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OMM Lecture > Palpation And Motion > Flashcards

Palpation And Motion Flashcards

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1
Q

Somatic dysfunction

A

Impaired/altered function of related components of the somatic (body framework) system

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2
Q

Somatic system

A

Skin, fascia, muscle, arthrodial, and related vascular, lymphatic, and neural elements

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3
Q

T.A.R.t

A

. Tissue texture abnormality
. positional Asymmetry
. Restriction of motion
. tenderness

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4
Q

Palpation

A

. Application of variable manual pressure to surface of body to determine shape, size, consistency, position, motility, and health of tissues beneath
. Cornerstone of effective diagnosis and treatment

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5
Q

What can be determined through palpation?

A

Location, severity, and relevance of T.A.R.t

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6
Q

What is determined in identifying T.A.R. t?

A

. Motion impediment or restriction

. Interrelationship of structure and function and if it is messed up

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7
Q

What touch receptors are used in palpation exam and where are they most numerous?

A

. Merkel’s disks and Meissner’s corpuscles

. Numerous in finger pads

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8
Q

Are heat receptors superficial or deep to touch receptors?

A

Deep

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9
Q

What does light palpation reveal?

A

. Findings in skin and subcutaneous tissue

. Skin temp., moisture, texture, and turgor

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10
Q

Resting tone

A

. Normal feel of a resting muscle

. Can be hyper/hypotonic, or atomic compared with normal resting tone

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11
Q

What does deeper palpation reveal?

A

. Bones and joints

. Bony landmarks that are origin/insertion for muscles

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12
Q

What causes lack of turgor in skin?

A

Presence of dehydration, aging, and certain metabolic conditions

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13
Q

What does increased sympathetic tone to skin cause?

A

. Localized inc. in sweating and dec. in skin elasticity

. Keeps skin tight

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14
Q

Skin drag reaction

A

. Sense of resistance to light traction applied to skin and related to degree of moisture and degree of sympathetic nervous system activity
. Reflects area of somatic dysfunction
. Also indicated congestion if skin stays red

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15
Q

Where are changes from skin drag most intense in thoracic spine?

A

Costo-transverse articulation

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16
Q

Skin rolling test

A

. Grasp pinch of skin between thumb and index over area of palpable tissue change
. Pull skin away and note degree of resistance
. Could by hyperalgesic but not painful

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17
Q

What is common location for edema?

A

Subcutaneous tissue

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18
Q

Viscerosomatic reflexes produce tissue texture abnormality in what part of body and what are the characteristics of the abnormalities?

A

. Subcutaneous tissue

. Puffy, boggy, and rubbery feel

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19
Q

Long muscles receive innervation from ______ while short, deep muscles receive innervation from ____

A

Multiple spinal segments (long), single segments (short)

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20
Q

Long spinal muscles are ___ to short muscles

A

Superficial

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21
Q

What are long spinal muscles involved in?

A

. Postural patterns and group curves

. Lack segmental specificity

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22
Q

What are short spinal muscles involved in?

A

Segmental movement/dysfunction

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23
Q

Best way to palpate muscle

A

. Palpate in direction perpendicular to the fibers
. Superficial muscle: side to side
. Deep (oblique): vertical/ up-down

