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Exam #1 Flashcards

1
Q

What does “Feather’s Edge” represent?

A

The perceived quality of motion near the restrictive bordar

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2
Q

What is the indication for HVLA?

A

A distinct, solid border (need a firm end feel)

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3
Q

What is the most commonly used form of contraction in muscle energy?

A

Isometric contraction

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4
Q

Which technique would you use when the muscle of an extremity is so severely injured that it cannot be directly touched or manipulated?

A

Muscle Energy: Cross Extensor Reflex

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5
Q

A reversible dextroscoliosis or levoscoliosis means there is NO __________ _________ present.

A

NO Sagittal Component (no flexion or extension)

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6
Q

What Fryette Type mechanics does reversible dextroscoliosis or levoscoliosis follow?

A

Type I

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7
Q

Which scoliosis would have the convex side pointing to the right?

A

Dextroscoliosis

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8
Q

Which scoliosis indicates neutral side-bending LEFT, rotating RIGHT?

A

Dextroscoliosis

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9
Q

A left lateral convexity means the vertebrae are side-bent _____.

A

RIGHT

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10
Q

A right lateral convexity means the vertebrae are side-bent _____.

A

LEFT

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11
Q

When treating a group dysfunction with OMT, where in the curve do you go for treatment?

A

The apex (middle) of the group curve

Ex: T10-T12, go for T11

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12
Q

Which dysfunction type would usually occur at the apex (middle) of the group curve in situations where there is no sagittal component?

A

Type II

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13
Q

Translation to the right is _______ side-bending.

A

LEFT

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14
Q

Translation to the left is _______ side-bending.

A

RIGHT

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15
Q

If a dysfunction keeps returning after being treated, you could be missing a _______ or it could be ______.

A
  • lesion

- visceral

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16
Q

What year was AT Still born?

A

1828

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17
Q

What year was Osteopathy founded (“Flung the banner of Osteopathy”)?

A

1874

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18
Q

What year was the first DO school charted (The American School of Osteopathy in Kirksville, Missouri)?

A

1892

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19
Q

What year did AT Still die?

A

1917

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20
Q

What did AT Still’s 3 children die of?

A

Meningitis

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21
Q

Where on the body is the best for sensing temperature?

A

Dorsum of hand

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22
Q

Where on the body has the most kinesthetic nerve endings?

A

Pad of thumb, index finger, middle fingers

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23
Q

What is one of the first things you do in a physical exam after obtaining a history?

A

Observation

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24
Q

What is the 1st Principle of Osteopathic Medicine?

A

The body is a unit; the person is a unit of mind, body, and spirit

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25
Q

What is the 2nd Principle of Osteopathic Medicine?

A

The body is capable of self-regulation, self-healing, and health maintenance

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26
Q

What is the 3rd Principle of Osteopathic Medicine?

A

Structure and function are reciprocally interrelated

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27
Q

What is the 4th Principle of Osteopathic Medicine?

A

Rational treatment is based upon an understanding of the basic principles of body unity, self-regulation, and inter-relationship of structure and function.

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28
Q

What are the 5 Osteopathic Models?

A
  • Biomechanical
  • Neurological
  • Respiratory/Circulation
  • Metabolic/Nutritional
  • Behavioral (Psychobehavioral)
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29
Q

Which Osteopathic Model uses OMT directed toward normalizing mechanical somatic dysfunction, structural integrity, physiological function, and homeostasis?

A

Biomechanical

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30
Q

How are the superior facets oriented in the cervical region?

A

Backward
Upward
Medial

BUM

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31
Q

How are the superior facets oriented in the thoracic region?

A

Backward
Upward
Lateral

BUL

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32
Q

How are the superior facets oriented in the lumbar region?

A

Backward
Medial

BM

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33
Q

How are the inferior facets oriented in the cervical region?

A

Anterior
Inferior
Lateral

AIL

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34
Q

How are the inferior facets oriented in the thoracic region?

A

Anterior
Inferior
Medial

AIM

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35
Q

How are the inferior facets oriented in the lumbar region?

A

Anterior
Lateral

AL

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36
Q

Which barrier is the limit of active motion?

A

physiologic barrier

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37
Q

Which barrier is the limit of passive motion; the limit of motion imposed by anatomical structure?

A

anatomical barrier

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38
Q

Which barrier is the range in which passive ligamentous stretching occurs before tissue disruption?

A

elastic barrier

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39
Q

Which barrier is a functional limit that abnormally diminishes the normal physiologic range?

