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OS III > FInal > Flashcards

FInal Flashcards

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1
Q

What are some causes of incontenance

A

Ingestion of alcohol, chili peppers, heart meds, pregnancy, enlarged prostate, cancer, neuro disorders

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2
Q

What is the behavioral treatment for incontinence

A

Bladder training, double voiding, scheduled toilet trips, fluid and diet management; pelvic floor m exercises

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3
Q

What is the parasympathetic innervation to the kidneys vas the lower ureters and bladder

A

Kidneys: vagus

lower ureters and bladder: pelvic splanchnic

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4
Q

What is the symp innervation to the bladder

A

T11-L2

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5
Q

What is the anterior Chapman’s point for urethra

A

Inner edge of pubic Ramus near the symphysis

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6
Q

What are the posterior Chapman’s reflexes for urinary system

A

Adrenals: intrtransverse space btw T1/12
Kidneys: “” btw T12 Nd L1
Ureters: “” L1/2
Bladder and urethra: superior edge of L2 TP

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7
Q

What do you do for metabolic energetic treatment for bladder symptoms

A

If constipated, treat that first

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8
Q

What are contraindictions to treating renal patient with OMT

A

Unable to tolerate secondary to pain or positioning, delaying more definitive care

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9
Q

Where would you target your treatment for biomechanics model for a renal patient

A

Lower ribs, thoracolumbar, psoas, quadratus lumborum, pelvic floor m (attachments - Innominate, pubic bone, pelvic floor, sacrum)

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10
Q

Which counterstrain points can be usd to treat a renal patient

A

AT or PT 9-12

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11
Q

What is the respiratory circulatory technique for renal patient

A

Thoracic inlet -> thoracolumbar diaphragm -> treat lower ribs -> treat pelvic diaphragm -> pedal pump

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12
Q

What are some pre-op OMT considerations

A

Concerns about airway with anesthesia: optimize c spine motion for intubation
-OMT pre op to mid cervical shown to reduce post op pulm complications: somatostatic reflex (cervical SD -> thoracoabdominal diaphragm -> phrenic n)

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13
Q

What benefit does post op OMT have

A

Shorten hospital stay, decrease morbidity and mortality, decrease post op pain, facilitate lymph flow and improve diaphragm mobility, increase patient satisfaction

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14
Q

What are some considerations for OMT post op

A
  • increased treatment frequency at shorter duration but no more than 3 treatments a day
  • daily to every other day most common
  • consider indirect tx for acute and direct for chronic
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15
Q

What are the goals of lymphatic treatment

A

Reduce risk of infection, heal in time, fibrosis and scarring

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16
Q

What is the post op fever rule of W’s

A
  • wind: atelectasis, pneumonia
  • water: UTI
  • Walking: DVT/PE
  • wound: wound infection
  • wonder drugs: antimicrobials, anesthetic - generalized rash and bradycardia
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17
Q

What is the rule of W’s management

A
  • wind: CXR, sputum cultures, incentive spirometery,abx
  • water: UA, urine culture, remove foley,abx
  • walking: US with venous Doppler, CT angiogram, heparin
  • wound: abx, drainage, wound care
  • wonder drugs: remove
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18
Q

What OMT can be done for post op atelectasis

A

Rib raising, dome diaphragm, pectoral traction, soft tissue and myocardial releases to C3-5 for phrenic n stimulation, tapotement, lymph pumps, viscersomatic (T1-6/T2-7 and CNX)

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19
Q

What viscerosomatic reflex could be treated for pretibial edema

A

T10-L2 and S2-4

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20
Q

What is the OMT management of post op ileus

A

Rib raisin T5-L2 to decrease risk of post op ileus, mesenteric release, paraspinal inhibition, OA/AA, sacral rocking

