10 step screening exam

Question 1

Osteopathic Structural Exam

Answer 1

Screening exam (assymetry and rom)

Scanning/Regional exam (focuses on restricted or dysfunctional region, palpate for tissue changes)

Segmental exam (focusing on area you found tissue texture changes during the scanning exam)

ENDS IN DIAGNOSIS OF somatic dysfunction

Question 2

Patient Standing (10 step exam)

Answer 2

FIRST

Gait analysis/ posture 1
lower extremity mobility test (squat) 2
Spine sidebending 3
standing flexion test 4 a
scoliosis screen  4 b

Question 3

Patient seated (10 step exam)

Answer 3

5 Seated flexion test
6 Spine flexion, extension, sidebending, rotation
7 upper extremity mobility

Question 4

Patient supine (10 step exam)

Answer 4

8 Costal cage mobility with breathing assessment
9 Lower extremity mobility: Hamstring and FABERE test
10 Pelvic and lower extremity anatomic landmarks (PUBIS)

Question 5

Gait analysis

Answer 5

detects abnormalities in the motor system or musk structures that are more pronounced during walking

Question 6

lower extremity mobility (squat)

Answer 6

test assesses hip, knee, ankle flexion and extension

positive squat test - asymmetry, decreased ROM, pain or lack of ease in motion

watch heels off floor and make sure they are able to flex to atleast 90 degress (knees hips)

Question 7

sidebending

Answer 7

tests regional sidebending restriction in the thoracic or lumbar spine

should be 40 degrees in each direction

if two or more vertebra remain straight suggests SD or paravertebral muscle fullness

Question 8

standing flexion test

Answer 8

assesses iliosacral SD
discerns side of somatic dysfunction

if the ilium is restricted on one side it becomes adhered to the sacrum therefore must follow the sacrum forward during flexion

positive standing flexion test–> the dysfunctional sides PSIS will travel superiorly relative to the healthy sides PSIS

Question 9

Scoliosis screen

Answer 9

positive scoliosis test–> lateral curve found during flexion of spine

positivity can indicate vertebral anomalies, congenital defects, acquired defomrities, compenssation for short leg, muscle imbalance

***functional scoliotic curves appear reduced more likely to benefit from OMT

structural curves may not change significantly especially in adults

Question 10

seated flexion test

Answer 10

assesses dysfunction of the sacrum or lower lumbar spine

Question 11

Spine mobility test

Answer 11

asymmetry in rom indicates need for more specific segmental screening for SD

Question 12

Upper extremity mobility test

Answer 12

positive test = asymmetry or decreased rom

test assesses soft tissue or joint motion restrictions in the upper extremity including sternoclavicular, acromioclavicular, glenohumeral, wrist and hand joints

Question 13

rib cage mobility test

Answer 13

upper rib cage–> bucket handle gas pump

lower rib cage–> bucket handle

floating ribs–> caliper motion

Question 14

lower extremity mobility test

Answer 14

positive straight leg–> pain down posterior side of leg and past the knee during test– could mean radiculopathy (nerve impingement )

positive FABERE test (flexion, abduction, externally rotate, extend)
suggests SD in sacroiliac, hip, knee or ankle joints

Question 15

what does a tight hamstring cause during a standing flexion test

Answer 15

it gives a false positive because a tight hamstring may prevent the ipsilateral ilium from moving superiorly or anteriorly during a standing flexion test, potentially giving a false positive on the contralateral side

Question 16

supine pelvic lower extremity symmetry tests

Answer 16

first reset pelvis

look at ASIS- asymmetry

pubic symphysis assessment–> asymmetry

medial malleoli (leg length) - place thumbs under each medial malleolus and compare side to side - short leg??