Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

OPP > Exam 3 > Flashcards

Exam 3 Flashcards

1
Q

For ANY disease state, the patient must be ____ before performing OMT

A

STABLE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

The sicker/weaker/more injured a patient is, use ___________ (examples include rib raising, myofascial release(MFR) soft tissue, etc.)

A

gentler techniques

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Somatic dysfunction can occur anywhere in the body at

A

Sympathetics levels
Paraysmpathetic levels
Soma (not autonomic related)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Viscerosomatic reflexes occur at

A

Sympathetics levels

Parasympathetics levels

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Facilitated segments ONLY occur at

A

Sympathetics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Know your sympathetic levels, parasympathetic levels. If sympathetic is not in your answer choices, see if a parasympathetic level to that organ is present (lot of people tend to forget about the parasympathetics). For example, upper (proximal) ureters sympathetically are T10-T11, and the parasympathetic innervation is vagus ________ can affect the upper (proximal) ureters.

A

(so OA, AA (C1), C2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Viscerosomatic reflexes can be both sympathetic and parasympathetic, but if a questions asks where you would see paravertebral hypertonicity, keep in mind where the paraspinal muscles are. For example the sacrum does not have paraspinal muscles at S2-S4, but ____ would.

A

T12-L2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Thoracic Pump with respiratory assist is CONTRAINDICATED in a patient with ___________

A

Asthmatic Flare Up or COPD exacerbation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Thoracoabdominal diaphragm: Must evaluate neurological influence versus biomechanical influence

A

Neurologically: Phrenic Nerve (C3, C4, C5)
Biomechanically: Where the thoracoabdominal diaphragm attaches: lower ribs, thoraco-lumbar junction, T10-L3 are examples.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

If a patient has been sick recently and has had swollen glands/nodes in the neck and you suspect Mono, you worry about the person developing _______. If they are injured in a trauma, such as a sport, they may get a referral pain to the shoulder and if the spleen ruptures they can go into shock: low blood pressure/increased heart rate. They may lose consciousness. THIS IS A SURGICAL EMERGENCY!

A

splenomegaly

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Young males should not get recurrent urinary tract infections: must do _____

A

imaging studies of the uro-genital anatomy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Gallbreath technique

A

Great for treating otitis media, fluid in the ear, Eustachian tube somatic dysfunction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Internal rotation of the temporal bone partially or completely closes the Eustachian tube and may result in the _________

A

perception of a high-pitched ringing in the ear.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

External rotation of the temporal bone may open the Eustachian tube and result in the ____________

A

perception of a low-pitched roar

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

A parallelogram-shaped head in an infant is associated with a __________

A

lateral strain cranial pattern

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

B.I.T.E

A

Bottom Rib is key rib in Inhalation dysfunction

Top Rib is key rib in Exhalation dysfunction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Remember, sometimes muscle hypertonicity, contraction, spasm can be caused by direct irritation of the what is overlying the muscle:

A

For example, if there is a renal lithiasis, it may cause the psoas to become hypertonic and you would have a positive Thomas test
For example, if there is appendicitis, it may cause the psoas to become hypertonic and you would have a positive Thomas test
For example, if there are inflamed lymph nodes, this may make the muscle they are touching to become hypertonic such as sternocleidomastoid causing torticollis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

If someone has a nocturnal cough at night, a couple things to think about is it may be due to asthma (pulmonary issue) or reflux (GI issue) for example. Where you find somatic dysfunction may be a clue to which one it is and what medication may be helpful.

A

For example, if it is found at T2 you would think more pulmonary issue and maybe albuterol might be answer choice
For example, if it is found at T8 you would think this is more GI and maybe omeprazole might be answer choice
For example if it is found at T5 that could be either pulmonary or GI and you would need more information to get correct answer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Treating a facilitated segment would help avoid excessive neurologic impulse through the ______

A

viscerosomatic reflex arc

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Later stages of chronic facilitation is associated with _____

A

loss of inhibitory neurons

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

RVU:

A

Relative Value Unit

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Lumbar spine will side-bend towards the ____ and rotate towards the ____ (Type I like mechanics)

A

long leg side

short leg side

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Most commonly used form of contraction in muscle energy is

A

isometric contraction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Take a history prior to

A

physical exam

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

__________ the patient move is the first part of the physical examination

A

Observation/observing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

________ used in muscle energy tenses the Golgi Tendon organs causing a reflex inhibition of the muscle allowing an increase in muscle length

A

Isometric contraction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

A heel lift for a leg length difference may help prevent ______ in a patient

A

osteoarthritis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Feather’s Edge refers to the

A

RESTRICTIVE BARRIER

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Acute:

A 
Recent history (injury)
Sharp or severe localized pain
Warm, moist, sweaty skin
Boggy, edematous tissue
Erythematous
Local increase in muscle tone, contraction, spasm, increased muscle spindle firing
Normal or sluggish ROM
May be minimal or no somatovisceral effects
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Chronic

A 
Long-standing
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
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Orientation of superior facets:
Cervical
Thoracic
Lumbar

A

BUM
BUL
BM

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Orientation of inferior facets:
Cervical
Thoracic
Lumbar

A

AIL
AIM
AL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

In axial spine, the reference point is the _____ aspect of the vertebra

A

superior/anterior

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Rotation: Movement in a _______ plane about a _____ axis

A

transverse

vertical

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Sidebending: Movement in a _____ plane about a _____ axis

A

coronal

anterior-posterior

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Flexion: Anterior movement in a ____ plane about a ____ axis

A

sagittal

transverse

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Extension: Posterior movement in a _____ plane and a _____ axis

A

sagittal

transverse

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Fryette Law 1

A

When side-bending is attempted from neutral (anatomical) position, rotation of vertebral bodies follows to the opposite direction.
Typically applies to a group of vertebrae (more than two)
Occurs in a neutral spine (no extreme flexion or extension) NO SAGITTAL COMPONENT
Side-bending and rotation occur to opposite sides
Side-bending precedes rotation
Side-bending occurs towards the concavity of the curve
Rotation occurs towards the convexity of the curve
Diagnosed as a Type I dysfunction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Fryette Law 2

