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227 Cards in this Set

  • Front
  • Back
Most likely plane in which restriction exists
Tranverse
Restriction in rotation is in which axis
Vertical
Patient facilitated motion is
Active
Abduction of wrist takes place in the __________ plane
Coronal
Tissue texture change in a gall bladder patient reflects
Viscerosomatic reflex
Evaluation of the TMJ is done at
External auditory meatus
Side bending occurs in a/an
AP axis and coronal plane
If a transverse process is posterior on the right, it is…
Rotated right
The sternoclavicular joint lies 1cm lateral of the
Jugular notch
Normal bending of the knee and hip in a marching step is
Flexion of the hip and knee
Superior, wide, broad area of the sacrum
Base
The hip is _______ to the knee
Superior
Hardening of the arteries causes difficulty in circulation
Structure governs function
Large bony protuberances develop from weight lifting
Function modifies structure
Headache is treated in all areas of the spine
Body is a unit
Developing pneumonia 2 days after falling through the ice
Disease occurs when body is overwhelmed
Fracture heals without treatment
Inherent ability to repair itself
Back pain at L3 from bending forward, then turning right is
Flexed, rotated right, side bent right
Functional limit within anatomical range of motion that abnormally diminishes physiologic range
Restrictive barrier
Bones and ligaments are
Anatomic barriers
Temperature change is best detected with
Dorsum of the hand
T2-5 N SL RR follows
Fryette’s I
L5 F RR SR follows
Fryette’s II
Patient on side
Lateral recumbent
Osteopathic medicine is
A philosophy
The ________ barrier and ________ range of motion of a hypertonic cervical spine muscle would best be improved by warm-up exercises
Physiologic, active
Vertebrae prominens
C7
Motion without patient assistance
Passive
Rotation occurs toward the convexity of the curve
Fryette’s I
American School of Osteopathy founded in
1892
Still’s kids died of
Meningitis
Goal of manipulation
Restore and/or maintain homeostasis
Occurs in extreme flexion or extension
Fryette’s Type II
Found at apex of curve group
Fryette’s Type II
Involves more than one vertebrae
Fryette’s Type I
Movement in one plane limits another
Fryette’s Type III
Usually has traumatic origin
Fryette’s Type II
Scoliosis named by
Degree of curvature and side of convexity
Somatic dysfunction named for
Freedom of motion
A difference between acute and chronic dysfunction
Acute exhibits more tenderness
Has a double stance phase
Walking
Has a double swing phase
Running
When corrected, they tend to return within 24 hours
Chronic viscerosomatic dysfunctions
The mechanism of a torn ligament
Movement beyond anatomical barrier
Edema is characteristic of
Acute somatic dysfunction
A 35 degree right thoracic scoliosis is
Moderate
Go up stairs with crutches
Good leg first
Come down stairs with crutches
Crutches first
Scoliosis with no identifiable cause
Idiopathic
Hold body in position for 90 seconds and return to neutral slowly
Counter-strain procedure
6’10”, step length 18”, stride 36”, and cadence 86 is
Normal
Tissue is boggy and warm
Acute dysfunction
In active range of motion, patient can move only a few degrees to the left when compared to the right
Restrictive barrier
Post-op manipulation should be
Counter-strain and myofascial
Final step in OMM treatment
Reevaluate!!!!!
Osteopathic treatment normalizes
Homeostasis
Coolness, pallor, and atrophic tissue indicate
Chronic somatic dysfunction
Which comes first, compression or extension?
Compression
Vasoconstriction of blood vessels
Sympathetic
Dilation of pupil
Sympathetic
Inhibition of heart
Parasympathetic
Relaxation of gall bladder and ducts
Sympathetic
Contraction of bronchial muscles
Parasympathetic
Indirect methods utilize
Inherent forces
Ligamentous articular strain of anterior cervical fascia is directed
Inferior
Direct form of muscle energy uses
Isometric contraction
Counter-strain is a/an
Indirect treatment
Barrier is engaged and forces are applied against the restrictive barrier
Direct treatment
Subjective component of somatic dysfunction
Tenderness
Somatic dysfunction can
Compromise neurovascular components
Asthma causing tissue change is an example of
Viscerosomatic dysfunction
Rhythmic lateral stretching with the origin and insertion held stationary
Kneading
Sustained deep pressure over hypertonic myofascial structures
Inhibition
Gentle stroking to encourage lymph flow
Effleurage
Pinching or tweaking one layer and lifting it away from deeper areas
Petrissage
Percussion of tissue to break adhesion or encourage bronchial secretions
Tapotement
Osteopathic treatment is an appropriate, effective, and sufficient treatment for
Somatic dysfunction
Acute somatic dysfunction exhibits ________ edema than chronic somatic dysfunction
More
Acute somatic dysfunction exhibits ________ warmth and erythema than chronic somatic dysfunction
More
Exhibits ropy, fibrotic, changes in tissue texture
Chronic somatic dysfunction
The diagnostic modality most useful for diagnosing somatic dysfunction
Palpitation
Dry skin, decreased temperature, and blanched skin are indicative of
Chronic somatic dysfunction
Edema is characteristic of
Acute somatic dysfunction
The fascial layer which blends with the skin
Superficial fascia
The fascia around the trapezius muscle
Deep
Counter-strain was discovered by
Lawrence Jones
Muscle energy was discovered by
Fred Mitchell, Sr.
