Definitions Flashcards
TART
Tissue Texture Changes
Asymmetry
Restricted Motion
Tenderness
Observation-Normal and Abnormal
Ears (External Auditory Canal)–>Shoulders (Acromion Process)–>Greater Trochanter–>Feet (Anterior Medial Malleolus)
Somatic Dysfunction
Impaired or altered function of relevant components of the Somatic System. Includes Skeletal, Arthroidal, and Myofascial structures and the relevant vascular , Lymphatic, and neural elements.
Define Dorsum, and the advantage of Dorsum palpation
Dorsum: back of hand Advantage: temperature sensitivity
Components of a SOAP note
Subjective: report of a patient’s present chief complaint
Objective: Clinical findings of a patient’s present chief complaint upon examination
Assessment: Brief Description of a patient’s symptoms as well as a differential diagnosis
Plan: A course of action determined by the physician
Active Range of Motion (AROM)
The extent of motion that a patient can move through unassisted. Patient must give maximum effort!
Passive Range of Motion (PROM)
The extent of motion that a patient can move through with the physicians assistance. Patient must be fully relaxed and physician must block linkages, (stablilzation of associated and adjacent structures to limit motion to only the joint(s) being assessed).
AT Still’s Birthday
Born August 6, 1828 in Lee County, Virginia
How he learned anatomy
1855 began studying anatomy on Native American cadavers after obtaining tribal permission
What major battle of the Civil War did AT Still fight in?
The Battle of Westport (1864)
When AT Still “Flung the banner of Osteopathy to the breeze”
10 AM on June 22, 1874
1st Osteopathic Prinicple
The body is a unit; the person is a unit
of body, mind, and spirit.
2nd Osteopathic Principle
The body is capable of self regulation,
self healing, and health maintenance.
3rd Osteopathic Principle
Structure and function are
reciprocally interrelated.
4th Osteopathic Principle
Rational treatment is based on an understanding of the basic principles of body unity, self regulation, and the interrelationship of structure and function.
AT Still’s Father
A physician and minister
Allopathic vs. Osteopathic
Osteopathic Medicine treats the host
Allopathic Medicine treats the disease
First and Final States to grant licensure to DO’s
First: Vermont 1896
Last: Mississippi 1973
California Incident
In 1961, California referendum prohibited the granting new licenses to DOs. DOs could take a course over
12 Saturdays to earn an MD and this cost $65. 85% of DOs in the state chose to do this. College of Osteopathic Physicians and Surgeons was converted into an Allopathic Institution, and Proposition 22 passed which abolished the Osteopathic licensing board. This was resolved in 1974 when the California Supreme Court overturned these decisions. This series of events served as a catalyst for attaining full rights in all 50 states
Dr. Abraham Flexner
Inspected all medical schools (MD and DO alike). Very critical of both types of schools. Suggested clinical rotations.
Many schools were closed, and state licensing boards implemented strict regulations
Founding of the American Osteopathic Association (AOA)
began in 1901
1916
AOA revoked ban on teaching pharmacology at DO schools
Kansas City College of Osteopathy and Surgery established by A.A. Kaiser DO, and George Conley DO
1917-1918
Spanish Influenza casualties exceeded 100 million
Osteopathic Death rate - 0.25%
1922
AMA declares it unethical for MDs to
associate with DOs, labeled them “cult”
1929
AOA allows teaching of
pharmacology under “Comparative
Therapeutics”
DO’s in the Military: 1917
attempt to get federal recognition and rights to serve in the military. Was supported by President Roosevelt, but MD’s threatened to withdraw if DO’s were accepted.
DO’s in the Military: 1941
DO’s still not allowed to serve despite the shortage of MD’s during WW2. DO’s had to create their own hospitals because they weren’t given practicing privileges at other hospitals.
DO’s in the Military: 1957
Congress legalizes DOs to serve in civil service and armed forces (40 years after the initial effort began)
DO’s in the Military: 1963
DO’s officially recognized as equal to MDs
DO’s in the Military: 1966
Secretary of Defense instructs Army, Navy, and Air Force to accept DOs that volunteer as officers.
Harry J. Walter was first commissioned DO into the armed forces.
DO’s in the Military: 1996-2000
Past Surgeon General of the Army: Lieutenant General Ronald R. Blank DO
Women in Osteopathy: 1892
1892: AT Still supported equality for Women in Medicine. One of the first 5 DO’s was his daughter Blanche.
