Name abdur razzaq

Roll #415

Submited to madam uzma

Define following terms ?

(i) Disability:-

Disability is defined as a condition or function judged to be significantly impaired relative to the usual
standard of an individual or group.

(ii) Function of disability:-

According to the World Health Organization, disability has three dimensions: Impairment in a person's
body structure or function, or mental functioning; examples of impairments include loss of a limb, loss
of vision or memory loss. Activity limitation, such as difficulty seeing, hearing, walking, or problem
solving.

(ii) principal of etics:-

There are seven principles that form the content grounds of our teaching framework:

Non-maleficence. ...

Beneficence. ...

Health maximisation. ...

Efficiency. ...

Respect for autonomy. ...

Justice. ...

Proportionality

(iii) pain and tenderness:-

Pain:-

The International Association for the Study of Pain (IASP) defines pain as an unpleasant sensory and
emotional experience associated with actual or potential tissue damage.

Pain is not just a physical sensation. It is influenced by attitudes, beliefs, personality and social factors,
and can affect emotional and mental wellbeing.
Tenderness:-

In medicine, tenderness is pain or discomfort when an affected area is touched.[1] It should not be confused
with the pain that a patient perceives without touching. Pain is patient's perception, while tenderness is a
sign that a clinician elicits.

Clearnce test:-

A clearnce test involve asking the patient to perform groos movement of the body using multple muscle and
joint.

Antalgia:-

Reduce stance phase on one limb e.g due to joint pain,amputation,unilateral muscle weaknes etc and the
person spends less time weightbearnig on the affected limbs.

Q 2:- Explain closed pick position of hip and knee specifying bony and ligamantous tension ?

Closed pick position of hip:-

Full extension of the hip joint is the closed packed postion because this position draws the strong ligaments
of the joint tight, resulting in stability.

Closed pick position of knee:-

Full extension of the knee joint is the closed packed postion because this position draws the strong ligaments
of the joint tight, resulting in stability.

Q 3:- Define end feel ?what will be the normal and abnormal end feel at major joint of upper limb and
lower limb ?

End feel:-

The end feel is a type of sensation or feeling which the examiner experienced when the joint is at the end of
its available passive range of motion.

Normal end feel:

The normal end feels are generally described as

Hard: Type of "Bone-to-Bone" stiff sensation that is painless. An example elbow extension

Soft: There is a yielding compression (mushy feel) that stops further movement or gradual increase in
resistance as muscle, skin and subcutaneous tissues are compressed between the body parts. Examples are
elbow and knee flexion, which movement stopped by compression of the soft tissues, primarily the
muscles[2]

Firm: There is a hard or firm (springy) type of movement with a slight give.Toward the end of ROM,there is a
feeling of springy or elastic resistance. Tissue stretch is the most common type of normal end feel; it is found
when the capsule and ligaments are the primary restraints to movement. Examples are lateral rotation of the
shoulder,and knee and metacarpophalangeal joint.

Abnormal end feel:-

The Abnormal end feels are generally described as

Soft: Occurs sooner or later in the ROM than is usual or in a joint that Soft tissue edema normally has a firm
or hard end. Feels boggy, with a fluid shift.

Firm: Occurs sooner or later in the ROM than is usual, or in a joint that normally has a soft or hard end.

Hard: Occurs sooner or later in the ROM than is usual, or in a joint that normally has a soft or firm end. A
grating or bony block is felt.

Empty: No real end because pain prevents reaching the end of ROM.No resistance is felt except for the
patient’s protective muscle splinting or muscle spasm.

Normal end feel for shoulder:-

Flexion: Firm from tissue stretch; posterior and inferior capsüles become tight.

Extension: Firm from tissue stretch; anterior capsule becomes tight.

Abduction: Hard from humerus contacting acromial arch; firm from tissue

stretch; inferior capsule becomes tight.

Adduction: Soft from tissue approximation.

Internal rotation: Firm from tissue stretch; posterior capsule, infraspinatus,

or teres minor becomes tight.

External rotation: Firm from tissue stretch; anterior and inferior capsules

become tight.

Horizontal abduction: Firm from tissue stretch; anterior capsule becomes tight.

Horizontal adduction: Soft from tissue abecomes tightpproximation or firm from tissue

stretch; posterior capsule, infraspinatus, or teres minor .

End feel for elbow:-

Flexion : soft due to muscle bulk of anterior forearm and anterior arm.

Flexion : hard due to minimal muscle bulk', coronoid process contacts coronoid fossa.

Flexion : firm due to tension in the posterior joint capsule and the triceps
Extension : hard due to olecranon process contacting the olecronon fossa.

Extension : firms due to tension in the anterior joint capsule,colllateral ligaments,and biceps.

End feel for wrist:-

Flexion : firm due tO tension in the dorsal radiocarpal ligament and dorsal joint capsule.

Extension : firm due to tension in the palmar radiocarpal ligameny and palmar joint capsule.

Extension : hard

Radial deviation : hard

Radial deviation : firm due to tension in the ulnar collateral ulnocarpal ligament and ulnar portion of the joint
capsule.

Ulnar deviation : firm due to tension in the radial collateral ligment and radial portion of the jpint capsule.

End feel for hip:-

Flexion: Soft (tissue approximation) due to muscle bulk of the anterior thigh and lower abdominal muscles or
stretch of the hip extensors.

Extension: Firm due to tissue stretch of the anterior capsule; iliofemoral, ischio- femoral, and pubofemoral
ligaments; and hip flexor muscles.

Abduction: Firm due to tissue stretch of the inferior capsule, pubofemoral and ischiofemoral ligaments,
inferior band of iliofemoral ligament, and adductor muscles.

Abduction: Hard (femoral neck approximates the acetabulum). Adduction: Soft (tissue approximation of the
thighs).

Adduction: Firm due to stretch of the abductor muscles. Internal rotation: Firm due to tissue stretch of the
posterior joint capsule, ischiofemoral ligament, and externalrotators of thehip.

External rotation: Firm due to tissue stretch of the anterior joint capsule, iliofemoral and pubofemoral
ligaments, and internal rotator muscles.

End for knee:-

Flexion: Soft due to contact between muscle bulk of thhe posterior calf and thigh; firm due to tension in the
quadriceps muscle or anterior joint capsule

Extension: Firm due to posterior capsule, arcuate complex.

End feel of ankle:-

.Dorsiflexion: Firm due to tension in the posterior capsule, Achilles tendon, posterior portion of deltoid and
calcaneofibular ligament, andposterior talo- fibular ligament .
Plantarflexion: Firm due to tension in the anterior capsule, anterior portio of deltoid and anterior talofibular
ligament, anterior tibial muscle, and long extensors of the toes .

Plantarflexion: Hard due to the posterior tubercle of the talus contacting posterior tibia.

Q 4 : identify the weak musclulature in the following condition?

Q4.

1. Genu valgum: quads, Gluteals and abdominals

2. Pelvic rotation: gluteal and abdominal

3. Drop foot: dorsi flexors

4. Difficulty in inclined surface: quads and gluteal.

5 Torticollis:The muscle that runs up and toward the back of the neck (the sternocleidomastoid muscle)
becomes tight, weakened, or thickened.

Q 5 write the special test for following joints providing information about test ?

(i) Hip

(ii) knee

(iii) shoulder