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OPP Review
OPP
| Question | Answer |
|---|---|
| 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
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