M1T3 OMM Midterm Flashcards

1
Q

The ________ technique utilizes indirect and direct techniques.

A

Still

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2
Q

What specific OMM techniques are useful in cardiac disease?

A

BLTIndirect myofascial release Indirect release of diaphragmOccipito-atlantal decompressionRib raising

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3
Q

_________ test uses the scalenes to elevate the first rib. This test can identify scalene ________.

A

Adson’s, trigger points

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4
Q

The lower ureters are innervated by what spinal cord level(s)? (sympathetics)

A

T12-L1

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5
Q

The posterior Chapman’s point for the heart is located between ________ (between the ________ and the ________).

A

Vertebrae 2 and 3, spinous process, transverse process

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6
Q

Any condition or procedure that damages the lymph nodes or vessels that can cause lymphedema is ________ lymphedema.

A

Secondary

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7
Q

What are the three ways to increase lymphatic flow through osteopathic techniques?

A

1) reduction of primary tissue resistance (fibrotic/scarred/surgically altered)2) reduction of secondary tissue resistance (neurologic etiology)3) reduction of somatic dysfunction

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8
Q

LAS is very good for treating ________ and ________ issues.

A

Upper, lower extremity

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9
Q

What type of osteopathic medicine implements the use of oscillations?

A

Cranial

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10
Q

Muscle involvement in viscerosomatic reflexes may cause ________ and ________ to the side of the involved organ as well as ________.

A

SB, rotation, extension

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11
Q

Any cyclic change in the level of a bodily chemical or function is known as ________.

A

Biological rhythm

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12
Q

The biomechanics of the 11th and 12th ribs exhibit ________ motion.

A

Caliper

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13
Q

Although BLT/LAS are nearly identical, ________ has a greater diversity of techniques.

A

LAS

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14
Q

Indications for lymphatic treatment are ________, ________, ________, or ________.

A

CHF, parenchymal disease, infections, tonic stimulation

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15
Q

The biomechanics of ribs (6)7-10 are mainly ________ motion.

A

Bucket handle

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16
Q

The lower extremeties are innervated by what spinal cord level(s)? (sympathetics)

A

T11-L2

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17
Q

Dysfunctional rib motion can have ________, ________, and ________ effects.

A

Gastrointestinal, pulmonary, cardiovascular

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18
Q

Pump handle motion is generally in the ________ plane whereas bucket handle motion is in the ________ plane.

A

Sagittal, coronal

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19
Q

A ________ is a hyper-irritable spot in skeletal muscle associated with a hypersensitive palpable nodule, in a taut band.

A

Myofascial trigger point

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20
Q

The key lesion indicating a psoas major issue is a ________ biomechanical diagnosis at the level of ________ or ________ (the side of the shortened psoas will be the side in which side bending and rotation occur.

A

Type II, L1, L2

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21
Q

Viscerosomatic reflexes are ________ related to paraspinal muscle hypertonicity.

A

Segmentally

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22
Q

Overuse of the wrist/finger flexors and pronator teres can lead to ________.

A

Carpel tunnel syndrome symptoms

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23
Q

________ is an indirect technique that treats quickly within 3-5 seconds.

A

Facilitated positional release

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24
Q

The ________ reflex is an example of a vicserovisceral reflex.

A

Gastro-colic (food in, poop out)

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25
Q

The heart and lungs both drain into the ________ lymphatic duct system. However, the pericardium drains into the ________ lymphatic duct system.

A

Right, thoracic

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26
Q

Tightness in the left shoulder/arm with the onset of an MI is an example of a ________ reflex.

A

Viscerosomatic

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27
Q

In viscerosomatic reflexes of the GI tract, rib somatic dysfunctions will relate to foregut, midgut, and hindgut sympathetic innervation. The levels are ________, ________, and ________ respectively.

A

T5-T9, T10-T11, T12-L2

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28
Q

To perform FPR, the physician places the region of treatment into a ________ position or “flattens the curve.” Then an ________ is applied. The region is then placed further into its ________ and held for 3-5 seconds.

