KIN 2236 MIDTERM 2 QUESTIONS AND VERIFIED
ANSWERS
Soap Notes - Answers - - Subjective
- Objective,
- Analysis/Assessment
- Plan/Program
SOAP Notes: Subjective - Answers - - most important aspect
- Interviewing is the "art" of medicine
- ask open ended questions
- active listening (with open mind)
- primary complaint
- History of injury (MOI)
- symptoms
- pertinent Medical History
SOAP Notes: Objective - Answers - - Observable Physical Phenomenon indicative of a
conditions presence
1. observation
2. AROM
3. PROM
4. Resisted Movements
5. Neuro. Sensation/Reflex
6. Special Tests
7. Palpation
Observation / Visual Inspection - Answers - - assess their general demeanor
(expression, tone)
- Posture (are they guarding a body part?)
- obvious deformities
- signs of inflammation
- quality of movement (is it smooth or jerky or is it slow?)
Inert Tissue - Answers - - Ligaments
- Bursa
- Capsules
- Fascia
- Nerve Roots
- Dura Mater
Contractile Tissue - Answers - - Muscles
- Tendon
,- Tenoperiosteal Insertion
Theory of Selective Tissue Tension: Contractile Tissue - Answers - - increases in
tension when the tissue is both contracted or stretched
- active motion in one direction and passive motion in the opposite
Theory of Selective Tissue Tension: Inert Tissues - Answers - - increase in Tension
when they are stretched ONLY
- will elicit pain on active and passive movement in one direction ONLY
Active Range of Motion (AROM) - Answers - - first movement assessment
- active movements which cause pain do not
specifically indicate either an inert or contractile
lesion
- muscle tension and joint movement causing contractile and inert tension to both occur
What Information do AROM movements give us? - Answers - - where they are sore
- willingness to move
- quality of movement
- amount of available ROM
- gives us clues on how to handle them
Passive Range of Motion (PROM) - Answers - - passive movement are used to detect
lesions in inert tissues
- this stretching of the inert tissue will cause pain
- allows us to asses "end feel"
Normal End Feel - Answers - Soft Tissue Approximation
- soft spongy gradual painless stop when two muscles bellies meet
Bony
- distinct abrupt endpoint
- painless
Capsular
- Abrupt firm Endpoint with a little give
- A leathery feeling
Abnormal End Feel - Answers - Springy Block
- rebound, bounce or spring at some point through ROM
Spasm/Stretch
- involuntary contraction that prevents motion secondary to pain
- more of a rubbery feel prior to expected end of range
Abnormal Capsular - occurs prior to expected end of range
Empty End Feel
- no mechanical resistance detected
- significant soft tissue injury, bursitis or neoplasm
, Conditions for Resisted Training - Answers - - contraction of only target tissue
- no stretch on antagonsit
- no movement through joint or stretch on surrounding inert tissues
Info Gained from Resisted Training - Answers - - pain in contractile tissue
- will give us an indication of how the nerve is working
How to do Resisted Training - Answers - - Position the athlete with the muscle being
tested in the neutral position
- position yourself to maximize mechanical advantage
- ask them to hold the position
slowly increase the force in the opposite direction until you feel movement or pain is
elicited
- then slowly decrease the force
Neurological Testing (reflexes) - Answers - Different muscles/parts of the body are
connected to different parts of the spine
- Biceps/Briachioradialis = C5-C6
- Triceps = C7-C8
- Knee Jerk = L3
- Achilles = S1
Neurological Testing (sensation) - Answers - Dermatomes
- Cutaneous area (near skin) receiving the greater part of its intervention from a single
spinal nerve
Neurological Testing (Key Muscles) - Answers - Myotomes
- a muscle receiving the greater part of its Innervation from a single spinal nerve
- isometric contraction held for 5 seconds
- fatigable weakness vs. no strength for peripheral nerve
Manual Muscle Testing (Oxford Scale) - Answers - - its an isometric contraction
0 - mothing happens
1 - twitch or flicker only. No movement
2 - able to move but not against gravity
3 - able to move the joint fully against gravity
4 - movement with some resistance
5 - movement with some resistance equal to opposite side
The Shoulder Girdle - Answers - - Connects the upper limb to the axial skeleton on each
side
- contains the clavicle and scapula
- clavicle attaches medially to the sternal manubrium and laterally to the acronmion
process of the scapula
ANSWERS
Soap Notes - Answers - - Subjective
- Objective,
- Analysis/Assessment
- Plan/Program
SOAP Notes: Subjective - Answers - - most important aspect
- Interviewing is the "art" of medicine
- ask open ended questions
- active listening (with open mind)
- primary complaint
- History of injury (MOI)
- symptoms
- pertinent Medical History
SOAP Notes: Objective - Answers - - Observable Physical Phenomenon indicative of a
conditions presence
1. observation
2. AROM
3. PROM
4. Resisted Movements
5. Neuro. Sensation/Reflex
6. Special Tests
7. Palpation
Observation / Visual Inspection - Answers - - assess their general demeanor
(expression, tone)
- Posture (are they guarding a body part?)
