OPP 2 EXAM #1 Flashcards
(102 cards)
1
Q
Facilitated segments ONLY occur at
A
Sympathetics
2
Q
Convexity to the right equals
A
left side-bending
3
Q
Greatest motion in the thoracic spine is
A
rotation
4
Q
t motion in the thoracic spine is
A
extension
5
Q
Rib 10 can be categorized as
A
both a typical and atypical rib
6
Q
Rotatores most likely involved in
A
Type II somatic dysfunction
7
Q
Anterior T1-T6 counterstrain tender points are treated with
A
flexion
8
Q
Important to treat the thoracoabdominal diaphragm if
A
flattened (indicates diminished zone of apposition
9
Q
People with COPD are an example of people with
A
a flattened diaphragm and diminished zone of apposition
10
Q
treatment of a flattened diaphragm and diminished zone of apposition
A
- improves diaphragmatic excursion which improves the pressure gradient between abdominal cavity and thoracic cavity, which helps improve lymphatic flow
- Treatment improves lymphatic flow also by relaxing the tension in the thoracoabdominal diaphragm
11
Q
Vertebral bodies usually rotated towards the
A
side of dysfunction
12
Q
If you have left lower lobe pneumonia, the vertebra will rotate to the
A
left
13
Q
If you have gastritis, the vertebrae will rotate to the
A
left
14
Q
If you have cholecystitis (gallbladder issues), the vertebrae will rotate to the
A
right
15
Q
patient may be obese female, in her 40s, passing flatus after eating meals and the vertebra(e) would rotate to the
A
right in the area of the gallbladder
16
Q
Proprioception
A
The subconscious mechanism involved in the self-regulation of posture and movement through stimuli originating in the receptors imbedded in every joint, tendon, and muscle and combined with info from the vestibular system
17
Q
somatic dysfunction causes
A
altered proprioception
18
Q
Type 1
A
- Typically applies to a group of vertebrae (more than two)
- Side-bending precedes rotation
19
Q
Type 2
A
- Typically applies to a single vertebra
- Rotation precedes side-bending
20
Q
Rule of 3’s T1-3
A
spinous processes project posteriorly therefore the tip of the spinous process is in the same plane as the transverse process of that vertebra
-T12
21
Q
Rule of 3’s T4-6
A
spinous processes project slightly downward, therefore the tip of the spinous process lies in a plane halfway between that vertebra’s transverse processes and the transverse processes of the vertebra below it
-T11
22
Q
Rule of 3’s T7-9
A
spinous processes project moderately downward, therefore the tip of the spinous process is in a plane with the transverse process below it
-T10
23
Q
Examples of Indirect Techniques
A
- Counterstrain
- Facilitated Positional Release (FPR)
- Balanced Ligamentous Tension Technique (BLT)
- Functional Technique
24
Q
FPR
A
- Body part in NEUTRAL position (flatten the curve/spine)
- COMPRESSION applied to shorten muscle/muscle fibers (some cases may have TRACTION instead)
- Place area into EASE of motion (INDIRECT) for 3-5 seconds
25
IVC hiatuses
T8
26
Esophagus hiatuses
T10
27
Aorta hiatuses
T12
28
Examples of Direct Techniques
```
Soft tissue
Articulatory
Muscle Energy
High velocity, low amplitude (HVLA)
Springing
```
29
Orientation of Superior Facets
BUM
BUL
BM
30
Orientation of Inferior Facets\
AIL
AIM
AL
31
Viscero-somatic reflex
gallstones causing tissue texture changes
32
Somato-visceral reflex
manipulating someone and causing constipation
33
post ganglionic sympathetic fibers lead to
tissue texture changes such as hypertonicity, moisture, erythema
34
Sympathetic Pre-ganglionics levels
T5 through L2
35
Celiac Ganglion (T5-T9) Post-ganglionic to
```
Distal Esophagus
STOMACH (epigastric)
Liver
GALLBLADDER (cholecystitis)
Spleenportions of Pancreas
proximal Duodenum (foregut)
```
36
Superior Mesenteric Ganglion (T10-T11) Post-ganglionic to
```
Portions of Pancreas
Duodenum
Jejunum
Ileum
Ascending Colon
Proximal 2/3 of Transverse Colon (midgut)
Adrenals
Gonads
Kidneys
upper ½ Ureter
```
37
Inferior Mesenteric Ganglion (T12-L2) Post-ganglionic to
