Midterm Flashcards
(137 cards)
1
Q
ENT Reflex Levels: Head and Neck (including Upper Esophagus); Is it Sympathetic or Parasympathetic
A
T1-T5; Sympathetic
2
Q
GI Reflex Regions include: ___, ___, ___, ___
A
1) Upper GI (including upper esophagus)
2) Small Intestines/Ascending Colon
3) Ascending and Transverse Colon
4) Descending and Sigmoid Colon/Rectum
3
Q
Sympathetic GI Reflex Levels: Upper GI (Including upper Esophagus)
A
T5-T10
4
Q
Sympathetic GI Reflex Levels: Small Intestines/Ascending Colon
A
T9-T11
5
Q
Sympathetic GI Reflex Levels: Ascending and Transverse Colon
A
T10-L2
6
Q
Sympathetic GI Reflex Levels: Descending and Sigmoid Colon/Rectum
A
T12-L2
7
Q
Parasympathetic GI Reflex Levels: Upper GI (Including Upper Esophagus)
A
OA, AA - Vagus n.
8
Q
Parasympathetic GI Reflex Levels: Small Intestine/Ascending Colon
A
OA, AA - Vagus n.
9
Q
Parasympathetic GI Reflex Levels: Ascending and Transverse Colon
A
OA, AA - Vagus n.
10
Q
Parasympathetic GI Reflex Levels: Descending and Sigmoid Colon/Rectum
A
S2-S4 (Sacrum)
11
Q
Extremity Reflex Levels: Upper/Lower are they sympathetic or parasympathetic
A
T2-T7 and T11-L2; Sympathetic
12
Q
Cardiovascular Reflex Regions
A
Heart and Adrenals
13
Q
Sympathetic Cardiovascular Reflex Levels: Heart and Adrenals
A
T1-T6 and T5-T10
14
Q
Parasympathetic Cardiovascular Reflex Levels:
A
OA, AA - Vagus n.
15
Q
Pulmonary Reflex Regions:
A
Lungs
16
Q
Sympathetic Pulmonary Reflex Levels
A
T1-T7
17
Q
Parasympathetic Pulmonary Reflex Levels
A
OA, AA - Vagus n.
18
Q
Pelvic, OBGYN Reflex Regions for Sympathetic
A
1) Genitourinary Tract
19
Q
Urology Reflex Regions for Sympathetic
A
1) Genitourinary Tract (includes Bladder)
2) Ureter- Upper
3) Ureter- Lower
20
Q
Pelvic, OBGYN Reflex Regions for Parasympathetic
A
Reproductive Organs, Pelvis
21
Q
Urology Reflex Regions for Parasympathetic
A
1) Upper Ureter
2) Bladder
3) Lower Ureter
4) Reproductive Organs
22
Q
Sympathetic Pelvic, OBGYN Reflex Levels: Genitourinary Tract
A
T10-L2
23
Q
Parasympathetic Pelvic, OBGYN Reflex Levels: Reproductive Organs, Pelvis
A
S2-S4 (Sacrum)
24
Q
Sympathetic Urology Reflex Levels: Genitourinary Tract (Includes Bladder)
A
T10-L2
25
Sympathetic Urology Reflex Levels: Ureter- Upper
T10-T11
26
Sympathetic Urology Reflex Levels: Ureter- Lower
T12-L2
27
Parasympathetic Urology Reflex Levels: Upper Ureter
OA,AA- Vagus n.
28
Parasympathetic Urology Reflex Levels: Bladder, Lower ureter, and Reproductive Organs
S2-S4 (Sacrum)
29
Anterior GU Chapman's Reflex Point: Kidney
1in lateral and 1in superior to umbilicus (10 and 2 o'clock position)
30
Anterior GU Chapman's Reflex Point: Ureters
None
31
Anterior GU Chapman's Reflex Point: Bladder
Umbilicus
32
Anterior GU Chapman's Reflex Point: Urethra
Superior Surface of Pubic Bone
33
If you suspect that a person has Pyelonephritis, What musculature will be hypertonic, and where?
Paraspinal Musculature
| T10-L2
34
___ spasms is a common somatic finding in acute and chronic renal patients
Iliopsoas
35
If a patient has SBO/Ileus where would you find paraspinal TART findings?
T9-L2
36
How would you treat paraspinal musculature from T9-L2 in SBO/Ileus?
Paraspinal Inhibition
37
Where would the suspected anterior chapman points be for small intestines?
