Lecture 2: OAT Surgical Patient Flashcards
OMT pre-op to reduce SD’s in which region has shown to significanty decrease post-op pulmonary complications; via what type of reflex?
- Mid-cervical (C3-5)
- Somatosomatic reflex: Cervical SD –> thoracoabomibal diaphragm - phrenic n.
Presence of SD before surgery may be a complication factor due to what concept of neurology?
Facilitation (one cause of increased chronic pain)
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?
3 treatments/day
What type of treatment modality should be used for acute vs. chronic SD (indirect or direct)?
- Acute SD –> indirect tx
- Chronic SD –> direct tx
What does it mean to increase the number of treatments acutely in a post-OP patient?
- ↑ 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
Post-op OMT plan use a 5-model approach and select 1-2 techniqus that will address which 3 areas of the 5-models?
- Neurologic
- Respiratory/Circulatory
- Biomechanical
When choosing techniques/modalities of OMT for post-op patient techniques that cause or necessitate what should be avoided?
Those incorporating unecessary shaking (i.e., lymphatic pumps) or overhead arm techniques
Which OMT technique is good post-op because it has SNS, respiratory, lymphatic, and mechanical benefit?
Rib raising
Sympathetic innervation levels for heart/lung?
T1-T6
Sympathetic innervation levels for esophagus/UE?
T2-T8
Sympathetic innervation levels for upper GI?
T5-T9
Sympathetic innervation levels for middle GI (i.e., small intestine and R colon)?
T10-T11
Sympathetic innervation levels for adrenal medulla?
T10
Sympathetic innervation levels for upper GU and lower GU?
- Upper GU = T10-T11
- Lower GU = T12-L2
Sympathetic innervation levels for bladder?
T12-L2
Sympathetic innervation levels for lower extremites/erectile tissue?
T11-L2
Sympathetic innervation levels for prostate?
T12-L2
Sympathetic innervation levels for adrenal?
T10-T11
Anterior Chapman’s points for stomach acidity, stomach, and spleen?
- Acidity = L 5th ICS
- Stomach = L 6th ICS
- Spleen = L 7th ICS
Post-orthopedic surgery how should treating a SD be approached?
Treat SD above and below to ↑ mobility
A fever is defined as how many degree farenheit and celsius?
>100.4 °F (38°C)
What are the 5 “rule of W’s” for post-op fever; how many days post-op (POD) is each associated with?
- 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
Shallow breaths without maximal inhalation may lead to what post-op complication?
Atelectasis
What are 3 contributing factors to pre-tibial edema?
- Immobility due to bedrest
- Systemic inflammation secondary to surgery
- Insufficient circulation and lymph drainage
