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Flashcards in Midterm Material Deck (108)
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1

1961 event where DOs traded degree for MD degree

California incident; prohibited DO licenses

2

1996-2000 surgeon general of army

Lieutenant General Ronald R.Blank, DO

3

1st minority AOA president

Marcelino Oliva

4

1st Tenet of Osteopathic Medicine

The mind, body & spirit are a unit

5

2nd Tenet of Osteopathic Medicine

The body is capable of self-regulation, self-healing, and health maintenance

6

3rd Tenet of Osteopathic Medicine

Structure and function are reciprocally interrelated

7

4th Tenet of Osteopathic Medicine

Rational treatment is based upon understanding and implementing the other 3 tenets

8

Active ROM

Pt motivated and pt must give maximum effort

9

Acute Somatic Dysfunction

Immediate or short-term impairment or altered function
Characterized by: vasodilation, edema, tenderness, pain, and tissue contraction

10

Anatomical Barrier (AB)

limit of motion imposed by anatomical structure; limit of passive motion

11

Anterior Landmarks

acromion, clavicle, rib cage, umiblicus, crest of ilium, greater trochanter, patellar alignment

12

Articulatory Technique (ART)

- "sprining" techniques; gentle and reptetitive motions through restrictive barrier
- low velocity/high amplitude
- direct

13

Articulatory Technique Contraindications

- fracture/dislcoation
- neurologic entrapment syndrome
- serious vascular compromise
- local malignancy
- local infection
- bleeding disorders

14

Articulatory Technique Indications

well tolerated by:
- arthritic pts
- elderly or frail
- critically ill or post operative
- infants or very young patients
- patients unable to cooperate with instructions

15

Asymmetry

Absence of symmetry of position or motion

16

Asymmetry of muscles treatment goals

return symmetry and normalize tone

17

AT Still flung banner of osteopathy to the breeze on...

June 22, 1874 at 10am

18

Axial and Appendicular Fascia (investing layer)

internal to pannicular layer; fused to panniculus and surrounds all muscles and periosteum of bone and peritendons of tendons

19

Barrier "end feel" characteristics

Bone to bone (elbow extension)
Soft tissue approximation (knee flexion)
Tissue stretch (finger extension)

20

Bind

palpable restriction of connective tissue mobility

21

Bogginess (tissue texture change)

tissue texture abnormality characterized by sense of sponginess in tissue (resulting from congestion due to increased fluid)

22

Chronic Somatic Dysfunction

Impairment or altered function of related components of the somatic system
Characterized by: tenderness, itching, fibrosis, paresthesias, tissue contraction

23

Concentric isotonic muscle contraction

contraction of a muscle with shortening of muscle length

24

Contraction

Normal tone of muscle when it shortens

25

Contracture

Abnormal shortening of muscle due to fibrosis; result of chronic condition; muscle unable to reach normal length

26

Coupled motion

consistent association of motion about one axis with another motion about a second axis; principle motion cannot be produced without both

27

Creep

connective tissue under sustained, constant load will elongate (deform) in response to load

28

Crossed extensor reflex (MET)

used when muscle needing treatment is severely injured (burns or fractures); when flexor of one extremity is contracted volunarily, flexor muscle in contralateral extremity relaxes and extensor contracts

29

Describe Fascia

connective tissue layers composed of collagen fibers in an amorphous matrix of hydrated proteoglycans (PGs) which links collagen fiber networks together

30

Direct Techniques

go towards & eventually through the restrictive barrier

31

Ease

the direction in which connective tissue may be moved most easily during deformational stretching; palpated as a sense of tissue "looseness"

32

Eccentric isotonic muscle contraction

contraction of a muscle with increase in length of muscle

33

Ectomorph vs Endomorph vs Mesomorph

Ectomorph = associated w/ ectoderm (tall and lean)
Endomorph = associated w/ endoderm (thick and heavy); also pyknic
Mesomorph = associated w/ mesoderm (average person)

34

Ehlers-Danlos Syndrome Dx

Beighton score + Brighton criteria

35

Elastic barrier

range between physiologic and anatomic barrier or motion in which stretching occurs before tissue disruption; area that "warms up" with stretching

36

End Feel of ROM Meanings: abrupt, crisp, hard, elastic, empty

Abrupt - OA or hinge joint
Crisp - involuntary muscle guarding (pinched nerve)
Hard - somatic dysfunction
Elastic - like a rubber band
Empty - stops due to guarding (pt doesn't allow motion due to pain)

37

Factors Influencing Successful Muscle Energy - by Operator

- not controlling joint position in relation to barrier movement
- not providing counterforce in correct direction
- not giving accurate instruction
- moving to new joint position too soon after pt stops contracting

