OMM Winter Exam 2 Written Flashcards by vinay goyal

What happened in 1936?

Applied Academy of Osteopathy (AAO) is formed.
improve the art of total health care
management,
emphasis on palpation and OMT

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What happened in 1944

Applied Academy of Osteopathy changed its name to American Academy of Osteopathy (AAO)

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What happened in 1950?

Dr. Angus Cathie forms first undergraduate class of American Academy of Osteopathy at PCOM

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Which way do occipital condyles converge?

anteriorly

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What is the major motion of the occiput?

Flexion/extention

accounts for 50% of cervical flexion

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Describe the relationshp bw sidebending and rotation of the the Co on C1

Occur in opposite directions

NOT Type 1 mechanics, though

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What is the motion test for the Co on C1

translation

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Describe a Posterior Occiput Right

OA rotated R, sidebent L
Right OA can traslate posteriorly
Resists anterior translation and extension
Tissue Texture change on right

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Describe an Anterior Occiput Left

OA rotated R, sidebent L
Left OA translates anteriorly
Resists posterior translation and flexion
Tissue Texture change on Left

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What is the alternate terminology for a Posterior (open) Occiput?

Flexed Occiput

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What is the alternate terminology for an Anterior (closed) Occiput?

Extended Occiput

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What is the major motion of C1 (on C2)?

Rotation about dens (‘no’ motion)

50% of cervical rotation occurs here

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When the atlas rotation about C2, describe its translation behavior

It translates inferiorly, equally on both sides

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What is the most likely dysfuncitno of atlas on axis?

Restriction of major motion - rotation
(Flex to lock C2-7 for motion testing)
(Flexion/extension not involved in lesioning)

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Does the atlas sidebend?

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Describe a posterior atlas Right

Easier rotation to Right
When rotating to the Left, barrier is engaged on the right
Tissue Texture change on Right

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Describe Anterior Atlas Left

Easier rotation to Rgith
When rotated to Left, barrier is engaged on Left
Tissue Texture change on Left

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Describe the angle of z-joints in C2-7

45 degree nateriorly towards eye

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What are unciform (uncinate) processes?

on superior surface of body producing concave shape that articulates with body of higher vertebra
synovial joints of Luschka

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What goes through the transverse foramina of cervical vertebral bodies?

vertebral a.

does not pass through C7 transverse foramen though

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What does the vertebral a supply? And what does vertebral a insufficiency indicate?

posterior aspect of circle of Willis
insufficiency produces vertigo
nystagus occurs upon cervical rotation

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Do Cervical vertebra (C2-C7) demonstrate type 1 or Type 2 mechanics?

Type 2 (not type 1)
(Though they are typical vertebrae)

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If you wanted to treat the cervical spine, what should you treat first?

Treat upper thoracic first

because cervical dysfunctionoften linked to upper back/ribs dysfunction)

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In what diseases, is the transverse ligament of C2 more lax?

Down’s

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What is osteoarthritis associated with in cervical psine?

hypertrophic changes (spurr) in z-joints and vertebral bodies

Which muscles in the neck covers the great mscules in the neck?

SCM

What is the motion of the SCM?

ipsilateral sidebending controlateral rotation bilateral: flexion of neck

What can trapezius pain be oftenly misinterpreted as?

dysfunction of 1st rib

What is a treatment of congenital torticollis?

Indirect technique to thoracic outlet and cranium

Contrast congenital vs adult torticollis

congenital: 'contraction of SCM' so sidebent towards effected side, rotated away adult: cervical sidebending and rotation in same direction 'contraction of scalenes'

What are the suboccipital muscles? What can their dysfunctions present as?

``` Rectus Capitis Posterior Major Rectus Capitis Posterior Minor Obliqus Capitis Inferior Obliqis Capitis Superior Tension-type headaches ```

What are the originis and insertions of teh nateiror and middle scalenes?

origin: trasnverse processes C3-6 insert: 1st rib

Which area of primary spinal SD is responsible for scalene spasm?

upper thoracic region

At what level do teh vertebral aa unite? What does it become thereafter and what does it supply

LEvel of pons Becomes basilar a. occipital love, cerebellu, brain stem

Which two bones form the jugular foramen?

occipital (condylar) and temporal (petrous)

What does a sentinel node of Vrichow indicate? Why?

abdominal malignancy | Beacsue abdominal malignancy spreads along thoracic duct and nodes

What layer do superficila lymphatics penetrate to get to deep cervical nodes?

investing fascia layer

Which fascial layer does the carotid sheath blend with?

pretrachial fasia

Which cutaneous nn arise from the cervical plexus?

lesser occipital n great auricular n transverse colli n supraclavicular n

In what part of the cell colum do sympathetics travel?

intermediolateral cell column (gra)

What levels do cervical sympathetic innervation come from?

T1-4

Dysfuction (hyperstimulation) of the R vagus SA nerve can lead to what?

sinus bradycardia

What can Left vagus dysfunction lead to in the heart?

AV prolongation

What part of GI does L vagus innervate?

greater curvature of stomach | dusdenum

What are symptoms of vagal GI dysfunction?

hyperchlorydria hpermotility IBS

Which types of patients had the least decrease in vertebral a blood flow in cervical rotationfor Heinkings/Kaepplers study?

older patients with stiff necks | long hypermobile necks showed greater decrease in flow

Is the dens in the CNS?

No | Trasnverse ligament prevents this

What demographic is neck pain more comon in?

middle aged women

Who proposed teh cranial concept? When?

Dr. Sutherland | 1939

What is the drving force in PRM?

inherent motility of brain

Which types of cells in the brain can move rhythmically like PRM?

neuroglial cells

What is the hydraulic component of PRM?

CSF fluctuation | CSF moves in response ot brain shape change

What is cranial compliance

homeostatic mechanism | Movement of cranial bones contributes to this

What is the Sutherland fulcrum?

origin of straight sinus | where falx cerebri and tentorium cerebelli originate

What makes up the reciprocal tension membrane?

Falx cerebri Tentorium cerebelli Falx cerebelli Spinal dura (sacrum, S2)

Who coined the Cranial Rhythmic Impulse?

Drs John and Rachel Woods in MO

In the brain, there are rhytmic movements correspnding to what?

1) systole/diastole of heart 2) inspiration/expiration 3) vascular variations of vasomotion

What are the 3 types of oscillatory motions proposed by Dr. Frymann?

1) motion from breathing 2) every 5-6 sec independent from breathing (Sutherland wave) 3) very slow, 1min-several min

What is the Sutherland wave?

oscillation every 5-6 seconds independt from breathing

What is the Traubbs Meyer oscillation?

slow rate osillation + | pule pressure fluctuation even after arrested breathing

Do CRI and THM occur together?

yes

What is the effect of manipulation on oscillations?

Amplitude icnreases

What is formed by the articulation bw the sphenoid and occiput?

