COPD Flashcards
What are 3 things we do Pre-OMT for possible COPD patients?
Look, Listen, Palpate
What are 3 things we “Look” for Pre-OMT COPD patients?
Barrel Chest, Type/Depth of Breathing/Paradoxical, Posture
What are 3 things we “Listen” for Pre-OMT COPD patients?
Pertinent History (Sx/Indication-Contraindication/Risks), All lung fields (wheeze, rale egophony, etc), Heart
What are 3 things we “Palpate” for Pre-OMT COPD patients?
Chest wall resistance/compliance, Tactile fremitus or not, Somatic dysfunction (TART) incl STERNUM
What can prolonged use of steriods make patients prone to?
Osteoporosis
What would osteoporosis contraindicate?
HVLA
Where do we have TTC for the posterior sites of the lungs for their viscerosomatic reflexes?
T1-6 (esp T2-4)
Where do we have TTC for Anterior Chapman Points of the lungs for their viscerosomatic reflexes?
ICS 2-4
What is the 24-hour rule?
If we treat someone getting a cold within 24 hours with OMT it will go away
What is the 3:3:3 approach?
3 goals, 3 techniques, in 3 minutes or less
What are the 3 goals in the 3:3:3 approach for a Pulmonary Issue?
Improvement in sympathetic, parasympathetic, and lymphatics
What are the 3 areas for the parasympathetic goal?
Suboccipital inhibition, OM / OA / C2 (vagus), OCMM-Temporal (vagus)
What are the 6 areas for the sympathetic goal?
T1-6, Rib 1, Chapman’s reflexes, (ICS 2-4; T2-4), Rib raising (also in lymph), Rib 1-6, Generalized soft tissue
Lymph is anything else
85% of dyspnea is due to what 4 things?
Asthma, Pneumonia, Interstitial lung disease, COPD
PACI
Name the 7 P’s
Pneumonia, Pulmonary Bronchial Constriction, Pump Failure, PE, Pneumothorax, Possible Foreign Body, Psyochogenic
Decreasing workload is a part of what model?
Metabolic-Hormonal Model
When do we give the influenza immunization?
When there is no other infection
How does chest percussion sound on a Pink Puffer?
Hyperresonance
Name 2 distinguishing factors for a blue bloater
Increased Hgb, Increased JVD
What rib do COPD patients have problems with/adjust to help with their breathing?
Rib 1 (mainly exhalation)
Scalene fascia is continuous with what fascia?
Sibson Fascia
What are the 3 most severe manifestations a COPD patient will have?
SCM Hypertrophy, Rib Cage Compliance Reduced, Sternum Restricted
What is Sampter’s Triad for COPD patients?
Nasal Polyps, Asthma, and Aspirin Allergy findings
What are 2 common findings in COPD patients upon observation and on a CXR?
Accessory muscle hypertrophy and extended thoracic cavity with flat diaphragm
What can coughing cause?
Exhalation rib dysfunction
What OMT do we do for Upper Thoracic SD?
Seated T1-T4 and Thoracic inlet BLT
What bones make up the thoracic inlet?
T1-4; R1-2; manubrium
What are the 2 Clinical Goals for the Upper Thoracic treatment?
Normalize SYMPATHETICS to EENT & Lungs, Open FASCIAL PATHWAYS for drainage
What was Sutherland’s quote?
“Ligamentous Articular Strains are treated by using Balanced Ligamentous Tension.”
What model do we use to Implement Respiratory-Circulatory Homeostasis?
Postural-Biomechanical Model
Are mechanical principles primary or secondary to respiration?
Secondary
Are the lungs governed more by mechanics or chemistry?
Mechanics
What is the driving force for the Respiratory-Circulatory Model?
Chest cage mechanics
Give the primary and secondary muscles of inspiration
Primary - external intercostals, diaphragm, and interchondral part of intercostals
Secondary - SCM, scalenes
Name the muscles we use for conscious, forced exhalation
Transversus abdomninis, external oblique, abdominal muscles, rectus abdominis, internal oblique
TEARI
Most signs of respiratory failure are actually signs of what?
Respiratory muscle fatigue
Muscular fatigue is the immediate factor leading to the demise of patients with what?
Acute asthma
Respiratory muscle fatigue has been implicated in what?
Pulmonary edema, lung shock & difficulty weaning patients off ventilators
Manubrium direction named for what?
Superior – anterior part of the structure is preferring
What ribs do the latissimus dorsi attach to?
Ribs 9-11
What ribs do the quadratus lumborum attach to?
Ribs (11) 12
What technique do we use for Ribs & Accessory Ms’s of Respiration?
Counterstrain
Are anterior ribs depressed or elevated?
Depressed (posterior are elevated)
What are the 3 clinical goals for seated counterstrain?
Affect CERVICOTHORACIC DIAPHRAGM; ⇓WORK of RESPIRATION
Improve ability to BREATHE (Decrease DYSPNEA)
Diminish COUGH and COUGH SEQUELAE
What technique do we use to treat the Head-Neck?
FPR/Still
Can we lie orthopnic patients down for short periods of time?
Yes
What are the 3 clinical goals for FPR/Still?
Improve PARASYMPATHETICS
Enhance depth & rate of RESPIRATION (⇓DYSPNEA & work)
Enhance THORACOABDOMINAL DIAPHRAGM function
Innervation of OA, AA and C2
Vagus
What do problems or treatment at C5-C7 affect?
Scalenes
What do we treat the diaphragm with?
Seated Direct MFR/MET
What are the 2 clinical goals for seated direct MFR/MET?
Counter FLATTENED DIAPHRAGM to reduce Paradoxical Respirations
Enhance THORACOABDOMINAL DIAPHRAGM function
What treatment do we use to establish homeostasis?
Seated Soft Tissue (Shoulder Girdle & Quadratus Lumborum Ms’s)/ Articulatory (Seated Rib Raising)
What are the 4 clinical goals of establishing homeostasis with soft tissue and articulatory?
Affect SYMPATHETICs (Sympathetic Chain Ganglia)
Affect THORACOABDOMINAL DIAPHRAGM (Resp-Circ Step 2)
Enhance LYMPHATIC PUMP & MOBILIZE LOCAL FLUID from Mediastinum (Resp-Circ Steps 3-4)
⇓WORK of RESPIRATION
