- Shuffle
Toggle OnToggle Off
- Alphabetize
Toggle OnToggle Off
- Front First
Toggle OnToggle Off
- Both Sides
Toggle OnToggle Off
Front
How to study your flashcards.
Right/Left arrow keys: Navigate between flashcards.right arrow keyleft arrow key
Up/Down arrow keys: Flip the card between the front and back.down keyup key
H key: Show hint (3rd side).h key
PLAY BUTTON
PLAY BUTTON
176 Cards in this Set
- Front
- Back
|
what are the models of osteopathic care?
|
1. psychobehavioral
2. respiratory-circulatory 3. postural-structural 4. neurological 5. bioenergetic |
|
Name this model of osteopathic care and provide examples:
patient is approached from a biomechaimical orientation toward the musculoskeletal system |
Postural-structural model
postural exam structural exam s/d diagnosis omt exercise prescription |
|
Name this model of osteopathic care and provide examples:
the patient is approached by diagnosis or treatment of the autominic nervous system and associated reflexes |
Neurological model
referred pain viscerosomatic reflexes Chapmans points |
|
Name this model of osteopathic care and provide examples:
the patient is approached from the perspective of improving blood and lymph flow |
Respiratory-circulatory model
-palpation for edema -evaluation and treatment of fascial diaphragms -OMT to improve drainage |
|
Name this model of osteopathic care and provide examples:
the patient is approached from the perspective of enhancing the capacity to relate and both internal and external environments |
Psychobehavioral model
stress/anxiety chronic pain insomnia mood disorders |
|
Name this model of osteopathic care
examples include: chronic myofascial pain trauma rehabilitation resistant s/d complementary and alternative medicine |
Bioenergetic model
|
|
what osteopathic model would you use?
musculoskeletal problems postural treatment sports medicine rehab. |
postural-structural
|
|
what osteopathic model would you use?
somatization behavior modification chronic pain depression |
psychobehavioral
|
|
what osteopathic model would you use?
referred pain visceral diagnosis visceral treatment |
neurologic
|
|
what osteopathic model would you use?
systemic problems edema infectious disease immune function |
respiratory-circulatory
|
|
Name this treatment
1. find tender point 2. name 10/10 3. position to 2/10 4. fine tune to 0/10 5. hold 90 sec. 6. SLOW passive return 7. retest |
Counterstrain
|
|
Name this treatment
1. diagnosis restricted motion 2. slowly move into position of laxity 3. follow release until completed (indirect)---or---slowly move inot restriction and stretch until tissue give is completed (direct) 4. retest |
myofacial release
|
|
what are 3 types of manipulation in the cranial field?
|
1. balanced membranous tension
2. ligamentous articular strain 3. sutural disengagement |
|
Name this treatment:
1. diagnose restriction 2. move into restrictive barrier 3. isometric contraction 3-5 seconds 4. stretch until give stops 5. repeat 3-5 times 6. retest motion |
muscle energy technique
|
|
Name this treatment
1. diagnosis restriction 2. move into restrictive barrier for all planes 3. short, quick movement through the barrier 4. retest motion |
thrust technique
|
|
name the treatment:
1. diagnosis restricted joint motion 2. slow movement of joint to its position of laxity for all planes 3. slow movement of joint into its restriction for all planes 4. 3-5 repetitions as one smooth movement 5. retest |
articulatory technique
|
|
What techniques are utilized in autonomic normalization?
|
sympathetic techniques
parasympathetic techniques |
|
What techniques are utilized in lymphatic treatments?
|
diaphragm release
lymphatic release effleurage/petrissage |
|
what techniques are utilized in visceral treatments?
|
ventral techniques
visceral manipulation |
|
When are indirect techniques subjectively better?
|
1. rapid onset
2. acute duration (<2 weeks) 3. elderly 4. trauma 5. neurological symptoms 6. systemic/visceral symptoms |
|
when are indirect treatments objectively better?
