OSI Flashcards by Aly Wurster

what are the 3 basic body types?

endomorph, ectomorph, mesomorph

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what are the 3 basic body types?

endomorph, ectomorph, mesomorph

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person whose body habitus is comprised of tissues predominantly endoderm (obese, fatty)

endomorph

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person whose body habitus is comprised of tissues predominantly from endoderm (tall, lanky)

ectomorph

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color can be an important indicator in clinical observation. what are some colors to watch out for in patients and what might they mean?

pale- bad
red- erythema, inflammation
yellow- jaundice (liver disease)
blue- cyanosis
black- necrosis

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what is the proper order for assessing structural diagnosis? (always do structural exam in context of total H&P)

observe, auscultate, percuss, palpate

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what factors create asymmetry?

bone or joint deformity, kyphoscoliosis, dress, occupation, mental attitude, habit, lower extremity defects, somatic dysfunction

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which of the following is likely to cause postural asymmetry?

a. belt
b. eye color
c. organ transplant
d. anatomical short leg
e. type of muscle tissue

d. anatomical short leg

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which of the following is likely to cause postural asymmetry?

a. belt
b. eye color
c. organ transplant
d. anatomical short leg
e. type of muscle tissue

d. anatomical short leg

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what are some landmarks we use to assess symmetry of the patients anterior side?

eye level
nose angle to midline
ear lobe level
shoulder height
clavicle alignment
fingertip level
breast
crest of ilium
angle of patella
medial or lateral malleolus

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what are some landmarks we use to assess symmetry of the patients posterior side?

shoulder level
inferior angle of scapula
fingertip level
iliac crest height
gluteal line
popliteal space
medial and lateral malleolus

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What is TART?

Tissue texture changes
asymmetry
restriction of motion
tenderness

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what is active ROM?

patient demonstrates the activity (less than passive)

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what is passive ROM?

patient is not active, examiner takes the relaxed limb through ROM (no muscles only ligaments stop motion)

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what is an anatomic barrier?

limit of motion imposed by anatomic structure (just beyond passive ROM)

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what is an elastic barrier?

range between physiologic and anatomic barrier of motion in which passive ligamentous stretching occurs before tissue disruption (between active and passive)

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what is a restrictive barrier?

functional limit within anatomic ROM which abnormally diminishes normal range of motion

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what is the term we use to describe impaired or altered function of related components of the somatic system: skeletal, arthrodial, myofascial structures and related vascular lymphatic and neural elements

somatic dysfunction

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what is OMT

osteopathic manipulative treatment: therapeutic application of manual forces used to improve physiologic function and support homeostasis

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term describing the normal feel of muscle in the relaxed state?

tone
(hypertonicity when spastic paralysis)
(hypotonicity when flaccid paralysis)

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term describing abnormal shortening of muscle due to fibrosis often resulting from a chronic condition

contracture

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what is abnormal contraction of muscle maintained by physiologic need? (hint it often is accompanied by pain and restriction of motion)

spasm (hypertonicity)

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state of muscle with increased fluid in hypertonic muscle (like a wet sponge)

bogginess

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state of muscle with hard, firm, rope like tone usually indicating a chronic condition

ropiness

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what are qualities of vascular textures that indicate acute dysfunction? chronic?

actue: inflamed, peptide release VASODILATION chronic: sympathetic tone increases VASOCONSTRICTION

what is end feel?

palpatory experience or quality of motion when a joint is moved to its limit or barrier is approached

what are the 4 types of abnormal end feels and an example of each

early muscle spasm- protective after injury late muscle spasm- chronic hard capsular- frozen shoulder soft capsular-synovitis (knee swells after injury)

what is the term for: discomfort or pain elicited by physician through palpation (unusual sensitivity to touch or pressure)

tenderness

what are acute TART affects?

Texture: red, swollen, boggy, increased tone asymmetry: present restriction: present and painful with motion tenderness: sharp pain

What are chronic TART effects?

Texture: dry, cool, ropy, pale, decrease tone asymmetry: present, compensation occurs restriction: present (maybe not guarded) tenderness: dull, achy pain or paresthesias

What are chronic TART effects?

Texture: dry, cool, ropy, pale, decrease tone asymmetry: present, compensation occurs restriction: present (maybe not guarded) tenderness: dull, achy pain or paresthesias

how do we name somatic dysfunction

"where they like to live" position of ease if it freely rotates left and is restricted right we name it: rotated left

to decrease the angle between bones of a joint

flexion

what is fryettes principle (#1)

Type 1 mechanics become Type 1 dysfunction! FP#1. when thoracic and lumbar spine are in neutral position (no flexion or extension), the coupled motion of side bending and rotation occur in opposite directions for each group of vertebrae (to ration occurs toward convexity) Remember by TONGO (Type One Neutral Group goes Opposite for rotation and side bending )

what happens when someone gets restriction of motion in the spine?

reduce efficiency (as body tries to compensate) impair fluid flow alter nerve function throws off balance

where are flexor muscles of the spine located in relation to the spine

ventral to the spine (anterior)

where are extensor muscles of the spine located?

dorsal (posterior) to spine

if you are assessing a spinal segment and vertebra will not rotate to the right (hard end feel) how would you name this dysfunction?

rotated left somatic dysfunction

what is fryettes principle (#2)

FP#2. when thoracic and lumbar spine are sufficiently flexed or extended, the coupled motion of side bending and rotation in a vertebral unit occur in the same direction (usually occurs in a single segment) rotation is toward the concavity this type of mechanics occur in lumbar thoracic AND typical cervical spine segments (excluding OA joint)

to chart Type I somatic dysfunction we locate vertebra (or group), indicate position (neutral), indicate side bending and rotation. How would you chart "restriction is to rotation left and side bending right"

T1-3 N R(R) S(L) Thoracic vertebrae 1-3 in a neutral position are rotated right and side bent left

to chart Type II somatic dysfunction we locate vertebra, indicate position (flexion or extension), indicate side bending and rotation. How would you chart "restriction is to flexion, rotation left and side bending left"

T6 E R(R) S(R) thoracic vertebra 6 in an extended position is rotated right and side bent left

what is freyettes principle (#3)

initiating vertebral segment motion in any plane of motion will modify movement of that segment in other planes of motion (motions are coupled)

what is PTP on the right a result of ?

