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History > Y3 M1 > Flashcards

Y3 M1 Flashcards

1
Q

Which category of evidence sits highest on the evidence hierarchy pyramid?

A

Meta-analysis

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2
Q

According to Michael Patterson who were the main contributors to each phase of osteo research?

A

Phase 1: 1874-1939 - AT Still and the early American Osteopaths

  • Phase 2: 1940-1969 - Kirksville College of Osteopathic Medicine
  • Phase 3: 1969-2000 - Michigan State University
  • Phase 4: 2001-2016 - Osteopathic Research Centre at the University of North Texas
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3
Q

What is the lowest stage of osteopathic research?

A

background information & expert opnion

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4
Q

What investigation was Louisa Burn’s first research article in 1907 primarily concerned with?

A

Viscero-somatic and somato-visceral spinal reflexes

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5
Q

What were the key findings of … Louisa Burns’ first research article published in 1907?

A

where viscerosensory impulses affect visceromotor nerves - in the sympathetic ganglia or spinal cord?- the ganglia
used electrode stinulation of visceral pleura under anaesthesia
- observed contraction of intercostal, diaphragm, QL
destruction of symp ganglia = no response
- “considerable difference in reaction time” across individuals
viscerosensory impulses enter the spinal cord through its posterior roots
somato-visceral reflexes are much less circumscribed and direct than are viscero-somatic reflexes
somato-sensory nerve stimulation plays a key role in normal visceral activity
Using irritating stimulus at segments or inhbiitoru pressure at segments
BP changed more sig with stim near lower splanhncis nerves

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6
Q

In what year was the AT Still Research Institute established in Chicago?

A

1913

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7
Q

Who debuted a physical spinal model at the AOA convention in 1919?

A

Halladay

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8
Q

What was the focus of J.S. Denslow’s research published in the journal of neurophysiology in 1914?

A

neurological aspects of the lesion
studied through electromyography EMG
sites of lesions would exhibit abnormal reflexes contractions in relation to tissue texture changes
lesioned areas showed high degrees of muscle contraction- action potentials firing
normal areas had low contraction- no action potentials firing
-used pressure meters - inserted needle into spine- D4, 6, 8, 10
areas that were lesioned- insertion potentials would last ways longer
-sympathetic osteopathic centres
lesioned areas require way less pressure to instigate a muscle to contraction
different threshold potentials on either side of spine
(Denslow- how lesioned areas make the nerves “Go”)
found
abnormal muscles activity in upset patients
impulses coming from brain- thoughts affect soma
fascilitated segments produced motor and sensory effects- fascilitated

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9
Q

What did Denslow leave out of his research article in 1914?

A

(he left out the word Osteopathy) published under the radar

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10
Q

What term did J. Denslow coin to describe the enduring hyper-irritable condition of motor cells in the anterior horn in the sub-threshold state of excitation?

A

Facilitation

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11
Q

ACCORDING TO IRVIN KORR’S 1951 ADDRESS. ‘ THE THREE FUNDAMENTAL PROBLEMS IN OSTEOPATHIC RESEARCH’ WHICH 3 categories could be used to describe ‘all observed and possible manifestations of the osteopathic lesion?

A

1 - Sensory and suprasegmental
2 - motor or neuromuscular
3 - autonomic or vegetative

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12
Q

What did william johnston D.O’s research on palpatory reliability demonstrate?

A

Demonstrating palpatory reliability between operators was inconsistent
A lot of the research showing this inconsistency came from cranial research.
Conditions for low agreement between operators
Examiners with variable skill levels
No preparatory calibration of palpatory refinement occurred
Poor definition of palpatory procedure
Recording methods unwieldy

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13
Q

What is Phase 1: 1874-1939 Research by Still & Early Osteopaths?

A

“I quote no authors but God and experience […]” - AT Still, Philosophy of Osteopathy
- Still’s research: clinical trials on his patients shared through his writings
- 1898 JM Littlejohn research on the impact of spinal manipulations (stimulation and inhibition)
- William Smith angiograms of cadavers (mercury in tallow/beeswax); 70min X-rays; radiography to study treatment effects on circulation

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14
Q

Who is Louisa Burns DO 1870-1958?

A

1903: graduate of Pacific College of Osteopathy
1906: taught physiology
1914: joined the AT Still Research Institute in Chicago
1917: directs the AT Still Research Institute in California

5 books; numerous articles

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15
Q

What is the summary of Burns’ first article (1907)?

