Exam1 Flashcards
(162 cards)
1
Q
For ANY disease, the patient must be ______ before performing OMT
A
Stable
2
Q
New onset of chest pain or shortness of breath is not the time for what?
A
OMT
3
Q
Somatic dysfunctions can occur where?
A
Anywhere!
Sympathetic levels
Parasympathetic levels
Soma (not autonomic related)
4
Q
Viscerosomatic reflexes occur at?
A
Sympathetic levels and Parasympathetic levels
5
Q
Facilitated segments ONLY occur at?
A
Sympathetic levels
6
Q
What is the treatment for temporal arteritis?
A
Steroids
7
Q
Sometimes, muscle hypertonicity, contraction, and/or spasm can be caused by?
A
Direct irritation of the muscle from the structure overlying it
8
Q
If there is a renal lithiasis, it may cause?
A
It may cause the psoas to become hypertonic & you would have a positive Thomas test
9
Q
If there is appendicitis, it may cause?
A
The psoas to become hypertonic and you would have a positive Thomas test
10
Q
If there are inflamed lymph nodes, it may cause?
A
The muscle they are touching to become hypertonic, such as the sternocleidomastoid
11
Q
After obtaining a history, you perform what?
A
A physical exam
12
Q
What is the first thing you do in a physical exam?
A
Observation
13
Q
A reversible dextroscoliosis or levoscoliosis means?
A
There is NO Sagittal component present (no flex ion or extension component) so it follows Fryette Type I mechanics
14
Q
A dextroscoliosis would have the convex side pointing which direction?
A
Right. Therefore indicating a neutral side-bending left, rotating right pattern for the vertebrae
15
Q
A dextroscoliosis from T4-T6 would have all the vertebrae?
A
Neutral, side bent left, rotated right
16
Q
Left lateral convexity means?
A
Vertebrae are sidebent right
17
Q
Right lateral convexity means the vertebrae?
A
Side-bent
18
Q
When treating a group dysfunction with OMT, treat what group of the curve
A
The apex. Example T10-T12, then go for T11
19
Q
Type II dysfunction would usually occur at?
A
The apex/middle of the group curve
20
Q
Translation to the right =
A
Left side bending
21
Q
Translation to the left =
A
Right sidebending
22
Q
Principle 1 of osteopathic medicine
A
The body is a unit; the person is a unit of mind, body, spirit.
23
Q
Example of principle 1
A
Gastric ulcer causes thoracic tissue texture changes
24
Q
Principle 2 of osteopathic medicine
A
The body is capable of self regulation, self healing & health maintenance
25
Example of principle 2
Healed fracture
26
Principle 3 of Osteopathic medicine
Structure & function are reciprocally interrelated
27
Principle 4 of osteopathic medicine
Rational treatment is based upon an understanding of the basic principles of body unity, self-regulation, & the inter-relationship of structure and function
28
Biomechanical model
Anatomy of muscles, spine, extremities; posture, motion
OMT directed toward normalizing mechanical somatic dysfunction, structural integrity, physiological function, homeostasis
29
Neurological model
Emphasizes CNS, PNS and ANS that control, coordinate and integrate body functions
Proprioceptive and muscle imbalances, facilitation, nerve compression disorders, autonomic reflex and visceral dysfunctions, brain/CNS dysfunctions
30
Respiratory/circulatory model
Emphasizes pulmonary, circulatory and fluid (lymphatic, CSF) systems
Lymphatic techniques
31
Metabolic/nutritional model
Regulates through metabolic processes
32
Behavioral (psychobehavioral)
Focuses on mental, emotional, social & spiritual dimensions related to health & disease
33
Post ganglionic sympathetic fibers lead to what?
Tissue texture changes, such as hypertonicity, moisture, erythema, etc...
34
Dorsal horn of the spinal cord is where somatic and visceral AFFERENTS nerves do what?
Synapse! Giving a viscerosomatic reflex
35
Somatosomatic reflex
localized somatic stimuli producing patterns of reflex response in segmentally related somatic structures. For example, rib somatic dysfunction from an innominate dysfunction.
