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OS > Exam 1 > Flashcards

Exam 1 Flashcards

1
Q

AT still’s birthday

A

August 6, 1828

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2
Q

What year did three of Still’s children die?What did they die of?

A

1864
spinal meningitis
infant Marcia pneumonia

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3
Q

What date did AT Still MD fling to the breeze the banner of osteopathy?

A

June 22, 1874

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4
Q

Four principles

A
  • the body is a unit; the person is a unit of body, mind, and spirit
  • the body is capable of self-regulation, self-healing, and health maintenance
  • structure and function are reciprocally interrelated
  • rational treatment is based on an understanding of the basic principles of body unit, self regulation, and the interrelationship of structure and function
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5
Q

What day did the first school of osteopathy open

A

october 3, 1892

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6
Q

What was the name of the first school of osteopathy?

A

American School of Osteopathy (ASO)

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7
Q

Host + disease =

A

illness

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8
Q

Treating both the host and disease is what?

A

osteopathic

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9
Q

Treating just the disease is what?

A

allopathic

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10
Q

What are environmental factors

A

structural, medical, surgical, psychosocial, ETOH/smoking/drugs, allergens

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11
Q

Illness leads to?

A

decompensation

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12
Q

How do osteopaths treat the host? How do we treat disease?

A

OMT

medical treatment

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13
Q

Treating of the host and disease by osteopaths leads to what?

A

homeostasis

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14
Q

What was A. T. Still’s and his father’s jobs?

A

m&m

medicine and ministry

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15
Q

What happened that allowed Dr. Still to have access to so many cadavers in his study of anatomy?

A

in 1855 there was a cholera epidemic that wiped out a bunch of indians and tribe gave him permission

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16
Q

What duties die Dr. STill do during the Civil War?

A

ardent abolitionist
combat officer
wrote he did duties of a surgeon but was officially recorded as hospital steward

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17
Q

Be able to briefly discuss the Battle of Westport

A

“gettysburg of the West” Oct 23, 1864 at the Big Blue River
ended the last significant confederate operation west of the mississippi
one of the largest mcivil war battles fought west of the mississippi
30,000 soldiers 3000 casuals total
and NO he did not use soldiers as cadavers

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18
Q

What happened to 4 of Dr. Still’s children and how did these events shape his thoughts on medicine of the day?

A

three died due to spinal meningitis and infant of pneumonia
he returned to farming and was dissatisfied with orthodox medicine and its failures and felt there must be a better way to treat patients

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19
Q

What significance did the events of his children play in the founding of osteopathy?

A

led him to come up with osteopathy

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20
Q

What were some of the discoveries of medicine and science in the world during the times of the development of Osteopathic Medicine? How did they relate to Dr. Still’s though processes?

A

heroic medicine- every effort made to preserve the life force
stimulants if patient drowsy- alcohol
hypnotics if patient agitated- opium
effort was aimed at conquering disease- enough force, enough drugs would cast out the demons
AT was well trained in these and did not believe they worked

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21
Q

Explain the basic philosophy of osteopathic medicine as noted in the Kirksville consensus of 1953.

A

“osteopathy, or osteopathic medicine, is a philosypy, a science, and an art. its philosophy embraces the concept of the unity of the body structure and function in health and disease”

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22
Q

Where did Dr. Still first introduce his ideas and how were they received?

A

Baker University (he helped found it)
preacher declared him satanic declaring only Christ heals with the laying of the hands
Still was evicted from the church and moved to Kirksville

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23
Q

What was the response to Dr. Still’s way of practice after going to Kirksville, MO?

A

accepted him and overwhelmed him quickly

called him magnetic healer and lightning bone setter

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24
Q

How did Dr. Still deal with Kirksville response to his practice?

A

tried to train apprentices but this failed because they lacked knowledge of anatomy and body function

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25
Q

Who were the faculty of the first school?

A

Still and William Smith MD

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26
Q

What was the name of the organization that preceded the American Osteopathic Foundation?

A

American Association for Advancement of Osteopathy (AAAO)

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27
Q

Who is Dr. Adam Flexner and what is the significance of his contribution to medical education?

