Flashcards in OMM Deck (58):
1
Which two bones articulating mediate the primary respiratory mechanism?
Sphenoid and Occipital bones that make up the SBS
2
Why is Cervical HVLA contraindicated for RA patient?
Weak transverse lig of dens can cause Atlanto-axial subluxation
3
Which areas should you treat first?
1. Upper Thoracic
2. Upper Rib
3. OA
4. Cervical spine
5. Peripheral out to extremities
4
Chapman points:
Retina
Nasal Sinuses
Ears
Retina: Lateral humerus neck
Nasal Sinuses: Below proximal 1/3 clavicle
Ears: Above proximal 1/3 clavicle
5
Chapman points:
Pharynx
Larynx
Neck
Pharynx: Manubrium junction below 1st rib
Larynx: 2nd rib superior aspect
Neck: Humerus at medial aspect
6
Chapman points:
Heart, Bronchus, Esophagus, Thyroid
Upper Lung
Lower Lung
Heart, Bronchus, Esophagus, Thyroid: 2nd ICS
Upper Lung: 3rd ICS
Lower Lung: 4th ICS
7
Chapman points:
Pylorus
Stomach acid, peristalsis
Liver
Gallbladder
Pylorus: Sternum
Stomach acid, peristalsis: Left 5th, 6th ICS
Liver: Right 5th ICS
Gallbladder: Right 6th ICS
8
Chapman Points:
Spleen
Pancreas
Spleen: Left 7th ICS
Pancreas: Right 7th ICS
9
Chapman Points:
Adrenals
Kidneys
Small Intestine
Adrenals: Anterior: 2" above, 1" lateral to umbilicus; Posterior: T11-T12 between spinous and trans. processes
Kidneys: Anterior: 1" above, 1" lateral to umbilicus;
Posterior: T12-L1 between spinous and trans. processes
Small intestine: 7th-9th ICS bilaterally
10
Chapman Points:
Intestinal peristalsis
Appendix:
Intestinal peristalsis: between Iliac crest and Gr. Trochanter
Appendix: Anterior: Tip Rib 12;
Posterior: Tip of T11 trans. process
11
Chapman Points:
Cecum
Transverse 1/3 Colon
Transverse 2/3 Colon
Sigmoid
Rectum
Cecum: Right hip
Transverse 1/3 Colon: Right knee
Transverse 2/3 Colon: Left knee
Sigmoid: Left hip
Rectum: Medial femur
12
Chapman Points:
Bladder
Prostate, Vagina
Urethra
Bladder: Periumbilicus
Prostate, Vagina: Sacral sulcus
Urethra: 2cm lateral to pubic symphysis
13
Still Technique: procedure
Ease
Compress
Barrier
(Still Technique is "EC", but FPR is "NiCE")
14
FPR: procedure
Neutral
Compress
Ease
(Still Technique is "EC", but FPR is "NiCE")
15
Ant. Lumbar Tenderpoints:
L1:
L2-L4:
L5:
Tx?
L1: medial to ASIS
L2-L4: on the AiiS
L5: Lateral to pubic symphysis
Tx: supine, flex hip and knees, rotate away
16
posterior Lumbar Tenderpoints:
location?
Tx?
Either side of that level's spinous processes
Tx: prone, extend hip, sidebend away
17
Thoracic Rule of 3's
T1-T3: spinous process = transverse process
T4-T6: spinous process 1/2 way down between TP of adjacent vertebrae
T7-T9: spinous process at level of next vertebra's TP
T10-T12: spinous process = transverse process
18
Freyette's Law 1
v.
Freyette's Law 2
N, SLRR (opposite) - group curve
v.
F/E, SRRR (same) - individual vertebra
19
Scoliosis COBB angles and complications
5-15: Mild
20-45: Moderate [Tx. Start bracing]
>50: Respiratory compromise
>75: Cardiac compromise
20
Superior Facet Orientation:
Cervical
Thoracic
Lumbar
"BUMBLBM"
BUM
BUL
BM
21
What techniques are indirect and passive?
Counterstrain, FPR
22
What techniques are direct and passive?
Cranial, HVLA, Lymphatics, Chapman
23
What techniques are direct and active?