|
1. abnormal vital signs
2. traumatic signs (bruising/swelling) 3. antalgic posture 4. severe tenderness 5. guarding with movement 6. visceral abnormalities |
|
A patient comes to you with an acute severe problem...what is your
method? dose? frequency? duration? |
ACUTE/SEVERE
indirect method fewer regions/lower dose 1-2 tx. per week 2-4 treatments in duration |
|
A patient comes to you with a chronic problem...what is your
method? dose? frequency? duration? |
any technique method
more regions/higher dose every 2-6 weeks can continue as long as helpful |
|
Describe the movement of rib 1
|
elevation and depression
|
|
Describe the movment of ribs 2-10
|
*pump handle inhalation and exhalation
*bucket handle inhalation and exhalation |
|
Describe the movement of ribs 11-12
|
caliper type inhalation and exhalation
|
|
Which ribs move primarily in pump handle motion moving anterior and superior with inhalation?
|
ribs 2-5
|
|
Which ribs move primarily in lateral and superior motion with inhalation?
|
ribs 6-10
|
|
How do you evaluate ribs 2-5?
|
karate chop
|
|
How do you evaluate ribs 6-10?
|
palpate at the lateral chest
|
|
How do you evaluate ribs 11 &12?
|
patient is prone
|
|
how do you name sternum somatic dysfunctions?
|
sternum in flexion or extension
|
|
What are the s/d that can be occuring in ribs 2-10?
|
1. inhalation or exhalation
2. anterior or posterior subluxation |
|
How do you treat anterior rib tender point?
|
1. lean opposite shoulder on your knee
2. turn their head toward the rib 3. lean them away from rib tender point |
|
How do you treat a posterior rib tender point?
|
1. put the same side arm on your knee
2. lean them toward side of affected rib |
|
what rib do you treat for exhaled rib s/d?
|
treat top rib
|
|
what is the proper sequence for treating ribs?
|
1. treat thoracic first (type II and then type I)
2. treat subluxation 3. treat respiratory ribs |
|
what are some reasons for Rib OMT?
|
rib pain
chest wall pain mechanical back pain tension headache thoracic outlet syndrome pneumonia asthma postural problems (scoliosis) congenital deformities (pectus excavatum or pectus carinatum) |
|
List the absolute contraindications for direct rib treatment.
|
multiple myeloma
rib metastasis rib fracture costochondral separation |
|
List the relative contraindications for direct rib treatment
|
osteoporosis
costochondritis arrhythmia osteoarthritis |
|
when is rib raising used?
|
Rib raising is used for rib restriction or related organ autonomic dysfunction
|
|
what are the major motions of the hips?
|
1. flexion/extesion
2. adbuction/adduction 3. internal rotation/external rotation |
|
what are the minor motions of the hips?
|
1. anterior glide (hip external rotation)
2. posterior glide (hip internal rotation) |
|
When you turn the knee medial and the ankle lateral---what motion are you testing in the hip?
|
internal rotation
|
|
What would you check if the hip was in external rotation?
(restricted in internal rotation?) |
piriformis or gluteus
|
|
What would you check if the hip was in internal rotation?
|
hip adductors
hip internal rotators |
|
What would you check if the hip was in flexion (restricted in extension)
|
quadriceps or iliopsoas
|
|
What would you check if the hip was in extension (restricted in flexion)
|
hamstrings
gluteus |
|
What would you check if the hip was in abduction (restricted in adduction)
|
gluteus
greater trochanter or iliotibial band |
|
What would you check if the hip was in adduction (restricted in abduction)
|
hip adductors
|
|
if you have a hip s/d what else should be evaluated?
|
SI joint
sacrum pelvis lumbar short leg **lower extremity s/d!! |
|
What are some indications for Hip treatment?
|
Hip pain
-trochanteric bursitis -iliotibial band syndrome -psoas syndrome -piriformis syndrom -hamstring strain Any s/d a joint above or a joint below--low back, pelvic, sacral, knee pain *** |
|
List contraindications to hip treatment.
|
1. hip fracture/dislocation
2. infection, inflammation, cancer 3. DVT 4. femoral head avascular necrosis 5. severe hip or knee arthritis |
|
What are the knee s/d?
|
patella: restricted in patellofemoral glide
tibia: Flexion/extension internal/external rotation tibiofibular joint: anterior fibular head, posterior fibular head |
|
When the anterior tibial tuberosity is lateral to the midline of the patella, what is the s/d?