A

authored a report on the state of medical education in US (including DO) resulted in closure of a great number of schools and stricter requirements
8 DO schools were left and he labeled offered instruction in 8 schools as worthless

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28
Q

How did the osteopathic profession respond to the changes related to Dr. Flexner’s contribution?

A

DO schools didn’t have luxury to merge with large institutions so it put them behind in educational reform but curriculum was 4 year program by 1915
by 1930s schools required 2 years of undergrad studies

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29
Q

How did the osteopathic way of treating patients help in treating patients during the influenza pandemic of 1917-1918?

A

osteopathic care- 0.486% death rate

medical/osteopathic care- 1.08% death rate

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30
Q

Be able to explain the contrast difference between the osteopathic philosophy to approaching a patient’s medical problem to the allopathic philosophical approach.

A

we treat the host not just the disease

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31
Q

In what year did congress legalize the right of DOs to serve in the civil service and armed forces?

A

1957

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32
Q

Who was the first woman to receive the DO degree and in what year?

A

Jeanette Bolles

1892

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33
Q

Who was the foremost research in osteopathic medicine?

A

Louisa Burns

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34
Q

What year was the first charter of the American School of Osteopathy (ASO) issued by the State of Missouri?

A

1892

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35
Q

What year was Kansas City College of Osteopathy and Surgery established?

A

1916

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36
Q

Who was Kansas City College of Osteopathy and Surgery established by?

A

A.A. Kaiser DO and George Conley DO

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37
Q

What committee did the AMA use to inspect osteopathic schools and determine the education is comparable to most medical schools and recommend to remove the cult label? What year?

A

Cline committee

1955

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38
Q

During what decade did six new osteopathic colleges become university affiliated?

A

1970s

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39
Q

What was the first university for an osteopathic college become affiliated with? What month and year?

A

Michigan State

July 1971

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40
Q

What year and in what state was osteopathy first recognized as a practice?

A

1896

Vermont

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41
Q

In what year and in what state did a public referendum prohibit the granting of new licenses to DOs in the state? the College of Osteopathic Physicians and Surgeons was converted to what?

A

1961
The California Incident
allopathic medical school

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42
Q

Following the California Incident, in what year did the College of Osteopathic Medicine of the Pacific open?

A

1977

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43
Q

What state was the last to extend full practice rights to DOs? In what year?

A

Mississippi

1973

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44
Q

In the 2000s about how many DOs were there? How many students?

A

60,000

13,000 students

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45
Q

About how many DOs were board certified but an AOA board in the 2000s?

A

15,000

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46
Q

What percentage of DOs prated in family medicine in the 2000s? About what percent were in non-primary care specialities?

A

45%

35%

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47
Q

80% of DOs are younger than

A

55 years

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48
Q

About how many active DOs does Missouri have? Kansas?

A

1800

600

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49
Q

How can we figure out if a somatic lesion is a somatic dysfunction?

A

if it is treatable by using OMT

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50
Q

Which will be greater PROM or AROM?

A

PROM

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51
Q

What three planes do we use to define joint motion?

A

sagittal, frontal (coronal), horizontal (transverse)

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52
Q

What are three types of joints and examples of each?

A

fibrous- skull articulations
cartilaginous- discs between vertebra
synovial- extremities

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53
Q

What is an anatomic barrier?

A

limit of motion imposed by anatomic structure, limit of passive motion

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54
Q

what’s the limit of a passive motion called?

A

anatomic barrier

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55
Q

What’s the limit of an active motion called?

A

physiologic barrier

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56
Q

What is the range between he physiologic and anatomic barrier of motion in which passive ligamentous stretching occurs before tissue disruption?

A

elastic barrier

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57
Q

What is a pathologic barrier?

A

PERMANENT restriction of joint motion associated with pathologic change of tissues

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58
Q

What is the functional limit within the anatomic range off option, which abnormally diminishes the normal physiologic range called?

A

restrictive barrier

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59
Q

What movement is in the sagittal plane?

A

lumbar flexion

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60
Q

What movement is in the horizontal plane?

A

rotation

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61
Q

What movement is in the frontal plane?

