CAOM Flashcards
What is the T10 dermatome associated w/?
Umbilicus
What spinal segment is related to the sympathetic innervation of the ovaries?
T10-11
When is the hormone relaxin at the highest concentrations?
1st trimester
A 47-year-old female patient comes to the clinic with a history of dysmenorrhea and heavy flow. On physical examination, it is determined that she has a fibroid tumor and a hysterectomy is recommended. Pre-and postoperatively, where should you look for the viscerosomatic reflex related to pain which of the following areas?
T10-L1
A 24 year old female at 36 weeks gestation comes to the clinic complaining of low back pain. On structural exam you found L3 F RSr. You decide to perform an indirect myofascial release to help relieve muscle tension before treating the segmental this dysfunction. While you were doing, so you felt an articulation under your hands in the patient tells you that she heard a pop. The case with which this happened may be due to increased levels of?
Relaxin
On structural examination, you note an ease of translation to the left in flexion at the level of T6. If you were to use muscle energy technique to resolve this dysfunction in what direction would you direct the patient to make their effort?
T6 E SRr
They direct their effort towards the Dx
Which of the following is true regarding thoracic outlet syndrome?
Venous compression is a common problem
What is the name of the test in which the patient’s affected arm is abducted while the physician monitors the patient’s pulse and the patient turns their head toward the arm, extends the neck and takes a deep breath?
Adson’s test
Looking for thoracic outlet syndrome
Where will the T5 spinous process be located?
Halfway between the transverse process above in the transverse process below
Which spinal segment is most related to somatic or sympathetic dysfunction as seen with pneumonia, COPD or asthma?
Thoracic spine, and therefore ribs
What is the mechanism by which asthma or COPD cause a flattening of the diaphragm?
Air trapping
Stimulation of the sympathetic nervous system serving the lungs will cause?
Increased vasoconstriction within the lungs
Which of the following muscles is a muscle of inhalation?
External intercostals
In a patient with migraine, which of the following dysfunctions would be critical to address?
Temporal bone dysfunction
A 14-year-old female presents to the clinic with decreased stature, bowed legs, and a lack of sexual development. Which cranial area is likely to be affected?
Sella turcica
The zygomatic bone presented in external rotation is an expected, finding in normal CRI if the sphenoid is in what position?
Flexion
Which of the following is most likely to play a role in the maintenance of a headache?
Facial nerve
During the pregnancy, the center of gravity is maintained against the growing abdomen by?
Increased lumbar lordosis
During pregnancy, it is important to remember that prolonged supination of the pregnant patient’s body can increase the risk of?
Compression of the vena cava
In pregnancy joint laxity begins during the first trimester due to?
Relaxin
What test do you use to evaluate for hypertonicity of the psoas muscle?
Thomas test
The hormone relaxin is at it’s highest levels during what trimester?
First trimester
If the hormone relaxin is present in excess levels, how can this impact the prolongation of gestation?
Increased risk of preterm labor
Which hormone helps to increase the glomerular filtration rate during pregnancy?
Relaxin
Tell me an epidural increase the risk of pubic dysfunction in the postpartum period?
- An epidural will decrease the patient’s ability to sense pressure and pain equally across both legs
- This presents the opportunity for a symmetry to occur along the pelvis, due to the flexion required in the McRoberts position
- The flexion can be maintained an unequally as two individuals are required to hold her legs
What structures the secrete relaxin?
- Corpus luteum
- Decudua basalis
What structures, secrete progesterone?
Corpus luteum
{{BLANK}} dysfunctions of the lumbar spine are expected to be seen in a pregnant patient
Extended
A {{BLANK}} rotation of the pelvis is expected to be seen in pregnancy.
Anterior
Due to the increased load, a pregnant patient will carry what is expected to be seen with their sacrum?
Anterior rotation
What type of dysfunction do you expect to see along the cervical spine in a pregnant patient?
Increased kyphosis
What nodes are the primary lymphatic drainage points for the breast?
Axillary nodes
What are some common contraindications to OMT for a pregnant patient?
- Unexplained vaginal bleeding
- Threatened abortion
- Ectopic pregnancy
- Placenta previa or abrupta
- Preterm labor
- Prolapsed cord
- Eclampsia or severe preeclampsia
What are the primary muscles of respiration?
- Intercostal muscles
- Diaphragm
What are the secondary muscles of respiration?
- Scalenes
- Pectoralis minor
- Quadratus lumborum (attached via caliper ribs)
- Psoas (attached via MAL)
What symptom will patients suffer from with an exhaled rib?
Coughing
Inhaled ribs are common of obstructive pathologies regarding the pulmonary system. Name two pathologies in which you will see this occur.