|
tibia in external rotation
|
|
List some indications for treating the knee:
|
knee pain
-strain -chondromalacia patellae -patella tendonitis -osgood Schlatter syndrome -osteoarthritis shin splints hip or ankle sprain plantar fasciitis |
|
what is this a treatment for:
1. locate the tender point at the medial knee joint line; labeling it 10/10 2. hold ankle, flex knee by dropping it off the table and retest for tenderness 3. fine tune with slight tibia internal rotation and adduction until tenderness is 2/10 4. hold 90 sec. 5. slowly and passively return leg to neutral |
medial meniscus counterstrain
|
|
Name this treatment
1. place pillow under the foot and locate the tender point in the patella tendon 2. push the distal femur posterior to extend the knee and retest for tenderness 3. fine tune with slight tibia internal or external rotation 4. 90 seconds 5. slowly, return |
patella tendon counterstrain
|
|
what s/d can occur at the occipitoatlantal joint?
|
flexion/extension** primary
sidebending and rotation to the opposite sides |
|
What s/d can occur at the atlanto axial joint?
|
rotation only
|
|
what s/d can occur at C2-C7?
|
flexion-extension
sidebending and rotation to the same sides |
|
in relation to movement in the neck--what is the 50% rule?
|
50% of cervical flexion and extension occurs at the OA joint
50% of the cervical rotation occurs at the AA joint |
|
how many turns does the vertebral artery make around the foramen magnum?
|
3 turns therefore increasing the risk of arterial compromise with s/d and OMT
|
|
what screening tests should be performed before treatment of cervical s/d?
(5 things) |
1. vertebral artery challenge test (DeKlejn's)
2. cervical compression test (Spurlings maneuver) 3. hypermobility screen (Beighton's score) 4. DTRs 5. upper extremity strength testing |
|
what nerve is responsible?
DTR= biceps strength= biceps |
C5
|
|
what nerve is responsible?
DTR= brachioradials strength= wrist extensors |
C6
|
|
what nerve is responsible?
DTR = triceps strength= wrist flexors |
C7
|
|
what nerve is responsible?
DTR= none strength= finger flexors |
C8
|
|
what nerve is responsible?
DTR= none strength= interossei |
T1
|
|
List some indications for cranial manipulation
|
neck pain--acute or chronic
headache TMJ dysfunction pharyngitis, sinusitis cranial/thoracic/rib s/d |
|
what are the absolute contraindications for cervial OMT?
|
patient refusal
risk outweighs benefits pain or intolerance during the procedure |
|
What are the relative contraindications for cervical OMT?
|
vertebral arter insufficiency
sprain joint inflammation joint hypermobility (thrust) rheumatoid arthritis downs syndrome |
|
translating the cervical spine right means sidebending in which direction?
|
translating right = sidebending left
sidebending and rotation are to the same side C2-C7 |
|
name the somatic dysfunction if C3 is restricted in right sidebending worse in flexion
|
C3 ERS left
|
|
What levels to Fryette mechanics not apply?
|
cervical region
|
|
Name the cervical technique:
begin at the indirect barrier and rotate through the direct barrier |
articulatory
|
|
Name the cervical technique:
generally sidebend and rotate away |
counterstrain
|
|
Name the cervical technique:
rotation: at direct flexion/extension and rotation barrier |
rotation ME
|
|
Name the cervical technique:
sidebending: at direct flexion/extension and sidebending barrier |
sidebending ME
|
|
What is Fryette's Law #1?
|
when the spine is in neutral sidebending and rotation are in opposite directions
-facets are not engaged -found in thoracic and lumbar spines -forms long curves, multiple segments -compensatory |
|
What is Fryette's Law #2?
|
when the spine is flexed or extended sidebending and rotation are in the same directions
-facets are engaged -occurs in thoracic and lumbar spines -usually single segements -found at apices and crossovers and/or sites of viscerosomatic reflexes -primary somatic dysfunction |
|
What is Fryette's Law #3?
|
when motion introduced in one plane it modifies (reduces) motion in other two planes
-when a segment is brought up to a restrictive motion barrier it will move in the position of greatest ease in the other two planes -restriction = direction it won't go -s/d = direction it wants to be |
|
which type of thoracic/lumbar somatic dysfunction rotates towards the concavity?
