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OPP Week 1 Podcasts > Direct vs Indirect > Flashcards

Direct vs Indirect Flashcards

1
Q

Vertebral Segment

A

Single vertebrae

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2
Q

Vertebral Unit

A

2 adjacent vertebrae and their associated elements

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3
Q

Associated elements of vertebral unit

A
  1. Ligamentous
  2. Intervertebral disk
  3. Arthrodial
  4. Muscular
  5. Neural
  6. Vascular, including lymphatics
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4
Q

How do we name vertebral motion?

A

In relation to segment below and for movement of a point on the anterior/superior portion of the vertebral body

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5
Q

What does the posterior component refer to? Anterior?

A

Prominent transverse process; less prominent

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6
Q

Fryette 3rd Law of Motion

A

When one motion is introduced, it reduces the amount of the other motions

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7
Q

What are atypical vertebrae

A

Do NOT follow Fryette’s rules due to their anatomy

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8
Q

What is AT Still’s birthday? Where was he born?

A

August 6th, 1828 - Virginia

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9
Q

AT Still’s letters after his name. Where did he study medicine?

A

MD, DO - Kansas City School of Physicians and Surgeons

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10
Q

AT Still’s dad’s professions

A

Farmer, physician, and minister

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11
Q

What are the 3 atypical vertebrae?

A
  1. OA - occiput on atlas (C0 on C1)
  2. AA - atlas on axis (C1 on C2)
  3. Sacrum
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12
Q

What are all techniques based off of?

A

The Barrier Concept

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13
Q

What does The Barrier Concept describe? Contain?

A

Describes motion in a joint or in a tissue in ONE plane; contains neutral point along with barriers

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14
Q

What do we have in SD in relation to Barrier Concept?

A

Additional barriers and pathological neutral

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15
Q

Barrier defines what?

A

Limit of motion

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16
Q

What makes up normal joint motion and barriers to that motion?

A
  1. Balance point - O
  2. Physiological barrier - PB
  3. Anatomical barrier - AB
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17
Q

What is the balance point?

A

Midline between physiologic barriers

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18
Q

What can be altered by warm up?

A

PB

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19
Q

When does tissue disruption occur?

A

Beyond the AB

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20
Q

What is a Restrictive Barrier?

A

Change in ROM

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21
Q

What happens because of a RB?

A

Pathologic neutral (asymmetric point of balance)

22
Q

What makes up somatic dysfunction and barriers to motion?

A
  1. O - balance point
  2. PB
  3. AB
  4. RB
  5. SD
23
Q

Full definition of Restrictive Barrier

A

A functional limit within the anatomical ROM, which abnormally diminishes the normal physiologic range

24
Q

What is another term for the ROM?

A

Quantity; tissue motion

25
Q

What is the Quality of motion?

A

Endfeel

26
Q

What is the Endfeel of motion?

A

Perceived as an anatomic or physiologic barrier as approached

27
Q

What is Endfeel used for?

A

Describe osteopathic manipulative procedures

28
Q

How do we tell what the tissues are doing?

A

Based on what our hand FEEL

29
Q

3 examples of “End Feel” descriptions

A

Firm, rubbery, boggy

30
Q

Diagnosis with TART

A
  1. What you feel
  2. What you see
  3. How it responds to motion testing
  4. Tender?
31
Q

Is TART equal?

A

No; some more equal than others depending on which technique to choose

32
Q

What skill is needed for to define Barrier Mechanics?

A

Restriction in Motion

33
Q

What is the Manipulative Description?

A
  1. Your goal?
  2. Which technique?
  3. How much?
  4. How often?
34
Q

How do we choose the right technique?

A
  1. Initial positioning

2. Find activating force

35
Q

Definition of “Direct Treatment”

A

A manipulative technique where the restrictive barrier is engaged; the dysfunctional body part is moved into the restrictive barrier until tissue tension is localized in all planes and directions, then an activating force is used to either move through the barrier or release the barrier in increments

36
Q

3 main points with Direct Treatment

A
  1. Position in restrictive barrier
  2. Localize in all planes
  3. Utilize activating force
37
Q

Definition of “Indirect Treatment”

A

A manipulative technique where the restrictive barrier is disengaged; the dysfunctional body part is moved away from the restrictive barrier until tissue tension is equal in one or all planes and directions

38
Q

3 main points with Indirect Treatment

A
  1. Position in direction of freer motion
  2. Balance tension on all sides, hold
  3. Released via inherent forces
39
Q

Definition of inherent force?

A

Using the body’s natural tendency to seek homeostasis, inherent force is the rhythmic activity in all tissues that work to improve the hydrodynamics and bioenergetics factors around the restricted tissues and articulations

40
Q

Direct engages what? What about its Activating Forces?

A

Restrictive (pathological) barrier; its activating forces vary

41
Q

Indirect engages what?What about its Activating Force?

A

Moves away from restrictive barrier to a point of ease (new pathological neutral); the activating force is the inherent force of the body

42
Q

6 Direct Techniques

A
  1. Direct Myofascial Release (D-MFR)
  2. Articullatory (ART)
  3. Muscle Energy (ME or MET)
  4. Soft Tissue (ST)
  5. High Velocity, Low Amplitude (HVLA)
  6. Direct Osteopathic Cranial Manipulative Medicine (OCMM)
43
Q

6 Indirect Techniques

A
  1. Counterstrain (CS)
  2. Indirect balancing
  3. Faciliated Postural Release (FPR)
  4. Balanced Ligamentous Tension (BLT)
  5. Osteopathic Cranial Manipulative Medicine (OCMM)
  6. Indirect Myofascial Release (I-MFR)
44
Q

What is the “Combined Technique”

A

First INDIRECT, then direct

45
Q

3 Activating Forces in Direct Technique

A
  1. Operator induced
  2. Patient activated
  3. Inherent force
46
Q

Activating Force in Indirect Technique

A
  1. Inherent forces
47
Q

Describe Soft Tissue Treatment. What is its Activating Force?

A

Direct. Directed toward tissues other than skeletal or arthrodial elements, which involves lateral/linear stretching, deep pressure, traction and/or separation of muscle origin and insertion while monitoring tissue response and motion changes by palpation

Activating Force: intermittent engagement and release of the restricted tissues

48
Q

Describe Direct Muscle Energy Technique. What is its Activating Force?

A

Patient voluntarily moves their body from a precisesly controlled position against a controlled resistance applied by the physician

Activating Force: patient induced

49
Q

Describe Indirect Counterstrain. What is its Activating force?

A

A treatment form in which a tender point is monitored for continual palpatory feedback as the patient is positioned to a “point of ease” and held for 90 seconds to achieve release of myofascial tissues; the patient is passively returned to the “normal” position.

Activating Force: inherent force

50
Q

Describe Indirect Myofascial Release. What is its Activating Force?

A

A treatment form which engages continual palpatory feedback to achieve release of myofascial tissues; with indirect MFR the myofascial tissues are moved to the balance point or “point of ease” in ALL planes of motion until a tissue release occurs.

Activating Force: inherent

51
Q

Describe the Still Technique. Activating Force?

A

Combined. Indirect-Direct. A technique where the initial movements are indirect; as the technique is completed the movements change to direct forces

Activating Force: 1) the inherent release within the soma and 2) the physician’s slow, gentle force through the restrictive barrier

OPP Week 1 Podcasts (12 decks)

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