36
Somatovisceral reflex
localized somatic stimulation producing patterns of reflex response in segmentally related visceral structures. For example, triggering an asthmatic attack when working on thoracic spine
37
Viscerosomatic reflex
localized visceral stimuli producing patterns of reflex response in segmentally related somatic structures. For example gallbladder disease affecting musculature.
A
38
Viscerovisceral reflex
localized visceral stimuli producing patterns of reflex response in segmentally related visceral structures. For example, myocardial infarction and vomiting.
39
Old is _____, hot is _____
Cold, not
40
Signs of acute somatic dysfunction when palpating
```
Recent history (injury)
Sharp or severe localized pain
Warm, moist, sweaty skin
Boggy,, edematous tissue
Erythematous
Local increase in muscle tone, contraction, spasm, increased muscle spindle firing
Normal or sluggish ROM
May be minimal or no somatovisceral effects
```
41
Signs of chronic somatic dysfunction when palpating
```
Long-standing
Dull, achy diffuse pain
Cool, smooth, dry skin
Possible atrophy
Fibrotic, ropy feeling tissue
Pale/skin pallor
Decreased muscle tone, contracted muscles, sometimes flaccid
Restricted ROM
Somatovisceral effects more often present
```
42
Orientation of superior facets
Cervical: BUM
Thoracic: BUL
Lumbar: BM
43
Orientation of inferior facets
Cervical: AIL
Thoracic: AIM
Lumbar: AL
44
Fryette Law 1
When side-bending is attempted from neutral (anatomical) position, rotation of vertebral bodies follows to the opposite direction.
Typically applies to a group of vertebrae (more than two)
Occurs in a neutral spine (no extreme flexion or extension) NO SAGITTAL COMPONENT
Side-bending and rotation occur to opposite sides
Side-bending precedes rotation
Side-bending occurs towards the concavity of the curve
Rotation occurs towards the convexity of the curve
Diagnosed as a Type I dysfunction
45
Fryette Law 2
When side-bending is attempted from non-neutral (hyperflexed or hyperextended) position, rotation must precede side-bending to the same side.
Typically applies to a single vertebra
Occurs in a non-neutral spine (flexion or extension of spine present) SAGITTAL COMPONENT
Side-bending and rotation occur to same sides
Rotation precedes side-bending
Rotation of the vertebra occurs into the concavity of the curve
Diagnosed as a Type II dysfunction
May be described as traumatic injury
46
If indirect treatment is used, the dysfunction is?
Exaggerated/augmented
47
If direct treatment is used, the dysfunction is?
The barrier is engaged/dysfunction reversed
48
Examples of Direct Techniques
Myofascial Release (May also be indirect)
Soft tissue
Articulatory
Muscle Energy
High velocity, low amplitude (HVLA)
Springing
Cranial (may also be indirect)
Still Technique (combined indirect and direct)
Initial positioning of Still Technique set up is indirect
Ending positioning of Still Technique is direct
49
Stretching
Longitudinal or parallel traction technique in which the origin & insertion of the myofascial structures being treated are longitudinally separated
50
Kneading
A perpendicular traction technique in which a rhythmic, lateral stretching of a myofascial structure, where the origin and insertion are held stationary and the central portion of the structure is stretched like a bowstring
51
Inhibition
A deep inhibitory pressure, which is a sustained deep pressure over a hypertonic myofascial structure
