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OMM Final Flashcards

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1
Q

hip flexors

A 
iliacus*
psoas*
(iliosoas)
rectus femoris
sartorius
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2
Q

rectus femoris origin/insert

A

AIIS

patella

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3
Q

sartorius origin/insert

A

ASIS

medial tibia

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4
Q

hip extensors

A

semimembranosus
semitendinosus
biceps femoris
gluteus maximus

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5
Q

adductors

A 
adductor magnus*
adductor brevis*
adductor longus*
gracilis
pectineus
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6
Q

abductors

A

gluteus medius
gluteus minimus
tensor fascia lata

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7
Q

piriformis fxn

A

ext rotation*
abduction
extension

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8
Q

what makes piriformis special

A

only rotator that connects to sacrum

only muscle on ant surface of sacrum

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9
Q

male pelvis

A 
narrow pubic arch
acute pubic angle
rounded iliac crest
heart shaped pelvic opening
sacral promontory not in line w/ pelvic brim
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10
Q

female pelvis

A 
broad pubic arch 
obtuse pubic angle
broad/flat iliac crest
oval shaped pelvic opening
sacral promontory in line w/ pelvic brim
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11
Q

innominate dysfunctions

A

rotational: ant or post
shear: sup or inf
flare: int or ext

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12
Q

steps of innominate dx

A

ID dysfuntion side:
standing flexion test
(reset pelvis)
ASIS compression

ID dysfunction:
ASIS/PSIS positions
(reset pelvis)
Leg lengths

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13
Q

standing flexion test findings

A

side that moves first/furthest is side of dysfunction (+)

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14
Q

ASIS compression test findings

A

side that’s harder to press in dysfunction side (+)

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15
Q

ASIS/PSIS position findings

A 
ASIS lo, PSIS hi --> ant rot
ASIS hi, PSIS lo --> post rot
ASIS hi, PSIS hi --> sup shear
ASIS lo PSIS lo --> inf shear
ASIS med, PSIS lat --> .inflare
ASIS lat, PSIS med --> outflare
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16
Q

leg length findings

A

short –> post rotation or sup shear
long –> ant rot or inf shear
even –> in/outflare

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17
Q

ME innominate ant rot

A 
pt supine
flex hip/knee
monitor PSIS
3-5 x for 3-5 s
final stretch
return, RESET, reassess
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18
Q

ME innominate post rot

A 
pt supine, dysfunctional leg off table
stabilize opp ASIS
extend hip to barrier
3-5 x for 3-5 s
final stretch
return, RESET, reassess
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19
Q

ME innominate inflare

A 
pt supine
stabilize opp ASIS
flex hip 90
abduct to barrier
3-5 x for 3-5 s
final stretch
return, RESET, reassess
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20
Q

ME innominate outflare

A 
pt supine
monitor dysfunctional PSIS 
flex hip 90
adduct into barrier
pull PSIS lat during contraction
3-5 x for 3-5 s
final stretch
return, RESET, reassess
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21
Q

HVLA innominate superior shear

A 
pt supine
dr @ foot of table
grasp tib/fib, int rot
apply traction to barrier
thrust
return, RESET, reassess
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22
Q

sacrum fusion

A

5 unfused at birth
fusion begin @ 16
complete @ 26

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23
Q

muscles of sacrum (+fxns)

A

gluteus maximus (extend, abduct hip)
multifidus
piriformis (ext rotation, weak extension)

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24
Q

sacroiliac motion

A

nutation (~flexion)

counternutation (~extension)