A

sidebending

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62
Q

How do you assess the range and quality of a motion? What is another characteristic of a motion?

A

range- visual
quality- visual and palpation

direction

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63
Q

If the feel of end ROM is bouncy or rubbery what is that indicative of?

A

viscerosomatic reflex

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64
Q

If the end feel of ROM is firm what is that indicative of?

A

micro traumatic (overuse)

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65
Q

IF the end feel of ROM is sloppy?

A

ligamentous laxity

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66
Q

What does a normal end feel feel like?

A

elastic

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67
Q

How does an osteoarthritis end feel feel?

A

abrupt

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68
Q

How does somatic dysfunction end feel feel?

A

hard

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69
Q

How does an end feel feel if you stop due to pain?

A

empty

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70
Q

How does an end feel that is involuntary muscle guarding feel?

A

crisp

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71
Q

Presence of normal passive motion in one direction of one plane and restiance in the other is presumptive evidence of what?

A

a somatic dysfunction

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72
Q

You can tell in what direction the somatic dysfunction has occurred because

A

the joint will move farther in that direction

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73
Q

With neuromusculoskeletal dysfunction you will see a decreased overall what?

A

ROM for affected joint

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74
Q

Define TART

A

t-tissue texture changes
a- asymmetry
r- restriction of motion
t- tenderness

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75
Q

What is the ROM commonly present in a joint or group of joints that allows normal and unimpaired function?

A

flexibility

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76
Q

What is the maximal ROM a joint can achieve with an externally applied force?

A

static flexibility

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77
Q

What is ROM an athlete can produce and speed at which he/she can produce it?

A

dynamic flexibility

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78
Q

What is the physical measurement of a reduced ROM of a join or group of joints?

A

stiffness

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79
Q

What do you call the relationship of joint mechanics with surrounding structures?

A

linkage

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80
Q

What are examples of linkages?

A

should-spine

spine-hip/pelvis

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81
Q

What is important to do to get an accurate measurement and evaluation of a particular joint?

A

isolate the joint

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82
Q

What is the devices used for the actual measurement of a ROM? What are the greek origin?

A

goniometer
gonia- angle
metron- measure

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83
Q

What’s the placement for the goniometer?

A

stationary part over the “body”

moveable arm over the moving part

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84
Q

What is usually the “body” when using the goniometer?

A

proximal portion of the joint

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85
Q

What serves as the baseline or 0 degree for the goniometer?

A

stationary arm (on the “body”)

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86
Q

What is the zero starting position for using the goniometer?

A

extended anatomic position

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87
Q

The goniometer should be parallel to the?

A

bone

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88
Q

What are some uses for goniometer measurements?

A

pre vs post-op
disability physicals
during and after PT
research

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89
Q

What do you compare goniometer measurements with?

A

contralateral side and/or normative values

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90
Q

What do you call two vertebrae, their associated disc, neuromuscular and other soft tissues?

A

functional unit

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91
Q

C-spine passive rotation

A

70-90 each way

92
Q

C-spine whole rotation

A

140-180

93
Q

C-spine passive sidebending

A

20-45 each way

94
Q

C-spine whole sidebending

A

40-90

95
Q

C-spine flexion

A

45-90

96
Q

C-spine extension

A

45-90

97
Q

C-spine whole motion flex/extend

A

90-180

98
Q

What are the four articulations of the pectoral girdle?

A

glenohumoral, acromioclavicular, sternoclavicular, scapulothoracic (not a true but indirect via muscles)

99
Q

shoulder actie flexion

A

180

100
Q

shoulder active extension

A

60

101
Q

shoulder active abduction

A

180

102
Q

shoulder active horrid adduction

A

40-50 or 130-140

103
Q

shoulder active horiz abduction

A

130-145 or 40-55

104
Q

shoulder active external rotation

A

90

105
Q

shoulder active internal rotation

A

90

106
Q

three articulations of the elbow

A

humeroulnar, humeroradial, proximal radioulnar

107
Q

elbow active flexion

A

140-150

108
Q

elbow active extension

A

0-5

109
Q

forearm pronation

A

90

110
Q

forearm supination

A

90

111
Q

wrist active flexion

A

80-90

112
Q

wrist active extension

A

70

113
Q

wrist active abduction

A

20-30

114
Q

wrist active adduction

A

30-40

115
Q

What causes significant variance in biomechanics from person to person when it comes to the hip?

