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OMM Year 1 > Exam 2 - Spring > Flashcards

Exam 2 - Spring Flashcards

1
Q

spine is ___ shaped in utero and then what?

A

c-shared… then C and L become lordosis

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2
Q

TP of C1 is located…

A

behind the mastoid process of the skull

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3
Q

what has the largest cervical SP

A

C7 and then C2

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4
Q

fx of c-spine (3)

A
  1. protection
  2. exit for spin-N from cerv and brachial plexus
  3. mobility and support of head in environ
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5
Q

what is the keystone of the body

A

neck

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6
Q

what is major conduit of body?

A

c-spine b/w head and rest of body

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7
Q

superficial cervical fascia

A

b/w dermis and deep layer

N, bv, lymph

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8
Q

deep cerv fascia

A

3 layers: investing, pretracheal, prevert

supports viscera

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9
Q

posterior cerv M

A

nuchal line –> sacrum

  • LBP can cause motion restriction to upper cervical region

sig mod of M at c2

  • lots of oblique M txverse atlas and axis to occiput
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10
Q

cerv M act as…

A

“auto balancing system”

  • keep head lvl during mvmt
  • high concentration of proprio
  • N reflexes to suboccitpal M
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11
Q

anterior cerv M

A

T3 –> occiput: mandible to hyoid, sternum, clavicle

  • “strap M”
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12
Q

SCM

A

sup anterior M

imp for BALANCE

  • high concentration of proprioceptors

fx:

  • SB and R head in opposite direction
  • bilateral flexor of c-spine

congenital torticollis

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13
Q

trapezius

A

superficial posterior M

  • primary connection b/w head, neck, UE

nuchal line –> distal 1/3 of clavical and scapula

  • elevates and retracts scapula
  • extend, laterally flex, contralateral rotate head
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14
Q

levator scapulae

A

upper 4 c-vert –> medial border of scapula

fx: elev scapula
* lifting arm distributes forces to head

referred pain from acute herniated disc at mid c-spine lvl

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15
Q

scalene M

A

lateral stabilizers

  • anterior and middle attached to rib 1
  • posterior attaches to rib 2
  • origin @ tubercles on C-TP

fx:

  • flex c-spine
  • breathing assist
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16
Q

restriction of OA or AA can cause restriction in what N?

A

vagus

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17
Q
A
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18
Q

cerv vasc

A

SC

  • can be impinged by hypertonic scalene muscles or elevated 1st rib

carotid (anterior to c-vert)

  • can listen for bruits

vert

  • comes off SC
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19
Q

Vertebral Artery parth

A

C6 to TP of atlas –> Turns 90 degrees posteriorly –> Turns 90 degrees medially around the posterior edge atlas –> Turns to pass anteriorly and superiorly into the cranium where right and left vertebral a. form the basilar artery of the brain

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20
Q

what combo of mvmts on the c-spine causes the MOST structural challenge on vasc flow to brain?

A

extension, SB, rotation on SAME SIDE

  • dixxiness
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21
Q

VERY impt to not put head into _____ during HVLA

A

extension

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22
Q

bony structure of c-vert

A

7 vert

vert foramina LARGEST at C1 and tapers down to C7 BUT vert become progressively LARGER

allow for sig mobility w/o restricting cord

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23
Q

Orientation of
Zygopophyseal (Facet) Joints

A

45 deg horizonal, face superior and posterior

b/w hori and coronal plane

STEEPER caudally (towards tail)

limits flex and extension

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24
Q

zygophyseal joints get more ________ more inferiorly

A

angle becomes flatter, more horizontal

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25
Q

Articular Pillars

A

lateral masses that lie b/w superior and inferior facets

  • posterior to c TPs
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26
Q

cerv TP characteristics

A

short and stubby

have txvrse foramen for vert A

each TP cradles a c-N which passes POSTEIROR to position of vert A

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27
Q

Joints of Lushka

A

C3-C7: synovial

  • formed by uncinate process and superior adj vert
  • create stab of heavy head and smaller neck
    • babies do not have b/c they do not need to support head wt @ birth