A

When side-bending is attempted from non-neutral (hyperflexed or hyperextended) position, rotation must precede side-bending to the same side.
Typically applies to a single vertebra
Occurs in a non-neutral spine (flexion or extension of spine present) SAGITTAL COMPONENT
Side-bending and rotation occur to same sides
Rotation precedes side-bending
Rotation of the vertebra occurs into the concavity of the curve
Diagnosed as a Type II dysfunction
May be described as traumatic injury

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

_______ side-bends to one side and rotates to opposite , whether there is a sagittal component or not (Type I like)

A

OA joint

OA Joint Accounts for 50% of Total C-Spine FLEXION/EXTENSION

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

______ primarily rotational

A

AA joint

AA Joint Accounts for 50% of Total C-Spine ROTATION

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

_____ rotate and side-bend to same side , whether there is a sagittal component or not (Type II like)

A

C2-C7

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

Rule of 3’s:
_______: spinous processes project posteriorly therefore the tip of the spinous process is in the same plane as the transverse process of that vertebra

A

T1-T3 and T12

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

Rule of 3’s:
_______: spinous processes project slightly downward, therefore the tip of the spinous process lies in a plane halfway between that vertebra’s transverse processes and the transverse processes of the vertebra below it

A

T4-T6 and T11

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

Rule of 3’s:
_______: spinous processes project moderately downward, therefore the tip of the spinous process is in a plane with the transverse process below it

A

T7-T9 and T10

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q 
Counterstrain
Facilitated Positional Release (FPR)
Balanced Ligamentous Tension Technique (BLT)
Functional Technique
*Myofascial Release
*Cranial 
**Still Technique
A

Indirect techniques

  • Can be direct
  • *Indirect to direct
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q 
*Myofascial Release 
Soft tissue 
Articulatory
Muscle Energy
High velocity, low amplitude (HVLA)
Springing
*Cranial 
**Still Technique
A

Direct techniques

  • Can be indirect
  • *Indirect to direct
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

_____ Muscle Energy

Patient is Instructed to GENTLY Push AWAY From the Barrier

A

Post-isometric

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

_____ Muscle Energy

Patient is Instructed to GENTLY Push TOWARD the Barrier

A

Reciprocal inhibition

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q 
Sympathetic Levels:
Kidneys 
Adrenal Medulla 
Upper Ureters 
Lower ureters
Bladder
Gonads 
Uterus/Cervix
Erectile tissue
Prostate
Arms
Legs
A 
T10-T11
T10 
T10-T11
T12-L1
T12-L2
T10-T11
T10-L2
T11-L2
T12-L2
T2-T8 
T11-L2
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

Parasympathetic

kidneys and proximal ureter

A

Vagus nerve (OA, AA, C2)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

Parasympathetic

Distal ureter, bladder, reproductive organs and external genitalia

A

S2-S4

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

Parasympathetic

Ovaries and testes

A

Variations:

Vagus and S2-S4

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

Peripheral Sympathetic Supply:
UE Vasculature ____
LE Vasculature ____

A

T2-T8
T11-L2
***No parasympathetic supply to LE/UE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

Sympathetic Innervation

Lesser Splanchnic Nerve (T10-11) - synapses at _____

A

Superior Mesenteric Ganglion

Kidney, upper ureter, gonads

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

Sympathetic Innervation

Least Splanchnic Nerve (T12) and Lumbar Splanchnic Nerve (L1-2) - synapses at _____

A

Inferior Mesenteric Ganglia

Prostate, lower ureter, bladder

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

(Thoracic inlet/outlet has to be cleared/opened/treated _____ ANY other lymphatic treatment)

A

BEFORE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

Thoracic inlet/outlet components:

A

Supraclavicular space

1st rib

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

Treatment examples for lymphatics include:

A

Anterior cervical fascia release
Thoracic inlet myofascial release
Pectoral Traction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

Chapman Reflex Point - Adrenal Gland
Anterior:
Posterior:

A

Anterior: 1” lateral and 2” superior to umbilicus ipsilaterally
Posterior: intertransverse spaces of T11 and T12 ipsilaterally midway between spinous and transverse processes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

Chapman Reflex Point - Kidneys
Anterior:
Posterior:

A

Anterior: 1” Lateral and 1” Superior to Umbilicus Ipsilaterally
Posterior: Intertransverse Spaces Midway Between Spines and Transverse Tips of T12-L1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

Chapman Reflex Point - Urinary Bladder
Anterior:
Posterior:

A

Anterior: Umbilical Area (Periumbilical)
Posterior: Intertransverse Spaces Midway Between Spines and Transverse Tips of L1-L2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

Chapman Reflex Point - Urethra
Anterior:
Posterior:

A

Anterior: Along superior margin of the pubic ramus about 2 cm lateral to the symphysis
Posterior: L3 transverse processes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q

Sympathetics
Heart: T1-6 with synapses in upper thoracic and cervical chain ganglia.

When considering arrhythmia:
Right and left-sided distributions
Right- sinoatrial (SA) node and right deep cardiac plexus– predisposes to _________
Left-atrioventricular (AV) node and left deep cardiac plexus- predisposes to _________
Asymmetries in sympathetic tone may play a role in the generation of serious arrhythmias.

A

supraventricular tachyarrhythmias. Sinus tach, A-fib, A-flutter, PACs

ectopic PVCs and V fib and V tach

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
65
Q

Parasympathetic - Heart
Right vagus-via SA node and hyperactivity predisposes to ______
Left vagus- via AV node where hyperactivity predisposes to ____

Vagus nerves have fibers course to them from the C-1 & C-2 nerve roots.

A

sinus bradyarrhythmias.

