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Exam1 Flashcards

1
Q

For ANY disease, the patient must be ______ before performing OMT

A

Stable

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2
Q

New onset of chest pain or shortness of breath is not the time for what?

A

OMT

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3
Q

Somatic dysfunctions can occur where?

A

Anywhere!
Sympathetic levels
Parasympathetic levels
Soma (not autonomic related)

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4
Q

Viscerosomatic reflexes occur at?

A

Sympathetic levels and Parasympathetic levels

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5
Q

Facilitated segments ONLY occur at?

A

Sympathetic levels

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6
Q

What is the treatment for temporal arteritis?

A

Steroids

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7
Q

Sometimes, muscle hypertonicity, contraction, and/or spasm can be caused by?

A

Direct irritation of the muscle from the structure overlying it

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8
Q

If there is a renal lithiasis, it may cause?

A

It may cause the psoas to become hypertonic & you would have a positive Thomas test

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9
Q

If there is appendicitis, it may cause?

A

The psoas to become hypertonic and you would have a positive Thomas test

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10
Q

If there are inflamed lymph nodes, it may cause?

A

The muscle they are touching to become hypertonic, such as the sternocleidomastoid

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11
Q

After obtaining a history, you perform what?

A

A physical exam

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12
Q

What is the first thing you do in a physical exam?

A

Observation

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13
Q

A reversible dextroscoliosis or levoscoliosis means?

A

There is NO Sagittal component present (no flex ion or extension component) so it follows Fryette Type I mechanics

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14
Q

A dextroscoliosis would have the convex side pointing which direction?

A

Right. Therefore indicating a neutral side-bending left, rotating right pattern for the vertebrae

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15
Q

A dextroscoliosis from T4-T6 would have all the vertebrae?

A

Neutral, side bent left, rotated right

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16
Q

Left lateral convexity means?

A

Vertebrae are sidebent right

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17
Q

Right lateral convexity means the vertebrae?

A

Side-bent

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18
Q

When treating a group dysfunction with OMT, treat what group of the curve

A

The apex. Example T10-T12, then go for T11

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19
Q

Type II dysfunction would usually occur at?

A

The apex/middle of the group curve

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20
Q

Translation to the right =

A

Left side bending

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21
Q

Translation to the left =

A

Right sidebending

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22
Q

Principle 1 of osteopathic medicine

A

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

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23
Q

Example of principle 1

A

Gastric ulcer causes thoracic tissue texture changes

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24
Q

Principle 2 of osteopathic medicine

A

The body is capable of self regulation, self healing & health maintenance

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25
Q

Example of principle 2

A

Healed fracture

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26
Q

Principle 3 of Osteopathic medicine

A

Structure & function are reciprocally interrelated

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27
Q

Principle 4 of osteopathic medicine

A

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

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28
Q

Biomechanical model

A

Anatomy of muscles, spine, extremities; posture, motion
OMT directed toward normalizing mechanical somatic dysfunction, structural integrity, physiological function, homeostasis

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29
Q

Neurological model

A

Emphasizes CNS, PNS and ANS that control, coordinate and integrate body functions
Proprioceptive and muscle imbalances, facilitation, nerve compression disorders, autonomic reflex and visceral dysfunctions, brain/CNS dysfunctions

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30
Q

Respiratory/circulatory model

A

Emphasizes pulmonary, circulatory and fluid (lymphatic, CSF) systems
Lymphatic techniques

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31
Q

Metabolic/nutritional model

A

Regulates through metabolic processes

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32
Q

Behavioral (psychobehavioral)

A

Focuses on mental, emotional, social & spiritual dimensions related to health & disease

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33
Q

Post ganglionic sympathetic fibers lead to what?

A

Tissue texture changes, such as hypertonicity, moisture, erythema, etc…

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34
Q

Dorsal horn of the spinal cord is where somatic and visceral AFFERENTS nerves do what?

