OPP Techniques Flashcards
(190 cards)
1
Q
Year of “flung osteopathy to the breeze”
A
1874
2
Q
Basic coordinated body functions
A
Control of posture and movement Respiration Circulation Regulation of water and electrolyte balance Digestion and absorption of nutrients elimination of wastes Metabolism and energy balance Protective mechanisms Sensory system Reproduction Consciousness and behavior
3
Q
Five models function
A
Provide framework for interpreting the significance of somatic dysfunction.
4
Q
Biomechanical model
Structure/anatomy
A
Postural muscles, spine and extremities
5
Q
Biomechanical model
Function/physiology
A
Posture and motion
6
Q
Biomechanical model
Health
A
Efficient and effective posture and motion throughout the musculoskeletal system
7
Q
Biomechanical disease
A
Somatic dysfunction, inefficient posture, joint motion restrictions
Alterations of postural mechanics affect dynamic function
8
Q
Biomechanical model
Patient care
A
Alleviate somatic dysfunction with OMT to restore normal motion and function throughout the body
9
Q
Respiratory circulatory model
Structure/ anatomy
A
Thoracic inlet and diaphragmas of the body, costal cage, heart, lungs, vasculature, lymphatics
10
Q
Respiratory circulatory model
Function. Physiology
A
Respiration circulation
Venous and lymphatic drainages
11
Q
Respiratory circulatory model
Health
A
Efficient and effective arterial supply
Venous and lymphatic drainage to and from all cells
Effective respiration
12
Q
Respiratory circulatory model
Disease
A
Vascular compromise
Edema
Tissue congestion
Poor gas exchange
13
Q
Respiratory circulatory model
Patient care
A
Removal of mechanical impediments to respiration and circulation
Relieve congestion and edema
Improve venous and lymphatic drainage
14
Q
Metabolic energy model
Structure/ anatomy
A
Internal organs
Endocrine glands
15
Q
Metabolic energy model
Function/ physiology
A
Metabolic processes Homeostasis Energy balance Regulatory processes Immunologic activities and inflammation
16
Q
Metabolic energy model
Health
A
Efficient and effective cellular metabolic processes
Energy expenditure and exchange
Endocrine and immune regulation and control
17
Q
Metabolic energy model
Disease
A
Energy loss, Fatigue Ineffective metabolic processes Toxic waste buildup Inflammation
18
Q
Metabolic energy model
Patient care
A
Restore efficient metabolic processes and bioenergetics
Alleviate inflammation infection
Restore healing
19
Q
Neurological model
Structure/anatomy
A
Head, organs of senses
Brain
Spinal cord
Peripheral nerves
20
Q
Neurological model
Funciton/ physiology
A
Control coordination and integration of body function
Protective mechanisms
Sensation
21
Q
Neurological model
Health
A
Efficient and effective sensory processing
Neural integration and control
Autonomic balance
22
Q
Neurological model
Disease
A
Abnormal sensation
Imbalance of autonomic functions
Pain syndromes
23
Q
Neurological model
Patient care
A
Restore normal sensation
Neurological processes and control
Alleviate pain
24
Q
Behavioral model
Structure/anatomy
A
Brain
25
Behavioral model
| Funciton/ physiology
Psychological and social activities
26
Behavioral model
| Disease
Ineffective function due to drug abuse, environmental exposures
Trauma
Poor lifestyle choices
Inability to adapt
27
Behavioral model
| Patient care
Assess and treat the whole person
| Collaborative partnership
28
Biomechanical model omt technique
```
Multiple omt modalities to the spine and extremities
Hvla
Me
Mfr
Cs
Still
Blt
Fpr
```
29
Respiratory circulatory omt technique
Treating the transverse diaphragms of the body
Cranial
Mfr
Lymphatic pumps
30
Metabolic energy omt technique
Lymphatic pump techniques
| Focus on somatic dysfunction that could interfere with metabolic functions, visceral techniques
31
Neurological omt technique
Omt reduction of mechanical stress, balance of neural inputs, elimination of nocieptive drive
Inhibition techniques, counterstain, Chapman points
32
Behavioral omt technique
Omt to address reactions to biopsychosocial stresses
33
Hvla
Employs rapid therapeutic force of brief duration that travels a short distance within the anatomic range of motion of a joint
Engages restricts barrier to elicit a release.