A

restrictive barrier

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40
Q

What are the barriers of normal joint motion?

A

Anatomic barrier
Physiologic barrier
Elastic barrier

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41
Q

What are the barriers of abnormal joint motion?

A

Restrictive barrier

Pathologic barrier

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42
Q

In an abnormal joint, motion stops before the joint reaches what barrier?

A

Physiologic barrier

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43
Q

Which barrier is a restriction of joint motion associated with pathologic changes of tissues?

A

Pathologic barrier

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44
Q

Which barrier is a permanent change?

A

Pathologic barrier

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45
Q

Which reflex is a rib somatic dysfunction from an innominate dysfunction?

A

Somatosomatic reflex

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46
Q

Which reflex is gallbladder disease affecting musculature?

A

Viscerosomatic reflex

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47
Q

Which reflex is a myocardial infarction and vomiting?

A

Viscerovisceral reflex

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48
Q

Which reflex is triggering an asthma attach when working on the thoracic spine?

A

Somatovisceral reflex

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49
Q

What do post ganglionic sympathetic fibers lead to?

A

Tissue texture changes

ex: hypertonicity, moisture, erythema

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50
Q

Which horn of the spinal cord is where somatic and visceral afferent nerves synapse?

A

Dorsal horn

Viscerosomatic Reflex

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51
Q

Functional Landmarks:

Spine of scapula

A

T3

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52
Q

Functional Landmarks:

Inferior angle of scapula

A

SP T7

TP T8

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53
Q

Functional Landmarks:

Suprasternal Notch

A

T2

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54
Q

Functional Landmarks:

Angle of Louis (Sternal Angle)

A

T4

Rib 2

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55
Q

Functional Landmarks:

Xiphoid Process

A

T9

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56
Q

Functional Landmarks:

Umbilicus

A

L3/L4 area

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57
Q

Functional Landmarks:

Iliac Crest

A

L4/L5 area

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58
Q

Sympathetic Levels:

Heart

A

T1-T5

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59
Q

Sympathetic Levels:

Lungs

A

T1-T6 (T2-T7)

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60
Q

Sympathetic Levels:

Stomach

A

T5-T9

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61
Q

Sympathetic Levels:

Gallbladder

A

T5-T9

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62
Q

Sympathetic Levels:

Bladder

A

T12-L2

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63
Q

Sympathetic Levels:

Prostate

A

T12-L2

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64
Q

Parasympathetic Levels:

Hear

A

OA
C1
C2
(Vagus)

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65
Q

Parasympathetic Levels:

Lungs

A

OA
C1
C2
(Vagus)

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66
Q

Parasympathetic Levels:

Stomach

A

OA
C1
C2
(Vagus)

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67
Q

Parasympathetic Levels:

Gallbladder

A

OA
C1
C2
(Vagus)

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68
Q

Parasympathetic Levels:

Bladder

A

S2-S4

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69
Q

Parasympathetic Levels:

Prostate

A

S2-S4

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70
Q

Vertebral bodies are usually rotated _______ the side of dysfunction.

A

TOWARDS

71
Q

Left lower lobe pneumonia, vertebra rotated________

A

LEFT

72
Q

Gastritis, vertebra rotated ________

A

LEFT

73
Q

Cholecystitis, vertebra rotated ______

A

RIGHT

74
Q

Somatic dysfunction tends to return rapidly after successful treatment with OMT because the ____________ reflex is still present.

A

Viscerosomatic

75
Q

Vertebrae will rotate towards the ________ side

A

Dysfunctional

76
Q

Viscerosomatic reflex example:

Stomach

A

T5-T9 on the LEFT (ulcers, gastritis)

77
Q

Viscerosomatic relex sample:

Gallbladder

A

T5-T9 on the RIGHT (gallstones)

78
Q

“________ reflexes produce unmeasured changes on the internal organs”

A

Somatovisceral

79
Q

Acute or Chronic?

  • Sharp or severe localized pain
  • Warm, moist, sweaty skin
  • Boggy, edematous tissue
  • Erythematous
  • Local increased muscle tone, contraction, spasm, spindle firing
  • Normal or sluggish ROM
  • May be minimal or no somatovisceral effects
A

ACUTE

80
Q

Acute or Chronic?

