Definitions

Question 1

TART

Answer 1

Tissue Texture Changes
Asymmetry
Restricted Motion
Tenderness

Question 2

Observation-Normal and Abnormal

Answer 2

Ears (External Auditory Canal)–>Shoulders (Acromion Process)–>Greater Trochanter–>Feet (Anterior Medial Malleolus)

Question 3

Somatic Dysfunction

Answer 3

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.

Question 4

Define Dorsum, and the advantage of Dorsum palpation

Answer 4

Dorsum: back of hand Advantage: temperature sensitivity

Question 5

Components of a SOAP note

Answer 5

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

Question 6

Active Range of Motion (AROM)

Answer 6

The extent of motion that a patient can move through unassisted. Patient must give maximum effort!

Question 7

Passive Range of Motion (PROM)

Answer 7

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).

Question 8

AT Still’s Birthday

Answer 8

Born August 6, 1828 in Lee County, Virginia

Question 9

How he learned anatomy

Answer 9

1855 began studying anatomy on Native American cadavers after obtaining tribal permission

Question 10

What major battle of the Civil War did AT Still fight in?

Answer 10

The Battle of Westport (1864)

Question 11

When AT Still “Flung the banner of Osteopathy to the breeze”

Answer 11

10 AM on June 22, 1874

Question 12

1st Osteopathic Prinicple

Answer 12

The body is a unit; the person is a unit

of body, mind, and spirit.

Question 13

2nd Osteopathic Principle

Answer 13

The body is capable of self regulation,

self healing, and health maintenance.

Question 14

3rd Osteopathic Principle

Answer 14

Structure and function are

reciprocally interrelated.

Question 15

4th Osteopathic Principle

Answer 15

Rational treatment is based on an
understanding of the basic principles of
body unity, self regulation, and the
interrelationship of structure and
function.

Question 16

AT Still’s Father

Answer 16

A physician and minister

Question 17

Allopathic vs. Osteopathic

Answer 17

Osteopathic Medicine treats the host

Allopathic Medicine treats the disease

Question 18

First and Final States to grant licensure to DO’s

Answer 18

First: Vermont 1896
Last: Mississippi 1973

Question 19

California Incident

Answer 19

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

Question 20

Dr. Abraham Flexner

Answer 20

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

Question 21

Founding of the American Osteopathic Association (AOA)

Answer 21

began in 1901

Question 22

1916

Answer 22

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

Question 23

1917-1918

Answer 23

Spanish Influenza casualties exceeded 100 million

Osteopathic Death rate - 0.25%

Question 24

1922

Answer 24

AMA declares it unethical for MDs to

associate with DOs, labeled them “cult”

Question 25

1929

Answer 25

AOA allows teaching of pharmacology under “Comparative Therapeutics”

Question 26

DO's in the Military: 1917

Answer 26

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.

Question 27

DO's in the Military: 1941

Answer 27

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.

Question 28

DO's in the Military: 1957

Answer 28

Congress legalizes DOs to serve in civil service and armed forces (40 years after the initial effort began)

Question 29

DO's in the Military: 1963

Answer 29

DO's officially recognized as equal to MDs

Question 30

DO's in the Military: 1966

Answer 30

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.

Question 31

DO's in the Military: 1996-2000

Answer 31

Past Surgeon General of the Army: Lieutenant General Ronald R. Blank DO

Question 32

Women in Osteopathy: 1892

Answer 32

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

Question 33

Women in Osteopathy: Louisa Burns

Answer 33

- 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

Question 34

Women in Osteopathy: Mamie Johnston

Answer 34

- 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

Question 35

Women in Osteopathy: Barbara Ross-Lee

Answer 35

-First Female Dean of a medical college (MD OR DO) At Ohio University -First osteopathic physician to win Robert Wood Johnson Health Policy Fellowship

Question 36

Women in Osteopathy: Progression

Answer 36

- 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

Question 37

Minorities in Osteopathy: general statistics

Answer 37

``` -1998 25% of total enrollment in osteopathic medical schools were minorities -2009-2010 40% of osteopathic medical student enrollees minority ```

Question 38

Minorities in Osteopathy: Marcelino Oliva 1935-2011

Answer 38

- Cuban born - KCU grad - First minority AOA president in 1988-1989

Question 39

Minorities in Osteopathy: William G. Anderson (1927-present)

Answer 39

- Big in the Civil Rights Movement - AOA president 1994-1995 - AOA board of trustees for 20 years

Question 40

- Tenderness - Tissue contraction - Vasodilation - Erythema - Edema - Pain (sharp, severe, cutting) - Muscle spasm - Increase in muscle tone (hypertonic)

Answer 40

Acute Somatic Dysfunction

Question 41

``` Tenderness Tissue contraction Vasoconstriction Itching Fibrosis Pain (dull, ache) Paresthesias (tingling, burning, gnawing) Contracture Decrease in muscle tone (hypotonic) ```

Answer 41

Chronic Somatic Dysfunction

Question 42

Mesodermal body type

Answer 42

- Muscular or sturdy-average build - Features prominent anatomic structures that are derived from Mesoderm (i.e. muscle, average quantity of fat, etc.) - Average ROM

Question 43

Ectodermal body type

Answer 43

- 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

Question 44

Endodermal body type

Answer 44

- Obese body type. - Lower than average ROM - Features prominent anatomic structures that are derived from Endoderm (i.e. excessive fat, GI viscera)

Question 45

Observation of color

Answer 45

- 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

Question 46

Skin Lesions

Answer 46

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?

Question 47

Anterior View Observational Landmarks

Answer 47

- 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

Question 48

Posterior View Observational Landmarks

Answer 48

- 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

Question 49

Lateral View Observational Landmarks (Plumb Line)

Answer 49

Plumb Line: ears, Acromion process, Greater Trochanter, Medial and Lateral Maleoli

Question 50

Lateral View Observational Landmarks (Spinal Curvatures)

Answer 50

Spinal Curvatures: Lordosis (concave Lumbar and Cervical Spine) Kyphosis: convex Thoracic Spine

Question 51

Illness

Answer 51

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

Question 52

What can be treated by manipulation

Answer 52

- Somatic Dysfunction - Chiropractic Subluxation-->results in tissue disruption - Joint Lock, Blockage, and Mobility/Motility - Minor Intervertebral Damage

Question 53

Somatic Dysfunction

Answer 53

``` Impaired or altered function of the somatic (body framework) system: skeletal, arthrodial, and myofascial structures; and related vascular, lymphatic, and neural elements. ```

Question 54

Application to a systemic disease: Fluid Congestion (venous and lymphatic)

Answer 54

- Delineate drainage pathway - Identify potential obstacles in the drainage pathway - Suggest Osteopathic techniques for maximizing pathological fluid drainage

Question 55

Application to a systemic disease: Nervous System

Answer 55

- 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

Question 56

Application to a systemic disease: Biomechanical

Answer 56

- Delineate local and regional concerns - Find interregional biomechanical concerns - Suggest Osteopathic techniques for maximizing restoration of biomechanical function

Question 57

Application to a systemic disease: Visceral

Answer 57

-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

Question 58

Joint Mobilization Methods

Answer 58

``` Direct Indirect Combined Physiological Exaggeration ```