34
Muscle energy
Direct treatment
| Muscles employed upon request in controlled position and manner against counterforce
35
Lymphatic techniques
To remove impediments to lymphatic circulation and promote and help flow
36
Counterstain
Diagnosis and indirect treatment in which patient’s somatic dysfunction is treated by using spontaneous tissue release while simulataneously monitoring the tenderpoint
37
Myofascial release
Described by at still
Continual palpitory feedback to alleviate restriction of somatic dysfunction and its related fascia and musculature
Direct or indirect
38
Soft tissue
Direct technique
Involves kneading, stretching, deep pressure, inhibition and/or traction
Monitoring tissue response and motion changes
39
Visceral
Diagnosis and treatment directed to viscera and/or supportive structures to improve physiologic function
40
Osteopathic cranial manipulative medicine
Diagnosis and treatment using primary respiratory mechanisms and balanced membranous and ligamentous tension
41
Theories of joint dysfunction
Alteration in opposing joint surfaces
Articular capsule problems
Neural control mechanisms
42
Why dysfunctional segment wont move
Joint inhibited from completing its full normal motion
Irritation creates edema and swelling> tightening of fascial structures> articular distortion results in hypertonicity of muscle crossing joint> decrease of ROM
43
Joint play
Small movements at synovial joints
| John mennell
44
How much movement does the body’s synovial joints have
1/8”
45
Tensegrity and articulatory technique affects
Joint surfaces
Tensile elements related to them
Everything that passes through those tensile elements
46
Secondary effects of articulatory techniques
Alter length and tone of connective tissue
Remove inappropriate compression of blood vessels and lymphatics
Remove compression on nerves
47
Articulatory technique
Direct joint focused group of techniques which use LVHA movements
48
Articulatory technique walk through
Physician gently carries body region being treated through the restrictive barrier
49
Indications of articulatory techniques
Joint restriction due to localized joint somatic dysfunction
| Joint restriction due to periarticuluar tissue somatic dysfunction
50
Absolute contraindications of articulatory techniques
```
Fracture/dislocation
Neurological entrapment syndromes
Serious vascular compromise
Malignancy
Infection
Bleeding disorders
```
51
Relative contraindications for articulatory techniques
Acute herniated nucleus pulposa
In upper cervical region due to possibility of vertebral artery compromise - avoid combo of repetitive extension and rotation
52
Short lever technique
Force is imparted through your body which is close to the dysfunctional joint to which you are imparting the corrective forces
53
Long lever technique
Force is imparted through tour body which is far away from the dysfunctional joint to which you are imparting corrective forces
54
Myofascial release
| Functions
To treat somatic dysfunctions involving Myofascial tissues or other connective tissues
55
Myofascial release
| Indications
Enhance circulation to local Myofascial structures
Improve local tissue nutrition, oxygenation and removal of metabolic wastes
Improved local and systemic immune responsiveness
56
Myofascial release
| Indications as adjunct
Identify other areas of somatic dysfunction
Observe tissue response to the application of manipulative technique
Provide general state of relaxation
Prepare tissue for other types of manipulation
57
Myofascial release
| Contraindications absolute
Lack of consent/cooperation
58
Myofascial release
| Relative contraindications
```
Fractures
Open wounds
Soft tissues/bony infections
Abscesses
DVT
Anticoagulation, disseminated or focal neoplasm
Recent post operative conditions
Aortic aneurysm
```
59
Soft tissue
| Somatic dysfunction
Characterized/inferred by asymmetry, restriction of motion, tissue texture changes, and tissue tenderness
60
Soft tissues
| Indications
Hypertonic muscles
Excessive tension in fascial structures
Abnormal somato somatic and somato visceral reflexes.
