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Flashcards in upper respiratory - Ferrill and Kania Deck (48)
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1
Q

upper lungs chapman’s point

A

anterior: b/w ribs 3-4 close to the sternal border
posterior: b/w T3-T4 near spinous processes

2
Q

lower lungs chapman’s point

A

anterior: b/w ribs 4-5 close to sternal border
posterior: b/w T4-T5 near spinous processes

3
Q

bronchus chapman’s point

A

anterior: b/w ribs 3-4 close to sternal border
posterior: midway b/w TP and SP of T2 on posterior aspect of TP

4
Q

nose chapman’s point

A

anterior: costochondrol junction of 1st rib
posterior: place finger under the jaw angle, like you are drawing a line across the face to parallel the line of the mouth and pushing the finger backward until you come in line with the TP of the vertebrae

5
Q

tonsils chapman’s point

A

anterior: 1st and 2nd intercostal space closer to sternum
posterior: surface of C1 TP, midway between the median line of the neck and the tip of the TP

6
Q

sinuses chapman’s point

A

anterior: 3.5in from the sternum, on the upper edge of 2nd rib and in the 1st intercostal space above
posterior: midway b/w TP and SP of C2 on the superior aspect of the TP

7
Q

middle ear chapman’s point

A

anterior: upper edge of the clavicle, just beyond where it crosses the 1st rib
posterior: upper edge of the posterior aspect of the tip of C1 TP

8
Q

pharynx chapman’s point

A

anterior: front of the 1st rib 3/4-1in toward the sternum from where the clavicle crosses the rib
posterior: midway b/w the SP and TP of C2, on the posterior aspect of the TP

9
Q

larynx chapman’s point

A

anterior: upper surface of the 2nd rib, 2-3in from the sternum
posterior: midway b/w the TP and SP of C2 on the superior aspect of the TP

10
Q

5 treatment models

A
  1. biomechanical, postural, structural
  2. neurological - symp and PS
  3. resp/circulatory/lymph
  4. metabolic, nutritional, bioenergetic
  5. psychobehavioral - influences perceptions of pain, illness, disability
11
Q

upper thoracic dysfx with resp problems (viscerosomatic changes)

A

extended segments palpatory changes at T2-T4 on the left

12
Q

cervical dysfx during resp problems affects?

A

superior, middle, and inferior cervical ganglia

13
Q

pertinent autonomics for resp problems?

A

T1-6: synpases occurs in the upper thoracic and/or cervical chain ganglia

14
Q

SD at the thoracolumbar junction (esp flexed T10-L2) can cause?

A

increased sympathetic tone to the adrenal gland which can lead to weakening of the immune system if chronically present, can also impair toxin excretion via the kidneys and intestines with chronic SD

15
Q

scoliosis >75 degrees can affect?

A

can compromise resp function

16
Q

vagus nerves run through which structures in the cranium?

A

OA
AA
cranial base
occipitomastoid sutures

17
Q

SD in which structures can alter drainage of the sinuses and function of the diaphragm?

A
  1. cranium (SBS compression, occipitomastoid compression affecting jugular foramen)
  2. occiput
  3. atlas
  4. remainder of cervical spine
18
Q

SD in which structures can affect production of mucus and nasal congestion?

A

superior, middle, and inferior cervical ganglia

sphenopalatine ganglia

19
Q

clavicles affect?

A

anterior cervical fascia

20
Q

impairment in sacrum/coccyx/ganglian causes?

A

increased sympathetic tone in the thoracic spinal region

21
Q

immune triangle

A

sternum - thymus
right lower ribs - liver
left lower ribs - spleen

22
Q

CI for resp OMT

A
  1. no forceful direct treatments
  2. no HVLA to thoracic spine due to initial increase in sympathetic activity
  3. do not overtreat and tire the patient
  4. do not use treatment positions that aggravate patient’s breathing or pain (relative caution)
  5. thoracic pump technique in COPD patients
  6. visceral techniques in the acute phase
23
Q

what affect does opening sibon’s fascia have on URI?

A

drain anterior and posterior cervical regions to enhance drainage of lymph

24
Q

layers of cervical fascia

A
  1. subQ tissue
  2. masticator fascia, submandibular fascia, SCM-trap fascia
  3. strap mm fascia and prevertebral fascia
  4. visceral fascia and carotid sheath
25
Q

how to address sinus pressure in URI?