```
Distal 1/3 Transverse Colon
Descending Colon
SIGMOID
Rectum (hindgut)
lower ½ Ureter
Bladder
Prostate Genitalia
```
38
Sympathetic Innervation Greater Splanchnic Nerve (T5-9) synapse
Synapses at the Celiac Ganglion\
39
Sympathetic Innervation Lesser Splanchnic Nerve (T10-11) synapse
Synapses at the Superior Mesenteric Ganglion
40
Sympathetic Innervation Least Splanchnic Nerve (T12) and Lumbar Splanchnic Nerve (L1-2) synapse
Synapses at the Inferior Mesenteric Ganglia
41
Sympathetic Innervation Greater Splanchnic Nerve (T5-9) innervates
```
Stomach
Liver
Gall Bladder
Pancreas
Parts of Duodenum
```
42
Sympathetic Innervation Lesser Splanchnic Nerve (T10-11) innervates
Small Intestines
Right Colon
(APPENDIX is found here)
43
Sympathetic Innervation Least Splanchnic Nerve (T12) and Lumbar Splanchnic Nerve (L1-2) innervates
Left Colon
| Pelvic Organs
44
Sympathetic Innervation: Chapman’s Reflexes Tip of right 12th rib (right and left)
appendicitis
| McBurney’s point
45
what has to be cleared/opened/treated BEFORE ANY other lymphatic treatment)
```
Thoracic inlet/outlet
-Another way of saying this is that you have to open myofascial pathways at the transition zones
-Examples include:
Anterior cervical fascia release
Thoracic inlet myofascial release
Pectoral Traction
```
46
Flattening of the diaphragm causes
- Stagnation of lymph
- Increased tissue congestion
- Decreased cardiac output
- Associated with increased infection, mortality, prolonged healing time, fibrosis and scarring
47
Thoracoabdominal Diaphragm Must evaluate neurological influence
Phrenic Nerve/C3, C4, C5
48
Thoracoabdominal Diaphragm Must evaluate biomechanical influence
Where the thoracoabdominal diaphragm attaches: lower ribs, thoraco-lumbar junction, T10-L3 are examples
49
COPD: Musculoskeletal Changes
Restricted motion of the diaphragm
- Flattened diaphragm (Diminished Zone of Apposition)
- Decreased lymphatic drainage will occur because rib cage and diaphragm are not moving well
50
Pump-Handle motion
- ribs move anterior and superior with inhalation
- rib 1-5
- best palpated at mid-clavicular line
51
Bucket-Handle motion
- Predominantly ribs 6-10
- Ribs move laterally and increase transverse diameter with inhalation
- Best palpated at mid-axillary line
52
Inhalation Rib Somatic Dysfunction
Motion toward inhalation is more free
| Motion toward exhalation is restricted
53
Exhalation Rib Somatic Dysfunction
Motion toward exhalation is more free
| Motion toward inhalation is restricted
54
Bottom Rib is key rib in
Inhalation dysfunction
55
Top Rib is key rib in
Exhalation dysfunction
56
Exhaled ribs are prominent
posteriorly
57
Inhaled ribs are prominent
anteriorly
58
Anterior Rib Counterstrain Points are associated with
Exhalation Rib Somatic Dysfunction
59
Posterior Rib Counterstrain Points are associated with
Inhalation Rib Somatic Dysfunction
60
If pain increases when patient inhales
indicates exhalation rib somatic dysfunction
61
If pain increases when patient exhales
indicates inhalation rib somatic dysfunction
62
Strain-Counterstrain ribs 1-2
Pain in anterior chest wall
63
Strain-Counterstrain Ribs 3-6
Pain in lateral chest wall
64
Tender Point Locations AR1
Below clavicle on 1st chondrosternal articulation associated with pectoralis major and internal intercostal muscles
65
Tender Point Locations AR2
Superior aspect of 2nd rib in midclavicular line
66
Tender Point Locations AR3-10
On the dysfunctional rib at the anterior axillary line associated with the serratus anterior (AR3-8) and internal intercostal muscles (AR9-10)
67
Postisometric Relaxation
- Patient is Instructed to GENTLY Push AWAY From the Barrier
| - doctor towards barrier
68
Reciprocal Inhibition
Patient is Instructed to GENTLY Push TOWARD the Barrier
| -patient pushes towards the barrier
69
Compression fractures causes
Increased kyphosis
| -altered mechanics of the thoracic spine and rib cage
70
Scalene triangle entrapment
- ant/mid scalene