A
  • Interest was specifically related to clarifying exactly where viscero-sensory impulses affect viscero-motor nerves - in the sympathetic ganglia or spinal cord?
  • Methods: human and animal (cats and dogs) experiments; “young and healthy” human participants were blinded, reactions described were verified in minimum of 5 individuals (usually 10-12)
  • Animal viscero-somatic reflexes: electrode stimulation of visceral pleura under anaesthesia
  • Observed contractions of intercostals, diaphragm, QL
  • Destruction of sympathetic ganglia = no response
  • Vagal sectioning did not alter somatic contractions
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16
Q

What were the factors of the experiments by Burns on the somato-visceral effects on animals?

A
  • short, sharp forceful pinching
  • using cutaneous receptors effects on viscera were inconspicuous and inconsistent
  • D4-5 stimulated: observed lung colour change (lightening with vasoconstriction)
  • cut out cardiac nerves to rule out viscero-viscero influence; same results with lungs collapsed
  • reactions also remained when vagi above superior cervical ganglion were cut, but when vagi below SCG cut reaction was faint or absent
  • paraspinal tissue at D5-12 stimulated stomach secretions and motility, but when the splanchnic nerves were directly stimulated action was inhibited
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17
Q

What were the inferences and conclusions made by Burns’ experiments?

A
  • “considerable difference in reaction time” across individuals
  • “a very important, if not only pathway of viscero-sensory impulses enter the spinal cord through its posterior roots”
  • somato-visceral reflexes are much less circumscribed and direct than are viscero-somatic reflexes
  • somato-sensory nerve stimulation plays a key role in normal visceral activity
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18
Q

Who was successful in reproducing Burns’ experiments and data?

A

Wilbur Cole DO

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19
Q

When did the Halladay Spine debut and where?

A

The AOA Convention in Chicago 1919

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20
Q

What did AG Walmsley DO say about the Halladay Spine in the preface to “Applied Anatomy of the Spine” in 1920?

A

To say that the exhibit at Chicago made a profound impression upon the profession is putting it mildly. The movements of the spine were so closely demonstrated that one could see just what happened at a given articulation, thus affording a means of criticizing methods of spinal adjustment long in vogue and enabling the practician to visualize the lesion and to determine better the proper procedure for correction.

21
Q

Who were the two major players of Phase 2: 1940-1969 at Kirksville College of Osteopathic Medicine (KCOM)?

A
  1. John Stedman Denslow DO
  2. Irvin M. (Kim) Korr, PhD
22
Q

Who is John Stedman Denslow DO?

A
  • graduate of KCOM 1929
  • internship at Massachusetts Osteopathic Hospital
  • 1930-38: Director of Clinics, Chicago College of Osteopathy
  • 1938-63: Professor and Chair of Department of Osteopathic Theory and Methods, KCOM
  • 1965-77: Vice-President of KCOM
23
Q

Who is Irvin M. (Kim) Korr PhD?

A
  • 1930-31: BA, MA University of Pennsylvania
  • 1935: PhD Princeton
  • 1936: Department of Physiology NYU College of Medicine
  • 1942-45: Research under War Department at Columbia
  • 1945-75: KCOM
  • 1975-78: Michigan State University, College of Osteopathic Medicine
  • 1970-90s: TCOM (University of North Texas)
24
Q

When was Korr working with Denslow?

A

1945-75 at KCOM

25
Q

What did Korr say about the manifestations of osteopathic lesions?

A

Regardless of its nature, location, or origin, appear to fall into three main categories:

They are (1) the sensory and suprasegmental; (2) the motor or neuromuscular; and (3) the autonomic or vegetative

26
Q

What were the results of Korr’s experiments with skin resistance and posture/time of day?

A

“Late afternoon; standing” had highest resistance, followed by “Morning; standing”, and “Afternoon; seated”

27
Q

What type of studies are at the top of the hierarchical pyramid?

A
  1. Meta analysis
  2. Systemic Reviews
  3. Critically Appraised Topics

Considered “Filtered Information”

28
Q

What type of studies are in the middle of the hierarchical pyramid?

A
  1. Randomized control trails
  2. Cohort studies
  3. Case control studies
  4. Case reports/case series

Considered unfiltered information

29
Q

What are some examples of sources that are at the top of the hierarchical pyramid?

A
  • Cochrane Database of Systemic Reviews
  • Database of Abstracts of Reviews of Effectiveness (DARE)
  • Campbell Collaboration Library of Systemic Reviews
  • *TRIP (searches filtered and unfiltered information simultaneously)
30
Q

What are some examples of sources in the category “critically appraised topics”?

