General Review Flashcards
inguinal ligament TP
Superior, lateral surface of pubic bone
Legs flexed to 90 degrees, adducted and internal rotation of affected femur
iliacus (psoas) TP
2” inferior and 2” medial from ASIS
Stand on TP side. Flex pt legs, externally rotate legs and place them on your thigh. Flex, sidebend toward the TP until resolves
low ilium TP
lateral ramus of anterior surface of pubic bone
Affected side leg flexed to 90 degrees and abducted as needed
lateral trochanter TP
Lateral surface of femor 0-15cm distal from greater trochanter in IT band
Slight flex the hip, add abduction (generally more then flexion) and internal rotation
posterior lateral trochanter TP
superior surface of posterior greater trochanter
Add in moderate amount of extension, some abduction and whole lote of external rotation until the TP resolbes
anterior lateral trochanter
5-7cm lateral and inferior to ASIS but anterior and superior to the greater trochanter
Flex hip 70-90 degrees; add abduction and external rotation until TP resolves
high ilium TP
4-5 cm lateral to PSIS
Extend affected leg and add slight abduction of thigh
midpole SI (ilium inflare superior, MPSI)
3-4 cm inferior to PSIS over SI Joint
Slight flexion of affected leg with abduction and rotation
Piriformis TP
Belly of the piriformis 8-9 cm medial and slightly superior to greater trochanter (but can be anywhere along the track of the muscle
Suspend pt’s leg off table and rest the leg on your thigh. Flex the hip to about 135 degrees, abduct slightly via the knee and internally or externally rotate the knee until the TP resolves
High ilium out flare (HIFO)
Coccyx or sacrococcygeal joint
Extend affected leg and adduct over opposite leg
posterior sacrum (PSI-5)
median crest centrally or bilaterally
Gentle anterior pressure on opposite part of sacrum from TP or attempt to bring base and apex together by cupping the sacrum and flexing your fingers
adrenal glands anterior and posterior chapman’s
Anteriorly 2” superior and 1” lateral to umbilicus
heart anterior and posterior CP
anterior rib 2
posterior T3
upper lung CP a/p
Anterior rib 3
posterior T3
lower lung CP a/p
Anterior rib 4
Posterior T4
kidneys anterior and posterior CP’s
anterior - 1” lateral of the median line and 1” superior above umbilicus
posterior - intertransverse space of T11-T12 between spinous and transverse process
bladder anterior and posterior CP’s
Anterior in the periumbilical region
Posterior - upper edge of transverse process of L1-L2
heart facilitation level
T1-4
lungs, visceral pleura Viscerosomatic reflex level
T1-T6
Adrenal glands facilitation level
T10-11
Kidneys facilitation level
T10-11
Ureters (proximal) facilitation level
T10-11
Ureters (distal) facilitation level
T12-L1
Bladder facilitation level
T12-L2
patient has sinus tachycardia… where is the SD
T1-6 right side
right sided fibers pass to the right deep cardiac plexus and innervate the right heart and SA node
patient has ventricular tachycardia or ventricular fibrillation .
where is the dysfunction
T1-5(6)
left side (left heart and AV node)
anterior wall MI. where is the SD?
T2-3 on the left
inferior wall MI. where is the SD?
dysfunction at C2 and cranial base (vagus) with inferior wall MI
soft single murmur of short duration during systole LLSB that is prominent when she is supine.
innocent Stills murmur
what are the Seven S’s that are key features of innocent murmurs
Sensitive (changes with child’s position or with respiration)
Short duration (not holosystolic)
Single (no associated chicks or gallops)
Small (murmur limited to a small area and nonradiating)
Soft (low amplitude)
Sweet (not harsh sounding)
Systolic (occurs during and is limited to systole)
anterior tenderpoints for ribs….
flex slightly rotate and sidebend TOWARD
posterior tenderpoints for ribs
Extend, rotate away and slightly sidebend away
what are the important things in the OPP SOAP note?
In PMH you need to be more aware of trauma, birth, and sports hx
Also make sure to ask if they ever wore braces
Review of systems after HPI
Osteopathic section of the Objective should include the screening findings, TART changes, and diagnosed somatic dysfunctions
The procedure section is your own OMT performed (chart)
Need BOTH patient and doctors perception of improvement in procedure section
what brings parasympathetic innervation to the kidney and upper ureter
vagus
what brings parasympathetic innervation to the lower ureter and bladder
S2-S4
