M1T2 OMM Midterm Flashcards by Gregory Skedros

Normal physiological motion does not apply to the cervical region due to the ________ of OA and AA, the ________ of the facets of C2-C7, and the ________ of the vertebral bodies, ligamentous attachments, and muscular insertions.

Atypical facets, oblique plane, shape

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Dysbiosis and intestinal hyperpermeability can lead to a ________, ________, and ________.

Hyperactive immune system, allergic reactions, increased HPA axis activity

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Sensory fibers are composed of two types. ________ are activated in slow and rapid lengthening of muscle spindle fibers. ________ are activated only during slow lengthening.

Primary endings (annulospiral), secondary endings

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In an allostatic response, compensation is usually through ________, ________, and ________.

Posture, mechanics, metabolism

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Aδ fibers alone can localize within ________, but coupled with ________ receptors, the pain can be nearly exactly localized.

10 cm, tactile

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Aδ fibers use ________ as their neurotransmitter and terminate in the ________.

Glutamate, lamina marginalia of the dorsal horns

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The upper extremities innervated by what spinal cord level(s)? (sympathetics)

T2-T6

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What are indirect options for cervical injury?

Cranial manipulationCounterstrainMFRBLT/LASFPR

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Hyperextension occurs within the first ________ seconds following impact.

0.25

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The volatile oil found in peppermint (menthol) has what property? What is this most likely due to?

AntispasmodicCalcium channel blockade

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Probiotics are particularly helpful for treating ________.

Antibiotic associated diarrhea

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What are some examples of tonic/postural muscles in the pelvic/hip region?

HamstringsIliopsoas PiriformisTensor fascia lataRectus femorus Thigh adductors

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When a greater noxious stimulus is required to tigger an action potential but pain shoots directly to maximal intensity and lasts longer than normal, it is known as ________.

Hyperpathia

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An important aspect of integrative medicine is that it is informed by ________.

Evidence

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Muscle spindles have few or lack ________.

Actin or myosin filaments

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________ are receptors responsible for touch and pressure.

Free nerve endings

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TCM originated in China and evolved over ________ years ago

2500

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Muscle spindles are located in the ________ of the muscle and give info about muscle ________ and ________.

Belly, length, rate of change of length

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Fast, sharp pain from mechanical or heat stimuli travels on ________ rapidly.

Aδ fibers

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A ________ strain or sprain is a ________ injury that consists of complete tissue rupture, severe bleeding/swelling, spasm/hypertonicity, unstable joints, and 6-8 weeks of recovery. This type usually requires ________.

Third, macroscopic, surgery

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Opioid substances bind to ________ in the brain and spinal cord.

μreceptors

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________ point tenderness is likely to be associated with a more serious injury than posterior element pain.

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Due to its antispasmodic properties on smooth muscle in the GI tract, peppermint may actually make someone with ________ worse.

Acid reflux

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Medicine that views the physical, mental, and spiritual aspects of life as closely interconnected is known as ________ medicine.

Holistic

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What are 4 safety factors impacting MVA-related cervical strain/sprain?

1) firm seat back2) seat belt/shoulder strap3) high stiff headrest4) inflatable airbag

A noxious stimulus that is more painful than expected is known as ________.

Hyperalgesia

When did board certification by the American Board of Integrative Holistic Medicine start?

2000

What year did the American Holistic Medical Association start?

1978

In the GI system, fennel has ________ effects and probably acts as an ________ and ________.

Antispasmodic, anticholinergic, calcium blocker

How are upper and lower crossed syndrome treated? (In what sequence)

1) Core retraining2) Stretch and lengthen hypertonic postural muscles3) Activate and strengthen inhibited dynamic muscles4) Maintenance (home exercises)

Homeopathy became popular with physicians in Philadelphia in what year(s)?

1830s

What are some herbs/nutritional medicines that can be recommended for irritable bowel syndrome?

PeppermintFennelProbioticsSaccharomyces boulardii

The lower ureters are innervated by what spinal cord level(s)? (sympathetics)

T12-L1

The upper ureters are innervated by what spinal cord level(s)? (sympathetics)

T10-T11

“Vital dynamis” is disease caused by deterioration of an immaterial vital principle in individuals and is associated with ________.

Homeopathy

In the ALS, the primary neuron synapses in the ________, the secondary neuron synapses in the ________ and the tertiary neuron synapses in the ________.

