HDC DOCS Flashcards by Angela Mitchell

These are the first two pieces of information you get from the patient

Identifying information, Chief Complaint

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What is involved in medication history?

Name of drug, dose, prescribed frequency and actual frequency

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What is involved in Allergy history?

Specific allergies with reactions to each

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What is involved in PMHx?

Adult Illnesses
Health maintenance - immunizations, cancer screenings, etc

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What is involved in PSHx?

Procedure, date/year, indication, complications

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What is involved in FHx?

Medical conditions of first degree relatives (one up, one down)
If living - current age and health status
If deceased - age of death and cause

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What is involved in SocHx?

Personal Geographic Map and travel history
Significant relationship and support systems
Occupation and Education
Substance Use History
Safety Measures

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What is involved in ROS?

System of concern + 2 additional systems w/ at least 2 common symptoms per system:
Constituional (general)
Hematologic/Lymphatic
ENMT
Allergic/Immuno

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What is involved in the upper extremity neuro exam?

Sensation:
Superior shoulders - C4
Lateral upper arms - C5
Lateral forearms/thumbs - C6
Middle finger - C7
Pinky finger - C8
Medial forearm - T1

Strength:
Shoulder abd
Elbow F/E
Wrist E
Grip
Finger Abd
Thumb opposition

DTRs:
Biceps: C5-6
Brachioradialis: C5-6
Triceps: C6-7

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What is involved in the MSK exam of the Cervical Spine

Inspection
Palpation
ROM (seated)
Special tests

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What is involved in the Inspection of the MSK Cervical Spine exam?

Head, neck, shoulders, UE
Muscle tone/bulk, posture, deformities
Edema, erythema, ecchymosis, derm findings

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What is involved in the Palpation of the MSK Cervical Spine exam?

Landmarks:
Mastoid processes; angles of mandible; C2-C7 spinous processes; paravertebral muscles; C2-C7 articular pillars; T1 spinous process; external occipital protuberance

TART

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What is involved in the ROM of the MSK Cervical Spine exam?

Active and Passive ROM
Flexion, Extension, Side-bending, Rotation

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What is involved in the Special Tests of the MSK Cervical Spine exam?

Cervical:
Cervical Distraction Test
Cervical Compression or Spurling’s Test
Vertebral Artery Challenge Test

Thoracic Outlet Testing:
Military Posture, Wright’s or Adson’s Test

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Describe the Anterior Neurolymphatic (Chapman’s) Reflexes

Middle ear - superior to middle clavicles
Sinuses - inferior to middle clavicles
Pharynx - inferior to sternoclavicular joints
Tonsils - medial to 1st intercostal space
Tongue - medial to 2nd ribs

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Describe the Posterior Neurolymphatic (Chapman’s) Reflexes

Middle ear - C1 rami
Sinuses - C2 articular pillars
Pharynx - C2 articular pillars
Tonsils - C2 articular pillars
Tongue - C2 articular pillars

Outline the pathway of Head and Neck LN palpation in a rotary motion

Occipital –> posterior auricular –> pre-auricular –> tonsillar –> submandibular –> submental –> anterior superficial –> posterior superficial –> deep cervical –> supraclavicular

Note the LNs of the upper extremities

Anterior/Pectoral
Posterior/Subscapularis
Lateral/Humoral
Epitrochlear

Suboccipital release, Thoracic inhibition and Lumbar inhibition are what kind of OMT?

Soft Tissue

Rib Raising and treatment for Rib 1 SD are what kind of OMT?

Articulatory

Cervical spine OA and AA SD, Cervical Spine SD and ribs 1 and 2 inhalation/exhalation SD are treated with which type of OMT?

Muscle Energy

Cervical Spine Tenderpoint are treated with what type of OMT?

Counterstrain

Diaphragm Doming is what type of OMT?

Myofascial Release (direct)

Describe how to perform Adson’s Test and what dysfunctions it is looking for

Stand behind seated pt and monitor radial pulse
Slight abduct the arm and extend it at the shoulder and elbow
Externally rotate arm and instruct pt to look toward ipsilateral side

Test is positive if radial pulse decreases/disappears or if pts has pain/paresthesia

Checking for hypertonic scalenes that may be compressing brachial plexus

Describe how to perform Military Posture Test and what dysfunctions it is looking for

1. Stand behind seated patient and palpate radial pulse 2. Extend shoulder with one hand while depressing clavicle and shoulder with the other Test is positive if pulse diminishes or pt feels pain/paresthesia **Checking for SD of first rib and clavicle that could be impinging brachial plexus**

Describe how to perform Wright's Test and what dysfunctions it is looking for

1. Stand behind seated pt and palpate radial pulse with one hand 2. Abduct pts arm overhead with external rotation and extension Test is positive if radial pulse decreases/disappears or if pts has pain/paresthesia **Checking for hypertonicity of pec minor which can compress brachial plexus**

Explain the Common Anterior Cervical Counterstrain points and their treatment positions

AC1 mandible - Ra AC1 transverse process - Ra AC2-6 - F to segment, Sa Ra AC7 - F to segment, **St **Ra AC8 - f-F, Sa Ra

Explain the Common Posterior Cervical Counterstrain points and their treatment positions

PC1 inion - F **St** Ra PC1 occiput - e-E with mild compression, Sa Ra PC2 occuput - e-E with mild compression, Sa Ra PC2 spinous process - e-E with mild compression, Sa Ra PC3 spinous process - **f-F**, Sa Ra PC4-8 spinous process - e-E to the segment, Sa Ra PC3-C7 lateral - e-E to the segment, Sa Ra

Outline the order of ENT lymphatic drainage

Release of thoracic inlet --> anterior cervical arches --> cervical chain drainage --> submandibular release --> mandibular drainage --> auricular drainage --> alternating nasal pressure and frontonasal distraction --> trigeminal stimualtion (supraorbital --> infraorbital --> mental) --> temporomandibular effleurage

What is the treatment order/goals for the lymphatic approach to respiratory-circulatory model?

1. Open myofascial pathways at transition areas (C-T, T-L, L-P) 2. Maximize normal diaphragmatic motions 3. Increase pressure differentials 4. Mobilize targeted tissue fluids

What are the three fundamental human needs for patients to be self-determined?

Autonomy, Competence, Relatedness

What is rhinitis medicamentosum?

Rebound congestions from using decongestants too much - built a tolerance