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OMM 1 > General Concepts > Flashcards

General Concepts Flashcards

1
Q

Heroic Medicine consists of:

A
  1. Bloodletting
  2. Purging
  3. Calomel and other
    poisonous compounds
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2
Q

Pivotal years in AT Still Life:

4 dates

A

1860: 2nd wife marriage

1861: AT Still enlisted in civil
war.

1864: 3 children die from meningitis
1867: father dies from pneumonia

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3
Q

What is important day of founding of Osteopathy

A

June 22nd, 1874

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4
Q

Basic concept of health according to AT Still.

A

Health is maintained by unobstructed blood impulses of nerves

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5
Q

1st state to license DOs and year

A

Vermont in 1896

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6
Q

Influenza Pandemic year and significance

A

1918 to 1919

Saw an increase in use of OMT as less DO patients died

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7
Q

In 1920’s to 1940’s what happened to use of OMT?

A

Decreased

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8
Q

California and osteopathy in the 1960’s:

A

1961: $65 to change D.O degree to M.D.

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9
Q

What is emphasized in DO philosophy?

A

Primary care emphasis, health maintenance and preventive care.

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10
Q

4 philosophical principles of Osteopathy.

A

Body functions as mind, body, and spirit.

Structure and function are reciprocally interrelated.

Body possesses all self regulatory mechanisms

Body has inherent capacity to heal itself

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11
Q

Osteopathy is a —- oriented philosophy with a —— focus.

A

health, patient centered

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12
Q

Finish these statements:

Musculoskeletal system as the primary manifestation of health and disease,

Embraces all known forms of medical treatment and therapy,

A

Musculoskeletal system as the primary manifestation of health and disease, and by influencing somatic systems by manipulation, normal dynamic anatomy and therapy maximizes health and comfort to individual.

Embraces all known forms of medical treatment and therapy, incorporating and being informed by science, philosophy, and practice of osteopathy.

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13
Q

Finish this statement:

A complete system of medical care with a philosophy that combines

A

needs of the patient with current practice of medicine, surgery, and obstetrics; that emphasizes the interrelationship between structure and function; and has appreciation of body’s ability to heal itself.

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14
Q

4 tenets:

A
  1. A person is a product of dynamic interactions between body, mind, and spirit.
  2. An inherent property of this dynamic interaction is the capacity of the individual for the maintenance of health and recovery of disease.
  3. Many forces, both intrinsic and extrinsic to the person, can challenge this inherent capacity and contribute to the onset of illness
  4. The musculoskeletal system significantly influences the individuals ability to restore this inherent capacity and therefore to resist disease processes.
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15
Q

Finding — should be object of the doctor.

A

health

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16
Q

What is the DMFR method?

A

When a restrictive is identified in a myofascial tissue and is engaged with a loaded, constant, directional force until the tissue releases and motion is restored.

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17
Q

What are activating forces?

A
  1. Inherent: tendency towards homeostasis
  2. Respiratory force
  3. Physician Guided Force
  4. Springing/vibration
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18
Q

Articulatory Techniques

A

Clinician repetitively takes the part of the body being treated directly to the restrictive barrier in order to improve to improve physiological motion.

Low velocity, mo-high amplitude.

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19
Q

Articulation examples

A

Rib Raising, Spencer’s techniques

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20
Q

Indications for articulatory techniques

A

Post-operative patients, elderly patients suffering from osteoarthritis, osteoporosis.

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21
Q

Muscle Energy Technique is when

A

The patient’s muscle are actively used on request from a precisely controlled position, against a distinctly executed physician counterforce.

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22
Q

What are the indications for muscle energy:

A
  1. relaxes hypertonic muscles

2. treat joint restriction

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23
Q

MET Treatment Flow:

A
  1. Diagnose joint dysfunction or tight muscle
  2. position joint muscle towards the restrictive barrier
  3. Clinician resists patient movement for 3-5 seconds with ISOMETRIC FORCE
  4. Patient instructed to relax–> clinician simultaneously relaxes
  5. Limb/lever is taken further towards the restrictive barrier
  6. Repeat steps 3- 6 until no further improvement is achieved
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24
Q

What does isometric contraction mean?