A

Synapse! Giving a viscerosomatic reflex

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35
Q

Somatosomatic reflex

A

localized somatic stimuli producing patterns of reflex response in segmentally related somatic structures. For example, rib somatic dysfunction from an innominate dysfunction.

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36
Q

Somatovisceral reflex

A

localized somatic stimulation producing patterns of reflex response in segmentally related visceral structures. For example, triggering an asthmatic attack when working on thoracic spine

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37
Q

Viscerosomatic reflex

A

localized visceral stimuli producing patterns of reflex response in segmentally related somatic structures. For example gallbladder disease affecting musculature.
A

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38
Q

Viscerovisceral reflex

A

localized visceral stimuli producing patterns of reflex response in segmentally related visceral structures. For example, myocardial infarction and vomiting.

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39
Q

Old is _____, hot is _____

A

Cold, not

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40
Q

Signs of acute somatic dysfunction when palpating

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
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41
Q

Signs of chronic somatic dysfunction when palpating

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
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42
Q

Orientation of superior facets

A

Cervical: BUM
Thoracic: BUL
Lumbar: BM

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43
Q

Orientation of inferior facets

A

Cervical: AIL
Thoracic: AIM
Lumbar: AL

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44
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

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45
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

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46
Q

If indirect treatment is used, the dysfunction is?

A

Exaggerated/augmented

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47
Q

If direct treatment is used, the dysfunction is?

A

The barrier is engaged/dysfunction reversed

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48
Q

Examples of Direct Techniques

A

Myofascial Release (May also be indirect)
Soft tissue
Articulatory
Muscle Energy
High velocity, low amplitude (HVLA)
Springing
Cranial (may also be indirect)
Still Technique (combined indirect and direct)
Initial positioning of Still Technique set up is indirect
Ending positioning of Still Technique is direct

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49
Q

Stretching

A

Longitudinal or parallel traction technique in which the origin & insertion of the myofascial structures being treated are longitudinally separated

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50
Q

Kneading

A

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

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51
Q

Inhibition

A

A deep inhibitory pressure, which is a sustained deep pressure over a hypertonic myofascial structure

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52
Q

Effleurage

A

Gentle stroking of congested tissue used to encourage lymphatic flow

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53
Q

Petrissage

A

Involves pinching or tweaking one layer and lifting it or twisting it away from deeper areas

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54
Q

Tapotement

A

A striking the belly of a muscle with the hypothecate edge of the open hand in rapid succession in order to increase it’s tone and arterial perfusion. A hammering, chopping percussion of tissues to break adhesions and/or encourage bronchial secretions

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55
Q

Examples of indirect techniques

A 
Counterstrain
FPR
BLT
Functional technique
Myofascial release
Cranial
Still technique
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56
Q

Neurologic exam of root C4

A

Sensation- shoulder
Motor- none
Reflex- none

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57
Q

Neurologic exam root of C5

A

Sensation- lateral elbow
Motor- biceps
Reflex- biceps

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58
Q

Neurologic exam of root C6

A

Sensation- thumb, index finger
Motor- wrist extensors
Reflex- triceps

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59
Q

Neurologic exam root of C7

A

Sensation- mid finger
Motor- triceps
Reflex triceps

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60
Q

Neurologic exam root C8

A

Sensation- ring finger, pinky
Motor- wrist flexors
Reflex- none

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61
Q

Neurologic exam root of T1

A

Sensation- medial elbow
Motor- interossi
Reflex- none

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62
Q

Sympathetic level for head and neck

A

T1-T4

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63
Q

Sympathetic levels heart

A

T1/T2-T5/T6

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64
Q

Sympathetic levels respiratory

A

T1/T2-T6/T7

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65
Q

Sympathetic levels esophagus

66
Q

Sympathetic levels upper GI tract

A

T5-T9

Stomach, liver, gallbladder, spleen, pancreas, duodenum

67
Q

Sympathetic levels middle GI tract

A

T10-T11

Pancreas, duodenum, jejunum, ileum, ascending colon, right transverse colon, kidney, upper ureter, gonads

