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OPP > Didactic_Lecture 2 > Flashcards

Didactic_Lecture 2 Flashcards

1
Q

The 5 Osteopathic Models In Patient Assessment & Treatment

A
  • are specific care approaches to the patient
  • represent physiological functions that maintain health
  • the 5 models play key roles in:
    1. Adaptation to stressors
    2. Recovery & repair from illness and disease
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2
Q

Osteopathic Philosophy & the 5 Models

A

the physcial musculoskeletal system often will reflect signs of internal diseases

5 models provide framework for interpreting significance of somatic dysfunction

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3
Q

Biomechanical Anatomical Correlates

A
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4
Q

Respitory-Circulatory Anatomical Correlates

A
  1. Thoracic inlet
  2. Thoracic & pelvic diaphragms
  3. Tentorium cerebelli
  4. Costal cage
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5
Q

Metabolic-Energy Anatomical Correlates

A
  1. Internal organs
  2. Endocrine glands
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6
Q

Neurological Anatomical Correlates

A
  1. Head (organs of special senses)
  2. Brain
  3. Spinal cord
  4. Autonomic nervous system (ANS)
  5. Peripheral nerves
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7
Q

Behavioural Anatomical Correlates

A

Brain

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8
Q

Biomechanical Physiological Functions

A
  1. Posture
  2. motion
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9
Q

Respiratory-Circulatory Physiological Functions

A
  1. respiration
  2. circulation
  3. venous & lymphatic drainage
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10
Q

Metabolic-Energy Physiological Functions

A
  • Metabolic processes:
    1. homeostasis
    2. energy balance
    3. regulatory processes
  • Immunological activities and inflammation & repair
  • Digestion, absorption of nutrients, waste removal
  • Reproduction
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11
Q

Neurological Physiological Function

A
  1. Control & coordination
  2. Integration of body functions
  3. Protective mechanisms ( i.e. fight or flight)
  4. Sensation
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12
Q

Behavioural Physiological Function

A
  1. Psychological & social activities (e.g., stress, work, family)
  2. Habits (e.g., sleep, exercise, drug abuse)
  3. Values, attitudes, beliefs
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13
Q

Biomechanical Model OMT Techniques

A

Objective: Optimize patient’s adaptive potential through restoring structural integrity & functio

  1. Assess patient for structure abnormality (somatic dysfunction)
  2. Use OMT to correct somatic dysfunction = patient regains associated structural, vascular, neurologic, metabolic, & behavioral functions.

EX) Whiplash

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14
Q

Biomechanical Dysfunctions

A

Structural impediment via dysfunction of muscles, joints, connective tissue

  • Can compromise vascular or neurological structures
  • ↓↓↓ patient’s homeostatic capacity (Patient’s ability to adapt to insults & stressors)
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15
Q

Respiratory-Circulatory Central Processes

A

Tissues that screw the circulation of body fluids can affect health of tissues

  1. Central neural control
  2. CSF fluid flow
  3. Pulmonary & cardiovascular function
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16
Q

Respiratory-Circulatory Peripheral Processes

A

Delivery of oxygen & nutrients
Removal of cellular waste products via

  1. Arterial supply
  2. Venous & lymphatic drainage
17
Q

Respiratory-Circulatory OMT Techniques

A

Objective: Maximize capacity & efficiency of respiratory- circulatory functions

OMT addresses dysfunction in:

  1. Respiratory mechanics
  2. Circulation
  3. Flow of body fluids

Ex) Pneumonia

18
Q

Neurological Model OMM

A

There is a relationship between somatic & visceral autonomic systems

This model consides the neuroendocrine immune network by:

– Spinal facilitation
– Proprioceptive function
– Autonomic nervous system (ANS)
– Activity of nociceptors (pain fibers)

19
Q

Neurological Model OMT Methods

A

Objective: re-establish optimal neural function

  • Attain autonomic balance
  • Address neural reflex activity
  • Remove facilitated segments
  • ↓↓↓ afferent nerve signals
  • pain relief

OMT focuses on:

  • ↓↓↓ of mechanical stresses
  • Balance of neural inputs
  • Elimination of nociceptive drive
20
Q

Neurological Model Example

A

example: patient with peristalsis (lack of intestinal motion) after surgery

OMT focus:

  • release paraspinal tensions & spasms

= ↓ sympathetic hyperactivity & ↑↑↑ parasympathetic activity

= Restoring normal intestinal motility

21
Q

Metabolic-Energy Model OMT

A

Model requires energy-efficient response to infectious agents & repair of injuries

OMT REPAIRS SOMATIC DYSFUNCTION = OPTIMAL ENERY ECONOMY

  • Adequate nutrition = normal biochemical processes, cellular functions, & neuromusculoskeletal activity
  • INJURY (somatic disfunction) to musculoskeletal system burdens body’s energy economy
    1. Dysregulate production, distribution, or expenditure of energy
    2. Increase allostatic load
    3. Interfere w/ immunological & endocrine regulatory functions
22
Q

