52: Manual Medical Approach to the Lower Extremity - Klock Flashcards

1
Q

principles of osteopathic medicine

A
  1. The human being is a dynamic unit of function.
  2. The body possesses self-regulatory mechanisms that are self-healing in nature.
  3. Structure and function are interrelated at all levels.**
    - – [Normal body structure promotes normal body function/Improving the functionality of the body will promote good health/Truing up the frame of the body will allow it to function more efficiently]
  4. Rational treatment is based on these principles.
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2
Q

what does “truing up” the frame of the body do?

A
    • Promotes normal arterial circulation.
    • Promotes normal venous and lymphatic return.
    • Improves the health of the tissues.
    • Decreases the wear-and-tear on the joints from normal use.
    • Decreases the wear-and-tear on the joints from extraordinary use.
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3
Q

define somatic dysfunction

A
  • impaired or altered function of related components of the somatic system or body framework
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4
Q

key indicators that somatic dysfunction is present ***

A

TART

tenderness
asymmetry of motion and position
restriction of motion
texture changes of the tissues

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5
Q

We describe/document SD by position and motion characteristics

The position of a body part as determined by …

A

– palpation (described in relation to other body structures or landmarks).

– The directions into which the body part moves freely.

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6
Q

acute v. chronic SD

A

Acute: Redness, Swelling, Tenderness, Pain

Chronic: Tenderness, Itching, Ropiness, Paresthesias (altered sensation)

Both: tissue contraction/increased tension

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7
Q

what is a restrictive barrier? how do you identify it?

A
    • Asymmetry of joint motion caused by restrictive barriers indicates a problem exists.
    • Often times it is somatic dysfunction.
    • These barriers are often caused by muscular strains.
    • Strained muscles are often tighter than normal and restrict joint motion.
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8
Q

jones tender point

A
    • The injury is often due to over-stretching resulting in a strain.
    • A strained muscle will typically have a tender point in a specific location along its’ length
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9
Q

the limit of passive motion =

the limit of active motion =

A

anatomic barrier
physiologic barrier

elastic barrier = The range between the physiologic and anatomic barrier in which passive ligamentous stretching occurs

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10
Q

the hallmark of SD

A

restrictive barrier
- Functional limit within the anatomic range of motion that abnormally diminishes the normal physiologic range of motion.

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11
Q
if the following m are tight ..,
psoas
hamstrings
popliteus
gastrocnemius
soleus
A
Reduced hip extension
Reduced knee extension
Reduced knee extension
Reduced ankle dorsiflexion
Reduced ankle dorsiflexion
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12
Q

what do you do for muscle strain?

A
    • Can’t be made normal by just stretching.
    • To establish a lasting lengthening of strained muscles:
  • —Resolve the strain.
  • —Allow the muscle to reach a normal length by normal use.
  • —Stretch the muscle
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13
Q

what is OMM?

A
    • The intent is to restore symmetry of position and motion, to improve body function and restore health.
    • OMM is to be integrated into management of the whole patient
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14
Q

describe indirect OMM

A

The body part is moved away from the restrictive motion barrier.

It is placed in a position where tissue tension is decreased and equal in one or all planes and directions.

The physician holds and directs the body part until a tissue release is noted

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15
Q

describe counterstrain

A
  • Dysfunction is considered to be a continuing, inappropriate strain reflex.
  • The reflex is inhibited by putting slack in the area of strain in the muscle:
  • – Find a tender point in the strained muscle.
  • – Position the muscle so that the tenderness is 75-100 % relieved.
  • – Hold the position for 90 seconds.
  • The circuit is broken and the strain is “erased.”
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16
Q

describe indirect myofascial release

A

The muscle/connective tissues are carried away from the restrictive barrier.

A force is applied and maintained until a release is observed

17
Q

describe direct OMM

A

The body part is taken to the restrictive barrier.

The physician guides and moves the body part through the restrictive barrier to motion.

18
Q

describe muscle energy (isometric technique)

A

The patients muscles are actively used on request:

  • – The patient is asked to push…
  • – From a precisely controlled position…
  • – Against a distinctly executed physician counterforce .
  • – An equal counterforce in this case
19
Q

describe LVMA low velocity moderate amplitude

A

A joint is carried through its full motion.

The activating force a repetitive springing motion or repetitive movement of the joint through the restrictive barrier

20
Q

body interconnectivity: body –>

A

foot –> ankle –> knee –> hip –> innominate –> SI joint –> sacrum –> spine