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OMT Flashcards

1
Q

Acute or chronic?

Decreased tone, flaccid, mushy, cool, pale, doughy, stringy, fibrotic, thickened, contracted

A

Chronic

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2
Q

Acute or chronic?

Increased tone, warm, moist, red, inflamed, boggy, edematous

A

Acute

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3
Q

3 fryette principles

A
  1. In neutral, SB precedes rotation and they occur in opposite directions (group SD)
  2. In non-neutral (F or E), SB and rotation occur in same direction (single segment SD)
  3. (Nelson) — motion in one plane diminishesd ability for motion in other planes

[Note: Fryette 1 and 2 only apply to thoracic and lumbar]

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4
Q

Facet orientation in cervical, thoracic, lumbar

A

BUM — cervical — backward, upward, medial

BUL — thoracic — backward, upward, lateral

BUM — lumbar — backward, upward, medial

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5
Q

Muscle contraction that results in the approximation of the muscle’s origin and insertion without a change in its tension; operator’s force is less than patient’s force

A. Concentric contraction
B. Eccentric contraction
C. Isotonic contraction
D. Isolytic contraction
E. Isometric contraction
A

C. Isotonic contraction

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6
Q

Muscle contraction that results in the increase in tension without an approximation of origin and insertion; operator’s force and patient’s force are equal

A. Concentric contraction
B. Eccentric contraction
C. Isotonic contraction
D. Isolytic contraction
E. Isometric contraction
A

E. Isometric contraction

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7
Q

Muscle contraction against resistance while forcing the muscle to lengthen; operator’s force is greater than patient force

A. Concentric contraction
B. Eccentric contraction
C. Isotonic contraction
D. Isolytic contraction
E. Isometric contraction
A

D. Isolytic contraction

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8
Q

Muscle contraction that results in the approximation of the muscles origin and insertion

A. Concentric contraction
B. Eccentric contraction
C. Isotonic contraction
D. Isolytic contraction
E. Isometric contraction
A

A. Concentric contraction

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9
Q

Lengthening of muscle during contraction due to an external force

A. Concentric contraction
B. Eccentric contraction
C. Isotonic contraction
D. Isolytic contraction
E. Isometric contraction
A

B. Eccentric contraction

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10
Q

The _____ ligament extends from the sides of the dens to the lateral margins of the foramen magnum. The _______ ligament of the atlas attaches to the lateral masses of C1 to hold the dens in place. RA and Downs synrome can weaken these ligaments leading to atlanto-axial subluxation

A

Alar; tranverse

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11
Q

Primary motions at OA and AA

A

OA: Flexion/extension (SB and rotation occur in opposite directions)

AA: rotation

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12
Q

Primary motion frm C2-C4 and from C5-C7

A

C2-C4: rotation

C5-C7: sidebending

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13
Q

The articular masses on the lateral aspects of the cervical vertebrae are most appropriately described as:

A. Anterior to the cervical transverse processes
B. The cervical transverse processes
C. The bone located between the superior and inferior facets
D. Medial to the cervical lamina
E. Medial to the cervical pedicle

A

C. The bone located between the superior and inferior facets

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14
Q

Indications for treatment of the ______ ganglion include thick secretions associated with a URI. The goal of treatment is to enhance ________ activity, which decreases goblet cells and thus encourages thin watery secretions

A

Sphenopalatine ganglion

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15
Q

Muscle of the shoulder that abducts, flexes, and extends shoulder

A

Deltoid

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16
Q

Innervation of deltoid

A

axillary n. (C5, C6)

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17
Q

Muscle of the shoulder that abducts arm

A

Supraspinatus

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18
Q

Innervation of supraspinatus and infraspinatus

A

Suprascapular n. (C4, C5, C6)

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19
Q

2 muscles of the shoulder that externally rotate arm

A

Infraspinatus

Teres minor

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20
Q

________ is a shoulder muscle that internally rotates the arm

________ is a shoulder muscle that adducts AND internally rotates the arm

_______ is a shoulder muscle that adducts, extends, AND internally rotates the arm

A

Subscapularis m.

Teres major m.

Lat.Dorsi m.

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21
Q

Innervation of subscapularis m.

A

Upper and lower subscapular n. (C5, C6, C7)

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22
Q

Innervation of teres major m.

