OMM COMAT Flashcards
1
Q
What is an isotonic concentric contraction?
A
approximate ends
2
Q
What is an isotonic eccentric contraction?
A
further ends
3
Q
What is an isometric contraction?
A
like muscle energy; patient makes a contraction against an outside force; no approximation or lengthening of the muscle
4
Q
Explain the rule of 3s
A
T1-3 -> TP located at the same level as the SP
T4-6 -> TP located 1/2 level above SP
T7-10 -> TP located 1 full level above SP
T11 -> TP located 1/2 level above SP
T12 -> TP located at the same level as SP
5
Q
Which way are the facets oriented in the cervical spine?
A
BUM (backwards, upwards, medial)
6
Q
Which way are the facets oriented in the thoracic spine?
A
BUL (backwards, upwards, lateral)
7
Q
Which way ware the facets oriented in the lumbar spine?
A
BM (backwards, medial)
8
Q
What is the direction of treatment for counterstain of the anterior cervicals?
A
fSARA
9
Q
What is the direction of treatment for counterstain of the anterior thoracic?
A
fSTRA
10
Q
What is the direction of treatment for counterstain of the anterior lumbars?
A
fSART
11
Q
What is the direction of treatment for counterstain of the anterior ribs?
A
fSTRT
12
Q
What is the direction of treatment for counterstain of the posterior cervicals?
A
eSARA
13
Q
What is the direction of treatment for counterstain of the posterior thoracic?
A
eSARA
14
Q
What is the direction of treatment for counterstain of the posterior lumbars?
A
eSARA
15
Q
What is the direction of treatment for counterstain of the posterior ribs?
A
fSARA
16
Q
What is the treatment position for counterstain of AC1?
A
maverick point
Ra
17
Q
What is the treatment position for counterstain of AC7?
A
maverick point
F STRA
18
Q
What is the treatment position for counterstain of AT1-6?
A
maverick points
F
19
Q
What is the treatment position for counterstain of AL1?
A
maverick point
AL1 F STRA
20
Q
What is the treatment position for counterstain of AL5?
A
maverick point
F SARA
21
Q
What is the treatment position for counterstain of PC1 midline?
A
maverick point
F
22
Q
What is the treatment position for counterstain of PC3 midline?
A
maverick point
F SARA
23
Q
What is the treatment position for counterstain of PT midline?
A
maverick points
E
24
Q
What is the treatment position for counterstain of PR1?
A
maverick point
E SART
25
Where are AL1-5 points located?
```
AL1 - ASIS
AL2 - AIIS
AL3 - lateral to AL2
AL4 - inferior to AL2
AL5 - superior pubic ramus/pubic symphysis
```
26
What are some causes of psoas dysfunction?
bending forward over a work bench, standing up too quickly, or quickly jumping up from a chair; ureteral calculi, diverticulitis
27
What somatic dysfunctions/PE findings would you expect with psoas dysfunction?
contralateral pelvic shift, gait abnormalities, increased lumbar lordosis, positive Thomas test. Spine will flex, rotate, and sideband toward the hypertonic muscle.
28
What is the counterstain tender point for the psoas? How do you treat it?
2/3 distance from the ASIS to the umbilicus. Treat with flexion, SB toward, ER
29
What motion occurs around each of the sacral axes?
superior - respiration and cranial motion
midline - postural motion
oblique - weight shifting during gait
inferior - innominate rotation
30
What does the sacrum do during inhalation? Exhalation?
sacral extension during inhalation; sacral flexion during exhalation
31
What motion occurs at the SBS during cranial extension?
Flexion
32
What motion occurs at the SBS during cranial flexion?
Extension
33
What are the flexed sacral torsion somatic dysfunctions?
R on R or L on L
34
What are contraindications to HVLA?
osteoporosis, fractures, cancer, RA, Down syndrome
35
Where is AC7 located? What muscle is it associated with? What is the treatment?