Facilitated positional release was developed by
Stanley Schiowitz, DO
An increased kyphosis as well as a lateral curve concave on the right represents which type of dysfunction
Fryette’s Type I dysfunction
Boggy and warm tissue is a characteristic of
Acute somatic dysfunction
Findings of coolness, pallor and atrophic tissue in a patient with leg pain and weakness is characteristic of
Chronic somatic dysfunction secondary to degenerative discs
Indirect treatment utilizes _________ forces
Inherent
Counterstrain is a _____________ treatment
Indirect
HVLA, muscle energy, springing, and soft tissue techniques are
Direct treatments
Supraspinatus tenderpoint is treated with counterstrain. The position of the patient is
Shoulder abducted and externally rotated
In counterstrain, anterior tenderpoints are treated in
Flexion
Midline between physiological barriers
Balance point
Limits motion by bony structure
Anatomic barrier
Functional limit within anatomical range of motion is decreased
Restrictive barrier
Limits active motion
Physiologic barrier
Fascia
Compartmentalizes
If tension increases on a tendon and muscle, the ________ will cause inhibition of muscle contraction, allowing the tendon to lengthen
Golgi organ
This action is called the
Golgi tendon reflex
Muscle length shortens during contraction
Isotonic
Muscle length remains the same during contraction
Isometric
Muscle length increases during contraction
Isolytic
A _______ force is most commonly used for muscle energy treatment
Isometric
A very quick force over a short distance is used with
HVLA
HVLA is ________ for a patient with an acute rheumatoid arthritis condition
Contraindicated
Muscle energy osteopathic manipulative treatment is
Direct and active
HVLA is
Direct and passive
Counterstrain osteopathic manipulative treatment is
Indirect and passive
Soft tissue techniques are
Direct and passive
Flexion of the arm occurs in the
Saggital plane
The scapula moving away the spine is
Abduction
Spine of the scapula corresponds to
T3
The inferior angle of the scapula corresponds to
T7
Ability of a strained body or tissue to recover its original shape after deformation
Elasticity
Ability to retain a shape attained by deformation
Plasticity
Form follows function
Wolff’s law
Fascia meets its demand 1:1
Hooke’s law
Maintenance of static or constant conditions in the internal environment
Homeostasis
Chapman’s reflex points may be helpful in identifying
Gallstones
Motion that occurs the greatest in the upper thoracic spine
Rotation
Motion that occurs the least in the upper thoracic spine
Extension
Place metacarpal phalangeal joint on ___________ of articular pillars for rotation
Posterior aspect
Place metacarpal phalangeal joint on ___________ of articular pillars for sidebending
Lateral aspect
Inhibition, muscle energy, soft tissue, springing, thrust, myofascial release, and articulatory exaggeration are
Direct treatments
In indirect treatment, the restrictive barrier is
Disengaged
The qualitative description of the cessation of motion is
End feel
The force that, once the patient has been properly positioned, results in the therapeutic effect of the technique
Final activating force
We describe the final activating force with direct techniques in terms of
Amplitude & velocity
Distance over which the force is applied
Amplitude
Speed with which force is applied
Velocity
What is the final activating force for indirect techniques?
Inherent motion
What determines the level of aggressiveness of the technique employed?
Patient tolerance
Limb is taken through its full range of motion; attention directed at dysfunctional barrier
Articulation
Restrictive barrier is engaged repeatedly to produce an increased freedom of motion
Springing
Incorporates lateral or linear stretching and/or deep pressure, using intermittent force
Soft tissue
Soft tissue restrictive barrier is engaged and held with a constant force until release occurs
Myofascial release
Localizes forces to the area of dysfunction
HVLA
The patient voluntarily moves their body from a precisely controlled position against a controlled resistance applied by the physician (isometric force).
Muscle energy
Contraction of a muscle against resistance while maintaining constant muscle length
Isometric
Contraction of a muscle against resistance while allowing the origin & insertion to approximate (patient wins)
Isotonic
Contraction of a muscle against resistance while forcing the muscle to lengthen (doctor wins)
Isolytic
The muscle spindle reports increased tension; this results in increased
Gamma tone and muscle spasm
The short window where muscles will not reflexively contract; the muscles can be stretched during this time
Absolute refractory period
When a critical amount of tension occurs, increased ___________ activity brings about reflex relaxation of the muscle as a whole.
