Test 2 notecards Flashcards
1
Q
what must the patient be for any disease state?
A
STABLE before performing OMT
use more gentle techniques if they are sicker/weaker
2
Q
do you do OMT for new onset of chest pain or SOB?
A
NO
3
Q
facilitated segments only occur where?
A
sympathetics
4
Q
if someone has a nocturnal cough at night
A
think about asthma (pulmonary issue) or reflux (GI)
5
Q
somatic dysfunction at T2
A
pulmonary issue
use albuterol
6
Q
somatic dysfunction at T8
A
GI issue
use omeprazole
7
Q
somatic dysfunction at T5
A
pulmonary or GI issue
8
Q
need to treat thoracoabdominal diaphragm if flattened (diminished zone of apposition)
A
seen in COPD patients
- improves diaphragmatic excursion -> improves pressure gradient b/w abdominal cavity and thoracic cavity -> improve lymphatic flow
- also improve lymphatic flow by relaxing the tension on the diaphragm
9
Q
what do you target when treating a group dysfunction for OMT?
A
apex (middle) of the group curve
ex. T10-T12 -> treat T11
10
Q
which way to the vertebrae rotate?
A
TOWARD the dysfunctional organ
- GB issues -> vertebrae rotates to right
- gastritis -> vertebrae rotates to left
11
Q
counterstain
A
- continuous monitoring
- hold for 90 sec
- return patient to neutral slowly
12
Q
anterior cervical I CS point
A
- posterior side of ascending ramus on mandible at earlobe level
- lateral aspect of transverse process of C1
- RA
13
Q
anterior cervical 2-6 CS point
A
- anterolateral aspect of corresponding anterior tubercle of the transverse process
- F SARA
14
Q
anterior cervical 7 CS point
A
-clavicular attachment of the SCM
F STRA
15
Q
anterior cervical 8 CS point
A
- sternal attachment of SCM on the medial end of clavicle
- F SARA
16
Q
AT1 CS point
A
- midline or lateral to jugular (suprasternal notch)
- Flexion
17
Q
-AT2 CS point
A
- midline or lateral to manubrium (angle of Louis)
- Flexion
18
Q
-AT3-5 CS points
A
- midline at level of corresponding rib
- Flexion
19
Q
-AT6 CS point
A
- midline xiphiod-sternal junction
- Flexion
20
Q
post isometric muscle energy
A
patient pushes AWAY from barrier
physician pushes TOWARD barrier
21
Q
reciprocal inhibition muscle energy
A
patient pushes TOWARD barrier
physician pushes AWAY from barrier
22
Q
heart sympathetics
A
T1-T6 - synapses in upper thoracic and cervical chain ganglia
23
Q
the SA node in arrhythmias (sympathetics)
A
- RIGHT heart
- right deep cardiac plexus
- lead to SVT
24
Q
the AV node in arrhythmias (sympathetics)
A
- LEFT heart
- left deep cardiac plexus
- lead to ectopic PVCs and V fib and V tach
25
sympathetic supply to UPPER extremity vasculature
T2-T8
26
sympathetic supply to LOWER extremity vasculature
T11 - L2
27
myocardium, thyroid, esophagus, bronchus chapman points
anterior -> 2nd intercostal space near sternum
posterior -> b/w spinous process and tips of TP at T2
28
UPPER lung chapman points
anterior -> 3rd intercostal space near sternum
posterior -> b/w SP and TP of T3,T4
29
LOWER lung chapman points
anterior -> 4th intercostal space near sternum
posterior -> b/w SP and TP of T4,T5
30
adrenal glands chapman points
- anterior -> 1" lateral and 2" superior to umbilicus ipsilateral
- posterior -> inter transverse spaces of T11 and T12 ipsilateral
31
kidneys chapman points
- anterior -> 1" lateral and 1" superior to umbilicus ipsilaterally
- posterior -> inter transverse spaces of T12-L1
32
heart parasympathetics
CN X (vagus) -> OA, C1,C2
33
SA node in arrhythmias (parasympathetics)
- right vagus via SA node
| - sinus bradyarrhythmias
34
AV node in arrhythmias (parasympathetics)
- left vagus via AV node
| - AV blocks
35
CN X
-jugular foramen, Occipitomastoid suture (temporal bone + occiput), OA, AA, C2
- right vagus -> SA node
- left vagus -> AV node
36
heart transplant leading to cutting of the vagus nerve
-suboccipital release would NOT be effective since the vagus is cut****
37
which organs drain the right lymphatic duct?
