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who is the founder of osteopathic medicine?

Dr. Andrew Still


why did Dr. Still start osteopathic medicine?

lost his wife and several children to spinal meningitis, wanted to improve medicine
there weren't a lot of medicines available in the late 1800's; aspirin, penicillin, tylenol, and advil developed in 1900's


how did the first osteopathic medical school start?

AT Still built a clinic and a hotel for out of state patients, then the first school in Missouri in 1892


health event that showed effectiveness of OMT?

1918 Spanish influenza pandemic
mortality rate .25% with OMT+SMC, 5-6% with standard medical care (SMC)


significant historical events for the early DOs

1962- allowed DOs to convert to MDs for only $65, couple thousand converted
1966- now DOs can work for the military


what are the 4 tenets of osteopathic medicine?

1. self-regulatory mechanism
2. body unity
3. structure and function reciprocally related
4. rational therapy


body unity principle and example

the body's whole is greater than the sum of its parts; treat the whole person, not just a specific body part or symptom. Consider the body, mind, and spirit when treating.
example: A person's stress and mental health can affect their physical health; can lead to myocardial infarction


self-healing mechanism principle and example

the body has an innate ability to heal itself, so DOs provide support mechanisms
bone remodels itself, healing a scrape


structure influences function principle and example

a problem in one part of the body may inhibit function in that area and beyond
examples: enlarged heart doesn't pump blood well, an inflamed tendon leads to calcification and inhibits movement


rational treatment principle and example

disease occurs when normal adaptability is disrupted or when the environmental changes overcome the body's capacity for self-maintenance
rational treatment is based on the other 3 tenets of osteopathic medicine


what are the 5 models in osteopathic patient care?

biomechanical model, neurologic model, respiratory/circulatory model, behavioral model, and metabolic-energy model


anatomical correlates of biomechanical model, and OMT application

anatomical correlates: postural muscles, spine and extremities
app: decrease muscle spasms and normalize joints


anatomical correlates of respiratory-circulatory model, and application to OMT

anatomical correlates: thoracic inlet, thoracic and pelvic diaphragms, costal cage, tentorium cerebelli
app: want to improve thoracic cage motion, address diaphragm restrictions, promote fluid movement


anatomical correlates of metabolic-energy model, and application to OMT

anatomical correlates: internal organs, endocrine glands
application: decrease the body's energy expenditure so that it can focus on healing, e.g. decreasing work of breathing, try to restore balance between energy production and expenditure


anatomical correlates of neurological model, and OMT application

anatomical correlates: head, brain, spinal cord, nerves, autonomic NS
app: balances autonomic tone by removing restrictions that affect the NS, influencing other nervous systems for treatment


anatomical correlates of behavioral model, and application to OMT

anatomical correlates: brain
application: want to consider the patient's mental health, affect their pain perception, coping mechanisms, and decrease disability. Decrease the patient's stress about disability by treating their illness that causes the disability


how do OMT's help a patient with pneumonia's systems?

improve thoracic cage movement to decrease work of breathing
promote circulation/lymph flow
balance autonomic tone, decreases secretions and opens up lung vessels
counsel and support the patient through their illness


viscerosomatic reflexes

inflammation stimulates local nociceptors
these visceral nociceptors can converge with nociceptors from other somatic tissues
can produce referred pain and segmental facilitation at spinal cord level (so that nerve might be more sensitive)


acute changes from viscerosomatic reflexes: temperature, color, skin drag, texture, muscles

vasodilation (hotter skin)
cutaneous erythema ("red reflex")
sweating (increased skin drag)
skin thickening/edema
muscle spasm


chronic changes from viscerosomatic reflexes: temperature, color, skin drag, texture, movement, muscles

vasospasm (decreased skin temp)
reduced sudomotor activity (decreased skin drag)
subcutaneous fibrosis
muscle hardness and tension
firm, dry sponginess
joint motion restricted/fixed
"rubbery" barrier
rigid, sluggish movement


what is autonomic tone

the general activity rate of the autonomic nervous system, both the sympathetic and parasympathetic aspects of the system.



decreased skin temperature



hotter skin