Exam #1 Flashcards
1
Q
What does “Feather’s Edge” represent?
A
The perceived quality of motion near the restrictive bordar
2
Q
What is the indication for HVLA?
A
A distinct, solid border (need a firm end feel)
3
Q
What is the most commonly used form of contraction in muscle energy?
A
Isometric contraction
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
5
Q
A reversible dextroscoliosis or levoscoliosis means there is NO __________ _________ present.
A
NO Sagittal Component (no flexion or extension)
6
Q
What Fryette Type mechanics does reversible dextroscoliosis or levoscoliosis follow?
A
Type I
7
Q
Which scoliosis would have the convex side pointing to the right?
A
Dextroscoliosis
8
Q
Which scoliosis indicates neutral side-bending LEFT, rotating RIGHT?
A
Dextroscoliosis
9
Q
A left lateral convexity means the vertebrae are side-bent _____.
A
RIGHT
10
Q
A right lateral convexity means the vertebrae are side-bent _____.
A
LEFT
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
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
13
Q
Translation to the right is _______ side-bending.
A
LEFT
14
Q
Translation to the left is _______ side-bending.
A
RIGHT
15
Q
If a dysfunction keeps returning after being treated, you could be missing a _______ or it could be ______.
A
- lesion
- visceral
16
Q
What year was AT Still born?
A
1828
17
Q
What year was Osteopathy founded (“Flung the banner of Osteopathy”)?
A
1874
18
Q
What year was the first DO school charted (The American School of Osteopathy in Kirksville, Missouri)?
A
1892
19
Q
What year did AT Still die?
A
1917
20
Q
What did AT Still’s 3 children die of?
A
Meningitis
21
Q
Where on the body is the best for sensing temperature?
A
Dorsum of hand
22
Q
Where on the body has the most kinesthetic nerve endings?
A
Pad of thumb, index finger, middle fingers
23
Q
What is one of the first things you do in a physical exam after obtaining a history?
A
Observation
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
25
What is the 2nd Principle of Osteopathic Medicine?
The body is capable of self-regulation, self-healing, and health maintenance
26
What is the 3rd Principle of Osteopathic Medicine?
Structure and function are reciprocally interrelated
27
What is the 4th Principle of Osteopathic Medicine?
Rational treatment is based upon an understanding of the basic principles of body unity, self-regulation, and inter-relationship of structure and function.
28
What are the 5 Osteopathic Models?
- Biomechanical
- Neurological
- Respiratory/Circulation
- Metabolic/Nutritional
- Behavioral (Psychobehavioral)
29
Which Osteopathic Model uses OMT directed toward normalizing mechanical somatic dysfunction, structural integrity, physiological function, and homeostasis?
Biomechanical
30
How are the superior facets oriented in the cervical region?
Backward
Upward
Medial
BUM
31
How are the superior facets oriented in the thoracic region?
Backward
Upward
Lateral
BUL
32
How are the superior facets oriented in the lumbar region?
Backward
Medial
BM
33
How are the inferior facets oriented in the cervical region?
Anterior
Inferior
Lateral
AIL
34
How are the inferior facets oriented in the thoracic region?
Anterior
Inferior
Medial
AIM
35
How are the inferior facets oriented in the lumbar region?
Anterior
Lateral
AL
36
Which barrier is the limit of active motion?
physiologic barrier
37
Which barrier is the limit of passive motion; the limit of motion imposed by anatomical structure?
anatomical barrier
38
Which barrier is the range in which passive ligamentous stretching occurs before tissue disruption?
elastic barrier
39
Which barrier is a functional limit that abnormally diminishes the normal physiologic range?
restrictive barrier
40
What are the barriers of normal joint motion?
Anatomic barrier
Physiologic barrier
Elastic barrier
41
What are the barriers of abnormal joint motion?
Restrictive barrier
| Pathologic barrier
42
In an abnormal joint, motion stops before the joint reaches what barrier?
Physiologic barrier
43
Which barrier is a restriction of joint motion associated with pathologic changes of tissues?
Pathologic barrier
44
Which barrier is a permanent change?