A

Lower subscapular n. (C6, C7)

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23
Q

Innervation of Lat dorsi

A

Thoracodorsal n. (C6, C7, C8)

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24
Q

Rule of 3’s for thoracic spinous processes

A

T1-3 — located at the level of corresponding transverse processes

T4-6 — located 1/2 a segment below corresponding transverse processes

T7-9 — located at the level of the transverse process of the vertebrae below

T10 follows T7-9
T11 follows T4-6
T12 follows T1-3

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25
Q

The sternal angle (angle of Louis) attaches to rib ____ and is level with T____

A

Rib 2; T4

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26
Q

Main motion of the thoracic spine

A

Rotation

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27
Q

Which rib is considered atypical because it has a large tuberosity on the shaft for the serratus anterior?

A

Rib 2

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28
Q

Which ribs are considered atypical because they articulate only with the corresponding vertebrae and lack tubercles?

A

Rib 11 and 12

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29
Q

Ribs ___-____ are considered false ribs because they do not attach directly to the sternum

A

8-12

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30
Q

Which ribs are characterized by pump handle, bucket handle, and caliper motion?

A

1-5 = primarily pump handle

6-10 = primarily bucket handle

11-12 = primarily caliper

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31
Q

Most common anomaly of the lumbar spine

A

Facet (zygopophyseal) trophism — asymmetry of the facet joint angles where instead of following BUM pattern, they are more closely aligned to the coronal plane

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32
Q

Bony deformity in which one or both of the transverse processes of L5 are long and articulate with the sacrum

A

Sacralization

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33
Q

Main motion of lumbar spine

A

Flexion/extension

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34
Q

Sidebending of L5 will cause a sacral oblique axis to be engaged in the _______ direction

Rotation of L5 will cause the sacrum to rotate in the ______ direction

A

Same

Opposite

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35
Q

98% of lumbar disc hernations occur at what 2 levels?

A

Between L4-5

Between L5-S1

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36
Q

A herniation of the L3-L4 disc results in pressure on the _____ nerve root

A

L4

[A herniated disc in the lumbar region will exert pressure on the nerve root of the vertebrae below]

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37
Q

A flexion contracture of the iliopsoas is often associated with what type of lumbar dysfunction?

A

F or E dysfunction of L1 or L2

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38
Q

Anterior displacement of one vertebrae in relation to the one below; often occurs at L4 or L5 and is usually due to fatigue fractures in the pars interarticularis of the vertebrae

A

Spondylolisthesis

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39
Q

A defect usually of the pars interarticularis without anterior displacement of the vertebral body; oblique views on imaging will identify a fracture of the pars interarticularis often seen as a “collar” on the neck of a scotty dog

A

Spondylolysis

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40
Q

Radiographical term for degenerative changes within the intervertebral disc and ankylosing of adjacent vertebral bodies

A

Spondylosis

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41
Q

The Cobb angle for scoliosis is measured by: 1. Draw horizontal lines from the vertebral bodies of the extreme ends of the curve. 2. Draw perpendicular lines from these horizontal lines and measure the acute (Cobb) angle.

What degrees are associated with mild, moderate, and severe scoliosis?

A

Mild = 5-15 degrees

Moderate = 20-45 degrees

Severe = >50 degrees

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42
Q

At what degree of scoliosis is respiratory and cardiovascular function compromised?

A

Respiratory function is compromised if thoracic curvature is >50

CV function is compromised if thoracic curvature is >75

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43
Q

Short leg syndrome compensation at the sacral base

A

Sacral base will be lower on the side of the short leg

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44
Q

Short leg syndrome compensation at the innominate

A

Short leg side = anterior innominate rotation

Long leg side = posterior innominate rotation

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45
Q

Short leg syndrome compensation at the lumbar spine

A

Lumbar spine will sidebend away and rotate toward the side of the short leg

Lumbosacral (Ferguson’s) angle will increase 2-3 degrees

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46
Q

Accessory pelvic ligament that divides the greater and lesser sciatic foramen

A

Sacrospinous ligament

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47
Q

During craniosacral flexion, the sacral base rotates posteriorly, aka ___________

[nutation or counternutation?]

A

Counternutation

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48
Q

During craniosacral extension, the sacral base rotates anteriorly, or _______

[nutation or counternutation?]

