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OMM Lecture > Palpation And Motion > Flashcards

Palpation And Motion Flashcards

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
Q

Flaccidity and cause

A

. No muscle tone

. Caused by disruption of proper neuronal info to the muscle (nerve root compression

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26
Q

Increased muscle tone is a sign of ____

A

Anxiety, inc. sympathetic outflow, or facilitated neural reflexes

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27
Q

Rough skin

A

Bumpy irregular surface

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28
Q

Smooth skin

A

Surface free from irregularities, roughness, or projections

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29
Q

Soft skin

A

Smooth or fine to the touch w/o firmness

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30
Q

Boggy sub-Q

A

Quality of inc. fluid (wet sponge)

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31
Q

Doughy sub-Q

A

Soft, thick, pasty mass

32
Q

Puffy sub-Q

A

Swell or seem to swell as w/ air or fluid

33
Q

Flaccid muscle

A

Lacking firmness, soft and weak

34
Q

Hypertonic muscle

A

. Condition of excessive tone of skeletal muscles

. Inc. resistance of muscle to passive stretching

35
Q

Muscle ropiness

A

Cord-like or rope-like feel to muscle that has been chronically contracted

36
Q

Muscle stringiness

A

Palpable tissue texture abnormality characterized by string-like Myofascial structures

37
Q

Tendons

A

.Fibroelastic strands of CT
. Feel like taut band of tissue, tense and smooth, homogeneous
. Easy to palpate

38
Q

Ligaments

A

. Tough fibrous band that connect bone to bone
. Difficult to palpate bc they lie deep
. Serious injuries to them cause joint laxity

39
Q

CT/fascia

A

. CT that lines, divides, separates, and support internal organs, muscles, cavities
. Feels like butter melting as it releases

40
Q

Bone and joint palpation

A

. Reveals motion restriction/ asymmetry
. May elicit tenderness partially bc of depth of palpation
. Tissue overlying bone can sometimes feel boggy

41
Q

Acute somatic dysfunction

A

. Immediate/ short-term impairment or altered function of related components of somatic system

42
Q

How is acute somatic dysfunction characterized in early dysfunction?

A

. Vasodilation, edema, tenderness, pain, and contraction
. Tenderness even to light touch(hyperalgesia)
. Muscle tends to be hypertonic and puffy

43
Q

Acute inflammation characteristics

A

. Redness (rubor)
. Warmth (calor)
. Pain (dolor)
. Swelling (tumor)

44
Q

Blush reaction

A

Tissue remains red after palpation from local vasoactive mediators and autonomic mechanisms

45
Q

Chronic somatic dysfunction

A

. Impairment or altered function of related components of somatic system

46
Q

How is chronic somatic dysfunction characterized?

A

. Tenderness, itching, fibrosis, paresthesias, contracture
. Tissue change less intense ( dry, slick, thin, cool)
. Significant motion restrictions
. Pigment changes

47
Q

Active motion

A

Motion produced by patient

48
Q

Passive motion

A

Motion produced by physician without patient effort

49
Q

What does quantity and quality mean in regards to motion?

A

What is range of motion and how does motion feel

50
Q

How is quantity of motion measured?

A

Inspection, goniometer, inclinometer, tape measure

51
Q

How is quality of motion measured?

A

Palpation

52
Q

Once tissue texture change is found what happens?

A

Motion testing is performed after screening

53
Q

What is determined in motion testing?

A

. Quality and quantity of motion

. Direction, range, and characteristics of tissue motion

54
Q

Terms to describe quality of motion

A

Smooth, ratcheting, rubbery

55
Q

How is quantity of motion addressed in motion testing?

A

Taking joint or tissue trough all directions of motion

56
Q

What objective information does muscle testing provide?

A

Type, severity, and etiology of dysfunction

57
Q

What is palpation used for during OMT?

A

Localize corrective forces and monitor for improvement in tissue

58
Q

Gross movement of spine

A

Movement of group of vertebra

59
Q

Segmental spine movement

A

. Movement of specific vertebra
. Named for superior segment in relationship to inferior segment
(Motion of T3 named for motion in relation to T4)

60
Q

Major motions of spine

A

Flexion/extension, sidebending, rotation

61
Q

Minor motions of spine

A

Translation (front/back, side to side, motion along axis), compression (pushing together), distraction (pulling apart)

62
Q

Appendicular motion

A

. Movement of extremity joints

. Named for movement in relation to its proximal bone

63
Q

What motions does somatic dysfunction usually occur in appendicular skeleton?

A

In minor motions of joint

64
Q

Osteopathic medical practice requires what components?

A

. Thorough history
. Thorough physical exam
. Reasoned diagnosis
. Logical treatment plan based on above

65
Q

Osteopathic manipulative medicine

A

application of osteopathic philosophy, structural diagnosis, and use of osteopathic manipulative treatment in diagnosis and management of patient

66
Q

Osteopathic manipulative treatment (OMT)

A

Therapeutic application of manually guided forces by an osteopathic physician to improve physiologic function and homeostasis that have been altered in somatic dysfunction

67
Q

Functional spinal unit (vertebral unit)

A

2 adjacent vertebra plus their related neural, vascular, CT, and muscles

68
Q

How to determine functional spinal unit’s orientation in space?

A

Based on theoretical point on ant. Sup. Surface of upper vertebral body of unit
(Twist to right the dot moves to the right)

69
Q

Spinal segment

A

Division of the spinal cord containing a bilateral pair of nerve roots

70
Q

What do palpation skills help with?

A

. 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
Q

Order of examination in osteopathic patient

A

.standing structural exam screen
. Motion testing
. Screening palpation exam
. Detailed palpation exam based on above

72
Q

Hypotonicity

A

Result from underuse or aberrant neuronal info

73
Q

How many aspects of T.A.R.t do you need to diagnose somatic dysfunction?

A

2 aspects

74
Q

Tissue texture abnormality

A

. Palpable change in tissues from skin to periarticular structures that accompanies somatic dysfunction
. Different for acute v. Chronic injuries

75
Q

Acute tissue abnormalities

A 
. Recent history
. Severe pain
. Warm, moist, red skin
. Sympathetic: vasodilation of skin
. Increased muscle tone
. Edematous, puffy tissue
. Moist skin
. Minimal somatovisceral effect
76
Q

Chronic tissue texture abnormalities

A 
. 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

OMM Lecture (16 decks)

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