61
Soft tissue indications
| Adjunct
Identify other areas of somatic dysfunction
Observe tissue response to the application of manipulative technique
Provide general state of relaxation
Prepare tissue for other types of manipulation
62
Soft tissue
| Absolute contraindications
Lack of patient consent/cooperation
63
Soft tissue
| Relative contraindications
Skin disorders that would preclude skin contact
Acute muscle disorders (myositis, strains) or muscle neoplasm
Acute fascial injuries
Acute ligamentous or bone injury
Infection
Vascular abnormalities (DVT, coahulopathy, hematoma)
64
Patient complaints when cervial/ thoracic soft tissue/ MFR would be indicatred
```
Headache - tension, sinus, migraine
Neck pain
Throat pain
Globus
Cough
Upper and lower thoracic back pain
Shoulder pain
```
65
Palpable tissue texture abnormalities in somatic dysfunction
| Acute
```
Warm
Sweaty
Erythematous
Boggy
Rigid/tissue contraction
Painful
```
66
Palpable tissue texture abnormalities in somatic dysfunction
| Chronic
```
Cool
Dry
Pale/blanched
Strophic
Fibrotic
Tissue contracture
Painful
```
67
Position of danger for cervical spine
Hyperextension
| With hyper rotation
68
Cranialcervical MFR release indications
Acute cervical sprains/strains,
Mild cervical degenerative diseases
URIs
Sinusitis
69
Craniocervical MFR release indirect
| Tart changes
Occipital to C4
70
Craniocervical MFR release indirect treatment
Pt on back. Hands cradled.
Stacked in position of ease
Add compression
Breathe reassess
71
Compression
Inferior motion
72
Traction
Superior motion
73
Contralateral traction
```
Stand contralateral
Cephalad hand on forehead
Caudal hand on lateral to spinous processes
Rotate head away
Don’t scissor
Pull toward you
```
74
Cradling with traction/ longitudinal traction
Start at c7.
Circular pressure
Move up to occipital
75
Forward bending traction
Cross forearms under patient and contact anterior surface of shoulders with palms
Lift patients head.
76
Lateral traction
One forearm under patients head and contact anterior surface of opposite shoulder with palms
Apply lateral stretch to neck muscles
Don’t rotate head
77
Diagnose tissue texture abnormalities in cervial region
Cup patients occipital
Slowly and gently bend the head to the left and right along coronal plane, paying attention to the tension in the lateral neck musculature and overall cervical ROM
Bend head and neck forward paring attn to tension in posterior neck musculature and overall cervical ROM
78
Suboccipital release
Focus is to release tension in muscles and connective tissue so they have a full range of motion
79
Suboccipital decompression
If goal is to increase relaxation around occipitoatlantal joint
80
Suboccipital inhibition
Goal is to inhibit muscle tension
One of effects is to enhance the parasympathetic aspect of ANS balance
Parasympathetic influence increases as sympathetic influence decreases
81
Suboccipital inhibition
Fingers below occipital
Inferior to inferior nucal line in soft tissues of suboccipital triangle
Balance head with cranium off palms
Maintain until head falls
82
Suboccipital release/inhibition
| Indication
Suboccipital TART changes
Muscle tension headaches
Neck ache or tension
83
Indirect upper thoracic MFR supine
```
Place one hand underneath so contact upper thoracic spinous processes with fingers spread
Place opposite hand on sternum
Assess separately
Stack in direction of ease and hold
Respiratory cooperation
```
84
Thoracic prone pressure/ prone pressure with thumb
Place thumb and the air eminence of one hand on opposite side of thoracic spine in gutter
Place other hand to reinforce it
Exert anterolateral pressure on soft tissues away from spine
85
Thoracic prone pressure with counter pressure
Head turned toward you
One hand on one side of spine fingers toward head
Other on other side finger pointing caudad
Simultaneous longitudinal pressure
86
Upper thoracic lateral recumbent traction
Caudad hand under patients arm.
Grasp paravertebral muscles lateral to spinous processes. Draw laterally until resistance noticed
Work wat up and down from cervical thoracic junction to mid thoracic spine
87
Trapezius prone traction
Grasp superior trap with cephalad hand
Pt head toward you
Caudad hand on gh joint
Pull trap in caudal direction diagonally toward your body.
