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OPP IV EXAM 2 > Hospitalized patient > Flashcards

Hospitalized patient Flashcards

1
Q

Most common hospital consults (Top 4)

A

Pneumonia
COPD
Asthma
Bronchitis

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2
Q

C6 nerve emerges between which 2 vertebrae?

A

C5 and C6 vertebrae

Thus C5-C6 disc herniation can impinge upon C6 nerve root.

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3
Q

C6: motor, reflex

A

Biceps (C5-C6)
Wrist extensors
Reflex: brachioradialis

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4
Q

L4 - motor, reflex, sensation

A

Foot inversion (tibialis anterior)
Patellar reflex
Medial aspect of foot sensation

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5
Q

L5 - motor, reflex, sensation

A

Great toe extension (EHL)
NO REFLEX* trick :)
Dorsum of foot sensation

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6
Q

S1 - motor, reflex, sensation

A 
Foot eversion (peroneus longus, brevis)
Achilles tendon
Lateral foot
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7
Q

Spurling’s test tests for

A

Narrowing of neural foramina
Sidebend and backward bend head –add compression
Positive if pain radiates to ipsilateral arm

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8
Q

Underburg test tests for

A

Vertebral artery insufficiency
Supine, backward bend, rotate, WAIT 30 seconds
+ with dizziness, nausea, lightheadedness

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9
Q

3 primary goals and guidelines as written by Kenneth Graham

A

Prevention and tx of many common problems/complications of hospitalization
Return to function
Guidelines are not designed to address a lifetime of somatic dysfunction

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10
Q

Situations to avoid or be cautious in when doing OMT on hospitalized patient

A 
CVA/TIA/DVT/PE/MI
Uncooperative
Osteomyelitis
Unresponsive/lethargic
Cancer/Mets/Spinal fxs
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11
Q

Sympathetics to bladder

A

T11-L2

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12
Q

Sympathetics to prostate

A

T12-L2

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13
Q

Sympathetics to LE

A

T11-L2

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14
Q

Sympathetics to UE

A

T2-8

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15
Q

Sympathetics to upper ureters

A

T10-11

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16
Q

Sympathetics to lower ureters

A

T12-L1

17
Q

Sympathetics to uterus and cervix

A

T10-L2

18
Q

Sympathetics to erectile tissue

A

T11-L2

19
Q

Sympathetics to adrenals

A

T10

20
Q

Somatic dysfuncton of OA (vagus and cranial base) may result in what effects on CN X and the head

A

Direct muscular pressure and myofascial tension on CN X.
Compression of jugular v. causing venous back pressure on CN X
Inhibit venous and lymphatic drainage and return from head
Somatic dysfunction in superior cervical ganglia –unopposed SANS stimulation (vasoconstriction/mucosa drying), increased SANS tone (beneficial vasoconstriction and decongestant), inhibited SANS tone

21
Q

11 beneficial effects of rib raising

A

(1) Enhance and encourage the “toilet” expectorant function of the lungs
(2) Facilitate and encourage venous and lymphatic circulation and drainage in the lungs and abdomen
(3) Encourage mucous drainage from the lungs
(4) Increase rib cage mobility, which encourages chest and diaphragm excursion
(5) Decrease pulmonary inflammation and congestion
(6) 1-5 plus gentle ballottement of lung tissue, secondary to rib raising motion, can decrease the incidence of atelectasis and pneumonia
(7) Directly stimulate increased ANS tone, thru a pumping action on the SANS chain ganglia, resulting in bronchodilation
8) Rib raising on lower 6 ribs can encourage diaphragm motion
(stimulates diaphragm to wake up)
(9) Improved SANS function, chest cage mobility, diaphragm motion, and venous and lymphatic drainage can all combine to imporve arterial and venous/lymphatic circulation within the lungs and other areas, which can decrease pulmonary congestion and inflammation, maximize tissue levels of oxygen and adaptive immunity (macrophages, IG’s, T-cells etc), improving delivery of antibiotics and other meds to lungs and body tissues
(10) Gentle rocking motion produced by rib raising can stimulate and encourage return to normal peristaltic activity( ileus, nausea).
(11) Rib raising motion can also stimulated other internal organs to recover from organ stasis and return to normal functioning
12) Encourage increase SANS tone to the heart (benefit in CHF) - enhancing HR, Cardiac output, and Conduction of Heart

(13) Balance excessive SANS tone to the GI Tract, and GenitourinarynSystems
(14) Balance SNS tone to ENT and sinuses
(15) Enhance venous and lymphatic return from ENT and sinuses-decreasing swelling, edema, congestion, and inflammation

22
Q

SD of OA/cranial base may result in what effect on cranial venous sinuses and vertebral vv.?

A

back pressure extending into lower brainstem where vegetative centers for heart, GI, respiratory centers are located. Thus may result in decreased arterial circulation to the brainstem and put direct venous compression to the brainstem.

23
Q

SD of OA/cranial base may result in what kinds of effects in GI system?

A

Can facilitate excessive sensory input to vomiting center – > N/V
Excessive PANS to small intestine, right colon, and transverse colon causing increased motility, spasticity, and diarrhea.
Excessive PANS to esophagus causing excessive/inappropriate spasticity of esophagus or relaxation of LES, promoting GERD.
Inhibition of PANS to entire GI tract causing constriction of LES and decreased motility from esophagus to splenic flexure causing distention, constipation, gas retention, and N/V.

24
Q

Why is H/A associated with OA and cranial disturbances?

A

Vagal stim of occipital nn C1 and C2 may also facilitate increased sensitivity to pain in occipital area of head inreasing possibility of headache often found in association with GI tract disturbances.

25
Q

SD of OA/cranial base results in what effects on renal system

A 
Inhibition of PANS tone causes:
Vasoconstriction of afferent arterioles
Decreased GFR
Decreased urine volume/output
Decreased peristalsis in proximal ureter
Inhibition of stone passage
Facilitates formation and retention of stones
May foster environment for UTIs
26
Q

What’s so great about the kidney pump?

A

When this pumping action is performed in the area of ribs 10-12 it can help restore normal physiologic functioning to the kidney.

27
Q

Effects of thoracic diaphragm soft tissue and myofascial release

A

(a) Involves soft-tissue stretching, inhibition and MFR of diaphragm
(b) Increases diaphragm tone if too relaxed
(c) Decreases diaphragm tone if contracted
(d) Enhances venous and lymphatic return
(e) Enhances ventilatory effectiveness and O2 and CO2 exchange and diaphragm excursion

28
Q

4 clinical uses for tx of thoracic diaphragm

A

Extubation
Improve resp effort
Pneumonia/asthma/COPD/resp infections
Post-op patients

29
Q

7 clinical scenarios in which pedal pump should be used with caution

A 
Pulm emboli
DVT
CHF
Cancer/mets
Post-op
Cellulitis
Swelling
30
Q

Lumbosacral somatic dysfunction may affect which nerve?

A

Perineal n.

Weakness and dysfunction of pelvic diaphragm may result

OPP IV EXAM 2 (5 decks)

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