OPP Exam 2 Flashcards
(36 cards)
HVLA: Mechanism of Treatment
- Restoration of Motion IN the joint
- Restoration of normal proprioceptive input FROM the joint
- Reflex relaxation of muscles surrounding joint
HVLA: Absolute Contraindications
RA, Down Syndrome, Chiari malformation,
Klippei Fiel Syndrome, blocked vertebrae
Advanced carotid disease, local metastases
local osseous or ligamentous disruption
Osteoarthritic joint with ankylosis
severe herniated disc, Patient apprehension, unskilled physician.
Thoracic HVLA: NEUTRAL + SEATED!
Note: If RR, then Right hand is on the back + Vice Versa
DX: Neutral SLRR
Patient: Seated (straddle table) + Cross armed
Left Hand: Under left arm and across chest to SHOULDER
Right Hand: HYPO-THENAR eminence on TP + Right elbow on hip!
Patient: FLEX OR EXTENDED
HVLA Force: ANTERO-SUPERIORLY
Thoracic HVLA: Supine Position
Neutral vs non neutral
Thenar Eminence Position
- Neutral: Upper of the two vertebra
- Non-neutral: Lower of the two vertebra
Characteristics of a myofascial tenderpoint
Hyperirritable spot Taut Band Painful on compress Refers pain AUTONOMIC phenomenon
Visualization of Tenderpoints
Ultrasound and EMG activity
Peripheral nociceptor afferents go to _____ of spinal chord
Dorsal Horn
NORMAL afferent signals can excite…
BOTH somatic AND visceral efferents.
Viscerosomatic Reflex of the Heart
Somatic dysfunction in T1-4, especially 3-4.
Note: Posterior chapman reflex points = T2-T4
Referred Pain of the Heart
Left Arm
Anterior Chest Wall
Left Jaw
Upper Back
Cross-organ sensitization aka
viscero-viscero reflexes
Reason why breast becomes hard after child birth of find tumor in either breasts
VENOUS system (azygos and mammary veins) has failed to return blood supplied by MAMMARY and INTERCOSTAL arteries.
Clavicles and Ribs (1-8) are found to be dislocated on the sternum or vertebrae.
Sternum: Regions and Functions
Regions: Manubrium, body, and xyphoid process
F(x): Protects heart, lungs, etc.
Accessory site for hematopoesis, often site for bone marrow biopsies (!)
Rib Muscle Attachments Rib 1: Rib 2: Rib 3-5: Rib 6-9: Rib 10-11: Rib 12:
Rib 1: Anterior and Middle Scalenes Rib 2: Posterior Scalenes Rib 3-5: Pectoralis Minor Ribs 6-9: Serratus Anterior Ribs 10-111: Latissimus Dorsi Rib 12: Quadratus Lumborm
Costochondritis: Symptoms
- Upper costal cartilages at the costochondral or costosternal junctions are most frequently involved
- Area of tenderness are NOT ACCOMPANIED by heat, erythema, or localized swelling.
Breast Venous drainage
- Axillary Vein + superficial Lateral Thoracic Vein
- Azygos, accessory hemiazygos, and hemiazygos vein + intercostal vein.
Breast Blood Supply
(Bolded) - Posterior and anterior intercostal arteries.
2/3 - internal mammary/thoracic artery (from subclav.)
1/3 - lateral thoracic artery (supplies upper outer quad.)
Osteopathic 5 Model Approach
Biomechanics Model Respiratory-Circulatory Model Neurological Model Metabolic-Energy Model Behavioral Model
Cranial Bones at Birth: Parts of Temporal (Focus)
3 parts: Petrosal, squamous and mastoid
Cranial Bones at Birth: Parts of Occipital (Focus)
4 parts: Base, Squama, 2 lateral condylar parts
NOTE: Most commonly susceptible to somatic dysfunction from birthing process (!!!)
Cranial Bones at Birth: Parts of Sphenoid (eh)
3 parts: Central body with lesser wings, 2 greater wings, pterygoid processes
Cranial Bones at Birth: Parts of Frontal (eh)
Metopic suture present
Temporal Bone Symmetry
Externally rotated: tip of mastoid is posteromedial/less prominent
Internally rotated: Tip of mastoid is anterolateral or more prominent
Note: asymmetry = position of the occiput as the temporal bone moves in relation
Somatic Dysfunction in Newborns:
Plagiocephaly, Parellelogram, Respiratory, and Roticollis
Plagiocephaly: Flat spot on baby’s head
Parellelogram: abnormal position/movement of the eye
Respiratory: Irregular breathing due to truama, thoracic diaphragm, etc.
Torticollis: “wry neck”, shortening of SCM on one side, restriction of motion.
