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Noorda OMM > 101 Midterm 1 > Flashcards

101 Midterm 1 Flashcards

1
Q

What is arthrodial SD end-feel

A

Hard

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2
Q

What is muscular SD end-feel

A

Protective spasm

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3
Q

What is myofascial SD end-feel

A

Binding and hard

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4
Q

What is an early muscle spasm

A

Protective after injury

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5
Q

What is a late muscle spasm

A

Chronic

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6
Q

What is a hard capsular end feel example

A

Frozen shoulder

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7
Q

What techniques are 30-60 seconds

A

MFR
ST (Traction and Deep pressure)

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8
Q

What techniques are 1-2 seconds

A

ST (Stretching)

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9
Q

What techniques are 90 seconds

A

SCS

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10
Q

SCS treatment for anterior cervical vertebrae

A

FSARA

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11
Q

SCS treatment for posterior cervical vertebrae

A

ESARA

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12
Q

SCS treatment for anterior thoracic vertebrae

A

FSTRA

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13
Q

SCS treatment for posterior thoracic vertebrae

A

SP - ESARA
TP - ESART

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14
Q

SCS treatment for anterior ribs

A

FSTRT

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15
Q

SCS treatment for posterior ribs

A

FSARA

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16
Q

What techniques are 120 seconds

A

Ribs

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17
Q

Location of anterior lumbar tender points

A

AL1 - medial to ASIS
AL2 - medial to AIIS
AL3 - lateral to AIIS
AL4 - inferior to AIIS
AL5 - 1 cm lateral to pubic symphysis on superior ramus

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18
Q

SCS treatment for posterior lumbar

A

ESARA minus exceptions

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19
Q

Exceptions for SCS treatment for posterior lumbar (4)

A

PL3 gluteus
PL4 gluteus
UPL5
LPL5

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20
Q

SCS treatment for psoas

A

Frog leg with side bend
FSTER

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21
Q

SCS treatment for iliacus

A

Frog leg
FER

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22
Q

SCS treatment for piriformis

A

“pee-riformis”

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23
Q

SCS position for levator scapulae

A

Head ST

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24
Q

SCS position for trapezius

A

Head STRA
Arm above head
Cephalad traction (if necessary)

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25
Q

SCS position for SH-biceps

A

FAdIr (shoulder scratch)

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26
Q

SCS position for IT band

A

Slightly flex and abduct hip

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27
Q

SCS position for TFL

A

Flex hip to 45 degrees
Abduct hip

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28
Q

SCS position for sternocleidomastoid (AC7)

A

Flex down to C7
FSTRA

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29
Q

Neurons that contract extrafusal fibers

A

Alpha-motor

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30
Q

Neurons that contract intrafusal fibers

A

Gamma-motor

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31
Q

SCS treatment for posterior rib 1 (PR1)

A

ESART

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32
Q

What techniques are 3-5 seconds

A

ME

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33
Q

Goal of post-isometric relaxation

A

Muscle relaxation

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34
Q

Steps of post-isometric relaxation (4)
Steps of muscle energy

A

Engage RB
Isotonic/isometric contraction
Relaxation
Engage new RB

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35
Q

Goal of reciprocal inhibition

A

Lengthen muscle shortened by cramp

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36
Q

MOA of reciprocal inhibition

A

Gently contract antagonist muscle

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37
Q

Steps of oculocephalogyric reflex

A

IC - look towards/RI - look away from RB
Contract cervical muscles
(coordination of following flight patterns)

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38
Q

Goal of oculocephalogyric reflex

A

Relax antagonist muscle
Treats suboccipital

39
Q

Goal of respiratory assist

A

Improve physiology

40
Q

MOA of respiratory assist

A

Patient breathes in slow and out exaggerated

41
Q

Goal of crossed extensor reflex

A

Treat contraindicated muscles via contralateral muscles

42
Q

MOA of crossed extensor reflex

A

Gently flex contralateral muscle voluntarily to relax SD

43
Q

Contraction

A

Shortening of muscle

44
Q

Contracture

A

Tightening of muscle causing soreness

45
Q

Sherrington Law

A

Stimulated muscles inhibit opposing muscles

46
Q

Golgi tendon organ

A

Spindle shaped organ providing muscle tension info

47
Q

Concentric contraction

A

Joint angle decreases

48
Q

Eccentric contraction

A

Joint angle increases

49
Q

Isometric contraction

A

Joint angle stays the same

50
Q

Isotonic contraction

A

Force stays the same

51
Q

Isokinetic contraction

A

With resistance

52
Q

Isolytic contraction

A

Overpowering eccentric

53
Q

Physician force in joint mobilization

A

30-50 pounds

54
Q

Force in isokinetic strengthening

A

10-20 pounds

55
Q

Force in isolytic lengthening

A

30-50 pounds

56
Q

What do positive treatment outcomes depend on

A

Accurate diagnosis
Appropriate force
Sufficient localization

57
Q

Negative treatment outcomes are caused by (6)