A

It means that the patients muscle contraction is opposed by the practitioner’s counterforce.

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25
Q

Fill in the blanks:

when the patient moves body part away from restrictive barrier it is an ——-

A

opposite and equal force to the operator/ physician counterforce.

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26
Q

How long are contraction- relaxation cycles repeated?

A

Until no further improvement is felt.

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27
Q

Once you have resisted the final isometric contractions you must —–

A

Approach the barrier one last time prior to coming out of the treatment position.

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28
Q

How much force should be exerted in the contraction for small muscles and large muscles?

A

Small muscles: ounces

Large muscles: pounds of forces

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29
Q

What are the neurophysiology of stretching and muscle contraction?

A

Muscle is stretched to the barrier and muscle spindles are activated. Motor neurons are activated to resist stretch w/muscle contraction. Regular stretching limits the effectiveness of the stretch

30
Q

What is the post-isometric relaxation theory?

A

Muscle contraction causes action potential, refractory period occurs and causes further unopposed stretch towards barrier.

31
Q

Golgi Tendon Organ Theory is:

A

During muscle contraction, motor neurons are activated, tendon tension threshold is reached, and activated GTO inhibits the motor neuron activity, causing muscle tension to reduce.

32
Q

Muscle fatigue theory:

A

isometric contraction produced several times over will cause muscle fatigue, causing the fatigue of the muscle holding joint in place, allowing restored range of motion.

33
Q

What are contraindications to MET?

A
  1. people who are unable to follow verbal directions.
  2. internal bleeding
  3. post- surgery
  4. Immediately after heart attack
  5. acutely injured muscle
34
Q

What does HVLA mean?

A

RAPID, therapeutic force of brief duration that travels a short distance within the anatomical ROM of a joint and engages restrictive barrier in one or more planes of motion to elicit release of restriction.

35
Q

Why is HVLA performed?

A

To correct somatic dysfunction and joint restriction.

36
Q

What are benefits of HVLA?

A

Re-establishing of joint and tensions around joint are relieved.

Immediate motion gain and pain reduction.

37
Q

What are HVLA techniques?

A
  1. Bring the joint to the barrier- reverse the somatic dysfunction diagnosis
  2. Position carefully/fine tune
  3. Use relaxation/distractor technique
  4. Apply thrust in specific direction (HVLA) without letting off barrier.
38
Q

MOA of HVLA

A

Gapping of joint releases NO causing improved motion and sudden muscle stretch reflex.

39
Q

What is the noise in HVLA?

A

It is when joint fluid seal is gapped, releasing a nitrogen gas bubble, creating cavitation.

40
Q

What are contra-indications of HVLA?

A

Osteoporosis and arteriosclerosis .

Acute injuries –> disc herniations and muscle spasm

41
Q

Tender points are typically located near

A

bony attachments

42
Q

What is myofascial release?

A

Tissues are guided in the direction of least resistance until free movement is achieved.

43
Q

In MFR technique what happens to restrictive barrier?

A

barrier is engaged and tissues is loaded with constant force until tissue release occurs.

44
Q

What is MFR used for?

A

somatic dysfunctions involving myofascial or other connective tissues of the body.

45
Q

What are contraindications of MFR?

A
  1. somatic dysfunction
  2. lack of patient consent and/ cooperation

above two are absolute

  1. extreme caution in patients with fractures, open wounds, soft tissue or bony infections, abscesses, DVT, ect.
46
Q

What are the physical properties of fascia?

A

Elasticity: fascia returns to original shape after a load is placed on it.

Plasticity: when under longer loads fascia can turn into another shape.

47
Q

What is hysteresis?

A

The conversion of mechanical stress into energy such as heat.

48
Q

What does MFR do?

A

provides peripheral neuro-reflexive alterations in muscle tone by its influence on mechanoreceptors.

49
Q

What does “creep” mean?

A

Connective tissue plastic changes that releases heat.

50
Q

What is the sequence of order for the myofascial release?