|
type II
|
|
name the diaphragm
L5-S1 |
pelvic diaphragm
|
|
name the diaphragm
T12-L1 |
thoracic diaphragm
|
|
name the diaphragm
T1-1st rib |
thoracic inlet
|
|
name the diaphragm
OA, AA |
suboccipital
|
|
which model does Zink's fascial diaphragm theory utilize?
|
respiratory-circulatory
|
|
what are the 4 patterns of body structure according to Zink's fascial diaphragm theory?
|
1. ideal
2. common compensatory 3. uncommon compensatory 4. uncompensated or disparent |
|
when evaluating fascial diaphragms what is the treatment approach?
|
emphasis on crossover points of spinal curves
treat the worst first! |
|
what is the common compensatory pattern of diaphragms?
|
pelvic = right
abdominal = left thoracic inlet = right suboccipital = left |
|
what joints make up the shoulder complex?
|
scapulothoracic
acromioclavicular sternoclavicular costovertebral glenohumeral |
|
Describe the relationship between the glenohumeral joint and the scapulothoracic joint during arm abduction
|
for every 3 degrees of abduction--2 degrees occurs in the glenoumeral joint and 1 degree in the scapulothoracic joint
|
|
A restriction in scapular rotation leads you to believe there is what kind of problem?
|
shoulder girdle problem
|
|
A restriction in humeral abduction leads you to believe there is what kind of problem?
|
glenohumeral problem
|
|
what is the role of the clavical in abduction?
|
elevates from a pivot at the sternoclavicular joint as well as rotating on a long axis
|
|
what is this treatment for?
1. push or pull the medial clavical into its restrictive barrier 2. patient's flexed arm pulls posteriorly into your shoulder |
anterior clavicle
|
|
what is this treatment for?
1. push or pull the medial clavical into its restrictive barrier 2. patient's internally rotated arm pushes anteriorly |
superior clavicle
|
|
what is this treatment for?
1. push or pull the medial clavical into its restrictive barrier 2. patient's head rotated toward the restricted SC joint and pushes into rotation away from the restricted joint |
inferior clavicle
|
|
List the spencer technique:
|
1. extension
2. flexion 3. compression 4. traction 5. abduction 6. internal rotation 7. pump 8. adduction |
|
Name this extremity nerve compression syndrome
pain and/or parathesia in the upper extremity from brachial plexus compression neural compression is more common than vascular compression |
Thoracic outlet sydrome
|
|
Name this extremity nerve compression syndrome
median nerve compression associated with numbness, and pain in the arm and hand along the median nerve distribution repetitive micro trauma |
carpal tunnel syndrome
|
|
Name this extremity nerve compression syndrome
A type of peripheral nerve compression syndrome in which there is a 'central' compression that impacts on a nerve bundle–eg, at the thoracic or pelvic outlet, and a 2nd more peripheral compression–eg, at the carpal or tarsal tunnel; |
double crush syndrome
|
|
where is the compression in thoracic outlet syndrome?
what test would be positive? |
-between the clavicle and the 1st rib
-anterior and middle scalene muscles + Adsons maneuver (scalene compression test) = diminished pulse and/or reproduction or exacerbation of symptoms |
|
where is the compression in carpal tunnel syndrome?
what test would be positive? |
carpal tunnel (duh)
+ phalen's test...MUST HOLD IN FULL FLEXION FOR UP TO 60 SECONDS!!! +Tinel's test--gentle tapping over the median nerve in the carpal tunnel can elicit tingling in the nerve's distribution |
|
where is the compression in thoracic outlet syndrome?
what test would be positive? |
dimulatenous appearance of carpal tunnel and thoracic outlet syndrome
*compression of a nerve at one point renders it more susceptible to damage at another site both Adson's and Phalen's + |
|
what is the treatment for thoracic outlet syndrome?
|
OMT for elevated 1st rib
PT--postural correction, e. stim, deep heat management of chronic pain surgical resection of 1st rib |
|
what is the treatment for carpal tunnel syndrome?
|
OMT--myofascial release
*release transverse carpal ligament, opponens roll, wrist extension to pull flexor tendons *hyperextend thumb, laterally rotate, hold for 5-10 sec. wrist braces NSAIDs Vitamin B6 |
|
What direction does the ulnohumeral joint passively move with extension?