A

Inaccurate diagnosis
Improperly localized forces
Forces that are too strong
Inadequate patient instruction
Moving too soon after contraction into next joint position (“crashing into barrier”)
Forgetting to retest area

58
Q

What is the Thomas test for

A

Iliopsoas

59
Q

What is the Thomas test looking for

A

How much the opposing leg is lifted off the table (higher leg is the leg to treat)

60
Q

Patient is prone for what ME muscles

A

Psoas
Piriformis

61
Q

Patient is supine for what ME muscles

A

Hamstring

62
Q

Patient is seated for what ME muscles

A

Gastrocnemius
Forearm pronation
Forearm supination

63
Q

“The patient reports a 3-day history of worsening left knee pain, exacerbated by walking and relieved with rest. No recent trauma or injury.”

A

Subjective

64
Q

“The patient describes a throbbing headache that started two days ago, mainly located in the temples, with occasional nausea but no vomiting.”

A

Subjective

65
Q

“The patient states, ‘I feel more anxious than usual,’ and reports difficulty sleeping over the past week. No significant changes in appetite or weight.”

A

Subjective

66
Q

“The patient notes that the shortness of breath has gradually worsened over the past week, now occurring even at rest. Denies chest pain or palpitations.”

A

Subjective

67
Q

“The patient reports that since starting the new medication, they have experienced mild dizziness and dry mouth, but no other side effects.”

A

Subjective

68
Q

T: 37.2°C, P: 84 bpm, BP: 124/82 mmHg, RR: 19/min, O2 Sat: 98% on room air.

A

Objective

69
Q

The patient appears alert, oriented, and in no acute distress.

A

Objective

70
Q

Regular rate and rhythm, normal S1 and S2, no murmurs, rubs, or gallops.

A

Objective

71
Q

Lungs are clear to auscultation bilaterally, no wheezes, rales, or rhonchi.

A

Objective

72
Q

Soft, non-tender, mild tenderness in the right upper quadrant, positive bowel sounds in all four quadrants, no masses or organomegaly palpated.

A

Objective

73
Q

“The patient is a 69-year-old man with a history of hypertension and type 2 diabetes who presented with acute onset of severe retrosternal chest pain. The ECG and cardiac markers are within normal limits, making unstable angina the most likely diagnosis.”

A

Assessment

74
Q

“The patient is a 42-year-old woman on postoperative day 1 following a laparoscopic cholecystectomy. She is improving well, with stable vital signs and no signs of infection.”

A

Assessment

75
Q

“The patient is a 46-year-old female with paranoid schizophrenia, who has shown minimal improvement on her current medication regimen. She is now more engaged in daily activities, indicating slight improvement.”

A

Assessment

76
Q

“The patient is a 28-year-old, G2P1102, who had a spontaneous vaginal delivery. She is stable on postpartum day 1, with no significant complications noted.”

A

Assessment

77
Q

“The patient is a 58-year-old male presenting with new-onset weakness and difficulty speaking. The findings are consistent with a likely transient ischemic attack, pending further imaging.”

A

Assessment

78
Q

“Advance diet as tolerated. Follow-up with abdominal ultrasound tomorrow. Monitor CBC, electrolytes, BUN, and creatinine daily.”

A

Plan

79
Q

“Increase risperidone dose. Continue with individual, group, and milieu therapy.”

A

Plan

80
Q

“Start the patient on a beta-blocker and aspirin. Schedule an echocardiogram to evaluate for left ventricular function. Arrange a cardiology consultation for further management.”

A

Plan

81
Q

“Initiate IV antibiotics with broad-spectrum coverage. Obtain blood cultures and monitor daily. Reassess in 48 hours to narrow antibiotic coverage based on culture results.”

A

Plan

82
Q

“Continue postpartum care. Repeat CBC in the morning. Discharge planning for tomorrow, pending stable labs and patient condition. Provide breastfeeding support and advise on contraception.”

A

Plan

83
Q

Direct technique meaning

A

Into the restrictive barrier
Into the limitation
Against the direction of ease

84
Q

Indirect technique meaning

A

Away from the restrictive barrier
Away from the limitation
Into the direction of ease

85
Q

It’s late on a Friday afternoon and you are tired. Your 15th and last patient, a 62-year-old widower is particularly challenging because he has come in frequently during the last three months, each time complaining of a new ache or pain. You have been unable to find a physical cause for his complaints and conclude that his symptoms are part of his grieving process. Your offers to refer him to a support group were rejected, and he seems to have no insight at all. Which of the following questions represents mindfulness, and is most important to contemplate to make this encounter more successful, for you and for the patient?

