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Flashcards in COPD Deck (53):
1

What are 3 things we do Pre-OMT for possible COPD patients?

Look, Listen, Palpate

2

What are 3 things we "Look" for Pre-OMT COPD patients?

Barrel Chest, Type/Depth of Breathing/Paradoxical, Posture

3

What are 3 things we "Listen" for Pre-OMT COPD patients?

Pertinent History (Sx/Indication-Contraindication/Risks), All lung fields (wheeze, rale egophony, etc), Heart

4

What are 3 things we "Palpate" for Pre-OMT COPD patients?

Chest wall resistance/compliance, Tactile fremitus or not, Somatic dysfunction (TART) incl STERNUM

5

What can prolonged use of steriods make patients prone to?

Osteoporosis

6

What would osteoporosis contraindicate?

HVLA

7

Where do we have TTC for the posterior sites of the lungs for their viscerosomatic reflexes?

T1-6 (esp T2-4)

8

Where do we have TTC for Anterior Chapman Points of the lungs for their viscerosomatic reflexes?

ICS 2-4

9

What is the 24-hour rule?

If we treat someone getting a cold within 24 hours with OMT it will go away

10

What is the 3:3:3 approach?

3 goals, 3 techniques, in 3 minutes or less

11

What are the 3 goals in the 3:3:3 approach for a Pulmonary Issue?

Improvement in sympathetic, parasympathetic, and lymphatics

12

What are the 3 areas for the parasympathetic goal?

Suboccipital inhibition, OM / OA / C2 (vagus), OCMM-Temporal (vagus)

13

What are the 6 areas for the sympathetic goal?

T1-6, Rib 1, Chapman’s reflexes, (ICS 2-4; T2-4), Rib raising (also in lymph), Rib 1-6, Generalized soft tissue

Lymph is anything else

14

85% of dyspnea is due to what 4 things?

Asthma, Pneumonia, Interstitial lung disease, COPD

PACI

15

Name the 7 P's

Pneumonia, Pulmonary Bronchial Constriction, Pump Failure, PE, Pneumothorax, Possible Foreign Body, Psyochogenic

16

Decreasing workload is a part of what model?

Metabolic-Hormonal Model

17

When do we give the influenza immunization?

When there is no other infection

18

How does chest percussion sound on a Pink Puffer?

Hyperresonance

19

Name 2 distinguishing factors for a blue bloater

Increased Hgb, Increased JVD

20

What rib do COPD patients have problems with/adjust to help with their breathing?

Rib 1 (mainly exhalation)

21

Scalene fascia is continuous with what fascia?

Sibson Fascia

22

What are the 3 most severe manifestations a COPD patient will have?

SCM Hypertrophy, Rib Cage Compliance Reduced, Sternum Restricted

23

What is Sampter's Triad for COPD patients?

Nasal Polyps, Asthma, and Aspirin Allergy findings

24

What are 2 common findings in COPD patients upon observation and on a CXR?

Accessory muscle hypertrophy and extended thoracic cavity with flat diaphragm

25

What can coughing cause?

Exhalation rib dysfunction

26

What OMT do we do for Upper Thoracic SD?

Seated T1-T4 and Thoracic inlet BLT

27

What bones make up the thoracic inlet?

T1-4; R1-2; manubrium

28

What are the 2 Clinical Goals for the Upper Thoracic treatment?

Normalize SYMPATHETICS to EENT & Lungs, Open FASCIAL PATHWAYS for drainage

29

What was Sutherland's quote?

“Ligamentous Articular Strains are treated by using Balanced Ligamentous Tension.”

30

What model do we use to Implement Respiratory-Circulatory Homeostasis?

Postural-Biomechanical Model

31

Are mechanical principles primary or secondary to respiration?

Secondary

32

Are the lungs governed more by mechanics or chemistry?

Mechanics

33

What is the driving force for the Respiratory-Circulatory Model?

Chest cage mechanics

34

Give the primary and secondary muscles of inspiration

Primary - external intercostals, diaphragm, and interchondral part of intercostals

Secondary - SCM, scalenes

35

Name the muscles we use for conscious, forced exhalation

Transversus abdomninis, external oblique, abdominal muscles, rectus abdominis, internal oblique

TEARI

36

Most signs of respiratory failure are actually signs of what?

Respiratory muscle fatigue

37

Muscular fatigue is the immediate factor leading to the demise of patients with what?

Acute asthma

38

Respiratory muscle fatigue has been implicated in what?

Pulmonary edema, lung shock & difficulty weaning patients off ventilators

39

Manubrium direction named for what?

Superior – anterior part of the structure is preferring

40

What ribs do the latissimus dorsi attach to?

Ribs 9-11

41

What ribs do the quadratus lumborum attach to?

Ribs (11) 12

42

What technique do we use for Ribs & Accessory Ms’s of Respiration?

Counterstrain

43

Are anterior ribs depressed or elevated?

Depressed (posterior are elevated)

44

What are the 3 clinical goals for seated counterstrain?

Affect CERVICOTHORACIC DIAPHRAGM; ⇓WORK of RESPIRATION

Improve ability to BREATHE (Decrease DYSPNEA)

Diminish COUGH and COUGH SEQUELAE

45

What technique do we use to treat the Head-Neck?

FPR/Still

46

Can we lie orthopnic patients down for short periods of time?

Yes

47

What are the 3 clinical goals for FPR/Still?

Improve PARASYMPATHETICS

Enhance depth & rate of RESPIRATION (⇓DYSPNEA & work)

Enhance THORACOABDOMINAL DIAPHRAGM function

48

Innervation of OA, AA and C2

Vagus

49

What do problems or treatment at C5-C7 affect?

Scalenes

50

What do we treat the diaphragm with?

Seated Direct MFR/MET

51

What are the 2 clinical goals for seated direct MFR/MET?

Counter FLATTENED DIAPHRAGM to reduce Paradoxical Respirations

Enhance THORACOABDOMINAL DIAPHRAGM function

52

What treatment do we use to establish homeostasis?

Seated Soft Tissue (Shoulder Girdle & Quadratus Lumborum Ms’s)/ Articulatory (Seated Rib Raising)

53

What are the 4 clinical goals of establishing homeostasis with soft tissue and articulatory?

Affect SYMPATHETICs (Sympathetic Chain Ganglia)

Affect THORACOABDOMINAL DIAPHRAGM (Resp-Circ Step 2)

Enhance LYMPHATIC PUMP & MOBILIZE LOCAL FLUID from Mediastinum (Resp-Circ Steps 3-4)

⇓WORK of RESPIRATION