8th - 10th intercostal space bilaterally
38
Where is the Colon chapman point?
Anterior IT band
39
What Chapman points would be palpable if a patient has SBO/Ileus
Colon (Anterior IT Band) and Small Intestines (8th-10th intercostal space bilaterally)
40
Which Chapman Points will be present when a patient has an AKI?
GI: Small Intestines (8th-10th intercostal space bilaterally)
GU: Renal (1in lateral and 1in superior to the umbilicus)
41
Chapman Point: Esophagus
Between Rib 2 and 3 parasternally
42
Chapman Point: Stomach - Left
Between Rib 5-6 and 6-7 at costochondral junction
43
Chapman Point: Liver -Right
Between Rib 5-6 and 6-7 at costochondral junction
44
Chapman Point: Gallbladder -Right
Between Ribs 6-7 at costochondral junction
45
Chapman Point: Pancreas - Right
Between Ribs 7-8 at the costochondral junction
46
Chapman Point: Small Intestines
Between Ribs 8-11 bilaterally at the costochondral junction
47
Chapman Point: Appendix
Tip of the 12th Rib
48
Chapman Point: Intestinal Peristalsis
Lateral to AIIS bilaterally
49
Chapman Point: Colon, Cecum, Hepatic Flexure
Colon: Anterior Iliotibial Band
- Cecum: Right Greater Trochanter
- Hepatic Flexure: Above Right Knee
50
ROME Criteria: Constipation
** Need two of following
1) Fewer than 3 BM/wk
2) 25% or more defecations with either straining or sensation of incomplete emptying
3) Lumpy or Hard Stools
Manual Facilitation
51
Common Causes of Constipation
1) Delaying Defecation
2) Diet and Exercise
- Low fiber
- Dairy
- Caffeine and Alcohol (Dehydration)
3) Medications
4) Endocrine Dysfunction (Hypothyroid)
52
Muscle Energy Technique (MET) Process
1. Place Patient at the restrictive barrier
2) Ask patient to move toward position of ease while hold them at the restricted barrier
3) Have patient relax, and take them to the NEW RESTRICATIVE BARRIER
4) Repeat 3-5 times
5) Always finish MET by taking the patient to the FINAL BARRIER before returning to neutral
6) Reassess
53
Anterior Rotated Innominate SD: MET
1) Supine
2) Flex hip and knee to edge of restrictive barrier
- induces posterior rotation
3) Patient extends hip towards ease of motion
- induces an anterior rotation
54
Posterior Rotated Innominate SD: MET
1) Supine
2) Extend leg to restrictive barrier while leg is off of the table
3) Patient flexes up toward ease of motion
55
Superior Innominate Shear SD: MET
1) Supine w/ feet off table
2) Lean back to maintain traction to RB
3) Patient pulls hip towards ipsilateral shoulder
56
Inferior Innominate Shear SD: MET
1) Supine w/ feet off table
2) Lean forward pushing leg cephalad to RB
3) Patient push foot towards physicians thigh
57
Inflare Innominate SD
1) Supine
2) Allow dysfunctional side leg to cross the other leg
3) Push Externally rotate and abduct the hip to restrictive barrier
4) Patient pushes knee into physicians hand
58
Outflare Innominate SD: MET
1) Supine
2) Dysfunctional leg crosses other leg
3) Internally rotate and adduct hip to RB
4) Patient pushed knee into physician hand
59
Superior Pubic Shear
1) Stabilize the ASIS on the opposite side
2) Abduct and Slightly extend the leg
3) Patient flex hip medially and toward ceiling
60
Inferior Pubic Shear
1) Flex Patients hip until restrictive barrier and then adduct significantly
2) Patient abducts and extends hip
61
Balanced Ligamentous Tension
1) Indirect Position
2) Utilize Activating Force: Inherent respiration
- Respiratory assist
3) Return to Neutral and Reevaluate
62
Anterior Rotated Innominae BLT:
1) Seated
2) PULL DOWN on Ipsilateral Leg and PUSH UP on contralateral leg
3) Patient rotate to CONTRALATERAL side until leg begins to draw up
4) Utilize respiratory assist
63
Posteriorly Rotated: BLT
1) Seated
2) PUSH UP on ipsilateral leg and PULL DOWN on contralateral leg
3) Patient Rotates to IPSILATERAL side until leg begins to draw up
4) Utilize Respiratory Assist
64
High Velocity Low amplitude (HVLA)
1) Correctly Diagnose SD
2) Provide some soft tissue preparation to the area
3) Localize forces to a segment or joint and engage the restrictive barrier