A

How do I feel about the fact that he has rejected my efforts to help him with his real problem, the recent loss of his wife

86
Q

One of your colleagues made a serious mistake and administered the wrong antibiotic to a patient. Now it is 3 a.m. and you are trying to stabilize the patient, with mixed results so far. In the light of day, you will have to talk with the family and reveal the error to them. Which of the following questions are most important to contemplate to make that encounter more successful, for yourself and for the patient’s family?

A

What are my beliefs about such mistakes

87
Q

You just saw a patient whom you have known for many years-one of the first in your practice. You found her breast cancer during a routine check and supported her throughout her treatment. For 8 years she was in remission but now the cancer has recurred, and you had to give her the sad news. First, she was shocked and then she cried. You reassured her that you would continue to support her and made arrangements to start treatment. Even though you have to give such bad news two to three times a week, you felt quite sad and discouraged after she left. Which of the following considerations is most important to contemplate in order to optimize future encounters for yourself as well as for the patient?

A

I give bad news quite frequently, so what is it about this patient that makes me feel so discouraged?

88
Q

Your first patient is new, and you are trying to establish a rapport with her. As you are ready to examine her ears, you notice that the otoscope specula are once again missing. Clearly the exam rooms were not adequately restocked. This makes you angry because you have complained about this problem to the clinic administrator without results. The nursing aide responsible for restocking either is incompetent or lazy. This clinic should be able to hire better support staff. What could you contemplate during the clinical encounter to reduce your frustration and stay focused on the patient?

A

What successful strategies have I employed in the past to reduce stress

89
Q

Right now, you are way behind in your schedule. Three patients are waiting to talk to you, you are late for rounds, and you promised the social worker to call a nursing home on behalf of a patient. Your boss interrupts to tell you that for the second time you are passed over during the search for an Associate Unit Director. This seems very unfair, and you suspect that your race and gender had something to do with it. It annoys you even more because you have been putting a lot of effort into your job and have sacrificed valuable time that you could have spent with family. What should you contemplate to reduce your frustration and get ready for seeing the patients and catching up with the other tasks?

A

I’m so mad, I should call my spouse, even if the patients have to wait a bit longer

90
Q

For some years you’ve seen each in a couple for preventive care and minor health care problems. Today you had to tell the wife that she has gonorrhea, who assures you she only has sex with her husband. After the initial shock she besieged you with questions about her partner’s status and the possibility of him having affairs. You are aware that the husband has had affairs, and know that you must respect his privacy, but on the other hand you feel sympathy for the wife. What could you contemplate that might help you balance your feelings towards the wife with upholding the ethical principles?

A

Do I experience a similar type of helplessness and frustration as she does?

90
Q

You are following up with Mrs. Gonzales, who has persistent headaches. You’ve talked with her at length and done all the exams that seem appropriate, but you can’t arrive at a specific diagnosis. She is about to walk in. What could you contemplate (in the spirit of mindfulness) to improve the situation for yourself and for Mrs. Gonzales?

A

Am I assuming something about this patient that might not be true?

91
Q

You have good rapport with a 70-year-old woman with diabetes whom you’ve known for a long time. Sometimes her daughter brings her to the office, worried that she seems to be forgetful. She also mentioned some safety issues- namely burning food and serving spoiled food. You wonder how meaningful the daughter’s concerns could be since your patient always seems well put together and so much in charge of her own life. Her diabetes is a bit less under control at the moment, but she has been abroad visiting relatives and thus you thought that her diabetes self-care may have suffered in the process. What can you contemplate to make sure that you are not overlooking the onset of dementia?

A

Does the patient remind me of my own parents and their struggle to lead and independent life?

92
Q

Your new admission is a 90-year-old man in renal failure who has not much longer to live, and there is little you can offer medically at this point. You communicated this to the family who has assembled around his bed. As you leave the room you are disturbed by the feeling that you did so little for him. What can you contemplate to maximize your future impact in this and similar situations, for your patients as well as for yourself?

A

What would I want and need from my physician if I were dying?

93
Q

Your department chair asked you to take over the establishment of a new pain center, and this means that you will need to cut down on your patient load. You’ll need to transfer to colleagues some patients with whom you have long-standing relationships. What can you contemplate to prepare yourself for informing your patients about the upcoming transfers and changes?

A

What are my feeling about saying good-bye to these patients

Noorda OMM (16 decks)

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