Golgi tendon organ
What is Soma?
Body
Asymmetry is assessed primarily by
Observation
Long standing sympathetic overstimulation which leads to disease
Chronic hypersympathetonia
Palpatory stimulation which results in redness which remains longer than the rest of the area tested
Acute red reflex
Palpatory stimulation which results in initial redness followed by blanching of the tissues before the rest of the area blanches
Chronic red reflex
The ________ indicates either acute somatic dysfunction in that segmental area or somatic dysfunction secondary to visceral dysfunction innervating that segment
Acute red reflex
Functionally links true elbow & wrist joints
Interosseous membrane
Allows sharing of compressive forces & movements
Interosseous membrane
Distal radius moves posterior & lateral, radial head glides anterior, and Interosseous membrane becomes taut
Supination
Distal radius crosses over ulna, radial head glides posterior, and interosseous membrane becomes loose
Pronation
Anatomical configuration of ulnohumeral joint that causes functional aBduction of forearm and aDduction of wrist
Carrying Angle
Overuse syndromes associated with any activity that requires repetitive pronation/supination and associated wrist flexion/extension
Epicondylitis
Lateral epicondylitis
“Tennis elbow”
Medial epicondylitis
“Golfer’s elbow”
The most common articular somatic dysfunction found in the elbow
Radial head dysfunction
May result from a fall backward on an outstretched arm
An anterior radial head
May result from a fall forward on an outstretched arm
A posterior radial head
The distal articulation of the radius with the first row of carpal bones
True wrist joint
Assessment of radial and ulnar artery patency
Allen’s test
The most common presenting problem with the shoulder
Pain
The only joint in the body where a recurrent dislocation is common
Shoulder
Dermatome where shoulder pain will be felt
C5 dermatome
The most common cause of unilateral scapular pain
Cervical disc lesion
Rotator cuff pain is often referred to
Deltoid region
Scarring and thickening of the musculotendinous unit and surrounding tissue decreases the distance between the rotator cuff and the overlying coracoacromial arch
Impingement syndrome
Edema and hemorrhage
1st stage of impingement syndrome
Cuff fibrosis, thickening, and partial cuff tearing.
2nd stage of impingement syndrome
Full thickness tears, bony changes, and tendon rupture.
3rd stage of impingement syndrome
Tests for subtle impingement
Hawkins impingement sign
Pain reproduced by the painful arc maneuver
Neer impingement test
Flex the arm forward to 90 degrees and then internally rotating the shoulder (thumbs down), bringing the greater tubercle into greater contact with the undersurface of the acromion
Hawkins impingement sign
Assesses stability of the long head of biceps tendon in bicipital groove
Yergason’s test
Detects chronic shoulder dislocation
Apprehension test
Symptoms are often aching in nature and radiate into the distal arm, along the ulnar border of the forearm
Thoracic outlet syndrome
Compression of brachial plexus & subclavian artery between anterior & middle scalene
Anterior scalene syndrome
Tests for anterior scalene syndrome
Adson’s test
Compression of neurovascular bundle between pectoralis minor muscle and thoracic cage
Hyperabduction syndrome
Assessment for hyperabduction syndrome
Wright’s Test
Compression of neurovascular bundle between the clavicle and the first rib
Costoclavicular Syndrome
Assessment for costoclavicular syndrome
Halstead or Military Test
The use of the entire self in achieving or maintaining the location and configuration of the various segments
Posture
Postural muscles at resting tone with no additional energy beyond basal level needed for upright posture
Optimal posture
Center of gravity is approximately 5 cm anterior to
2nd sacral vertebra
Areas where curves reverse
Transitional zones
Appreciable deviation of a group of vertebrae from the normal straight vertical alignment of the spine
Scoliosis
Curve reduced with side bending, rotation or forward bending
Functional Scoliotic Curve
Curve fixed and not reduced with side bending, rotation or forward bending
Structural Scoliotic Curve
Mild scoliotic curve
5–15 degrees
Moderate scoliotic curve
20-45 degrees
Severe scoliotic curve
Greater than 50 degrees
From heel strike to toe off; 60% of Gait Cycle; foot in contact with ground at all times
Stance phase
From toe off to heel strike; 40% of Gait Cycle; foot does not contact ground at any time
Swing phase
Heel strike of one foot briefly overlaps the toe off of the opposite foot and a brief period of both feet in contact with ground
Walking
No double stance phase and there is a period when both feet are off of the ground
Running
Width of stride is an average of
2 - 4”
Length of step from heel strike of one foot to heel strike of opposite foot is an average of
15”
Length of gait cycle (stride) from heel strike of one foot to heel strike of same foot is an average
30”
Center of gravity normally lies 5 cm (2 inches) anterior to
2nd sacral vertebra
Ilium rotates on a _______ axis
Transverse
Cervical Vertebral motion is named for the motion of the more ________ vertebrae on the ________ vertebrae
Superior, inferior
OA (occipitoatlantal joint) “sideslips” to one side and rotates to
Opposite side
AA (atlantoaxial joint) is primarily
Rotational
C2-C7 rotate and sidebend to
Same side (“typical vertebrae”).