AV blocks.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
66
Q 
Parasympathetic Innervation to the Heart
Cranial Nerve X (Vagus)
Jugular foramen, Occipitomastoid (OM) suture, OA, AA, C2
Right and Left sided distribution
Right side= \_\_\_\_
Left side= \_\_\_\_
A

SA node
AV node
(PS: minimal and isolated peripheral arteriolar innervation)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
67
Q

Sinus Bradyarrhythmia:

A

OA, AA (C1), C2 will rotate towards the right (Right side is SA node)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
68
Q

1st, 2nd, 3rd degree AV Blocks:

A

OA, AA (C1), C2 will rotate towards the left (Left side is AV node)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
69
Q

Sinus Tachyarrhythmia, Atrial Fibrillation, Atrial Flutter, Premature Atrial Contractions (PAC):

A

Upper thoracic spine (T1-T5) will rotate towards the right (Right side is SA node)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
70
Q

V-fib, V-Tach, Premature Ventricular Contractions (PVC):

A

Upper thoracic spine (T1-T5) will rotate towards the left (Left side is AV node)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
71
Q

Vagus nerve originates in the brainstem and exits through the _______ The jugular foramen is formed from the ________ suture, which is made up from the temporal bone and the occiput. So dysfunction affecting the vagus nerve could come from ______ suture compression.

A

jugular foramen.
occipitomastoid
occipitomastoid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
72
Q

AV flutter

A

Thoracic vertebrae should be rotated to the right

73
Q 
Dry mouth (Xerostomia)
Can be caused by Cranial Nerve VII - (lacrimal glands, sublingual and submandibular glands).  Remember CN VII is associated with the \_\_\_\_\_\_ ganglion and exits through the \_\_\_\_\_\_\_

Can be caused by Cranial Nerve IX - (parotid gland). Remember CN IX is associated with the ____ ganglion and exits through the_____ foramen

A

Sphenopalatine (Pterygopalatine); stylomastoid foramen

Otic; jugular

74
Q

Anterior Tender Point: AT1
Location:
Treatment Position:

A

Midline or just lateral to the jugular (suprasternal) notch

Flexion

75
Q

Anterior Tender Point: AT2
Location:
Treatment Position:

A

Midline or just lateral to the junction of manubrium and sternum (angle of Louis)
Flexion

76
Q

Anterior Tender Point: AT3-AT5
Location:
Treatment Position:

A

Midline (or with some degree of sidedness) at level of corresponding rib
Flexion

77
Q

Anterior Tender Point: AT6
Location:
Treatment Position:

A

Midline (or with some degree of sidedness) xiphoid–sternal junction
Flexion

78
Q

Anterior Cervical CS Point: AC7
Location:
Treatment Position:

A

On the clavicular (lateral) attachment of the SCM

F STRA

79
Q

Sternocleidomastoid muscle (SCM) refers

A

pain lateral and behind the eye

80
Q

Splenius Capitus muscle refers

A

pain to the vertex of the head

81
Q

TMJ: Post Isometric ME
If patient can’t open mouth:
If patient can’t close mouth:
If patient’s jaw deviates to the left when the patient opens their mouth:
If patient’s jaw deviates to the right when the patient opens their mouth:

A
  • physician opens patient’s mouth to restrictive barrier and patient tries to close mouth against resistance
  • physician closes patient’s mouth to restrictive barrier and patient tries to open mouth against resistance
  • physician pushes the patient’s jaw to the right and the patient tries to push their jaw to the left against resistance
  • physician pushes the patient’s jaw to the left and the patient tries to push their jaw to the right against resistance
82
Q

TMJ Masseter CS
Tender Point Location:

The physician gently glides the patient’s slightly opened jaw/mandible laterally _____ side of the tender point

A

Masseter: Just inferior to the zygoma in the belly of the masseter muscle typically found on the side of mandibular deviation

toward

83
Q

TMJ Medial Pterygoid CS
Tender Point Location:

The physician gently glides the patient’s slightly opened jaw/mandible _____ side of the tender point

A

Jaw angle point or medial pterygoid: On the posterior surface of the ascending ramus of the mandible about 2 cm. above the angle of the mandible on the side opposite of mandibular deviation

laterally away

84
Q 
CN I 
CN V
CN VII
CN VIII
CN X
CN XI
CN XII
A

Anosmia
Cribiform plate through ethmoid bone

Trigeminal Neuralgia/Tic Douloureux
May complain of sudden, severe facial, ear, and/or jaw pain

Exits stylomastoid foramen
Bell’s Palsy

Labyrinthitis, Tinnitus, Vertigo Temporal bone is associated with tinnitus, labyrnthitis, vertigo

Exits jugular foramen (formed by occipitomastoid suture)
Can cause Nausea/Vomiting

Exits jugular foramen (formed by occipitomastoid suture)
Can cause Torticollis

Hypoglossal canal
Can cause nursing/latching problems in infants

85
Q 
Complaints associated with CN impingement: 
Difficulty nursing/latching 
Colic 
GERD 
Vomiting 
Torticollis 
Asthma
Otitis Media
A 
XII 
X
X
X
XI
X
VIII
86
Q

Pump handle motion
Primarily:
Palpation:

A

Primarily ribs 1-5

Palpation of Pump Handle Ribs: best at Mid-clavicular Line

87
Q

Bucket handle motion
Primarily:
Palpation:

A

Primarily ribs 6-10

Palpation of Bucket Handle Ribs: best at Mid-axillary Line

88
Q

Caliper motion:

Primarily:

A

Primarily ribs 11,12

89
Q

Somatic dysfunction usually characterized by a rib being held in a position of inhalation
Motion toward _____ is more free
Motion toward _____ is restricted
Pain with ____

Synonyms

A

Inhalation
Exhalation
Exhalation

Exhalation rib restriction
Inhalation strain
Elevated rib
Inhaled rib

90
Q

Somatic dysfunction usually characterized by a rib being held in a position of exhalation
Motion toward _____ is more free
Motion toward _____ is restricted
Pain with ____

Synonyms

A

Exhalation
Inhalation
Inhalation

Inhalation rib restriction
Exhalation strain
Depressed rib
Exhaled rib

91
Q

Exhaled ribs are prominent ____
Inhaled ribs are prominent ____

Anterior Rib Counterstrain Points are associated with ____
Posterior Rib Counterstrain Points are associated with

A

Posteriorly
Anteriorly
exhalation rib somatic dysfunction
inhalation rib somatic dysfunction

92
Q

Samples how to diagnose ribs:
If pain increases when patient inhales:
If pain increases when patient exhales:

If left ribs 2-5 lag on exhalation as compared to the right side, then left ribs 2-5 are dysfunctional and represent inhalation somatic dysfunction. The key rib would be rib 5 and the muscle that may have caused this is ______. Rib 5 is holding up rib 2, 3,4 and won’t let them exhale. Rib 5 is the ____ rib causing the dysfunction.