PTP: posterior transverse process result of segment rotated to the right

what type of mechanics are displayed at the OA joint

modified Type I

with type I mechanics, rotation and side bending occur to the ___ side

opposite

with type II mechanics, rotation and side bending occur to the ___ side

same

correct the following: OA N R(R) S(R)

OA joint follows modified type 1 mechanics so we know R and S occur to opposite sides

correct the following: C5 F R(R) S(R)

this is correct because C2-7 follow type II mechanics

correct the following: T6 F R(R) S(L)

T6 in flexion is looking at Type II mechanics so R and S must be to the same side T6 F R(R) S(R)

correct the following: L2-4 N R(L) S(L)

think of TONGO L2-4 N R(L) S(R)

lymphatic development begins at week __ of pregnancy but is significantly present by week __ however it remains immature at birth until 6-9 years

5, 20

what is the largest mass of lymphoid tissue

spleen (beneath ribs 9-11 on the left)

what does it mean that the spleen and liver are pressure sensitive?

movement of diaphragm is important for homeostatic movement of fluid

what is the spleens job?

destroy damaged RBCs synthesize Igs clear bacteria

what do we find in the right upper quadrant of the abdomen (palpable)

liver

who is the gate keeper of the shared hepato-biliary-pancreatic vein and lymph drainage

liver

this lymphoid organ is found in anterior mediastinum, it is large in infancy and replaced by fatty tissue as we age

thymus

what is Thymus's job

maturation of T cells

what are the 3 types of tonsils located in posterior oropharynx

palatine, lingual, pharyngeal

what is the job of tonsils

provide cells to build immunity (esp in childhood)

this little guy is located at the proximal end of the cecum and contains lymphoid pump to help GALT

appendix

what are important features of GI lymph tissue

peyer patches in ileum | lacteals in sm intestine (absorb large chylomicrons into lymph)

where do we find superficial lymph nodes? how bout the deep ones?

superficial- within subQ tissue along superficial veins | deep- beneath fascia, muscle, organs

what is the most highly organized lymph tissue

lymph node

what lymph node characteristics should cause us to look for cuts/ bites/ rashes/ infection near the node

swollen painful node

what LN characteristics should cause us to thing malignancy/ disease

swollen, indurated, nonpainful

what is palpable virchow's node?

L supraclavicular node (indicates abdominal or thoracic cancer)

what does palpable supratrochlear node indicate?

SYPHILIS

do lymph vessels have valves?

yep (low pressure needs to prevent back flow somehow)

vessels perfuse all body tissues except what??

bone marrow epidermis cartilage muscle endomysium

what composes lymph fluid?

proteins, electrolytes, immune cells, Ags, bacteria, viruses, clotting factors, chylomicrons (after eating)

what is the largest lymph vessel between aorta and azygous vein? what does it pierce? which side of the body does it drain?

thoracic duct pierces sibson's fascia left side (and both sides below umbilicus)

this is a dilation of the distal thoracic duct anterior to L1-2 and posterior to right crura of diaphragm receiving lymph from R and L lumbar lymphatic trunks

cisterna chyli

what drains into the right lymphatic duct?

R arm, head, neck, thorax heart lungs (except left upper lobe)

valves that prevent back flow of venous blood into the lymphatic system are under what kind of neural control

sympathetic (thus increased tone decreases lymph flow into the venous system)

how much fluid moves from capillary to interstitial space each day? (10% drains into lymph system)

30 L

what is the normal interstitial fluid pressure? at what pressure do lymph capillaries collapse causing flow to cease?

-6.3 mmHg | flow ceases at 0

in large lymph vessel walls what does smooth muscle do?

peristalsis

what are the two diaphragms in the body that are essential for pushing lymph fluid superiorly and centrally?

thoracic and pelvic

whats the biggest consequence of poorly functioning lymph system

edema (causing HTN, CHF, decreased plasma pressure, increased capillary permeability, compression of neuromuscular structures, decreased filtration of fluid)

chronic conditions warrant lymphatic OMM treatments that are what?

shorter and more frequent

what are indications for lymphatic OMM?

CHF, URI, LRI, asthma, COPD, sprains, acute somatic dysfunction, pregnancy

what are acute contraindications for lymphatic OMM?

anuria (need kidneys to process extra fluid return) | necrotizing fasciitis in treatment area

relative contraindications for lymphatic OMM

fracture or dislocation in area that will be stressed, splenomegaly due to mono, acute hepatitis, malignancy, bacterial infection, coagulopathy, unstable cardiac condition

whats the sequence for whole body lymphatic OMM treatment?

1. thoracic inlet 2. abdomen 3. upper extremity 4. lower extremity 5. head and heck 1. thoracic inlet

OSI Flashcards

(85 cards)