Cervical spine follows
Fryette’s III principle (Cervical spine does not follow Fryette’s I or II principles)
The major motion of Occiput on Atlas (C0 on C1) is
Flexion/extension
The motion of occiput on atlas follows ATYPICAL mechanics, which is
Rotation/ sidebending opposite directions
The OA Joint is responsible for _____ of forward-bending and backward-bending of the cervical spine
50%
The major motion of atlas on axis (C1 on C2) is
Rotation
Area of tissue 4 times more tender than surrounding area
Tender point
What is Neer's Test?
Shoulder Tests - Neer's impingement sign is elicited when the patient's rotator cuff tendons are pinched under the coracoacromial arch. The test is performed by placing the arm in forced flexion with the arm fully pronated. The scapula should be stabilized during the maneuver to prevent scapulothoracic motion. Pain with this maneuver is a sign of subacromial impingement.
what is Hawkins' Test?
shoulder test - The Hawkins' test is another commonly performed assessment of impingement. It is performed by elevating the patient's arm forward to 90 degrees while forcibly internally rotating the shoulder (Figure 6). Pain with this maneuver suggests subacromial impingement or rotator cuff tendonitis. One study found Hawkins' test more sensitive for impingement than Neer's test.
what is Drop-Arm Test?
shoulder test - A possible rotator cuff tear can be evaluated with the drop-arm test. This test is performed by passively abducting the patient's shoulder, then observing as the patient slowly lowers the arm to the waist. Often, the arm will drop to the side if the patient has a rotator cuff tear or supraspinatus dysfunction. The patient may be able to lower the arm slowly to 90 degrees (because this is a function mostly of the deltoid muscle) but will be unable to continue the maneuver as far as the waist.
What is Cross-Arm Test?
Patients with acromioclavicular joint dysfunction often have shoulder pain that is mistaken for impingement syndrome. The cross-arm test isolates the acromioclavicular joint. The patient raises the affected arm to 90 degrees. Active adduction of the arm forces the acromion into the distal end of the clavicle (Figure 7). Pain in the area of the acromioclavicular joint suggests a disorder in this region.
what is Apprehension Test?
The anterior apprehension test is performed with the patient supine or seated and the shoulder in a neutral position at 90 degrees of abduction. The examiner applies slight anterior pressure to the humerus (too much force can dislocate the humerus) and externally rotates the arm (Figure 8). Pain or apprehension about the feeling of impending subluxation or dislocation indicates anterior glenohumeral instability.
what is Relocation Test?
The relocation test is performed immediately after a positive result on the anterior apprehension test. With the patient supine, the examiner applies posterior force on the proximal humerus while externally rotating the patient's arm. A decrease in pain or apprehension suggests anterior glenohumeral instability.
what is Yergason Test?
Patients with rotator cuff tendonitis frequently have concomitant inflammation of the biceps tendon. The Yergason test is used to evaluate the biceps tendon. In this test, the patient's elbow is flexed to 90 degrees with the thumb up. The examiner grasps the wrist, resisting attempts by the patient to actively supinate the arm and flex the elbow (Figure 9). Pain with this maneuver indicates biceps tendonitis.
what is Posterior Apprehension and Instability?
Posterior instability of the shoulder can be assessed by using a simple test. With the patient supine or sitting, the examiner pushes posteriorly on the humeral head with the patient's arm in 90 degrees of abduction and the elbow in 90 degrees of flexion.
what is a 'Clunk' Sign?
Glenoid labral tears are assessed with the patient supine. The patient's arm is rotated and loaded (force applied) from extension through to forward flexion. A "clunk" sound or clicking sensation can indicate a labral tear even without instability.12
what is Spurling's Test?
In a patient with neck pain or pain that radiates below the elbow, a useful maneuver to further evaluate the cervical spine is Spurling's test. The patient's cervical spine is placed in extension and the head rotated toward the affected shoulder. An axial load is then placed on the spine (Figure 11). Reproduction of the patient's shoulder or arm pain indicates possible cervical nerve root compression and warrants further evaluation of the bony and soft tissue structures of the cervical spine.