38

First and lasts states to legally licence DO's

Vermont and Mississippi

39

First Female Dean of Medical College

Barbara Ross-Lee

40

first woman to receive DO degree

Jeanette Bolles

41

Functional unit of spinal cord

two vertebrae, their associated disc, neurovascular and other soft tissues

42

Hooke's Law

Strain (deformation) placed on elastic body is proportion to stress (force) placed on it

43

Hypertonia

state of abnormally high muscle tension; spastic

44

Hypotonia

state of low muscle tone; reduced muscle strength

45

Hysteresis

Difference between loading and unloading characteristics represents energy lost in connective tissue; energy lost is hysteresis
Stretching connective tissues into its plastic deformational range will bring about lengthening of tissue

46

Indications of MFR

- somatic dysfunction
- when HVLA or Muscle Energy is contraindicated (consider indirect MFR)
- when counterstrain may be difficult due to pt's inability to relax

47

Indirect Techniques

Go away from restrictive barrier

48

INR (Integrated Neuromusculoskeletal Release)

Uses REM's to speed the treatment of process during MFR

49

Isokinectic stregthening (MET)

when muscle is chronically tight, antagonist muscle is chronically loose (leads to weakness of muscles - asymmetry)
- sustained gentle pressure (10-20lbs); allows motion but slowly and controlled

50

Isolytic lengthening (MET)

used to lenghten muscle shorted by contracture or fibrosis (stroke/cerebral palsy)
patient contracts and and physician pulls against the contraction; can be painful technique (uses maximal force)

51

Isolytic muscle contraction

non-physiologic; attempted concentric contraction with an external force causing muscle lengthening

52

Isometric Muscle contraction

contraction of a muscle with no change in distance between origin and insertion (no length change)

53

Isometric vs Isotonic Procedures

Isometric - light to moderate contraction and unyeilding counterforce

Isotonic - hard to maximal contraction and counterforce permits controlled motion

54

joint mobilization methods

direct, indirect, combined, physiological, exaggeration

55

Joint Mobilization using Muscle Force (MET)

Hypertonicity of musculature across a joint causes distortion of joint; restoration of motion to the joint results in gapping or reseating of joint relations; uses maximal muscle contraction (usually 30-50 lbs)

56

Linkage

relationship of joint mechanism with surrounding structures; linking structures give you greater ROM
Ex. shoulder/spine

57

Meningeal Fascia

surrounds the nervous system; includes the dura mater

58

MET vs ART

MET: direct, pt muscle contraction 3-5 seconds 3-5 times, active (requires pt cooperation)
ART: direct, repetitive physician directed motions, passive (pt relaxed)

59

MFR Endpoint

when a 3D release is often palpated: warmth, softening, and increase compliance/ROM
- continue til forces no longer produce change

60

Models of Osteopathic Treatment

Psychosocial
Respiratory-circulation
Bioenergy
Biomechanical
Neurological

61

Most common compensatory pattern

L/R/L/R
tentorium cerebelli/thoracic inlet/thoracolumbar diaphragm/pelvic diaphragm

62

Muscle Energy Contrainidcations

- local fracture/dislocation
- moderate to severe segmental instability of cervical spine
- neurologica symptoms or signs on rotation of neck
- low vitality
- unable/unwilling to follow commands
- situation that could be worsened by muscle energy (post surgical, post MI, recent eye surgery)

63

Newton's Third Law

when 2 bodies interact, force exerted by one is equal in magnitude and opposite in diretion as forces exerted by other

64

Oculocephalogyric Reflex (MET)

eye movements reflexively affect cervical and truncal musculature as body attempts to follow lead provided by eye motion (exceptionally gentle)

65

Pannicular Fascia Layer (panniculus)

outermost layer derived from somatic mesenchyme and surrounds entire body except orfices; outer layer is adipose and inner layer is membranous and adherent

66

Passive ROM

Pt must relax fully and you must "block the linkage" of associated structures

67

Physiologic Barrier (PB)

limit of active motion

68

Flexion/Extension Plane

Sagittal

69

Abduction/Adduction Plane

Frontal/Coronal

70

Horizontal Abduction/Adduction Plane

Transverse/Horizontal

71

Plumb Line

Lateral View Landmarks: external auditory canal, acromion process, greater trochanter, anterior lateral malleolus

72

Post-isometric relaxation (MET)

muscle->golgi tendon organ (GTO)->tendon
muscle contraction->increases tension in GTO->inhibition of muscle contraction and muscle releases further

73

Posterior Landmarks

scapular spine, scapular angle, arm carriage, spinous process alignment, iliac crests, PSIS, gluteal line, popliteal space, achilles tendon