​fx:

  • main stab upright position of head
  • guides flex/ext
  • LIMIT LATERAL FLEXION
  • support disc
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28
Q

Degeneration of joints of Lushka can cause

A

“side slip” –> cerv N root stenoisis and impingement

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29
Q

The relative disc thickness is greatest in the

A

c-spine: 2/5! disk height: c-vert height

More flexion and extension is possible when the disc is thick and the AP diameter is relatively small.

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30
Q

c motion

A
  • Flexion: 80°-90°
  • Extension: 70°
  • Sidebending: 20-45°

Rotation: 70-90

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31
Q

Disc Motion in Flexion and Extension

A

On flexion, disc shifts more posteriorly

On extension, disc shifts more anteriorly

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32
Q

CERVICAL DIVISIONS

A

Upper Cervical Division

  • Occiput, Atlas, Axis
  • As a unit provide >50% of rotation, flexion/extension

Lower Cervical Division

  • C3-C7 vertebral segments
  • SB and rotates in SAME direction
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33
Q

flex/ext mostly controlled by

A

OA

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34
Q

rotation mostly controlled by

A

AA

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35
Q

SB controlled mostly by

A

C3-C7

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36
Q

gross cerv motion is guided by…

A

facet joint orientation

M

ligaments

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37
Q

coupled motions of c-spine

A

OA: SB and R in opp directions

AA: only R

C3-C7: SB and R in same direction

  • due to facet joints
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38
Q

Extension places facets more ____ therefore _____ is easier

A

vert

SB

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39
Q

Flexion moves the facet plane _____ facilitating ______

A

horizontal

rotation

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40
Q

typical c vert:

atypical c vert:

A

c3-c6

c1 (no body), c2, c7

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41
Q

Typical Cervical Vertebrae (6)

A

v-formaen is large and triangular

TP has foramina for vert A and V

BIFID SP

superior facets face superior/posterior

inferior facets face inferior/posterior

rectangular body

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42
Q

C1 (5)

A

no body –> RING-LIKE

no TRUE SP

articulation for dens

NO IV DISC

very palpable TPs

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43
Q

c2 (4)

A

dens (odontoid process) = superior axis of rotation

NO disc above

SP palpable

superior facets are CONVEX

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44
Q

c7

A

prominent SP, SELDOM BIFID!

  • appears like thor vert

NO vert-A

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45
Q

AA jt motion

A

ONLY R via odontoid process

  • txverse ligament allows SLIGHT flex

NO SB (lateral flex)

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46
Q

OA joint

A

“single” joint that is actually 2 sep joints

  • anterior: b/w dens and anterior arch: synovial
  • posterior: b/w dens and strong txverse lig of atlas
  • pivot about which AA joint rotates

convex condyles of occiput –> concase superior facets of atlas

LIMITED motion due to lig attachements

forms R and L “ellipsoid”, congruent synovial joints

superior facets of atla face: BUM - back, up, medial

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47
Q

OA ligaments

A

ALL, PLL

anterior and posterior OA membrance

tectorial membrane:

  • base of skull –> PLL in c-area
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48
Q

OA motion…

what is it limited by?

A

“makes smallest yes motion with head”

flex: lim by skull contact with dens
ext: lim by tectorial membrane

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49
Q

what can destab cerv lig?

A

RA

steriods

down syndrome

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50
Q

OA motiong

A

limited by M and lig

primary = flex/ext

  • flex –> posterior slide of occiput
  • ext –> anterior slide of occiput

SB and R are opposite!

  • due to lateral OA lig
  • rotation is linked to translatory SLIDE
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51
Q

Biomechanically, Occiput acts like

A

sphere

  • major motion = flex/ext
  • minor motion = SB, R
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52
Q

in motion testing (SB test) of C3-C7, translation to the R produces SB to the…

A

L

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53
Q

do fryettes principles apply to c-spine?

