Lectures 7, 8, & 9 Flashcards
The student will be able to define an Osteopathic Structural Examination. The student will be able to define static analysis and motion testing. The student will be able to define the different types of motion. The student will be able to define the different types of motion barriers. (106 cards)
Osteopathic Manual (Manipulative) Medicine
Application of Osteopathic philosophy, structural diagnosis, and the use of OMT in the diagnosis and management of the patient.
CRITERIA FOR DIAGNOSING A SOMATIC DYSFUNCTION
(S; Sensitivity) T:Tenderness Abnormal sensitivity of the tissue. Pain is what the patient complains about (subjective); tenderness is what you find when you palpate their tissues (objective). A: Asymmetry R: Restricted range of motion T:Tissue texture changes Ropy, boggy, pliable, compressible, rough, edematous \_\_\_\_\_\_\_\_\_\_ -Need at least 2 to have SD -If one is tenderness then need 3. -compare L and R sides for diferences
Most important 2 criteria for diagnosis SD?
restricted ROM and tissue texture changes
forces used in OMM
flexion (sagittal-AP), extension (sagittal-AP), side bending (frontal-coronal), rotation (transverse-horiz)
anatomic barrier
PHYS MOVES absolute limit of passive motion - its the final barrier limited by bone, muscle, ligament
-if you pass this limit = injury
physiologic barrier
PT MOVES -limit of active motion - what individuals can do themselves
restrictive barrier
- a limit that abnormally dimishes normal physiologic ROM
- caused by somatic dysfunctions, surgery muscle tightness, chronic dieases, swelling, scar tissue….
- IF NOT THE SAME ON BOTH SIDES THEN CLEARLY SOME SD
elastic barreir
- not a true barrier
- range between the physiologic and anatomic barriers
extrinsic force (OMT)
- (OUT OF)
- Treatment forces which are not supplied by the patient.
- Operator effort; thrusting, springing, traction, etc.
- Gravity.
- The use of a mechanical table (one that moves the patient).
intrinsic force (OMT)
- (IN)
- Voluntary or involuntary forces from within the patient that assist in manipulation.
- Respiration.
- Muscle contractions.
- Involuntary motions of the cranium and visceral organs.
active force (OMT)
Patient voluntarily performs a physician directed action.
Passive force (OMT)
Patient refrains from voluntary muscle contractions.
Osteopathic Manual (Manipulative) Treatment
Therapeutic application of manually guided forces by an Osteopathic physician to improve physiologic function and/or support homeostasis that has been altered by a somatic dysfunction.
Direct movement
Engagement of the restrictive barrier carrying the dysfunctional component (somatic dysfunction = SD) TOWARD OR THROUGH THE BARRIER.
indirect movmenet
- The motion barrier is disengaged.
- The dysfunctional body part (SD) is moved AWAY FROM THE RESTRICTIVE BARRIER and towards a point of balanced or decreased tissue tension in all planes or directions.
purpose of both indirect and direct movments?
to increase ROM
transitional areas are areas where
- Areas in the body where most dysfunctions can be found.
- Those areas that have the most mobility or are transition points within the: musculoskeletal system. Head/neck. Neck/thorax. Thorax/lumbar. Lumbar/sacral.
- Most SD’s will develop here because of the increased motion within these areas.–>Most people can adapt to these…it is when they don’t that they seek your help.
HVLA
- An articulatory manipulative procedure whereby the barrier or end-point of joint motion is engaged directly, carrying the dysfunctional component through the barrier in order to bring about an increase in freedom and range of motion.
- A quick motion over a short distance that may often produce an auditory noise (pop).
- Direct technique.
- Passive.-pt cant be doing anything
- Extrinsic.
- use is determined by pts condition
- Pt feels instant relief
- may overstretch ligaments if done too freqeuntly
- perform once or twice a week
HVLA treats…
BONY not MUSCULAR SD.
highest injury potential treatment
HVLA
over stretched ligaments can… (due to HVLA)
weakened ligaments = instability of the joint
HVLA mech of action:
gamma and alpha motor neuron inhibition due to stretch of spindle and Golgi apparatus mechanisms
After HVLA immediate change in muscle tone is due to
mimediate change in neural activity
How does HVLA trust change the neural activity
A sudden stretch or change in position of the joint alters the afferent output of the mechanoreceptors (of joint capsule), resulting in release of the muscle hypertonicity.