ME (post isometric relaxation and reciprocal inhibition)
24
Rib Motions:
1-5
6-10
11, 12
1-5: pump
6-10: bucket
11, 12: caliper
25
Rib mm's:
1
2
3-5
6-9
10-11
12
1: anterior and middle scalenes
2: posterior scalene
3-5: pec minor
6-9: serratus anterior
10-11: latissimus dorsi
12: quadratus lumborum
26
What lines form Ferguson's Lumbosacral angle?
formed between a line across the plane of the superior margin of S1 and a horizontal line
27
Short Leg Syndrome
results in?
How is the Ferguson's Lumbosacral angle affected?
results in sacral base unleveling
vertebral sidebending and rotation
innominate rotation
increases lumbosacral angle
28
Guidelines for Heel Lift
Fragile pt?
Flexible pt?
Max heel lift possible?
If pt. is fragile: start with 1/16" (1.6 mm) and increase by that much every 2 weeks
If pt. is flexible: start with 1/8" (3.2 mm) and increase by that much every 2 weeks
Max heel lift possible: 1/2"
29
How does Rib Raising work?
What conditions is it good for?
↑ rib excursion to normalize Sympathetics
Asthma, viral pneumonia
30
Grading of Spondylolisthesis
1
2
3
4
5
1: 25% slipped forward
2: 50%
3: 75%
4: 100%
5: Spondylolisthesis
31
What happens to sacral base during inhalation/craniosacral flexion?
Extends/counternutates
32
What happens to sacral base during exhalation/craniosacral extension?
Flexes/nutates
33
Left on Left
Seated R
Sulcus R
ILA L
Spring (-)
34
Left on Right
Seated L
Sulcus R
ILA L
Spring (+)
35
Right on Right
Seated L
Sulcus L
ILA R
Spring (-)
36
Right on Left
Seated R
Sulcus L
ILA R
Spring (+)
37
Unilateral Extension L
Seated L
Sulcus R
ILA R
Spring (+)
38
Unilateral Extension R
Seated R
Sulcus L
ILA L
Spring (+)
39
Radial head motion
Pronate --> Posterior
Supinate --> Anterior
40
Tx. Anterior Fibular Head
AIIP
Invert, IntRot, Plantarflex
41
Tx. Posterior Fibular Head
PEED
Evert, ExtRot, Dorsiflex
42
What happens to fibular head when you dorsiflex the foot? When you plantarflex the foot?
Dorsiflex --> Fibular head moves forward
Plantarflex --> Fibular head moves backward
43
What is the Q angle?
What is the Q angle in Coxa Vara?
Q angle in Coxa Valga?
Angle between neck and femur shaft
Vara: 135
44
What are the components of Primary Respiratory Mechanism?
1. Brain and spinal cord have inherent motility
2. CSF fluctuates
3. Intracranial and intraspinal membranes' movement
4. Cranial bones articular mobility
5. Sacrum's involuntary movement
45
CranioRhythmic Impulse (CRI) normal value?
What makes it decrease?
Increase?
[10-14 cycles/min]
Decreased by stress, depression, chronic fatigue, infection, SBS compression
Increased by exercise, systemic fever, after CV4 technique
46
Placement of fingers in vault hold
Index: Gr. wing sphenoid
Middle: Pre-auricular Temporal bone
Ring: Mastoid process of Temporal bone
Pinky: Occiput squamous portion
47
What are the dural attachments?
Foramen magnum
C2
C3
S2: posterior superior portion (allows for sacral counternutation)
48
What happens during Craniosacral Flexion?
Midline bones flex
AP diameter ↓
Paired bones ExtRot
Sacral base extends (counternutates)
49
What happens during Craniosacral Extension?
Midline bones extend
AP diameter ↑
Paired bones IntRot
Sacral base flexes (nutates)
50
What nerve is treated in Condylar Decompression?
CN XII
51
What segment of the sacrum allows the firm attachment of the dura mater to move into counternutation during the flexion phase of craniosacral motion?
posterior superior portion of S2
52
What bones make up the sphenobasilar synchondrosis (SBS)?
articulation between the sphenoid and occiput
53
Tx. of choice for Fibromyalgia
Counterstrain
54
Superior vertical strain
sphenoid base moves superiorly causing index fingers to move inferiorly. Occiput base moves inferiorly and so do 5th fingers move inferiorly. Hands ulnar deviate.
55
What levels are viscerosomatic reflexes from dysfunctions of the head and neck associated with?
T1-T4
56
At what axis does innominate rotation occur?
Inferior transverse axis
57
If the greater wing of the sphenoid is greater on the left, what is the most likely cranial strain pattern?
Torsion
58