Pathologic barrier
45
Which reflex is a rib somatic dysfunction from an innominate dysfunction?
Somatosomatic reflex
46
Which reflex is gallbladder disease affecting musculature?
Viscerosomatic reflex
47
Which reflex is a myocardial infarction and vomiting?
Viscerovisceral reflex
48
Which reflex is triggering an asthma attach when working on the thoracic spine?
Somatovisceral reflex
49
What do post ganglionic sympathetic fibers lead to?
Tissue texture changes
| ex: hypertonicity, moisture, erythema
50
Which horn of the spinal cord is where somatic and visceral afferent nerves synapse?
Dorsal horn
| Viscerosomatic Reflex
51
Functional Landmarks:
Spine of scapula
T3
52
Functional Landmarks:
Inferior angle of scapula
SP T7
| TP T8
53
Functional Landmarks:
Suprasternal Notch
T2
54
Functional Landmarks:
Angle of Louis (Sternal Angle)
T4
| Rib 2
55
Functional Landmarks:
Xiphoid Process
T9
56
Functional Landmarks:
Umbilicus
L3/L4 area
57
Functional Landmarks:
Iliac Crest
L4/L5 area
58
Sympathetic Levels:
Heart
T1-T5
59
Sympathetic Levels:
Lungs
T1-T6 (T2-T7)
60
Sympathetic Levels:
Stomach
T5-T9
61
Sympathetic Levels:
Gallbladder
T5-T9
62
Sympathetic Levels:
Bladder
T12-L2
63
Sympathetic Levels:
Prostate
T12-L2
64
Parasympathetic Levels:
Hear
OA
C1
C2
(Vagus)
65
Parasympathetic Levels:
Lungs
OA
C1
C2
(Vagus)
66
Parasympathetic Levels:
Stomach
OA
C1
C2
(Vagus)
67
Parasympathetic Levels:
Gallbladder
OA
C1
C2
(Vagus)
68
Parasympathetic Levels:
Bladder
S2-S4
69
Parasympathetic Levels:
Prostate
S2-S4
70
Vertebral bodies are usually rotated _______ the side of dysfunction.
TOWARDS
71
Left lower lobe pneumonia, vertebra rotated________
LEFT
72
Gastritis, vertebra rotated ________
LEFT
73
Cholecystitis, vertebra rotated ______
RIGHT
74
Somatic dysfunction tends to return rapidly after successful treatment with OMT because the ____________ reflex is still present.
Viscerosomatic
75
Vertebrae will rotate towards the ________ side
Dysfunctional
76
Viscerosomatic reflex example:
Stomach
T5-T9 on the LEFT (ulcers, gastritis)
77
Viscerosomatic relex sample:
Gallbladder
T5-T9 on the RIGHT (gallstones)
78
"________ reflexes produce unmeasured changes on the internal organs"
Somatovisceral
79
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
ACUTE
80
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
CHRONIC
81
Movement in a transverse plane about a vertical axis
Rotation
82
Posterior movement in a sagittal plane about a transverse axis
Extension
83
Movement in a coronal plane about an anterior-posterior axis
Side-bending
84
Anterior movement in a sagittal plane about a transverse axis
Flexing
85
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
Somatic dysfunction
86
TART
T - Tissue Texture Changes
A - Asymmetry
R - Restriction of motion
T - Tenderness
87
How is somatic dysfunction named?
Named for the way it likes to go
88
Are fractures, sprains, degenerative processes, and inflammatory processes somatic dysfunction?
NO
89
Which Fryette Principle:
When side-bending is attempted from non-neutral (flexed or extended) position, rotation must precede side-bending to the same side
Fryette's 2nd Principle
90
Which Fryette Principle:
Motion introduced in one plane limits and modifies in the other planes
Fryette's 3rd Principle
91
Which Fryette Principle:
When side-bending is attempted from neutral (anatomical) position, rotation of vertebral bodies follows to the opposite direction
Fryette's 1st Principle
92
NSxRy
Fryette's 1st Principle
93
When side-bending is introduced into a neutral spine, the bodies of the vertebra will rotate towards the side of ______.