4) Have patient breate in and out
5) Corrective thrust through barrier during patient exhalation
6) Return to neutral
7) Reassess for TART
65
Anteriorly Rotated Innominate: HVLA
1) Lateral recumbent SD side up
5) Posteriorly rotate to direct barrier
6) Thrust simultaneously by pulling the PSIS inferiorly in line with the greater trochanter and rotating shoulder posterior
7) Recheck TART
66
Direction of the Thrust for Anteriorly Rotated Innominate: HVLA
Pulling the PSIS inferiorly in line with the greater trochanter and rotating shoulder posterior
67
Posteriorly Rotated Innominate: HVLA
1) Anteriorly Rotate innominate to direct barrier
| 2) Pulling PSIS superiorly/anteriorly toward the umbilicus and rotating the shoulder posteriorly
68
Superior Innominate Shear: HVLA
1) Supine
3) Lean back to engage restrictive barrier
2) Thrust inferiorly as pt breathes out
69
Inferior innominate shear
1) Shift innominate superior to restrictive barrier
| 2) Thrust simultaneously by pulling the ischial tuberosity and PSIS superiorly and rotating the shoulder posterior
70
___ is a screening test for acute abdominal disease.
KUB
71
KUB is ___ and readily available and doesn't require consent or preparation
Quick
72
____ is useful in identifying air under the diaphragm; obstruction (air-fluid levels within the bowel); fractures; nasogastric tube placement
Acute Abdominal Series
73
___, __, and __ are advantages of acute abdominal series!
1) Readily Available
2) No Prep
3) No need for consent
74
A patient has Pneumoperitoneum (Free air under the diaphragm) what would you use to view this?
Acute Abdominal Series
75
How does a US work?
Sound waves from tissues at different speeds related to density.
-Solid = White
Liquid = Black
76
How does a HIDA scan work
Nuclear tagged material taken up by the liver and excreted in bile
77
If you want to know the size shape inflammation, or stones of a specific organ what imaging would you use?
US
78
Advantages of US
1) Quick - can be done at bedside
2) Readily available - ED, ICU, outpatient clinics
3) No ionizing radiation: safe in pregnancy, often preferred for infants and young children
4) Prep varies depending on study and situation
79
Disadvantages of US
Limited by bowel gas
80
You should avoid ___ if possible in pregnancy due to the nuclear tagged material
HIDA Scan
81
Advantage of HIDA Scan
Patients that have persistent symptoms of gallbladder stones or dysfunction with lack of evidence of stones identified on US
82
Disadvantage of HIDA Scan
Radiology for 2-4 hrs
83
___ evaluates GB function and cystic duct patency
HIDA
84
_____ is modified to assess Gallbladder function but the __ can cause Abdominal HIDA
HIDA w/CCK
| CCK
85
___ can coat the esophagus and aid in identifying irregularities like Zenker's Diverticula, Rings, webs, tumors/masses
Barium Swallow
86
Disadvantage of Barium Swallow
HIGH doses of radiation secondary to multiple images in sequence
87
Which Procedure has the HIGHEST Radiation Exposure
CT ABD and Pelvis
88
Mucosal Disease, ulcers and small neoplasms don't show up well on ____
CT
89
Advantage of CT Abd/Pelvis w/ Contrast
Readily available and fast; Noninvasive and doesn't require consent
90
Disadvantagae of CT Abd/Pelvis
HIGH doses of Radiation and Potential allergic reaction to contrast (Fish and Shellfish)
91
A patient presents with sudden onset unilateral flank pain radiating to the groin. What would you order
CT Abd and Pelvis
92
What is the Test of choice for Renal Lithiasis (Kidney Stones)
CT using low-radiation-dose protocols
93
What is a alterative modality for pregnant patients who have kidney stones
Renal and Bladder Ultrasound with or without KUB
94
____ is used for direct visualization and evaluation of upper GI tract including esophagus, stomach, and proximal duodenum
EGD
95
___ is used for evaluation of large bowel by direct visualization
Colonoscopy
96
___ is used for the evaluation of the urethra and bladder by direct visualization
Cystoscopy
97
When a patient has to undergo a ___ they cant eat after midnight and clear liquids up to 2hrs.