A

angular structure between pelvis, femur, and knee can vary a lot

116
Q

hip active flexion w/ knee straight

A

90

117
Q

hip active flexion w/knee flexed

A

120-135

118
Q

hip active extension

A

15-30

119
Q

hip passive external rotation

A

40-60

120
Q

hip passive internal rotation

A

30-40

121
Q

hip passive abduction with knee extended

A

45-50

122
Q

hip passive abduction with knee flexed

A

30-50

123
Q

hip passive adduction with knee extended

A

20-30

124
Q

hip passive adduction with knee flexed

A

60-70

125
Q

What are the articulations of the knee?

A

tibiofemoral and patellofemoral

126
Q

What plane is the knee motion primarily limited to?

A

sagittal plane

127
Q

What motions are associated with the frontal plane?

A

abduction and adduction

128
Q

What limits almost any motion in transverse or frontal plane for the knee?

A

full extension

129
Q

knee passive flexion

A

145-150

130
Q

ankle passive dorsiflexion

A

15-20

131
Q

ankle passive plantarflexion

A

50-65

132
Q

ankle active inversion

A

35

133
Q

ankle active eversion

A

20

134
Q

What type of motion does soft tissue preparation facilitate?

A

articular (historically fundamental to OMT)

135
Q

What technique is directly applied to the muscular and fascial structures of the body and affect the associated neural and vascular elements?

A

soft tissue techniques

136
Q

What all does soft tissue entail?

A

living tissues of the body other than the bone

fascia, muscles, organs, nerves, vasculature, lymphatics

137
Q

muscle fascia are layers that are composed of ______ in an amorphous matrix of ______?

A 
collagen fibers (also elastin fibers)
hydrated proteoglycans
138
Q

What are not fascia?

A

tendons, ligaments, aponeuroses

139
Q

What is the function of fascia?

A

involved in tissue protection and healing of surrounding systems

140
Q

How is fascia analogous to a deity for the body?

A

omnipresent, omnipotent, omniscient

141
Q

How is fascia omnipresent?

A

there is a myofascialarthrodial continuity throughout the body

142
Q

perimysiem (fascia) is anatomically continuous with ___ which is anatomically continuous with ___ on bone

A

peritendlium

periosteum

143
Q

What is the outermost layer of fascia called?

A

pannicular fascia

144
Q

Where do you not find pannicular fascia?

A

orifices

145
Q

The outer layer of pannicular fascia is generally what?

What about the inner layer?

A

adipose tissue

membranous and adherent generally to the outer portion

146
Q

What fascia layer is just internal to the pannicular layer? what is it also called?

A

axial and appendicular fascia

investing layer

147
Q

What does the investing layer surround?

A

muscles, periosteum of bone, peritendon of tendons

148
Q

What is the fascia that surround the nervous system? What does it include?

A

meningeal fascia

dura

149
Q

What fascia layer surround body cavities? What are examples?

A

body cavities

pleural, pericardial, peritoneum

150
Q

How is fascia omnipotent?

A

provides for mobility and stability of the MSK system

151
Q

What cells allow the fascia to be contractile?

A

myofibroblasts

152
Q

What cells allow the fascia to help with healing?

A

macrophages and mast cells

153
Q

75% of what consists of free ending in fascia?

A

stretch receptors for muscles and proprioception (balance)

154
Q

80% of C fibers are

A

polymodal

155
Q

What do you call liquid crystal-like properties?

A

piezoelectricity

156
Q

What do you call any material that deforms according to rate of loading and deformity?

A

viscoelastic material

157
Q

What is the force that attempts to deform a connective tissue structure?

A

stress

158
Q

What is the percentage of deformation of a connective tissue?

A

strain

159
Q

The difference between the loading and unloading characteristics represents energy that is lost in the connective tissue system. this energy loss is termed?

