Exam 1/17

Question 1

GI tract is linked to holistic mechanism via

Answer 1

Vascular system

also linked to neuromuscular system via viscerosomatics

Question 2

Acute Abdomen Signs

Answer 2

Lack of bowel sounds
High pitched tinkling bells sound
Abdominal wall rigidity w pain or rebound tenerness
Abn areas of tympani or dullness

Question 3

Viscerosomatic Reflexes are segmentally _____

Answer 3

Specific

Question 4

Viscerosomatic Finding:

Esophagitis

Answer 4

T3 Right

Question 5

Viscerosomatic Finding:
Peptic Ulcer (stomach)

Answer 5

T5- T6 Left

Question 6

Viscerosomatic Finding:

Duodenum

Answer 6

T6- T8 Right

Question 7

Viscerosomatic Finding:

Cholecstitis

Answer 7

T9-T10 Right

Question 8

Viscerosomatic Finding:

Pancreatitis

Answer 8

T5-T9 Bilateral block reaction

Question 9

Viscerosomatic Finding:

Acute Hepatitis

Answer 9

T5-T10 Right

Question 10

Viscerosomatic Finding:

Acute Gastroenteritis

Answer 10

T3-L2

Question 11

Viscerosomatic Finding:

Appendicitis

Answer 11

T9-T12 Right

Tip of 12th rib right

Question 12

Viscerosomatic Finding:
Mesenteric Adenines (small intestine)

Answer 12

T8-T11 bilateral

Question 13

Viscerosomatic Finding:

IBS

Answer 13

T8-L2 Bilateral

S2

Question 14

Viscerosomatic Finding:

Colitis

Answer 14

T11-L3

S2

Question 15

Viscerosomatic Finding:

Ovarian Disease

Answer 15

T10-T11

Question 16

Collateral ganglia are located

Answer 16

Anterior wall of abdominal aorta

Btw xiphoid process and umbilicus

Question 17

Celiac Ganglion controls

Answer 17

Stomach
Liver
GB
Spleen
Part of pancreas
Part of Duodenum

Question 18

Superior mesenteric Ganglion controls

Answer 18

Part of pancreas
Part of Duodenum
Jejunum
Ilium
Ascending Colon
Proximal 2/3 of transverse colon

Question 19

Inferior Mesenteric Gangion controls

Answer 19

Distal 1/3 transverse colon
Descending colon
Sigmoid colon
Rectum

Question 20

Sympathetic Nervous system mediated GI complaints

Answer 20

Constipation
Abd pain
Flatulence
Distension

Question 21

Parasympathetic Nervous System mediated complaints

Answer 21

Headache
N/V
Diarrhea
Cramping pain
GB pain (constriction of biliary ducts)

Question 22

Stop OMT treatment when pt shows signs of _____

Answer 22

Vasodilation

• Increased skin temp/ redness
• Sweating
• Increased HR/ RR

Question 23

“functional” before a diagnosis means

Answer 23

They know what the disease is, but not the etiology

Question 24

Constipation is common with inadequate _____ and _____

Answer 24

Fiber and

Water

Question 25

Required Reading on IBS

Answer 25

IBS-D has somatic dysfunctions of the OA/ AA/ C2 Overactive PNS --> hyperactive motility Treat IBS-D with COUNTERSTRAIN IBS-C is lower thoracic/ upper lumbar dysfunction (near collateral ganglions) Treat IBS-C w COUNTERSTRAIN or HVLA

Question 26

Required Reading Neonatal Jaundice

Answer 26

neonatal massage promotes bilirubin excretion decreasing the length of hospital stay Allows parent active role in baby's health

Question 27

Required Reading MOPSE

Answer 27

Study to see if OMT helps old people w pneumonia Thoracic and Cervical ST, Rib raising, doming diaphragm, Suboccipital (PNS), Thoracic inlet, Thoracic and Pedal lymph pump 15 mins, 2x daily

Question 28

Required Reading on Exercise and COPD

Answer 28

Trial still on-going | No conclusions

Question 29

Gray Turner Sign

Answer 29

Bruising of flanks Sign of retroperitoneal hemorrhage Due to abd trauma, ruptured aortic aneurysm, ruptured cyst, ectopic pregnancy

Question 30

Cullen's Sign

Answer 30

Superficial Periumbilical bruising and edema | Due to intraperitoneal hemorrhage

Question 31

Cholylithiasis

Answer 31

Stones in GB

Question 32

Cholydocholithiasis

Answer 32

Stones in the Common Bile Duct

Question 33

Biliary Colic

Answer 33

Stones/ Sludge (from ABX) increasing tension on GB wall Episodes sporadic and unpredictable Pain is constant Radiating to R Scapular Tip Cholecystectomy will not improve symptoms *Labs will all be within normal limits

Question 34

Uncomplicated Biliary Colic

Answer 34

Pain poorly localized and visceral Benign abd exam WITHOUT rebound tenderness or guarding Absence of fever

Question 35

Acute Cholecystitis

Answer 35

``` Well-localized RUQ pain Rebound and Guarding Positive Murphy Sign Fever Absence of peritoneal signs Tachy and Diaphoretic Absent or Hypoactive bowel sounds ```

Question 36

Gallstone Complications

Answer 36

Ascending cholangitis --> sepsis, shock Pancreatic pseudocyst after chronic pancreatic disease Perforation Porcelain gallbladder (needs resection) Chronic GB disease causes fibrosis (resection difficult) Pancreatitis w autodigestion from enzyme release

Question 37

Charcot Triad

Answer 37

Fever Jaundice RUQ pain *indicates ascending cholangitis

Question 38

Cutaneous and Scleral Icterus indicates

Answer 38

Choledocholithiasis with | Common Bile Duct obstruction

Question 39

Cullen sign or Grey-Turner Sign can be indicative of

Answer 39

Severe acute gallstone pancreatitis

Question 40

Osteopathic Approach to GB issues

Answer 40

Increased SNS relaxes GB and biliary ducts Increased PNS contraction of GB and biliary ducts Circulatory stasis --> tissue congestion

Question 41

If the GB is inflamed, it can irritate the _____

Answer 41

Diaphragm

Question 42

Treatment for GB issues

Answer 42

``` IV hydration and analgesics NPO Vitamins, Thiamine Insulin OMT Social worker eval ```

Question 43

Goal of OMT in GI treatment

Answer 43

Does NOT treat the disease | Removes/ Reduces functional impediment