A

NO! - No group curves or neutral mechanics!

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54
Q

epidemiology of neck pain

A

9-102

peaks b/w 20-40 y/o due to MVA

peaks b/w 30-49 in gen pop

neck pain high in females than males

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55
Q

what is the most common complain of pts seen by pcp?

A

neck pain

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56
Q

what is the most common cause of neck pain

A

mech neck disorder

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57
Q

neck pain is the ____ most common reason that pts seen manual med tx

A

neck pain

LBP is first

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58
Q

Most neck pain as a result

A

cervical paraspinal spasm or other musculoskeletal factors

  • decr ROM
  • pain WORSE with mvmt, BETTER with rest
  • lack of organic/systemic pathos
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59
Q

non-trauma neck pain can be caused by…

A

soft tissue disorders:

  • poor posture
  • repetitive activity @ work
  • sports

emotion/mental state

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60
Q

what is a stronger association? neck pain due to mental stress or due to repetitive occupational activities?

A

mental stress

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61
Q

when pain stricks, focusing on _____ is key

A

emotion

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62
Q

Risk Factors For Neck Pain

A
  1. depression
  2. incr age
  3. hx LBP, headache
  4. physical work, job demans
  5. lack of control over work (low job statisfaction), social support
  6. obesity
  7. smoking
  8. unusual postures
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63
Q

osteoarth usually appears…

A

after 60

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64
Q

edema where can cause difficulty swallowing and thus neck pain

A

overstretched ALL and retroesophageal tissues

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65
Q

spurlings manuver

A

neck compression with SB

tests for cerv radiculitis:

  • stenosis
  • cer spondylosis
  • osteophytes
  • trophic facet joints
  • herniated disc
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66
Q

distraction test

A

“lifts head up” to decrease/releieve pain of nerve root compression

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67
Q

wallenburg’s test

A

test vert A insufficiency:

supine –> SB (both sides) –> rotate –> wait 30 sec

postive = dizzy, nausea, lighthead

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68
Q

with erect posture, wt of head is….

in forward head position, head is approx ___ with which wt of head is…

A

10 lbs

3in in front of COG = 30 lbs

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69
Q

forward head position of depression

A

rounded back

fwd posture –> INCR cerv lordosis

  • approx posterior articulations
  • narrows IV foramina
70
Q

POSTURAL TRAINING TO REVERSE ANTERIOR POSITION OF THE HEAD AND EXESSIVE Cervical LORDOSIS.

A

distraction exercise with 5-10lbs sandbag on head and maint erect posture

proprioceptive concept of posture is learned with no effert

71
Q

cerv spondylosis

A

long standing disc degen –> narrow disc space –> marginal new bone formation

joints of lushka –> hypertrophy, calcification, OSTEOPHYTOSIS –> DECR IV foramen

72
Q

osteophytosis of joints of lushka encroach on…

A

spinal canal

IV foramen

degen changes of facet joints

—> neuro deficits of cord and nerve root

73
Q

vertebrobasilar ischemia

A

Encroachment of the osteophytes ON Cervical spondylosis) upon the vertebral arteries

can result in dizziness and vertigo

74
Q

whiplash

A

hyperflex –> hyperext injury usually due to MVC

may injure: ALL/PLL, interspinal lig, dura, articular capsule, and/or M

  • IV disc may be patho deformed
  • can laso have no tissue dmg

usu gets c-spined (head restraints)

75
Q

irritation of cerv symp N may…

A

hypertonicity of cer v soft supporting tiss, esp deep nuchal M

  • over-excit of beta receptors in injured neck –> traumatic vertigo
76
Q

restraction phase of whiplash

A

the upper torso is pushed forward by the seat back while the occupant’s head remains nearly stationary

forcing lower neck (C5-C7) into a pronounced extension while the upper part is in flexion.

phase ends when the maximum neck flexion and torso extension

77
Q

whiplash injury occurs during what phase? due to?