68
Q

Sympathetic levels lower GI tract

A

T12-L2

Left transverse colon, descending colon, sigmoid colon, rectum, prostate, bladder, lower ureter

69
Q

Sympathetic levels appendix

70
Q

Sympathetic levels kidneys

71
Q

Sympathetic levels adrenal medulla

72
Q

Sympathetic levels upper ureters

73
Q

Sympathetic levels lower ureters

74
Q

Sympathetic levels gonads

75
Q

Sympathetic levels bladder

76
Q

Sympathetic levels uterus & cervix

77
Q

Sympathetic levels erectile tissue

78
Q

Sympathetic levels prostate

79
Q

Sympathetic levels arms

80
Q

Sympathetic levels legs

81
Q

Parasympathetic levels

-vagus nerve (OA, AA, C2)

A

Trachea, esophagus, heart, lungs, liver, gallbladder, stomach, pancreas, spleen, kidneys, proximal ureter, small intestine, ascending colon, & transverse colon up to the splenic flexure

82
Q

Parasympathetic levels S2-S4

A

Distal to splenic flexure of the transverse colon descending colon, sigmoid colon, rectum, distal ureter, bladder, reproductive organs, & genitalia

83
Q

Parasympathetic levels

Ovaries & testes

A

Vagus nerve, S2-S4

84
Q

Sympathetic pre-ganglionic T5-T9

A

Greater Splanchnic

85
Q

Sympathetic Pre-ganglionics T10-T11

A

Lesser Splanchnic

86
Q

Sympathetic Pre-ganglionics T12

A

Least Splanchnic

87
Q

Sympathetic Pre-ganglionics L1-L2

A

Lumbar Splanchnic

88
Q

Celiac Ganglion (T5-T9) Post-Ganglionic to what structures?

A

Distal esophagus, stomach (epigastric), liver, gallbladder (cholecystitis), spleen, portions of pancreas, proximal duodenum (foregut)

89
Q

Superior mesenteric ganglion (T10-T11) post-ganglionic to what structures?

A

Portions of pancreas, duodenum, jejunum, ileum, ascending colon, proximal 2/3 of transverse colon (midgut); adrenals, gonads, kidneys, upper 1/2 ureter

90
Q

Inferior mesenteric ganglion (T12-L2) post-ganglionic to what structures?

A

Distal 1/3 transverse colon, descending colon, sigmoid, rectum (handgun)l; lower 1/2 ureter, bladder, prostate genitalia

91
Q

Greater splanchnic nerve

A

Sympathetic innervation
T5-T9
Synapses at the celiac ganglion
Stomach, liver, gallbladder, pancreas, parts of duodenum

92
Q

Lesser splanchnic nerve (T10-11)

A

Sympathetic innervation
Synapses at superior mesenteric ganglion
Small intestines & right colon (appendix is found here)

93
Q

Least splanchnic nerve (T12) & Lumbar splanchnic (L1-2)

A

Sympathetic innervation
Synapses at the inferior mesenteric ganglia
Innervation the left colon & pelvic organs

94
Q

Sympathetic nerve supply to the head & neck

A

T1 – T4
It forms the cervical ganglia (inferior, middle, and superior cervical ganglia), which affects the mid to lower cervical spine
From there, it contributes to other collateral ganglion that govern the sympathetic innervation to the head

95
Q

Increased sympathetic activity

A 
Increased goblet cells
Increased thick, sticky secretions
Dries the mucous membranes
Pupillary dilation
Decreased lymphatic/circulatory drainage
Impaired immune response
Tinnitus
Increased intraocular pressure
96
Q

Chapman Reflex Points

Liver

A

Anterior 5th intercostal space near sternum on R

97
Q

Chapman Reflex Points

Stomach

A 
Anterior 5th intercostal space near sternum on L
Stomach acid (think ulcers/NSAID use/steroid use)
98
Q