Convexity
94
Which Fryette Principle usually has non-traumatic etiology?
Fryette's 1st Principle
95
Which spinal regions does Fryette's 1st Principle apply to?
Thoracic and Lumbar
96
In Neutral mechanics, side-bending ______ rotation.
In Type I Fryette mechanics, side-bending _____ rotation.
Proceeds
Precedes
97
When side-bending is introduced into a non-neutral spine, the body of the vertebra will rotate towhead the side of ______
Concavity
98
NN (F/E) RxSx
Fryette's 2nd Principle
99
Which Fryette Principle involves groups of vertebrae?
Fryette's 1st Principle
100
Which Fryette Principle involves a single vertebra?
Fryette's 2nd Principle
101
Which Fryette Principle usually has traumatic etiology?
Fryette's 2nd Principle
102
Which spinal regions does Fryette's 2nd Principle apply to?
Thoracic and Lumbar
103
What is Fryette's 3rd Principle?
Initiating motion of a vertebral segment/joint in any plane of motion will modify the segment/joint in other planes of motion
104
What regions does Fryette's 3rd Principle apply to?
Cervical
Thoracic
Lumbar
All other joints
105
Which joint side-bends to one side and rotates to the opposite side, whether there is a sagittal component or not
OA joint
106
Which joint accounts for 50% of the total cervical spine rotation?
AA joint
107
Which joint accounts for 50% of the total cervical spine flexion/extension?
OA joint
108
Which Fryette type is the OA joint like?
Type 1
109
Which cervical vertebrae rotate and side-bend to the same side regardless if there is a sagittal component or not?
C2-C7
110
C2-C7 are like which Fryette Principle?
Type 2
111
What are the steps of tripositional diagnosis?
1- Determine which TP is posterior
| 2- Have patient flex/extend to see if the posterior TP moves more anteriorly (evens out)
112
If a posteriorly rotated process moves anteriorly with flexion it is ______
F RxSx
113
If a posteriorly rotated process moves anteriorly with extension it is ______
E RxSx
114
If rotational component does not change with either flexion or extension, it is _______
N SxRy
115
If a segment translates to the right, ______ side-bending is induced
LEFT
116
If a segment translates to the left, _____ side-bending is induced
RIGHT
117
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?
Indirect OMT
118
Which OMT classification is when the restrictive barrier is engaged and a final activating force is applied to correct somatic dysfunction?
Direct OMT
119
Which OMT classification is based on techniques which the patient refrains from voluntary muscle contraction?
Passive method
120
Which OMT classification is a technique in which the person voluntarily performs a motion?
Active method
121
Which OMT classification is HVLA (quick, short corrective thrust)?
Direct
| Passive
122
Which OMT classification is ME (patient straightens out body against resistance)?
Direct
| Active
123
Which OMT classification is counterstrain?
Indirect
| Passive
124
Which OMT classification is BLT (Balanced Ligamentous Technique)?
Indirect
| Passive
125
Which OMT classification is FPR (Facilitated Positional Release)?
Indirect
| Passive
126
What is the Direct Treatment setup?
- Reverse the somatic dysfunction
- Take it the way it doesn't want to go
- Engage the barrier
127
What is the Indirect Treatment setup?
- Exaggerate the somatic dysfunction
- Take it the way it likes to go
- Disengage the barrier
128
What happens to the restrictive barrier in Indirect Technique?
Restrictive barrier is disengaged
129
What forces does Indirect Technique use?
A compressive, tractional, or torsional component
130
What forces does Direct Technique use?
External forces
131
What happens to the restrictive barrier in Direct Technique?
Restrictive barrier is engaged
132
Which technique is:
- Soft tissue
- Articulatory
- Muscle energy
- HVLA
- Springing
- Myofascial release
- Cranial
- Still Technique
DIRECT
133
What is a longitudinal or parallel traction technique in which the origin and insertion of the myofascial structures being treated are longitudinally separated?
Soft Tissue Stretching
134
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?