A

retraction phase due to abnormal loading of soft-tissue

78
Q

after retraction phase of whiplash, entire head/neck complex moves into…

A

overall ext –> limted by contact with head restrait or reflex contracture of neck M

79
Q

Injury to anterior spinal structures can result

A

•cervical instability in extension, axial rotation, and lateral bending .

80
Q

hypoermobility of neck due to whiplash can result in….

A

early degen of IV disc or vert

segmental hypoermob –> long-term instab

81
Q

symptoms of whipllash

A

headache: greater superior occipital N (C1, C2 lvl)

pain b/w scapuale

paresthesia down arm (often temp) - scalenes (thoracic inlet like)

torticollis (contraction of SCM)

dysphagia: swell/edema in anterior cerv structure

dizzy/vertigo

82
Q

referred pain zones of C1-C7

A
83
Q

Dermatomal distributions of the Occipital Nerves

A

formed by roots of C2-C4

pain –> occipital vertex or parietal areas of head

84
Q

what lig may be injured during the retraction phase of whiplash

A

c5-c6 ALL

85
Q

Anterior structures in the lower cervical spine may be susceptible to injury through

A

•excess distraction during the retraction phase of whiplash.

86
Q

Cervical Spine Facet Referred Pain

A

C1-2 Posterior auricular in distribution of the greater occipital nerve.

C2-3, C3-4 Paraspinal and trapezial areas.

C4-5, C5-6 Trapezial areas.

C5-6, C6-7 Trapezial and periscapular areas.

87
Q

Trigger Point and Referral Pain of SCM, trapezius, leator scapulae

A
88
Q

Injury with Head Facing Forward Versus Effect of Head Rotated

A

more injury with rotation -> shear in lateral rotatory torque motion

89
Q

common Characteristics of Patients with Neck Pain after Automobile Accident

A
  • Female.
  • Age 20- 40 years old.
  • Head restraint height below the head center of gravity.
  • Lightweight car.
90
Q

CERVCAL RADICULAPATHY

A

“diskogenic syndrome”

Intervertebral disk herniation –> nerve root entrapment

  • acute injury
  • facet synovitis
  • preexisting degen changes aggravated by acute injury
  • annular bulge from torque injury
91
Q

Stiffness and an aching pain in cervical region often refers

A

to occipital region

  • hold and brace neck: anulus and PLL and then N impingement
  • ischemia
  • limited ROM
  • imflammed capsules
  • neuro symp (tingly, numbness)
92
Q

C6 root results pain to….

disthere digit paresthesia?

M weak?

A

radial forearm

thumb paresthesia

bicep, bracioradialis, wrist extensors

93
Q

C8 root results pain to….

disthere digit paresthesia?

M weak?

A

ulnar forearm

right and little finger paresthesia

intrinsic hand weak

94
Q

C7 root results pain to….

disthere digit paresthesia?

M weak?

A

dorsal forearm

index and middle finger paresthesia

tricep weak

95
Q

C5 root results pain to….

disthere digit paresthesia?

M weak?

A

arm but stops at elbow

no paresthesia

shoulder weak

96
Q

what kinds of colors of food will have antiox?

A

red, yellow, purple

97
Q

what should be used for sub-acute/chronic neck pain?

