COMBANK OMM COMAT Flashcards
relation between L5 and sacrum
L5 and the sacrum always rotate in opposite directions.
— Sidebending of L5 engages the ipsilateral sacral oblique axis.
Forward sacral torsions are associated with type I (neutral) mechanics at L5 whereas backward sacral torsions are associated with type II (non-neutral) mechanics at L5
anterior Chapman point for the sinuses
between the clavicle and first rib (superior aspect 2nd rib at midclavicular line)
posterior Chapman point for the sinuses
at the C2 articular pillar.
anterior CP for prostate
posterior/lateral margin of IT band
sulcus sign
- shows: glenohumeral joint ligamentous laxity
- pull humerus inferiorly.
HVLA of ankle
restrictive barrier engaged by dorsiflexing and applying traction to ankle until firm bony restrictive barrier is met (while pt is supine)
- traction maintained & force directed in an arcing motion posteriorly and towards the floor
pelvic floor and bladder connection
pelvic floor mm improves urethral sphincter’s ability to delay urination via reflex bladder inhibition
achilles reflex n root
S1
patellar reflex n root
L4
herniated disc effect on reflexes of n.
decreased/absent
pancreas VS reflex
T5-T9 bilaterally or R side
stomach VS reflex
T5-T10 on L
esophagus VS reflex
T3-T6
upper lungs CP
3rd intercostal spaces
post CP for gallbladder
R T6 transverse process
sacrum movement during inspiration and exhalation
inspiration - sacrum extends
exhalation - sacrum flexes
muscles involved in opening the jaw
lateral pterygoid m.
SD of lateral pterygoid presentation
chin deviates to contralateral side when opening the jaw
muscles involved in closing the jaw
masseter
medial pterygoid
temporalis
what does OMM to pterygopalatine fossa do
stimulation produces a parasympathetic reflex response
- helps with sinus congestion and pain (thins secretions)
AL5 TP s/cs treatment position
FSBaROTa
knees brought toward side of TP in order to rotate L5 segment away
tx for patellofemoral syndrome
strengthen VMO (vastus medialis oblique)
muscles used for costal muscle energy to treat rib exhalation SD (restricted on inhalation)
I got up at 1 Am 2 Pee because from 3-5 PM I drank 6-9 Sam Adams and from 10-11 I Laid Down Quietly until 12
1 anterior scalenes 2 posterior scalenes 3-5 pec minor 2-8 serratus anterior (but mainly ribs 6-8) 9-12 lat dorsi 12 QL
law of laplace
fluid mechanics
least splanchnic n carries
symp inn to hindgut (T12)
greater splanchnic n carries
symp inn to foregut (T5-T9)
lesser splanchnic n carries
symp inn to midgut (T10-T11)
percutaneous reflex of Morley means …
pain and/or guarding of abd upon palp in presence of visceral path
Wolff’s law
bone structure will remodel to help support patterns of stress
Sherrington’s law
neurophysiology
common SD after birth (for mom)
bilateral sacral flexion
how does inguinal lig affect pelvic SD
inguinal lig attaches to pubis and ipsilateral ASIS
- Tension causes pubis to be superior
loss of foot dorsiflexion and eversion caused by
common peroneal (fibular) nerve (lose both superficial and deep branches)
tibial n innervates
posterior thigh mm
plantar flexors
foot evertors
superficial peroneal n inn
foot eversion
sensation to lateral leg and dorsal foot
deep peroneal n inn
foot dorsiflexion
S1 compression causes
posterior leg pain/decreased sensation
gastroc weakness
diminished/absent achilles reflex
How to use FPR
Put area in neutral position, then aply a compressive or torsional force while placing the SD into its freedom for 3-5s
Setup for typical cervical HVLA with sidebending focus
only placed into restrictive barrier of sidebending (not rotation)
flexion/extension restrictive barrier is always engaged
- rotation for rotation focus
cardiac CP location
L 2nd intercostal space near the sternum
ME positioning for forward sacral torsion (R)
pt prone with arms off table
lateral recumbant
side of axis dysfunction down
OMT for dysmenorrhea
sacral inhibition
first line pharmacotherapy for dysmenorrhea
NSAIDs
indirect treatment of backward sacral torsion
anterior force to anterior ILA (opp ILA from the posterior/inferior one used in dx)
indirect treatment of forward sacral torsion
anterior force to deep side base
most common type of scoliosis
thoracic curvature convex on the R
where are the anterior thoracic tenderpoints located
- upper 6 are on sternum
- – AT2 = angle of Louis
- – AT5 = 1in superior to AT6
- – AT6 = xiphosternal junction
- lower are bilaterally on abdomen (except AT12)
- – AT7 = tip of xiphoid
Thomas test
screen for iliopsoas tightening
lumbar/sacral SD’s associated with psoas hypertonicity
- flexed dysfunctions of upper lumbars
- extended dysfunction of L5
- variable sacral and innominate dysfunctions
cranial SD often found with infant difficulty feeding
occipital condylar dysfunction
parallellogram pattern of SBS is associated with …
lateral strain
L4 innervation testing
patellar reflex
sensation at medial leg/foot
foot-ankle inversion/dorsiflexion
L5 innervation testing
- toe dorsiflexion (including great toe)
- LE abduction at hip (glut med)
- sensation to proximal lateral leg and middle dorsum of the foot
S1 innervation testing
- achilles reflex
- ankle eversion & plantarflexion
- hip extension (glut max)
- sensation to distal lateral leg and foot, including lateral portion of digit 5
cranial bones flex.