A

Nutation

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49
Q

Postural motion of the sacrum occurs about the middle transverse axis. As a person begins to bend forward, the sacral base moves _____

At terminal flexion, the _______ ligaments become more taut, and the sacral base will move ______

A

Anteriorly

Sacrotuberous; posteriorly

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50
Q

Dynamic motion of the sacrum is that which occurs during ambulation. Weight bearing on the left leg (stepping forward with the right leg) will cause a _____ sacral axis to be engaged

A

Left

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51
Q

When motion testing the sacrum, the seated flexion test is found on the ______ side of the oblique axis

A

Opposite

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52
Q

If L5 is F RR SR, testing the sacrum will reveal:

A positive seated flexion test on the ______

The sacrum will be rotated to the _____ on a _____ oblique axis

A

Left

Left; right

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53
Q

If L5 is N SL RR, sacrum testing will reveal:

A positive seated flexion test on the ____

The sacrum will be rotated to the _____ on a _____ oblique axis

A

Right

Left; left

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54
Q

In sacral torsions, L5 will always rotate to the _____ side relative to the sacrum

Recently, the educational council on osteopathic principles has recognized another sacral SD called sacral rotation on an oblique axis. This dysfunction is similar to sacral torsions, however L5 is rotated to the ____ side relative to the sacrum

A

Opposite

Same

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55
Q

Cause of TOS if positive adsons test

A

Compression between scalenes

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56
Q

Cause of TOS if positive military posture test

A

Compression between clavicle and rib 1

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57
Q

Cause of TOS if hyperextension test is positive

A

Compression under pec minor

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58
Q

Continuous impingement of the greater tuberosity against the acromion as the arm is flexed and internally rotated

A

Supraspinatus tendinitis

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59
Q

Humeral dislocation usually occurs _____ and _______; injury to the _____ n. can occur

A

Anteriorly; inferiorly; axillary

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60
Q

Winging of the scapula is usually weakness in the ________ muscle due to a _____ nerve injury

A

Serratus anterior; long thoracic n

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61
Q

Most common brachial plexus injury causing upper arm paralysis due to C5 and C6 damage

A

Erb duchenne palsy

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62
Q

Which of the following is the primary internal rotator of the humerus?

A. Teres minor
B. Subscapularis
C. Infraspinatus
D. Pectoralis minor
E. Deltoid
A

B. Subscapularis

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63
Q

The head of the femur will glide ________ with external rotation of the hip

A

Anteriorly

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64
Q

The head of the femur will glide posteriorly with _____ _____ of the hip

A

Internal rotation

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65
Q

What 3 motions at the ankle create pronation?

A

Dorsiflexion
Eversion
Abduction

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66
Q

What 3 motions at the ankle create supination?

A

Plantarflexion
Inversion
Adduction

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67
Q

The fibular head will glide ______ with pronation of the foot

A

Anteriorly

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68
Q

The fibular head will glide posteriorly with ____ of the foot

A

Supination (plantarflexion, inversion, adduction)

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69
Q

The Q angle is formed by the intersection of a line from the ASIS through the middle of the patella, and a line from the tibial tubercle through the middle of the patella. A normal Q angle is 10-12 degrees. An increased Q angle is referred to as _______

A

Genu valgum — knock kneed

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70
Q

With patellofemoral syndrome, an imbalance of musculature of the quads (strong vastus lateralis and weak vastus medialis) causes the patella to deviate ______ and eventually lead to irregular or accelerated wearing on the _____ surface of the patella. The quadriceps imbalance is generally thought to be due to biomechanics related to a _____ Q angle

A

Laterally; posterior; larger

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71
Q

Partial tear resulting in decreased tensile strength with mild to moderate laxity. What degree of sprain?

A. First degree
B. Second degree
C. Third degree
D. None of the above

A

B. Second degree

72
Q

No tear resulting in good tensile strength and no laxity. What degree of sprain?

A. First degree
B. Second degree
C. Third degree
D. None of the above

A

A. First degree

73
Q

Complete tear resulting in no tensile strength and severe laxity. What degree of sprain?

A. First degree
B. Second degree
C. Third degree
D. None of the above

A

C. Third degree

74
Q

O’donahue’s triad

A

Common knee injury resulting in injury to ACL, MCL, and medial meniscus

75
Q

Plantarflexion is paired with _____ glide of the talus

Dorsiflexion is paired with _____ glide

A

Anterior

Posterior

76
Q

The talus is wider anteriorly, making the foot more stable in _____

A

Dorsiflexion

[this is why 80% of ankle sprains occur in plantarflexion]

77
Q

The _____ joint acts mostly as a shock absorber in the foot, and also allows internal and external rotation of the leg while the foot is fixed

A

Subtalar joint (talocalcaneal)

78
Q

What bones form the medial longitudinal arch of the foot?

