Osteopathic Skills Exam Flashcards
(70 cards)
1
Q
Name the ligaments of the cervical spine
A
Anterior Longitudinal Ligament Posterior longitudinal ligament Ligamentum Flavum (yellow) Interspinous ligament Nuchal ligament (continuation of the supraspinous ligament)
Atlantoaxial joint capsule Atlantooccipital joint capsule Trasnverse ligament of the atlas Cruciform ligament Accessory atlantoaxial ligament Lateral atlantooccipital ligament Atlanto occipital membrane
2
Q
Name the ligaments of the shoulder joint
A
Transverse humeral ligament
Glenohumeral ligament (Superior, intermediate and inferior fibres)
Coracoclavicular ligament (cornoid and trapazoid) Coracohumeral ligament Coracoacromial ligament Superior transverse scapular ligament Acromioclavicular ligament
3
Q
Which ligament stabilizes the sternoclavicular joint?
A
Anterior and posterior sternoclavicular ligament
Interclavicular ligament
costoclavicular ligament
4
Q
Name the 4 ligaments of the elbow joint
A
Annular ligament
Quadrate ligament
Medial ulnar collateral ligament
Lateral radial collateral ligament
5
Q
Name the ligaments of the lumber spine and Sacroilliac joint.
A
iliolumbar ligament Sacrotuberous and sacrospinous ligaments Posterior sacroilliac ligament Anterior sacroilliac ligament Interosseus sacroilliac ligament Inguinal ligament
6
Q
Name the ligaments of the hip
A
iliofemoral ligament ischiofemoral ligament Pubofemoral ligament Ligamentum teres transverse acetabular ligament
7
Q
Name the ligaments of the knee
A
Anterior and posterior cruciate ligaments
Medial and lateral collateral ligaments of the knee
Transverse intermeniscal ligaments
Coronary ligament of the knee
Patellar ligament
8
Q
Which ligament binds the tubercle of the rib to the transverse process of the vertebrae?
A
Costotransverse ligament
9
Q
Which ligament binds the head of the rib to the body of the vertebrae?
Which ligament bind the 12th rib to the transverse processes of L1/2,
A
Radiate ligament
LUMBOCOSTAL LIGAMENT
10
Q
Which ligament binds the clavicle to the first rib?
A
Costoclaviclar ligament
11
Q
Which ligament binds the sternocostal joint?
A
Radiate sternocostal ligament
12
Q
Spheno-basilar symphysis ?
A
synchondrosis
13
Q
What type of joint is the Temporal mandibular?
A
What type of joint is the Temporal mandibular
14
Q
Name the 3 lateral collateral ligaments of the ankle joint?
A
Anterior talofibular ligament
Posterior talofibular ligament
calcaneofibular ligament
15
Q
Name the 4 deltoid ligaments of the ankle joint?
A
Tibionavicular ligament
tibiocalcaneal ligament
Anterior and posterior tibiotalar ligament
16
Q
Which ligament runs from the sustentaculum tali of the calcaneus to the navicular tuberosity?
A
calcaneonavicular ligament
17
Q
The long planter ligament joins from which 2 tarsal bones?
Which ligament stabilizes the tarsalmetatarsal joint?
A
Calcaneus to the cuboid
Transverse ligament
18
Q
The acronym START stands for?
A
Symptom Reproduction Tissue texture changes Asymmetry Reduction in range of movement Tenderness
19
Q
What are we looking for in an active assessment?
Which side do we assess first? why?
A
Quality of movement
Quantity of movement
Symptom Reproduction
Asymptomatic side
To determine what constitutes as normal for the patient
20
Q
What dives/maintains the flow of Lymph?
A
Blind ended open capillaries, keeps the flow of lymph one directional contraction of smooth muscle ABDOMINAL PRESSURE GRADIENT Movement of muscles Movement of joints Arterial pulsation Gravity/inversion
21
Q
Where does fluid present within interstitial space come from?
What is lymph made from?
What is the content of lymph
A
Intersticial fluid (fluid between blood vessels and cells) Substances which leak from blood capillaries is picked up by lymphatic capillaries
Carbon dioxide Lipids Protein Hormones Waste products such as lactic acid Lymphocytes
22
Q
Where is the thymus located?
A
Posterior to Manubrium of the sternum
Anterior to the pericardium of the heart
23
Q
What is the thymus made from?
A
Adipose tissue
Immature and mature lymphocytes
epithelial cells
24
Q
Which organs/marrow helps with the formation of the lymphatic system?
A
Red bone marrow found in long and flat bones
Thymus
Spleen
Tonsils
25
Where is the spleen located?
