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TART Tissue texture abnormality Asymetry Restriction of motion Tenderness
5 Models of Osteopathic Care Biomechanical, most common. Neurological, viscerosomatic Resp/Circulatory, blood, O2, lymph Behavioral, anxiety and stress (somatoemotional release) Metabolic/Energy, getting off crutches
Soft Tissue Techniques... ie suboccipital inhibition. More generally, traction, kneading, inhibition, effleurage, persitage
Planes of vertebral facets cervical=transverse thoracic=coronal lumbar=saggital
Treat type I of type II first? type II, may be the cause of the other SD's
Leaving the rest of Vert Biomech out its been covered enough I think
Scoliosis is named for convexity or concavity? convexity
What are some types of scoliosis curves? double major (most common), single scoliosis, junctional (uncommon) found at C7-T1 or T12-L1
The cause of most scoliosis is idiopathic, what does it mean? 70-90% are idiopatihc, it means we don't know the cause.
Scoliosis can also be acquired... inflamation and irradiation, osteomalacia, sciatic irritability, psoas syndrome, leg fractures and hip and knee replacements
Some rare causes of scoliosis are... congenital, usually the worst. Neuromuscular, MD, polio, CP, Arnold Chiari malformation. Others include autoimmune disorders, Marfans, dwarfism, RA...
Some important prognosticating factors... Thoracic curves = more risk for progression. Future growth potential (puberty) also increased risk progression
What type of vertebral biomechanics does scoliosis follow? Type I
What are the 6 point to look at on a Static postural exam? 1. popliteal creases 2. greater trochanters 3. iliac crests 4. inferior angles of scapula 5. acromion processes 6. mastoid processes
The Adam's test, aka forward bending test, tells you what? Functional vs Structural scoliosis Functional is flexible and potentially reversible. If the rib hump goes away when you sidebend towards it, it is functional. Otherwise...stuctural, inlfesible and non reducible
What does the Cobb angle tell you? How do you measure it? how severe the curve is, measure via xray.
What do the numbers from the Cobb angle mean? rule of 5's in degrees 5-15=mild 20-45=mod >50=severe progression is significant if >5 degree progression in 5 months
The other xray test? Fergusons angle (lumbosacral angle, LSA)is the angle between the sacral base and a line paralell to the ground. > 40 degrees=increased lumbar lordosis <30 degrees= decreased lumbar lordosis, flat back
How do you treat scoliosis? Mild=OMT, excersise(not one sided), heel lifts Moderate=same but add bracing Severe= same but consider surgery esp if visceral fxn impaired.
Conterstrain= tenderpoints, thank Dr. Lawrence Jones, "i did it because it worked" Basically you are trying to shorten the muscle that has the tenderpoint to get it to relax, is how I understand it.
The dominant current hypothesis of counterstrain... trauma or sudden strain causes proprioceptive disregulation, involves muscle spindles.
Comeaux's recipe for recall, 6 steps 1. ID and 10 scale tenderpoint 2. Passive positioning 3. Don't move your finger, seriously 4. 90 seconds 5. passive return 6. retest
Buckminster Fuller came up with the Bucky Ball, what else is attributed to him? The concept of tensegrity. bikes, bridges and geodesic domes. triangulation.
Tension elements of tensegrity are... a continuous series, tendons and ligaments
Compression elements... a discontinuous series, bones
Structutre follows function, like the karate guy that keeps kicking a tree with his shin, his tibia is going to remodel and get bigger. Who claimed this as their law? Wolff, we'll see it again with regard to myofascial release.
Tensegrity isn't just about bones and ligaments... it goes down to the cellular level (Thatcher) and OMT can affect all levels of tensegrity.
Tensegrity also touches on harmonics. What effect can harmonics have? It MAY do lots of things, like affect cellular differentiation and carcinogenisis, transfer info and direct all strucuture and function.
Fascia is Connective tissue made out of... collagen, elastin, and reticular fibers, and ground substance. Ground substance is colloidal, ie fluid and solid depending on pressure applied
Some functions of fascia are... immunity? nociception, and support. It is a continuous sheath, so naming is artificial...