Chapman Reflex Points

Liver, gallbladder (think cholecystitis)

A

Anterior 6th intercostal space near sternum on R

99
Q

Chapman Reflex Points

Pancreas (think amylase/lipase/blood glucose)

A

Anterior 7th intercostal space near sternum on R

100
Q

Chapman Reflex Points

Stomach (peristalsis)

A

Anterior 6th intercostal space near sternum on L

Stomach peristalsis think emptying time

101
Q

Chapman Reflex Points

Spleen

A

Anterior 7th intercostal space near sternum on L

102
Q

Chapman Reflex Points

Appendix

A

Anterior tip of right 12th rib

103
Q

Sympathetic Innervation: Chapman’s Reflexes

5th IC space

A

Right: Liver
Left: Stomach Acid (gastritis) (may raise red flag to NSAID use)

104
Q

Sympathetic Innervation: Chapman’s Reflexes

6th IC space

A

Right: liver, gallbladder (cholecystitis)
Left: stomach peristalsis (may have delayed stomach emptying time, food may not pass quickly through system)

105
Q

Sympathetic Innvervation: Chapman Reflexes 7th IC space

A

Right: pancreases (glucose, amylase, lipase)
Left: spleen

106
Q

Chapman Reflex Points are also known as what?

A

Ganglioform Nodules or Tissue

107
Q

CRP sinuses

A

Anterior points: lie 7 to 9 cm lateral to the sternum on the upper edge of the second rib
Posterior points: upon C2 midway between the spinous process & tip of the transverse process

108
Q

CRP pharynx

A

Anterior points: lie upon the first ribs 3 or 4 cm medial to where the ribs emerge from beneath the clavicles
Posterior points: upon C2 midway between the spinous process & the tip of the transverse process

109
Q

CRP Larynx

A

Anterior point: lie upon the second ribs, 5 to 7 cm lateral to the sternocostal junction
Posterior points: upon C2 midway between the spinous process & the tip of the transverse process

110
Q

CPR tonsils

A

Anterior points: between the first & second ribs adjacent to the sternum
Posterior points: midway between the spinous process **(posterior tubercle) & the tip of the transverse process

111
Q

CPR Middle Ear

A

Anterior points: lie upon the superior anterior aspect of the clavicles just lateral to where they cross the first ribs
Posterior points: upon the posterior aspect of the tips of the transverse processes of C1

112
Q

CPR Eye (retina/conjunctiva)

A

Anterior points: lie upon the anterior aspect of the humerus at the level of the surgical neck
Posterior points: lie upon the squamous portion of the occipital bone below the superior nuchal line

113
Q

Parasympathetic cranial nerves

A

III, VII, IX, X

114
Q

Ganglion for CN III

A

Ciliary ganglion

115
Q

Ganglion for CN IX

A

Otic ganglion

116
Q

Ganglion for facial nerve

A

Pterygopalatine ganglion & submandibular ganglion

117
Q

Although CN V conveys no presynaptic parasympathetic (visceral efferent) fibers from the CNS, ___ _______parasympathetic ganglia are associated with ___ _____ __ ___ _

A

The divisions of CN \

118
Q

Increased parasympathetic activity results in ?

A

Increased clear, thin, watery secretions of glands
Pupillary constriction
Improved/increased drainage

119
Q

Dry mouth (Xerostomia)

A

Can be caused by cranial nerve VII (lacrimal, sublingual and submandibular glands) & cranial nerve IX (parotid gland)

120
Q

CN VII is associated with what ganglion and exits through which foramen?

A

Associated with sphenopalantine (pterygopalatine ganglion) & exits through the stylomastoid foramen

121
Q

CN IX is associated with what ganglion and exits though which foramen?

A

Otic ganglion and exits through the jugular foramen

122
Q

Before treating lymphatics, what must you do first?