A

Neutral, activation force, direction of ease

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29
Q

________ demonstrated the existence of a circadian rhythm in plants.

A

Jean-Jacques D’ortous de Mairan

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30
Q

The innervation of the ________ side of the heart has more influence on heart rate via the SA node.

A

Right

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31
Q

________ sympathetic tone occurs with CHF and leads to an increased afterload. OMT has been shown to ________ sympathetic tone.

A

Increased, decrease (balance more so)

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32
Q

As fluid pressure increases in the interstitium, the fenestrations of the lymphatics ________.

A

Close

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33
Q

Metronomes are able to communicate and synchronize by transferring ________ or put another way, communicating through ________ forces.

A

Kinetic energy, mechanical

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34
Q

Viscerosomatic reflexes respond well to ________ and/or ________ techniques.

A

ME, BLT

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35
Q

Cardiac plexus fibers that come from the right tend to innervate the ________.

A

SA node

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36
Q

The appendix is innervated by what spinal cord level(s)? (sympathetics)

A

T12

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37
Q

Prolonged poor posture that leads to palpitations is an example of a ________ reflex.

A

Somatovisceral

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38
Q

In viscerosomatic reflexes of the GI tract, tissue texture changes that are likely to occur are paraspinal and intercostal muscle ________.

A

Hypertonicity

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39
Q

With CHF, you have to be careful to not ________ the pump when increasing fluid return with OMT.

A

Overload

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40
Q

________ is the most important Zeitgeber in nature.

A

Light

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41
Q

A useful osteopathic mantra for care consists of which models?

A

Neurologic (autonomics per Dr. Noto-Bell)Fluid (lymphatics per Dr. Noto-Bell)Mechanics (biomechanics per Dr. Noto-Bell)

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42
Q

For a targeted area, you should treat lymphatics in a ________ to ________ pattern.

A

Central, peripheral

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43
Q

One of the main differences between FPR and Still technique is that FPR does not utilize an _______ with a continuous vector towards the barrier.

A

Arc of motion

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44
Q

If hypertonicity is identified within a recurrent postural muscle pattern, treat the underlying ________.

A

Postural problem

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45
Q

The prostate is innervated by what spinal cord level(s)? (sympathetics)

A

T12-L2

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46
Q

In appendicitis, where are you likely to see hypertonicity?

A

Peri-umbilical, tip of 12th rib, McBurney’s point and rebound tenderness

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47
Q

The main treatment goal of lymphatic techniques is to ________.

A

Control limb swelling

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48
Q

What are the most common techniques used for rib dysfunctions?

A

PIR (less common)Respiratory assist (best for inhalation dysfunctions)Joint mobilization using muscle force (best for exhalation dysfunctions)

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49
Q

The upper ureters are innervated by what spinal cord level(s)? (sympathetics)

A

T10-T11

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50
Q

The three steps to perform BLT/LAS are ________, ________ and ________.

A

Disengagement, exaggeration (in the direction of ease), balance

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51
Q

Some of the treatments for hypertonicity consist of ________, ________, ________, and ________.

A

Soft tissue, myofascial release, counterstrain, ME

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52
Q

________ can be described as the normal joint state of ligaments in which they are equally balanced (similar to tensegrity)

A

Balanced ligamentous tension

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53
Q

The vital cycle depends on vibration or “waves of vibration” was an idea introduced by ________ in 1902.

A

J.M. Littlejohn

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54
Q

Chapman’s points around the umbilicus are viscerosomatic reflexes from the ________, ________, and ________.

A

Bladder, kidneys, and adrenal glands

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55
Q

In PIR costal ME, the hand anchoring the rib should ________ the rib to move in the inhalation direction.

A

Not allow

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56
Q

Extrinsic pumping of the lymphatics can be caused by ________ and ________.