A

address the superior cervical ganglion (OA and AA) because it affects nasal congestion and mucous production

26
Q

OMT on peds with otitis media

A
  1. biomechanical - cranial base, upper cervical
  2. resp/circulatory - anterior cervical musculature and fascia, diaphragms, thoracic outlet, Galbreath, auricular drainage
27
Q

what is the key muscle in eustachian tube function and key player in children with ET dysfx?

A

tensor veli palatini

28
Q

muscular dysfx affecting eustachian tube?

A
  1. tensor veli palatini spasm causes extrinsic obstruction

2. medial pterygoid contraction causes compression of the tube

29
Q

goal of OMT in otitis media

A
  1. improve lymphatic drainage from middle ear
  2. decrease effusion from middle ear
  3. improve function of the Eustachian tube
  4. improve cranial base and temporal bone motion
  5. decrease pain
30
Q

Galbreath technique’s purpose for otitis media

A

increase blood flow through the pterygoid plexus of veins and lymphatics, drainage of Eustachian tube, stretching of the peripharyngeal mm (tensor veli palatini) and fascia

31
Q

techniques parents can do for otitis media

A
  1. upper thoracic lymphatic drainage
  2. galbreath
  3. auricular drainage
  4. lots of warm water
32
Q

Acute otitis media (AOM) definition

A

inflamm or infection of the air-filled middle ear space

33
Q

otitis media with effusion (OME) definition

A

development of fluid (effusion) in the middle ear during inflammatory process

34
Q

acute otitis media patient presentation

A
  1. hx of acute onset of signs and symptoms (fever, irritability, ear pulling)
  2. presence of middle-ear effusion
  3. signs and symptoms of middle-ear inflammation
35
Q

sympathetic from sinuses and other head structures synapse at?

A

T1-4

36
Q

sympathetic from bronchial tree synapses at?

A

T1-6

37
Q

hypersympathetic activity upon the resp epithelium results in?

A

epithelial hyperplasia - increased numbers of goblet cells in relation to ciliated cells -> increased production of profuse, thick, sticky, tenacious, slow-moving resp mucosal discharge

38
Q

resp-circulatory model order of implementation

A
  1. open the pathways
  2. improve diaphragmatic function
  3. augment the rate of lymphatic return
  4. mobilize lymph locally
39
Q

if patient has pain and congestion in face and sinus regions, where should you place your fingers to relieve pain and congestion? and what nerves are you affecting?

A
  1. infraorbital and supraorbital foramen

2. branches of trigeminal nerve as they emerge from maxillary and frontal sinuses

40
Q

how to perform releasing of frontal nasal suture

A

providing a gentle distraction with slight side-to-side mobilization of the nasal bones. those with prior trauma to the nose may benefit from this simple manuever to return motion to this site

41
Q

which structure should be treated to influence parasympathetic outflow to the sinus and nasal resp epithelium? and what’s the main effect of the treatment?

A
  1. L and R sphenopalatine ganglia

2. immediate functional effect and long-term structural effect

42
Q

how to treat L and R sphenopalatine ganglia

A

indirectly through the open mouth of the patient by applying tension through fascias of the lateral pterygoid mm

43
Q

auricular drainage tech

A

V hand (spread middle and ring finger) on affected ear. move in clockwise and then counter-clockwise motion

44
Q

cervical FPR tech on peds

A
  1. hand one used to monitor tissue response and other hand is placed on head
  2. flex head to bring C-spine into neutral position
  3. axial compression to head until softening of tissue
  4. bring monitored segment into position of ease
  5. hold for 3-5 seconds, release, and reassess
45
Q

thoracic inlet MFR tech in peds

A
  1. physician contacts 1st and 2nd ribs anteriorly, costotransverse junction of T1 posteriorly
  2. area is engaged by gently lifting superiorly, then bring area into ease
  3. when breath is easily felt coming through the tissues, position is held until correction of the mechanical strain or improvement in tissue motion is noted
46
Q

Sibson’s fascial release tech

A
  1. patient is supine
  2. stand on R side facing the head
  3. curl R hand fingers into Sibson’s fascia
  4. L hand and arm support the R UE
  5. rhythmically abduct and flex the RUE while increasing pressure over Sibson’s fascia
47
Q

treating posterior compartment

A
  1. stand on side of supine patient
  2. rest cephalad hand on their forehead
  3. gently grasp the posterior aspect of the neck
  4. rhythmically turn their head toward the same side while pulling the musculature toward you
  5. repeat on opposite side
48
Q

treating vascular compartment

A
  1. seat behind supine patient
  2. place one hand on the mandible and the other on the ipsilateral clavicle to stretch the vascular compartment
  3. use rhythmic stretch