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21
Q

What is the OMT management for anxiety and delirium

A

Suboccipital release and CV4

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22
Q

Where is AC1 mandible and what is the counterstrain position

A
  • on posterior surface of ascending ramus of the mandible

- SARA with patient supine

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23
Q

Where is AC1 TP and what is the counterstrain for it

A

C1 TP midway between ramus of mandible and mastoid process

-push lateral to medial, saRA

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24
Q

Where are the A2-6 points and what is their countertrain position

A

Anterior aspect of TP

-F SARA; alternate E SARA

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25
Where is AC7 an what is the counterstrain position for it
Posterosuperior surfacce of proximal clavicle where SCM inserts -F STRA with patient supine
26
Where is AC8 and what is the counterstrain position
Clavicular insertion of SCM near sternal notch | -F SARA with patient supine
27
Where are AT1-6 and what is the counterstrain position for them
-AT1: midline on suprasternal notch -2:: midline on manubrium at sternal angle -3-4: midline at level of costal cartilage -5: midline one inch superior to xiphoid -6: midline at sternal-xiphoid junction Tx position: pt supine, cervical and thoracic flexion to level of TP or seated with patients head flexed
28
Where is AT7-9 (b/l) and what is their treatment
-7:: midline or lateral to midline 1/4 distance from tip of xiphoid and umbilicus -8:midline or lateral to midline halfway between xiphoid and umbilicus -9:: midline or lateral to midline 3/4 from xiphoid to umbilicus Tx: FSTRA patient seated
29
Where is AT10-12 and what is the treatment position
10: lateral to midline - 1/4 from umbilicus to pubic symphysis 11: lateral to midline halfway between umbilicus and pubic symphysis 12: lateral to midline; mid axillary line on superoanterior surface of iliac crest Tx: patient supine; doc on same side as TP; flex hips and knees and place on physician’s thigh; pull knees and ankles toward doc FSTRA
30
What is the counterstrain treatment for PC1 inion
FSTRA
31
What are the all the positions for the posterior TP for the thoracic spine
ESART
32
If there is more than one tendrpoint with equal intensity, which do you treat first
Most proximal or midline; if both thoracic and rib TP, treat thoracic first
33
What is true about a maverick point
Requires lengthening rather than shortening m
34
What are anterior vs posterior rib tender points indicative of
Anterior: depressed rib Posterior: elevated rib.
35
Where is AR1 and 2 located and what is their treatment position
AR1: inferior to clavicle on rib one - lateral to manubrium (directly inferior to SC joint) AR2: 1.5 in lateral to manubrium on rib 2, below MCL Tx: patient spine, FSTRT (neck); treats depressed rib and inhalation restriction
36
Where are AR3-6 located and what is their treatment position
Slightly anterior to mid-axillary line Tx: patient seated doc behind patient with knee under arm of side opposite TP; FSTRT (neck and torso); treats depressed rib and inhalation restriction
37
Where is PR1 located and what is the treatment position
Posterior margin of rib he’d beneath margin of trapezius | Tx: patient supine or seated; ERTS away or toward
38
Where is PR 2 and what is the tx position
Superior surface of angle of ribs at medial border of scapula Tx: patient seated, doctor places patients arm on side of dysfunction on knee FSARA (trunk and head)
39
Where is PR3-6 and what is the tx
Superior surface of angles or ribs at medial border of scapula Tx: patient seated; doc places knee on same side - FSARA (just trunk)
40
At what Cobb angle does respiratory function become compromised
>50
41
At what Cobb angle is CV function compromised
>75
42
What does the gait pattern have to do with cardiac function
Length of stride is reduced in patients with severe heart failure - very oxygen demanding - contributes to limited exercise capacity
43
Where do each of the pleuras drain
Parietal -> internal thoracic and intercostal chains Diaphragmatic -> mediastinal, retrosternal, celiac axis nodes Visceral -> deep pulmonary plexus
44
Where does lymph from the pericardium drain
Thoracic and right pulmonary ducts
45
Where does lymph from the heart and lungs drain
Carried back to heart via right lymphatic duct
46
How does MI affect lymphatics
Leads to dysfunctional lymph vessels and development of chronic myocardial edema which will aggravaate cardiac fibrosis; *VEGF-C -> cardiaclymphangiogenesis may improve cardiac function
47
What does the right half of the deep cardiac plexus innervate
Right coronary plexus -> right atrium and ventricle Left coronary plexus -> left atrium and ventricle SA node
48
What does the left half of the deep cardiac plexus innervate
AV node
49
What does sympathetic hyperactivity of the right half of the cardiac plexus lead to
Increased risk of SVT
50
What does right vagal hyperactivity lead to
Sinus bradyarrhythmias
51
What does sympathetic hyperactivity in the left half of the cardiac plexus lead to
Increased risk of ectopic foci and v fib
52
What does left vagal hyperactivity at the AV node lead to
AV block
53
What is the innervation of the costal and peripheral diaphragmatic parietal pleura