A

Talus
Navicular
Cuneiforms
1-3rd metatarsals

79
Q

What bones form the lateral longitudinal arch of the foot?

A

Calcaneus
Cuboid
4-5th metatarsals

80
Q

What bones form the transverse arch of the foot?

A

Navicular
Cuneiforms
Cuboid

81
Q

The 3 lateral stabilizers of the ankle prevent excess supination and include anterior talofibular, calcaneofibular, and posterior talofibular. Due to the less stable supination position of the ankle, sprains often cause damage to these ligaments. How does this relate to their classification as type I, II, or III?

A

Type I involves ATF

Type II involves ATF and calcaneofibular

Type III involves ATF, calcaneofibular, and PTF

82
Q

With a posterior fibular head dysfunction, ______ of the ankle will be restricted on the affected side

A

Dorsiflexion

83
Q

The condition in which there is a decrease in the angle between the neck and shaft of the femur is called

A. Coxa valga
B. Coxa vara
C. Genu varum
D. Genu valgum
E. A decreased Q angle
A

B. Coxa vara

84
Q

A decreased Q angle is associated with:

A. Genu valgum
B. Patellofemoral syndrome
C. A bow legged appearance
D. Coxa vara

A

C. A bow legged appearance

85
Q

Dr. William Garner Sutherland stated that the CNS, CSF, dural membranes, cranial bones, and sacrum functioned as a unit that he called the ______

A

Primary respiratory mechanism (PRM)

86
Q

5 anatomical-physiological elements of the primary respiratory mechanism (PRM)

A
  1. The inherent motility of the brain and spinal cord
  2. Fluctuation of CSF
  3. The movement of the intracranial and intraspinal membranes
  4. The articular mobility of the cranial bones
  5. The involuntary mobility of the sacrum between the ilia
87
Q

The brain and spinal cord lengthens and thins during the _____ phase, and shortens/thickens during the _____ phase of the PRM

A

Exhalation; inhalation

88
Q

Normal rate of the Cranial Rhythmic Impulse (CRI)

A

10-14 cycles per minute

89
Q

4 major dural attachment points

A

Foramen magnum

C2

C3

S2

90
Q

The meninges act as an inelastic rope causing the cranial bones to move in response to motility of the brain, spinal cord, and fluctuation of the CSF. Sutherland called this “inelastic rope” the ____________, which has been described as an automatic, shifting, suspension fulcrum

A

Reciprocal tension membrane (RTM)

91
Q

Flexion will ____ the head slightly and _____ its AP diameter

A

Widen; decrease

92
Q

Flexion of the SBS will cause the dura to be pulled cephalad, resulting in _____ of the sacrum

A

Counternutation (extension)

93
Q

Craniosacral flexion is associated with what motions at the midline bones, sacral base, AP diameter of the cranium, and paired bones?

A

Flexion of midline bones

Sacral base posterior (counternutation)

Decreased AP diameter of the cranium

External rotation of paired bones

94
Q

Craniosacral extension is associated with what motions at the midline bones, sacral base, AP diameter of the cranium, and paired bones?

A

Extension of midline bones

Sacral base anterior (nutation)

Increased AP diameter of the cranium

Internal rotation of the paired bones

95
Q

_____ strain of the SBS can result in severely decreased CRI. It is usually due to trauma, especially to the back of the head

A

Compression

96
Q

CN X SD can be due to ____, ____, and/or _____ dysfunction

A

OA, AA, C2

97
Q

[occipital] condylar compression can affect CN ____, resulting in poor suckling in the newborn. Dysfunctions of ____ and _____ at the jugular foramen can also cause suckling dysfunctions in the newborn

A

XII; IX; X

98
Q

The venous sinuses drain approximately 85-95% of the blood from the cranium. The remaining 5% of venous blood drains via the facial veins and external jugular. The purpose of the venous sinus technique is to increase venous flow thorugh these sinuses so blood may exit skull through jugular foramen. The procedure is to gently but directly spread apart the sutures of the cranium that overlay the ____, ____, and ____ sinuses