  • Dull, achy diffuse pain
  • Cool, smooth, dry skin
  • Possible atrophy
  • Fibrotic, ropy feeling tissue
  • Pale/skin pallor
  • Decreased muscle tone, contracted muscles, sometimes flaccid
  • Restricted ROM
  • Somatovisceral effects more often present
A

CHRONIC

81
Q

Movement in a transverse plane about a vertical axis

A

Rotation

82
Q

Posterior movement in a sagittal plane about a transverse axis

A

Extension

83
Q

Movement in a coronal plane about an anterior-posterior axis

A

Side-bending

84
Q

Anterior movement in a sagittal plane about a transverse axis

A

Flexing

85
Q

An impaired or altered function of related components of the somatic (body framework) system: skeletal, arthroidal, and myofasical structures, and related vascular, lymphatic, and neural elements

A

Somatic dysfunction

86
Q

TART

A

T - Tissue Texture Changes
A - Asymmetry
R - Restriction of motion
T - Tenderness

87
Q

How is somatic dysfunction named?

A

Named for the way it likes to go

88
Q

Are fractures, sprains, degenerative processes, and inflammatory processes somatic dysfunction?

A

NO

89
Q

Which Fryette Principle:

When side-bending is attempted from non-neutral (flexed or extended) position, rotation must precede side-bending to the same side

A

Fryette’s 2nd Principle

90
Q

Which Fryette Principle:

Motion introduced in one plane limits and modifies in the other planes

A

Fryette’s 3rd Principle

91
Q

Which Fryette Principle:

When side-bending is attempted from neutral (anatomical) position, rotation of vertebral bodies follows to the opposite direction

A

Fryette’s 1st Principle

92
Q

NSxRy

A

Fryette’s 1st Principle

93
Q

When side-bending is introduced into a neutral spine, the bodies of the vertebra will rotate towards the side of ______.

A

Convexity

94
Q

Which Fryette Principle usually has non-traumatic etiology?

A

Fryette’s 1st Principle

95
Q

Which spinal regions does Fryette’s 1st Principle apply to?

A

Thoracic and Lumbar

96
Q

In Neutral mechanics, side-bending ______ rotation.

In Type I Fryette mechanics, side-bending _____ rotation.

A

Proceeds

Precedes

97
Q

When side-bending is introduced into a non-neutral spine, the body of the vertebra will rotate towhead the side of ______

A

Concavity

98
Q

NN (F/E) RxSx

A

Fryette’s 2nd Principle

99
Q

Which Fryette Principle involves groups of vertebrae?

A

Fryette’s 1st Principle

100
Q

Which Fryette Principle involves a single vertebra?

A

Fryette’s 2nd Principle

101
Q

Which Fryette Principle usually has traumatic etiology?

A

Fryette’s 2nd Principle

102
Q

Which spinal regions does Fryette’s 2nd Principle apply to?

A

Thoracic and Lumbar

103
Q

What is Fryette’s 3rd Principle?

A

Initiating motion of a vertebral segment/joint in any plane of motion will modify the segment/joint in other planes of motion

104
Q

What regions does Fryette’s 3rd Principle apply to?

A

Cervical
Thoracic
Lumbar
All other joints

105
Q

Which joint side-bends to one side and rotates to the opposite side, whether there is a sagittal component or not

A

OA joint

106
Q

Which joint accounts for 50% of the total cervical spine rotation?

A

AA joint

107
Q

Which joint accounts for 50% of the total cervical spine flexion/extension?

A

OA joint

108
Q

Which Fryette type is the OA joint like?

A

Type 1

109
Q

Which cervical vertebrae rotate and side-bend to the same side regardless if there is a sagittal component or not?

A

C2-C7

110
Q

C2-C7 are like which Fryette Principle?

A

Type 2

111
Q

What are the steps of tripositional diagnosis?

A

1- Determine which TP is posterior

2- Have patient flex/extend to see if the posterior TP moves more anteriorly (evens out)

112
Q

If a posteriorly rotated process moves anteriorly with flexion it is ______

A

F RxSx

113
Q

If a posteriorly rotated process moves anteriorly with extension it is ______

A

E RxSx

114
Q

If rotational component does not change with either flexion or extension, it is _______

A

N SxRy

115
Q

If a segment translates to the right, ______ side-bending is induced

A

LEFT

116
Q

If a segment translates to the left, _____ side-bending is induced

A

RIGHT

117
Q

Which OMT classification is when the dysfunctional body part is moved away from the restrictive barrier until tissue tension is equal in one or all planes and directions?

A

Indirect OMT

118
Q

Which OMT classification is when the restrictive barrier is engaged and a final activating force is applied to correct somatic dysfunction?

A

Direct OMT

119
Q

Which OMT classification is based on techniques which the patient refrains from voluntary muscle contraction?