Distal 1/3 of the clavicle; associated with the SCM (specifically the clavicular head); treat with F, SB towards, R away
36
If the spring test is positive, what kind of sacral dysfunction do you have?
Extension
37
If the sphinx test is positive, what kind of sacral dysfunction do you have?
Extension
38
If the spring test is negative, what kind of sacral dysfunction do you have?
Flexion
39
If the sphinx test is negative, what kind of sacral dysfunction do you have?
Flexion
40
What are the rules of L5 mechanics in relation to the sacrum?
L5 F/E = opposite sacrum
L5 rotation = opposite sacrum
L5 SB = same axis that the sacrum is on
41
What hypertonic muscle can cause an anterior innominate rotation? What muscle will you use to treat it with MET?
hypertonic quads; use hamstrings
42
What hypertonic muscle can cause a posterior innominate rotation? What muscle will you use to treat it with MET?
hypertonic hamstrings; use quads
43
Which ribs are typical ribs? Why?
3-10; contain head, neck, tubercle, angle, and shaft
44
Which ribs are atypical ribs? Why?
```
1 = no rib angle
2 = another tubercle
11-12 = no tubercle or neck
```
45
Which ribs are true ribs? Why?
1-7; Connect to the sternum
46
Which ribs are false ribs? Why?
8-10; connect to cartilage that connects to sternum
47
Which ribs exhibit pump handle motion?
1-5
48
Which ribs exhibit bucket handle motion?
6-10
49
What motion do ribs 11-12 exhibit?
caliper; move outward with inhalation, inward with exhalation
50
What are the primary muscles of respiration?
diaphragm, intercostals
51
Where does the diaphragm attach to the body?
Ribs 6-12, L1-L3, xyphoid process
52
What are the secondary muscles of respiration?
scalene, pec minor, serratus anterior, latissimus dorsi
53
What muscle do you target with MET of exhalation dysfunction of rib 1?
anterior + middle scalene
54
What muscle do you target with MET of exhalation dysfunction of rib 2?
posterior scalene
55
What muscle do you target with MET of exhalation dysfunction of rib 3-5?
pec minor
56
What muscle do you target with MET of exhalation dysfunction of ribs 6-8?
serratus anterior
57
What muscle do you target with MET of exhalation dysfunction of ribs 9-10?
latissimus dorsi
58
How do you treat a superior dysfunction of the AC joint with MET?
supinate hand, patient will pull arm down against physician's force
59
How you treat an inferior dysfunction of the AC joint with MET?
pronate hand, patient will pull arm down against physician's force
60
How do you treat a superior dysfunction of the SC joint with MET?
use subclavius m. -> pt moves elbow backward (set up position) and tries to punch fist forward against physician's force
61
How you treat an inferior dysfunction of the SC joint with MET?
use SCM -> pt rotates away from side of dysfunction (set up position) and tries to sideband head toward side of dysfunction against physician's force
62
What are the seven stages of Spencer's technique?
Every Fine Cat Takes An (x2) Indoor Piss
(Extension, Flexion, Compression w/ circumduction, Traction w/ circumduction, ABduction, Adduction with ER, Internal rotation, Pump)
63
What is the action of the supraspinatus m.? Innervation? Nerve roots?
ABduction; suprascapular nerve; C5-C6
64
What is the action of the infraspinatus m.? Innervation? Nerve roots?
External rotation; suprascapular nerve; C5-C6
65
What is the action of the teres minor n.? innervation? Nerve roots?
External rotation; axillary n.; C5-C6
66
What is the action of the subscapularis m.? Innervation? Nerve roots?
Internal rotation; major and minor nerves to sub scapular m.; C5-C7
67
What is the treatment position for counterstain of the supraspintatus muscle?
Abduction (mostly), external rotation, flexion (slight, to adjust)
68
What is the treatment position for counterstain of the infraspinatus m.?
External rotation (mostly); Abduction, Flexion (slight, to adjust)
69
What is the treatment position for counterstain of the teres minor m.?