A

Occipital; transverse; sagittal

99
Q

The CV4 technique is done by first resisting the flexion phase and encouraging extension until a still point is reached, then allowing restoration of normal flexion and extension to occur. It has been reportedly helpful in fluid homeostasis and induction of uterine contractions in post-date gravid women. The CV4 technique will increase the ____ of the CRI

A

Amplitude

100
Q

Finger placement in vault hold

A

Index finger — greater wing of the sphenoid

Middle finger — temporal bone in front of ear

Ring finger — mastoid region of temporal bone

Little finger — squamous portion of occiput

101
Q

2 absolute contraindications to craniosacral tx

A

Acute intracranial bleed or increased intracranial pressure

Skull fracture

102
Q

2 relative contraindications to craniosacral tx

A

Pts with known seizure hx or dystonia

Traumatic brain injury

103
Q

Which of the following strains can be considered physiologic if it does not interfere with the flexion/extension components of the PRM?

A. Vertical strain
B. Lateral strain
C. Compression at the SBS
D. A torsion
E. None of the above
A

D. A torsion

[torsions and sidebending-rotations can be considered physiologic if they do not interfere with F/E at the SBS]

104
Q

Somatic dysfunction in all of the following may cause diplopia except:

A. Sphenoid
B. Temporal
C. Occiput
D. CN III
E. CN VI
A

C. Occiput

105
Q

Dysfunction of which of the following can cause symptoms similar to Tic Douloureux?

A. CN V1
B. CN V2
C. CN V3
D. CN III
E. CN VII
A

B. CN V2

106
Q

Sympathetic viscerosomatics associated with head and neck

A

T1-4

107
Q

Sympathetic viscerosomatics associated with heart

A

T1-5

108
Q

Sympathetic viscerosomatics associated with respiratory system

A

T2-7

109
Q

Sympathetic viscerosomatics associated with esophagus

A

T2-8

110
Q

Sympathetic viscerosomatics associated with upper GI tract (from staomch to portions of pancreas and duodenum)

A

T5-9

Greater splanchnic n.

Celiac ganglion

111
Q

Sympathetic viscerosomatics associated with middle GI tract (from portions of pancreas and duodenum to 2/3 of transverse colon)

A

T10-T11

Lesser splanchnic nerve

Superior mesenteric ganglion

112
Q

Sympathetic viscerosomatics associated with lower GI tract (distal 1/3 of colon to rectum)

A

T12-L2

Least splanchnic n.

Inferior mesenteric ganglion

113
Q

Sympathetic viscerosomatics associated with appendix

A

T12

114
Q

Sympathetic viscerosomatics associated with kidneys

A

T10-11

115
Q

Sympathetic viscerosomatics associated with adrenal medulla

A

T10

116
Q

Sympathetic viscerosomatics associated with upper ureters vs. lower ureters

A

Upper ureters = T10-11

Lower ureters = T12-L1

117
Q

Sympathetic viscerosomatics associated with bladder

A

T11-L2

118
Q

Sympathetic viscerosomatics associated with gonads

A

T10-11

119
Q

Sympathetic viscerosomatics associated with uterus and cervix

A

T10-L2

120
Q

Sympathetic viscerosomatics associated with erectile tissue of penis and clitoris

A

T11-L2

121
Q

Sympathetic viscerosomatics associated with prostate

A

T12-L2

122
Q

Sympathetic viscerosomatics associated with extremities

A

UE = T2-8

LE = T11-L2

123
Q

Parasympathetics of GI system

A

Proximal half up to ascending and transverse colon = Vagus n

Distal half including descending and rectosigmoid colon = pelvic splanchnic nn

124
Q

Parasympathetic innervation of GU system

A

Proximal half including kidneys and upper ureter = vagus n

Distal half including lower uretery and bladder = pelvic splanchnic nn

125
Q

In terms of parasympathetic innervation of the reproductive system, the ovaries and testes descend from a higher region in the posterior abdominal wall and are therefore innervated by the _______ nerve. All other reproductive structures are innervated by the ________

A

Vagus n; pelvic splanchnics

126
Q

Useful landmarks for sympathetic viscerosomatics include the ligament of treitz (divides duodenum and jejunum) and the splenic flexure of the large intestine.