A

Myofascial Release Treatment –> stimulation of mechanoreceptors–> CNS stimulation –> muscle tone change of related skeletal muscles –> palpable tissue response

51
Q

What is the general idea behind counter-strain?

A

Somatic dysfunctions are associated with para-vertebral tenderpoints, and these tender points are relieved by placing patient on comfortable position, waiting for 90 seconds, and then slowly returning to normal.

52
Q

What are tender points? What are they palpated as?

A

Are located near bony attachments of tendons, ligaments, or in the belly of some muscles.

They are palpated as small, tense, edematous areas in the soft tissue, which are fingertip size.

53
Q

What is pathophysiology of counter-strain:

A

Strain results from over-stretching myofascial tissues causing in an increase in gamma gain of the muscle spindles–> which tell CNS–> result in the perception of pain.

54
Q

Counter-strain

A

Increased firing of receptors causes increased gamma motor neuron activity, resulting in muscle contraction (tone). Sudden strain in muscle can cause this.

55
Q

What are the indications of counterstrain?

A
  1. acute or chronic somatic dysfunctions
  2. Somatic dysfunctions with a neural component like a hyper-shortened muscle
  3. as primary treatment or in conjunction with other approaches.
  4. Somatic dysfunctions in any area of the body
56
Q

What are contraindications of counterstrain?

A
  1. absence of somatic dysfunction
  2. Lack of patient consent and/or cooperation.
  3. Relative: patient cannot voluntarily relax, severely ill, vertebral artery disease, severe osteoporosis
57
Q

What are the principles of diagnosis in counterstrain?

A
  1. Patient history and obs. of body hiatus are elevated.
  2. Once area of potential dysfunction is determines, the specific tissue locations are evaluated for presence of tenderness and tissue texture abnormalities (increased tension)
58
Q

What is the approximate pressure used to elicit a tender point?

A

Enough to blanch a nail bed

59
Q

What are the steps to perform counterstrain?

A
  1. find a tenderpoint
  2. establish tenderness assessment/ pain scale
  3. place the patient passively in a position that results in the greatest reduction (greater or equal to 70- with a goal of 100% reduction)

(Approximate the position first, and then fine tune position through small arcs of movement)

  1. Maintain this position for 90 seconds
  2. Slowly return patient passively to a neutral position
  3. Re-test for tenderness at tender point.
60
Q

Anterior tender points require:

A

flexion

61
Q

Posterior tender points require —

A

extension

62
Q

Midline tender points require—-

A

primarily flexion or extension

63
Q

The more lateral the point the more—-

A

side-bending and rotation is required

64
Q

What is the goal of Facilitated Positional Release?

A

an indirect method to reduce hypertonicity

65
Q

What is Korr’s theory?

A

A somatic dysfunction is initiatedby increased gain in gamma motor neuron activity of that segment.

66
Q

What is Carew?

A

Shortening muscle shortens more than it should, causing decrease in muscle spindle output, lowering excitatory input to the spinal cord nerve fibers.

67
Q

What are the indications for FPR?

A
  1. acute or chronic dysfunctions
  2. somatic dysfunction with a neural component such as hypershortened muscle.
  3. As primary treatment or in conjunction with other treatments
  4. Somatic dysfunctions in any area of the body.
68
Q

What are contraindications for FPR?

A
  1. absolute: absence of somatic dysfunction and lack of patient consent and/or cooperation
  2. Relative: herniated/bulging disc due to compression, VAD, severe osteoporosis
69
Q

What are the two kinds of FPR?

A

They are tissue texture change treatment and intervertebral motion restriction treatment.

70
Q

What are the steps for tissue texture change treatment?

A
  1. AP spinal curve is flattened
  2. Patient musculature is placed in a relaxed position.
  3. A facilitating force is applied
  4. The position is held for 3- 5 seconds.
  5. Patient is re-evaluated.
71
Q

What are the steps for vertebral motion restriction treatment:

A
  1. A-P spinal curve of the treatment curve is flattened.
  2. Vertebra is placed into a position that allows freedom of motion in all planes
  3. facilitating force is applied
  4. The position is held for 3-5 seconds
  5. patient is re-evaluated.

OMM 1 (6 decks)

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