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OPP Review


Definition of Osteopathic Medicine OM is a complete system of medical care with a philosophy that combines the needs of the patient w/ the current practice of medicine..., that emphasizes the relationship b/w structure & function, and that has an appreciation for the body's ability to heal
Principles of OM 1. The body is a unit. 2. The body is capable of self-healing, self-regulation, etc. 3. Structure and function are reciprocally interdependent. 4. Rational treatment is based on the above.
Somatic dysfunction the impaired or altered function of related components of the somatic body
Spinal Facilitation the maintenance of a pool of neurons in a state of partial or sub threshold excitation - less afferent stimulation is required to trigger the discharge of impulses
Viscerosomatic reflex localized visceral stimuli producing patterns of reflex response in segmentally related somatic structures
Somatovisceral reflex localized stimulation producing patterns of reflex response in segmentally related visceral structures
TART tissue texture changes, asymmetry, restriction of motion, tenderness
Acute TART warm/hot, erythematous/prolonged red reflex, vasodilation, boggy/edematous, moist/increased tissue drag
Chronic TART cold/cool, pale/prolonged blanching, vasoconstriction, fibrotic/ropy, dray/scaly
Anatomic Barrier the limit of motion imposed by anatomic structure - limit of PASSIVE motion
Physiologic Barrier the limit of ACTIVE motion
Direct/Restrictive Barrier functional limit that abnormally diminishes the normal physiological range (Tx = ME, HVLA, etc)
Fryette's Law I when the spine is in neutral, SB & rotation are in OPPOSITE directions - forms long curves w/ multiple segments & is often compensatory
Freyette's Law II when the spine is flexed or extended, SB & rotation are in the SAME direction - usually involve single segments & is primarily due to a somatic dysfunction (strain or VS reflex)
Freyette's Law III when a segment is brough into a restrictive motion barrier, it will move in the position of greatest ease in the other two planes
During flexion, the facets... OPEN
During extension, the facets... CLOSE
A patient with upper back pain is found to have a R TP at T3. The asymmetry increases with extension. What accounts for this? Left facet is locked open.
The lateral line to test static posture should pass through which structures? 1. just anterior to the lateral malleolus 2. middle of the tibial plateau 3. greater trochanter 4. body of L3 5. middle of humeral head 6. external auditor meatus
A positive hip drop test (<25 degrees) on the right means... the lumbar spine is RESTRICTED in LEFT SB. This could be due to a short leg on the left.
Scoliosis an abnormal lateral curvature of the spine in the coronal plane
Adam's test forward bending to test for scoliosis - function = the hump REDUCES with SB toward the rib hump while structural = does NOT REDUCE with SB toward rib hump
A scoliotic curve is named for the.... while SB is names for... the side of the convexity... the side of the concavity
Risser score measure of skeletal maturity (1-5 and @ % skeletal maturity is reached)
Cobb angle draw lines from the top of superior vertebra & bottom of the inferior vertebra into the concavity of the curve - drop intersecting lines perpendicular to those lines & measure the acute angle --> moderate = 20-45 (brace, stim) and severe = >50 (surgery)
Exclusively direct techniques soft tissue, direct MFR, direct cranial, ME, HVLA
Exclusively indirect technqiues CS, indirect MFR, indirect cranial
2 ABSOLUTE CONTRAINDICATION for OMT 1. The absence of SD 2. The patient says NO.
If the patient presents bent forward, tender points tend to be located... anteriorly b/c the patient tends to bend around the tender points
CS vs. Chapman's vs. Trigger points (because they are all tender...) CS: non-radiating; Chapma's: VS reflex; Trigger: referred pain
Sherrington's Law (MF diagnosis) when a muscle receives a nerve impulse to contract, its antagonists receive, simultaneously, an impulse to relax.
Wolff's Law (MF diagnosis) Fascia will deform as a result of the lines of force to which it has been subjected.
Tensegrity (MF diagnosis) Fascia moves as a unit in a tensengrity matrix down to the cellular level.
Concentric contraction contraction of a muscle resulting in approximation of its attachments
Eccentric contraction lengthening of muscle during contraction due to an external force (pubic thrust)
Isometric contraction change in tension of the muscle WITHOUT approximation of its attachments (ME)
Soft tissue technique: traction longitudinal muscle stretch
Soft tissue technique: kneading lateral muscle pressure
Soft tissue technique: inhibition sustained muscle pressure
Soft tissue technique: effleurage stroking pressure to move fluid
Soft tissue technique: petrissage squeezing pressure to move fluid
Acute/severe problem prescription indirect techniques, fewer regions/doses, 1-2 treatments/week for 2-4 weeks
Chronic problem prescription any technique, more regions/higher dose, every 2-6 weeks for as long as its helpful
Right lymphatic duct drains RIGHT upper body, crosses thoracic inlet once, drains into jugulosubclavian junction
Left lymphatic duct drains LEFT upper body & all LOWER BODY, crosses thoracic inlet twice, drains into subclavian and left brachiocephalic vein junction
Talus glides anteriorly with ____ flexion plantarflexion
Talus glides posteriorly with ____ flexion dorsiflexion
Positive swing test means... restricted posterior talus = posterior talus glide = anterior talus somatic dysfunction = plantar flexed ankle = restricted in ankle dorsiflexion
Knee flexion results in ___ glide of the tibial plateau Anterior
Anterior fibular head means... fibular head restricted in posteromedial glide
External rotation of the tibia/ foot eversion... distal fibula glides posteriorly and the fibular head glides anteriorly
Superior transverse axis axis of movement during respiration and CRI
Middle transverse axis axis of movement during flexion/extension
Inferior transverse movement of ilium on sacrum (innominate rotations)
The Rule of 3's the relationship of the spinous process to underlying bony structures = T1-3: same level as its vertebral body; T4-6: 1/2 vertebral body down; T7-9: vertebral level down; T10-12: same level as its vertebral body
Action of supraspinatous m. abduction
Action of pectoralis major m. adduction
Action of corachobrachialis m. flexion
Action of posterior deltoid m. extension
Action of infraspinatous m. external rotation
Action of subscapularis m. Internal rotation
M. that elevates the scapula trapezius (superior part)m.
M. that depresses the scapula gravity
M. that protracts the scapula serratous anterior m.
M. that causes upward rotation of the scapula trapezius m.
M. that causes downward rotation of the scapula latissimus dorsi m.
The ulnohumeral joint passively ___ with flexion. adducts
Medial glide of the ulnohumeral joint causes ___ of the forearm. abduction
Posterior radial head somatic dysfunction... ease of pronation = restricted supination = restricted anterior glide (fall forward onto outstretched hand)
OA primary motion is flexion/extension & SB/rotation are in the OPPOSITE direction
AA primary motion is rotation
Cervical spine (C2-7) flexion/extension couples w/ SB & rotation to the SAME side
Primary respiratory mechanism 1. motility of the brain and spinal cord 2. fluctuation of CSF 3. mobility of the intracranial & intraspinal membranes 4. mobility of the cranial bones 5. involuntary of the sacrum between the ilium
CRI rate (10-14/min), amplitude, symmetry
Unpaired bones Ethmoid, mandible, occipute, sphenoid, vomer move in flexion/extension
Beighton Hypermobility Screen 1. dorsiflexion of second finger to >90 2. apposition of the thumb to the forearm 3. hyperextension of the elbow by >10 4. hyperextension of the knee by >10 5. hand flat on floor w/ knees extended
Iliolumbar ligament syndrome pain in multifidus triangle that mimics inguinal hernia
Piriformis syndrome usually attributed to pressure on sciatic nerve but there are NO neuro deficits in
Iliopsoas syndrome patient often presents w/ new scoliosis (usually Type 2 @ L1-2) w/ a pelvic shift & piriformis spasm to the oppostie side of the iliopsoas spasm
Costochondritis inflammation at costochondral junction
Scapulocostal syndrome posterior shoulder pain w/ scapular muscle trigger points
Rib tip syndrome stabbing pain and clicking at costochondral junction of ribs 8, 9, or 10
3 places the brachial plexus can be impinged 1. b/w the clavicle and 1st rib 2. between the anteior and middle scalene 3. under the pectoralis minor m.
Quadratus Lumborum easily mistaken for lumbar radicular pain or piriformis CS tender point/hip pain that can be treated w/ inhalation ME to the 12th rib to stretch the QL m.
Gluteus minimus "sciatica"- the more anterior the trigger point, the more lateral the referral zone- Tx/ MFR to the hip
Scalene m. often confused w/ cervical radiculopathy - Tx w/ MFR or ME to the scalenes
Trapezium m. frequently overlooked source of temporal and cerviocogenic headache
Created by: mbowling1