ECOS Midterm Flashcards
What was the motto and attitude of medicine before osteopathy?
“Preserve the life force”
If enough force and drugs used, could conquer disease
Treatments were few, give stimulants if drowsy and hypnotics if agitated
Who reduced mortality through hand washing before osteopathy
Ingaz semmelweiss
Who used UV light before osteopathy
Finsen
Who used X rays before osteopathy
Rontgen
Who used sterile rubber gloves before osteopathy
Halstead
When was AT still born
Aug. 6 1828
What did AT still do treat a headache when he was 11?
Used a rope swing
How did AT still learn medicine?
Studied medicine and ministry under his father - apprenticeship
How did AT still learn anatomy?
On Indian cadevars from the cholera epidemic
What happened after AT still got back from the civil war?
He had 4 children die; 1 from pneumonia and 3 from spinal meningitis so he started to think about medicine differently
When did AT still create osteopathy?
10 AM June 22 1874
When did AT still create the first American School of Osteopathy?
1892
How many students did AT Still’s first class have?
22 - 17 men and 5 women
5 of the students were his children
When did AT still die?
1917
What are the osteopathic principles?
Body is a unit: body, mind, spirit
Body is capable of self regulation and self healing
Structure and function are reciprocally related
Rational treatment should be based on tenants 1-3
What did Dr. Abraham Flexner do?
Travelled to all MD and DO schools and authored a harsh report/criticism for all - encouraged clinical rotations and stricter requirements
When was the Kansas city college of osteopathy and surgery established?
1916
Who was the first commissioned DO into armed forces?
Harry J. Walter
Who was the first woman to receive DO degree?
Jeanette Bolles
Which woman treated spinal meningitis with osteopathy?
Louisa burns
Who was the first female graduate from KCU?
Mamie Johnston - 1918 and then joined KCU faculty - building named after her on campus
Who was the first female medical school dean?
Barbara ross-lee
Who was cuban born, a graduate of KCU and the 1st minority AOA president?
Marcelino Oliva
Who was involved in the Civil rights movement, AOA president and served on the board of trustees for 20 years, and was also associate dean of KCUCOM?
William G. Anderson
When should gloves be worn?
When there is obvious blood, body fluids and pt is presenting with diarrhea
When should you wash hands?
Before and after wearing gloves
What are the types of handwashing?
Handwashing, Antiseptic handwashing, alcohol based hand rub, surgical hand hygeine
Steps to handwashing
Wet, lather, scrub for 20 seconds, rinse, dry
Bigger side of the stethoscope?
Diaphragm
What is the diaphragm of the stethoscope used to hear?
High pitched sounds such as breath and heart
Smaller side of the stethoscope?
Bell
What is the bell of the stethoscope used to hear?
Low pitched sounds (bruit)
What are the 4 basic general assessment things to look at?
Apparent state of health, level of consciousness, signs of distress, skin color and obvious lesions
How do you check posture?
Check alignment of features anteriorly and posteriorly; such as the ears, mouth, shoulders, spinal alignement, iliac crests, knees, ankles
What are some common findings when checking facial feature alignment?
Facial droop
What are some common findings when checking anterior posture?
Flexed arm against body, knock knees (knees facing inward)
What are some common findings when checking posterior posture?
Scoliosis, short leg, shoulder winging
What is the ideal posture?
All land marks are on or near the gravitational line
What is included in the stance phase of walking?
Heel strike - loading response(absorb ground reaction to weight) - mid stance to pre swing(the body weight is carried forward)
What is included in the swing phase of walking?
Toe off - mid swing and terminal swing = clear foot and advance LE
What are the common causes for gait abnormalities?
Neurologic and musculoskeletal
Describe Ataxic gait
- Neurologic disorder
- Affects both legs, irregular steps and lack of proprioception and balance
- Can be due to alcohol or damage to balance centers in the brain and spinal cord
Describe hemiparesis gait
- Neurologic disorder
- Affects one leg and one arm on same side
- Leg will drag and circumduct while the arm is flexed
- Due to damage in the motor control of brain (stroke)
Describe scissor gait
- Neurologic disorder
- - Bilateral; knees pointing inward and feet commonly cross midline
Describe steppage gait
- Neurologic disorder
- Affects one leg; flex at hip/knee to clear foot during swing phase
- Due to damage to a nerve that raises foot
Describe parkinsonian gait
- Neurologic disorder
- Bilateral; stiff and stooped over with tremors
- Short shuffling gait that speeds up involuntarily
Describe waddling/Trendelenburg gait
- MSK disorder
- - Bilateral; hip drops towards swing leg and trunk leans towards stance leg
Describe antalgic gait
- MSK disorder due to pain in LE
- - Affects one leg; stance phase is shorter in effected leg (pain/limp)
What is defined as the altered function of the somatic system (skeletal, arthrodial, myofascial) along with their related vascular, lymphatic and neural elements?
Somatic Dysfunction!
How do you diagnose somatic dysfunction?
TART:
- Tissue texture abnormalities
- Asymmetry
- Range of motion
- Tenderness
What is defined as the act of a muscle shortening length?
Contraction
What is defined as the abnormal, sometimes permanent contraction of a muscle?
Contracture
How could you distinguish between acute and chronic somatic dysfunction?
Chronic: skin is cool, ropey, stringy
Acute: skin is warm, red, swollen, contracted
How do you name somatic dysfunction?
FOR WHAT IT WILL DO
Is passive ROM or active ROM better?