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25
primary axis of sacroiliac mvmt
sup transverse axis (respiratory axis) | permanent
26
sacroiliac mvmt w/ resp
nutation (flex) @ exhalation | counternutation (ext) @ inhalation
27
secondary axis of sacroiliac mvmt
oblique axis temporary (when we walk) axis = locked side = closed SI joint
28
L5 flex/extend -->
sacral extend/flex
29
L5 sidebend -->
axis on same side | sidebent L --> (?) on L
30
L5 rotate -->
motion to opposite side | rotated L --> R (on ?)
31
type I vs II lumbar dysfunction -->
I --> ant rot | II --> post rot
32
ant torsions
physiologic (occur normally) L on L R on R
33
post torsions
non-physiologic (not normal) L on R R on L
34
tx for ant torsions
use gluteus maximus to pull dysfunctional base post
35
tx for post torsions
use piriformis to pull dysfunctional base ant
36
sacral shear dysfunctions
R/L unilateral flexion shear R/L unilateral extension shear bilateral flexion shear bilateral extension shear
37
R/L unilateral flexion shear
R/L half of sacrum moves ant
38
R/L unilateral extension shear
R/L half of sacrum moves post
39
sacral dx steps
``` seated flexion test spring test sacral sulcus inferior lateral angle (need 3/4) ```
40
seated flexion test findings
ID dysfunctional side feet planted first/furthest = + = dysfunctional opp side = axis
41
spring test findings
compression in sphinx | no recoil = + = post displacement of base (extension -->. RoL, LoR, UniER, UniEL, biE)
42
sacral sulcus (place)
medial to PSIS
43
inf lat angle (place)
inferior to PSIS by a few cm
44
SS/ILA findings (R axis)
deep SS L, deep ILA L (RoR) deep SS R, deep ILA R (LoR) deep SS L, deep ILA R (uniFL) deep SS R, deep ILA L (uniEL)
45
SS/ILA findings (L axis)
deep SS L, deep ILA L (RoL) deep SS R, deep ILA R (LoL) deep SS L, deep ILA R (uniER) deep SS R, deep ILA L (uniFR)
46
ME torsion directions
torso axis dr force
47
ME sacral ant torsion
``` up up up - use gluteus maximus pt in lat recumbent, chest up flex hips monitor base of dys side lift legs 3-5 for 3-5 final stretch return, reassess ```
48
ME sacral post torsion
``` up down down - use piriformis pt in lat recumbent, chest up flex hips monitor base of dys side lower legs (or just top) 3-5 for 3-5 final stretch return, reassess ```
49
ME sacral unilateral flexion shear
``` pt prone abduct/int rotate lower leg on dys side contact ILA of dys side push on INhalation resist on EXhalation return, reasses ```
50
ME sacral unilateral extension shear
``` pt prone, sphinx abduct/int rotate lower leg on dys side contact base of dys side push on EXhalation resist on INhalation return, reasses ```
51
ME sacral bilaterals
same as uni, but push on middle of base or ILA
52
pelvic floor make up
``` levator ani (puborectalis, pubococcygeous, iliococcygeous) transverse perineus muscle obturator fascia piriformis coccygeus ischial tuberocity ```
53
muscles attached closest to pubic symphysis
adductors
54
pubis dx steps
ASIS compression pubic tubercle positions tenderness
55
pubic tubercle position findings
symmetric, tender (compression) symmetric, widened (gapped) R/L superior (tender) --> R/L superior pubic shear R/L inferior (tender) --> R/L inferior pubic shear
56
ME inferior pubic shear
``` (same as ant rot innominate) pt supine gap PS (dr force open) flex hip/knee monitor PSIS 3-5 x for 3-5 s final stretch close PS (dr force close) return, RESET, reassess ```
57
ME superior pubic shear
``` (same as post rot innominate) pt supine, dysfunctional leg off table stabilize opp ASIS extend hip to barrier 3-5 x for 3-5 s final stretch gap PS (dr force open) return, RESET, reassess ```
58
piriformis dx steps
internal rotation | FAIR (flexion, adduction, internal rotation)
59
piriformis internal rotation findings
more difficult to IR --> piriformis dysfunction
60
FAIR findings
pain --> + --> piriformis dysfunction
61
piriformis counterstrain
spot: midpoint btwn sacrum and greater trochanter pt prone, dys leg off table hip/knee flex/abduct fine tune w/ ER
62
psoas dx steps
Thomas test
63
psoas major counterstrain
spot: 2/3 from ASIS to midline pt supine hip knee flex ST
64
tibiofibular dx steps
seesaw lateral malleolus and fibular head
65
tibiofibular dysfunctions
