motion is stopped by the tension in the tendons surrounding the joint. This means that the tendons are providing resistance and preventing further movement, giving a firm sensation when the end of the ROM is reached. This type of end feel is commonly found in joints such as the elbow or knee, where the tendons play a significant role in stabilizing the joint and limiting excessive motion.

During full shoulder flexion, full elbow flexion, and full forearm supination, the biceps muscle is in its most shortened position, resulting in minimal length. This is because the biceps muscle is responsible for flexing the elbow and supinating the forearm. When the shoulder is flexed, the elbow is flexed, and the forearm is supinated, the biceps muscle is maximally contracted, leading to minimal length.

When slow supination occurs without resistance, the muscle that is most active is the Supinator. The Supinator muscle is responsible for turning the palm of the hand upward. In this scenario, when positioning the hand in a palms up position to receive change from the cashier, the Supinator muscle is primarily engaged in the movement of supination. The other muscles listed, such as Brachioradialis, Biceps, and Brachialis, may also be involved in the movement to some extent, but the Supinator muscle is the most active in this particular action.

The correct answer is that muscle movement of the elbow is functionally independent from movement of the shoulder or wrist. This means that the muscles responsible for moving the elbow do not rely on or affect the movement of the shoulder or wrist. The other statements explain the functions of the elbow complex, such as allowing for hand orientation, providing stability during weight-bearing activities, and providing mobility of the hand in space.

Placing the hand on the distal end of the bone that is being moved by the muscle provides better mechanical advantage during a manual muscle test. This is because the lever arm is longer, allowing for more leverage and easier application of resistance. By placing the hand distal to the joint, the tester can effectively resist the muscle's action while minimizing the involvement of other muscles and reducing the risk of muscle substitutions.

Tennis elbow, also known as lateral epicondylitis, is caused by inflammation of the wrist extensors or wrist flexors at their origins. This inflammation occurs at the lateral epicondyle for wrist extensors and the medial epicondyle for wrist flexors. The repeated and forceful action of wrist extensors or wrist flexion, such as during a tennis swing, can lead to this condition. The inflammation and repetitive stress on these tendons result in pain and discomfort in the outer part of the elbow.

The correct answer is "Pt. has -30 degrees of elbow extension." This means that the patient is able to extend their elbow up to 30 degrees beyond the neutral position. The negative sign indicates that the extension is limited or restricted.

The correct answer is that MMT should be performed with the joint in an open packed position so that the client uses muscles and not joint soft tissue and/or boney structures to stabilize the joint. This is because when the joint is in an open packed position, the muscles surrounding the joint are more actively engaged and can provide better stability. In contrast, when the joint is in a closed packed position, the joint surfaces are maximally congruent and the surrounding soft tissues are under more tension, making it more difficult to isolate and assess the specific muscle strength.

The statement that AROM is always larger than PROM because of muscle contraction is not true. AROM (Active Range of Motion) refers to the range of motion that a person can achieve on their own, while PROM (Passive Range of Motion) refers to the range of motion that can be achieved with the help of an external force. In some cases, such as when there is muscle weakness or injury, AROM may be limited and smaller than PROM. Therefore, the statement is incorrect.

When performing fast supination with resistance, the biceps muscle is recruited in addition to the other muscles listed. The biceps muscle is responsible for the flexion of the elbow joint and also assists in the supination of the forearm. Therefore, when there is resistance involved in the supination movement, the biceps muscle is activated to provide the necessary strength and stability to perform the action effectively.

The pronator teres is a muscle located in the forearm that plays a role in pronating the forearm (rotating it so that the palm faces downwards). The minimum length of the pronator teres occurs when the forearm is fully pronated (rotated inwards) and the elbow is fully flexed (bent). The position of the shoulder is inconsequential because the pronator teres only acts on the forearm and not the shoulder joint.

The brachioradialis muscle operates as a force in a second-class lever system. In a second-class lever system, the resistance is located between the force and the fulcrum. The brachioradialis muscle acts as the force, the elbow joint acts as the fulcrum, and the weight of the forearm acts as the resistance. This lever system allows for greater force production but at the expense of speed and range of motion. However, the brachioradialis muscle does not operate as a force in a third-class lever system, where the force is located between the fulcrum and the resistance.

Elbow positioning is critical for optimal function of the extrinsic muscles of the hand because these muscles cross the elbow joint. The length tension relationship of the extrinsic muscles can be affected by the position of the elbow. The optimal position for extrinsic hand function is elbow flexion at 90 degrees.

When measuring range of motion (ROM), it is important for the therapist to proceed with caution in the presence of an inflammatory process in the joint. Inflammation can cause pain, swelling, and stiffness, which can affect the accuracy and reliability of ROM measurements. It is crucial to be mindful of the patient's comfort and avoid exacerbating the inflammation during the assessment.

Based on the information provided, the client is able to perform active range of motion (AROM) for shoulder abduction from 0 to 80 degrees. A MMT score of 2+ would be appropriate in this case, indicating that the client has good muscle strength and is able to move against gravity with some resistance.

Heterotrophic ossification refers to the abnormal formation of bone in soft tissues such as muscles, tendons, or ligaments. It can restrict joint movement and cause pain. Therefore, the presence of heterotrophic ossification is a contraindication for performing a range of motion (ROM) assessment as it may cause further damage or discomfort to the patient.

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When performing muscle strength testing on the brachialis muscle, the forearm should be positioned in pronation. This is because the brachialis muscle is a flexor of the elbow joint and is most active when the forearm is in a pronated position. Pronation refers to the rotation of the forearm so that the palm faces downwards. By positioning the forearm in pronation, the brachialis muscle is placed in an optimal position for contraction and can generate the most force during the strength testing.

The patient's ability to perform full passive range of motion (PROM) indicates that there are no restrictions or limitations in the shoulder joint itself. However, the patient's limited active range of motion (AROM) against gravity suggests that there may be a muscle weakness or dysfunction. Therefore, giving the patient a muscle grade of 3 for shoulder flexion is the correct interpretation.