|
abducts
= carrying angle |
|
with a posterior radial head somatic dysfunction--what glide will be restricted?
|
anterior glide is restricted
therefore supination is restricted |
|
A person falls backwards on an extended arm--what is the most likely somatic dysfunction?
|
anterior radial head somatic dysfunction
-ease of motion is anterior glide -restricted motion is posterior glide with pronation |
|
Patient with back pain...what muscles should you immediately think of evaluating?
|
psoas
iliacus quadratus lumborum |
|
name the visceral somatic levels
head/neck |
T1-T4
|
|
name the visceral somatic levels
stomach, liver, gall bladder |
T5-T9
|
|
name the visceral somatic levels
kidney, ureters, bladder |
T10-T11
|
|
name the visceral somatic levels
colon/rectum |
T8-L2
|
|
name the visceral somatic levels
heart |
T1-T5
|
|
name the visceral somatic levels
lungs |
T2-T7
|
|
name the visceral somatic levels
small intestine |
T9-T11
|
|
name the visceral somatic levels
uterus |
T10-T11
|
|
name the visceral somatic levels
prostate |
L1-L2
|
|
how do you treat an anterior innominate with HVLA?
|
1. patient on back
2. lift affected leg up 30 degrees 3. caudad tug down the leg |
|
how do you treat an anterior innominate with ME?
|
1. patient on back
2. stand beside the involved side and craddle patients bent knee (knee toward chest) 3. pull ischial tuberosity anteriorly 4. patient resists by pushing their knee against your shoulder |
|
how do you treat a posterior innominate with ME?
|
1. patient laying on the table with affected leg dangling off
2. stand on invovled side and hold the opposite ASIS 3. move into the barrier and have the patient push their thigh upward |
|
In sacral evaluation--if the spring test is positive, what does that limit your diagnosis to?
|
R/L
L/R unilateral extension |
|
describe the pathway of facilitation
|
ANS nerves--->organ--->aberrant activity --->affects systemic activities
|
|
name the visceral somatic levels
eye |
T1-T2
dilates pupil, relaxes for far vision |
|
name the visceral somatic levels
esophagus |
T3-T6
decreases peristalsis, contracts sphincter |
|
name the visceral somatic levels
gall bladder |
T6-T9
relaxation |
|
name the visceral somatic levels
right colon |
T8-T11
decrease peristalsis and secretion |
|
name the visceral somatic levels
cervix |
L1-L2
opens cervix |
|
name the visceral somatic levels
uterus |
T9-L2
contractions |
|
what organs have S2-S4 for parasympathetic innervation?
|
distal 1/3 of transverse colon to the rectum--contract lumen, relaxe sphincter, increase secretion/motility
uterus--decreases activity |
|
what is the parasympathetic innervation for...?
eye |
CN III
constricts pupil for near vision |
|
what is the parasympathetic innervation for...?
lacrimal/nasal glands |
CN VII
stimulates for extensive secretion |
|
what is the parasympathetic innervation for...?
parotid gland |
CN IX
stimulates for extensive secretions |
|
The following findings are suggestive of what?
-hot -moist -fullness -edema -tension -increased or prolonged redness |
acute findings
|
|
From the location, name this Chapman's point
-at the tip of the right 12th rib? |
appendix
|
|
From the location, name this Chapman's point
-2 inches superior and 1 inch lateral to the umbilicus -spinous process T11 |
adrenals
|
|
From the location, name this Chapman's point
-2nd medial intercostal space -spinous process of T2 |
heart
|
|
From the location, name this Chapman's point
-at the umbilicus |
kidney
|
|
From the location, name this Chapman's point
-anterior IT bands -L2-L4 spinous process |
colon
|
|
what is the CRI rate?
|
10-14
|
|
what is the amplitude of CRI?
|
distance from flexion to extension (0-5)
|
|
List the 5 components of the Sutherland primary respiratory mechanism
|
1. mobility of cranial bones
2. motility of CNS 3. fluctuation of CSF 4. mobility of sacrum and ilia 5. reciprocal tension of dura mater/membrane |
|
list the unpaired bones
|
mandible
occiput vomer ethmoid sphenoid |
|
describe the movement of unpaired bones
|
flexion/extension
|
|
describe the movement of paried bones
|
external and internal rotation
|
|
how many bones are in the adult human skull?
