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OPP test 2
WVSOM OPP test2
| Question | Answer |
|---|---|
| Carpal Tunnel | contains flexor tendons, median nerve |
| Carpal Tunnel syndrome | compression of the median nerve - numbness, pain in arm and hand |
| flexor retinaculum | makes the roof of the carpal tunnel (aka transverse carpal ligament) |
| median nerve | innervates all forearm flexors, sensory forearm innervation of the hand (1st 3.5 fingers) |
| EMG/nerve conduction studies | electromyogram - can confirm a diagnosis. Nerve conduction studies show increased nerve function after OMT |
| myofascial release | |
| opponens pollicus | originates from the flexor retinaculum - allows you to oppose the thumb |
| Phalen test | hands with palms together |
| tinel sign | tap on the flexor retinaculum - positive sign = pain |
| transverse carpal ligament | same as flexor retinaculum |
| double crush syndrome | carpal tunnel syndrome + thoracic outlet syndrome |
| radiculopathy (C5-C8) | nerve root pathology - impingement in the neck. Keep as a diagnostic option |
| Carpal Tunnel treatment: 3 phases | 1. release transverse carpal lig. 2. opponens roll. 3. wrist extension to pull flexor tendons into carpal tunnel |
| anterior subluxation | anterior position of the rib |
| costochondritis | aka Tietze's syndrome - inflammation of 2nd costochondral junction. Treat with steroids |
| counterstrain | can treat rib tender points: posterior tenderpoint - elevate it (stretch it out), anterior tenderpoint -depress it (bend ribcage around it) |
| depressed rib | exhalation dysfunction (inhalation restriction) |
| elevated rib | inhalation dysfunction (exhalation restriction) |
| exhalation rib | rib "stuck" in exhalation (depression) |
| inhalation rib | rib "stuck" in inhalation (elevation) |
| key rib | inhalation dysfunction - inferior ribexhalation dysfunction - superior rib |
| myofascial release | |
| posterior subluxation | "speed bump" |
| rib tip syndrome | lancinating (sharp) pain chondral mass of ribs 8-10, clicking at painful area |
| scapulocostal syndrome | radiating pain from shoulder |
| xiphoidalgia | pain/in the region of the xiphoid cartilage |
| ulnohumeral joint | true elbow joint - olecranon process of ulna + trochlea of humerus |
| radioulnar joint | allow pivot action - supination and pronation |
| radiocarpal joint | between radius an carpal bones. Carpal bones have anterior glide in extension, posterior glide in flexion |
| interosseous membrane | between 2 closely associated bones - e.g. ulna and radius. Somatic dysfunction of the interosseous membrane can perpetuate elbo/wrist pain after the injury should have healed |
| ulnar abduction somatic dysfunction | evident in flexion at end point - increased carrying angle |
| ulner adduction somatic dysfunction | decreased carrying angle - evident in extension |
| anterior radial head somatic dysfunction | stuck in supination, restricted in pronation, radial head will not glide posteriorly, from backward fall |
| posterior radial head somatic dysfunction | Stuck in pronation, radial head will not glide anteriorly, result from a forward fall |
| lateral epicondylitis | actually should be termed "lateral tendinosis of elbow" does NOT involve inflammation - tissue degeneration of tendon |
| viscerosomatic reflex | |
| deQuervian tenosynovitis | swelling of tendon sheath that surrounds abd. pollicis longus and extensor pollicis brevis tendons at the wrist. Inflammation thickens tendon sheath and constricts tendon as it glides in sheath - crepitus over tendon sheath as pt flexes and extends thumb |
| nerve compression syndromes | ulnar nerve (cubital tunnel syndrome), median nerve compression at the elbow, posterior interosseous nerve compression, pronator syndrome (muscular compression of median nerve in the proximmal forearm), radial tunnel syndrome |
| structural scoliosis | spinal curve is fixed and inflexible |
| functional scoliosis | spinal curve is flexible - correctable condition caused by postural or biomechanical factors |
| adams test | forward bending test - patient bends forward at the waist - identify a rib hump - pt sidebends toward the side of rib hump. Disappears - functional scoliosis, persists - structural scoliosis |
| rib hump | when patient is bent over, ribs protrude |
| static postural exam | look for symmetry - line passes through midline of the body. Check levelness of popliteal creases, greater trochanters, iliac crests, inferior angles of the scapula, tops of shoulders, mastoid processes |
| postural x-rays | use after finding static postural exam abnormality, structural scoliosis determined from Adam's test, OMT not successful, suspect conjenital abnormality, or to monitor progress of postural treatment regimen |
| cobb angle | line across top survace of superior vertebra, line across bottom of inferior vertebra, perpendicular lines off of both. Then angle of intersection = Cobb angle |
| lumbosacral angle (ferguson's angle) | angle between sacral base and line parallel to the ground - normally 25-35° |
| short leg syndrome | unlevel sacral base due to one leg shorter than the other leads to functional scoliosis causing the spine to compensate with a type 1 curve to keep the eyes level |
| asymmetry | can be indicative of restriction or of structural problem (i.e. short leg syndrome) |