HEART and LUNGS
38
what must you do 1st before any other lymphatic treatment?
clear/open the thoracic inlet/outlet***
aka open myofascial pathways at transition zones**
ex. anterior cervical fascia release, thoracic inlet myofascial release, pectoral traction
39
chapman reflex points of myocardium
- anterior -> 2nd intercostal space
| - posterior -> b/w T2 and T3
40
anterior infarct MI
T2-T3 on the LEFT
41
inferior wall infarct MI
T3-T5 on the LEFT, C2
42
right pectoralis minor trigger point
- 5th intercostal space
| - associated with SVT due to sympathetic nervous system
43
somatic dysfunction associated with HTN
-C6, T2, T6
44
prolonged sympathetic stimuli to the kidneys (T10-T11)
where ACE inhibitors would work -> salt and water retention
45
ST elevations and Q waves in leads V1-V4, aVL
acute anterior wall MI
46
where are thoracic vertebrae rotated in sinus tachycardia?
RIGHT
47
where are thoracic vertebrae rotated in A-fib?
RIGHT
48
where are cervical vertebrae rotated in 1st or 3rd degree AV block?
LEFT
49
where are cervical vertebrae rotated in sinus bradycardia?
RIGHT
50
thoracoabdominal diaphragm - neurological
phrenic nerve - C3,4,5
51
thoracoabdominal diaphragm - biomechanical
attaches to the lower ribs, thoracolumbar junction, T10-L3
52
bronchial asthma treatment - acute attack
- monitor vitals
- give O2, medications (B2 agonist, anticholinergic, steroids, nebulizers
- NEVER use thoracic pump w/ respiratory assist (recoil) in acute attack**
- do OMT once stable
53
COPD MSK changes
- hypertrophy of accessory muscles -> may lead to neuromuscular impingement (thoracic outlet syndrome) and decreased lymphatic drainage
- decreased rib and diaphragm (flat) motion -> decrease lymphatic drainage
54
side effects of long term steroids for asthma/COPD
- osteoporosis, diabetes mellitus, adrenal insufficiency
| - adrenal insufficiency -> fatigue and may stop working
55
what position do you not treat COPD/asthma patients?
SUPINE (suffocate)
56
BITE
- bottom rib INHALATION
| - top rib EXHALATION
57
all anterior rib counterstrain tender points
STRT
- AR 1,2 -> lying down
- AR 3-10 -> sitting up
58
PR 1 counterstrain tender point
STRT
59
PR 2-10 couterstrain tender points
SARA
60
where does the physician contact the rib for an exhalation somatic dysfunction?
Posteriorly at the rib ANGLE
61
Muscles in ME used to treat rib exhalation somatic dysfunction
Rib 1 -> anterior/middle scalene
Rib 2 -> posterior scalene
Ribs 3-5 -> Pec Minor
Ribs 6-8 -> Serratus anterior
Ribs 9-11 -> Latissimus dorsi
Rib 12 -> Quadratus lumborum
-can cause INHALATION SD if they become hypertonic***
62
seated inhaled rib 1 - HVLA
-side bend head TOWARD, and rotate head AWAY
apply only about 5% of force to the patient's neck**
63
Rib HVLA (inhalation or exhalation)
place thenar eminence (fulcrum) on posterior aspect of rib angle
- inhaled rib -> push UP
- exhaled rib -> push DOWN
64
can you do ME if patient is unable to follow commands (language barrier, dementia, delirium)?
NO
-cannot follow instructions to push against resistance
