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136 Cards in this Set
- Front
- Back
When osteopathy founded?
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June 22 1874
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What was the significance of the spanish flu pandemic?
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1918
Ribraising dramatically reduces morbidity and mortality |
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Who was the founder of the following OMM Technique:
Cranial |
William Sutherland
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Who was the founder of the following OMM Technique: Muscle Energy
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Fred Mitchell
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Who was the founder of the following OMM Technique: Counterstrain
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Lawrence Jones
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Who was the founder of the following OMM Technique: Facilitated Positional release
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Stanley Schiowitz
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Who was the founder of the following OMM Technique: "resdiscoverd" AT Still technique?
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Richard Van Buskirk
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What are the 4 Osteopathic Principles?
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1.The body is a unit, and represents a combination
of body, mind & spirit. 2.The body is capable of self regulation, self- healing, and health maintenance. 3.Structure and function are reciprocally interrelated. 4.Rational treatment is based on an understanding of these principles: body unity, self-regulation, and the interrelationship of structure and function. |
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What does this define:
Is an impaired or altered function of related components of the somatic (body framework) system; skeletal, arthrodial and myofascial structures, and related vascular, lymphatic and neural elements. |
somatic dysfunction
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What does TART stand for?
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Tissue texture changes, Asymmetry,
Restricted motion & Tenderness) |
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Motion within the transverse plane about a
longitudinal or vertical axis is what motion? |
Rotation
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Motion within the coronal/frontal plane
about a AP axis is what motion? |
Sidebending
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Motion within the sagittal plane about a
transverse axis is what motion? |
Flex/Extension
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What is a Type I Fryette?
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Type I: Neutral position, sidebending and
rotation occur to opposite sides. |
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What is a Type II Fryette?
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Type II: Non-neutral, sidebending and
rotation occur to the same side. |
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What Fryettes Third Law?
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Type III: Motion in one plane alters motion
in other planes of motion. |
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Where would you find the spinous process of the T1-T3? What other level behaves this way?
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T1-3 Spinous process of segment is with its
transverse process T12 Also follows this rule |
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Where would you find the spinous process of the T4-T6? What other level behaves this way?
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T4-6 Spinous process of segment is half
way, to t-process of segment below T11 also |
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Where would you find the spinous process of the T7-T9? What other level behaves this way?
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Spinous process of seg. is at level with
t-process of seg. below T10 also |
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What is the motion of the OA (C0-C1)?
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Motion of the occiput on the
atlas. Atypical motion. Sidebending and rotation occur in opposite directions in a non- neutral position |
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What is the motion of the AA (C1/C2)?
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Motion of the atlas on the
axis. Atypical motion. Pure Rotation. |
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What is the motion of C2-C7?
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Generally follow Fryette’s type II
motion. Non- neutral, rotation and sidebending to the same side. |
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If T4 is compared with T5. We notice that T4
moves into flexion freer and sidebending and rotation is easier to the right. How do we name this? |
T4FRSR
Rotation is listed FIRST in Type II Dysfunctions |
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If segments T5 through T9 have
paravertebral humping noted on the right side and the patient is restricted with right sidebending without flexion or extension. How would you name this? |
T5-T9NSLRR
Side-bending is listed FIRST in Type II Dysfunctions |
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What is active motion testing?
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When the patient moves them selves - Quantitative
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What is passive motion testing?
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When the doctor moves the patient - Qualitative
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Name the Barrier: End range of joint motion
limited by bones, ligaments, and tendons. Passively tested. |
anatomic
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Name the Barrier: Limit of end range of motion
produced by the patient. Actively tested. |
Physiologic
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Name the Barrier: Abnormal limited
motion within the physiologic range that is altered by somatic dysfunction. OMM deals with this. |
Restrictive/Pathological
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Treatment
consists of moving into the restrictive barrier. |
Direct
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Treatment
consists of moving away from the restrictive barrier. |
Indirect
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What Techniques are Direct
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HVLA, ME, Myofascial Release (both) Cranial on Kids
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What Techniques are INDirect
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Conterstrain
Cranial in adults FPR Still (Indirect to direct) |
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Which are the true ribs?
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1-7 True ribs. Articulate with sternum.
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Which are the false ribs?
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8-10 False ribs. Articulate with cartilage
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Which are the floating ribs?
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11-12 Floating ribs. No anterior
articulation. |
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What Ribs have a Pump handle motion
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1-5
AP diameter expansion with respirations. |
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What Ribs have a bucket handle motion?
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Ribs 6-10
lateral diameter expansion with respirations. |
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If ribs 5-9 are inhaled you must treat which rib?