A

spinal manipulation b/c it is more effective thant M relaxants

98
Q

Isometric Muscular Contraction Exercises

A

start in a few days (contraindicated to begin early)

active resistive done solely by pt

ice and heat afterwards

99
Q

Contra indicators to Manipulation of the Cervical Spine

A
  • Aneurysm
  • Bone tumor
  • Carotid or vertebrobasilar disease
  • Infection
  • Ligamentous rupture or instability
  • Metastatic carcinoma
  • Osteopenia
  • Anticoagulation therapy
  • Previous surgery involving neck joints
  • Rheumatoid arthritis of the cervical spine
  • Unstable odontoid peg
100
Q

nuchal headache is due to…

A

traps

greater occipital N

101
Q

cerv lymph nodes

A
  • Superficial Occipitial Lymph Node (#10)
  • Jugulo-Digastric Lymph Node (#10)
102
Q

Motor strength testing grade

A
  • 5-Normal strength
  • 4‐Active movement against gravity and some resistance
  • 3‐Active Movement against gravity
  • 2‐Active Movement of body part with gravity eliminated
  • 1‐Barely detectable flicker or trace of contraction
  • 0‐No movement
103
Q

•Deep tendon Reflexes grading

A

0 Absent

1+ or + Diminished

2+ or ++ “Normal”

3+ or +++ Hyperactive without clonus

4+ or ++++ Hyperactive with clonus

104
Q

C5 Motor and Sensory

A
105
Q

C6 Motor and Sensory

A
106
Q

C7 Motor and Sensory

A
107
Q

C8 Motor and Sensory

A
108
Q

T1 Motor and Sensory

A
109
Q

why are we concerned about T1?

A

Cervical Sympathetic ganglion

•Tumor

  • Pancoast tumor
  • Horner’s Syndrome: Miosis, Ptosis, anhydrosis
110
Q

Pancoast Tumor

A

tumor at apex of lung

symp:

  • pain in post shoulder, ax, cerv spin, often down arm
  • horners due to distruption of superior cerv gang
111
Q

Valsalva Test

A

“bear down” to increased intrathecal P

112
Q

swallowing test

A

tests atnerior cerv osteophytes, swelling –> pain

113
Q

adson’s test

A

test thoracic outlet

114
Q

brudzinski’s sign

A

meningeal irritation

115
Q

the shoulder girdle consists of what bones?

A

clavicle

scapula

humerus

116
Q

joints of shoulder girdle

A

GH: ball and socket

SC: saddle

AC: plane biaxial/planer

***SC and AC have reciprocal motion

  • anterior/post
  • elev/depression
  • rotational
117
Q

clavicle acts as…

A

strut for UE: allow max freedom of motion and txmit forces for UC to axial spine

ONLY boney attachment of arm to axial spine

118
Q

pseudojoints of shoulder

A

Suprahumeral joint or Coracoacromial arch limits the abduction of the shoulder.

Scapulothoracic:

  • indirectly attaches scapula to the thoracic wall via muscles
  • helps the GH joint stability by keeping it aligned during movement.
119
Q

joint capsule of shoulder

A

thickening = primary stability to the glenohumeral joint

outer layer = fibrous - support/str

inner = synovial - reduce friction

120
Q

the shoulder has the ____ ROM of any joint

A

greater

most venerability

121
Q

when hyaline cartilage breaks down, it is called…

A

arthritis

122
Q

GH joint

A

ball cmpt 3-4x larger than socket cmpt

glenoid labrum (fibrocartilage) = angled lip of GH joint to compensate for jt shallowness –> incr depth of socket by ~50%

123
Q

shoulder bursa fx to…

A

reduce friction b/w structures

124
Q

M of GH joint and shoulder

A

flex: anterior deltoid
ext: lat dorsi, t. major, posterior deltoid
abd: middle deltoid
add: pac major, lat dorsi

ext-R: infraspinatus, t. minor

int-rot: subscapularis

125
Q

Normal Range of Motion
Shoulder

A

Abduction 180°

  • There is a 2:1 ratio between the glenohumral joint and the scapulothoracic joint.
  • Pure abduction of the glenohumeral is 90°, After 120° external rotation is incorporated into the motion.
  • Adduction 45° — must be done in front of body so some flexion
  • Flexion 180°
  • Extension 45-60°
  • Internal rotation 55°
  • External rotation 40-45°
126
Q

For every ___degrees of abduction at the glenohumeral joint, there is ___ degrees occur at the GH and ____ degree occurs at the scapulothoracic joint

A

3, 2, 1

127
Q

what happens then at 120 degrees?