Somatic dysfunction is common in the 5 transverse fascial diaphragms, what are they? pelvic thoracic thoracic inlet suboccipital cranial
The pericardium, pleura, and thoracic diaphragm are a type of fascia. T/F? true, specialized
Myofascial Release (MFR) engages the tensegrity structure of the body, trying to reach a state of balanced tension. The idea is to help? let the body heal itself?
Trigger points are evoked by? (diff from tender points) abnormal depolarization of motor end plates.
So the goal of Myofascial release is? normamlize motor end plate activity, change abnormal strain pattern.
How do fibroblasts respond to stress? making more fibers, usually along same stress lines as direction of force (carpal tunnel)
3 types of fascia? 1. Superficial, it's subcutaneous, involved with skin mobility, temp insulator, store energy, lymph and neuromuscular bundles 2. Deep fascia, separates muscle into muscle groups (same as in your steak) 3. Subserous fascia, viscera and organ capsules
More functions of fascia, 5 1. Musculoskeletal; mobility, stability, postural 2. Nervous;75% muscle stretch receptors have free endings in fascia 3. Circulatory; channels for vessels 4. Lymphatic; aids in lymph return 5. Cell metab.; alters transfer of nutrients etc...
reciprocal inhibition in muscles, ie when bicep flexes, tricep relaxes is stated in whos law? Sherrington's Law
Wolff's law with respect to fascia, says. Fascia will deform as a result of the lines of force to which it has been subjected. How does this effect the mechanism of treatment? Sometimes the mechanism of injury can also be the mechanism of treatment.
The mechanism of direct myofascial release is at the ________________level? neurological. it lengthens the muscle and resets the neurological millieu. Indirect is more about finding the position of ease, or "point of balance" in all planes, not sure what level that is.
Integrated Neuromuscular Release (INR), Fascilitated Positional Release (FPR), Funtional Technique, Ligamentous Articular Strain (LRS) are all variations or synonomous with? Myofascial release.
Dr. Fred Mitchell Sr. = Muscle Energy Technique. Direct treatment where the patient is active
Types of muscle contraction, 3 Concentric, eccentric, isometric
counter force = patient force? Isometric
counter force > patient force? eccentric. isolytic is a type of eccentric contraction and can be used to break adhesions
2 subtypes of concentric contraction isokinetic, force modulated through range of movement. isotonic, contant force
What is the MOST important thing to remember when performing Muscle Energy Tech. LOCALIZE
Muscle Energy can be a stand alone technique or be paired with? HVLA. Muscle Energy is a good technique to use on someone with Parkinson's to keep muscles loose
There are four proposed physioogical mechanisms for Muscle Energy, what are they and which one is probably going to be on the test? 1. Tissue creep, constant load= tissue give 2. Conditioning, less resistance with repeated stretch 3. ****Post isometric relaxation***, muscle relaxation doe to GTO (triggers relaxation prevents tearing) 4. reciprocla inhibition
What do you need to look out for in joints when using muscle energy? hypermobolity
How do you check for hypermobility? Beighton non dominant hypermobility screening. 4/5 positive = caution for all direct treatments. here comes Ehrlers Danlos again
What other symptoms would lead you to treat with caution using muscle energy? osteoporosis, joint inflammation, elderly, and if patient is guarding
Minor joint motions are often the cause of SD, what is ine example? joint glide
being restricted in all or most planes of a joint motion is called? capsular pattern, a rheumatological issue
What glide to you get when you flex your knee joint? extend? flexion=anterior glide of tibial plateau extension= posterior glide " "
A tibia anterior somatic dysfunction means... restricted posterior glide, so extension would be restricted and possibly painful. (stuck anterior)
A fibular head posterior somatic dysfunction means..? stuck posterior, pull anteriorly while pressing the gas. can cause fibular neuritis.
What is a common injury that can have implication to the fibula and may benfit from treating a fibular head somatic dysfunction? ankle sprain
2 parts of the ankle joint? upper=tibiotalar (talocrural) lower=subtalar (talocalcaneal)
3 hip tender points? greater trochanter, piriformis, iliopsoas
Which hand do you use to diagnose a interosseous membrane dysfunction. distal
Created by: pcwvsom