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Key rib is 9
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If ribs 5-9 are exhaled you must treat
which rib? |
5
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Viscerosomatic Reflexes head and neck?
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Head and Neck T1-4
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Viscerosomatic Reflexes Heart
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Heart T1-5
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Viscerosomatic Reflexes Lung
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Lung T2-5
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Viscerosomatic Reflexes Cervical Upper Esophagus
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Cervical Upper Esophagus T2-4
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Viscerosomatic Reflexes Thoracic Mid Esophagus
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Thoracic Mid Esophagus T3-T6
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Viscerosomatic Reflexes Lower Esophagus and Stomach
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Lower Esophagus and Stomach T5-T8
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Viscerosomatic Reflexes Spleen and Pancreas
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Spleen and Pancreas T5-11
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Viscerosomatic Reflexes Liver
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Liver T6-9
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Viscerosomatic Reflexes Gallbladder
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Gallbladder T9-10 R
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Viscerosomatic Reflexes Small Intestine
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Small Intestine T9-11
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Viscerosomatic Reflexes Appendix
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Appendix T12
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Viscerosomatic Reflexes Ovary/testes
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Ovary / Testes T9-10
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Viscerosomatic Reflexes Kidney, Ureter, Bladder
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Kidney, Ureter and Bladder ALL T10-L1
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Viscerosomatic Reflexes Prostate and Urethra
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Prostate and Urethra L1-2
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Viscerosomatic Reflexes Cervix
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Cervix L1-2
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Viscerosomatic Reflexes Ascending and transverse colon
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Ascend. and Trans. Colon T10-12
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Viscerosomatic Reflexes genitals
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Genitals T12
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Viscerosomatic Reflexes Uterus
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Uterus T10-L1
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Viscerosomatic Reflexes Descending and Sigmoid Colon and
Rectum |
Descending and Sigmoid Colon and
Rectum L1-2 |
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Viscerosomatic Reflexes Adrenals
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Adrenal T8-T10
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Lower extremity viscerosomatic reflex?
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LE T10-L2
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What re Chapmans reflexes?
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Neuro-lymphatic tissue texture abnormalities
that are reflections of visceral dysfunction or pathology (viscerosomatic reflexes) |
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What do Chapmans points indicate?
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Indicate increased activity of the
sympathetic nervous system. NOT PARASYMP |
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Where is the Chapmans Reflex for the heart?
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Cardiac- 2 nd anterior intercostal space
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Where is the Chapmans Reflex for Upper respiratory infections and the Lungs?
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3 rd and 4 th anterior intercostal
space |
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Where is the Chapmans Reflex for otitis Medai
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Middle clavicle
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Where is the Chapmans Reflex for sinusitis
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1st Rib
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Where is the Chapmans Reflex for eye pathology
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Lateral Humerus
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Where is the Chapmans Reflex for Colon and prostate pathology?
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IT Band
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Where is the Chapmans Reflex for the Appendix
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Tip of right 12 th rib
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Where is the Chapmans Reflex for the Rectum?
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Lesser trochanter
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Anterior chapmans points are for diagnosis... Where do you treat?
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Can treat both anterior and posterior points
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What is piriformis insertion?
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GREATER trochanter
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Where does illiopsoas insert?
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Lesser troch
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Finish the following sentence: When L5 is sidebent, a sacral oblique axis is engaged to the same side as the ____________
(chose sidebending or rotation) |
Sidebending
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Finish the following sentence:
When L5 is rotated, the sacrum rotates the _____________ way on an oblique axis (choose same or opposite) |
Opposite
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The seated flexion test is found on the ____________ side of the oblique axis.
(choose same or opposite) |
Opposite
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If L5 is FRSR, what side is the seated flexion test positive on?
How is the sacrum rotates? |
+SFT on the LEFT
Sacrum rotated to the left on a right oblique axis or L on R |
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What type of torsion is a L on L?
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Forward
It would have a negative spring test indicating that the sacrum DID moce |
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What type of torsion is a R on L?
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backwards
Spring test would be positive indicating LACK of movement |
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What is a shear?
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The slippage of one sacroiliac joint about a
vertical axis with translation of the sacral base. |
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Diagnosis?
Positive spring test Sulcus is shallow on the same side as an anterior ILA Positive seated flexion test on shallow sulcus side. |
Unilateral Sacral Extension
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What happens in Cranial/sacral flexion:
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1. midline bones flex.