Dorsal horn, thalamus, cortex

Contraction of a muscle involves reciprocal inhibition of the ________ antagonist and ________ agonist.

Ipsilateral, contralateral

The Golgi tendon reflex occurs when ________.

Stress on a tendon becomes too great

The adrenal medulla is innervated by what spinal cord level(s)? (sympathetics)

T10

What are direct options for cervical injury?

Soft tissueMFRME (PIR)HVLA

Upper crossed syndrome involves weak ________ and ________, and tightened ________ and ________.

Neck flexors, middle/lower trapezius, upper trapezius/levator scapulae, SCM/pectorals

When did the first fellowship in Integrative Medicine begin?

1997

The primary motion of AA is ________ and accounts for the first ________ of this motion.

Rotation, 50%

Dysfunctions in hip extension can lead to ________ pelvic tilt, lumbar ________, and a number of other issues.

Anterior, hyperlordosis

The appendix is innervated by what spinal cord level(s)? (sympathetics)

T12

What are two other names for the “joints of Luschka” and what do they prevent?

Uncinate processes, uncovertebral jointsPrevent posterolateral disc herniation

The downward spiral is a combination of ________, ________, and ________ and leads to maintenance and exacerbation of somatic dysfunction.

Chronic inflammation, vasoconstriction, muscle spasm

The coupling at the OA joint exhibits type I like motion due to the ________ and the ________.

Lateral atlanto-occipital membrane, morphology of the superior facets of the atlas

What are some examples of dynamic/phasic muscles in the pelvic/hip region?

Vastus medialis/lateralisGluteus minimus Gluteus mediusGluteus maxiums

Inactivation of pain pathways can occur via two kinds of substances. These are ________ and ________.

Exogenous opiates, endogenous opioid substances

The higher a stimulation risers above a threshold, the ________ the frequency of action potentials.

Greater

The uterus and cervix are innervated by what spinal cord level(s)? (sympathetics)

T10-L2

The TCM concept of acupuncture consists of ________ principle meridians and ________ “extraordinary” meridians.

12, 8

Substance P is released ________ and builds up in concentration over ________.

Slowly, minutes

The analgesia system suppresses pain by sending efferent signals to inhibitory complexes in the ________.

Dorsal horns

A ________ degree strain/sprain is a ________ injury that consists of moderate-to-severe bleeding and swelling, spasms/hypertonicity, moderate-to-severe pain, relative joint/tissue stability, and 4-6 weeks of recovery.

Second, macroscopic

Pseudounipolar sensory neurons contained within the dorsal root ganglia are capable of secreting ________.

Substance P

Who first described upper and lower crossed syndromes?

Vladimir Janda, MD, DSc

________ are receptors responsible for fast vibration.

Pacinian corpuscles

________ occurs due to a neuron being repeatedly fired and thus results in a raised resting membrane potential.

Facilitation

The maintenance of a pool of neurons in a state of partial or sub-threshold excitation is known as ________.

Segmental facilitation

The ________ acts via the periaqueductal gray, periventricular areas, raphe magnus nucleus, and nucleus reticularis paragigantocellularis.

Analgesia system

Slow, chronic pain from chemical, mechanical, or thermal stimuli travels on ________ slowly.

C fibers

Who described the 2 phase mechanism of whiplash and when?

Heilig (1960s)

________ are receptors responsible for muscle stretch and load.

Golgi tendon apparatus

The pathway for muscle stretch reflexes is a ________ pathway.

Monosynaptic

Pain is suppressed by the ________, sending signals to inhibit pain input.

Brain

What are the 4 R’s of Functional Medicine?

RemoveReinnoculationReplaceRepair

The focus of ________ medicine is on systems, often starting with the GI system.

Functional

What is the muscle firing pattern of hip extension?

1) Hamstrings2) Gluteus Maximus3) Contralateral lumbar erector spinae4) Ipsilateral lumbar erector spinae

The ends of muscle spindles contract via ________ and the mid portion contains ________.

Gamma motor nerve fibers, sensory fibers

When was the Office of Alternative Medicine set up with NIH?

1993

Normal vertebral arteries can narrow as much as ________ of their luminal size on the ________ side to cervical rotation.

90%, contralateral

Integrative medicine was first made popular by ________ at his program in ________.

Dr. Weil, Tucson, AZ

What are the two ways intensity can be increased?

Spatial summation and temporal summation

When a non-noxious stimulus is painful, it is known as ________.

Allodynia

Lower crossed syndrome involves weak ________ and ________, and tightened ________ and ________.