Anything before the ligament of treitz is innervated by ______

Anything between both landmarks is innervated by _____

Anything after the splenic flexure is innervated by _____

A

T5-9

T10-11

T12-L2

127
Q

Anterior and posterior chapmans points associated with appendix

A

Anterior = Tip of right 12th rib

Posterior = transverse process of T11 vertebrae

128
Q

Anterior and posterior chapmans points associated with adrenals

A

Anterior = 2” superior and 1” lateral to the umbilicus

Posterior = between the spinous and transverse processes of T11-12

129
Q

Anterior and posterior chapmans points associated with kidneys

A

Anterior = 1” superior and 1” lateral to umbilicus

Posterior = between spinous and transverse processes of T12-L1

130
Q

Bladder chapmans point

A

Periumbilical region

131
Q

Colon chapmans point

A

On lateral thigh within IT band from greater trochanter to just above knee

132
Q

A hypersensitive focus, usually within a taut band of skeletal muscle or in the muscle fascia that is painful upon compression, and can give rise to a characteristic referred pain, tenderness, and autonomic phenomena

A

Travell’s myofascial trigger points

133
Q

What is the major difference between trigger points and tenderpoints regarding referred pain?

A

Trigger points may refer pain when pressed

Tenderpoints do NOT refer pain when pressed

134
Q

4 physiologic diaphragms important in lymphatic return

A

Tentorium cerebelli

Thoracic inlet

Abdominal diaphragm

Pelvic diaphragm

135
Q

4 compensatory curves of the spine (4 Zink locations)

A
  1. Occipitoatlantal junction
  2. Cervicothoracic junction
  3. Thoracolumbar junction
  4. Lumbosacral junction
136
Q

Common compensatory pattern (80%) of rotation at the Zink junctions

A

L/R/L/R

[other 20% of healthy people will be R/L/R/L]

137
Q

Most structures of the body are drained via the left (major) lymphatic duct. What structures are drained via the right (minor) lymphatic duct?

A

Right UE, right hemicranium (including head and face), and the heart and lobes of the lung (except left upper lobe)

138
Q

The lymphatic drainage of the right (minor) lymphatic duct is variable; it usually drains into the _________ vein or the junction of the _____ and _____ veins

A

Right brachiocephalic; right IJV; subclavian

139
Q

The lymphatic drainage of the left (major) lymphatic duct is more consistent than the right. It drains into the junction of the _____ and _____ veins

A

Left IJV and subclavian

140
Q

Lymphatic drainage from an infection of the right first toe would drain into the _________ lymphatic duct via the _______ duct.

A right maxillary sinus infection would drain into the _____ lymphatic duct, as would extracellular fluid resulting from lymphedema of the right UE

A

Left; thoracic

Right

141
Q

The _____, _____, and coronary and triangular ligaments of the _____ drain directly into the thoracic duct (thus they are not directly associated with lymphoid tissue)

A

Thyroid; esophagus; liver

142
Q

Post-isometric relaxation is the typical technique for MET. However, another method that can be used is reciprocal inhibition — how does this technique work?

A

Instead of contracting the dysfunctional muscle against resistance, the antagonistic muscle is contracted against resistance (i.e., if biceps is dysfunctional, contracting the triceps against resistance)

Note that this can be direct or indirect and it is still considered MET

143
Q

Setups for treating exhalation rib dysfunctions for rib 1, rib 2, ribs 3-5, ribs 6-9, and ribs 10-12

A

Rib 1 — pt raises head directly toward ceiling

Rib 2 — pt turns head 30 degrees away from dysfunction and lifts head toward ceiling

Rib 3-5 — pt pushes elbow of dysfunctional side toward opposite ASIS

Rib 6-9 — push arm anterior

Ribs 10-12 — pt adducts arm

144
Q

What muscles are being treated with exhalation dysfunctions of rib 1, rib 2, ribs 3-5, ribs 6-9, ribs 10-11, and rib 12?

