Ortho - Overview Flashcards

1
Q

What are the four stages Of Ortho Acup. Process?

A
  1. Questioning
  2. Performing
  3. Thinking
  4. Applying
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2
Q

An important part of determining tx effectiveness?

A

Outcome Measures

ie: Pain Scales, ROM, MMT

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3
Q

What is the most important part of the patients intake?

A

History

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4
Q

Five key questions to ask of Main Complaint after history of patient?

A
  1. Any Dx? What is story
  2. When? Timeline, when it started
  3. How? Mechanism of Injury
  4. Where? Structures involved
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5
Q

What is pain?

A

An unpleasant sensory and emotional experience associated with actual or potential tissue damage.

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6
Q

What does HIPS stand for?

A
  1. History - WM or TCM (root and/or branch)
  2. Inspection/Observation - muscle imb. ab. posture
  3. Palpation - meridian/Zangfu, tg, pulse
  4. Special Testing - ROM, MMT(manual muscle test), OPA (orthopedic Physical Assessment
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7
Q

What are dermatomes?

A

A skin area innervated by the sensory fibers of a single nerve root.

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8
Q

What are myotomes?

A

A group of muscles primarily innervated by the motor fibers of a single nerve root.

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9
Q

What are six different pain types?

A
  1. Somatic
  2. Neuropathic
  3. Psychogenic
  4. Visceral
  5. Sympathetic
  6. Phantom
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10
Q

Name three different types of pain quality?

A
  1. Paroxysmal - shooting, electric
  2. Superficial - itchy, tingling
  3. Deep-achy - heavy, cramping
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11
Q

Name four types of diagnostic imaging?

A
  1. X-ray
  2. CT-scan
  3. MRI
  4. Ultrasound
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12
Q

Do sinew channels connect to the internal organs?

A

A: No

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13
Q

Name five External Pathogenic Influences?

A

Wind, Cold, Damp, Heat/Fire, Dryness

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14
Q

The main physical clinical manifestations of Bi Syndrome (Painful Obstruction) are?

A
  1. Pain
  2. Aching
  3. Numbness
  4. Heaviness
  5. Reduced ROM
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15
Q

What is radiculopathy?

A

Pain that radiates down.

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16
Q

In Cross Syndrome which two muscle groups are deficient?

A

Rhomboids and neck flexors.

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17
Q

When checking ROM what is degree for side flexion of neck?

A

20-45 degrees

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18
Q

What TCM pattern does tissue tension indicate?

A

Wind, Blood, Stagnation, Cold or Deficiency.

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19
Q

What does AROM stand for?

A

Active Range of Motion

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20
Q

What does TCM pattern does tissue thickness indicate?

A

Dampness

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21
Q

What does TCM pattern does palpable, fibrous tissue texture indicate?

A

Blood stagnation, cold

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22
Q

What WM conditions do cold vs hot indicate?

A

Poor blood circulation vs inflammation

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23
Q

What does PROM stand for?

A

Passive Range of Motion

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24
Q

What does RROM stand for?

A

Resisted Range of Motion

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25
Q

What are tests for neck ROM?

A

R / L Rotation, Neck Flexion, Lateral Flexion

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26
Q

What does MMT stand for?

A

Manual Muscle Testing

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27
Q

What is the difference between Break Test and Active Resistance Test?

A

BT: manual resistance applied to limb after movement complete. Tests myotomes/muscle/tendon lesions. Locked feeling.
RT: manual resistance applied to limb against actively contracting muscle. Also tests myotomes/muscle/tendon lesions.

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28
Q

What types of Outcome Measures can be used?

A

Pain Scales, ROM, MMT, ADL (Activity of Daily Living)

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29
Q

What diagnostic imaging is best to show tendon, ligaments, and spinal chord?

A

MRI

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30
Q

Name the five criteria that dictate prognosis?

A
  1. Condition duration
  2. Structures involved
  3. Age of patient
  4. Degree dysfunction
  5. Clinical experience tx condition
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31
Q

What is the dosage (#of treatments) in the beginning of treatment?

A

1-3/week

32
Q

How many treatments to create a measurable change?

A

3-5 treatments (4-6tx for complex)

33
Q

How many treatments for 80-95% resolution?

A

6-8 treatments (8-12 for complex)

34
Q

What is the average treatment time?

A

30 minutes

35
Q

What is nociception?

A

A noxious, potentially damaging biological kind of pain.

36
Q

What are the five diagnostic descriptors of pain?

A
  1. Location
  2. Type
  3. Intensity
  4. Frequency
  5. Duration
37
Q

These channels have a horizontal flow of energy, are prone to EPFs and are where most blood stasis occurs?

A

Luo Channels

38
Q

These channels are more like regions and are responsible for muscle aches and stiffness?

A

Sinew Channels

39
Q
  1. For severe pain you focus your energy first where? 2. And then when the pain is under control where?
A
  1. Meridian

2. Organ pathology

40
Q

Special Tests confirm an idea of what a condition is. Specials tests must demonstrate these four qualities:

A
  1. Reliability - consistent results
  2. Validity - does what its supposed to
  3. Interrater Reliability - group of practitioners gets consistent results
  4. Intrarater reliability - one practitioner gets consistent results
41
Q

Name five different types of tests?

A
  1. Joint and muscle function
  2. Joint stability Tests
  3. Special Tests
  4. Neurological Assessment
  5. Vascular Assessment
42
Q

What are trigger points?

A

Palpable nodules or bands that when compressed will refer pain that is reproducible and predictable.

43
Q

What is an innervation zone?

A

Located in the belly of the muscle, these are zones where nerve enters muscle then branches.