A

Passive method

120
Q

Which OMT classification is a technique in which the person voluntarily performs a motion?

A

Active method

121
Q

Which OMT classification is HVLA (quick, short corrective thrust)?

A

Direct

Passive

122
Q

Which OMT classification is ME (patient straightens out body against resistance)?

A

Direct

Active

123
Q

Which OMT classification is counterstrain?

A

Indirect

Passive

124
Q

Which OMT classification is BLT (Balanced Ligamentous Technique)?

A

Indirect

Passive

125
Q

Which OMT classification is FPR (Facilitated Positional Release)?

A

Indirect

Passive

126
Q

What is the Direct Treatment setup?

A
  • Reverse the somatic dysfunction
  • Take it the way it doesn’t want to go
  • Engage the barrier
127
Q

What is the Indirect Treatment setup?

A
  • Exaggerate the somatic dysfunction
  • Take it the way it likes to go
  • Disengage the barrier
128
Q

What happens to the restrictive barrier in Indirect Technique?

A

Restrictive barrier is disengaged

129
Q

What forces does Indirect Technique use?

A

A compressive, tractional, or torsional component

130
Q

What forces does Direct Technique use?

A

External forces

131
Q

What happens to the restrictive barrier in Direct Technique?

A

Restrictive barrier is engaged

132
Q

Which technique is:

  • Soft tissue
  • Articulatory
  • Muscle energy
  • HVLA
  • Springing
  • Myofascial release
  • Cranial
  • Still Technique
A

DIRECT

133
Q

What is a longitudinal or parallel traction technique in which the origin and insertion of the myofascial structures being treated are longitudinally separated?

A

Soft Tissue Stretching

134
Q

What is a perpendicular traction technique in which a rhythmic, lateral stretching of a myofascial structure, where the origin and insertion are held stationary and the central portion of the structure is stretched like a bowstring?

A

Soft Tissue Kneading

135
Q

What is a deep inhibitory pressure, which is a sustained deep pressure over a hypertonic myofasical structure?

A

Soft Tissue Inhibition

136
Q

What is a gentle stroking of congested tissue used to encourage lymphatic flow?

A

Soft Tissue Effleurage

137
Q

What involves pinching or tweaking one layer and lifting it or twisting it away from deeper areas?

A

Soft Tissue Petrissage

138
Q

What is striking the belly of a muscle with the hypothenar edge of the open hand in rapid succession in order to increase its tone and arterial perfusion? (A hammering, chopping percussion of tissues to break adhesions and/or encourage bronchial secretions)

A

Soft Tissue Tapotement

139
Q

What is somatic afferent counterstrain?

A

Muscle spindle - muscle length

Rate of change of length

In parallel

140
Q

What is somatic afferent muscle energy?

A

Golgi tendon - muscle tension

Rate of change of muscle tension

In series

Nociceptors

141
Q

What is the goal of postisometric relaxation (ME)?

A

muscle relaxation

142
Q

What is the physiologic basis for postisometric relaxation?

A

The neuromuscular apparatus is refractory immediately after an isometric contraction.

143
Q

Which ME technique has the procedure:

1- Dysfunctional structure positioned at feathers edge of direct barrier
2- Physician continuously monitors dysfunction
3- Patient instructed to push AWAY from the barrier
4- Physician resists patients efforts for 3-5 seconds
5- Patient instructed to relax
6- Physician repositions patient to feathers edge of new barrier
7- Repeat 3-5 times
8- Passively reposition to neutral after last effort
9- Recheck area of dysfunction for change

A

Postisometric Relaxation

144
Q

What is the goal of Reciprocal Inhibition (ME)?

A

Relax and lengthen muscles in acute spasm

145
Q

What is the physiologic bases for Reciprocal Inhibition?

A

Initiate a very gentle contraction in the agonist muscle group, a reflexive relaxation occurs in the antagonist muscle group, this allows further motion toward the direct barrier.

146
Q

Which ME technique has the procedure:

1- Dysfunctional structure positioned at feathers edge of direct barrier
2- Physician continuously monitors dysfunction
3- Patient instructed to push TOWARD the barrier
4- Physician resists patients efforts for 3-5 seconds
5- Patient instructed to relax
6- Physician repositions patient to feathers edge of new barrier
7- Repeat 3-5 times
8- Passively reposition to neutral after last effort
9- Recheck area of dysfunction for change

A

Reciprocal inhibition

147
Q

Which technique is:

  • Counterstrain
  • FPR (Facilitated Positional Release)
  • BLT (Balanced Ligamentous Tension)
  • Functional technique
  • Myofascial Release
  • Cranial
  • Still Technique
A

INDIRECT

148
Q

What are the steps of Counterstrain Treatment?

