Intro To Somatic Dysfunction

Question 1

Somatic dysfunction is defined as the

Answer 1

Impaired or altered function of related components of the somatic (bodywork) system including the skeletal, arthrodial (joints), and myofascial structures, and their related vascular, lymphatic and neural elements

Question 2

What are the consequences of somatic dysfunction?

Answer 2

Poor posture may lead to tight trapezius muscles leading to HA or other pains
Can also be visceral - interactions b/w the vertebra and the nerves they protect may cause change in visceral fxn or vice versa

Question 3

How do you diagnose somatic dysfunction?

Answer 3

Tissue texture abnormalities 
Asymmetry (static or active) 
Restriction of motion 
Tenderness 
The position of a body part as determined by palpitation and referenced to its defined adjacent structure

Question 4

Tissue texture abnormalities

Answer 4

Temperature, drag, texture, edema, bogginess, elasticity, dryness, oiliness, scars, contraction, flaccidity, spasm, ropey or stringy

Question 5

How do you name a somatic dysfunction?

Answer 5

Name it for what the structure WILL do

Ex: elbow can extend but is has restricted flexion then then it is elbow extended somatic dysfunction

Question 6

Acute somatic dysfunction

Answer 6

Impairment or altered fxn of related components of the body framework system that is characterized by one or more of the following sx: pain, erythema, relative warmth, increased moisture/bogginess, vasodilation, edema, tenderness, and tissue contraction

Question 7

Chronic somatic dysfunction

Answer 7

Impairment or altered fxn of long standing duration of related components fo the body framework system characterized by one or more of the following sx: itching, paresthesia, a palpable sense of tissue dryness, coolness, tissue contracture, fibrosis tenderness and pallor

Question 8

Explain the difference between contraction and contracture

Answer 8

Contraction is the process of which a muscle becomes or is made shorter and tighter (acute)
Contracture is an abnormal, sometimes permanent, contraction of a muscle

Question 9

What are some key words used for acute tissue texture abnormalities?

Answer 9

Erythematous, hot/increased warmth, bogginess, edema, spasm and tissue contraction

Question 10

What are some key works for chronic tissue texture abnormalities?

Answer 10

Pale/blanching, cool, ropey, stringy, scar and doughy

Question 11

How is somatic dysfunction treated?

Answer 11

By using OMT

Question 12

Osteopathic manipulative treatment is the

Answer 12

Therapeutic application of manually guided forces by an osteopathic physician to improve physiologic function and/or support homeostasis that has been altered by somatic dysfunction

Question 13

If a patient is doing the moving then they are

Answer 13

Active

Question 14

If the doctor does the moving for the patient then they are

Answer 14

Passive

Question 15

Which ROM (passive or active) has a greater range?

Answer 15

Passive ROM > active ROM

Question 16

What is the physiologic barrier?

Answer 16

Limit of active motion

Question 17

What is the anatomic barrier?

Answer 17

Limit imposed by anatomic structure

Question 18

What is the elastic range?

Answer 18

The range between the physiologic and anatomic barrier (end of passive motion)

Question 19

What is the restrictive barrier?

Answer 19

Functional limit that abnormally diminishes the normal physiologic range

Question 20

What are the levels of evidence for OMT in order of highest level to lowest?

Answer 20

A: randomized clinical trials (RCTs), systematic reviews or meta-analyses of RCTs
B: case control or cohort studies, retrospective studies and certain uncontrolled studies
C: consensus statements, expert guidelines, usual practice and opinion

Question 21

What are the contraindications for OMT?

Answer 21

If you find no somatic dysfunction
Pt does not give consent
In an inappropriate clinical situation (ex. Pt is unstable bc of a trauma)

Question 22

What are some ways to avoid post OMT sx?

Answer 22

Take a good history and PE which allows operator to ascertain avoidable risks
Appropriate choice of technique by contemplating risk vs benefit ratio
Appropriate application of technique
Advise the pt to hydrate and rest & notify them that post OMT soreness is similar to post exercise soreness

Question 23

What are the 10 body systems?