A

surg neck of humerus is stopped by suprahumeral joint –> then needs to rotate out of way

128
Q

Codman Maneuver

A
  • Standing anatomical position
  • Abduct arm 180°
  • Return arm to side of body in sagittal plane
  • Note the difference in the direction of the palm
129
Q

Apley Scratch Test

A
130
Q

Apprehension Test

A

tests shoulder dislocation

131
Q

Yergason Test

A

tests bicep tendonitis/bursitis or tear of txverse lig

  1. felx elbow to 90
  2. grasp elbow and wrist
  3. ER and pull down on elbow while pt resists
132
Q

Drop Arm Test

A

test rotator cuff tears

133
Q

Cross Arm Test

A

tests AC joint disorder

134
Q

Testing for Bicipital Tendonitis

A

feel in bicepital groove while pt rotates forearm

135
Q

cardiac pain can refer to…

A

neck, shouler, ax, arm

cardiac plexus –> T1-4 –> L shoulder pain (infraclav and ulnar)

136
Q

aortic arch refers pain to

A

right neck

137
Q

gallballder refers pain to

A

tip of R shoulder and posterior scapula

138
Q

duodenal inflammation refers pain to the

A

L shoulder

139
Q

diaphragm refers pain to the

A

neck, shoulder, supraclav, trap, superior angle of scapula

same as shared N roots: C3-5

140
Q

stomach refers pain to

A

b/w scapula @ lvl of T5-9

141
Q

pancoasts tumor refers pain to

A

shoulder –> horder syndrom

142
Q

headache is defined as…

A

pain in head located above/around eyes/ears @ front/back of head or upper neck

143
Q

crucial pain sensitive headache locations

A

suboccipital

upper cerb

scalp

144
Q

greater occipital N refers pain to

A

head

145
Q

is the brain sensitive to pain?

A

almost totally insenstive!

146
Q

sudden onset headaches mean

A

subarachnoid hemorrhage

blood

mass lesion

147
Q

worsening headache indicates

A

mass lesions

subdural hematoma

med overuse

148
Q

headaches with systemic illness means.

A

meningitis/encephalitis

lyme disease

arthritis

149
Q

lyme disease is due to

A

menigoencephalitis

150
Q

Common Causes of Head Pain

A
  1. bv dilation/constriction
  2. M in neck/head
  3. M in eye
  4. sinus swollen
  5. tooth infection
  6. N
  7. joints in jaw/neck with overuse or dmg
151
Q

A 28 year old female medical student complains of frequent headaches. They feel like a band of pain around her head and the pain radiates into the upper neck on both sides. She’s had them since high school, but they seem to be more frequent and painful since she’s been studying for the boards and since she recently broke up with her boyfriend. There is no nausea or vomiting associated with them.

A

tension headache

  • increased myofascial pain sensitivity due to sens of N in supraspinal region & second order N in spinal dorsal horn/trigeminal nuc
  • decreased antinoci/inability of body to stop painful stim
152
Q

types of tension headaches

A

1.Emotional

  • Stress and anxiety
  • Depression
  • Anger/unresolved conflicts

2.Postural

  • Occupational
  • Postural imbalance
  • Abnormal spinal curves
  • Poor posture

3.Muscle hypertonicity or fatigue

  • Maintenance of a frown- frontalis muscle affected
  • Bruxism- temporalis and masseter affected
  • General fatigue- decreased support of head
153
Q

what is the most common location that causes tension headache

A

OA

154
Q

•A 34 year woman presents complaining of frequent episodes of severe head pain. She knows one is coming because she often sees wavy lines or blind spots just before it starts. The pain is throbbing, on one side, and is often so bad that she vomits. She has to lie down in a dark room until it goes away which can be hours or the whole day. Sleeping helps. She thinks that they are associated with her period and maybe some foods or wine.