| adductor tension | short leg syndrome can cause this |
| body of vertebra L3 | center of gravity - stays still and motion rotates around it |
| dynamic functional assessment | gait provides information on how the muscle systems interact with each other. Includes relationships of agonists and antagonists. |
| energy conservation | momentum from one stride is carried into the next |
| gait | |
| initial loading | "heel strike" - contact --> lower forefoot to ground |
| initial swing | in swing phase - accelerate thigh |
| loading response | "flat foot" - after heel strike, accept weight onto foot |
| midstance | between loading response (flat foot) and terminal stance (heel off). Stabilize the pelvis |
| midswing | clear the foot (between initial swing and terminal swing) |
| pelvic rotation | part of a normal stride |
| restriction of motion | can be observed as asymmetry in stride |
| preswing | toe off - continue to accelerate |
| propulsion | function of gait |
| sacral torsion | sacrum twists around its own longitudinal axis |
| shock absorption | function of the joints (knee and hip) |
| stance | stance phase = foot on ground (not swing phase) |
| stance stability | symmetry |
| static postural exam | observation of patient's symmetry |
| stride | 1 complete gait cycle |
| swing | swing phase - leg is in the air |
| terminal stance | "heel off stance" - before preswing (toe off) -begin to accelerate |
| terminal swing | "deceleration" - last part of swing phase before heel strike, extend knee, position foot |
| abdominal diaphragm | central tendon and muscle - along rib margin. Makes up a transverse fascial diaphragm |
| zink's fascial pattern | transverse fascial diaphragms - fascia rotates a particular way. Each fascial diaphragm alternates. 80% "healthy" people have R rotated pelvic diaphragm, L rotated abdominal dia., R rotated cervicothor., L rotated occipitoatlanto. |
| collectors | functional unit: lymphangion. + valves, 3 layers - intima, media, adventitia |
| common compensatory fascial pattern | Right rotated pelvic diaphragm, Left rotated abdominal diaphragm, right rotated cervicothoracic diaphragm, left rotated occipitoatlanto diaphragm |
| cysterna chyle | large collecting duct in the pelvis |
| edema | increased fluid in the interstitium - SYMPTOM. Disrupts anchoring filaments, disables intrinsic pumping mechanism |
| extrinsic lymphatic pumps | diaphragms, respiratory system, adjacent arteries, exercise, peristalsis, external coompression (OMT, compression stockings, bandages) |
| interstitium | space between cells |
| intrinsic lymphatic pumps | lymphangions (collectors), interstitial fluid pressure |
| lymph fluid | clear-yellow, resp. for absorbing fats from the diets (via lacteals). Contains clotting factors, lymphocytes, bacteria and viruses before filtration through org. lymph tissues |
| lymph capillaries | 1 layer "leaky" endothelium, discontinuous BM, no valves. Patency maintained by anchoring filaments |
| lymph nodes | organized lymph filtering centers - expose to immune system. Purifies lymph |
| lymphangions | functional unit of lymph collection - main transporting unit of lymphatic system |
| lymphodynamic edema | edema in normal system - accumulation of fluid bc of increased volume |
| lymphostatic/lymphedema | abnormal system accumulates fluid. Primary (congenital) or secondary |
| pre-collectors | 1-3 layers of endothelium, + valves |
| right lymphatic duct | drains the right quarter of the body's lymph. Empties into the right subclavian v. |
| thoracic duct | drains the lower body's lymph - empties into the left subclavian v. Crosses Sibson's fascia 2x. |
| left lymphatic duct | aka thoracic duct |
| thoracic inlet | opening to the rib cage |
| cervicothoracic fascia | sibson's fascia |
| uncompensated fascial compensatory pattern | zink's fascial pattern - transverse diaphragms do NOT alternate the direction they're rotated. Assoc. w. poorer health, increased constriction. |
| unorganized pathways | improvised flow of fluid - how interstitial fluid empties into the lymphatic capillaries |
| lymphatic treatment | remove restrictions to flow - treat transverse diaphragms (esp. cervicothoracic) |
| neurological model | diagnosis of viscerosomatic reflexes, , normalization of autonomic tone |
| respiratory-circulatory model | lymphatic drainage - treat thoracic inlet |
| viscerosomatic reflexes and treatment | visceral dysfunction (organ malfunctions) send afferent info. (GVA) --> WDR that affect both visceral effects (GVE) and somatic tissue (GSA) contraction |
| visceral dysfunction | OMT can be used to complement routine care for tx of visceral disease |
| treatment of sympathetic component of visceral disease | rib raise, chapman's points (dx on front, treat on back), inhibition of celiac, sup. + inf. mesenteric ganglia |
| treatment of parasympathetic component of visceral disease | cervical soft tissue (treat vagus), sacral rocking (S2-S4) |
| treatment of organ dysfunction component of visceral disease | mesenteric lifts, organ pumps, visceral manipulation |
| treatment of lymphatic component of visceral disease | fascial diaphragms, lymphatic pumps (e.g. thoracic pump), organ pumps |
Created by:
eegitto
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