Fellows Review Flashcards
Principles of osteopathic medicine
The body is a unit
The body is capable of self regulation
Structure and function are reciprocally interrelated
Rational treatment is based on understanding of first 3 principles
Year that AT Still’s children died and he started thinking about osteopathic medicine
1864
Day AT Still flung to the breeze the banner of osteopathy
June 22, 1874
Year first school of osteopathy opened
1892
Year KCU established
1916
Year of the Spanish flu outbreak
1917-1918
Year DO’s started being able to serve in the military
1957
Years of the California Referendum
1961-1974
Acute or chronic:
Pale, dry, achy
Chronic
Acute or chronic:
Blanching, hypertonic, sharp
Acute
5 principles of lymphatic diagnosis
- Indications and risk-to-benefit ratio
- Central myofascial pathways
- Fluid pumps
- Spinal involvement
- Peripheral/regional pathways
Which lymphatic duct drains the majority of the body
Thoracic duct
What does the right lymphatic duct drain
Right side of the head, neck, and thorax
Right upper limb
Transition zones of the spine and transverse restrictors
OA, C1, C2 (tentorium cerebelli)
C7, T1 (thoracic inlet)
T12, L1 (thoracolumbar diaphragm)
L5, Sacrum (pelvic diaphragm)
Principles of lymphatic treatment (4)
- Open pathways to remove restriction to flow (transverse myofascial restrictors, regional lymphatic drainage)
- Maximize diaphragmatic functions (abdominal and pelvic diaphragms)
- Increase pressure differentials or transmit motion (fluid pumps)
- Mobilize targeted tissue fluids (localized to specific SDs)
The thoracic inlet is always opened first. What would your next treatment area be for an HEENT problem?
Suboccipitals
The thoracic inlet is always opened first. What would your next treatment area be for a problem below the diaphragm?
Abdominal diaphragm
The thoracic inlet is always opened first. What would your next 2 treatment areas be for a lower extremity problem?
Abdominal diaphragm
Pelvic diaphragm
Which of the following types of contraction is contraction of a muscle with approximation of origin and insertion?
A. Isometric contraction
B. Concentric isotonic contraction
C. Eccentric isotonic contraction
D. Isolytic contraction
B. Concentric isotonic contraction
Which of the following types of contraction is considered non-physiologic?
A. Isometric contraction
B. Concentric isotonic contraction
C. Eccentric isotonic contraction
D. Isolytic contraction
D. Isolytic contraction
Which of the following types of contraction is contraction of a muscle with no change in distance between the origin and insertion?
A. Isometric contraction
B. Concentric isotonic contraction
C. Eccentric isotonic contraction
D. Isolytic contraction
A. Isometric contraction
Which of the following types of contraction is attempted concentric contraction with an external force causing separation of origin and insertion?
A. Isometric contraction
B. Concentric isotonic contraction
C. Eccentric isotonic contraction
D. Isolytic contraction
D. Isolytic contraction
Which of the following types of contraction is contraction of a muscle with separation of origin and insertion?
A. Isometric contraction
B. Concentric isotonic contraction
C. Eccentric isotonic contraction
D. Isolytic contraction
C. Eccentric contraction
What are 2 other names for articulatory technique?
Springing technique
Low velocity/high amplitude
Steps for BLT
- Move toward position of ease (shifted neutral)
- Activating force: breath hold in position of ease
- Hold until air hunger
- Return to neutral
- Reassess
Steps for FPR
- Neutralize sagittal plane
- Apply compression
- Place in position of ease
- Hold 3-5 seconds
- Return to normal
- Reassess
Steps for Still Technique
- Place in position of ease
- Add compression
- Move through RB to AB
- Remove compression
- Return to neutral
- Reassess
Which cervical vertebrae are typical vs. atypical?
Typical = 3-6
Atypical = atlas (c1), axis (c2), and C7
Why is C7 considered atypical
Vertebra prominens = non-bifid, with small or absent foramen transversarium
The atlas is bounded anteriorly on the dens by the ______ ______ and posteriorly by the __________ ________ ligament
Anterior arch
Transverse atlantal ligament
When looking at imaging for the C spine and examining the different lines in the lateral view, which type of fractures are we concerned about because they are unstable?
Lamina fractures
Major vs. minor motions at OA
Major = flexion, extension
Minor = sidebending, rotation
Why do rotation and sidebending tend to occur in the same direction for C2-7?
Theoretically d/t uncinate processes
MET Lumbar Type 1 (neutral) SD, Lateral recumbent, long lever technique
NUDR
Neutral dysfunction, ptp Up, patient force Down, Recumbent
MET Lumbar Type 2 Flexed SD, Lateral recumbent, long lever technique
FDDR
Flexed dysfunction, ptp Down, pt force Down, lateral Recumbent
MET Lumbar Type 2 Extended SD, Lateral Recumbent, long lever technique
SUUE
Modified Sims, ptp Up, pt force Up, Extension dysfunction
T/F: in the lumbar spine, spinous processes are in the same plane as the transverse processes
True
The most superior portion of the iliac crests corresponds with the spinous process of what vertebrae?
L4
Which nerve root corresponds to patellar reflex
L4
An L4 nerve root would be affected by disc herniation at which of the following?
A. L2-L3
B. L3-L4
C. L4-L5
D. L5-L6
B. L3-L4
Which nerve root corresponds to the achilles reflex
S1
Which nerve roots correspond to the following:
Ankle dorsiflexion
Great toe dorsiflexion
Ankle plantarflexion
Ankle dorsiflexion = L4/5
Great toe dorsiflexion = L5
Ankle plantarflexion = S1
Positive vs negative hip drop tests
Negative (normal) = hip on unsupported side drops 15 degrees
Positive = hip on unsupported side does NOT drop 15 degrees, indicating pathology on unsupported side
[ex: right iliac crest drops 10 degrees = positive R hip drop test –> problem with lumbar left sidebending]
The straight leg raise test is used to test for sciatic nerve irritation by stretching the dura. How is the test performed and what are the possible results?
Patient supine. Physician extends knee, medially rotates and adducts pt’s hip, then flexes hip while maintaining knee extension.
Positive test = pain in the BACK of the leg
If pain is felt at <30-35 degrees or in opposite leg, may indicate disc protrusion or rupture radiculopathy
Dura stretch starts at 30 degrees, pain above this may indicate nerve root irritation, but greater than 70 degrees may be mechanical LBP