foot supination/inversion --> posterior fibular head | foor pronation/eversion --> ant fibular head
66
posterior fibular head ease
(supination) plantarflexion inversion adductions
67
anterior fibular head ease
(pronation) dorsiflexion eversion abduction
68
ME post fibular head
``` pt supine, knee bent monitor post aspect of fibular head dr force EXternal rotation 3-5 x for 3-5 s final stretch return, reassess ```
69
ME ant fibular head
``` pt supine, knee bent monitor ant aspect of fibular head dr force INternal rotation 3-5 x for 3-5 s final stretch return, reassess ```
70
HVLA post fibular head
``` pt prone pronate foot (barrier) MCP behind fibular head flex knee into barrier thrust with MCP return, reassess ```
71
HVLA ant fibular head
``` pt supine, pillow under knee supinate foot (barrier) heel of hand over fibular head thrust into fibula (valgus) return, reassess ```
72
knee ROM angles
flexion: 120 - 150 extension: 5 - 10 IR: 10 ER: 30 - 40
73
MCL test
valgus stress test
74
LCL test
varus stress test
75
ACL test
anterior drawer test | lachman's test
76
PCL test
posterior drawer test | lachman's test
77
meniscus test
McMurray's test Apley's test (bounce home test)
78
medial hamstring CS
``` spot: medial popiliteal fossa pt supine hip flex (cptn) knee: F, IR, Add (can add compressive @ calcaneous) return, reassess ```
79
lateral hamstring CS
spot: lateral popiliteal fossaa pt supine, leg off table knee: F, ER, Ab return, reassess
80
gastrocnemius CS
spot: med/lateral head of gastroc pt prone knee flex, plantarflex (capt) return, reassess
81
fibularis CS
spot: post to lateral malleolus pt supine plantarflex, evert return, reassess
82
tibialis ant CS
spot: inf to med malleolus pt supine invert, dorsiflex return, reassess
83
tibialis post CS
spot: post to med malleolus plantarfelx, invert return, reassess
84
types of ankle sprain
lateral (inversion) - 80% | medial (eversion) - 20%
85
types of lateral ankle sprains
1st degree: ATFL (ant talofibular lig0 2nd degree: TC (calcaneofibular) 3rd degree: PTFL (post talofibular lig)
86
why medial less common?
deltoid lig very stable
87
talocrural joint mvmt
dorsiflexion | plantar flexion
88
subtalar joint mvmt
inversion | eversion
89
supination mvmts
plantarflexion inversion adduction (spadi)
90
pronation mvmts
dorsiflexion eversion abduction (pabED)
91
ankle-knee-hip relationships
supination - ER tibia, post fibular head - IR hip pronation - IR tibia, ant fibular head - ER hip
92
gait energy conservation
architecture recycles energy absorbs natural shocks designed to navigate uneven or run
93
components of gait energy conservation
spring lig achilles tendon inertia
94
spring lig
absorb energy when arch flattens | rebound fuels toe off
95
achilles tendon
absorb potential energy btwn stance and toe off | convert to kinetic for toe off
96
talocrural joint dx steps
ant drawer test sulcus (static landmark) plantar/dorsiflexion (motion test)
97
anterior tibia on talus signs
easy post translation (drawer) deep sulcus prefer dorsiflexion
98
post tibia on talus signs
easy ant translation (drawer) shallow sulcus prefer plantarflexion
99
HVLA ant tibia on talus
``` pt supine cup calcaneous contact tibia @ distal dr force down into tibia return, reassess ```
100
HVLA post tibia on talus
``` pt supine fingers woven over dorsum, thumbs @ ball of foot bring to dorsiflxion barrier thrust thru return, reassess ```
101
subtalar (talocalcaneous) joint dx
inversion vs eversion
102
MFR subtalar
pt supine hold calcaneous and forefoot in/direct for 30 s
103
HVLA subtalar (ankle decompression)
``` pt supine hold calc and forefoot traction into in/eversion barrier thrusr return, reassess ```
104
midfoot HVLA
pt prone, leg off table thumb contact inf bone whip return, reassess
105
midfoot MFR
plantar fasciitis pt supine fascia into planes of resistance/ease 30-60 s
106
midfoot CS
plantar flex, push inferior
107
HVLA plantar styloid process
plantar force @ 5th head w/ thumb | dorsal force w/ MCP
108
HVLA phalanges
traction | use flex/extend too
109
sacrum true ligs
ant SI interosseous SI post SI
110
sacrum accessory lig
sacrotuberous sacrospinous iliolumbar

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