52
Effleurage
Gentle stroking of congested tissue used to encourage lymphatic flow
53
Petrissage
Involves pinching or tweaking one layer and lifting it or twisting it away from deeper areas
54
Tapotement
A striking the belly of a muscle with the hypothecate edge of the open hand in rapid succession in order to increase it’s tone and arterial perfusion. A hammering, chopping percussion of tissues to break adhesions and/or encourage bronchial secretions
55
Examples of indirect techniques
```
Counterstrain
FPR
BLT
Functional technique
Myofascial release
Cranial
Still technique
```
56
Neurologic exam of root C4
Sensation- shoulder
Motor- none
Reflex- none
57
Neurologic exam root of C5
Sensation- lateral elbow
Motor- biceps
Reflex- biceps
58
Neurologic exam of root C6
Sensation- thumb, index finger
Motor- wrist extensors
Reflex- triceps
59
Neurologic exam root of C7
Sensation- mid finger
Motor- triceps
Reflex triceps
60
Neurologic exam root C8
Sensation- ring finger, pinky
Motor- wrist flexors
Reflex- none
61
Neurologic exam root of T1
Sensation- medial elbow
Motor- interossi
Reflex- none
62
Sympathetic level for head and neck
T1-T4
63
Sympathetic levels heart
T1/T2-T5/T6
64
Sympathetic levels respiratory
T1/T2-T6/T7
65
Sympathetic levels esophagus
T2-T8
66
Sympathetic levels upper GI tract
T5-T9
| Stomach, liver, gallbladder, spleen, pancreas, duodenum
67
Sympathetic levels middle GI tract
T10-T11
| Pancreas, duodenum, jejunum, ileum, ascending colon, right transverse colon, kidney, upper ureter, gonads
68
Sympathetic levels lower GI tract
T12-L2
| Left transverse colon, descending colon, sigmoid colon, rectum, prostate, bladder, lower ureter
69
Sympathetic levels appendix
T10-11
70
Sympathetic levels kidneys
T10-T11
71
Sympathetic levels adrenal medulla
T10
72
Sympathetic levels upper ureters
T10-T11
73
Sympathetic levels lower ureters
T12-L2
74
Sympathetic levels gonads
T10-T11
75
Sympathetic levels bladder
T12-L2
76
Sympathetic levels uterus & cervix
T10-L2
77
Sympathetic levels erectile tissue
T11-L2
78
Sympathetic levels prostate
T12-L2
79
Sympathetic levels arms
T2-T8
80
Sympathetic levels legs
T11-L2
81
Parasympathetic levels
| -vagus nerve (OA, AA, C2)
Trachea, esophagus, heart, lungs, liver, gallbladder, stomach, pancreas, spleen, kidneys, proximal ureter, small intestine, ascending colon, & transverse colon up to the splenic flexure
82
Parasympathetic levels S2-S4
Distal to splenic flexure of the transverse colon descending colon, sigmoid colon, rectum, distal ureter, bladder, reproductive organs, & genitalia
83
Parasympathetic levels
| Ovaries & testes
Vagus nerve, S2-S4
84
Sympathetic pre-ganglionic T5-T9
Greater Splanchnic
85
Sympathetic Pre-ganglionics T10-T11
Lesser Splanchnic
86
Sympathetic Pre-ganglionics T12
Least Splanchnic
87
Sympathetic Pre-ganglionics L1-L2
Lumbar Splanchnic
88
Celiac Ganglion (T5-T9) Post-Ganglionic to what structures?
Distal esophagus, stomach (epigastric), liver, gallbladder (cholecystitis), spleen, portions of pancreas, proximal duodenum (foregut)
89
Superior mesenteric ganglion (T10-T11) post-ganglionic to what structures?
Portions of pancreas, duodenum, jejunum, ileum, ascending colon, proximal 2/3 of transverse colon (midgut); adrenals, gonads, kidneys, upper 1/2 ureter
90
Inferior mesenteric ganglion (T12-L2) post-ganglionic to what structures?
