OPP Lect 13
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| Osteopathic versus orthopedic probelm | Somatic dysfunction is likely to be found in the minor motions (joint glide) that involves restriction at the end ROM.
Orthopedic problems are due to joint instability evident by laxity/instability at end ROM
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| Ulnohumeral Joint | Major motions: Flexion and Extension
**Minor Involuntary motions: Abd (with extension) and Add (with flexion)
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| Pain or Restriction with elbow flexion | SD is ulnar abduction
Restriction is ulnar adduction
**May see and Increased carrying angle
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| Pain or Restriction with elbow extension | SD is ulnar adduction
Restriction is unlar abduction
**may see decreased carrying angle
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| Radial head motion | Glides posteriorly with pronation, anteriorly with supination
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| Posterior Radial Head SD | often seen with falling forward onto outstretched hands.
**Restriction will be supination/anterior radial head glide (pain with supination)
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| Anterior Radial Head SD | Often results from a fall backward with hands supinated.
**Restriction will be pronation/posterior radial head glide (pain with pronation)
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| Radial Head tenderpoints are often confused with? | Lateral Epicondylitis (degeneration of the tendon of an extensor)
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| True wrist joint | Radiocarpal joint: Radius, scaphoid, lunate, triquetrum
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| Radiocarpal major axes of motion | Transverse axis: Flex(80-90deg)/ext(70deg)
Anterioposterior axis: add(30-50deg)/abd (20deg)
**More flexion and adduction
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| Minor involuntary motions of the wrist that cause most SD | Anterior carpal bone glide (extension) are the most common.
Posterior carpal bone glide (flexion).
**SD can be named for the major motions even though they are caused by the minor motion
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| Counterstrain tenderpoints from wrist SD | found in tendons or muscle bellys. If found in flexor compartment (anterior/palmar) treat with wrist flexed. Opposite for posterior/dorsal points
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| Anatomical snuff box tenderness | suspect scaphoid fracture and necrosis
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| Main SD in Carpometacarpal joints | Dorsal glide
**Restriction in ventral glide
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| What type of joint is the thumb | Saddle joint. Allows movement in almost any plane making it more susceptable for sprains than SD
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| MP and IP Joint glides | SD can be in: AP glide, ML glide, Int/Ext glide
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| Viscerosomatic reflexes related to arm pain | 1. Diaphragm referred pain in trapezius
2. MI referred pain to left axilla and arm
3. Gall Bladder pain to right AC and Scapula
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Popular Osteopathic Principl sets