Intercostal ns
54
What is the innervation of the mediastinal and central diaphragmatic parietal pleura
Phrenic ns
55
What mainly controls the smooth m tone of the airways
Parasympathetic (M3)
56
Where are the anterior and posterior Chapman’s points for the myocardium
Anterior: 2nd ICS along sternal border Posterior: intertransverse spaces btw T2-3
57
Where is the posterior bronchus Chapman’s point
Lateral to T2 spinous process
58
What technique can be used in HTN to decrease SVR
General paraspinal inhibition or treat OA/AA
59
What neuro treatments would you do to someone with CHF
OCMM, paraspinal inhibition to T1-6, suboccipital release, Chapman’s points
60
What treatments go under the metabolic model for CHF
Treat diaphragmatic and thoracic cage dysfunctions, lymphatic pumps and effleurage can help restore electrolyte imbalance, CHF meds
61
What can be done for arrhythmias that fits the respiratory circulatory model
Valsalva maneuver; carotid sinus massage
62
What Biomechanical treatments would be done for pneumonia
Cervical/thoracic/rib SD; percussion hammer to break up consolidation
63
What neuro treatments can be done for pneumonia
Paraspinal inhibition, CV4, treat OA/AA
64
What can be done to treat pneumonia under the metabolic model
Abx, lymphatics, tapotement, sinus drainage, inhaled bronchodilators
65
At what stage of pneumonia can you do a lymphatic pump
Stage III (recovering, afebrile, productive cough)
66
What are cardiopulmonary specific considerations with OMM
-consider indirect treatments
67
What is the counterstrain position for AL1
Doc on same side with foot on table; flex knees and hips > 90; knees and ankles pulled toward doc; FSTRA
68
What is the position for treatment of AL 2
Doc opposite TP with foot on table; flex knees hips to 90; knees and ankles towards doc; FSART *significant rotation
69
What is the treatment position for AL 3 and 4
Doc opposite TP with foot on table; flex knees and hips to 90, pull knees and ankles towards doc; FSART
70
What is the position for AL5
(On anterior aspect of pubic bone 1 cm lateral to pubic symphysis near pubic tubercle); doc same side of TP it’s foot on table; flex 90-135; push ankles away from doc and rotate knees toward doc - FSARA
71
What is the treatment for upper pole
(Superomedial border of PSIS); doc opposite TP; extends ipslateral hip and externally rotates
72
Where is Lower pole
Inferior aspect of PSIS
73
What is the treatment for PL3/4
Extension
74
Where is the iliacus TP and what is the position
1-2 inches medial to ASIS; frog leg
75
Where is the low ilium TP and how is it treated
Lateral aspect of superior ramus where psoas m crosses pelvic rim; doc Same side; flex > 90, slight ER *only one leg
76
Where is the inguinal ligament TP and what is the treatment
Lateral surface of pubic bone near attachment of inguinal lig; doc on same side with foot on table; flex hips/knees to 90 and rest on drs knee, cross opposite ankle over leg on side of dr; ankles toward doc (IR of hip)
77
Where is the psoas major TP and what is the position
2/3 from ASIS to midline; doc same side of TP with foot on table; markedly flex pt knees and rest on doc, pull feet and ankles towards TP
78
Where is HISI and what is the treatment
Lateral aspect of PSIS; doc same side - monitor point by pressing lateral to medial; extend
79
Where is high ileum flare out point and what is the position
Lateral aspect of ILA (coccygeus); doc opposite side, extend leg on side o dysfunction and adduct and externally rotate
80
Where is the Piriformis TP and what is the position
Halfway from sacral ILA to greater trochanter; doc seated on same side; flex to 135 off side of table abduct and externally rotate
81
Where is PS 5 located
Superomedial ILA
82
What are the stages of response to stress
Startle: adrenal, CV, resp and MSK functions increase Attempt to cope and problem solve: if unsuccessful becomes exhausted Exhaustion
83
What testing can you do for metabolic aspect of GI case
Malnutrition: food diary; test for signs of dysphasia | Chronic fatigue: obtain TSH, CBC, vit D
84
What is carbohydrate deficient transferrin
CDT; identifies alcohol consumption
85
What is the pharm treatment for alc abuse (metabolic model)
Naltrexone, disulfiram (side effects when combined with alcohol)
86
What is psychogenic polydipsia
Excessive intake of water; can be caused by drugs that cause dry mouth or sarcoidosis
87
What is patient health questionnaire used for
Depression screen
88
What metabolic tests can you do for a Renal patient
Blood sugar, DRe, lipid panel, PSA, urinalysis, STI NAAT
89
What exacerbates symptoms of BPH
Antihistamines
90
Which ganglion is prostate innervated by
Inferior mesenteric - T10-L2; parasympathetic form SS2-4
91
When does gout pain occur more often
At night
92
What ddx would you come up with for the behavioral model for someone with. Renal colic
Bladder cancer if smoker
93
What would you do for treatment of kidney stone for metabolic model
Alkalization of urine, increased fluid intak, reduction of Uris acid production - modify diet, if xanthine oxidase inhibitor given, stop urinary alk alkalization
94
What can be given to treat the metabolic part of depression
Folic acid and B vitamins

OS III (2 decks)

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