this is called nutation or counter-nutation?
what happens to sacrum?
counter-nutation
sacrum moves posterior and superior
cranial bones extend.
nutation or counter-nutation?
what happens to sacrum?
nutation
sacrum moves anterior and inferior
SD associated with Horner’s syndrome
elevated 1st rib
anterior lumbar TPs
L1 = medial ASIS pressing laterally L2 = medial AIIS pressing laterally L3 = lateral AIIS pressing medially L4 = inferior AIIS pressing cephalad L5 = superior pubic ramus 1cm lat to pubic symph
treatment positions for ant lumb TPs
L1 = stand on same side as TP, flex, SB towards TP L2-3 = stand opposite, flex, SB away from TP L4 = stand same, flex, SB towards TP L5 = stand same, flex, SB and ROT towards TP
pedal pump contraindications
DVT, fx to lower extremity, recent abd surg
order of spencer technique
Every Foolish Child Tries Aspirating In Pools Extension Flexion Circumduction with compression Circumduction with traction abduction internal rotation pump
external rotation of temporal bone causes
low-pitched roaring tinnitus
& ipsilateral mandible deviation
internal rotation of temporal bone causes
high-pitched humming/buzzing tinnitus
& contralateral mandible deviation
change to ipsilateral medial malleolus in unilateral sacral flexion
inferior (due to relative leg lengthening)
parasympathetic stimulation effect on phlegm
decreases number of goblet cells
thins secretions
(symp does opposite)
most common thing resulting in severe complication of cervical HVLA
vertebral artery problems (Ex/ pre-existing unilateral atresia)
compensatory changes in short leg syndrome
- sacral base lower on the short side
- innominate rotated anteriorly on short side
- L spine SB away and ROT toward short side
- iliolumbar and SI joints stressed on ipsilateral side
when and how to do heel lift for short leg
do for femoral head diff >5mm
work up to same as discrepancy if recent inj
max 10-12mm lift
lateral winging of scapula caused by
trap paralysis
instead of medial winging by SA
medial pterygoid TP
post surface of ascending ramus of mandible about 2cm above angle of mandible on the side opposite of jaw dysfunction
C1 TP
posterior surface of angle of the mandible at the level of the earlobe
what happens to cuboid in inversion or supination ankle sprain
typically internally rotated (dropped)
– downward rotation of cuboid on the calcaneus
tx for dropped cuboid
Hiss plantar whip (direct force to cuboid dorsally)
- other options: muscle energy, BLT
Locke’s technique
- treats 1st metatarsal dorsal glide.
- force applied to joint of 1st MT and 1st cuneiform
treatments for talocalcaneal joint
- talar tug
- talo-calcaneal crunch
tx position for inion TP
flexion
Morton foot
- shortening of the first metatarsal in relation to the second metatarsal
- pain in ball and arch of foot associated with excessive pronation of the foot with internal hip rotation and functional shortening of the leg
bunionette deformity
abnormal bony protuberance on the lateral side of the 5th MTP joint with an overlying hard corn
restricted forearm supination = _____ radial head
posterior
restricted pronation = anterior
landmark used to calculate heel lift height
sacral base unleveling
Scheuermann kyphosis
- rigid curvature not corrected by changes in position
- on XR, see anterior wedging of at least 3 adjacent vertebral bodies and endplate abnormalities
- also see Schmorl’s nodes
Schmorl’s nodes
- small protrusion of intervertebral discs into adjacent vertebral bodies
- seen in Scheuermann kyphosis
In seated or standing, SD is on the side of
superior PSIS