- obvious deformities
- signs of inflammation
- quality of movement (is it smooth or jerky or is it slow?)
Inert Tissue - Answers - - Ligaments
- Bursa
- Capsules
- Fascia
- Nerve Roots
- Dura Mater
Contractile Tissue - Answers - - Muscles
- Tendon
,- Tenoperiosteal Insertion
Theory of Selective Tissue Tension: Contractile Tissue - Answers - - increases in
tension when the tissue is both contracted or stretched
- active motion in one direction and passive motion in the opposite
Theory of Selective Tissue Tension: Inert Tissues - Answers - - increase in Tension
when they are stretched ONLY
- will elicit pain on active and passive movement in one direction ONLY
Active Range of Motion (AROM) - Answers - - first movement assessment
- active movements which cause pain do not
specifically indicate either an inert or contractile
lesion
- muscle tension and joint movement causing contractile and inert tension to both occur
What Information do AROM movements give us? - Answers - - where they are sore
- willingness to move
- quality of movement
- amount of available ROM
- gives us clues on how to handle them
Passive Range of Motion (PROM) - Answers - - passive movement are used to detect
lesions in inert tissues
- this stretching of the inert tissue will cause pain
- allows us to asses "end feel"
Normal End Feel - Answers - Soft Tissue Approximation
- soft spongy gradual painless stop when two muscles bellies meet
Bony
- distinct abrupt endpoint
- painless
Capsular
- Abrupt firm Endpoint with a little give
- A leathery feeling
Abnormal End Feel - Answers - Springy Block
- rebound, bounce or spring at some point through ROM
Spasm/Stretch
- involuntary contraction that prevents motion secondary to pain
- more of a rubbery feel prior to expected end of range
Abnormal Capsular - occurs prior to expected end of range
Empty End Feel
- no mechanical resistance detected
- significant soft tissue injury, bursitis or neoplasm
, Conditions for Resisted Training - Answers - - contraction of only target tissue
- no stretch on antagonsit
- no movement through joint or stretch on surrounding inert tissues
Info Gained from Resisted Training - Answers - - pain in contractile tissue
- will give us an indication of how the nerve is working
How to do Resisted Training - Answers - - Position the athlete with the muscle being
tested in the neutral position
- position yourself to maximize mechanical advantage
- ask them to hold the position
slowly increase the force in the opposite direction until you feel movement or pain is
elicited
- then slowly decrease the force
Neurological Testing (reflexes) - Answers - Different muscles/parts of the body are
connected to different parts of the spine
- Biceps/Briachioradialis = C5-C6
- Triceps = C7-C8
- Knee Jerk = L3
- Achilles = S1
Neurological Testing (sensation) - Answers - Dermatomes
- Cutaneous area (near skin) receiving the greater part of its intervention from a single
spinal nerve
Neurological Testing (Key Muscles) - Answers - Myotomes
- a muscle receiving the greater part of its Innervation from a single spinal nerve
- isometric contraction held for 5 seconds
- fatigable weakness vs. no strength for peripheral nerve
Manual Muscle Testing (Oxford Scale) - Answers - - its an isometric contraction
0 - mothing happens
1 - twitch or flicker only. No movement
2 - able to move but not against gravity
3 - able to move the joint fully against gravity
4 - movement with some resistance
5 - movement with some resistance equal to opposite side
The Shoulder Girdle - Answers - - Connects the upper limb to the axial skeleton on each
side
- contains the clavicle and scapula
- clavicle attaches medially to the sternal manubrium and laterally to the acronmion
process of the scapula