- COPD
- Asthma
How can the depth of breathing affect the respiratory circulatory model of OMM?
- Decrease depth of breathing will lead to any Factive movement of fluids in the low pressure, circulatory system
- This results in venous and lymphatic stasis
Which thoracic inlet diagnoses can be treated with one step at HVLA?
the ones in which side bending occurs in a different direction than rotation
What is a contraindication for the side lying rib raising technique
They shoulder pathology, creating pain or discomfort for the patient
When you are evaluating a patient in the ER complaining of chest pain, you place one palm on the patient sternum and the other palm along the vertebral bodies of T3 to T7. When you can press slightly, the patient says that their pain level drops from 8/10 to 4/10. This helps to rule out which of the following differential diagnoses?
Myocardial infarction
Which muscle is responsible for the depression or opening of the mandible?
Lateral pterygoid
What is the most common position of displacement seen in TMJD?
anterior
Regarding TMJD what type of risk factors do you see?
Lifestyle, e.g., smoking jaw, injury, rheumatoid arthritis, orthodonture, stress, and neck pain
A patient comes in complaining of intermittent, sharp electric pains in the forehead and around their eyes. Sometimes this causes tearing in rhinorrhea. What is most likely cause of the symptoms and what nerve is likely the eliciting this response?
- Trigeminal neuralgia
- Ophthalmic branch (V1)
The ophthalmic branch of trigeminal enters its position out of the cranium via what hole?
Superior orbital fissure
Union of sphenoid & frontal bones
The maxillary branch of trigeminal reaches its position out of what structure of the cranium?
Foramen rotundum
Base of greater wing of sphenoid
The mandibular branch of trigeminal reaches its position via what structure of the cranium?
Foramen ovale
Greater wing of sphenoid
The facial nerve reaches its position via what hole of the cranium?
Stylomastoid foramen
Temporal bone between the mastoid and styloid processes
The glossopharyngeal nerve reaches its position via what foramen?
Jugular foramen
Temporal and occiput
The glossopharyngeal nerve which exit out of the jugular foramen, can become dysfunctional, resulting in impaired sensation along the tongue. What type of technique treating what structure can relieve this dysfunction?
The V spread technique treating the occipitomastoid suture
The hypoglossal nerve exits out of what hole of the cranium?
Foramen magnum
Occiput
The hypoglossal nerve which exit out of the skull via the foramen magnum, can become dysfunctional, which would impair the motor function of the tongue. What type of technique do you propose to treat this dysfunction?
Condylar decompression
The trapezius muscle will have what effect on the occiput?
Pull inferolaterally
The trapezius will have what effect on normal extension or flexion of the SBS?
- restricts normal extension
- stuck in flexion
The sternocleidomastoid will have what effect on the temporal bone?
Restricts motion
The sternocleidomastoid will have what effect on the SBS regarding extension and flexion?
- Restricts extension
- Favors flexion
The suboccipital triangle will have affect on the SBS regarding extension and flexion?
- Restricts extension.
- Favors flexion
The anterior cervical musculature, e.g., the longus capitis, and longus Colli will have what effect on the SBS regarding flexion and extension?
- Restricts flexion.
- Favors extension
You’re observing a preceptor form a cranial technique. They say they chose this technique because the CRI was sluggish and felt some areas of congestion in the cranium. They placed a thumb in an X pattern and gently rest the cranium on these two fingers. You know that this is above the area you would find the lambda.
What is the likely suture being influenced?
What is the name of this technique?
- Sagittal sinus.
- Dural venous sinus drainage
What is the indication for the CV4 technique?
Diminished CRI
What is the indication for the dural venous sinus drainage technique?
- Sluggish fill of the CRI and cranium.
- General patient malaise
What is the indication for the parietal lift technique?
- Sinus congestion.
- Restriction of the squamous suture
What is the indication for the V spread technique?
Specific suture restriction
What is the orientation of the superior facets of the T-spine?
Backward, upward, lateral (BUL)
What is the main motion of the T-spine?
Rotation
Scoliotic curvature of the T-spine is named for what?
The convexity
E.g., if the convexity is on the right = dextroscoliosis
The thoracic inlet is made up of what structures?
- T1
- 1st rib.
- Manubrium
What test is used to determine if a patient has scoliosis?
The Adams test
What is the “Rule of 3s”?
- T1-3: TP @ same level of SP
- T4-6: TP 1/2 segment above SP
- T7-9: TP 1 segment above SP
- T10: TP 1 segment above SP
- T11: TP 1/2 segment above SP
- T12: TP @ same level of SP
Regarding vertebral attachment to ribs, a vertebra is attached to the same # rib and to the one directly {{BLANK}}
To the same # rib, and to the one below
SANS for the Head and Neck originates from?