EGD
98
In an ___ the patient has to undergo Sedation with intubation in order to protect the airway
EGD
99
Dysphagia, Odynophagia, Upper GI Bleed, GERD, Placing Feeding tube are indications of ___
EGD
100
A conscious sedation is common during an ____
Colonoscopy
101
Diagnosis of AKI
1) BMP:
- Increase in CR 1.5x patient or 0.3gm/dl increase
- BUN:Cr >20:1 suggestive prerenal AKI
2) Urinalysis with urine microscopy
- Protein, Blood, Glucose
3) Albumin/creatine ratio
102
Pre-renal AKI Physical Exam Findings
Skin turgor/tenting
| Dry oral mucosa and tounge fissuring
103
Pre-renal AKI patient my have a history of ___ and ___
Vomiting and diarrhea
104
Diagnostic Imaging for Bowel Obstruction
CT scan
105
___ Dysmotility that prevents intestinal content from moving distally
*** Common occurrence post-operatively (intra-abdominal surgery)
Ileus
106
___ is the main cause of Small Bowel Obstruction
Adhesion
107
Symptoms associated with small bowel obstruction
Vomiting , cramping pain, and distention
108
Principles of Treatment for Lymphatics
1) Open pathways to remove restriction to flow
2) Maximize diaphragmatic functions
3) Increase pressure differentials or transmit motion
4) Mobilize targeted tissue fluids
109
Principles of Diagnosis
1) Evaluate for indications/risks benefit ratio
2) Evaluate central myofascial pathways
3) Evaluate fluid pumps (Thoracic inlet, thoracic diaphragm, pelvic Diaphragm)
4) Evaluate Peripheral/regional pathways
110
Ways to mobilize targeted tissue fluids
Effleurage
| Petrissage
111
____ induces stroking force distally to proximally
Effleurage
112
__ induces a kneading/twisting force distally to proximally
Petrissage
113
Ulnar Adducted (___ testing) is coupled with wrist ___ (___ deviation)
1) Varus
2) Abduction
3) Radial Deviation
114
Ulnar abduction (___ testing) is coupled with wrist ___ (___ deviation)
1) Valgus
2) Adduction
3) Ulnar Deviation
115
Radial head ___ is coupled with supination
Anterior Glide
116
Radial head __ is coupled with pronation
Posterior Glide
117
Ulnar Abduction SD HVLA
1) Supinate and extend elbow to 5 degrees
2) Ulnar Adduction
3) Medial to lateral thrust over medial olecranon
118
Ulnar Adduction SD HVLA
1) Supinate and extend elbow to 5 degrees
2) Ulnar abduction
3) Lateral to medial thrust over lateral olecranon
119
Anterior radial Head SD HVLA
1) Flexes elbow and pronates forearm
2) Hyperflexion
3) Thrusting radial head posteriorly
120
Posterior Radial Head SD HVLA
1) Extend and Supinate
2) Place thumb over posterior aspect of radial head
3) Rapid Hyperextension and thrusting radial head anteriorly
121
Wrist Flexion ROM
80-90 degrees
122
Wrist Extension ROM
70 Degrees
123
Wrist flexion is coupled with ___/___ glide of proximal carpal bones
1) Poster/Dorsal
124
Wrist Extension is coupled with __/___ glide of proximal carpal bones
Anterior/ventral
125
wrist extension/ventral carpal SD: HVLA
Whip-like thrust moving from extension to flexion through carpal dys.
126
Wrist Flexion/Dorsal Carpal SD HVLA
Whip-like thrust moving from flexion to extension
127
Knee Flexion ROM
145-150
128
Knee Extension
0
129
Posterior Fibular Head is a common dysfunction with ___ ankle sprains
Inversion
130
What must you do before the lateralization test ASIS compression
Reset the hips first
| **Always perform prior to supine evaluation of pelvis
131
Ankle Inversion ROM:
20
132
Talocalcaneal Inversion ROM:
5
133
Ankle Eversion ROM
10-20
134
Talocalcaneal Eversion ROM
5
135
Posterior Fibular Head HVLA
Evert, Dorsiflex foot and ankle and externally rotate the leg and then abruptly flex the knee
136
Inhalation flattens the lumbar lordotic curve and causes the sacrum to move ___ and the apex to move ____.
Posteriorly
| Anteriorly
137
Exhalation causes lordotic curve increases and then the base moves ___ while the apex moves ___
1) Anteriorly
| 2) Posteriorly
