Midterm Material Flashcards
(108 cards)
1
Q
1961 event where DOs traded degree for MD degree
A
California incident; prohibited DO licenses
2
Q
1996-2000 surgeon general of army
A
Lieutenant General Ronald R.Blank, DO
3
Q
1st minority AOA president
A
Marcelino Oliva
4
Q
1st Tenet of Osteopathic Medicine
A
The mind, body & spirit are a unit
5
Q
2nd Tenet of Osteopathic Medicine
A
The body is capable of self-regulation, self-healing, and health maintenance
6
Q
3rd Tenet of Osteopathic Medicine
A
Structure and function are reciprocally interrelated
7
Q
4th Tenet of Osteopathic Medicine
A
Rational treatment is based upon understanding and implementing the other 3 tenets
8
Q
Active ROM
A
Pt motivated and pt must give maximum effort
9
Q
Acute Somatic Dysfunction
A
Immediate or short-term impairment or altered function
Characterized by: vasodilation, edema, tenderness, pain, and tissue contraction
10
Q
Anatomical Barrier (AB)
A
limit of motion imposed by anatomical structure; limit of passive motion
11
Q
Anterior Landmarks
A
acromion, clavicle, rib cage, umiblicus, crest of ilium, greater trochanter, patellar alignment
12
Q
Articulatory Technique (ART)
A
- “sprining” techniques; gentle and reptetitive motions through restrictive barrier
- low velocity/high amplitude
- direct
13
Q
Articulatory Technique Contraindications
A
- fracture/dislcoation
- neurologic entrapment syndrome
- serious vascular compromise
- local malignancy
- local infection
- bleeding disorders
14
Q
Articulatory Technique Indications
A
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
Q
Asymmetry
A
Absence of symmetry of position or motion
16
Q
Asymmetry of muscles treatment goals
A
return symmetry and normalize tone
17
Q
AT Still flung banner of osteopathy to the breeze on…
A
June 22, 1874 at 10am
18
Q
Axial and Appendicular Fascia (investing layer)
A
internal to pannicular layer; fused to panniculus and surrounds all muscles and periosteum of bone and peritendons of tendons
19
Q
Barrier “end feel” characteristics
A
Bone to bone (elbow extension)
Soft tissue approximation (knee flexion)
Tissue stretch (finger extension)
20
Q
Bind
A
palpable restriction of connective tissue mobility
21
Q
Bogginess (tissue texture change)
A
tissue texture abnormality characterized by sense of sponginess in tissue (resulting from congestion due to increased fluid)
22
Q
Chronic Somatic Dysfunction
A
Impairment or altered function of related components of the somatic system
Characterized by: tenderness, itching, fibrosis, paresthesias, tissue contraction
23
Q
Concentric isotonic muscle contraction
A
contraction of a muscle with shortening of muscle length
24
Q
Contraction
A
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