Passive - pt is passive and doctor does the moving
How do you treat somatic dysfunction?
OMT
What are the 5 osteopathic models?
Biomechanical, neurological, respiratory/circulatory, metabolic/energetic/immune, behavioral
What movements are done in the coronal plane?
Sidebending, ABduction and ADduction
What movements are done in the sagittal plane?
Flexion and extension
What movements are done in the horizontal/transverse plane?
Rotation
3 types of joints?
Fibrous, cartilagenous, synovial
6 types of synovial joints?
Ball and socket, pivot, hinge, condyloid, plane, saddle
3 things that ROM includes?
Direction, range and quality
What is the end feel felt in somatic dysfunction?
Hard
What are the other types of end feel?
Elastic, abrupt, hard, empty, crisp
What area of the spine displays the greatest motion?
Cervical
Stiffness?
Reduced ROM
Motion along one axis with motion along another axis; and the 1st motion cannot be produced without the next motion to protect the spinal cord
Coupled motion
What is in a functional unit?
2 vertebra, IV disc, and neurovascular components
Link multiple structures together to increase the ROM such as the spine and pelvis
Linkage (same plane)
What is always are the same level of the corresponding vertebral body?
Its transverse processes
Where are the spinous processes located for T1-3 and T12?
At the same level as the vertebral body
Where are the spinous processes located for T4-6 and T11?
Located 1/2 a segment below their corresponding transverse processes
Where are the spinous processes located for T7-10?
Located 1 segment below their corresponding transverse processes
What vertebrae is equal to the iliac crests?
L4
What vertebrae is equal to the inferior angle of the scapula?
T7 SP
What vertebrae is equal to the scapular spine?
T3
What is the superior facet orientation for cervical vertebrae?
BUM (backwards, upwards, medial)
What is the superior facet orientation for thoracic vertebrae?
BUL (backwards, upwards, lateral)
What is the superior facet orientation for lumbar vertebrae?
BM (backwards, medial)
What does the restrictive barrier create?
A shifted neutral
What does spinal somatic dysfunction cause?
Restrictions of motion of the spine, reduced efficiency, impaired flow of fluids, alters nerve function and creates a structural imbalance
If a segment is sidebending and rotating the same way, what muscle group is affected?
Rotatores
If a segment is sidebending and rotating opposite ways, what muscle groups are affected?
Multifidus and semispinalis
In flexion, what do the facets of vertebrae do?
open
In extension, what do the facets of vertebrae do?
close
What is another name for the spinal motion principles?
Fryette’s principles
Who developed the first 2 spinal motion principles and when?
Harrison Fryette, DO - 1918
What part of the spine are fryette’s principles applicable?
Thoracic and lumbar
Who developed the 3rd spinal motion principle and when?
C.R. Nelson, DO - 1948
What is Type 1 fryette principle?
Group of vertebrae are neutral, side bent and rotated in opposite directions;
Semispinalis and multifidus muscle groups
What is Type 2 fryette principle?
One segment is either flexed or extended, side bent and rotated in the same direction;
Rotatores muscle
What is Type 3 fryette principle?
Initiating movement of a vertebral segment in any plane of motion will modify the movement of that segment in other planes of motion
- If motion is restricted in one plane, it will be restricted in other planes
- If motion is improved in one plane, it will be improved in other planes
Where do you test for rotation somatic dysfunction of the vertebrae?
Push on a transverse process, and the vertebrae will rotate towards the other side
– pressing on the right TP will initiate left rotation
How do you test for sidebending somatic dysfunction of the vertebrae?
Translate the segment to the left or right
– translating the segment to the right will induce left side bending
This vitamin is fat soluble, aids in vision and maintenance of the epithelia and can be found in dark green and yellow veggies/tomatoes
Vitamin A
This vitamin is fat soluble, aids in bone metabolism and calcium homeostasis and can be found in milk and mushrooms
Vitamin D
This vitamin is fat soluble, scavenges reactive oxygen species and can be found in wheat germ and avocado
Vitamin E
This vitamin is fat soluble, aids in blood clotting, and can be found in green leafy veggies
Vitamin K
What are the fat soluble vitamins?
ADEK
What are the water soluble vitamins?
C, B1,B2,B3,B6,B9,B12
This vitamin aids in carb and AA metabolism and is found in legumes
B1 - thiamine
These vitamins are oxidoreductases and found in wheat germ
B2 - riboflavin
B3 - niacin
This vitamin aids in the synthesis of NTs and is found in animal products
B6 - pyridoxine
This vitamin aids in 1-carbon transfers and the synthesis of thiamine and is found in uncooked leafy veggies
B9 - folic acid
This vitamin supports heme structure and NOT found in plants
B12 - cobalamin
This vitamin is an antioxidant, supports collagen synthesis and is found in fruits and veggies
Vitamin C
What mineral is used for contraction of muscles?
calcium
What mineral is used for hemoglobin?
iron
Tofu, broccoli, cauliflower are all sources of what?
Minerals - calcium and iron
A BMI over 30 is considered
Obese
A BMI between 25.1 - 29.9 is considered
Overweight
A BMI between 18 - 25 is considered
Healthy
How do you calculate BMI
Weight/Height^2
This disease should eat a low carb diet, individualized meat intake and 1 hr a day aerobic exercise
Diabetes
These disease should eat a DASH diet, whole grains, limit red meat and include resistance training in to their exercise
Hypertension and Hyperlipidemia