| - Brachial plexus, subclavian artery
71
Costoclavicular space entrapment
- 1st rib, clavicle
| - Brachial plexus, subclavian artery and vein
72
Subcoracoid space entrapment
Overlying ribs under pectoralis minor attachment at coracoid process
73
Aortic Stenosis
Crescendo decrescendo
74
Mitral stenosis
crescendo
75
Aortic regurgitation
decrescendo
76
Mitral regurgitation
plateau
77
ventricular septal defect
holosystolic murmur
78
late systolic murmur
mitral valve prolapse
79
early diastolic murmur
incompetent semilunar valves
80
CK-MB vs Cardiac troponin
-both used for diagnosis of acute MI (CK-MB will rise first but less specific than cardiac troponin)
81
components of the Mini Mental Status Exam
```
orientation
registration
attention and calculation
recall
language
```
82
affect
what you as the doctor observe the patients mood to be
-definition: the pattern of observable behaviors which is the expression of a subjectively experienced feeling state (emotion) and is variable over time in response to changing emotional states
83
mood
what the patient thinks (how they feel)
84
patient’s ability for Judgment
process of deciding on a course of action given alternatives
85
patient’s ability for insight
awareness that symptoms or disturbed behaviors are normal or abnormal
86
Functional status
is the ability to perform tasks and fulfill social roles associated with daily living across a wide range of complexity
87
Functional assessment from the social history
home life, martial status, relationship status the ability to maintain stable home life and relationships; occupation -> the ability to maintain function in education and employment status; social activities -> clubs, churches, attends events
88
Six activities of daily living
```
bathing
dressing
toileting
continence
transferring
feeding
```
89
instrumental activities of daily living
```
transportation (driving the car)
taking medication (managing meds)
managing money (finance, accounts, the will)
```
90
Egophony
EE sounds like AA
91
Bronchophony
99 will be louder and clear rather than muffled and indistinct
92
Fremitus
patients says a 99 and vibrations are felt
| -more vibrations = positive test
93
Stertor
snoring
| -partial obstruction of the airways from the nose to the hypopharynx
94
Coarse inspiratory crackles indicates
the presence of mucus (sputum) in the airways
| -Bronchitis
95
Fine inspiratory crackles
indicating re-expansion of collapsed alveoli or respiratory bronchioles
- Pneumonia
- Atelectasis
96
Inspiratory strider
Indicates partial obstruction in the airways from the epiglottis until the airways enter the intrathoracic influence
97
Wheezing
narrowing of the airways
- Asthma
- Foreign body
- Bronchomalacia
- Extra-bronchial compression
98
Grunting
- Closing the glottis at the middle of expiration to increase the airway positive end expiratory pressure
- attempts to prevent collapse of the alveoli at the end of expiration
99
Finger Clubbing
-Caused by endothelial platelet-derived growth factor
Happens in:
1. Destructive lung disease (Cystic Fibrosis)
2. Cyanotic congenital heart disease
3. Ulcerative colitis
4. Crohn’s disease
5. Can be familial
100
Respiratory syncytial virus (RSV)
is a common, and very contagious, virus that infects the respiratory tract. For most babies, the infection causes nothing more than a cold, but for a small percentage, infection with RSV can lead to serious problems such as bronchiolitis, which is inflammation of the small airways of the lungs, or pneumonia, which can become life threatening. Symptoms include coughing and a runny nose, which usually lasts for 1-2 weeks
101
Pertussis
paroxysmal cough with a “whoop” at the end
102
Newborn respiratory distress
the most common etiology is transient tachypnea; this is triggered by excessive lung fluid, and symptoms usually resolve spontaneously. Can occur in premature infants as a result of surfactant deficiency and underdeveloped lung anatomy