44
Q

True or false: Innervation zones can treat trigger points, but trigger points don’t treat innervation zones.

A

True

45
Q

What kind of needle do you use to treat periosteum?

A

Osteoacupuncture (periosteal needle)

46
Q

True or False: All Ashi points are Trigger Points, but not all Trigger Points are Ashi.

A

False. All Trigger Points are Ashi Points.

47
Q

Ashi Points can bring about better results of myofascial and joint pain than Acupuncture Points.

A

True

48
Q

What are different types of trigger points?

A

Primary & Active - (reproduce pain referral)
Latent - (tender and limits PROM)
Satellite - (activated b/c in ref. zone of another trigger pt)

49
Q

What causes a trigger point?

A
  1. Repetition/overload
  2. Trauma
  3. Psycho-emotional
  4. Another trigger pt
  5. Infections
50
Q

What is a SOAP note?

A

Subjective/Objective/Assesment/Plan

51
Q

What is a key ingredient to determining improvement at your follow-up exam?

A

Recording pain data: (location/intensity/frequency/duration)

52
Q

Name some special considerations to think of if your treatment is not effective after 24 hours?

A
  • change thickness of needle
  • point stimulation
  • point selection
  • intensity of modalities
53
Q

How do you treat a trigger point?

A

Locate tender point, “dry needle” and get twitch.

54
Q

What are some things to notice upon observing client?

A
  1. crepitus (joint noise)
  2. muscle atrophy or spasm
  3. scarring
  4. temperature/swelling
  5. color/texture
  6. any deformities/contour
55
Q

Two types of postural assessment?

A

Static and Dynamic.

56
Q

What number correlates to Maximal Resistance 0-5?

A
5 = (100% normal) 
4 = (is moderate 75%) 
3+ = (is minimal 50%)
57
Q

What does the dark areas on an X-ray indicate?

A

Degeneration.

58
Q

What are factors that determine treatment strength?

A
  1. Stimulation method (lift/thrust/rotate)
  2. Acute vs Chronic
  3. Treatment time
  4. Needle gauge
  5. Tissue type
59
Q

Acute Tx vs Chronic Tx?

A

Acute:

  1. Mild technique
  2. Less time (15-20 minutes)
  3. Thinner gauge (0.18-0.22mm)

Chronic:

  1. Stronger technique
  2. Longer Tx (30 minutes)
  3. Thicker gauge (0.22-0.30mm)
  4. Source Point of effected channel w/ Luo Point on paired meridian
60
Q

What must you identify before you treat a musculoskeletal condition?

A

A) Disharmony (int/ext, Root/Branch)
B) Meridians Involved
C) Where Pain Is
D) Treatment Approach

61
Q

What are four different treatment approaches?

A
  1. Point selection
  2. Manual Therapy
  3. Int/Ext herbal medicine
  4. Adjunctive therapies
62
Q

What are four things you look for in a point selection?

A
1. Energetics 
(TCM theory, Luo/Source etc.., Special)
2. Properties 
(Actions and Effects)
3. Location 
(distal, mirror etc..)
4. Anatomical 
(Trigger Points, Inn. Zones, osteoacup., anatomical needling)
63
Q

What are Luo Points good at treating?

A
  • Yin/Yang of related channel
  • Qi and Blood Stagnation
  • Stop Bleeding
  • Edema
  • Invasion of EPF
  • To Reinforce Treatment
64
Q

What Luo point would be good for treating lateral epicondylitis?

A

Li6 (Luo)

65
Q

What Guest/Host points would be good to treat stiff neck, shoulder pain on lateral upper arms?

A

Si4 + HT5

66
Q

If the meridian is DEFICIENT how would you needle the Guest/Host points?

A
  • Tonify the meridian’s Source Point

- Disperse the paired meridians Luo Point

67
Q

What point for chronic Bone Bi?

A

BL11 (Hui Point)

68
Q

What point for weakness and stiffness of the joints?

A

GB34 (Hui Point)

69
Q

What Point for marrow?

A

GB39 (Hui Point)

70
Q

What point category is good for acute conditions involving pain and inflammation?

A

XiCleft Point

71
Q

What area of the body does Zone Acupuncture refer to?

A

Wrist and Ankle

72
Q

Can you name the 5 Systems of Dr. Tan?

A
  1. Name Sharing Meridian - (LU/SP)
    (ex: sick: Hand Tai Yin, Tx opp: Foot Tai Yin)
  2. Branching Channels - (LU/BL)
    (ex: sick: Hand Tai Yin, Tx either: Foot Tai Yin)
  3. Int/Ext
  4. Clock Opposites
  5. Clock Neighbors
73
Q

Distinguish between:

  1. Wandering Bi
  2. Painful Bi
  3. Fixed Bi
  4. Febrile Bi
A
  1. Wind - numb/tingling
  2. Cold - sharp
  3. Damp - heavy/low body/stenosis
  4. Heat - rheumatoid arthritis/hot to touch
74
Q

Wandering Bi point prescription?

A

Expel Wind: GB20, 21, GV16, BL12, Li4

also: TW6, GB39, GV14

75
Q

Painful Bi point prescription?

A

Warm channels: ST36, CV6 Moxa
Move Qi and Blood: Li11, Si5
CV4, BL10, GV14

76
Q

Fixed Bi point prescription?

A

Invigorate Spleen and resolve damp.

ST36, SP6, SP9, ST40, BL20, BL21, SP5

77
Q

Febrile Bi Point prescription?

A

Clear heat, dispel wind, resolve damp, nourish yin.

ST43, Li4, GV14, Li11