2. Paired bones externally rotate. 3. SBS rises. 4. Sacral base moves posterior / counternutation. 5. Respiratory inhalation encourages flexion. |
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What happens in Cranial/sacral extension:
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1.Midline bones extend
2.Paired bones internally rotate. 3. SBS lowers 4. Sacral base moves anterior / nutation. 5. Respiratory exhalation encourages extension. |
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Cranial Pearls -Part I
Torsion: Named for the high greater wing of the sphenoid. Sidebending Rotation: Named for the side of the produced convexity. Convexity side is rotated toward the feet. Vertical Strain: Named for the position of basisphenoid. Superior/inferior shearing of the BSB. |
Cranial Pearls Part II
Vertical strain associated with trauma such as an uppercut. Lateral Strain: Named for the position of basisphenoid. Side to side shearing of the BSB. Caused by trauma such as a hook. Seen in infants with a “parallelogram shaped head” Compression: No motion, caused by trauma. |
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What is the Spencer technique used to treat? What motion is NOT part of the technique?
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Adhesive Capsulits
Not included: external rotation |
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Grading Deep Tendon Reflexes
What is Normal? |
Grade 2 is normal
grade 0--no response; grade 1--minimal response; grade 2--mid-range normal response; grade 3--slightly hyperactive response; grade 4--hyperactive response with clonus. |
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Muscle Strength Grading
What is normal? |
5 is normal
Grade 0: Total Paralysis Grade 1: Palpable or visible contraction Grade 2: Full range of motion with gravity eliminated Grade 3: Full range of motion against gravity Grade 4: Full range of motion with decreased strength Grade 5: Normal Strength |
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What is a ligament injury called? Muscle injury (tendon)?
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A sprain for ligament
strain=muscle |
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What are the Grades of Sprains?
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Grade I sprain: stretch of ligament
Grade II sprain : partial tear. Grade III sprain: complete tear. |
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What is O'Donahue's triad?
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Pop goes the ACL, Medial meniscus, and
medial collateral ligament |
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Which is the most common mechanism of injury of the ACL, contact or noncontact?
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non contact. a planted foot with subsequent twisting motion is the usual cause
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What is the best test for a torn ACL? What other tests can you do?
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Lachman is the best
Other options re anterior drawer and pivot shift |
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Torn Meniscus Facts
Pain often localized to the joint line and popliteal region with knee flexion. Locking of the joint, which prevents full knee extension. Buckling or “ giving out” sensation. Knee pain often worse with full knee flexion or extension. |
Torn Meniscus Facts
Pain often localized to the joint line and popliteal region with knee flexion. Locking of the joint, which prevents full knee extension. Buckling or “ giving out” sensation. Knee pain often worse with full knee flexion or extension. |
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What tests/physical exam findings would you anticipate with a torn meniscus
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Joint line tenderness with bent knee
+Apley Grind Test +McMurray +Pain and instability with walking, pt may "baby" leg by keeping knee bent Knee effusion and pain with full flexion or extension |
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What is the most common type of ankle
sprain? |
Inversion injury
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What ligaments are injured with inversion? List in order of how they tear
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ATF
CFL PTF (In that order) |
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What are the rotator cuff muscles?
What are the motions of each muscle? |
SITS
Supraspinatous=Abduction Infraspinatus=EX Rot Teres MINOR= EX Rot Subscapularis = Internal Rotation |
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Jobe’s Test?
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Supraspinatous
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Speed’s Test?
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Biceps brachii
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Hawkin’s Test?
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Impingement
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Neer’s Test?
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Impingement
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Yergeson’s Test?
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Long head of biceps
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Cross Arm Test?
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AC Joint dysfunction
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Patrick’s Test?
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Hip Joint Dysf
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Straight Leg Raise?
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nerve root impingement
( |
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Thomas Test?
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Illiopsoas
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Thompson Test?
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Torn Achillies
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Ober’s Test?
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IT Band
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Stork Test?
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Apondylolysis
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Trendelenberg Test?
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Superior gluteal nerve/Glut Med on side opposite the fallen side
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Common Features of Herniated Disks:
What levles/direction? More males or Females? |
L4/5 or L5/S1 most common in posterior lateral direction (due to posterior Longitudinal Ligament)
Males more ofter and pain is worse with increasing intrathecal pressure |
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What are the possible treatments for a Herniated nucleus pulposus?
What imaging to diagnose |
Treatment: Local heat/ice, OMT,
Corticosteroids, NSAIDS, Opioids, epidural injection, Surgery ( last resort ). Tricyclic antidepressants and gabapentin are often used for neuropathic pain unresponsive to opioids. Diagnosis: MRI, CT, Myelogram. |
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Connective tissue and bone overgrowth
reducing the size of the vertebral foramina = |
Spinal Stenosis
Normal aging proocess most common in peopl over 60 |
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How does spinal stenosis present?