External rotation (mostly); Abduction, Flexion (slight, to adjust)
70
What is the treatment position for counterstain of subscapularis m?
Internal rotation (mostly); Extension (slight, to adjust)
71
When you have a valgus carrying angle (>15 deg), what are the actions at the ulna and wrist?
Ulna is abducted, wrist is adducted (elbow close to body)
72
When you have a varus carrying angle (<3 deg), what are the actions at the ulna and wrist?
Ulna is adducted, wrist is abducted) (elbow away from body)
73
When you pronate your arm, where does the radial head go?
posterior
74
When you supinate your arm, where does the radial head go?
anterior
75
What is the treatment position for counterstain of the long head of the biceps?
Flex, abduct, internally rotate
76
What is the treatment position for counterstain of medial epicondylitis?
flexion, pronation, adduction (medial epicondylitis = golfer's elbow, all flexors attach here)
77
What is the treatment position for counterstain of lateral epicondylitis?
extend, supinate, ABduct (lateral epicondylitis = tennis elbow, all extensors attach here)
78
What are the steps of treatment for Spencer's technique of the hip?
Felines Eating Catnip Trip Into Everything Around Austin
Flexion, Extension, Compression with circumduction, Traction with circumduction, Internal rotation, External rotation, Abduction, Adduction
79
What is the origin and insertion of the piriformis m?
```
origin = posterior sacrum
insertion = greater tubercle of the femur
```
80
What is the action of the piriformis m.?
LE external rotation
81
What is the treatment position for counterstain of the MCL and medial meniscus?
Flexion, Adduction, Internal rotation
82
What is the treatment position for counterstain of the LCL and lateral meniscus?
Flexion, ABduction, External rotation
83
What is the treatment position for counterstain of the ACL?
pillow behind femur, tibia posterior
84
What is the treatment position for counterstain of the PCL?
pillow behind tibia, push femur posterior
85
What is the treatment position for counterstain of the piriformis m.?
External rotation (mostly), Abduction, flexion (slight, to adjust)
86
What is the treatment position for counterstain of the glut muscles?
Extension (mostly), can add Abduction and external rotation slightly to adjust
87
What is the counterstain point and treatment position for psoas m.?
2/3 between ASIS and umbilicus; treat with flexion, external rotation, SB toward
88
What is the counterstain point and treatment position for iliacus m.?
1/3 between ASIS and umbilicus; treat with flexion, external rotation, ABduction
89
What is the motion of pronation at the foot? What motions do the talus and tibia do during pronation of the foot?
Pronation of foot = dorsiflexion, eversion, external rotation; talus and tibia externally rotate, talus also moves posteriorly
90
What is the motion of supination at the foot? What motions do the talus and tibia do during supination of the foot?
Supination of foot = plantar flexion, inversion, internal rotation; talus and tibia will internally rotate, talus also moves anteriorly
91
What is the motion of the fibular head with dorsiflexion of the foot?
fibular head moves anterior with dorsiflexion; lateral malleolus moves posterior
92
What is the motion of the fibular head with plantar flexion of the foot?
fibular head moves posterior with plantar flexion; lateral malleolus moves anterior
93
What bones make up the transverse arch of the foot?
navicular, cuneiforms, cuboid
94
What bones make up the medial longitudinal arch of the foot?
navicular, cuneiforms, metatarsals 1-3, talus
95
What bones make up the lateral longitudinal arch of the foot?
cuboid, metatarsals 4-5, calcaneus
96
What is the counterstain position for treatment of the lateral ankle ligaments? (anterior talofibular, calcaneofibular, posterior talofibular)
Eversion of foot
97
What is the Cobb angle for a mild scoliotic curve? What's the treatment?
5-15; OMM
98
What is the Cobb angle for a moderate scoliotic curve? What's the treatment?
20-45; OMM + brace
99
What is the Cobb angle for a severe scoliotic curve? What's the treatment?