Jeanette Bolles DO was the first to receive DO degree
Women in Osteopathy: Louisa Burns
- 1870-1958–> a teacher from Indiana
- Had spinal meningitis, which she successfully treated with Osteopathy
- Using histology, she postulated the connective tissue model of somatic dysfunction
- The Louisa Burns award for research still exists
Women in Osteopathy: Mamie Johnston
- 1889-1986
- First female graduate from KCU in 1917
- joined the KCU faculty in 1919
- taught gynecology and pediatrics. Retired at 92
- KC campus has a science hall named after her
Women in Osteopathy: Barbara Ross-Lee
-First Female Dean of a medical college (MD OR DO) At Ohio University
-First osteopathic physician to win Robert Wood
Johnson Health Policy Fellowship
Women in Osteopathy: Progression
- 1940’s 5% of applicants to osteopathic colleges
- As of 2007 more women than men graduate from osteopathic medical school (51%-49%)
- 56% of DO’s in active practice in the past ten years are women
Minorities in Osteopathy: general statistics
-1998 25% of total enrollment in osteopathic medical schools were minorities -2009-2010 40% of osteopathic medical student enrollees minority
Minorities in Osteopathy: Marcelino Oliva 1935-2011
- Cuban born
- KCU grad
- First minority AOA president in 1988-1989
Minorities in Osteopathy: William G. Anderson (1927-present)
- Big in the Civil Rights Movement
- AOA president 1994-1995
- AOA board of trustees for 20 years
- Tenderness
- Tissue contraction
- Vasodilation
- Erythema
- Edema
- Pain (sharp, severe, cutting)
- Muscle spasm
- Increase in muscle tone (hypertonic)
Acute Somatic Dysfunction
Tenderness Tissue contraction Vasoconstriction Itching Fibrosis Pain (dull, ache) Paresthesias (tingling, burning, gnawing) Contracture Decrease in muscle tone (hypotonic)
Chronic Somatic Dysfunction
Mesodermal body type
- Muscular or sturdy-average build
- Features prominent anatomic structures that are derived from Mesoderm (i.e. muscle, average quantity of fat, etc.)
- Average ROM
Ectodermal body type
- Lean and thin body type. Also usually tall
- Features prominent anatomic structures that are derived from Ectoderm (i.e. Nervous tissue, skin, etc.)
- Higher than average ROM
Endodermal body type
- Obese body type.
- Lower than average ROM
- Features prominent anatomic structures that are derived from Endoderm (i.e. excessive fat, GI viscera)
Observation of color
- Pale
- Erythema: red–>edema (inflammation/swelling)
- Cyanosis: blue–>Reynaud’s Disease (arterial spasms reduce blood flow, lack of O2 to tissues)
- Jaundice: yellow–>insufficient heme metabolism, cirrhosis
- Black: necrosis–>tissue death
Skin Lesions
A: Asymmetry: A line down the middle would not create identical mirror images
B: Border: Is it well defined against skin?
C: Color: Inconsistent or uneven (i.e. color gradient from light brown to black)
D: Diameter: is it greater than 6 mm across in any direction?
E: Evolution: Does the shape, color, symmetry change over time?
Anterior View Observational Landmarks
- Eye Level
- Ear Level
- Acromion Processes
- Angle of Clavicles
- Length of upper limb to end of finger tips, compared to Iliac crests
- Angle of Rib cage
- Umbilicus
- Crest of Ilium (likely requires palpation)
- Level of Greater Trochanter (requires palaption)
- Compare symmetry of both upper and lower legs (bilaterally)
- Patellar Alignment
- Medial and Lateral Maleoli
Posterior View Observational Landmarks
- Carriage of the head
- Scapular Spine
- Angle of Scapula
- Medial border of Scapula
- Arm Carriage
- Spinous processes (deviations from midline)
- Iliac Crest height (requires palpation)
- PSIS height (requires palpation)
- Greater Trochanter (requires palpation)
- Upper and Lower Leg Symmetry
- Popliteal Line and Space
- Achilles Tendon
- Medial and Lateral Maleoli
Lateral View Observational Landmarks (Plumb Line)
Plumb Line: ears, Acromion process, Greater Trochanter, Medial and Lateral Maleoli
Lateral View Observational Landmarks (Spinal Curvatures)
Spinal Curvatures: Lordosis (concave Lumbar and Cervical Spine)
Kyphosis: convex Thoracic Spine
Illness
Host+Disease
While Osteopaths do work to eliminate disease, the primary focus is always the host. This is not necessarily the case for allopaths
Health is not in this paradigm
What can be treated by manipulation
- Somatic Dysfunction
- Chiropractic Subluxation–>results in tissue disruption
- Joint Lock, Blockage, and Mobility/Motility
- Minor Intervertebral Damage
Somatic Dysfunction
Impaired or altered function of the somatic (body framework) system: skeletal, arthrodial, and myofascial structures; and related vascular, lymphatic, and neural elements.
Application to a systemic disease: Fluid Congestion (venous and lymphatic)
- Delineate drainage pathway
- Identify potential obstacles in the drainage pathway
- Suggest Osteopathic techniques for maximizing pathological fluid drainage
Application to a systemic disease: Nervous System
- Delineate innervation to the affected area(s)
- Identify potential obstacles that can change function of innervation
- suggest Osteopathic Techniques for maximizing the restoration of nervous function
Application to a systemic disease: Biomechanical
- Delineate local and regional concerns
- Find interregional biomechanical concerns
- Suggest Osteopathic techniques for maximizing restoration of biomechanical function
Application to a systemic disease: Visceral
-Delineate the peritoneal/ pleural/fascial
elements for the viscus relevant to the
innervation/vascular/lymphatic influences
on the patient problem. Point out the pathway to relevant anatomy.
-Describe what can changes can occur/be made by the relevant anatomy along the pathway of the innervation, vasculature, lymphatic drainage.
-Suggest possible OMM interventions
Joint Mobilization Methods
Direct Indirect Combined Physiological Exaggeration