Answer 23

HEENT, cardiovascular, respiratory, GI, genitourinary, MSK, endocrine, integumentary, nervous, immune and psychiatric

Question 24

What are the 5 osteopathic models?

Answer 24

Biomechanical, neurologic, respiratory/circulatory, metabolic/energetic/immune and behavioral (biopsychosocial)

Question 25

Biomechanical model

Answer 25

MSK system including bones, muscles, tendons, ligaments and fascia Integumentary Body and its response to gravity

Question 26

Neurologic model

Answer 26

Includes the nervous system, brain, spinal cord and its extension to the MSK system, autonomic system (including CN III, VII< IX and X & sacrum) as well as the sympathetic system

Question 27

Respiratory/circulatory model

Answer 27

Cardiovascular including lymphatics system, respiratory, nose, throat and genitourinary

Question 28

Metabolic/energetic/immune model

Answer 28

GI, lymph organs including spleen, liver, thymus, tonsils, appendix, lymph nodes, and the endocrine system including the hypothalamus-pituitary-adrenal axis

Question 29

Behavioral (biopsychosocial) model

Answer 29

Psychological - behaviors that influence health and health decisions

Question 30

What does health of the biomechanical model look like?

Answer 30

Efficient and effective posture and motion throughout the MSK system

Question 31

What does disease of the biomechanical model look like?

Answer 31

Somatic dysfunction; inefficient posture; joint motion restrictions or hyper mobility; instability

Question 32

How would you go about giving pt care in terms of the biomechanical model?

Answer 32

Alleviate somatic dysfunction utilizing osteopathic palpatory diagnosis and OMT to restore normal motion and function throughout the body

Question 33

What does health of the neurologic model look like?

Answer 33

Efficient and effective sensory processing, neural integration and control, autonomic balance, central and peripheral nervous functions

Question 34

What does disease of the neurologic model look like?

Answer 34

Abnormal sensation, imbalance of autonomic functions, central and peripheral sensitization/malfunction; pain syndromes

Question 35

How can you give pt care for the neurological model?

Answer 35

Restore normal sensation, neurologic processes and control; alleviate pain

Question 36

What does a healthy respiratory-circulatory model look like?

Answer 36

Efficient and effective arterial supply, venous and lymphatic drainage to and from all cells; effective respiration

Question 37

What does a diseased respiratory-circulatory model look like?

Answer 37

Vascular compromise, edema, tissue congestion; poor gas exchange

Question 38

How can you give pt care in the respiratory-circulatory model?

Answer 38

Remove mechanical impediments to respiration and circulation and relieve congestion and edema by improving venous and lymph drainage

Question 39

What does a healthy metabolic-energetic-immune model look like?

Answer 39

Efferent and effective cellular metabolic processes, energy expenditure and exchange, endocrine and immune regulation and control

Question 40

What does a diseased respiratory-circulatory model look like?

Answer 40

Energy loss, fatigue, ineffective metabolic processes, toxic waste buildup, inflammation, infection, poor wound healing, poor nutrition; adverse response to medication; loss of endocrine control of vital functions

Question 41

How can you give pt care in the metabolic-energetic-immune model?

Answer 41

Restore efficient metabolic processes and bioenergetics, alleviate inflammation, infection, restore healing and repair functions and endocrine control

Question 42

What does health look like in the behavioral model?

Answer 42

Efficient and effective mental, emotional, and spiritual functions, healthy lifestyle choices and actives, good social support system

Question 43

What does disease look like in the behavior model?

Answer 43

Ineffective function due to drug abuse, environmental chemical exposure or trauma, poor lifestyle choices; inability to adapt to stress or environmental changes

Question 44

How can you give pt care in the behavioral model?

Answer 44

Assess and treat the whole person-physical, psychological, social, cultural, behavioral, and spiritual aspects; collaborative partnership; individualized pt care ad self responsibility for healthy lifestyle choices

Question 45

During the thought process of the 5 osteopathic models you should

Answer 45

Evaluate a pt’s problem and formulate a tx plan