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OS III > FInal > Flashcards

FInal Flashcards

1
Q

What are some causes of incontenance

A

Ingestion of alcohol, chili peppers, heart meds, pregnancy, enlarged prostate, cancer, neuro disorders

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2
Q

What is the behavioral treatment for incontinence

A

Bladder training, double voiding, scheduled toilet trips, fluid and diet management; pelvic floor m exercises

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3
Q

What is the parasympathetic innervation to the kidneys vas the lower ureters and bladder

A

Kidneys: vagus

lower ureters and bladder: pelvic splanchnic

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4
Q

What is the symp innervation to the bladder

A

T11-L2

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5
Q

What is the anterior Chapman’s point for urethra

A

Inner edge of pubic Ramus near the symphysis

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6
Q

What are the posterior Chapman’s reflexes for urinary system

A

Adrenals: intrtransverse space btw T1/12
Kidneys: “” btw T12 Nd L1
Ureters: “” L1/2
Bladder and urethra: superior edge of L2 TP

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7
Q

What do you do for metabolic energetic treatment for bladder symptoms

A

If constipated, treat that first

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8
Q

What are contraindictions to treating renal patient with OMT

A

Unable to tolerate secondary to pain or positioning, delaying more definitive care

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9
Q

Where would you target your treatment for biomechanics model for a renal patient

A

Lower ribs, thoracolumbar, psoas, quadratus lumborum, pelvic floor m (attachments - Innominate, pubic bone, pelvic floor, sacrum)

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10
Q

Which counterstrain points can be usd to treat a renal patient

A

AT or PT 9-12

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11
Q

What is the respiratory circulatory technique for renal patient

A

Thoracic inlet -> thoracolumbar diaphragm -> treat lower ribs -> treat pelvic diaphragm -> pedal pump

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12
Q

What are some pre-op OMT considerations

A

Concerns about airway with anesthesia: optimize c spine motion for intubation
-OMT pre op to mid cervical shown to reduce post op pulm complications: somatostatic reflex (cervical SD -> thoracoabdominal diaphragm -> phrenic n)

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13
Q

What benefit does post op OMT have

A

Shorten hospital stay, decrease morbidity and mortality, decrease post op pain, facilitate lymph flow and improve diaphragm mobility, increase patient satisfaction

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14
Q

What are some considerations for OMT post op

A
  • increased treatment frequency at shorter duration but no more than 3 treatments a day
  • daily to every other day most common
  • consider indirect tx for acute and direct for chronic
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15
Q

What are the goals of lymphatic treatment

A

Reduce risk of infection, heal in time, fibrosis and scarring

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16
Q

What is the post op fever rule of W’s

A
  • wind: atelectasis, pneumonia
  • water: UTI
  • Walking: DVT/PE
  • wound: wound infection
  • wonder drugs: antimicrobials, anesthetic - generalized rash and bradycardia
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17
Q

What is the rule of W’s management

A
  • wind: CXR, sputum cultures, incentive spirometery,abx
  • water: UA, urine culture, remove foley,abx
  • walking: US with venous Doppler, CT angiogram, heparin
  • wound: abx, drainage, wound care
  • wonder drugs: remove
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18
Q

What OMT can be done for post op atelectasis

A

Rib raising, dome diaphragm, pectoral traction, soft tissue and myocardial releases to C3-5 for phrenic n stimulation, tapotement, lymph pumps, viscersomatic (T1-6/T2-7 and CNX)

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19
Q

What viscerosomatic reflex could be treated for pretibial edema

A

T10-L2 and S2-4

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20
Q

What is the OMT management of post op ileus

A

Rib raisin T5-L2 to decrease risk of post op ileus, mesenteric release, paraspinal inhibition, OA/AA, sacral rocking

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21
Q

What is the OMT management for anxiety and delirium

A

Suboccipital release and CV4

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22
Q

Where is AC1 mandible and what is the counterstrain position

A
  • on posterior surface of ascending ramus of the mandible

- SARA with patient supine

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23
Q

Where is AC1 TP and what is the counterstrain for it

A

C1 TP midway between ramus of mandible and mastoid process

-push lateral to medial, saRA

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24
Q

Where are the A2-6 points and what is their countertrain position

A

Anterior aspect of TP

-F SARA; alternate E SARA

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25
Q

Where is AC7 an what is the counterstrain position for it

A

Posterosuperior surfacce of proximal clavicle where SCM inserts
-F STRA with patient supine

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26
Q

Where is AC8 and what is the counterstrain position

A

Clavicular insertion of SCM near sternal notch

-F SARA with patient supine

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27
Q

Where are AT1-6 and what is the counterstrain position for them

A

-AT1: midline on suprasternal notch
-2:: midline on manubrium at sternal angle
-3-4: midline at level of costal cartilage
-5: midline one inch superior to xiphoid
-6: midline at sternal-xiphoid junction
Tx position: pt supine, cervical and thoracic flexion to level of TP or seated with patients head flexed