A

Rib 1 = Anterior and middle scalenes

Rib 2 = Posterior scalene

Ribs 3-5 = Pectoralis minor

Ribs 6-9 = Serratus anterior

Ribs 10-11 = Latissimus dorsi

Rib 12 = quadratus lumborum

145
Q

Absolute contraindications to HVLA

A 
Osteoporosis
Osteomyelitis (including Pott’s disease)
Fractures in the area
Bone metastasis
Severe RA
Down’s syndrome
146
Q

Relative contraindications to HVLA

A 
Acute whiplash
Pregnancy
Post-surgical conditions
Herniated nucleus pulposus
Anticoagulated pts or hemophiliacs
Vertebral artery ischemia (positive Wallenberg’s test)
147
Q

When treating an extended SD in the thoracic spine with HVLA, the corrective thrust is directed at the vertebrae _____the dysfunctional segment, and the thrust is aimed 45 degrees _____

A

Below; cephalad

148
Q

7 stages of spencer technique

A
  1. Stretching tissues and pumping fluids with arm extended
  2. Glenohumeral extension/flexion with elbow flexed
  3. Glenohumeral flexion/extension with elbow extended
  4. Circumduction and slight compression with elbow flexed/extended, THEN circumduction and traction with elbow extended
  5. Adduction and external rotation with elbow flexed
  6. Abduction and internal rotation with arm behind the back
  7. Stretching tissues and pumping fluids with the arm extended
149
Q

2 Special tests for vertebral artery insufficiency prior to attempting HVLA

A

Wallenberg’s test = in supine position, doc flexes pts neck, holding for 10 seconds, then extends the neck and holds for 10 seconds. The same is done for head and neck rotation to the right and left, rotation right and left WITH extension, and in positions that the doc would attempt to mobilize the C spine. A positive test results when the pt complains of dizziness, visual changes, lightheadedness, or nystagmus occurs

Underbergs test = neck extended and head fully rotated to either side. If pt develops vascular or neuro symptoms, HVLA is contraindicated

150
Q

What is the purpose of the hip-drop test?

A

To evaluate sidebending (lateral flexion) of the lumbar spine

151
Q

A positive pelvic side-shift test is often seen with flexion contracture of the iliopsoas. A flexion contracture of the right iliopsoas will cause a positive pelvis shift test to the _____

A

Left

152
Q

The trendelenberg test will assess which of the following muscle groups?

A. The hip extensors
B. The hip flexors
C. The hip abductors
D. The hip adductors
E. The hip external rotators
A

C. The hip abductors

153
Q

In a pt with low back pain, the dysfunctional T12 segment is found to have a restriction in a transverse plane and around a transverse axis. Which of the following dysfunctions best describes the position of T12?

A. Flexed
B. SB right
C. Rotated left
D. N SR RL
E. E RR SR
A

E. E RR SR

154
Q

The first cervical segment has the greatest degree of freedom in which plane(s)?

A. Transverse
B. Coronal
C. Sagittal
D. Oblique
E. Transverse and coronal
A

A. Transverse

155
Q

Which of the folowing is considered to be the most common congenital anomaly in the lumbar spine?

A. Sacralization
B. Lumbarization
C. Facet hypertrophy
D. Facet tropism
E. Spina bifida occulta
A

D. Facet tropism

156
Q

A pt is diagnosed with a right anterior innominate rotation. About which sacral axis does this rotation occur?

A. Inferior transverse
B. Oblique
C. Middle transverse
D. Sagittal
E. Superior transverse
A

A. Inferior transverse

157
Q

Burning pain between the third and fourth metatarsal heads. What is most likely dx?

A. Hammer toe
B. Claw toe
C. Morton’s neuroma
D. Bunion
E. Corns
A

C. Morton’s neuroma

158
Q

What is the primary reason for treating the thoracolumbar junction in a pt with a kidney stone?

A. Decrease pain
B. Increase function of contralateral kidney
C. To decrease ureterospasm and increase GFR
D. To decrease bladder spasm
E. To decrease pts BP

A

C. To decrease ureterospasm and increase GFR

159
Q

In a pt with GERD, treatment of the anterior Chapman reflex point for their hyperacidity would be directed just lateral to the sternum at the interspace of:

A. Ribs 4 and 5 on the left
B. Ribs 5 and 6 on the right
C. Ribs 5 and 6 on the left
D. Ribs 6 and 7 on the right
E. Ribs 6 and 7 on the left
A

C. Ribs 5 and 6 on the left

160
Q

A pt with low back pain presents to the clinic. On postural analysis, her head is located forward of the plum line. She has a slight increase in her cervical lordosis. Her thoracic spine is slightly kyphotic in the upper segments with a flattening of the lumbar spine. Her lumbar vertebrae are straightened and have moved posterior relative to the plum line. Which of the following best describes her posture?

A. Military posture
B. Swayback posture
C. Posterior postural deviation
D. Flat back posture
E. Anterior postural deviation
A

D. Flat back posture

161
Q

Plexopathy involving the medial cord of the brachial plexus will have the greatest effect on which of the following?