Distal 1/3 transverse colon, descending colon, sigmoid, rectum (handgun)l; lower 1/2 ureter, bladder, prostate genitalia
91
Greater splanchnic nerve
Sympathetic innervation
T5-T9
Synapses at the celiac ganglion
Stomach, liver, gallbladder, pancreas, parts of duodenum
92
Lesser splanchnic nerve (T10-11)
Sympathetic innervation
Synapses at superior mesenteric ganglion
Small intestines & right colon (**appendix** is found here)
93
Least splanchnic nerve (T12) & Lumbar splanchnic (L1-2)
Sympathetic innervation
Synapses at the inferior mesenteric ganglia
Innervation the left colon & pelvic organs
94
Sympathetic nerve supply to the head & neck
T1 – T4
It forms the cervical ganglia (inferior, middle, and superior cervical ganglia), which affects the mid to lower cervical spine
From there, it contributes to other collateral ganglion that govern the sympathetic innervation to the head
95
Increased sympathetic activity
```
Increased goblet cells
Increased thick, sticky secretions
Dries the mucous membranes
Pupillary dilation
Decreased lymphatic/circulatory drainage
Impaired immune response
Tinnitus
Increased intraocular pressure
```
96
Chapman Reflex Points
| Liver
Anterior 5th intercostal space near sternum on R
97
Chapman Reflex Points
| Stomach
```
Anterior 5th intercostal space near sternum on L
Stomach acid (think ulcers/NSAID use/steroid use)
```
98
Chapman Reflex Points
| Liver, gallbladder (think cholecystitis)
Anterior 6th intercostal space near sternum on R
99
Chapman Reflex Points
| Pancreas (think amylase/lipase/blood glucose)
Anterior 7th intercostal space near sternum on R
100
Chapman Reflex Points
| Stomach (peristalsis)
Anterior 6th intercostal space near sternum on L
| Stomach peristalsis think emptying time
101
Chapman Reflex Points
| Spleen
Anterior 7th intercostal space near sternum on L
102
Chapman Reflex Points
| Appendix
Anterior tip of right 12th rib
103
Sympathetic Innervation: Chapman’s Reflexes
| 5th IC space
Right: Liver
Left: Stomach Acid (gastritis) (may raise red flag to NSAID use)
104
Sympathetic Innervation: Chapman’s Reflexes
| 6th IC space
Right: liver, gallbladder (cholecystitis)
Left: stomach peristalsis (may have delayed stomach emptying time, food may not pass quickly through system)
105
Sympathetic Innvervation: Chapman Reflexes 7th IC space
Right: pancreases (glucose, amylase, lipase)
Left: spleen
106
Chapman Reflex Points are also known as what?
Ganglioform Nodules or Tissue
107
CRP sinuses
Anterior points: lie 7 to 9 cm lateral to the sternum on the upper edge of the second rib
Posterior points: upon C2 midway between the spinous process & tip of the transverse process
108
CRP pharynx
Anterior points: lie upon the first ribs 3 or 4 cm medial to where the ribs emerge from beneath the clavicles
Posterior points: upon C2 midway between the spinous process & the tip of the transverse process
109
CRP Larynx
Anterior point: lie upon the second ribs, 5 to 7 cm lateral to the sternocostal junction
Posterior points: upon C2 midway between the spinous process & the tip of the transverse process
110
CPR tonsils
Anterior points: between the first & second ribs adjacent to the sternum
Posterior points: midway between the spinous process **(posterior tubercle) & the tip of the transverse process
111
CPR Middle Ear
Anterior points: lie upon the superior anterior aspect of the clavicles just lateral to where they cross the first ribs
Posterior points: upon the posterior aspect of the tips of the transverse processes of C1
112
CPR Eye (retina/conjunctiva)
Anterior points: lie upon the anterior aspect of the humerus at the level of the surgical neck
Posterior points: lie upon the squamous portion of the occipital bone below the superior nuchal line
113
Parasympathetic cranial nerves
III, VII, IX, X
114
Ganglion for CN III
Ciliary ganglion
115
Ganglion for CN IX
Otic ganglion
116
Ganglion for facial nerve
Pterygopalatine ganglion & submandibular ganglion
117
Although CN V conveys no presynaptic parasympathetic (visceral efferent) fibers from the CNS, ___ _______parasympathetic ganglia are associated with ___ _____ __ ___ _
The divisions of CN \
118
Increased parasympathetic activity results in ?