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28
Q

Where is AT7-9 (b/l) and what is their treatment

A

-7:: midline or lateral to midline 1/4 distance from tip of xiphoid and umbilicus
-8:midline or lateral to midline halfway between xiphoid and umbilicus
-9:: midline or lateral to midline 3/4 from xiphoid to umbilicus
Tx: FSTRA patient seated

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29
Q

Where is AT10-12 and what is the treatment position

A

10: lateral to midline - 1/4 from umbilicus to pubic symphysis
11: lateral to midline halfway between umbilicus and pubic symphysis
12: lateral to midline; mid axillary line on superoanterior surface of iliac crest
Tx: patient supine; doc on same side as TP; flex hips and knees and place on physician’s thigh; pull knees and ankles toward doc FSTRA

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30
Q

What is the counterstrain treatment for PC1 inion

A

FSTRA

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31
Q

What are the all the positions for the posterior TP for the thoracic spine

A

ESART

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32
Q

If there is more than one tendrpoint with equal intensity, which do you treat first

A

Most proximal or midline; if both thoracic and rib TP, treat thoracic first

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33
Q

What is true about a maverick point

A

Requires lengthening rather than shortening m

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34
Q

What are anterior vs posterior rib tender points indicative of

A

Anterior: depressed rib
Posterior: elevated rib.

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35
Q

Where is AR1 and 2 located and what is their treatment position

A

AR1: inferior to clavicle on rib one - lateral to manubrium (directly inferior to SC joint)
AR2: 1.5 in lateral to manubrium on rib 2, below MCL
Tx: patient spine, FSTRT (neck); treats depressed rib and inhalation restriction

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36
Q

Where are AR3-6 located and what is their treatment position

A

Slightly anterior to mid-axillary line
Tx: patient seated doc behind patient with knee under arm of side opposite TP; FSTRT (neck and torso); treats depressed rib and inhalation restriction

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37
Q

Where is PR1 located and what is the treatment position

A

Posterior margin of rib he’d beneath margin of trapezius

Tx: patient supine or seated; ERTS away or toward

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38
Q

Where is PR 2 and what is the tx position

A

Superior surface of angle of ribs at medial border of scapula
Tx: patient seated, doctor places patients arm on side of dysfunction on knee FSARA (trunk and head)

39
Q

Where is PR3-6 and what is the tx

A

Superior surface of angles or ribs at medial border of scapula
Tx: patient seated; doc places knee on same side - FSARA (just trunk)

40
Q

At what Cobb angle does respiratory function become compromised

A

> 50

41
Q

At what Cobb angle is CV function compromised

A

> 75

42
Q

What does the gait pattern have to do with cardiac function

A

Length of stride is reduced in patients with severe heart failure - very oxygen demanding - contributes to limited exercise capacity

43
Q

Where do each of the pleuras drain

A

Parietal -> internal thoracic and intercostal chains
Diaphragmatic -> mediastinal, retrosternal, celiac axis nodes
Visceral -> deep pulmonary plexus

44
Q

Where does lymph from the pericardium drain

A

Thoracic and right pulmonary ducts

45
Q

Where does lymph from the heart and lungs drain

A

Carried back to heart via right lymphatic duct

46
Q

How does MI affect lymphatics

A

Leads to dysfunctional lymph vessels and development of chronic myocardial edema which will aggravaate cardiac fibrosis; *VEGF-C -> cardiaclymphangiogenesis may improve cardiac function

47
Q

What does the right half of the deep cardiac plexus innervate

A

Right coronary plexus -> right atrium and ventricle
Left coronary plexus -> left atrium and ventricle
SA node

48
Q

What does the left half of the deep cardiac plexus innervate

A

AV node

49
Q

What does sympathetic hyperactivity of the right half of the cardiac plexus lead to

A

Increased risk of SVT

50
Q

What does right vagal hyperactivity lead to

A

Sinus bradyarrhythmias

51
Q

What does sympathetic hyperactivity in the left half of the cardiac plexus lead to

A

Increased risk of ectopic foci and v fib

52
Q

What does left vagal hyperactivity at the AV node lead to

A

AV block

53
Q

What is the innervation of the costal and peripheral diaphragmatic parietal pleura

A

Intercostal ns

54
Q

What is the innervation of the mediastinal and central diaphragmatic parietal pleura

A

Phrenic ns

55
Q

What mainly controls the smooth m tone of the airways

A

Parasympathetic (M3)

56
Q

Where are the anterior and posterior Chapman’s points for the myocardium

A

Anterior: 2nd ICS along sternal border
Posterior: intertransverse spaces btw T2-3

57
Q

Where is the posterior bronchus Chapman’s point

A

Lateral to T2 spinous process

58
Q

What technique can be used in HTN to decrease SVR

A

General paraspinal inhibition or treat OA/AA

59
Q

What neuro treatments would you do to someone with CHF

A

OCMM, paraspinal inhibition to T1-6, suboccipital release, Chapman’s points

60
Q

What treatments go under the metabolic model for CHF

A

Treat diaphragmatic and thoracic cage dysfunctions, lymphatic pumps and effleurage can help restore electrolyte imbalance, CHF meds