74

Reciprocal Inhibition (MET)

when a gentle contraction is initiated in the agonist muscle, there is a reflex relaxation of muscle antagonistic group; uses ounces not pounds of pressure; same side - ipsilateral

75

REMs

- Breath holding
- R/L cervical rotation
- Prone and supine simulated swimming and pendulum arm swing
- Isometric limb and neck movement against table or chair
- Pt evoked movement from cranial nerves (eye, tongue, jaw, oropharynx)

76

Respiratory Assistance (MET)

use of breathing and exaggerated respiratory motion in the muscle forces (does not use a lot of force); used in treating ribs and sacrum

77

Restricted motion of soft tissue Treatment Goal

set the fascia free

78

Restriction of Motion

resistance or impediment to movement

79

Restrictive barrier (RB)

a functional limit that abnormally diminishes normal physiologic range

80

Ropiness

Hard, firm, rope-like muscle tone; usually indicates chronic condition

81

SAM VLAN

Skeletal
Arthrodial
Myofascial structures and their related

Vascular
Lymphatic
and
Neural elements

82

Sherrington's Law

When muscle receives a nerve impuse to contract, its antagonist receive a simultaneous impulse to relax

83

Soft Tissue (ST) Contraindications

- Severe Osteoporosis - prone pressure may be contraindicated but lateral recumbent techniques could be applied
- Acute Injuries - direct techniques may do additional damage and increase pain

84

Soft Tissue (ST) Indications

- Diagnostically to idenfity areas of restricted motion, tissue texture changes, and sensitivity
- Feedback about tissue response to OMT
- Provide general state of relaxation
- Enhance circulation to myofascial structures

85

Soft Tissue Absolute Contraindications

Don't use in local region of any:
- fracture/dislcoation
- neurologic entrapment syndrome
- serious vascular compromise
- local malignancy
- local infection
- bleeding disorders

86

Soft Tissue Techniques

Stretch - increase distance between origin and insertion
Knead - repetitive pushing of tissue perpendicular to muscle fibers
Inhibition - push and hold perpendicular to fibers; hold until relaxation of tissue

87

Somatic Dysfunction

Impaired or altered function of related components of the somatic (body framework) system

88

Spasm

suddent involuntary muscular contraction usually accompanied by pain/restriction of normal function

89

Static vs Dynamic Flexibility

Static - max ROM a joint can achieve with externally applied force
Dynamic - ROM an athelete can produce and speed at which it can be produced

90

Stress-Strain

Stress is force that attempts to deform connective tissue structure
Strain is percentage of deformation of connective tissue
During cyclic loading of tendon, stress-strain curve shifts right

91

TART

Diagnostic Criteria for Somatic Dysfunction

Tissue texture abnormalities
Asymmetry of structure or motion
Restriction of motion
Tenderness

92

Tenderness Treatment Goals

normalize neurologic activity (pain) and improve abnormal somato-somatic and somato-visceral reflexes

93

Tenderpoints

small discrete hypersensitive areas within myofascial structures - results in localized pain

94

Timeline of AT Still life events: 1864, 1874 (2), 1885

1864 - battle of westport; 1874 - flung banner of osteopathy; 1874 - removed from methodist church; 1885 - coins term "osteopathy

95

Tissue Texture Abnormalities

Palpable change in tissues
Ex. bogginess, thickening, striginess, ropiness, firmness, temperature change, moisture change

96

Tissue Texture Abnormality Treatment Goals

- stretch and increase elasticity of shortened myofascial structures
- improve local tissue nutrition and removal of metabolic waste to normalize tissues

97

Trigger point

small discrete hypersensitive areas within myofascial structures - palpation causes referred pain away from site

98

Visceral Fascia

surrounds body cavities (pleural, pericardial, and peritoneum)

99

What body systems do somatic dysfunction have an affect on?

nervous + fluid dynamics + biomechanics + visceral

100

What did AT Still study from his father?

Medicine and ministry

101

What is Muscle Energy?

- voluntary contraction of patient muscle in a precisely controlled direction
- varying levels of intensity
- against a distincly executed counterforce
- active technique
- can be direct or indirect

102

What makes up ROM?

Direction, Range, Quality

103

What year did American School of Osteopathy open?

1892

104

When were DO's accepted as equal to MDs in military? When were DO's drafted as military medical officers?

1963; 1967

105

Which is greater? PROM or AROM

PROM because pt's muscles are relaxed

106

Which part of the spine produces the greatest ROM?

Cervical Spine

107

Who decreased mortality rate in obstetrics by washing hands?

Ingaz Semmelweiss

108

Wolff's Law

bone will develop under the sress placed upon it; extends to fascia too