If left ribs 2-5 lags on inhalation as compared to the right side, then left ribs 2-5 are dysfunctional and represent exhalation somatic dysfunction. The key rib would be rib 2. Rib 2 is holding down rib 3, 4, 5 and won’t let them inhale. Rib 2 is the ___ rib causing the exhalation rib somatic dysfunction.

A

indicates exhalation rib somatic dysfunction
indicates inhalation rib somatic dysfunction

pectoralis minor.
BOTTOM
Other findings = There may be posterior rib counterstrain points associated with inhalation rib somatic dysfunction
Ribs would be prominent anteriorly with inhalation rib somatic dysfunction

TOP
Other findings = There may be anterior rib counterstrain points associated with exhalation rib somatic dysfunction
Ribs would be prominent posteriorly with exhalation rib somatic dysfunction

93
Q

If right ribs have an increased 6th intercostal space (ICS), then at this point either

If right ribs have a decreased 6th intercostal space (ICS), then at this point either

A

rib 6 is inhaled or rib 7 is exhaled.

rib 6 is exhaled or rib 7 is inhaled.

94
Q

Indications of Anterior Rib Tender Points:

Ribs 1-2: Pain in ____
Ribs 3-6: Pain in ____

A

Anterior chest wall

Lateral chest wall

95
Q

Anterior Rib Tender Point Locations:
AR1
AR2
AR3-10

A

Below clavicle on 1st chondrosternal articulation associated with pectoralis major and internal intercostal muscles

Superior aspect of 2nd rib in midclavicular line

On the dysfunctional rib at the anterior axillary line associated with the serratus anterior (AR3-8) and internal intercostal muscles (AR9-10)

96
Q

Treatment of AR 1-2 Tender Points:

Position =

A

F STRT
The physician passively flexes patient’s head and neck to engage the dysfunctional rib level

The patient’s head and neck are side-bent and rotated toward the tender point

97
Q

Treatment of AR 3-10 Tender Points:

Position =

A

F STRT
The physician stands behind the patient with the foot opposite the tender point

Inducing rotation toward and translation away (side-bending toward) the tender point.

98
Q

Indications of Posterior Rib Tender Points:

Rib 1: Pain in ___
Ribs 2-6: Pain in ____

A

Cervicothoracic junction

Upper to mid-thoracic and/or periscapular region

99
Q

Posterior Rib Tender Point Locations:
PR1:
PR2-6:
PR7-10:

A

On the posterior superior angle of the first rib just lateral to the costotransverse articulation

On superior aspect of angle of dysfunctional rib associated with the levatores costarum and/or serratus posterior superior muscles

On superior aspect of angle of dysfunctional rib associated with the levatores costarum

100
Q

Treatment of PR 1 Tender Point:

Position =

A

ESART
The physician’s foot is placed on the table on the opposite side as the tender point.

With the other hand, the physician gently extends and side-bends the head and neck away from the tender point, then, carefully monitoring the movement so it is vectored to engage the first rib.
The physician rotates the head toward the tender point.

101
Q

Treatment of PR 2-10 Tender Points:

Position =

A

FSARA
The physician stands behind patient with the foot ipsilateral to the tender point

The patient is asked to slowly extend the shoulder and arm opposite the tender point and allow the arm to hang down. This induces side bending away (translation towards) and rotation away from the tender point.

102
Q

Inhalation Dysfunction ME
Pump handle ribs -
Bucket handle ribs -

A

Flex the patient’s head and neck

Flex the patient’s head and neck and side-bend the patient toward dysfunctional rib

Physician places a hand, thumb, or fingers on the anterior, superior surface of the rib

103
Q 
Exhalation Dysfunction ME
Ribs 1-10: 
Rib 1: 
Rib 2: 
Ribs 3-5: 
Ribs 6-8: 
Ribs 9-10:
A

Physician contacts the key rib posteriorly at the rib angle.

R1: while lifting their head anteriorly
R2: rotates head away 30 degrees, while lifting their head anteriorly
R3-5: pushes their elbow to their contralateral ASIS
R6-8: pushes their elbow toward the ceiling OR pushes their elbow to their ipsilateral ASIS,
R9-10: ADduct their arm

104
Q 
Muscles used in ME to treat rib exhalation somatic dysfunction: 
RIb 1
Rib 2
Rib 3-5
Rib 6-8
Ribs 9-11
Rib 12
A 
Rib 1: Anterior and mid scalene 
Rib 2: Posterior Scalene
Ribs 3 – 5: Pectoralis Minor
Ribs 6 – 8: Serratus anterior 
Ribs 9 – 11: Latissimus Dorsi 
Rib 12: Quadratus Lumborum

NOTE: If these muscles become hypertonic, they can cause an inhalation somatic dysfunction!!!!
For example if you have a 4th inhalation rib somatic dysfunction, then pectoralis minor would be the hypertonic muscle
For example if a patient has a hypertonic pectoralis minor muscle on the right, what is the likely rib(s) that may be inhaled? 3-5
For example if rib 10 is an inhalation somatic dysfunction, latissimus dorsi would be the involved muscle

105
Q

Rib HVLA 2-10 (Inhalation or Exhalation)
Place thenar eminence (fulcrum) on posterior aspect of ____ instead of transverse process

For exhalation rib HVLA, your thenar eminence on the rib angle will ______
For inhalation rib HVLA , your thenar eminence on the rib angle will ______

A

rib angle

pull downward (inferior/caudad) on rib angle
push upward (superior/cephalad) on rib angle
106
Q

Short Leg Syndrome
Anatomical or functional
Signs and symptoms:

Heel life can be used to help prevent arthritis in person with short leg syndrome

A

Sacral base unleveling
Anterior innominate on side of short leg
Posterior innominate on side of long leg
L-spine will side-bend away from and rotate towards short leg
Lumbosacral (LS) angle will increase
Stress on iliolumbar ligaments then SI ligaments

107
Q

Heel Lift Guidelines:
Final lift height should be _______
Start with 1/8” heel lift, then _______
Frail patients should start with 1/16” heel lift, then ______

A

½ – ¾ of the measured discrepancy. If acute discrepancy (i.e. hip fracture), lift full amount

increase by 1/8” every two weeks

increase by 1/16” every two weeks.