A
  • FirstConsult
  • DynaMed
  • Epocrates Essentials
  • National Guideline Clearinghouse
31
Q

What are some examples of sources that are in the middle of the hierarchical pyramid?

A
  • MEDLINE
  • PubMed
  • PsychINFO
  • Scopus
  • CINAHL
  • *TRIP (searches filtered and unfiltered information simultaneously)
32
Q

In Burns’ human research experiments, stimulation near the 4th and 8th-10th thoracic spine did what to the pulse of the volunteer?

A

Increased it

33
Q

In Burns’ human research experiments, steady pressure near the 4th and 8th-10th thoracic spine did what to the pulse of the volunteer?

A

Decreased it

34
Q

In Burns’ human research experiments, stimulation near the 4th and 8th-10th thoracic spine did what to the blood pressure of the volunteer?

A

raised it

35
Q

In Burns’ human research experiments, steady pressure near the 4th and 8th-10th thoracic spine did what to the blood pressure of the volunteer?

A

Lowered it

36
Q

What new field of technology did Denslow use in his experiments to investigate neurological aspects of the osteopathic lesion?

A

Electromyography (EMG)

37
Q

What did Dr. Edmond Jacobsen discover about the condition of skeletal muscle at rest in healthy patients and in patients with psychiatric disorders?

A

Healthy: Skeletal muscle at rest showed no contraction and no action potentials

Psychiatric Disorder: showed action potentials at rest indicating abnormal reflex muscle contraction

38
Q

Using Jacobsen’s earlier findings, what did Denslow discover about the condition of skeletal muscles when investigating osteopathic lesions?

A

Lesioned areas showed high degrees of muscle contraction; normal areas showed little to no contraction

39
Q

To avoid prejudice, what did Denslow do when publishing his experimental findings?

A
  1. Omitted the word “osteopathy”
  2. Concealed the fact that the experiments were conducted at the biomechanics laboratory of the KCOM
  3. Created a special non-profit organization called the Still Memorial Research Trust
40
Q

What did Denslow discover about subjects experiencing apprehension, anxiety, or emotional states?

A

Abnormal muscle activity at rest

41
Q

What was Korr’s conclusions about the SNS after his experiments with sudomotor and vasomotor tissues, and what is the significance of this?

A

Dry skin offers high resistance to a direct electrical current; moist skin offers low resistance. Upon testing of hundreds of subjects he found patterns of low skin resistance individual to each, which remained constant over many months. Some areas of low resistance appeared to be dermatomally related to various visceral and musculoskeletal disturbances.

Sudomotor and vasomotor hyperactivity began as parts of a reflex response to increased afferent impulses mediated by osteopathic lesions/facilitated segments, leading him to describe the spinal cord as the ‘organizer of disease processes,’ acting as a ‘neurological lens’ to focus and magnify the effect of afferent stimuli.

42
Q

What does Denslow and Korr’s work show?

A

How osteopathic lesions facilitate not only the motor and sensory but also the sympathetic nerve, and thereby interfere with the body’s ability to adjust circulation, metabolism, and visceral activity to constantly changing musculoskeletal and environmental demands.

43
Q

Who was the main player in Phase 3: 1969-200 University based (MSU) Osteopathic Research?

A

William Johnston DO

44
Q

Who is WIlliam Johnston DO?

A
  • University of Toronto graduate
  • 1943: Graduate of Chicago College of Osteopathic Medicine
  • Internship at Massachusetts Osteopathic Hospital
  • 1944-73: Private practice in general medicine
  • 1973-1999: Michigan State University Clinical Researcher
45
Q

What questions were the basis of William Johnston DO’s research?

A
  1. What am I feeling?
  2. What does it mean?
  3. How do we communicate about what we feel?
  4. Consistency?
46
Q

What were William Johnston DO’s main contributions?

A
  • Palpation testing procedures
  • Studies of interrater reliability
  • Standardization of hospital record for MSK/somatic dysfunction findings
  • Development and application of the “functional technique”
47
Q

What were the conditions for low agreement outlined by William Johnston DO?

A
  1. Examiners with variable skill levels
  2. No preparatory calibration or palpatory refinement occurred
  3. Poor definition of palpatory procedure
  4. Recording methods were unwieldy

Some of the findings are related specifically to cranial rhythm palpation

48
Q
A

History (1 decks)

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