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Chronic and progressive
Bilateral and poorly locaized Pain that RADIATES wo butt thigh or legs Worse with Extension (standing or walking) Better with flexion (sitting or stooping.) Stopping ambulation may not improve sx like it would if the problem were vascular claudication |
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What are the risk factors for peripheral vascular disease/claudication?
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Smoking, DM, hyperlipidemia, FMHX
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What is the presentation of peripheral vascular disease/claudication?
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Chronic, progressive
bliateral or unilateral, poorly localized worse with any lower extremity exertion Diminished puses, delayed cap refill and cyanotic cool extremities are classic clues on physical exam |
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A Separation of the pars interarticularis of the
vertebral arch = |
Spondylolysis
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Slippage of one vertebral body onto the next. =
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Spondylolithesis
(must be lilateral for slippage to occur, most common L5/S1) |
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What type of injuries or athletes are most prone to Spondylolithesis?
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Hyperextension injuries as seen in football lineman and gymnastic participants
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Common Features of Herniated Disks:
What levles/direction? More males or Females? |
L4/5 or L5/S1 most common in posterior lateral direction (due to posterior Longitudinal Ligament)
Males more ofter and pain is worse with increasing intrathecal pressure |
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What are the possible treatments for a Herniated nucleus pulposus?
What imaging to diagnose |
Treatment: Local heat/ice, OMT,
Corticosteroids, NSAIDS, Opioids, epidural injection, Surgery ( last resort ). Tricyclic antidepressants and gabapentin are often used for neuropathic pain unresponsive to opioids. Diagnosis: MRI, CT, Myelogram. |
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What % of 20-80 yr olds have bulging or protruding discs on MRI and are ASYMPTOMATIC!!!
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52
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Connective tissue and bone overgrowth
reducing the size of the vertebral foramina = |
Spinal Stenosis
Normal aging proocess most common in peopl over 60 |
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How does spinal stenosis present?
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Chronic and progressive
Bilateral and poorly locaized Pain that RADIATES wo butt thigh or legs Worse with Extension (standing or walking) Better with flexion (sitting or stooping.) Stopping ambulation may not improve sx like it would if the problem were vascular claudication |
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What are the risk factors for peripheral vascular disease/claudication?
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Smoking, DM, hyperlipidemia, FMHX
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What is the presentation of peripheral vascular disease/claudication?
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Chronic, progressive
bliateral or unilateral, poorly localized worse with any lower extremity exertion Diminished puses, delayed cap refill and cyanotic cool extremities are classic clues on physical exam |
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A Separation of the pars interarticularis of the
vertebral arch = |
Spondylolysis
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Slippage of one vertebral body onto the next. =
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Spondylolithesis (scotty dog)
(must be lilateral for slippage to occur, most common L5/S1) |
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What type of injuries or athletes are most prone to Spondylolithesis?
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Hyperextension injuries as seen in football lineman and gymnastic participants
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What is the grading scale for Spondylolithesis? What grades is atpropriate to monitor the injury?
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Grade I – 0-25% displacement.
Grade II – 25-50 % displacement. Grade III – 50-75 % displacement. Grade IV -75-100% displacement. Grade III and IV are often surgical. Grade I and II monitoring is appropriate. |
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What is the disorder based on the following description?
Pain in the back, in the facet region with no radiation below the knee Signs of spasm at segmental level Paravertebral tenderness Pain is felt in the morning upon rising, tending to lessen with physical activity. Painful motion especially hyperextension Normal neuro exam |
Facet joint syndrome
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Who gets Fibromyalgia? What is the criteria?
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Incidence in ambulatory edicine, 3-10% population
Over 75% are women between 20-60 years of age Characterized by diffuse aches, stiffness, and fatigue American College of Rheumatology: at least 11/18 tenderpoints for greater then 3 months duration |
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What sould be ruled or or a DDx when considering Fibromyalgia?
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Rule out thyroid disease, lupus,
rheumatoid arthritis, malignancy, infectious disease, etc. |
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What things exacerbate Fibromyalgia?
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Pain and fatigue are worse with stress,
cold, and physical activity. |
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Greater than 70% of people with fibromyalgia have problems with this normal activity...
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Sleep!
70% of patients have alpha wave intrusion into non-REM delta wave sleep. Assocaiated with IBS, depression and headaches |