A

Thoracic inlet/outlet has to be cleared/opened/treated before any other lymphatic treatment

123
Q

What are the components of the thoracic inlet/outlet?

A

Supraclavicular space and 1st rib

124
Q

Venous drainage

A

Approximately 85% of the venous drainage from the head occurs via the internal jugular veins
They pass through the jugular foramina, located along the occipitomastoid suture between occipital and temporal bones

125
Q

Altered temporal bone motion and occipitomastoid compression may impair what?

A

Venous flow through the jugular foramen and may lead to congestion in the head

126
Q

Myofascial release to the pteryoid fascia can be used to treat what?

A

Maxillary sinusitis by stimulating the parasympathetic supply to the nasal mucosa, which is CN VII

127
Q

Galbreath technique is great for treating what?

A

Otitis media, fluid in the middle ear, Eustachian tube somatic dysfunction

128
Q

Galbreath technique

A

You are pulling traction on the mandible and the goal is decongestion of fluid in the middle ear

129
Q

CN I dysfunction/entrapment

130
Q

CN V dysfunction/entrapment

A

Headache, trigeminal neuralgia

131
Q

CN VII dysfunction/entrapment

A

Altered taste, bell’s palsy

132
Q

CN VIII entrapment/dysfunction

A

Vertigo, tinnitus, labyrinthitis

133
Q

CN IX & X dysfunction/entrapment

A

Poor suckling, failure to thrive

134
Q

CN III, IV, VI dysfunction/entrapment

A

pass under the Petrosphenoidal ligament formed by the tentorum cerebelli
Symptoms: blurred vision, diplopia, nystagmus, eye fatigue, HA

135
Q

CN VI is closest to what?

A

The dura, most likely affected, results in medial strabismus

136
Q

CN I through what foramen

A

Cribiform plate

137
Q

CN II through what foramen

A

optic canal

138
Q

CNIII, IV, V1, VI through what foramen

A

Superior orbital fissure

139
Q

CNV2 (maxillary n) through what foramen?

A

Foramen rotundum

140
Q

CNV3 (mandibilar n) through what foramen?

A

Foramen ovale

141
Q

CN VII & CN VIII through what foramen?

A

Internal acoustic meatus

142
Q

CN IX, X, XI through what foramen?

A

Jugular foramen

143
Q

CNXII through what foramen?

A

Hypoglossal canal

144
Q

Difficulty latching/nursing

145
Q

Colic

146
Q

GERD

147
Q

Nausea/vomiting

148
Q

Torticollis

149
Q

Asthma

150
Q

Otitis media/tinnitus/vertigo/labrynthitis

151
Q

CN I

A

Anosmia

Cribiform plate through ethmoid bone

152
Q

CN V

A

Trigeminal neuralgia/tic deloureaux

May complain of sudden, stabbing severe facial, ear and/or jaw pain

153
Q

CN VII

A

Exits stylomastoid foramen

Bell’s Palsy

154
Q

CN VIII

A

Labyrinthitis, tinnitus, vertigo

temporal bone is associated with these*

155
Q

CN X

A

Exits jugular foramen

Can cause nausea/vomiting

156
Q

CN XII

A

Hypoglossal canal

Can cause nursing/latching problems in infants

157
Q

Jugular foramen is formed by what bones?

A

Temporal bone and occiput which make up occipitomastoid suture

CN IX, X, & XI exit the jugular foramen

158
Q

Tension headache description

A

Bilateral pressure

No aura, nausea

159
Q

Migraine headache description

A

Unilateral
Triggers
May have aura, nausea/vomiting, photophobia/phonophobia

160
Q

Cluster headache description

A

Unilateral, severe

161
Q

Trigger point for SCM

A

Refers pain lateral & behind the eye

162
Q

Trigger point splenius capitus

A

Refers pain to the vertex of the head

OPP (1 decks)

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