T1-4
PANS for the Head and Neck originates from?
CN III, VII, IX, X
SANS for the Heart originates from?
T1-5
PANS for the heart originates from?
Vagus N
SANS for the lungs originates from?
T1-6
PANS for the lungs originates from?
Vagus N
SANS for the kidneys originates from?
T10-11
K 2U TOUF
SANS for the upper 2/3 of ureters originates from?
T10-11
K 2U TOUF
SANS for the testes and ovaries originates from?
T10-11
K 2U TOUF
SANS for the upper fallopian tubes originates from?
T10-11
K 2U TOUF
PANS for the kidneys, upper 2/3 of ureters, testes/ovaries, upper fallopian tubes originates from?
Vagus nerve
K 2U TOUF
SANS innervation for the lower 1/3 ureters originates from?
T12-L2
L1U B LF UPET
PANS innervation for the lower 1/3 ureters, bladder, lower fallopian tubes, uterus/prostate, and erectile tissue originates from?
S2-4
L1U B LF UPET
SANS innervation for the bladder originates from?
T12-L2
L1U B LF UPET
SANS innervation for the lower fallopian tubes originates from?
T12-L2
L1U B LF UPET
SANS innervation of the uterus/prostate originates from?
T12-L2
L1U B LF UPET
SANS innervation of the erectile tissue originates from?
T12-L2
L1U B LF UPET
Where is the anterior Chapman point for the prostate and broad ligament?
Lateral iliotibial bands
Where is the posterior Chapman point for the prostate and the broad ligament?
PSIS
Where is the anterior Chapman point for the uterus?
Inferior pubic rami
Where is the posterior Chapman point for the uterus?
L5 TPs
Where is the anterior Chapman point for the urethra and ovaries?
Pubic tubercles
Where is the posterior Chapman point for the urethra?
L3 TPs
Where is the posterior Chapman point for the ovaries?
T10 TPs
Where is the anterior Chapman point for the bladder?
Periumbilical
Where is the posterior Chapman point for the bladder?
L2 TPs
Where is the anterior Chapman point for the kidneys?
1 inch lateral, and 1 inch superior to the umbilicus
Where is the posterior Chapman point for the kidneys?
L1 TPs
Where is the anterior Chapman point for the lower lungs?
Medial 4th ICS
Where is the posterior Chapman point for the lower lungs?
T4 TPs
Where is the anterior Chapman point for the upper lungs?
Medial 3rd ICS
Where is the posterior Chapman point for the upper lungs?
T3 TPs
Where is the anterior Chapman point for the bronchus, esophagus, thyroid, and heart?
Medial 2nd ICS
Where is the posterior Chapman point for the bronchus, esophagus, thyroid, and heart?
T2 TPs
Where is the anterior Chapman point for the tongue?
Medial 2nd ribs
Where is the posterior Chapman point for the tongue?
C2 APs
Where is the anterior Chapman point for the tonsils?
middle lateral edge of manubrium
Where is the posterior Chapman point for the tonsils?
C2 APs
Where is the anterior Chapman point for the pharynx?
Superior lateral edge of manubrium
Where is the posterior Chapman point for the pharynx?
C2 APs
Where is the anterior Chapman point for the sinuses?
Medial inferior clavicles
Where is the posterior Chapman point for the sinuses?
C2 APs
Where is the anterior Chapman point for the middle ear?
Medial superior clavicle
Where is the posterior Chapman point for the middle ear?
C1 TPs
Where is the anterior Chapman point for the cerebellum?
Tip of coracoid process
Where is the posterior Chapman point for the cerebellum?
Superior to C1 TPs
Where is the anterior Chapman point for the neck?
Medial superior humerus
Where is the posterior Chapman point for the neck?
C3-7 TPs
Where is the anterior Chapman point for the retina or conjunctiva?
Lateral superior humerus
Where is the posterior Chapman point for the retina or conjunctiva?
Suboccipital nerve; level of mastoid process
What tenderpoint is found at the sternal notch? How is it treated?
AT1; flexion
What tender point is found at the middle of the manubrium? How is it treated?
AT2; flexion
What tender points or located midline to the corresponding ribs 3-6? How are they treated?
AT3-6; flexion
What tender point is either located at the tip of the xiphoid or a quarter from the xiphoid to the umbilicus displaced 1 to 2 cm laterally? How is this tender point treated?