A

Contraction of the surrounding muscles, movement of body parts

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57
Q

Pectoralis trigger points in patients with cardiac disease may be associated with ________.

A

Coronary artery insufficiency

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58
Q

What is the leading precipitating and perpetuating factor of myofascial trigger points?

A

Postural imbalance

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59
Q

The ________ and ________ are principle muscles in inhalation.

A

External intercostals, diaphragm

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60
Q

One of the major applications of OMT in the respiratory-circulatory model is ________.

A

Freeing restricted diaphragms

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61
Q

60% of patients with coronary artery disease have been found to have ________ trigger points.

A

Pectoralis major

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62
Q

In BLT/LAS you serve as a ________ vs providing a direct action.

A

Facilitator

63
Q

The ribs can be palpated just ________ to the thoracic transverse processes.

A

Lateral

64
Q

For inhalation dysfunctions, the key rib will be the ________ rib of the group.

A

Lowest

65
Q

________ describes the somatic dysfunction that occurs in the ligamentous structures that surround a joint.

A

Ligamentous articular strain

66
Q

Always treat ________ dysfunctions first and then costal dysfunctions, unless the costal dysfunction is ________.

A

Thoracovertebral, non-physiologic

67
Q

Other techniques that can incorporate oscillations include ________, ________, ________, and ________.

A

BLT, counterstrain, ME, and soft tissue

68
Q

With ME treatments, ________ is used for an acute painful muscle and utilizes reflex relaxation. ________ is used for a tight muscle (usually chronic) and causes intramuscular change.

A

Reciprocal inhibition, post-isometric relaxation

69
Q

Best performance on thinking tests occurs at ________.

A

12:00

70
Q

The sharpest rise in blood pressure occurs in the ________.

A

Early morning

71
Q

________ causes the greatest increase in lymph flow (15-20 times greater flow rate).

A

Exercise

72
Q

Facilitated segments require ________ stimulation than normal to trigger an action potential.

A

Less

73
Q

Posterior Chapman’s points are used more so for ________.

A

Treatment

74
Q

Sonoelastography imaging is utilized to identity trigger points by measuring ________ within muscle.

A

Stiffness

75
Q

A shortened psoas major leads to a positive ________.

A

Thomas test

76
Q

Which muscle is the most overlooked cause of myofascial low back pain?

A

Quadratus lumborum

77
Q

An ________ is a mechanical or electronic device that works on the principles of oscillation.

A

Oscillator

78
Q

The anterior Chapman’s point for the heart is located in the ________ space between ________.

A

Intercostal, ribs 2 and 3

79
Q

When treating ribs, PIR is used to treat dysfunction in which the restriction is secondary to ________.

A

Muscle hypertonicity

80
Q

Anterior Chapman’s points are used more so for assistance with ________.

A

Diagnosis

81
Q

Lymphedema is distinct from generalized edema by its ________, ________, and ________.

A

Localization, gradual progression, absence of generalized edema causes

82
Q

Cardiac plexus fibers that come from the left tend to innervate the ________.

A

AV node

83
Q

In the Still technique, ________ has profound effects on the effectiveness of the technique.

A

Maintaining the force vector

84
Q

For costal dysfunctions, treatments should last ________ seconds.

A

5-7

85
Q

The upper extremeties are innervated by what spinal cord level(s)? (sympathetics)

A

T2-T6

86
Q

In viscerosomatic reflexes of the GI tract, ________ reflexes or ________ may be present.

A

Chapman’s, myofascial trigger points

87
Q

Of the numerous scenarios in which hypertonicity can occur, ________ and ________ are special conditions that have associated pain, decreased range of motion, and N-V-L entrapment.

A

Myofascial trigger points, viscerosomatic reflexes

88
Q

Sympathetic innervation of the heart comes from the ________ plexus and arises from ________ of the sympathetic trunk.

A

Cardiac, T1-T5

89
Q

The myocardium is generally innervated more so by the ________ side of the cardiac plexus.