108
Q

Heel Lift Guidelines:

  1. The heel lift should be applied to the side of the short leg
  2. The final lift height should be ½ - ¾ of the measured leg length discrepancy, unless there was a recent sudden cause of the discrepancy (hip fracture, prosthesis) then lift the full amount
  3. The “fragile” patient (elderly, arthritic, osteoporotic, acute pain) should begin with a 1/16” (1.5 mm) heel lift and increase 1/16” every two weeks
  4. The “flexible” should begin with 1/8” (3.2mm) heel lift and increase 1/8” every two weeks
  5. A maximum of ¼” may be applied to the inside of the shoe (if >1/4” is needed, then this must be applied to the outside of the shoe
  6. Maximum heel lift possible = ½”. If more is needed, an ipsilateral anterior sole lift extending from heel to toe should be used in order to keep the pelvis from rotating to the opposite side

For example, if a patient has an 8 mm leg length discrepancy chronically (Long Term), your goal is to lift to _____

A

4 mm

109
Q

Standing Flexion Test:
Patient standing with feet flat on floor and shoulder width apart
Physician monitors the inferior aspect of patient’s PSIS
Patient forward bends maximally
Positive: side PSIS moves ______

Purpose: identifies side of sacroiliac somatic dysfunctions
“Gold Standard” Test for iliosacral SD

A

more cephalad at the end range of motion

110
Q

ASIS Compression Test:
Apply a posterior-medial pressure on one ASIS while stabilizing the other.
Imagine aiming the pressure toward the SI joint.
Repeat the test on the other side.
The restricted side is _____

A

the positive side.

111
Q

Seated Flexion Test:
Patient seated on stool with feet flat on floor and shoulder width apart
Physician monitors the inferior aspect of patient’s PSIS
Patient forward bends maximally
Positive: side PSIS moves ________
Purpose: identifies side of sacroiliac somatic dysfunctions
“Gold Standard” Test for _______

A

more cephalad at the end range of motion

sacroiliac SD

112
Q

innominate Rotation - Anterior

\+ standing flexion (on side of the dysfunction)
ASIS Compression test + (on side of dysfunction)
\_\_\_\_ ASIS (on side of the dysfunction)
\_\_\_\_ PSIS (on side of the dysfunction)
\_\_\_\_ ischial tuberosity (on side of the dysfunction)
\_\_\_\_ sacral sulcus (on side of the dysfunction)
\_\_\_\_ iliac crest height
\_\_\_\_ medial malleolus (long leg) (on side of the dysfunction)
A 
Inferior
Superior 
Superior
Shallow 
Equal
Inferior
113
Q 
Innominate Rotation - Posterior 
\+ standing flexion (on side of the dysfunction)
ASIS Compression test + (on side of dysfunction)
\_\_\_\_ ASIS (on side of the dysfunction)
\_\_\_\_ PSIS (on side of the dysfunction)
\_\_\_\_ ischial tuberosity (on side of the dysfunction)
\_\_\_\_ sacral sulcus (on side of the dysfunction)
\_\_\_\_ iliac crest height
\_\_\_\_ medial malleolus (long leg) (on side of the dysfunction)
A 
Superior 
Inferior 
Inferior 
Deep 
Equal 
Superior
114
Q 
Innominate Outflare (Abducted)
\+ standing flexion (on side of the dysfunction)
ASIS Compression test + (on side of dysfunction)
ASIS \_\_\_\_ (on side of the dysfunction)
PSIS \_\_\_\_ (on side of the dysfunction)
Distance from ASIS to umbilicus \_\_\_\_\_ on dysfunctional side (is more lateral)
ASIS \_\_\_\_ from midline
\_\_\_\_\_ sacral sulcus (on side of the dysfunction)
A 
Lateral
Medial 
Increased 
Further
Narrow
115
Q 
Innominate Inflare (Adducted) 
\+ standing flexion (on side of the dysfunction)
ASIS Compression test + (on side of dysfunction)
ASIS \_\_\_\_ (on side of the dysfunction)
PSIS \_\_\_\_ (on side of the dysfunction)
Distance from ASIS to umbilicus \_\_\_\_\_ on dysfunctional side (is more lateral)
ASIS \_\_\_\_ to midline
\_\_\_\_\_ sacral sulcus (on side of the dysfunction)
A 
Medial 
Lateral 
Decreased 
Closer 
Wide
116
Q 
Superior Innominate Shear (Upslipped) 
\+ standing flexion (on side of the dysfunction)
ASIS Compression test + (on side of dysfunction)
\_\_\_\_\_ ASIS (on side of the dysfunction)
\_\_\_\_\_ PSIS (on side of the dysfunction)
\_\_\_\_\_ iliac crest height (on side of the dysfunction)
\_\_\_\_\_ pubic tubercle (on side of the dysfunction)
\_\_\_\_\_ ischial tuberosity (on side of the dysfunction)
\_\_\_\_\_ medial malleolus (on side of the dysfunction)
Sacrotuberous ligament \_\_\_ (on side of the dysfunction)
A