A

migraine: nociceptors are vasc but pulsations perceived painful when sens occurs

155
Q

pathophys of migraine

A

disorders neuro control of craniocerebral circ: cephalic and intracranial cerebral A

migraine is triggers when inflam response reaches pain-sensitive

vasoconstric –> vasodil of sympath bv @ base of brain and meninges

suscep can be inherited

156
Q

Multi-Mechanistic Action of Migraine

A

inflam involving PG and neuropeptides –> vasodil –> (+) nocic surr brain –> pain sig –> 1st sensation of pain

periph sens from activation of nocic –> incr stim of N in trigeminal N –> central sensitization

157
Q

Migraine
Osteopathic Treatment: during attack

A

–Evaluate SD of head, neck and shoulders (as well as whole body)

–Gentle indirect treatment so not to stimulate vagus

–Counterstrain to cervical especially suboccipital and inion

–Avoid HVLA –Lymphatic drainage

–Sympathetic reflexes at T1-T4 related to bv of the head

158
Q

Migraine
Osteopathic Treatment: b/w attacks

A

–Patient is more tolerant of manipulation

  • Cranial OMT better in between attacks

–Treat SD that are present in the head, cervical and upper thoracic spine (and whole body)

159
Q

•A 26 year old man presents with severe, intermittent headaches that he has had for years. These headaches are characterized by an intense burning pain on one side of his head, accompanied by tearing in his eye and a runny nose. When they strike, the attacks typically occur several times a day and usually last anywhere from 15 minutes to 3 hours. He states he feels better walking around. He can be headache free for months at a time, but the attacks always return lasting for weeks or months with increased frequency in the fall and spring. He has seen several healthcare providers, including headache specialists, with little or no improvement.

A

Cluster Headaches

160
Q

cluster headaches

A

pain around 1 eye

drooping of lid

tearing, congestion

involves CN V

  • neurogenic inflam of vasc plexus of cav sinus/tributaries/autonomic N
  • affects sphenopalatine ganglion (pterygopalatine) and cervical sympathetic ganglion
161
Q

proposed mechanisms of cluster headaches (5)

A
  1. hemodynamic: vaso change 2ndary to primary neuro discharge
  2. CN V: substance P carry impulses to max and ophal div –> sphenopalatine gang
  3. ANS
  4. circadian rhythm: hypoT controls circadiam rhy since they occur at same time every day
  5. serotonin
162
Q

OMT Treatment Considerations
Cluster Headaches

A

T1-4 SNS

upper ribs

severe pain behind eye responds well to tx SD @ C1/2

163
Q

•A 45 year man complains of pain and pressure around his face, forehead, and upper teeth that he’s had for 3 weeks. He’s had a cold that just won’t go away and has congestion, a post-nasal drip, and complains of feeling tired. He says that when he presses on his checks and forehead it feels sore.

A

sinus headache

164
Q

sinuses are formed by…

A

4 bones:

  • frontal: drained by gravity
  • sphenoid
  • ethmoid
  • maxillary
  • ***other cav drained by ciliated cells that move mucus to nasal passages
165
Q

•Goblet cell secretions are thinned by ___ and thickened with _____ stimulation

A

PNS

SNS

166
Q

Osteopathic Manipulative Medicine
Sinusitis

A

tx

  • SNS of upper thorax
  • PNS of OA and upper cerv
  • sphenopalatine gang to decr thick mucus

“milk”, P, lymph drainage to face

CS tender points of neck

ME

suboccipital myofasical to cerv spine

167
Q

Cervical Spine Referral
Greater Occipital Nerve

A
168
Q

trigger pts of SCM and upper trap

A
169
Q

Trigger Points
Suboccipital Muscles

A

side of head and face

170
Q
A

dowager hump

171
Q

cafe au lait indiccate

A

neurofibromatosis

OMM Year 1 (5 decks)

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