Somatic Dysfunction And Barriers

Question 1

4 tenets of Osteopathic Medicine

Answer 1

1. The mind, body, and spirit are a unit
2. The body is capable of self-regulation, self healing, and self maintenance
3. Structure and function are reciprocally related
4. Rational treatment is based upon understanding and implementing the other 3 tenets

Question 2

AROM

Answer 2

Patient motivated; patient must give maximum effort

Patient initiated ROM; examiner visually observes

Question 3

PROM

Answer 3

Patient must fully relax; you must “block linkage” of associated structure; examiner initiated ROM with passive patient

Greater then AROM because the patient muscles are relaxed

Question 4

“Block the linkage”

Answer 4

Stabilization of associated and adjacent structures to focus movement to only the joint/s being assessed

Question 5

Anatomic barrier

Answer 5

Limit of motion imposed by anatomic structure; limit of passive motion beyond which you have tissue disruption

Question 6

Physiologic barrier

Answer 6

Limit of active motion

Question 7

Elastic barrier

Answer 7

Range between physiologic and anatomic barrier of motion in which passive stretching occurs before tissue disruption; area that “warms up” with stretching

Question 8

Restrictive barrier

Answer 8

Functional limit that abnormally diminishes the normal physiologic range

Question 9

Diagnostic criteria for somatic dysfunction

Answer 9

T.A.R.T

Tissue texture abnormalities
Asymmetry of structure or motion
Restriction of motion
Tenderness

Question 10

Characteristics of acute somatic dysfunction

Answer 10

Vasodilation, edema, tenderness, pain, tissue contraction

Question 11

Characteristics of chronic somatic dysfunction

Answer 11

Tenderness, itching, fibrosis, paresthesias, tissue contractions

Question 12

Acute somatic dysfunction

Answer 12

Immediate or short-term impairment or altered function of related components of the somatic system (body framework)

Question 13

Chronic somatic dysfunction

Answer 13

Impairment or altered function of related components of the somatic system

Question 14

Tissue texture abnormality

Answer 14

Palpable changes in tissues from skin to periarticular structures

Types include bogginess, thickening, springiness, rosiness, firmness or hardening, temperature or moisture change

Question 15

Bogginess

Answer 15

Tissue texture abnormality characterized by a palpable sense of sponginess in the tissue resulting from congestion due to increased fluid content

Question 16

Sign

Answer 16

Physical thing that you can reproduce and feel with your hands (objective)

Question 17

Symptom

Answer 17

Thing that the patient experiences (reported in a history) that the physician cannot perceive (subjective)

Question 18

Tone

Answer 18

Normal feel of muscle in the relaxed state

Question 19

Hypertonicity

Answer 19

Extreme tone, i.e. spastic paralysis

Question 20

Hypotonicity

Answer 20

Lack of tone, i.e. flaccid paralysis

Question 21

Contraction

Answer 21

Normal tone of a muscle when it shortens or is activated against resistance

Question 22

Contracture

Answer 22

Abnormal shortening of muscle due to fibrosis

Most often in tissue itself and often results from chronic condition

Muscle is no longer able to reach its full normal length

Question 23

Spasm

Answer 23

Abnormal contraction maintained beyond physiologic need

Often sudden and involuntary contraction resulting in abnormal motion; generally accompanied by pain and restriction of normal function

Question 24

Ropiness

Answer 24

Hard, firm, rope- or cord-like muscle tone

Generally indicative of chronic condition

Question 25

Asymmetry

Answer 25

Absence of symmetry of position or motion Dissimilarity in corresponding parts/organs on opposite sides of the body that should be alike Determined by vision OR palpating

Question 26

Restriction of motion

Answer 26

Resistance or impediment to movement

Question 27

Barrier “end feel” characteristics

Answer 27

Palpatory experience or perceived quality of motion when joint is moved to its limit Three examples: bone to bone (elbow extension), soft tissue approximation (knee flexion), tissue stretch (ankle dorsiflexion, shoulder lateral rotation, finger extension) ***Look for amount AND quality of motion***

Question 28

Early muscle spasm

Answer 28

Protective spasm after injury (“guarding”)

Question 29

Late muscle spasm

Answer 29

Chronic spasm potentially due to chronic tissue changes

Question 30

Hard capsular

Answer 30

Frozen shoulder; reduced ROM in injured shoulder

Question 31

Soft capsular

Answer 31

Synovitis such as swelling in the knee after injury

Question 32

Tenderness

Answer 32

Discomfort or pain elicited via palpation A state of unusual sensitivity to touch or pressure

Question 33

Pain

Answer 33

Unpleasant sensation induced by noxious stimuli and generally received by specialized nerve endings

Question 34

Tenderpoints

Answer 34

Small, discrete, hypersensitive areas within myofascial structures that result in localized pain

Question 35

Trigger point

Answer 35

Small, discrete, hypersensitive areas within myofascial structures that when palpated cause referred pain

Question 36

Goal of OMT

Answer 36

Remove somatic dysfunction and restore homeostasis

Question 37

Role of OMT in the biomechanical model

Answer 37

Myofascial and joint functional optimization

Question 38

Role of OMT in neurological model

Answer 38

Remove neurological imbalances and address nociception

Question 39

Role of OMT in the respiratory/circulatory model

Answer 39

Maximize respiratory/circulatory function

Question 40

Role of OMT in the metabolic model

Answer 40

Structure and function are reciprocally related

Question 41

Direct OMT techniques

Answer 41

Method of action engages the restrictive barrier directly Ex: MFR, INR, ST, MET, HVLA, Visceral

Question 42

Combination OMT Techniques

Answer 42

Ex: MFR, Still, Percussor, PINS

Question 43

Indirect OMT Techniques

Answer 43

Method of action involves positioning away from the restrictive barrier Ex: MFR, INR, BLT/LAS, FPR, Functional, Visceral