Superior

Lax

117
Q 
Inferior Innominate Shear (Downslipped) 
\+ standing flexion (on side of the dysfunction)
ASIS Compression test + (on side of dysfunction)
\_\_\_\_\_ ASIS (on side of the dysfunction)
\_\_\_\_\_ PSIS (on side of the dysfunction)
\_\_\_\_\_ iliac crest height (on side of the dysfunction)
\_\_\_\_\_ pubic tubercle (on side of the dysfunction)
\_\_\_\_\_ ischial tuberosity (on side of the dysfunction)
\_\_\_\_\_ medial malleolus (on side of the dysfunction)
Sacrotuberous ligament \_\_\_ (on side of the dysfunction)
A

Inferior

Tight

118
Q

Superior Pubic Shear
+ standing flexion (on side of the dysfunction)
ASIS Compression test + (on side of dysfunction)
_____ pubic tubercle/ramus (on side of the dysfunction)
Ipsilateral inguinal ligament tense and tender
ASIS may be even or may be ______ (on side of the dysfunction)
PSIS may be even or may be ______ (on side of the dysfunction)

Findings may look similar to a _________

A

Superior
Superior
Inferior

Posteriorly rotated innominate

119
Q

Inferior Pubic Shear
+ standing flexion (on side of the dysfunction)
ASIS Compression test + (on side of dysfunction)
_____ pubic tubercle/ramus (on side of the dysfunction)
Ipsilateral inguinal ligament tense and tender
ASIS may be even or may be ______ (on side of the dysfunction)
PSIS may be even or may be ______ (on side of the dysfunction)

Findings may look similar to a _________

A

Inferior
Inferior
Superior

Anteriorly rotated innominate

120
Q

Anterior Innominate Rotation ME:

A

Patient supine
They are extending their hip
Patient using hamstrings

121
Q

Posterior Innominate Rotation ME:

A

Patient can be supine or prone
They are flexing their hip
Patient using quads

122
Q

Innominate In-Flare ME

A

Flex and abduct patients hip and knee and place in a figure 4 or frog leg position

123
Q

Innominate Out-Flare ME

A

Flex the patient’s hip and knee, adduct the knee across the midline, engaging the restrictive barrier

124
Q

Superior Pubic Shear ME

A

Abduct the knee to gap the pubic symphysis

*Treated like a posterior innominate rotation with the addition of abduction

125
Q

Inferior Pubic Shear ME

A

Abduct the thigh to gap the pubic symphysis

*Treated like an anterior innominate rotation with the addition of abduction

126
Q

Innominate Up Slip ME

A

Internally rotate and slightly flex the hip and abduct to about 20 degrees.
Apply traction

127
Q 
Sacral Anatomical Axis 
Transverse Axis:
Superior - 
Middle - 
Inferior -
A

the cranial primary respiratory mechanism creates motion around this axis

sacral base anterior and posterior (FB/BB) occur around this axis
sacrum flexes and extends around this axis (sagittal plane)

the innominates rotate around this axis relative to the sacrum

128
Q

Sacral Somatic Dysfunction:

Physiologic - dysfunction that occurs around a physiologic axis:

A

Transverse

Oblique - neutral and non-neutral

129
Q

Sacral Somatic Dysfunction:

Non-physiologic - dysfunction that does not occur around an axis. Usually caused by trauma:

A

Unilateral sacral shear - unilateral sacral flexion/extension

130
Q

The side of the posterior ILA is also ____

The side of the anterior ILA is also ____

A

inferior

Superior

131
Q

Sacral Torsion Rules:
L5 Side-bends Towards _____
L5 Rotates Opposite _____

LOL
LOR
ROR
ROL

A

oblique axis
sacral rotation

L5 SLRR
L5 RRSR
L5 SRRL
L5 RLSL

132
Q

Seated Flexion Tested +R:

A

LOL
ROL
RUF
RUE

133
Q

Seated Flexion Tested +L:

A

ROR
LOR
LUF
LUE

134
Q

Negative Seated Flexion Test

A

No SD
B/L sacral extension
B/L sacral flexion

135
Q

Spring Test +:

A

(Non-neutral) - ROL, LOR
UE
B/L sacral extension

136
Q

Spring Test -:

A

(Neutral): ROR, LOL
UF
B/L sacral flexion

137
Q

Sphinx Test (Backward Bend Test) +

A

(Non-neutral): ROL, LOR

UE

138
Q

Sphinx Test (Backward Bend Test) -

A

(Neutral): ROR, LOL
UF
B/L sacral flexion
B/L sacral extension

139
Q 
B/L Sacral Flexion: 
\_\_\_\_ Seated Flexion Test
\_\_\_\_ Lumbosacral Spring Test (Spring Test)
\_\_\_\_ Sphinx Test (Backward Bending Test)
\_\_\_\_ Sacral Sulci
\_\_\_\_ Sacral Base
\_\_\_\_ ILA bilaterally
\_\_\_\_ Sacrotuberous ligaments b/l
A 
Negative 
Negative 
Negative 
Deep 
Anterior 
Posterior 
Tight
140
Q 
B/L Sacral Extension: 
\_\_\_\_ Seated Flexion Test
\_\_\_\_ Lumbosacral Spring Test (Spring Test)
\_\_\_\_ Sphinx Test (Backward Bending Test)
\_\_\_\_ Sacral Sulci
\_\_\_\_ Sacral Base
\_\_\_\_ ILA bilaterally
\_\_\_\_ Sacrotuberous ligaments b/l
A 
Negative 
Positive
Negative 
Shallow
Deep 
Anterior 
Loose
141
Q

Forward Sacral Torsion (Neutral) - LOL ROR
_____ Seated Flexion Test (opposite side of axis)
_____ Lumbosacral Spring Test (Spring Test)
_____ Sphinx Test (Backward Bending Test)
L5 Neutral Mechanics
Anterior Base (Deep Sulcus) is on opposite side of Posterior/Inferior ILA
Sacrotuberous ligament ____ on side of _____ ILA

