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Osteopathic Screening Examination First tool to assess patient's structure. many variations, must strive to standardize.
Ten Step OSE Gait, Static Exam, Seated Cervical Exam, Seated Thoracic Exam, Pelvic Lateralization, Seated Flexion test, FABERE Test, Supine Ribcage, Upper Extremity Screen, Lower Extremity Screen.
Gait Look at how people are walking. Must be observed with adequate distance. looking for obvious abnormalities.
Static Exam Inspection and light palpation of landmarks in 3 planes (anterior,posterior,lateral) Must maintain eye level. Must be mindful of dominant eye. Look for patterns, identify problem areas. Look for the WORST problem.
Anterior View of symmetry and Asymmetry Medial arches, medial malleoli, patellas, greater trochanters, asis, height of iliac crests, waist creases, rib cage angle, rib cage rotation.
Levels that you should look at anteriorly for symmetry and asymmetry Level of Shoulders, fingertips, earlobes, and eyes. Also, deviation of cervical spine and skill,
Posterior View of Symmetry and Asymmetry Achilles tendon, medial malleoli, popliteal lines, greater trochanters, PSIS, height of iliac crests, thoracolumar spinefor deviations from midline or flattening, waist creases.
Side View midgravitational line, anterior body line, posterior body line, head position, cervical curve, cervical thoracic jn, thoracic curve, thoracocolumbar junction, lumbar curve, lumosacral junction, sacral curve, arm position
Seated Cervical Exam Assessive active and passive range of motion of cervical spine with respect to patient.
normal ROM for cervical exam. flexion , 0-45. Extesion, 0-45. rotation, 0-80. Sidebending, 0-45.
Seated thoracic exam assessing active and passive range of motion for thoracic spine. Focus on rotation and sidebending.
Sidebending in seated thoracic exam. Downward pressure medially assesses upper thoracics. moving lateral corresponds to lower thoracics. normaly ROM - 0-30.
Rotation in seated thoracic exam. place hands on hips ideally, measure against coronal plane line. Normal = 0-30.
Pelvic Lateralization To determine dysfunctional pelvic mechanics : Standing flexion test, ASIS compression test, Stork Test. Just do the first one, if that works, you're done. Positive = Side that moves first.
Standing Flexion Test Assess SI Joints. positive test indicates dysfunction in 1 of 3 ways. inominate dysfunction on positive side. sacrum dysfunciton on positive side. tight hamstrings on opposite side.
ASIS compression test Assess for restriction. Indicates innominate or sacrum dysfunction on positive side.
Stork Test Assess SI joints. Positive test is dysfunction of sacrum or inominate.
seated flexion test Follows a positive laterality test. removes pelvic component. significant for sacral dysfunction
FABERE patrick test. used to differentiate hip joint vs sacroiliac pathology. Acronym: FABERE. Flexion, ABduction, External Rotation, Extension.
Pain in FABERE test Pain in groin region significant for hip pathology. pain in low back on extension is significant for sacroiliac dysfunction (innominate or sacrum)
Supine Rib Cage General screen for patient breathing looking for restricted or asymmetrical motion
Created by: nady