A

hysteresis

160
Q

What do we call the elongation (deformation) of connective tissue in response to a sustained, constant load (below failure threshold)?

A

creep

161
Q

What do we call the direction in which the connective tissue may be moved most easily during deformational stretching?

A

ease

162
Q

How does ease of motion feel via palpation?

A

loose or laxity or a greater degree of mobility

163
Q

What do you call a palpable restriction of connective tissue mobility?

A

bind

164
Q

Fascial restrictions in one area of the body will create what in another area?

A

connective tissue restrictions (pulls)

165
Q

What is Newton’s Third Law?

A

when two bodies interact, the force exerted by one is equal in magnitude and opposite in direction to the forces exerted by the other

166
Q

What do you call “the strain (deformation) placed on an elastic body is in proportion to the stress (force) placed upon it”?

A

hooke’s law

167
Q

What do you call “bone will develop according to the stresses placed upon it”? What does this concept extend to?

A

Wolff’s law

fascia

168
Q

What techniques go towards and eventually through a restrictive barrier

A

direct

169
Q

What techniques go away from the restrictive barreir

A

indirect

170
Q

Any one of what must be present for the diagnosis of somatic dysfunction

A

T-tissue texture abnormalities
A-asymmetry of structure
R-restriction of motion
T-tenderness

171
Q

What are the treatment goals for tissue texture abnormality and asymmetry of tissues?

A

stretch and increase elasticity to return to symmetry

improve local tissue nutrition and oxygenation and remove metabolic wastes to normalize tissue texture

172
Q

what are treatment goals for asymmetry of muscles?

A

return symmetry and normalize tone

173
Q

What are treatment goals for restricted motion of soft tissues?

A

set the fascia FREE!!!!!

174
Q

What are treatment goals of tenderness?

A

normalize the euro activity and improve abnormal somato-somatic and tomato-visceral reflexes

175
Q

What is common compensatory patterns?

A

L/R/L/R

176
Q

What is uncommon compensatory patterns?

A

R/L/R/L

177
Q

What is characteristic of uncompensated pattern? What is a common cause?

A

symptomatic

trauma

178
Q

Where are transition zones of the spine?

A

OA, C1, C2
C7, T1
T12, L1
L5, sacrum

179
Q

What are transverse restrictors at the transition zones?

A

tentorium cerebelli
thoracic inlet
thoracolumbar diaphragm
pelvic diaphragm

180
Q

What is a system of diagnosis and treatment directed toward tissues other than skeletal or arthrodial elements?

A

soft tissue technique

181
Q

What are indications for ST?

A

diagnostically- to identify areas of TART
feedback about issue response to OMT
improve local/systemic immune response
provide a general state of relaxation
enhance circulation
provide general state of tonic stimulation

182
Q

What are ST absolute contraindications

A 
fracture or dislocation
neuralgic entrapment syndromes
serious vascular compromise
local malignancy
local infection (abscess, cellulitis, septic arthritis, osteomyelitis)
bleeding disorders
183
Q

What re the four principles of ST technique?

A

patient comfort
physician comfort
forces are very gentle and low amplitude (rhythmical)
as tissues respond increase amplitude but RATE REMAINS THE SAME1
technique is continued until the desired effect is achieve

184
Q

How do you know if you’ve achieved the desired effect of ST?

A

amplitude of excursion of the soft tissue has reached a maximum and has plateaued at that level

185
Q

What do you call parallel traction? What is the purpose?

A

stretch

increase distance between origin and insertion

186
Q

The taffy pull =

A

stretch

187
Q

What do you call perpendicular traction? It’s known as the bowstring.

A

kneading

188
Q

What do you call when you push and hold perpendicular to the fibers at the musculotendinous part of hypertonic muscle? How long do you hold it?

A

inhibition

relaxation of tissue

189
Q

What is a treatment system in which combined procedures are designed to stretch and reflexively release patterned soft tissue and joint related restrictions?

A

INR

integrated neuromuscular release

190
Q

What do you call the law “when a muscle receives a nerve impulse to contract, its antagonists, receive simultaneously an impulse to relax”

A

sherringtons law

191
Q

What speed the INR treatment process?