Behavioral Model OMT

A

Objective: improve body’s ability to effectively manage, compensate, or adapt to stressors (maximizing coping abilities)

  • Musculoskeletal system can express emotions
  • Stress = ↑↑↑ neuromuscular tension

OMT: Somatic dysfunction affects musculoskeletal system’s reaction to biopsychosocial stressors

Provide patient education on:

  • Health
  • Disease & lifestyle choices
  • Mental outlook
  • Preventative care
  • Helps Patient Trust/ build Rapport
23
Q

Neuroendocrine-Immune System Response

A

body has homeostatic rhythms (maintain appropriate changes necessary for promoting survival)

  • immune response sensitizes the PAN = to ↑↑↑ release of neurotransmitters & neuromodulators
    • Activation of primary afferent nociceptor (PAN) and release of pro-inflammatory compounds into surrounding tissue
    • Repetitive stimuli = PANs to be ↑↑ sensitive to low thresholds of energy
  • = greater pain sensation: primary hyperalgesia
  • = Allodynia: non-noxious stimuli elicits sensation of pain– Neurogenic inflammation
24
Q

The Arousal System and Sickness Behaviours

A

Triggers of the arousal system:

  1. Somatic dysfunction (stress)
  2. Visceral dysfunction (stressors)
  3. Emotional dysfunction (stress)

Leads to Sickness Behaviour (Changes in Acute-Phase Response)

25
Q

Neuroendocrine-Immune Network

A

Physical (somatic or visceral) & Emotional stimuli triggers the arousal system = impacted homeostasis

via triggering strong synpathetic response = release of adrenal cortical steroid hormones

NEURAL and ENDOCRINE systems interact with IMMUNE system

= ↑↑↑ cytokines, cortisol, & catecholamines

26
Q

Homeostasis

A

Tendency of the body to seek and maintain a condition of balance or equilibrium within its internal environment, even when faced with external changes

27
Q

Allostasis

A

Maintenance of stability through change: bring the body back to homeostasis

Disease processes will ACTIVATE allostatic response

  • As threat diminishes, feedback control systems should suppress levels of allostatic compounds
    • = returning body to normal function
28
Q

Allostasis Arousal System

A
29
Q

Somatic stressors

A

trauma or injury including somatic dysfunction

30
Q

Visceral stressors

A

traumatic injury, infection, or inflammation of visceral organs

• More subtle, diet-related events

31
Q

Emotional stressors

A

STRESS RESPONSE

Frequent activation of stress response =

  • damages body chronically through activation of the hypothalamic-pituitary adrenal (HPA) axis
  • Effects add up progressively (cumulative)
32
Q

Allostatic load

A

chronic compensatory state

price paid for chronic exposure to stress-mediated neuroendocrine adaptations

  • Long-term exposure to allostatic chemical environment (catecholamines, cortisol, cytokines)

Gradual loss of effectiveness of feedback pathways to reestablish normal homeostasis

33
Q

Allostatic Load Disease

A

– Degenerative & inflammatory diseases may have roots in

this mechanism

– Correlated to increased occurrence of cardiovascular dx

– Memory & depression (central nervous system)

– Multiple, complex effects on immune system

34
Q

Screening

A

FAST & NONSPECIFIC test to locate dysfunction area

Static Postural Exam

  1. Observation of skin
  2. Observation of static landmarks
  3. Observation of asymmetry

Dynamic Postural Exam

  1. Gait
  2. Range of Motion: Cervical, Thoracic, Lumbar, Ribs, Sacrum
  3. Special Tests: Upper Extremity Quick Tests, Squat Test, Standing/Seated Flexion Tests
35
Q

Anterior Mid-Gravity Line

A
  1. Glabella
  2. Symphysis menti
  3. Episternal notch
  4. Mid-sternum
  5. Xiphoid process
  6. Umbilicus
  7. Pubic symphysis
  8. Mid-heel point
36
Q

Posterior Mid-Gravity Line + Landmarks

A

Posterior Mid-Gravity Line

  1. Inion
  2. Spinous processes of:
    • Cervical vertebrae
    • Thoracic vertebrae
    • Lumbar vertebrae
    • Sacral vertebrae
  3. Gluteal crease
  4. Mid-heel point
37
Q

Lateral Landmarks

A

Lateral Mid-Gravity Line

  1. External auditory meatus (canal)
  2. Greater tuberosity of the humerus (on lateral head)
  3. Mid-body of L3
  4. Sacral promontory (anterior third of sacrum)
  5. Greater trochanter of the femur
  6. Lateral condyle of the knee
  7. Lateral malleolus (slightly anterior to)

OPP (2 decks)

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