>50 compromises respiration; >75 compromises heart function; surgery
100
What is the difference between a functional and structural scoliotic curve?
functional curve goes away with movement of the spine; a structural curve is always present
101
What findings on exam suggest an acquired short leg syndrome?
posterior innominate rotation, superior shear, psoas syndrome
102
What findings on exam suggest a congenital short leg syndrome?
anterior innominate rotation, inferior shear, inferior sacral base on side of short leg, lumbar spine convex on side of short leg
103
How do you treat short leg syndrome with heel lifts?
1/8", increase by 1/8" every 2 weeks for healthy patient; older patient = 1/16", increase by 1/16" every 2 weeks; trauma = give all length back at once (no time for the body to compromise)
104
What are contraindications to treating with lymphatics?
cancer, fractures, severe infection
105
What is the order of treatment locations for lymphatics?
1. thoracic outlet (clavicle, ribs 1-2)
2. diaphragm or axilla (dome, ribs 6-12, L1-L3, xyphoid, pec minor)
3. hip (psoas, quads, innominate)
4. posterior knee (hamstrings, gastroc)
5. any distal dysfunction
106
What structures receive sympathetic innervation from T1-T6?
head, neck, esophagus, heart, lungs
107
What structures receive sympathetic innervation from T5-T9?
(think of celiac ganglia); stomach, duodenum, pancreas, liver, gallbladder, spleen
108
What structures receive sympathetic innervation from T10-T11?
(think of superior mesenteric ganglia); remainder of small intestines, cecum, appendix, ascending colon, first 1/2 of transverse colon, kidneys, upper ureters, gonads
109
What structures receive sympathetic innervation from T12-L2?
(think of inferior mesenteric ganglia); rest of the colon, lower ureters, bladder, prostate, rest of sex organs
110
Where is each finger located in the vault hold?
Index finger = greater wing of the sphenoid
Middle = temporal bone anterior to ear
Ring = temporal bone posterior to ear
Little = squamous occiput
111
How is a cranial torsion dysfunction named? What/how many axes does it rotate around? In what directions?
named for the more superior greater wing of the sphenoid; rotates OPPOSITE directions around 1 AP axis
112
How is a cranial SB + rotation dysfunction named? What/how many axes does it rotate around? In what directions?
Named for which direction the sphenoid is rotating; rotate in the SAME direction around 1 AP axis and then rotate in OPPOSITE directions around 2 vertical axes
113
How is a cranial shear dysfunction named? What/how many axes does it rotate around? In what directions?
Named for which direction the sphenoid is rotating; rotate in the SAME direction around 2 horizontal axis.
114
How is a cranial lateral dysfunction named? What/how many axes does it rotate around? In what directions?
Named for the direction the sphenoid is moving. Rotate in opposite directions around one vertical axis?
115
What is a normal CRI?
8-12 per minute
116
Where is the dura mater attached to the spine?
foramen magnum, C2, C3, and S2
117
What are factors that can increase the PRM?
systemic fever, strenuous physical exercise, OMT directed at the PRM/CRI
118
What are factors that can decrease the PRM?
emotional or physical stress, depression, chronic infection, chronic fatigue
119
What five factors make up the PRM?
1. Flow of CSF
2. Mobility between sacrum and ilia
3. Motility of the brain and spinal cord
4. Mobility of the intracranial and intraspinal membranes
5. Involuntary mobility of the cranial bones
120
Describe the mobility of the brain and spinal cord in relation to the PRM.
Coiling during flexion/inhalation and uncoiling during exhalation/extension
121
Impingement of the sciatic nerve between the piriformis and what ligament is a common cause of lower back/leg pain?
sacrospinous ligament
122
What are the four rules of the interaction between L5 and the sacrum?
1. Clinically significant interactions between L5 and the sacrum only occur during sacral torsions (not shears).
2. L5 will always be sideband to the same side as the axis of the torsion
3. Seated flexion test is positive on the OPPOSITE side as the axis of the torsion
4. L5 will always be rotated to the opposite of the direction of the sacral torsion