Abdominals, gluteus maximus, hip flexors, erector spinae

S. boulardii also helps prevent ________ associated with antibiotic use, tube feedings, and GI infections (especially of children)

Diarrhea

Free nerve endings are not ________ and responsive to ________.

Encapsulated, noxious stimuli

Nociception is the sensing of ________.

Tissue damage

What are some theoretical causes of muscle imbalance?

Dysregulation of the CNSPostural adaptation to gravityChange in mechanical behavior of jointsHabitual movement pattersNoxious stimuliMuscle balance responds to physical demandsPsychological influences

________ are receptors responsible for touch, slow vibration.

Meissner’s corpuscles

Other GI effects that peppermint oil can have are:

Improve rhythmic peristaltic activity Relieves intestinal spasmIncreased bile secretionAntiulcerogenic effect

The kidneys are innervated by what spinal cord level(s)? (sympathetics)

T10-T11

________ is a non-pathogenic yeast strain isolated from the skins of tropical fruit and is used to prevent and treat diarrhea.

Saccharomyces boulardii

The lower extremities are innervated by what spinal cord level(s)? (sympathetics)

T11-L2

When the neck is rotated 45 degrees, the ability to normally extend ________ by 50%

Decreases

________ are slow adaptive receptors in order to give the brain constant information.

Golgi tendon apparatus’

The body knows when a sensory receptor is receiving more or less stimulation by ________.

The frequency of action potentials

What are the three distinct biomechanical areas of the cervical region?

OA (C0-C1), AA (C1-C2), C2-C7

________ are receptors responsible for pressure and joint rotation.

Ruffini’s end organ

Cervical strain and sprain can be defined as:

Microscopic or macroscopic injury to the soft tissues of the cervical region

The jaw is thrown ________ during rear impact and thrown ________ during frontal impact.

Inferiorly, superiorly

An allostatic response is a _______ level change and is a generalized adaptive reaction to stress.

Macro

The motions of C2-C7 are ________ and the coupling is ________ like.

Flexion-extension, Type II (rotation and side bending are the same)

________ are rapidly adaptive receptors and give information about change as it happens.

Pacinian corpuscles

A chronic facilitated muscle can lead to prolonged ________ of an antagonist and eventually muscle weakness.

Inhibition

Muscle stretch reflexes are initiated by a ________.

Sudden stretch of muscle spindle.

________ produces a protein that breaks down and inhibits the binding of C. difficile-produced toxin A.

S. boulardii

Glutamate acts ________ and last for ________.

Instantaneously, a few milliseconds

With prolonged stimulation, the frequency of action potentials ________.

Falls

Golgi tendon organs are located in muscle ________ and give info about ________ and ________.

Tendons, tendon tension, rate of change of tendon tension

Who introduced the term “whiplash” and when?

Crow (1925)

An acute injury can be either ________ or ________, where as chronic injuries are usually just ________.

Microscopic, macroscopic, microscopic

When was the National Center for Complementary and Alternative Medicine established?

1998

A ________ is a musculotendinous soft tissue injury and a ________ is a ligamentous injury.

Strain, sprain

Pain can be suppressed by either activating the ________ or inactivating ________.

Analgesia system, pain pathways

C fibers use ________ and glutamate as their neurotransmitters and terminate in the ________.

Substance P, substantia gelatinosa of the dorsal horns

The superior facets of C3-C7 are positioned ________, ________, and ________.

Backwards, upwards, medial (BUM)

When was the American Board of Integrative Medicine established?

2014

Stimulation of the intralaminar nuclei of the thalamus has a strong ________ effect on the entire brain.

Arousal

The prostate is innervated by what spinal cord level(s)? (sympathetics)

T12-L2

When it comes to adaptation, pain receptors adapt ________.

Little, if at all

A ________ of the cervical curvature indicates a significant abnormality.

Reversal

Why are individuals less likely to sustain an injury in a collision that is <15 mph?

Able to brace on the steering wheel

The coupling of OA is ________ like and exhibits this coupling whether neutral or non-neutral.

Type I (rotation and side bending are opposite)

Prebiotics are complex sugars used as ________ by bacteria.

Fuel

The bladder is innervated by what spinal cord level(s)? (sympathetics)

T11-L2

A ________ degree strain/sprain is a ________ injury that consists of little-to-no bleeding and swelling, joint/tissue stability, and a 1-4 week recovery period.

First, microscopic injury