A

Positive
Negative
Negative
Tight; posterior/inferior

142
Q

Backward Sacral Torsion (Non-Neutral) - LOR, ROL
_____ Seated Flexion Test (opposite side of axis)
_____ Lumbosacral Spring Test (Spring Test)
_____ Sphinx Test (Backward Bending Test)
L5 Neutral Mechanics
Anterior Base (Deep Sulcus) is on opposite side of Posterior/Inferior ILA
Sacrotuberous ligament ____ on side of _____ ILA

A

Positive
Positive
Positive
Loose; anterior/superior

143
Q

Unilateral Sacral Flexion (Sacral Shear)
____ Seated Flexion Test (side of dysfunction)
____ Lumbosacral Spring Test (Spring Test)
____ Sphinx Test (Backward Bending Test)
Anterior Base (Deep Sulcus) is on same side of Posterior/Inferior ILA or another way of saying this is Posterior Base (Shallow Sulcus is on the same side of Anterior/Superior ILA

A

Positive
Negative
Negative

144
Q

Unilateral Sacral Extension (Sacral Shear)
____ Seated Flexion Test (side of dysfunction)
____ Lumbosacral Spring Test (Spring Test)
____ Sphinx Test (Backward Bending Test)
Anterior Base (Deep Sulcus) is on same side of Posterior/Inferior ILA or another way of saying this is Posterior Base (Shallow Sulcus is on the same side of Anterior/Superior ILA

A

Positive
Positive
Positive

145
Q

Forward Sacral Rotation (Neutral) - ROR, LOL

A

Patient is lying face-down (hug the table) with hips flexed greater than 90 degrees

146
Q

Backward Sacral Rotation (Non-Neutral) - LOR, ROL

A

Patient lies on their back and hips are flexed less than 90 degrees

147
Q

Unilateral Sacral Flexion ME

Dx: R USF

A

Place your left hypothenar eminence on patient’s right ILA

Ask patient to inhale and hold breath, while you push anterior and superior on the ILA

148
Q

Unilateral Sacral Extension ME

Dx R USE

A

Place your left hypothenar eminence on the patient’s right sacral sulcus
Ask the patient to exhale and hold breath, while you push anterior and caudad on the superior sulcus

149
Q 
Psoas Syndrome 
Condition that results from \_\_\_\_\_\_\_
Usually the result of being in a position that allows \_\_\_ of the psoas followed by its \_\_\_\_
Examples:
working at a desk or crawlspace
road trips, plane trips
sitting in a soft easy chair or recliner
bending over from the waist for a long period of time
weeding in the garden
trauma (strain)

May be precipitated by overuse, such as doing sit-ups with the lower extremities fully extended
Creates a neuromuscular imbalance that results in psoas muscle hypertonicity. Psoas muscle and lumbar spine are affected.
Patient may complain of pain in the thoracolumbar region and/or the anterior hip, thigh, or groin.

A

hypertonicity/spasm of the psoas muscle

prolonged shortening; sudden lengthening

150
Q

Causes of Psoas Syndrome:

A 
Viscerosomatic reflex (ureteral calculi as an example)
Direct irritation (ie, psoas fascia touches the sigmoid colon and ureters)
Ureteral calculi as an example
151
Q

Psoas Syndrome: Diagnosis
Patient may stand _______
Motion testing of the affected leg will resist _____
Tender points will be found at Psoas Major muscle (may also find at Psoas Minor and Iliacus if involved) and may be found at contralateral Piriformis muscle.
Special test: ____ will be positive on side of hypertonic psoas muscle
Possibly contralateral piriformis tender point TP - May or may not have sciatic type pain down the opposite leg
Central low back pain - May be significant

A

slightly flexed at the waist and side-bent toward the dysfunctional side (hypertonic psoas muscle)

hip extension

Thomas Test

152
Q

The key somatic dysfunction initiating or perpetuating psoas syndrome is believed to be a type II (non-neutral) somatic dysfunction (F Rx Sx) usually occurring in the L1 or L2 vertebral unit, where “x” is the side of side-bending of the somatic dysfunction. If this key somatic dysfunction remains, the patient’s symptoms may progress to full-blown psoas syndrome. Osteopathic structural exam findings indicative of this syndrome include:

A

The key, nonneutral (type II) somatic dysfunction at L1 and/or L2
Sacral somatic dysfunction on an oblique axis, usually to the side of lumbar side-bending
Pelvic shift to the opposite side of the greatest psoas spasm
Hypertonicity of the piriformis muscle contralateral to the side of greatest psoas spasm
Sciatic nerve irritation on the side of the piriformis spasm
Gluteal muscular and posterior thigh pain that does not go past the knee, on the side of the piriformis muscle spasm

153
Q 
Psoas Syndrome: 
Non-neutral L1 and/or L2. 
Side bent and rotated to the side \_\_\_\_ 
Spasm of the piriformis muscle on the \_\_\_\_
Oblique axis sacral dysfunction 
Pelvic shift to the \_\_\_\_\_\_
Sciatic irritation on \_\_\_\_\_\_
A

of the psoas spasm
opposite side of the psoas
opposite side
opposite side

154
Q 
Special Tests 
Hip Drop Test - \_\_\_\_\_
Trendelenburg Test - \_\_\_\_\_\_ 							
FABERE/Patrick Test - \_\_\_\_\_\_
Ober Test - \_\_\_\_\_\_\_
Straight Leg Raising (SLR) Test - \_\_\_\_\_\_\_\_\_                                          
Contralateral Straight Leg Raising - \_\_\_\_\_\_\_
Bragard Test - \_\_\_\_\_\_\_\_
Thomas Test - \_\_\_\_\_\_\_
Babinski Reflex - \_\_\_\_\_\_\_\_\_\_							   
Hoover Test - \_\_\_\_\_\_\_\_
A
  • Thoracolumbar/Lumbar Side-Bending Abnormality
  • Gluteus Medius Weakness
  • SI joint or hip pathology
  • Tensor fascia latae tightness
  • Herniated Lumbar Disc (L1-L5, S1)
  • Herniated Lumbar Disc (L1-L5, S1)
  • Herniated Lumbar Disc (L1-L5, S1)
  • Hip Flexion Contracture (Psoas Muscle Hypertonicity)
  • Upper Motor Neuron Pathology
  • Malingerer
155
Q