AT7; F StRa
Seated; knee under good side
What tender point is located halfway from the xiphoid to the umbilicus displaced 2 to 3 cm laterally? How is this tender point treated?
AT8; F StRa
Seated; knee under good side
What tender point is located 3/4 of the way from the xiphoid to the umbilicus displace 2 to 3 cm laterally? How is this tender point treated?
AT9; F StRa
seated; knee under good side
What tenderpoint is found a quarter from the umbilicus to the pubic symphysis displaced 2 to 3 cm laterally? How is this tender point treated?
AT10; F StRa
Supine; good over evil
What tenderpoint is found halfway from the umbilicus to the pubic symphysis displaced 2 to 3 cm laterally? How is this tenderpoint treated?
AT11; F StRa
Supine; good over evil
What tender point is located along the superior aspect of the iliac crest? How is the tender point treated?
AT12; F StRa
Supine; good over evil
What tender point is found along the T1 and T2 spinous processes? How are they treated?
- PT1-2
- Midline: Extension
- Inferolaterally: E SaRa
Supine
What tender points are found along the thoracic spine vertebrae (spinous processes) levels 3-10? How are they treated?
- PT3-10
- Inferolaterally or Midline: E SaRa
Prone; lift good shoulder for S & R
What tender points are found along the thoracic spine vertebrae levels 1&2 transverse processes? How are these tender points treated?
- PT1-2 TP
- E SaRt
Supine
What tender points are found along the thoracic spine levels 3-10 transverse processes? How are these treated?
- PT3-10 TPs
- E SaRt
Prone; Put bad arm up to S away
What tender points are found along the thoracic spine levels 11-12 transverse processes? How are these treated?
- PT11-12 TPs
- E SaRt
In lower crossed syndrome, the pelvis tilt anteriorly, and there’s increased lumbar lordosis. What muscles do you expect to be tightened or hypertonic in this syndrome?
- Iliopsoas.
- Rectus femoris
- thoracolumbar extensors
In lower crossed syndrome, there is anterior pelvic tilt with increased lumbar lordosis. What muscles do you suspect to be weak in the syndrome?
- Abdominals
- Gluteals (min, max, med)
Which suboccipital triangle muscle has a dural attachment and when spasm occurs the underlying “core link” is impeded?
Rectus capitus posterior minor
A shifting of the {{BLANK}} suture can mimic ear pain & tinnitus seen in TMJD.
Sphenosquamosal (sphenoid & temporal) suture
The {{BLANK}} ligament connects from the malleus to the articular disc and sphenomandibular ligament resulting in ear pain associated with TMJD.
Discomallear ligament
Canal = Huguier’s canal; petrotympanic fissure
Ribs will articulate with what part of the thoracic spine?
- Vertebral body (above)
- Vertebral body + TP (same #)
Ribs 11-12 do not articulate with which part of the thoracic spine?
TPs
Rib 1 articulates with only?
T1
What are the key points considering acute somatic dysfunction versus chronic somatic dysfunction?
- Acute: Red, Wet, Boggy/Spongy, Tight, sharp, stabbing, throbbing
- Chronic: Cool, thin & dry, stringy/fibrotic, achy, dull, burning
What changes do you expect to see of the pelvic diaphragm considering pregnancy
- The pelvic diaphragm can be overstretched and weekend.
- Can spasm secondary to pelvic somatic dysfunction.
- Strain and/or spasm this muscle can make delivery difficult and result in tearing of the perennial area
Which ligaments do you test by having the pregnant patient lay supine while flexing their hip and applying axial compression to relieve strain on the joint?
- Sacrospinous
- Sacrotuberous
As weight increases 20%, strain increase 100% on the SI joint
The Pelvic Diaphragm made up of the {{BLANK}} muscle and the {{BLANK}} muscle is a common site of lymphatic and venous obstruction. It can become overstretched or weakened during pregnancy.
- Coccygeus
- Levator Ani
The {{BLANK}} is a common site of lymphatic and venous obstruction seen in pregnancy. It can suffer from reduced fluid movement but can be treated with doming.
Respiratory diaphragm
The {{BLANK}} nerve is also responsible for dural sensory innervation.
Trigeminal nerve
A patient has bilateral parasternal chest wall pain that is exacerbated by deep breaths, coughing, and stretching. What do you suspect because if palpation of the costochondral junction produces pain?
Costochondritis
What nerve innervates the temporomandibular joint?
CN V3 (mandibular)
When performing two-step HVLA for thoracic inlet dysfunction in what direction do you apply your force when treating side bending? What about rotation?
- Sidebending: Angle of Louis or ASIS
- Rotation: Axilla
If one-step: between Angle of Louis & Axilla