88
Active motion
Voluntary movement by patient
89
Passive emotion
Movement performed by practitioner while patient is relaxed
90
Physiologic barrier
End point of active ROM
| Can be increased with warm up exercises or stretches
91
Anatomic barrier
Limit of motion by anatomic structures
92
Elastic barrier
Felt at end of active range of motion between the physiologic and anatomic barriers
Where ligamentous stretch occurs
93
Restrictive barrier
Obstacle to movement within physiological range of motion that will reduce the amount of active motion available
94
Pathological barrier
Permanent restriction of active and passive range of motion with permanent changes in the tissues
95
Somatic dysfunction
Impaired / altered function of related components of the somatic body system
96
Somatic dysfunction happens
Any stress on body that alters the tissues so they are unable to return to their neutral states
Functional and positional change
Muscle length and tone are unable to return to physiologic neutral
97
Tart
Tissue texture abnormalities
Asymmetry
Restriction of ROM
Tenderness
98
Tissue texture abnormalities
```
Temperature
Moisture
Bogginess
Rolpiness
Red reflex
```
99
Direct techniques
Moves tissues towards barrier
Directly confronts barrier
Myofascial structures are stretched and then relaxed
Replaced tissues allow for better blood and lymph flow
100
Indirect techniques
Tissues taken away from barrier
Tissues relax as tension taken off
Blood and lymph flow improve
101
Goals of soft tissue treatment
Relax hypertonic muscles
Stretch passive fascial structures
Enhance circulation to local Myofascial structures
Improve local and systemic immune responsive
Provide general state of relaxation
102
Absolute contraindications
Lack of patient cooperation/consent
Inability to position patient appropriately
No somatic dysfunciton identified
Inability of patient to respond to treatment
Malignancy
103
Relative contraindication
```
Acute injury
Fracture/dislocation
Neurological compromise
Osteopenia or osteoporosis
Malignancy
Infection
```
104
Traction
Origin and insertion and held stationary
| Central portion stretched like bowstring perpendicular
105
Inhibition
Sustained deep pressure and compression of hypertonic Myofascial structures
106
Fascia originates from
Mesoderm
107
Fascia contains:
```
Mechanoreceptors
Golgi tendon organs
Pacinian corpuscles
Ruffini endings
Free nerve endings
```
108
Functions of fascia
```
Packaging
Protection
Posture
Passageways
Fascial continuity
```
109
Diagnosis of fascia
Passive motion testing of fascia in region is performed to identify a restrictive barrier and a position of ease
110
Inhalation respiratory component
Spinal curves flatten/ decrease
| Extremities tend toward external rotation
111
Exhalation respiratory component
Spinal curves increase
| Extremities toward internal rotation
112
Indications for soft tissue treatment
Relax hypertonic muscles and reduce spasms
Stretch and increase elasticity of shortened fascial structures
Enhance circulation
General state of relaxation
113
Absolute contraindications of soft tissue treatment
```
Fractures. Dislocation
Neurological entrapment syndromes
Serious vascular compromise
Malignancy
Local infection
Bleeding disorders
Patient refusal
```
114
Prone traction
Cephalad hand on base of sacrum pointing caudad
Other palm straddling spinous processes of lumbar vertebrae
Exert separating force using traction
115
Prone pressure with counter leverage
Grasp ASIS with caudad hand lifting toward ceiling
Contact lumbar paravertebral muscles on contralateral side of spine with heel of hand.
Apply anterior and lateral force to stretch lumbar paravertebral tissues like bowstring
Return to table
116
Seated lumbar soft tissue
Strand behind and contralateral to patient
Grasp pt arm
Heel of caudal hand over paravertebral muscles on contralateral spine
Drop weight onto your arm
Rotate patient toward you with anterior hand
Use posterior hand to provide lateral and anterior force
117
Prone lumbosacral Myofascial release
| Indication
Pt complains of low back pain, stiffness, difficulty bending and turning
118
Prone lumbosacral Myofascial release
Face feet
Place caudad hand on sacrum with heel over sacral base
Place other hand over thoracolumbar junction with fingers over lumbar region
Stack in position of ease
Test with inspiration
119
Indirect mfr and respiratory cooperation
Hold breath at end of phase which relaxes the tissues being treated
120
Direct mfr and respiratory cooperation
Ask patient to hold breath at end of phase which tightens tissues being treated
121
Sacral rock
Cephalad hand on base of sacrum with fingers pointing toward feet
Put caudla hand over top with fingers toward head
Follow sacrum as repiration moves
Follow and enhance slightly each time
122
Sacral rock inhalation
Extension.