Soft Tissue Kneading
135
What is a deep inhibitory pressure, which is a sustained deep pressure over a hypertonic myofasical structure?
Soft Tissue Inhibition
136
What is a gentle stroking of congested tissue used to encourage lymphatic flow?
Soft Tissue Effleurage
137
What involves pinching or tweaking one layer and lifting it or twisting it away from deeper areas?
Soft Tissue Petrissage
138
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)
Soft Tissue Tapotement
139
What is somatic afferent counterstrain?
Muscle spindle - muscle length
Rate of change of length
In parallel
140
What is somatic afferent muscle energy?
Golgi tendon - muscle tension
Rate of change of muscle tension
In series
Nociceptors
141
What is the goal of postisometric relaxation (ME)?
muscle relaxation
142
What is the physiologic basis for postisometric relaxation?
The neuromuscular apparatus is refractory immediately after an isometric contraction.
143
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
Postisometric Relaxation
144
What is the goal of Reciprocal Inhibition (ME)?
Relax and lengthen muscles in acute spasm
145
What is the physiologic bases for Reciprocal Inhibition?
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
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
Reciprocal inhibition
147
Which technique is:
- Counterstrain
- FPR (Facilitated Positional Release)
- BLT (Balanced Ligamentous Tension)
- Functional technique
- Myofascial Release
- Cranial
- Still Technique
INDIRECT
148
What are the steps of Counterstrain Treatment?
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
What is the only time you press firmly while doing counterstrain?
When finding the point and repositioning the point
150
What are the steps of FPR?
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
What are the steps of the Still technique?
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
What does it mean when a tissue or joint is moved through restriction?
moved into and through the restrictive barrier
153
What is the optimal weight bearing line in the sagittal plane?
- 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
Where is the center of mass?
S2
155
Who discovered the common compensatory pattern?
Dr. Gordon Zink, DO
156
What is the common compensatory pattern?
A regional compensation pattern exhibited through the fascia
157
What did Dr. Zink postulate?
A compensatory posture that deviated from ideal would consist of an alternating directional pattern in the transition areas of the body.
158
What is the common compensatory pattern directions?
- OA: 80% rotated Left, 20% reverse entire pattern
- CT: RIGHT
- TL: LEFT
- LS: RIGHT
159
What is uncompensated?
When the pattern is NOT alternating
160
What are the 4 junctional/transition zones which are commonly susceptible to somatic dysfunction?
- OA (occipitalcervical)
- CT (C7-T1)
- TL (T12-L2)
- LS (L5-S1)
161
What part of the curves are evaluated for greater or less than expected curvature and somatic dysfunction?
Apex
162
Which gait has an unsteady, uncoordinated walk, and a wide base of support (often due to cerebellar disease)?
Ataxic gait
163
Which gait has short, accelerating steps that are used to move forward (often seen in people with Parkinson's disease)?
Fenestrating gait
164
Which gait has a walk in which legs are held close together and move in a stiff manner (scissor gait in cerebral palsy)?
Spastic gait
165
Which gait is painful where a limp is adopted to avoid pain on the weight bearing structures (hip, knee, ankle)?
Antalgic gait
166
Which gait is an abnormality where the phase of gait is abnormally shortened relative to the swing phase?
Antalgic gait
167
Which gait is caused by weakness of the abductor muscles of the lower limb (gluteus medius and gluteus minimus)?
Trendelenburg gait
168
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?
Hemiplegic gait
169
What is loss of ankle dorsiflexion (common with L5 neuropathy)?
Steppage gait (foot drop gait)
170
Which gait is when the advancing foot is lifted higher than usual so that it can clear the ground (because it cannot be dorsiflexed)?
Steppage gait (foot drop gait)
171
How is scoliosis named?
Named according to the CONVEXITY of each curve
| named for the side of ROTATION - not the side bending
172
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?
FUNCTIONAL
173
What is pes planus?
Reduced (fallen) medial arches shift center of mass forward
174
What is pes planovalgus?
Flat foot with valves ankle-medial angulation (rolled-in) with heel rolled out
Shifts center of mass forward