Hip Drop Test: Positive
Iliac crest does not drop 20-25 degrees on the non-weight bearing side and there is a poor lumbar spinal curve towards _____ side. A positive test indicates that the lumbar and/or thoracolumbar spine has _____ of the body (ie, the side opposite the positive test)

A

the weight bearing

difficulty side-bending toward the weight bearing side

156
Q

Sympathetic Innervation:
Ovaries, Testes: ______
Fallopian tubes, Vagina: ______
Uterus and cervix: ______

A

T10-T11
T11-T12
T10-L2

157
Q

Parasympathetic Innervation:

Uterus, cervix, vagina, clitoris, walls of the urethra: ____

A

S2-S4

158
Q

Pregnant Patient - Sympathetic Innervation

T10-L2 Stimulation

A

vasoconstriction = poor nutrition and O2 exchange
Increased uterine contraction
Decreased threshold for pain from the uterine body

159
Q

Pregnant Patient - Parasympathetic Innervation

S2-S4 Stimulation

A

Vasodilation
Increased relaxation of uterine muscle
Decreased threshold for pain from cervix

160
Q

Direct MFR of Pelvic Diaphragm :

A

With thumbs medial to the tuberosities gently apply cephalad pressure while maintaining contact with tuberosities at all times

Great for lymphatics/addressing hypertonic pelvic floor musculature

161
Q

Absolute contraindication of OMT during pregnancy

A

Abruptio placenta
Ectopic pregnancy
Placenta previa
Undiagnosed vaginal bleeding

162
Q

Osteopathic Considerations:
If a patient has been laboring on their back for an extended period of time or if they have undergone cesarean section or other abdominal surgery, consider what type of somatic dysfunctions you might encounter.

A

*** Note: For example if the sacrum is extended, the base would be posterior and the apex anterior. If you were to do a Muscle Energy treatment on this somatic dysfunction (even though you may never have), you would apply the principles of Muscle Energy by engaging the barrier (which in this case is pushing the base anteriorly). If the patient holds there breath in exhalation this will help move the sacral base anteriorly
ALSO NOTE: If someone has had abdominal surgery recently, don’t put them on their belly (prone)

163
Q

Occipital Condylar Compression
Affecting cranial nerves _______; it can be the cause of poor suckling, swallowing difficulties, colic, emesis/vomiting, hiccups, congenital torticollis.
________ is useful in treating condylar compression

A

The “most important” or most clinically significant somatic dysfunction which should be addressed in all newborns is occipital condylar compression.

IX, X, XI, XII

OA decompression

164
Q

Reproductive System:

Parasympathetics S2-S4

A

Role in erectile dysfunction

165
Q

Sexual Dysfunction:
Impotence: Functional etiology derived from ____

_____ for erection
_____ for ejaculation

A

S2-S4

parasympathetics
sympathetics

166
Q

Osteopathic Considerations - Renal Physiology Autonomics

Decreased ureteral peristalsis =

A

may causes ureteral spasm (uretospasm)

167
Q

Renal Parasympathetics - Vagus Nerve
Affects _____
Superior vagal ganglion sits ______
Inferior vagal ganglion sits ______

A

Kidney and proximal ureters
jugular foramen
around body of C2

168
Q

Renal Parasympathetics - S2-S4
Affects ____
Via _____

A

distal ureters and bladder

pelvic splanchnic nerves

169
Q

Osteopathic Considerations - Renal Physiology Autonomics
Parasympathetic Effects on Renal Physiology
Kidneys:
Ureters:
Bladder:

A

Kidneys ?

Ureters:
Maintain normal peristalsis

Bladder:
Maintains bladder wall tonicity
Excitatory to detrusor muscle
Inhibitory to trigone muscle
Works in concert with pudendal nerve in micturition
Parasympathetic nerves control bladder wall musculature
Voluntary pudendal nerve controls external urethral sphincter
Sympathetic relaxation of the internal urethral sphincter
Must also occur for voiding to take place

170
Q

Remember indications and contraindications for techniques:

A

For example if a patient is too young or is not able to follow commands, you can not do techniques such as muscle energy
If a patient has lax ligaments such as Rheumatoid Arthritis or Trisomy 21, you do not want to do HVLA, or ANY type of articulatory techniques in the upper cervical spine. Remember Still Technique is an articulatory technique.

171
Q

Established Patient: 99211
Average min: ___
CC: ___
Exam: ___

A

5 minutes
Required
None

172
Q

Established Patient: 99212
Average min: ___
CC: ___
Exam: ___

A

10 minutes
Required
PF

173
Q 
Established Patient: 99213
Average min: \_\_\_
CC: \_\_\_
Exam: \_\_\_
MDM: \_\_\_
A

15 minutes
Required
EPF
Low

174
Q 
Established Patient: 99214
Average min: \_\_\_
CC: \_\_\_
Exam: \_\_\_
MDM: \_\_\_
A

25 minutes
Required
Detailed
Moderate

175
Q 
Established Patient: 99215
Average min: \_\_\_
CC: \_\_\_
ROS: \_\_\_
Exam: \_\_\_
MDM: \_\_\_
A 
40 minutes 
Required 
*ROS 10+
Exam comprehension 
High
176
Q 
Defining level of risk:
Minimal \_\_\_\_
Self-limited/Minor \_\_\_\_
Low severity \_\_\_\_
Moderate severity \_\_\_\_
High severity \_\_\_\_
A 
Could see RN 
Not likely 
Low risk
Increased probability 
High risk
177
Q 
98925 OMT to \_\_\_\_ regions
98926 OMT to \_\_\_\_ regions
98927 OMT to \_\_\_\_ regions
98928 OMT to \_\_\_\_ regions
98929 OMT to \_\_\_\_ regions
A 
1-2 
3-4
5-6
7-8
9-10** the max amount of regions you can treat with OMT in a single encounter
178
Q

Goal of ME in innominate SD treatment is to _____

A

restore joint motion

OPP (3 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions