

Where is Physical Therapy?

And why I should know it

• Physical therapy (PT) is no new discipline.

• Physical therapy is located within what have been termed as “Health Sciences.”

• Among the Health Sciences, PT is considered a clinical discipline.

• As most Health Sciences, PT also is a mixture of several fields of knowledge.

Where is Physical Therapy?
The origins

 Using exercise, massage, heat, cold, water, and electricity,

date back to Greek culture.

 In Europe during the 1500s – 1700s, the use of exercise to

treat muscle and bone disorders and disabilities continued to
progress.

 By the 1800s, exercise and muscle re-education were utilized

for a variety of orthopedic diseases and injuries.
Where is Physical Therapy?

 During the second half of the 19th century,

terms like “physical medicine,” “physical
therapy”, “physiotherapy”… came into use to
categorize the various healing methods of
exercise, manipulation, and massage
(collectively known as mechanotherapy),
hydrotherapy, balneotherapy, electrotherapy,
light therapy, air therapy, and heat and cold
therapy (thermotherapy) under one heading.
Where is Physical Therapy?

 The earliest documented origins of physiotherapy as a professional group

date back to Per Henrik Ling, “Father of Swedish Gymnastics,” who
founded the Royal Central Institute of Gymnastics (RCIG) in 1813

 The Swedish word for physiotherapist (physical therapist) is “sjukgymnast”

= “sick-gymnast.

 In 1851, the military physician Lorenz Gleich had already used the term
“physiotherapie”

 One of the first to use the generic term “physikalische Heilmethoden” was
the German physician and professor of medicine at Würzburg University,.
Rossbach

 Other countries soon followed. In 1894 four nurses in Great Britain formed
the Chartered Society of Physiotherapy
Where is Physical Therapy?

And what about Spain?

 Where is Physical Therapy?

 The curriculum for the profession of practitioner

were regulated in 1857 and the Real Orden of 26,
june, 1860 established certain competences exclusive
to PTs, such as the use of professional bandaging.
 Therapeutic massage only became part of the
competences of a practitioner in 1888.
Where is Physical Therapy?

 Practitioners were indistinctive of nurses from 1915 until

1957.

 In 1957, PTs were segreggated from nurses in terms of their

curriculum.

 In 1969, the first PT Association is established in Spain.

 In 1980, Physical Therapy becomes a university degree.

 In 1989, the degree in Physical Therapy reaches professional

competences.
Where is Physical Therapy?

 So, is PT a field of study in itself?

 Yes, it is. It is a discipline in itself, but there are some issues that
should not be forgotten.

 PT is located in a very awkward, so to say, position, as it has

evolved from other disciplines and practices, and has given rise
to new disciplines as well.
Where is Physical Therapy?

 A revision of some key terms will help locate PT and address its
hybrid condition

 Which are the terms that become usually associated with PT?

Body, pain, massage, therapy, anatomy, bone, muscle, tendon, ligament, joint…

 Which of them pertain to Health Sciences in general and not

exclusively to PT?

 Then… What do I have to study when I study PT?

Where is Physical Therapy?

 Do I have to study anatomy?

 Do I have to study physiology?

 Do I have to study developmental biology?

 Do I have to study citology/histology?

 Do I have to study endocrinology?

Where is Physical Therapy?

 Anatomy? Well, yes you do.

 As a matter of fact, “anatomy” is a far more complicated term and

field of study than it appears to be.
 As you may know, the term “anatomy” refers to the branch of science
that studies body structures and the relationships of its organs. So, it
is a very important concept in PT.
 The etymology of the word, shows that it has to do with dissecting in
a particular direction to arrange our findings. The word comes from
ana- “up”and temnein “to cut”. “Atom”, “lobotomy” and “vasectomy”-
to mention just three- share the same root.
 But, within the term “anatomy” we may find some other very
interesting terms:
Where is Physical Therapy?

 surface anatomy
 the study of internal structures that can be identified from the outside of
the body through visualization and palpation

 gross anatomy
 the study of body structures that can be examined without a microscope

 systemic anatomy
 the study of specific systems of the body such as the nervous or respiratory
systems
Where is Physical Therapy?

 regional anatomy
 the study of the structural arrangement of specific body areas, such as
the head, neck, chest, or abdomen

 radiographic anatomy
 the study of body structures that can be visualized with x-rays

 pathological anatomy
 the study of structural changes in the body associated with disease
Where is Physical Therapy?

 Physiology? Again; yes, you do.

 Physiology, as I am sure you understand, is that branch of science that
studies the functions of the body.
 As for the origin of the word, Physiology is important for PT because it
comes from physio- “nature” and logia- “study”. So, in fact, what it implies
is the study of normal functioning of living things.
 Once more, a key element of the Health Sciences that becomes relevant
when studying PT.
 And, let me tell you this: physiology is another one of those powerful
terms. Comprised in this term, there are several terms and words. To
mention some of them:
Where is Physical Therapy?

 neurophysiology
 the study of the functional properties of nerve cells

 cardiovascular physiology

 the study of the functions of the heart and blood vessels

 respiratory physiology

 the study of the functions of the air passageways and lungs

Where is Physical Therapy?

 renal physiology
 the study of the functions of the kidneys

 exercise physiology
 the study of the changes in cell and organ functions due to muscular
activity

 pathophysiology

 the study of the functional changes associated with disease and aging
Where is Physical Therapy?

 And what about developmental biology? Some of you may have

not heard about this term before.
 Developmental biology is the study of the complete development of
an individual from fertilization to death.
 The term biology differs from physiology in the fact that whereas
the former studies living things as they are when they are ok,
biology studies life. Period.
 Even when it is not as relevant as others, PT is colaterally affected
by developmental biology.
 So, in fact, you may be lucky about developmental biology and
study just a little bit of embriology or reproduction.
Where is Physical Therapy?

 Embriology?

 Just maybe…
Where is Physical Therapy?

 What is sure you will study in your PT degree is cytology, the

study of cellular structure and functions.

 The etymos of this word is very interesting, as it, literally,

means “the study of a receptacle”. In fact, the root for cytology
is different from “cyst”, but their meaning is very, very close.

 Once again, cytology is a very important term for the Health

Sciences, not only for PT.

 In fact, cytology is important because it includes one of the

basis for the Health Sciences…
Where is Physical Therapy?

 Histology!!, or the study of the microscopic structure of tissues.

 Tissues… yes, the very origin of the word says so. “Histos-” means
tissue. Well, not exactly. It means any reticular disposition or
arrangement, such as the ones that may be found in facrib or in a
spiderweb.
 Even when it does not sound as much to you at this point, as we go
over some of the terms that may be found within histology, your
opinion may change.

 But that will be soon, not know.

Where is Physical Therapy?

 Last, but not least, you will also have to study endocrinology,
another big word in the Health Sciences.
 Endocrinology is concerned with changes caused internally by
hormones. The root of the word, let’s not forget this, is the same as
the one in “crisis”. In fact, Hippocrates and Galene used it to express
the evolution of a disease.
 Endocrinology is the study of hormones and how they control body
functions. Of course, it is not as important as others for PT students,
same as it was the case with developmental biology, but it is
interesting to be acquainted with how endocrinology works and in
what ways it is connected to the systemic functioning of the whole
body.
Where is Physical Therapy?

 In order to place correctly PT in terms of the various fields of

study that have just been presented to you, keywords may be
important.

 Starting from the very beginning; several subfields within

anatomy were described:
Where is Physical Therapy?
 surface anatomy

 gross anatomy

 systemic anatomy

 regional anatomy

 radiographic anatomy

 pathological anatomy
Where is Physical Therapy?

 So, let’s check some of the keywords in each of the previous

subfields.

 This will (hopefully) help you understand where PT is, what

issues are directly related to it, and which others are colateral
but yet very important.

 This description by means of keywords will also be a first

contact with most of the elements that you’ll be studying both
in this course and in a significant number of other courses not
only this year, but in the years to come.
Where is Physical Therapy?
 surface anatomy

 noninvasive diagnostic technique: any method of assessing certain

aspects of body structure and function that does not involve
insertion of an instrument or device through the skin or a body
opening

 inspection: examining the body by observing for any changes that

deviate from normal
 palpation: examining the body by touching and feeling body surfaces
with the hands
 auscultation: examining the body by listening to body sounds to
evaluate the functioning of certain organs
 percussion: examining the body by tapping on the body surface with
the fingertips and listening to the resulting echo
Where is Physical Therapy?
 gross anatomy

 anatomical position: a standard method of observing the human body

 Prone: lying face-down

 Supine: lying flat on the back ("on the spine")

Where is Physical Therapy?
 Gross anatomy
Plane: an imaginary division of the body or a structure into specific regions

Anterior: the front of the body; also called ventral

Posterior: the back of the body; also called dorsal

Medial: closer to the body's midline

Lateral: farther from the body's midline

Superior: towards the head

Inferior: away from the head

Proximal: closer to the attachment of a limb to the trunk

Distal: farther from the attachment of a limb to the trunk

Where is Physical Therapy?

 Gross anatomy
 Section: this results from the actual physical cuts made through
the body or a structure
 Midsagittal section: this divides the body or structure into equal
right and left halves
 Frontal section: this divides the body or structure into anterior and
posterior portions; also referred to as "coronal"
 Transverse section: this divides the body or structure into superior
and inferior portions; also referred to as "horizontal" or "cross-
sectional"
 Oblique section: this divides the body or structure in a diagonal
direction
Where is Physical Therapy?
 Systemic anatomy
 controlled condition: a body factor that is continually monitored by receptors

 control center: this determines the next action in a feedback system by sending
output to an effector

 Stimulus: any change in the internal or external environment of an organism

 Effector: a muscle or gland that generates a response that adjusts a controlled

condition

 Receptor: a specialized nerve cell that monitors a controlled condition

 Negative feedback system: a process that results in a response that reverses the
original stimulus

 Positive feedback system: a process that results in a response that enhances the
original stimulus
Where is Physical Therapy?

 regional anatomy
 Dorsal body cavity: this includes the cranial cavity and the spinal canal
 Ventral body cavity :the large, anterior area of the body that consists of the
thoracic and abdominopelvic cavities
 Serous membrane: this lines the pleural, pericardial, and peritoneal cavities
 Parietal layer the portion of a serous membrane that lines the walls of a
body cavity
 Visceral layer: the portion of a serous membrane that covers and adheres to
organs inside a body cavity
 Serous fluid: the membrane secretion that functions as a lubricant, allowing
visceral organs to slide past each other without friction
Where is Physical Therapy?

 In turn within the ventral cavity some other terms may be

distinguished:

 thoracic cavity: this consists of the mediastinum, pleural, and

pericardial cavities

 abdominopelvic cavity: this area of the body is located inferior

to the thoracic cavity
Where is Physical Therapy?

 And, of course, you know there are some other key terms for
each of them:
 thoracic cavity:

 Mediastinum: the cavity that surrounds the heart, great blood vessels,
esophagus, trachea, and thymus gland

 Pleural cavity: this surrounds each lung

 pleural membrane: this lines the cavity that surrounds each lung

 Pericardial cavity: this surrounds the heart

 pericardial membrane: this surrounds and protects the heart
Where is Physical Therapy?

 abdominopelvic cavity

 Peritoneum: the transparent membrane that lines the abdominal

cavity and covers most of its organs
Where is Physical Therapy?

 As you can see, language in general and terms in particular help

to relate the different parts of the different fields of study in the
Health Sciences.

 Each of the subfields within anatomy, for instance, are

connected by the central concept of the body, their differents
parts, how they are studies, how they are interpreted, and so
on.
Where is Physical Therapy?
 The same happens with other fields within anatomy and external aids:

 radiographic anatomy
 conventional radiography: an imaging technique that passes x-rays through the body, which expose x-ray film to produce a
negative image called a radiograph

 contrast xray: an imaging technique that generates radiographs using an injected medium; used to create more detailed views
of blood vessels, the urinary system, and GI tract

 computed tomography: a type of radiography using a moving x-ray beam, where multiple scans are combined to create 3-D
views revealing more soft tissue details

 ultrasound: a procedure that uses high-frequency sound waves to determine the size and position of a developing fetus

 magnetic resonance imaging: a noninvasive imaging technique that exposes the body to a high-energy magnetic field, which
causes protons in the body to arrange themselves in relation to the field; creates a color-coded image on a monitor

 radionuclide scanning: an imaging technique using an IV radioactive substance that generates a color video image, with areas of
intense color representing high tissue activity and areas of less intense color representing low tissue activity; used to study the
activity of a tissue or organ such as the brain, heart, lungs, and liver

 positron emission tomography: an imaging technique that uses an injected substance which emits positively charged particles,
a gamma camera, and a computer that constructs a color image; shows where the injected substance is being used in the body
Where is Physical Therapy?

 The same takes place with pathological anatomy; terms in this

subfield of anatomy include:
 Immunology: the study of how the body defends itself against
disease-causing agents
 Responsiveness :an organism's ability to detect and react to changes
in its external or internal environment
 Disorder: a general term for any abnormal bodily function
 DIsease: a specific term that describes a certain illness
 Sign: an objective change in the body that can be observed and
measured, such as a rash or fever
 Symptom: a subjective change in the body not obvious to an observer,
such as a headache or nausea
 Aging: the gradual decline in the body's ability to maintain and restore
homeostasis
Where is Physical Therapy?

 But relations between terms and fields are not exclusive of

just one particular field of study.

 Terms and concepts are related across different fields of

study
Where is Physical Therapy?

 When it was stated you’d be studying Citology and, within it,

Histology, several terms must have come to mind:
 Tissue: a group of similar specialized cells that work together to
perform specific functions
 Organ: a structure composed of two or more different types of
tissues working together to perform specific functions
 System: a group of related organs having a common function
 Organism: a collection of inter-connected living systems
 Atom: the smallest unit of matter that participates in chemical
reactions
 Molecule: two or more atoms bonded together
 Cell: the basic structural and functional unit of a living organism
Where is Physical Therapy?

 And, of course, within the idea of cell, several other terms show their
key importance; among these:

 Stem cell: a precursor cell that can divide and give rise to cells that
undergo differentiation
 Differentiation: the development of a cell from an unspecialized to
a specialized state
 Intracellular fluid: the cytoplasm found inside cells

 Extracellular fluid: the tissue fluid found outside cells; also called
intercellular or interstitial fluid
 Plasma: the specific extracellular fluid that surrounds blood cells
Where is Physical Therapy?
 And to finish this quick review to place PT in the Health Sciences, Endocrinology comes into
play. Endocrinology involves a great deal of relevant key terms in general for the Health
Sciences, but perhaps it is not as important for PT. Yet, a good score of terms will be familiar to
you:

 Metabolism: the sum of all the chemical processes that occur in the body
 Catabolism: the breakdown of complex chemical substances into simpler components
 Anabolism: the building up of complex chemical substances from smaller, simpler
components
 Homeostasis: the balanced state of equilibrium in the body's internal environment that is
constantly maintained through interactions of all body processes
 Movement: includes motion of the whole body, individual organs, single cells, and tiny
structures inside cells
 Growth: an increase in body size that results from an increase in the size of existing cells,
an increase in the number of cells, or both