A. Elbow flexion
B. Elbow extension
C. Finger abduction
D. Shoulder abduction
E. Shoulder external rotation
A

C. Finger abduction

162
Q

Head and neck lymphatic congestion and drying of the nasopharyngeal mucosa is most likely associated with increased autonomic activity originating from the preganglionic nerve fibers of which structure?

A. Vagus n.
B. Inferior cervical ganglia
C. Superior cervical ganglia
D. Intermediolateral cells of the spinal cord at T1-4
E. Intermediolateral cells of the spinal cord at T5-7

A

D. Intermediolateral cells of the spinal cord at T1-4

163
Q

A pt with a herniated disc has an EMG showing abnormalities in the anterior tibialis and extensor hallucis longus. Based on the innervation of these muscles, which nerve root is most likely affected?

A. L3
B. L5
C. S1
D. S2
E. Not enough info
A

B. L5

164
Q

Patellofemoral syndrome is most closely associated with:

A. Genu recurvatum
B. Increased Q angle
C. Decreased Q angle
D. Coxa valgus
E. Coxa varus
A

B. Increased Q angle

165
Q

The Chapmans point for the thyroid is just lateral to the sternum and at the interspace of:

A. Ribs 1 and 2
B. Ribs 2 and 3
C. Ribs 3 and 4
D. Ribs 4 and 5
E. Ribs 5 and 6
A

B. Ribs 2 and 3

166
Q

For exhalation dysfunctions, Are anterior rib counterstrain points located on rib angles or at midaxillary line?

A

Midaxillary line

167
Q

tx for tenderpoint on right articular process of C5

A

F SL RL

168
Q

In a pt with a posterolateral disc herniation at the L3-4 level, weakness is most likely to be present in which of the following muscles?

A. Extensor hallucis longus
B. Flexor hallucis longus
C. Anterior tibialis
D. Hamstrings
E. Peroneus longus
A

C. Anterior tibialis

169
Q

Which of the following is most associated with a vertical downward force on the sacrum at the SI joint:

A. Innominate anterior
B. Innominate posterior
C. Innominate inferior shear
D. Forward sacral torsion
E. Unilateral sacral flexion
A

E. Unilateral sacral flexion

170
Q

Which of the following would have a viscerosomatic reflex with a pheochromocytoma?

A. Occiput
B. Atlas
C. T8
D. T10
E. L2
A

D. T10

171
Q

Around which axis does craniosacral motion occur?

A. Inferior transverse
B. Oblique
C. Middle transverse
D. Sagittal
E. Superior transverse
A

E. Superior transverse

172
Q

The median nerve is formed from which of the following spinal nerve roots?

A. C5-6
B. C5-7
C. C5-T1
D. C7-T1
E. C2-5
A

C. C5-T1

173
Q

61 Which of the following is most likely to be associated with sacral dysfunctions?

A. Spasm of rectus abdominis
B. Positive obers test
C. Piriformis tenderpoint
D. Tight hamstrings
E. Quadratus lumborum tenderpoint
A

C. Piriformis tenderpoint

Piriformis is associated with sacral dysfunctions. Spasm of the rectus abdominis is associated with superior pubic shear. Positive obers test is associated with tight IT band. Tight hamstrings are more likely to produce innominate dysfunction, specifically posterior rotation. Quadratus lumborum is associated with lumbar sidebending dysfunctions and/or rib 12 dysfunction

174
Q

Which of the following runs through the carpal tunnel?

A. Palmaris longus tendon
B. Flexor carpi ulnaris
C. Radial n
D. Flexor pollicis longus tendon
E. Adductor pollicis
A

D. Flexor pollicis longus tendon

175
Q

Tinnitus that is associated with a low pitched roar is due to:

A. Imbalance of suprahyoid muscle
B. TMJ disruption
C. External rotation of temporal bone
D. Internal rotation of temporal bone
E. Barotrauma to TM
A

C. External rotation of temporal bone

176
Q

A pt presents with weakness with wrist flexion and forearm pronation. Which nerve is most likely affected?

A. Axillary
B. Musculocutaneous
C. Ulnar
D. Radial
E. Median
A

E. Median

[the median and ulnar n innervate the wrist flexors, however only the median n. innervates the pronator teres and pronator quadratus]

Boards Pathology (19 decks)

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