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OMM > 2014 Winter Quarter Written 1 > Flashcards

2014 Winter Quarter Written 1 Flashcards

1
Q

What happened in 1917 to the AOA?

A

Right to serve in uniformed services. President Roosevelt supported it. Vetoed by Gorgas.

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2
Q

What happened in 1963 to the AOA?

A

DO’s accepted by civil service as medical officers

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3
Q

What happened in 1966?

A

Robert McNamara, Sec of Defense, makes DOs as qualified medical officers.

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4
Q

What types of patients frequently have thoracic dysfunction?

A

Patients with shortness of breath, chest pain, or GI complaints

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5
Q

A flattening of the thoracic spine may indicate what type of dysfunction?

A

Extended dysfunction

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6
Q

At what vertebral level is the sternal notch?

A

T2 anteriorly

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7
Q

At what vertebral level is the Xipho-sternal level?

A

T9

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8
Q

What are the relations of spinous processes to their bodies?

A

T1-3: same level
T4-6: 1/2 level down
T7-9: 1 level down
T10-12: same-ish

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9
Q

Where are viscerosomatic tissue texture changes seen the most in thoracics?

A

rib angles

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10
Q

What layer is viscersomatic reflexes seen the most?

A

subcutaneous tissue

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11
Q

In what direction do you palpate for muscles?

A

perpendicular to muscle fibers

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12
Q

Fryette’s Type 1>

A

Group curves; sidebending and rotation occur in opposite directions.

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13
Q

Fryette’s Type 2?

A

Single unit effected. sidebending and rotation in the same direction

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14
Q

Fryette’s Type 3?

A

Initiating motion of a vertebral segment in any plane of motion will modify the movement of that segment in other planes of motion

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15
Q

What structures exhibit reciprocal motion?

A

ulna and radius ; tibia and fibula

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16
Q

What is caliper motion?

A

motion of ribs 11 and 12; analogous to internal and external rotation.

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17
Q

In what direction is the axis of rib motion?

A

from the head of the rib to the rib angle. But, at 1st rib, axis is in coronal plane. Axis moves more posterior as you move inferior

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18
Q

Describe motion testing in various positions

A

Seated: focused on palpation.
Supine: Rib motion, Jones tender points, Fascial restriciton
Prone: thoracic spine

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19
Q

Describe Type 2 segmental dysfunction?

A

Very common in upper thoracics
Found out of step with group curves
Can effect A-P curvature (E or F)

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20
Q

Describe Type 1 segmental dysunction?

A

related to short leg or pelvic sideshift
Seen in idopathic scoliosis
Seen in postural patterns from repetitive activity
Seen in long standing viscerosomatic reflexes

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21
Q

Describe Muscular/Fascial dysfunction

A

Seen in repetitive use, macro-trauma, and poor posture

Co-dependent with articular dysfunction

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22
Q

Describe A-P Curve Problems

A

may be a long standing postural change to nocceptive or viscerosomatic input

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23
Q

What is the definition of viscerosomatic reflexes?

A

Localized visceral stimuli producing patterns of reflex and response in segmentally related somatic structures

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24
Q

Name Cardiac, Pulmonary, and Upper GI viscerosomatic examples?

A

Cardiac: texture change in upper L thoracics
Pulmonary: Texture change bilateral or unilateral
GI: Texture with alternating pattern in upper and mid thoracics

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25
Q

What do double-labeling studies show at CCOM?

A

An anatomic connection bw visceral and somatic structures in DRG

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26
Q

What is the difinition of somato-visceral reflexes?

A

Localized somatic stimuli producing aptters of reflex response in segmentally related visceral structures

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27
Q

When is HVLA appropriately used?

A

When the main component is articular. If the barrier is less distinct then try indirect

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28
Q

What do articular dysfunction and Co-existent Orthopedic disease have in common?

A

the joint is jammed with a rock hard endpoint. Do not lose localization during setup.

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29
Q

Name examples of treatments for tender points

A

Jones counterstrain, Chapmans inhibitory pressure, Travell and Simon trigger point spray,
Injection

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30
Q

What are trigger points?

A

They radiate to a pain reference zone

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31
Q

What happened to AOA in 1939?

A

First specialty board is formed - Radiology

32
Q

What is unique about ribs 11 and 12?

A

They haev no costotransverse articulation

33
Q

Describe properties of the rib segments

A

1-7 are true. 8-10 are false. 11-12 are floating. Ribs 1, 11, 12 are atypical

34
Q

Where does the brachial plexus pass through?

A

Between the anterior and posterior scalenes

35
Q

Name 3 sites of thoracic outlet sydrome

A
  1. Bw anterior and middle scalene (ant. scalene syndome)
  2. bw clavicle and 1st rib (costoclavicular syndrome)
  3. bw pec minor and chest wall
36
Q

Describe fluid movement in thoracic outlet

A

negative intrathoracic pressure + positive intra-abdominal pressure.

37
Q

Pump handle motion

A

affects AP diameter, upper ribs 1-5

38
Q

bucket handle motion

A

effects transverse diameter, lower ribs 6-10

39
Q

Which rib is more associated with elevation of the rib?

A

1st rib

40
Q

Which ribs have the most pump handle motion

A

Ribs 1 and 2. Predominance of this motion decreases as you move inferiorly. BUT all ribs exhibit both pump and bucket handle - just to varying degrees

41
Q

Describe the motion of ribs 11 and 12

A

pincer, caliper motion. Move posteriorly and laterally on inhalation, and anteriorly and medially on exhalation

42
Q

What are respiratory ribs?

A

Exhibit motion restriction in the movement of inhalation/exhalation

43
Q

What are structural ribs?

A

Exhibit restriction of motion associated with thoracic cage restriction/dysfunction

44
Q

What is Greenman’s list of structural ribs?

A

Anterior sublux
Posterior sublux
External rib torsion (associated with E dysfunction)
Sup. 1st rib sublux
A-P rib compression
Lateral Rib Compression
Lateral flexed rib (usually 2nd) (‘bucket bail’)

45
Q

What is associated with a Reflex dysfunction?

A

Tender points, viscerosomatic patterns

46
Q

What is a key rib?

A

For exhalation group: top rib is key rib restricting inhalation
For inhalation group: bottom rib is key rib restricting exhalation
(key rib is often structural rib and should be treated)

47
Q

Describe structural ribs

A

often presents as intercostal neuralgia. usually fixed when thoracics are treated.
ant-post sublexes: tension of iliocostalis

48
Q

Who is Dr. Irwin Korr?

A

PHysio prof at KCOM. Paper on autonomic activity at the level of dermatomes and the relationship to reflex motor activity.

49
Q

Who is Dr. Louisa Burns?

A

studied viscerosomatic and somatovisceral reflexes and the effect of OMT

50
Q

What did Dr. Louis Burns; studies conclude?

A
  1. Pathway of viscerosomatic enters sinal chord through post. roots
  2. somatvisceral reflexes are less circumscribed and direct than V.S.
  3. normal visceral activity depends on somato-sensory nerves
  4. V.S. aids in diagnosis
51
Q

What did Dr. Korr and Dr. Denslow conclude?

A

Physiology of spinal segmental facilitation and its somatic dysfunction.

52
Q

What fibers are activated in V.S and S.V reflexes?

A

nociceptive, general visceral afferents; somatosensory nociceptive neurons, respctively

53
Q

Where and with what do primary afferent neurons synapse?

A

In the dorsal horn with internuncial neurons

54
Q

What is facilitation?

A

A state of irritability of ongoing irritation of internuncial nn, whether VS or SV.

55
Q

How does afferent activity effect the stimulus?

A

The response/threshold is lower and easier to reach in that segmental area

56
Q

Describe the difference in activity of ventral horn motor synapses and intermediolateral cell column synapses.

A

Ventral horn: segmental myospasticity in primary SD and VS reflexes
Inter: segmental somato-somatic, somatovisceral and viscero-visceral reflex sympathicotonia

57
Q

What do VS reflexes represent?

A

the somatic reflection of visceral pathology (SD secondary to visceral inflammation)

58
Q

Usually intensity of VS reflexes mirror severity of visceral pathology. What is the exception?

A

Visceral neoplasia, because they are avascular and not innervated. The surrounding effected tissue transmits the response.

59
Q

What are Chapmans reflexes?

A

2-3mm nodular masses, palpable in soft tissue. Sharp, pinpoint, non-radiating. Dysfunction of segmental symp. system w effected lymphatics. Anterior pionts diagnostics and posterior points are treated. In deep fascia or periosteum

60
Q

What are signs of chronic SD?

A

local vasospasm, subcu fibrosis, low temp, low skin drag

61
Q

What did Beal ccontribute?

A

reviewed anecdotal literature and gave review of locations of VS reflexes

62
Q

At what level do organs above diaphragm experience VS reflexes

A

at or above T5 (below T5 for organs below diaphragm)

63
Q

Where are parasympatetc reflexes found?

A

vagus nerve, and S2,3,4

64
Q

What occured in 1910?

A

Flexner report of Rockefeller. AOA developed standards and led to accredidation

65
Q

Anatomy of C0 on C1

A

occipital condyles converge anteriorly at 30 deg.
Major motion: Flexion/Extension 15 deg.
Atypical mechanics-rotation/sidebending opposite

66
Q

Anatomy of C1 on C2

A

major motion: rotation 35 deg each direction.

Atypical: restriction occurs onsly in rotation

67
Q

Anatomy of C2-C7

A

facets point toward eye 45 deg.

Atypical: sidebending induces rotation twowards concavity in both Type 1 and 2

68
Q

Describe range of motion of cervical spine

A

flexion/extension - 130 deg.
side bending - 35 deg left and right
rotation - 90 deg left and right

69
Q

What muscles cause flexed and extended dysfunction in cervical spine?

A

anterior: (longus colli,/rectus capitus anterior) cause flexed dysfunction
posterior: (semispinalis, cervicis, longissimus) cause extended dysfuction

70
Q

Vagus n receives branches from which root?

A

C2

71
Q

Which arteries are at risk of arterioal occlusion with extension and rotation?

A

Vertebral aa

72
Q

Which muscles are involved in acute and chronic neck problems?

A

Acute: (prevertebral) scalenes, sternocledio
Chronic: postural, trap, levator scapula

73
Q

What is associated with whiplash?

A

extended upper thoracic dysfunctions; use indirect techniques

74
Q

What is a common GI pattern?

A

C2 left, T3 right, T5, left, T7, right

75
Q

What test is positive for Compression syndromes?

A

Adson’s test

OMM (6 decks)

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