``` sphenobasilar synchondrosis (SBS) cartilagenous until 12-25 years ```

What are the primary movements of teh SBS?

Flexion/Extension

What happens to head size during flexion of midline bones?

head becomes wider | AP diameter bnecomes shorter

What happens to paired cranial bones during flexion of midline bones?

external rotation (widening of head)

Where is the CRI palpable?

Everywhere in the body | though most pronounced in head

Describe flexion of sacrum?

posterior movemnt of base about axis (S2)

Name the midline bones

occiput sphenoid ethmoid vomer sacrum

The facial bones follow which bone?

sphenoid

The sacrum follows which bone?

occiput

What is a still point?

Where there is no motion - no CRI | Therapeutic 'release' frequently occurs here

What does the vital cycle depend upon, according to AT STILL?

vibration

Who is Emanuel Swedenborg?

Swedish guy neuro-anatomist | 'the brain'

What are the 5 components of PRM?

1) inherent motility of brain 2) CSF fluctuation 3) cranialbone motility 4) intracranial membrane mobility 5) involuntary mobility of sacrum bw ilia

What is the currently accepted rate of the PRM?

6-14 cpm

blood flow in the brain fluctuates synchronousyl with what?

redox state of cytochrome oxidase

How much CSF is produced daily?

125 mL | from choroid plexus

What is CSF flow during cardiac systole?

flow from lateral ventricles to 3/4 ventricles also craniocaudad direction (reversed during diastole)

What frequency does the Traube Hering component have?

.1-.17 Hz | 6-10 cpm

Is the Traub Hering Meyer the CRI?

NO!

What school did Dr. Frymann attend and what does she currently study?

COPS (LA) Dr. Thomas Schooley 'schooled' her Cranial treatment in children

How many bnoes is the skull comopsed of?

29 | 8 cranial, 14 facial, 7 misc.

What does the falx cerebelli attach to ?

C2-3 | indirectly scarum

Which cranial nerve and ganglion is associated with the lacrimal gland and nasal mucosal glands?

Facial n | ptergopalatine ganglion

What can increased smpathetic tone lead to in the ehad (pathology) ?

``` photophobia unsteadiness tinnitis low nutrients from vasoconstriction thick nasal/mouth secretions dryness of mucosa ```

Which bone of the anterior cranium and face does the sphenoid not influence?

mandible

How many parts is the occiput made up of at birth?

What can SD of the temporal bone be associated with?

otitis media tinnitis vertigo

What can pathological internal rotationof temporal bone lead to ?

closing of auditory tube | chronic otitis media

How many bones does the parietalbone articulate w?

the motion of the frontal bones is directly linked to the motion of which other bones?

maxilla | ethmoid

What motion can you feel in the temporal bone in a torsion strain?

If there is R torsion (R greater wing goes up), temporal bone externall rotates and 'expands'

Describe sidebedning rotation of SBS

'cracking egg' - open and then pour | jazz hand/ judo chop

What are the physiological strains?

torsion | sidebending rotation

What kind of forces can cause SBS compression?

Froce to the back of the head, to the front of the head, circumferential compression (birth) results in low CRI amplitude

At birht, how many parts are the sphenoid and temporal bones in?

How can CN12 dysfucntion occur at birth?

compression of occipital condyles (near hypoglossal canal)

What type of birth trauma can incterfere with CN8?

change in axis of petrou temporal bone

What may happen from increased tension of the petrosphenoidal ligament?

CN 3, 4, 6 problems CN 6 most often->strabismus, diplopia ptosis accomodation probelms

When is direct action used?

when exaggeration of strain is not desired: acute trauma young newborns

What is disengagement?

the separation of impacted osseus components

What is Opposite physiological motion?

when one component is direct | and another component is indirect

For the vault hold, where do your 2nd and 3rd fingers go?

temporal bone

Improvement of which bone motion can improve treatment of sinus congestion?

frontal bones

In the valut hold, motion of CRI is largely palpated thorugh which bones?

parietla bones

What type of strain might you see after a blow to the top of the head from nderneath the chin?

vertical strain

OMM Winter Exam 2 Written Flashcards

(107 cards)