A

Left

90
Q

The kidneys are innervated by what spinal cord level(s)? (sympathetics)

A

T10-T11

91
Q

BLT is very good for treating ________ and ________ vertebral segmental dysfunctions.

A

Cervical, lumbar

92
Q

To perform the Still technique, place the structure in its ________, apply a ________, move the structure through an arc into the ________, and release the ________.

A

Position of ease, force vector, barrier, force vector

93
Q

Chapman’s points on the posterolateral thighs are viscerosomatic reflexes from the ________.

A

Prostate/broad ligament

94
Q

Upon palpation of a myofascial trigger point, you may feel a ________, ________ and the patient may experience ________.

A

Taut band, twitching, radiating pain

95
Q

Highest alertness occurs at ________.

A

10:00

96
Q

Which ME technique contracts the symptomatic muscle without lengthening or shortening to internally increase range of motion through the barrier?

A

Post-isometric relaxation

97
Q

The uterus/cervix are innervated by what spinal cord level(s)? (sympathetics)

A

T10-L2

98
Q

________ lymphedema is a rare and inherited condition.

A

Primary

99
Q

________ reflexes are tapioca bead like points that block lymphatic drainage, causing inflammation.

A

Chapman’s

100
Q

An active trigger point is one in which pain occurs at ________ with muscle activity or palpation.

A

Rest

101
Q

Although balanced ligamentous tension and ligamentous articular strain were developed by different groups, the techniques are almost ________.

A

Identical

102
Q

LAS can be caused when distribution and vectors of tension between and within ligaments are ________.

A

Altered

103
Q

Besides carrying excess fluid back to the heart, the lymphatics are responsible for carrying ________ and ________.

A

Proteins, large particulate matter

104
Q

When identified, the key rib is the rib that should be treated ________.

A

First

105
Q

Peri-umbilical pain is a _______ reflex, tip of the 12th rib is a ________ reflex, and McBurney’s point and rebound tenderness are ________ reflexes.

A

Visceral, viscerosomatic, peritoneocutaneous

106
Q

The ________ reflex and ________ are examples of somatosomatic reflexes.

A

Righting, myofascial trigger points

107
Q

A latent tigger point is one in which pain only occurs when probed with ________.

A

Steady pressure

108
Q

The stimuli that cause external changes in biological rhythm and synchronize us to the Earth’s cycles are known as ________.

A

Zeitgebers (time givers)

109
Q

The mechanics of the first and second rib can be described as ________ like.

A

Pump handle

110
Q

Which ME technique contracts an asymptomatic muscle in order to inhibit a tight muscle so that it can be lengthened?

A

Reciprocal inhibition

111
Q

The muscle tissue around the thoracic duct is innervated by ________.

A

Sympathetics

112
Q

An upper motor neuron lesion can lead to ________ and a lower motor neuron lesion can lead to ________.

A

Spasticity, flaccidity

113
Q

20% of patients have 2-3 separate lymphatic trunks emptying into the junction of the ________ vein and the ________ vein.

A

Jugular, subclavian

114
Q

FPR is used to decrease muscle ________ or to ________ motion to a restricted articulation/structure.

A

Hypertonicity, restore

115
Q

There are two terms that are related to the term “spasm.” ________ refers to an upper motor neuron lesion whereas ________ refers to tight muscles.

A

Spasticity, hypertonicity

116
Q

________ liters/day of fluid returns back into circulation via the lymphatics.

A

3

117
Q

Cytoplasm (neuroplasm) of an axon that encloses the neurofibrils is known as ________.

A

Axoplasm

118
Q

Best coordination/time to work out is in the ________.

A

Afternoon

119
Q

Rib springing is a ________ technique.

A

Non-physiologic/mechanical

120
Q

BLT/LAS, Still technique, and FPR are all ________ techniques.

A

Indirect

121
Q

Metabolic neuropathies, such as ________, can cause there to be less nociceptive input and mask an MI.