What is the function of the spleen?
Where is it located
Removes microorganisms from the body
The spleen acts as a filtration system for the blood
Destroying old, damaged erythrocytes (RBC)
Helps to retain iron which binds to the RBC
Upper left hand side of the abdomen, behind the ribs,
26
Where is the liver located?
| What role does the liver play in immunity?
On the upper right hand side of the abdomen
Detects pathogens entering the body via the gut,
It is designed to detect, capture, and clear bacteria, viruses, and macromolecules.
27
What role do the tonsils play in immunity?
Contain a concentration of WBC
| White detect and destroy germs
28
What is the role of the lymphatic system?
Primary function of the lymphatic system is to help retain homeostasis, it does so by..
1. Removes excess interstitial fluid
2. Helps to circulate fatty acids, protein, hormones (lipids)
3. Produces antigens
4. Removes cellular waste (lactic acid)
29
Name 3 conditions which effect the lymphatic system
Mil roys disease (Absence or damage to the lymphatic nodes to the legs)
Lymphedema
Lymphadenectomy
30
What conditions can effect the lymphatic system?
Tension in fascia
Diaphragmatic dysfunction
Lymphedema due to pregnancy/overweight
Stationary lifestyle
31
When would you use lymphatic techniques?
As part of a general osteopathic treatment
subsidiary to compliment another treatment
to help remove metabolic waste
Mobilization techniques help to promote localized blood flow, promote the flow of synovial fluid and help the client to overcome psychological apprehension to mobilize joints
32
Name some contraindications to lymphatic technique
```
Localized swelling after injury
Odema due to non pathological cause
Odema due to varicose veins
cirrhosis of the liver
Malnutrition
Thrombophlebitis
```
33
Name some total contraindications to lymphatic technique
```
Lack of concent
No clinical diagnosis
Cancer
DVT
Compartment syndrome
Adverse reaction to previous treatment
```
34
How would you describe lymphatic techniques?
| How many repetitions would you perform?
Gentle, rhythmical, passive movements
| 10 to 30
35
What facial compartments are present on the thigh?
Anterior, posterior, medial and lateral compartmetns
36
Give 5 benefits of lymphatic technique
Gives a boost to the immune system by promoting the flow of leukocytes (WBC)
Increase antigens response (mobilizes immune cells)
Neutrofils, basofils, lymphocytes monocytes
Helping to remove fluid build up due to the inflammatory response
Promotes the flow of lymph to help remove interstitial fluid, waste products (lactic acid), helps with the circulation of fatty acids, hormones and protein
Mobilizations stimulate localized blood flow, stimulate synovial fluid, helps patient to overcome psychological apprehension to move
37
Name 4 types of immune cells
Neutrofils, basofils, lymphocytes monocytes
38
Define somatic dysfunction
Somatic dysfunction is defined as impaired or altered functions of related components of the somatic (body framework) system. It can include the musculoskeletal, nervous, or lymphatic systems, viscera, fascial systems
39
What does the acronym start stand for?
```
Symptom reproduction
Tissue texture changes
Asymmetry
Reduction in range of movement
Tenderness
```
40
Name psychological effects of NMT
Induce relaxation
| Reduce anxiety
41
Name neurological effects of NMT
Innervates the parasympathetic nervous system, inducing relaxation (rest and digest)
Influences the muscle spindles and golgi tendon organs thus DECREASING EXICTABILITY/HYPER ACTIVITIY OF the muscular system
42
Describe the physiological effects of NMT
Stimulate localized blood flow
Stimulate the flow of lymph
Increase the release of seratonin and oxytoxin
Increase parasympathetic nervous system, improving sleep and altering perception of pain
Reduce cortisol
43
Describe the bio mechanical effects of NMT
Reduce hyperactivity in muscles thus increasing available ROM of joint
Increase compliance of joints/muscles
Alters perception of pain
Regains association/pro preoceoptive of tissue
44
What is the aim of NMT
To restore functional normality be reducing hyperactivity of tissues by influencing muscle spindles and GTO
* Deactive myofascial trigger points
*Prepare the area for other modalities, manipulation, myofascial stripping, mobilisation, MET, AIS
Enhance lymphatic drainage technique
Restore appropriate resting length to muscles and restore ROM at joints
45
What is a muscle spindle?
Where are they located
How does the mechanism work?
Muscle spindles are receptors which run parallel to muscle fibers
They are responsible for monitoring muscle length
Sensory afferent neurons send information to the CNS regarding muscle spindles
it will synapse via an intereneuron
46
What are golgi tendon organs?