| Sacral base goes posteriorly
123
Sacral rock exhalation
Flexion
| Sacral base goes anteriorly
124
Si joint decompression
One hand under sacrum so fits in palm
Other hand under hip to grasp psis
Gentle lateral traction on psi’s
125
Indirect thoracolumbar mfr prone
Face cephalad with dominance eye closet to patient b
Place hands on thoracolumbar junction with fingers spread. On either side of spinous process
Stack all in ease
Respiratory cooperation
126
Seated lumbar flexion
Stand behind with your Axilla over shoulder hand on the other. Pt grasps you
Stabilize spinous processes of lower involved vertebrae using downward pressure
Use other hand to flex spine to level you’re working on
Spring the barrier
127
Seated lumbar extension
Stand behind pt hugging themself grasp elbows with hand
Place other hand below joint to be treated
Use long lever arm to induce extension
Use other hand as wedge to induce anterior translation
Spring barrier
128
Which vertebrae does seated articulatory lumbar flexion work on
Above
129
Which vertebrae does seated articulatory lumbar extension work on
Below joint
130
Seated articulatory technique lumbar sidebending
Standing behind and to side of patient place Axilla on one shoulder hand is on opposition shoulder
Place fingers on ipsilateral side
Press down with axilla and up with hand translating shoulders away from you.
Use other hand as wedge
Spring barrier
131
Seated articular technique lumbar rotation
Place thumb on contralateral gutter
Pull patients arm to induce rotation and accentuated it to the joint level by taking sensing hand and soft tissues more laterally
132
Lateral recumbent articulatory technique lumbar flexion
Face lateral recumbent patient
Flex knees and rest them against anterior thigh. Grab legs as lever
Using your thigh flex pt’s lumbar spine by brining knees cephalad
Use cephalad hand to stabilize superior lumbar vertebrae as motion pulls inferior lumbar vertebrae causally
133
Lateral recumbent articulatory technique lumbar flexion treats where
Treats joint below stabilized hand
134
Lateral recumbent articulatory technique lumbar sidebending
Stand facing lateral recumbent pt
Flex pt’s knees and rest them against your anterior thigh
Grasp pt ankles to use as long lever
Lift ankles to induce sidebending
Use cephalad hand to place downward vector that increases sidebending
135
Allopathy
Hahnemann
System of therapeutics with diseases are treated by producing a condition incompatible with or antagonistic to the condition to be cured
136
Year flung osteopathic banner to the breeze
1874
137
Year at still officially the branded term osteopathy
1889
138
Who received the first diploma
William smith
139
Flexner report 1910
Harshly criticized medical schools and osteopathic schools
Marginal schools closed
In 1910 only 8 of osteopathic schools remained in operation
140
California merger
1960 COA began negotionation with CMA.
AOA revoked COA charter approved new assoc OPSC
1961 COA merged with CMA
CA voted to stop DOs from practicing in CA
1962 DOs could apply for MD degree licensure
141
WWI and DOs
DO could serve as regular soldiers but couldn’t use medical training.