A

Diabetes

122
Q

In costal ME, the respiratory assist technique is most useful in ________ dysfunctions (primary joint restriction with minimal muscle involvement).

A

Articular costal

123
Q

The adrenal medulla is innervated by what spinal cord level(s)? (sympathetics)

A

T10

124
Q

The ________ and ________ aid in active breathing (exhalation).

A

Internal intercostals, abdominal musculature (rectus abdominis, external/internal oblique, transversus abdominis)

125
Q

________ can result from a number of stimuli such as local trauma, compensation, functional demand/overuse, visceral dysfunction, and reflex mechanisms.

A

Hypertonicity

126
Q

The innervation of the ________ side of the heart has more influence on cardiac output and myocardial contractility.

A

Left

127
Q

The AV node is innervated by the ________ vagus nerve.

A

Left

128
Q

In both BLT and LAS, the physician’s contact serves as a ________ to balance out the strain across the ligaments of a joint.

A

Fulcrum

129
Q

The SA node is innervated by the ________ vagus nerve.

A

Right

130
Q

Where is it easiest to palpate rib motion?

A

The location at which the rib traverses through its greatest arc.

131
Q

________ are the primary site of vascular resistance.

A

Arterioles

132
Q

Chapman’s points on the tip of the 12th ribs are viscerosomatic reflexes from the ________.

A

Appendix

133
Q

The ________ system facilitates the clearance of substance from the brain.

A

Glymphatic

134
Q

Facilitated segments can be maintained by ________ CNS activity.

A

NORMAL

135
Q

Lymphatic OMT in malignancy is ________ other than treating directly on the tumor.

A

Not contraindicated

136
Q

For exhalation dysfunctions, the key rib will be the ________ rib in the group.

A

Upper most

137
Q

________ angina is precordial chest pain that resembles true cardiac angina and results from cervical pathologies affecting the cervical spinal nerves.

A

Cervicogenic

138
Q

Rib palpation utilizing respiration is a ________ technique.

A

Physiologic

139
Q

The biomechanics of ribs 3-5(6) are a combination of ________ and ________ motions.

A

Pump handle, bucket handle

140
Q

Chapman’s points on the anterolateral thighs are viscerosomatic reflexes from the ________.

A

Large intestine

141
Q

The tissue texture change will be greater than the change in range of motion in ________ reflexes.

A

Viscerosomatic

142
Q

Viscerosomatic reflexes that occur via the vagus nerves will present at the ________, ________, and ________.

A

Occiput, C1, C2

143
Q

The Chapman’s point in the second intercostal space is a viscerosomatic reflex from the ________.

A

Myocardium

144
Q

________ occurs from overlap of visceral afferent neurons and somatic efferent neurons.

A

Referred pain

145
Q

There are three main categories in the spectrum of muscle tone. Muscle tone can either be ________ (tension), ________ (contracted), or _________(contracture).

A

Functional, dysfunctional, pathological

146
Q

The bladder is innervated by what spinal cord level(s)? (sympathetics)

A

T11-L2

147
Q

A ________ is defined as all the muscle fibers that receive innervation from the same nerve.

A

Myotactic unit

148
Q

Viscerosomatic reflexes that arise from cardiac arrhythmias will occur at ________.

A

T2

149
Q

Overuse of the scalenes/pectoral is minor can lead to ________.

A

Thoracic outlet syndrome

150
Q

The main site for lymphatic emptying is in the anatomic ________.

A

Superior thoracic aperture

151
Q

The ________ and ________ are accessory muscles that aid in inhalation.

A

Sternocleidomastoid, scalenes

152
Q

________ is the idea that treatment for certain conditions at specific times of the day/night can be either more or less effective. This was first suggested by ________.

A

Chronotherapy, Franz Halberg

153
Q

CHF is associated with increased venous pressure. Treatment of the lymphatics ________ lymphatic return and ________ central venous pressure.

A

Increases, decreases