The Golgi tendon organ (GTO) (also called Golgi organ, tendon organ, neurotendinous organ or neurotendinous spindle) is a proprioceptor – a type of sensory receptor that senses changes in muscle tension. It lies at the interface between a muscle and its tendon known as the myotendinous junction.
47
Which nerves innervate the erector spinae?
The erector spinae muscles are innervated by the dorsal rami of the first cervical nerve (C1) through the fifth lumbar nerve (L5). The dorsal rami are the nerves that form the back divisions of the spinal nerves.
48
Describe the barrier concept using the 3 components
Give example which makes reference to rotation of head and neck
The physiological barrier makes reference to the AROM someone is able to generate
The anatomical barrier is absolute end of range before tissue etc is compromised (over pressure)
End range until a bind is attained
Between physiological and anatomical is the elastic barrier (myofacial)
49
Name the 4 key principals of osteopathy
The body is a whole
(Each components works in a collaborative fashion not as the fragmentation of parts)
Structure governs function
(morphology/shape/architecture of a joint)
The body has a regulatory self healing mechanism
(The operator removes obstructions)
The artery reigns supreme
(perthes disease)
50
Why does pain manifest
Myofascial trigger points
Fibromyalgia
Articular dysfunction
51
What is the difference between muscle spindles and Golgi tendon organs?
How does the mechanism work via NMT
Muscle spindle
Muscle spindles are located in the belly of the muscle between the actin and myosin protein filments. Theyre primary job is to act as stretch receptors within the muscle. They are sensory.
Muscle spindles detect muscle stretch
Sends signal to the cns via a afferent (sensoroy) nerve
Impulse will be sent back via the effert nerve to the muscle spindles, inducing relaxation
(Disengading hyperactivtiy of the tissue)
Golgi tendon organ
Situated with tendon of muscle (Muscle tendon junction)
Detects muscle tension in tendon
52
Whilst assessing NMT, what are we looking for?
| Name three techniques that we use
```
We assess whilst we address
Longitudiinal, transverse, inhibit
Skin
Musculature
Tenderness
Tissue texture changes
Asymetry
Hyperactivity
```
53
Whilst performing accessory movements of the Shoulder joint. What movements are we looking for?
Anterior and posterior sheer
Superior and inferior sheer
Compression and decompression
within scapular plane
54
Whilst performing accessory movements of the A/C joint. What movements are we looking for?
Anterior and posterior sheer
medial and lateral sheer (Related to the postiion of the clavicle)
Compression and decompression (Step deformity)
55
```
What is the ROM for
Dorsiflexion
Planterflexion
Inversion
Eversion
```
Dorsiflexion 20
Planterflexion 50
Inversion 35
Eversion 15
56
What type of motion do accessory movements test?
Arthrokinematics
57
What is the difference between Arthrokinematics and osteokinematics?
osteokinematics movements you see
| Arthrokinematics movements you feel
58
What factors affect ROM?
Morphology, archetectutre, ligamentous support, antagonistic musculature, degenerative changes, neurological influance, hereditary conditions
59
What can effect the laxity of a joint
Displacement of the articulating surfaces
laxity of ligaments
partial/full thickness tear of muscularity
glenoid/acetabulum labrum
60
What is an accessory movement?
A passive movmeent that cannot be performed by the patient within isolation
61
What tissue can we influence with NMT?
```
Muscle
Tendon
Ligament
Fascia
periosteum of the bone
```
62
What is the palpation contact for the first rib?
Supraclavicular fossa
63
During rotation (passive of the ribs) what do you feel?
The ribs sheering on each other
64
Where is the angle of the rib located?
Lateral to the tubercle of the ribs
65
During lateral flexion (passive of the ribs) what do you feel?
Ribs fanning
| intercostal space increasing
66
What type of cancer would you find within the lymphatic system
metastatic cancer
| cancer which has broken away from primary site
67
Describe the flow of lymph (lower and upper)
```
Anterior tibial node
Popliteal
Inguinal
Illiac
intestinal and lumber (cisterna chyli)
intercostal
left thoracic
left sublavian
brachiocephalic
sueprior vena cava
left atrium
```
68
Signs of cancer
```
Weight loss
loss of apatite
Lethargic
Fever
Fatigue
Pain
```
69
Describe the flow of lymph from the arm
```
cubital
supratrochlear
inflraclavicular
supraclavicular
apical
```
70
Describe the flow of lymph of the head and neck
```
mastoid
occipital
parotid
superficial and deep cervical
submandibular
subclavicular
```