142
WWII. And DOs
Were deferred not drafted
| Stayed at home and treated the home citizens
143
11963
Acceptance of DOs as medical officers in US civil service
144
First commissioned officer
Harry Walter USAF
145
1967
AMA withdrew longstanding opposition and DOs included in doctor draft
146
1974
CA Supreme Court decided licensure of DO s must resume
147
2011
ACGME announced in 2016 would restrict access from moving from non ACGME program to ACGME program
148
Unified path for post grad med trading in
2012 AOA began talking to ACGME to create single pathway for GME programs
149
Osteopath
Person with limited practice rights who has achieved nationally recognized standards within country to independently practice diagnosis and treatment
150
Osteopathic physician
Person with full unlimited medical practice rights who has achieved nationally recognized standards within country to diagnosis and provide treatment
151
Osteopathic medicine countries
Limited to US except Germany/France
152
Level of suprasternal notch
T2
153
Level of sternal angle
T4/t5
154
Xiphoid process
T9
155
Spine. Of scapula level
T3
156
Inferior angle of scapula level
T7
157
Umbilicus
L3
158
Iliac crest level
L4
159
Normal red reflex
Initial blanching
Followed by reddending
Slow fading of redness back to normal
160
Abnormal red reflex
Remaining pale
Remaining red
Becoming red initially instead of pale
161
Meissner corpsuscle
Sense light touch
| Initial part of stimulation dynamic
162
Merkel cells
Sense light touch
| Sustained stimuli
163
Pacinian corpuscle
Deep pressure
| Rapid indentation of skin
164
Ruffini endings
Detection of stretch
165
Proprioceptors
Golgi tendon organs
Muscle spindle
Joint receptors
166
fascial symmetry landmarks
```
General
Supraciliary arches
Orbits
Nasal deviation
Angles of math
Symphysis menti
Rotation and sidebending
```
167
Shoulder landmarks
Muscle mass
| Neck/shoulder angle
168
Upper extremity postural landmarks
Shoulder heights
Shoulder rotations
Clavicle prominence
169
Arm postural landmarks
Internal external rotation
Anterior posterior
Fingertip heights
170
Thorax postural assessment landmarks
General symmetry
Precuts
Sternal angle
Costal arches
171
Pelvis postural assessment landmarks
Skin folds/angulation
Iliac crest height
ASIS
Rotation
172
Lower extremity postural assessment landmarks
```
Musculature
Knees (valgum vs varum)
Patella
Tibial tuberosity
Fibulae heads
Rotation
Feet rotation
Feet inversion
Pes planus/pes cavus
```
173
Posterior postural assessment
| Head landmarks
Earlobe
Mastoid process
Rotation and sidebending
174
Posterior postural assessment
| Neck landmarks
Muscle mass
| Shoulder angle
175
Posterior postural assessment
| Upper extremity
Shoulder height
| Shoulder rotator
176
Posterior postural assessment
| Scapurale
Prominence
Protected / retracted
Inferior angle
177
Posterior postural assessment
| Arms
Internal external rotation
Anterior posterior
Fingertip heights
178
Posterior postural assessmentthorax
Scoliosis
179
Posterior postural assessment
| Pelvis
```
Skin folds
Iliac crest heights
PSIS
Rotation
Greater trochanters
```
180
Posterior postural assessment
| Lower extremity
```
Glut, thigh, calf muscles
Popliteal fossa
Achilles’ tendon
Rotation
Feet inversion
Pes planus pes cavus
```
181
Lateral postural assessment gravity line points
```
EAM
Acromion process
Body of l3
Anterior 1/3 of sacrum
Lateral femoral condyle
Lateral malleotlus
```
182
Lateral postural assessment
| Head
Position - rotation, ant or post
| Position of neck - exten/flex
183
Lateral postural assessment
| Upper extremity
Position rot/ ant/ post
| Elbow flexion
184
Lateral postural assessment Thorax
Pectus
| Sternal angle
185
Lateral postural assessment
| Spinal curves
Cervical lordosis
Thoracic kyphosis
Lumbar lordosis
Lumbosacral angle
186
Lateral postural assessment
| Lower extremity
Knees (recurvatum)
Leg rotation
Feet everted/inverted
Arches
187
Articulatory general principles
Direct technique
Passive technique
To increase regional motion restriction in general manner
To obtain addl info
188
Articulatory contraindications
```
Severe osteoporosis
Compression fracture
Ruptured disk or disk bulge
Cancer or structurally weakening diseases
Acute inflammatory disease
```
189
Articulatory diagnosis
Locate 12th thoracic vertebrae and l1.
Place finger on spinous process of l1
Ask to bend only to where motion reached finger.
Observe which side is more restricted
190
If patient cannot sidebending left
Induce left sidebending