61
Q

What can be done for arrhythmias that fits the respiratory circulatory model

A

Valsalva maneuver; carotid sinus massage

62
Q

What Biomechanical treatments would be done for pneumonia

A

Cervical/thoracic/rib SD; percussion hammer to break up consolidation

63
Q

What neuro treatments can be done for pneumonia

A

Paraspinal inhibition, CV4, treat OA/AA

64
Q

What can be done to treat pneumonia under the metabolic model

A

Abx, lymphatics, tapotement, sinus drainage, inhaled bronchodilators

65
Q

At what stage of pneumonia can you do a lymphatic pump

A

Stage III (recovering, afebrile, productive cough)

66
Q

What are cardiopulmonary specific considerations with OMM

A

-consider indirect treatments

67
Q

What is the counterstrain position for AL1

A

Doc on same side with foot on table; flex knees and hips > 90; knees and ankles pulled toward doc; FSTRA

68
Q

What is the position for treatment of AL 2

A

Doc opposite TP with foot on table; flex knees hips to 90; knees and ankles towards doc; FSART *significant rotation

69
Q

What is the treatment position for AL 3 and 4

A

Doc opposite TP with foot on table; flex knees and hips to 90, pull knees and ankles towards doc; FSART

70
Q

What is the position for AL5

A

(On anterior aspect of pubic bone 1 cm lateral to pubic symphysis near pubic tubercle); doc same side of TP it’s foot on table; flex 90-135; push ankles away from doc and rotate knees toward doc - FSARA

71
Q

What is the treatment for upper pole

A

(Superomedial border of PSIS); doc opposite TP; extends ipslateral hip and externally rotates

72
Q

Where is Lower pole

A

Inferior aspect of PSIS

73
Q

What is the treatment for PL3/4

A

Extension

74
Q

Where is the iliacus TP and what is the position

A

1-2 inches medial to ASIS; frog leg

75
Q

Where is the low ilium TP and how is it treated

A

Lateral aspect of superior ramus where psoas m crosses pelvic rim; doc Same side; flex > 90, slight ER *only one leg

76
Q

Where is the inguinal ligament TP and what is the treatment

A

Lateral surface of pubic bone near attachment of inguinal lig; doc on same side with foot on table; flex hips/knees to 90 and rest on drs knee, cross opposite ankle over leg on side of dr; ankles toward doc (IR of hip)

77
Q

Where is the psoas major TP and what is the position

A

2/3 from ASIS to midline; doc same side of TP with foot on table; markedly flex pt knees and rest on doc, pull feet and ankles towards TP

78
Q

Where is HISI and what is the treatment

A

Lateral aspect of PSIS; doc same side - monitor point by pressing lateral to medial; extend

79
Q

Where is high ileum flare out point and what is the position

A

Lateral aspect of ILA (coccygeus); doc opposite side, extend leg on side o dysfunction and adduct and externally rotate

80
Q

Where is the Piriformis TP and what is the position

A

Halfway from sacral ILA to greater trochanter; doc seated on same side; flex to 135 off side of table abduct and externally rotate

81
Q

Where is PS 5 located

A

Superomedial ILA

82
Q

What are the stages of response to stress

A

Startle: adrenal, CV, resp and MSK functions increase
Attempt to cope and problem solve: if unsuccessful becomes exhausted
Exhaustion

83
Q

What testing can you do for metabolic aspect of GI case

A

Malnutrition: food diary; test for signs of dysphasia

Chronic fatigue: obtain TSH, CBC, vit D

84
Q

What is carbohydrate deficient transferrin

A

CDT; identifies alcohol consumption

85
Q

What is the pharm treatment for alc abuse (metabolic model)

A

Naltrexone, disulfiram (side effects when combined with alcohol)

86
Q

What is psychogenic polydipsia

A

Excessive intake of water; can be caused by drugs that cause dry mouth or sarcoidosis

87
Q

What is patient health questionnaire used for

A

Depression screen

88
Q

What metabolic tests can you do for a Renal patient

A

Blood sugar, DRe, lipid panel, PSA, urinalysis, STI NAAT

89
Q

What exacerbates symptoms of BPH

A

Antihistamines

90
Q

Which ganglion is prostate innervated by

A

Inferior mesenteric - T10-L2; parasympathetic form SS2-4

91
Q

When does gout pain occur more often

A

At night

92
Q

What ddx would you come up with for the behavioral model for someone with. Renal colic

A

Bladder cancer if smoker

93
Q

What would you do for treatment of kidney stone for metabolic model

A

Alkalization of urine, increased fluid intak, reduction of Uris acid production - modify diet, if xanthine oxidase inhibitor given, stop urinary alk alkalization

94
Q

What can be given to treat the metabolic part of depression

A

Folic acid and B vitamins

OS III (2 decks)

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