|
29
|
|
Name this cranial movment
SBS rises as sphenoid and occiput rotate opposite directions on transverse axis |
cranial flexion
|
|
Name this cranial movment
-sphenoid and occiput rotate opposite directions on AP axis -named for superior sphenoid great wing |
torsion
|
|
Name this cranial movment
-2 axes sidebend by rotating same direction on 2 parallel vertical axes rotate same way on AP axis -named for convexity of sidebending |
sidebending rotation
|
|
Name this cranial movment
-rotate same direction on 2 parallel horizontal axes -named for direction of sphenoid base |
vertical strain
|
|
Name this cranial movment
-rotation same direction about 2 parellel vertical axes -named for direction of base of sphenoid |
lateral strain
|
|
Name this cranial movment
-most often due to head trauma -limited degree of flexion and extension |
SBS compression
sphenoid/occiput are compressed together |
|
list the pysiological SBS strains
|
pysiological
-flexion/extension -torsion -sidebending rotation |
|
what is the common cranial nerve involvement in...
EOM dysfunction? |
III
IV VI |
|
what is the common cranial nerve involvement in...
trigeminal neuralgia |
V
|
|
what is the common cranial nerve involvement in...
bells palsy |
VII
|
|
what is the common cranial nerve involvement in...
feeding disorders |
IX
X XII *occipital decompression |
|
what is the common cranial nerve involvement in...
torticollis |
XI
*occipital decompression |
|
what are the contraindications for Osteopathy in the cranial field?
|
intracranial bleed
increased CSF CNS malignancy or infection craniofacial fracture |
|
what points should a static lateral line go through?
|
1. anterior to lateral malleolus
2. middle of tibial plateau 3. greater trochanter 4. body of L3 5. middle of humeral head 6. external auditory meatus |
|
what points should a static posterior line go through?
|
1. halfway between knees
2. along gluteal fold 3. through all spinous processes 4. along the midline of the head |
|
Name this screening test
-patient shifts weight onto one leg allowing the other knee to bend which induces a lumbar sidebending toward the weight bearing leg normally > 25 degrees + is less than 25 and indicates restricted lumbar sidebending toward the side of wieght bearing leg |
hip drop test
*test is named for the bent leg side (+ right hip drop test indicates restricted left lumbar sidebending) |
|
what postural x-rays should be ordered in the evaluation of scoliosis?
|
postural radiographs
-anterior-posterior erect -lateral erect both of these center on the iliac crest scoliotic x-ray -erect AP that includes the occiput and the sacral base!!! |
|
when you view a postural x-ray, what 4 things should you evaluate?
|
1. sacral base levelness
2. iliac crest levelness 3. femoral head levelness 4. thoracic or lumbar scoliosis (cobb angle) |
|
what is ferguson's angle?
|
weight bearing line and base of sacrum
normal is 40 degrees +/- 2 |
|
the convexity of functional scoliosis is usually the same side as what?
|
the short leg!!!
|
|
describe the appropriate progression of heel lifts
|
1/8 inch lift
increase lift no faster than 1/16 per week (or 1/8 every 2 weeks for non geriatric or acute pain patients) |
|
as described by the Adam's test---name this type of scoliosis
does not reduce with side bending toward the rib hump? |
structural
|
|
what is this angle
draw lines from the top of the superior vertebra and the bottom of the inferior vertebra into the concavity of the curve drop intersecting lines perpendicular to these lines and measure the actue angle |
Cobb angle
|
|
what is the cobb angle in mild scoliosis?
tx? |
5-15
tx: conservative, OMT, exercises and tx of short leg |
|
what is the cobb angle in moderate scoliosis?
tx? |
20-45
tx: bracing or e. stim |
|
what is the cobb angle in severe scoliosis?
tx? |
>50
surgical stabilization |
|
what is the OMT goal for scoliosis?
|
optimize the function of the existing structure
-remove joint s/d -improve general body ROM introduce strengthening exercises after structural strains to increase healing |
