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OS III Final Exam > Lecture 2: OAT Surgical Patient > Flashcards

Lecture 2: OAT Surgical Patient Flashcards

1
Q

OMT pre-op to reduce SD’s in which region has shown to significanty decrease post-op pulmonary complications; via what type of reflex?

A
  • Mid-cervical (C3-5)
  • Somatosomatic reflex: Cervical SD –> thoracoabomibal diaphragm - phrenic n.
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2
Q

Presence of SD before surgery may be a complication factor due to what concept of neurology?

A

Facilitation (one cause of increased chronic pain)

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3
Q

Increased tx frequency with a shorter duration with each treatment may be better tolerated by the patient, but no more than _________ treatments/day is recommended?

A

3 treatments/day

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4
Q

What type of treatment modality should be used for acute vs. chronic SD (indirect or direct)?

A
  • Acute SD –> indirect tx
  • Chronic SD –> direct tx
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5
Q

What does it mean to increase the number of treatments acutely in a post-OP patient?

A
  • ↑ the treatment frequency with shorter duration = may be better tolerated
  • i.e., instead of a 6 minute session, do 3 sessions of 2 minutes each
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6
Q

Post-op OMT plan use a 5-model approach and select 1-2 techniqus that will address which 3 areas of the 5-models?

A
  • Neurologic
  • Respiratory/Circulatory
  • Biomechanical
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7
Q

When choosing techniques/modalities of OMT for post-op patient techniques that cause or necessitate what should be avoided?

A

Those incorporating unecessary shaking (i.e., lymphatic pumps) or overhead arm techniques

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8
Q

Which OMT technique is good post-op because it has SNS, respiratory, lymphatic, and mechanical benefit?

A

Rib raising

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9
Q

Sympathetic innervation levels for heart/lung?

A

T1-T6

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10
Q

Sympathetic innervation levels for esophagus/UE?

A

T2-T8

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11
Q

Sympathetic innervation levels for upper GI?

A

T5-T9

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12
Q

Sympathetic innervation levels for middle GI (i.e., small intestine and R colon)?

A

T10-T11

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13
Q

Sympathetic innervation levels for adrenal medulla?

A

T10

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14
Q

Sympathetic innervation levels for upper GU and lower GU?

A
  • Upper GU = T10-T11
  • Lower GU = T12-L2
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15
Q

Sympathetic innervation levels for bladder?

A

T12-L2

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16
Q

Sympathetic innervation levels for lower extremites/erectile tissue?

A

T11-L2

17
Q

Sympathetic innervation levels for prostate?

A

T12-L2

18
Q

Sympathetic innervation levels for adrenal?

A

T10-T11

19
Q

Anterior Chapman’s points for stomach acidity, stomach, and spleen?

A
  • Acidity = L 5th ICS
  • Stomach = L 6th ICS
  • Spleen = L 7th ICS
20
Q

Post-orthopedic surgery how should treating a SD be approached?

A

Treat SD above and below to ↑ mobility

21
Q

A fever is defined as how many degree farenheit and celsius?

A

>100.4 °F (38°C)

22
Q

What are the 5 “rule of W’s” for post-op fever; how many days post-op (POD) is each associated with?

A
  • Wind (atelectasis/pneumonia) –> 1-2 days POD
  • Water (UTI-cystitis) –> 3 days POD
  • Walking (DVT/PE) –> 5-7 days POD
  • Wound (infection) –> 7-10 days POD
  • Wonder drugs (drug rxn = rash; bradycardi) –> 7+ days POD
23
Q

Shallow breaths without maximal inhalation may lead to what post-op complication?

A

Atelectasis

24
Q

What are 3 contributing factors to pre-tibial edema?

A
  • Immobility due to bedrest
  • Systemic inflammation secondary to surgery
  • Insufficient circulation and lymph drainage
25
Q

What are the 2 viscerosomatic levels that should be target for pre-tibial edema?

A
  • T10-L2
  • S2-S4
26
Q

Rib raising for which viscerosomatic levels has been shown to decrease incidence of post-op ileus?

A

T5-L2

27
Q

Why is respiratory depression when using opioids a rare AE in the post-op setting?

A

Pain = powrerful respiratory stimulant

28
Q

What are the 3 ways/techniques that you can use OMT for pain management in the post-op patient; which viscerosomatics?

A
  • Rib raising w/ paraspinal inhibition to normalize hyperactive SNS
  • ST and MFR
  • Viscerosomatic = T1-L2 and CN X/S2-4
29
Q

What are 2 OMT techniques that can be used for calming in a post-OP patient for anxiety/delirium?

A

Suboccipital inhibition and CV4

OS III Final Exam (10 decks)

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