A

REMs

192
Q

breath holding, R/L cervical rotation, pendulum/swimming arm swinging maneuvers as direct and indirect barriers are released, isometric limb and neck movements against the table or chair are all examples of what

A

REMs

193
Q

What are indications for MFR

A

somatic dysfunction-almost all soft tissue or joint restrictions
when HVLA or muscle energy is contraindicated- consider INDIRECT MFR
when counterstain may be difficult secondary to a patient’s inability to relax

194
Q

What are absolute contraindications of MFR

A

lack of patient consent

absence of somatic dysfunction

195
Q

What are relative contraindications of MFR

A

infection of soft tissue or bone
fracture, avulsion, dislocation
metastatic disease
soft tissue injuries: thermal, hematoma, open wounds
post-op patient with wound dehiscence
rheumatologic condition involving instability of c-spine
DVT or anticoag therapy

196
Q

What is an inherent force for MFR?

A

using the body’s PRM (primary respiratory mechanism)

197
Q

What refers to a physician directed, patient performed, inhalation or exhalation or a holding of the breath o assist with the manipulative intervention?

A

respiratory cooperation

198
Q

What refers to the patient is asked to move in specific directions to aid in mobilizing specific areas of restriction?

A

patient cooperaion

199
Q

What are three activating forces in MFR?

A

inherent forces
respiratory cooperation
patient cooperation

200
Q

What are the 3D releases that is often palpated at the endpoint of MFR treatment

A

warmth
softening
increased compliance/ROM

201
Q

How do you know when MFR treatment is done

A

continuous application of activating forces no longer produce change

202
Q

When finished with MFR what should the tissue demonstrate

A

symmetry

203
Q

When did Still return to farming and begin thinking about what would later become osteopathic medicine?

A

1864-1873

204
Q

When was Still’s brother addicted to morphine and cause Still to become even more against medication?

A

1875

205
Q

What year did Still move to Kirksville?

A

1876

206
Q

When did Still die? At what age?

A

December 1917

89

207
Q

What year did American Association for Advancement of Osteopathy form? When did it adopt standards for approving osteopathic colleges?

A

1897

1902

208
Q

What year did Adam Flexner release his critical report?

A

1910

209
Q

What year was the ban on teaching pharmacology lifted by the AOA even though Still was opposed to pharmacology?

A

1916

210
Q

When was the influenza epidemic?

A

1917-1918

211
Q

Who was the first minority-group president of the AOA and when did he serve?

A

Marcelino Olivo DO

1988-1989

212
Q

Who was the first african-american president of the AOA and who did he work with?

A

William Anderson DO

MLK jr

213
Q

When did DOs start serving in the military on equal footing as MDs?

A

1963

214
Q

How many DO schools became university affiliated in the 1970s?

A

6

215
Q

What plane is the change in spinal column that has scoliosis?

A

frontal/coronal plane

216
Q

What is the term for the normal feel of muscle in a relaxed state?

A

tone

217
Q

What is the term for a normal tone when muscle shortens or is activated against resistance?

A

contraction

218
Q

What is the term for the abnormal shortening of a muscle due to fibrosis; muscle no longer can reach full length?

A

contracture

219
Q

What is the term for an abnormal contraction maintained beyond physiologic need?

A

spasm

220
Q

What is the term for increased fluid in hypertonic muscle?

A

bogginess

221
Q

What is the term for hard, firm rope-like or cord-like tone which indicates a chronic condition?

A

ropiness

222
Q

What is the space between what my body has adapted to and what my maximum potential is?

A

elastic barrier

223
Q

“bone will develop according to the stresses placed upon it”

A

wolff’s law

224
Q

If you are right eye and your patient is prone what side do you stand on?

A

left so your RIGHT eye is over their midline

225
Q

what plane does vertebra rotate? On what axis?

A

transverse plane

superior-inferior axis

226
Q

What is the axis of the sagittal plane? What’s an example?

A

right-left (transverse axis)

cervical flexion/extension

227
Q

What’s the axis for the frontal plane? What’s an example?

A

anterior-posterior axis

cervical side bending

OS (6 decks)

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