Increased clear, thin, watery secretions of glands
Pupillary constriction
Improved/increased drainage
119
Dry mouth (Xerostomia)
Can be caused by cranial nerve VII (lacrimal, sublingual and submandibular glands) & cranial nerve IX (parotid gland)
120
CN VII is associated with what ganglion and exits through which foramen?
Associated with sphenopalantine (pterygopalatine ganglion) & exits through the stylomastoid foramen
121
CN IX is associated with what ganglion and exits though which foramen?
Otic ganglion and exits through the jugular foramen
122
Before treating lymphatics, what must you do first?
Thoracic inlet/outlet has to be cleared/opened/treated before any other lymphatic treatment
123
What are the components of the thoracic inlet/outlet?
Supraclavicular space and 1st rib
124
Venous drainage
Approximately 85% of the venous drainage from the head occurs via the internal jugular veins
They pass through the jugular foramina, located along the occipitomastoid suture between occipital and temporal bones
125
Altered temporal bone motion and occipitomastoid compression may impair what?
Venous flow through the jugular foramen and may lead to congestion in the head
126
Myofascial release to the pteryoid fascia can be used to treat what?
Maxillary sinusitis by stimulating the parasympathetic supply to the nasal mucosa, which is CN VII
127
Galbreath technique is great for treating what?
Otitis media, fluid in the middle ear, Eustachian tube somatic dysfunction
128
Galbreath technique
You are pulling traction on the mandible and the goal is decongestion of fluid in the middle ear
129
CN I dysfunction/entrapment
Anosmia
130
CN V dysfunction/entrapment
Headache, trigeminal neuralgia
131
CN VII dysfunction/entrapment
Altered taste, bell’s palsy
132
CN VIII entrapment/dysfunction
Vertigo, tinnitus, labyrinthitis
133
CN IX & X dysfunction/entrapment
Poor suckling, failure to thrive
134
CN III, IV, VI dysfunction/entrapment
pass under the Petrosphenoidal ligament formed by the tentorum cerebelli
Symptoms: blurred vision, diplopia, nystagmus, eye fatigue, HA
135
CN VI is closest to what?
The dura, most likely affected, results in medial strabismus
136
CN I through what foramen
Cribiform plate
137
CN II through what foramen
optic canal
138
CNIII, IV, V1, VI through what foramen
Superior orbital fissure
139
CNV2 (maxillary n) through what foramen?
Foramen rotundum
140
CNV3 (mandibilar n) through what foramen?
Foramen ovale
141
CN VII & CN VIII through what foramen?
Internal acoustic meatus
142
CN IX, X, XI through what foramen?
Jugular foramen
143
CNXII through what foramen?
Hypoglossal canal
144
Difficulty latching/nursing
CN XII
145
Colic
CN X
146
GERD
CN X
147
Nausea/vomiting
CN X
148
Torticollis
CN XI
149
Asthma
CN X
150
Otitis media/tinnitus/vertigo/labrynthitis
CN VIII
151
CN I
Anosmia
| Cribiform plate through ethmoid bone
152
CN V
Trigeminal neuralgia/tic deloureaux
| May complain of sudden, stabbing severe facial, ear and/or jaw pain
153
CN VII
Exits stylomastoid foramen
| Bell’s Palsy
154
CN VIII
Labyrinthitis, tinnitus, vertigo
| ***temporal bone is associated with these****
155
CN X
Exits jugular foramen
| Can cause nausea/vomiting
156
CN XII
Hypoglossal canal
| Can cause nursing/latching problems in infants
157
Jugular foramen is formed by what bones?
Temporal bone and occiput which make up occipitomastoid suture
CN IX, X, & XI exit the jugular foramen
158
Tension headache description
Bilateral pressure
| No aura, nausea
159
Migraine headache description
Unilateral
Triggers
May have aura, nausea/vomiting, photophobia/phonophobia
160
Cluster headache description
Unilateral, severe
161
Trigger point for SCM
Refers pain lateral & behind the eye
162
Trigger point splenius capitus
Refers pain to the vertex of the head