A

1- Assess pain level
2- Monitor tension by maintaining finger contact at all times
3- Find position of comfort, Retest by pressing with contact finger
4- Hold it for 90 seconds, Monitor tension and response
5- Return patient to neutral position SLOWLY
6- Recheck pain level (should be a 3 or less)

149
Q

What is the only time you press firmly while doing counterstrain?

A

When finding the point and repositioning the point

150
Q

What are the steps of FPR?

A

1- Body part in Neutral position
2- Compression applied to shorten muscle/muscle fibers
3- Place area into EASE of motion for 3-5 seconds
4- Return body part to neutral

151
Q

What are the steps of the Still technique?

A

1- Tissue/joint is placed in EASE of motion position (augments the somatic dysfunction)
2- Compression (or traction) vector force is added
3- Tissue/joint moved through restriction (into and through the restrictive barrier) while maintaining compression and force vector

152
Q

What does it mean when a tissue or joint is moved through restriction?

A

moved into and through the restrictive barrier

153
Q

What is the optimal weight bearing line in the sagittal plane?

A
  • External auditory meatus
  • Lateral humeral head
  • L3 body
  • Anterior 1/3 sacrum
  • S2 (center of mass)
  • Greater trochanter
  • Lateral femoral condyle
  • Anterior to lateral malleolus

“EAM is a Left Hander that Left play in the 31/3 so Sporting scored 2 Goals against FC Manchester”

154
Q

Where is the center of mass?

A

S2

155
Q

Who discovered the common compensatory pattern?

A

Dr. Gordon Zink, DO

156
Q

What is the common compensatory pattern?

A

A regional compensation pattern exhibited through the fascia

157
Q

What did Dr. Zink postulate?

A

A compensatory posture that deviated from ideal would consist of an alternating directional pattern in the transition areas of the body.

158
Q

What is the common compensatory pattern directions?

A
  • OA: 80% rotated Left, 20% reverse entire pattern
  • CT: RIGHT
  • TL: LEFT
  • LS: RIGHT
159
Q

What is uncompensated?

A

When the pattern is NOT alternating

160
Q

What are the 4 junctional/transition zones which are commonly susceptible to somatic dysfunction?

A
  • OA (occipitalcervical)
  • CT (C7-T1)
  • TL (T12-L2)
  • LS (L5-S1)
161
Q

What part of the curves are evaluated for greater or less than expected curvature and somatic dysfunction?

A

Apex

162
Q

Which gait has an unsteady, uncoordinated walk, and a wide base of support (often due to cerebellar disease)?

A

Ataxic gait

163
Q

Which gait has short, accelerating steps that are used to move forward (often seen in people with Parkinson’s disease)?

A

Fenestrating gait

164
Q

Which gait has a walk in which legs are held close together and move in a stiff manner (scissor gait in cerebral palsy)?

A

Spastic gait

165
Q

Which gait is painful where a limp is adopted to avoid pain on the weight bearing structures (hip, knee, ankle)?

A

Antalgic gait

166
Q

Which gait is an abnormality where the phase of gait is abnormally shortened relative to the swing phase?

A

Antalgic gait

167
Q

Which gait is caused by weakness of the abductor muscles of the lower limb (gluteus medius and gluteus minimus)?

A

Trendelenburg gait

168
Q

Which gait involves flexion of the hip because of inability to clear the toes from the floor at the ankle and circumduction at the hip?

A

Hemiplegic gait

169
Q

What is loss of ankle dorsiflexion (common with L5 neuropathy)?

A

Steppage gait (foot drop gait)

170
Q

Which gait is when the advancing foot is lifted higher than usual so that it can clear the ground (because it cannot be dorsiflexed)?

A

Steppage gait (foot drop gait)

171
Q

How is scoliosis named?

A

Named according to the CONVEXITY of each curve

named for the side of ROTATION - not the side bending

172
Q

What kind of scoliotic curve is it when you have a patient try to side-bend towards the side of the rib hump and it reduces the rib hump?

A

FUNCTIONAL

173
Q

What is pes planus?

A

Reduced (fallen) medial arches shift center of mass forward

174
Q

What is pes planovalgus?

A

Flat foot with valves ankle-medial angulation (rolled-in) with heel rolled out

Shifts center of mass forward

OPP (1 decks)

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