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24
Q

Hypertonic muscles characteristics

A

. Feel ropy/stringy
. Lack of homogeneity
. Bogginess

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25
Flaccidity and cause
. No muscle tone | . Caused by disruption of proper neuronal info to the muscle (nerve root compression
26
Increased muscle tone is a sign of ____
Anxiety, inc. sympathetic outflow, or facilitated neural reflexes
27
Rough skin
Bumpy irregular surface
28
Smooth skin
Surface free from irregularities, roughness, or projections
29
Soft skin
Smooth or fine to the touch w/o firmness
30
Boggy sub-Q
Quality of inc. fluid (wet sponge)
31
Doughy sub-Q
Soft, thick, pasty mass
32
Puffy sub-Q
Swell or seem to swell as w/ air or fluid
33
Flaccid muscle
Lacking firmness, soft and weak
34
Hypertonic muscle
. Condition of excessive tone of skeletal muscles | . Inc. resistance of muscle to passive stretching
35
Muscle ropiness
Cord-like or rope-like feel to muscle that has been chronically contracted
36
Muscle stringiness
Palpable tissue texture abnormality characterized by string-like Myofascial structures
37
Tendons
.Fibroelastic strands of CT . Feel like taut band of tissue, tense and smooth, homogeneous . Easy to palpate
38
Ligaments
. Tough fibrous band that connect bone to bone . Difficult to palpate bc they lie deep . Serious injuries to them cause joint laxity
39
CT/fascia
. CT that lines, divides, separates, and support internal organs, muscles, cavities . Feels like butter melting as it releases
40
Bone and joint palpation
. Reveals motion restriction/ asymmetry . May elicit tenderness partially bc of depth of palpation . Tissue overlying bone can sometimes feel boggy
41
Acute somatic dysfunction
. Immediate/ short-term impairment or altered function of related components of somatic system
42
How is acute somatic dysfunction characterized in early dysfunction?
. Vasodilation, edema, tenderness, pain, and contraction . Tenderness even to light touch(hyperalgesia) . Muscle tends to be hypertonic and puffy
43
Acute inflammation characteristics
. Redness (rubor) . Warmth (calor) . Pain (dolor) . Swelling (tumor)
44
Blush reaction
Tissue remains red after palpation from local vasoactive mediators and autonomic mechanisms
45
Chronic somatic dysfunction
. Impairment or altered function of related components of somatic system
46
How is chronic somatic dysfunction characterized?
. Tenderness, itching, fibrosis, paresthesias, contracture . Tissue change less intense ( dry, slick, thin, cool) . Significant motion restrictions . Pigment changes
47
Active motion
Motion produced by patient
48
Passive motion
Motion produced by physician without patient effort
49
What does quantity and quality mean in regards to motion?
What is range of motion and how does motion feel
50
How is quantity of motion measured?
Inspection, goniometer, inclinometer, tape measure
51
How is quality of motion measured?
Palpation
52
Once tissue texture change is found what happens?
Motion testing is performed after screening
53
What is determined in motion testing?
. Quality and quantity of motion | . Direction, range, and characteristics of tissue motion
54
Terms to describe quality of motion
Smooth, ratcheting, rubbery
55
How is quantity of motion addressed in motion testing?
Taking joint or tissue trough all directions of motion
56
What objective information does muscle testing provide?
Type, severity, and etiology of dysfunction
57
What is palpation used for during OMT?
Localize corrective forces and monitor for improvement in tissue
58
Gross movement of spine
Movement of group of vertebra
59
Segmental spine movement
. Movement of specific vertebra . Named for superior segment in relationship to inferior segment (Motion of T3 named for motion in relation to T4)
60
Major motions of spine
Flexion/extension, sidebending, rotation
61
Minor motions of spine
Translation (front/back, side to side, motion along axis), compression (pushing together), distraction (pulling apart)
62
Appendicular motion
. Movement of extremity joints | . Named for movement in relation to its proximal bone
63
What motions does somatic dysfunction usually occur in appendicular skeleton?
In minor motions of joint
64
Osteopathic medical practice requires what components?
. Thorough history . Thorough physical exam . Reasoned diagnosis . Logical treatment plan based on above
65
Osteopathic manipulative medicine
application of osteopathic philosophy, structural diagnosis, and use of osteopathic manipulative treatment in diagnosis and management of patient
66
Osteopathic manipulative treatment (OMT)
Therapeutic application of manually guided forces by an osteopathic physician to improve physiologic function and homeostasis that have been altered in somatic dysfunction
67
Functional spinal unit (vertebral unit)
2 adjacent vertebra plus their related neural, vascular, CT, and muscles
68
How to determine functional spinal unit’s orientation in space?
Based on theoretical point on ant. Sup. Surface of upper vertebral body of unit (Twist to right the dot moves to the right)
69
Spinal segment
Division of the spinal cord containing a bilateral pair of nerve roots
70
What do palpation skills help with?
. Identifying landmarks for electrocardiogram . Performing lumbar puncture . Starting IV, central line, arterial blood gas . Examine organs . Localizing injured/inflamed areas . Performing breast, testicular, or rectal exam
71
Order of examination in osteopathic patient
.standing structural exam screen . Motion testing . Screening palpation exam . Detailed palpation exam based on above
72
Hypotonicity
Result from underuse or aberrant neuronal info
73
How many aspects of T.A.R.t do you need to diagnose somatic dysfunction?
2 aspects
74
Tissue texture abnormality
. Palpable change in tissues from skin to periarticular structures that accompanies somatic dysfunction . Different for acute v. Chronic injuries
75
Acute tissue abnormalities
``` . Recent history . Severe pain . Warm, moist, red skin . Sympathetic: vasodilation of skin . Increased muscle tone . Edematous, puffy tissue . Moist skin . Minimal somatovisceral effect ```
76
Chronic tissue texture abnormalities
``` . Long standing . Dull, achy pain . Cool, pale skin . Sympathetic: vasoconstriction of peripheral vessels . Decreased tone, limited ROM . Doughy, stringy, ropy tissues . Pimples, scaly, dry, pigment change . Frequency somatovisceral effects ```

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