M1T3 OMM Final Flashcards

1
Q

Sympathetic innervation of the pulmonary system is from ________.

A

T1-T6

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2
Q

Within the musculoskeletal and neurological exam, you could use ________ test and measure the angle of trunk rotation using a ________.

A

Adam’s forward bend, Scoliometer

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3
Q

________ makes up for 80% of all structural scoliosis and at least ________ percent have a genetic etiologic basis.

A

Idiopathic, 90%

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4
Q

For an acute myocardial infarction, OMT should be limited to ________ techniques.

A

Indirect

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5
Q

The Charleston bending brace bends the patient towards the ________ of the curve and overcorrects. It is recommended for spinal curves of ________ degrees.

A

Convexity, 20-35

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6
Q

In general, there is a greater risk for curve progression as the Risser Sign grade ________.

A

Decreases

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7
Q

One of the problems with OMM research is in picking a ________ for the experimental group to be compared against.

A

Placebo

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8
Q

________ percent of scoliosis is due to neuromuscular, syndromic, or congenital disorders.

A

20%

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9
Q

________ is a local sensitivity to cold in peripheral vessels due to vasoconstriction.

A

Raynaud’s phenomenon

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10
Q

Documenting changes can be difficult due to ________ being subjective.

A

Pain/symptoms

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11
Q

The most popular modern underarm brace is known as the ________. It is prescribed for curves in the ________ or ________ spine.

A

Boston brace, lumbar, thoracolumbar

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12
Q

Methods: 55 patients who underwent major GI operation received OMT or notResults: Significant difference in time to flatus and postoperative hospital LOS in OMT group when compared to non-OMT groupConclusions: OMT applied after major GI operation is associated with decreased time to flatus and postoperative hospital LOS

A

Study: Effect of OMT on incidence of postoperative ileus and hospital LOS in general surgery patients

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13
Q

Neurological theories suggest that AIS patients may have lower levels of ________ and that children with idiopathic scoliosis may have a ________ deficit.

A

Cerebellar tonsillar, vestibular

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14
Q

Left sided parasympathetic innervation of the heart may be associated with what pathology?

A

AV block

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15
Q

In CHF, the goal of using ________ is to restore lymphatic return to normal levels.

A

Lymphatic pumps

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16
Q

A flattened thoracic curve can be associated with

A

Tachyarrhythmias

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17
Q

Researches were able to induce scoliosis in Zebra fish by mutating the ________ or ________ cilia genes. When the gene was repaired, they were able to ________ curves from forming.

A

c21, f59, prevent

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18
Q

The best osteopathic techniques for scoliosis patients are ________, ________, and ________ techniques.

A

soft tissue, myofascial release, indirect

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19
Q

________ is a subset of ITT analysis and induces only the people who completed the study.

A

Per-protocol population

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20
Q

Children with congenital scoliosis who are surgical candidates need extensive ________ and ________ evaluations.

A

Cardiopulmonary, genitourinary

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21
Q

Unlike the sympathetics, there is ________ parasympathetic activity on the lymphatics.

A

No

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22
Q

The main way to tell the difference between NS/F and S scoliosis is that the curve ________ in NS/F and ________ in S.

A

Corrects, does not correct

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23
Q

In addition to chondrification center defects, those with congenital scoliosis may also have ________ defects.

A

Genitourinary (20-40%)

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24
Q

Left sided sympathetic innervation of the heart may be associated with what pathologies?

A

Ectopic foci and Vfib

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25
Q

Congenital kyphosis can be caused by failure of ________ or failure of ________.

A

Formation, segmentation

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26
Q

Right sided sympathetic innervation of the heart may be associated with what pathology?

A

SVT

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27
Q

Facilitation due to heart issues generally occurs at the left paraspinal region at the levels of ________.

A

T2-T4

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28
Q

The parietal pleura (except the diaphragmatic pleura) is innervated by ________.

A

Intercostal nerves (ventral rami)

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29
Q

Patients with scoliosis will generally have pain less than ________ percent and is ________ after activity.

A

50%, worse

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30
Q

Juvenile scoliosis affects mainly ________ and is mainly a ________ convexity.

A

Girls, right sided thoracic

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31
Q

Osteopathic techniques will help optimize structure and function in scoliosis patients, but it is not intended to ________.

A

Straighten curves

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32
Q

Irritation of the ________ branches of the vagus have the strongest effect on slowing heart rate.

A

Pulmonary

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33
Q

Idiopathic scoliosis can be further broken down into ________, ________, and ________.

A

Infantile (0-3), juvenile (3-9), adolescent (>10)

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34
Q

Scoliosis can ________ even after skeletal maturity is achieved.

A

Progress

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35
Q

How is Wright’s test performed? Result?

A

Hyperabduct/externally rotate affected armFeel radial pulseIf decreased, test is positive

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36
Q

Sympathetic innervation for the head/neck vasculature comes from ________.

A

T1-T4

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37
Q

A right ________ curve is the most common type of curve, followed by a right ________ curve.

A

Thoracic, thoracolumbar

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38
Q

Intersegmental motion testing will change above and below the ________. Above will be ________ mechanics and below will be ________ mechanics.

A

Apex, type I, type II

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39
Q

The three classifications of structural scoliosis are ________, ________, and ________.

A

Idiopathic, congenital, neuromuscular

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40
Q

Although the inheritance pattern of scoliosis is unclear, ________ patients have a positive family history.

A

Adolescent idiopathic scoliosis (AIS)

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41
Q

Methods: 406 pneumonia patients at 7 community hospitals receiving OMT or conventional care only (CCO)Results: Significant difference in LOS and antibiotic duration when comparing OMT group vs CCO groupConclusions: Per protocol analysis found significant differences between OMT and CCO groups when looking at LOS, antibiotic duration, and respiratory failure/death

A

Study: Multicenter Osteopathic Pneumonia Study in the Elderly (MOPSE)

42
Q

________ treatment can make it easier to conduct studies, however, OMT isn’t performed in such a rigid fashion normally.

A

Protocol-based

43
Q

The posterior Chapman’s point for the upper lung is between the ________, midway between the spinous process and transverse process. The lower lung is similar but one level lower.

A

3rd and 4th transverse processes

44
Q

Severity of scoliosis is best diagnosed by ________.

A

X-ray

45
Q

Sympathetic innervation for the upper extremity vasculature comes from ________.

A

T2-T7

46
Q

Scoliosis is described by the side to which its ________ is directed.

A

Convexity

47
Q

Nonstructural/functional scoliosis is also known as ________ or ________. ________ refers to slight deviations that correct voluntarily and disappear with movement, while ________ is due to an underlying condition (shorter leg).

A

Postural, compensatory, postural, compensatory

48
Q

________ percent of scoliosis is idiopathic.

A

80%

49
Q

In the future, ________ will help OMT studies remain objective, quantifiable, and reproducible.

A

Biomarkers

50
Q

Methods: COPD patients undergo pulmonary rehab (PR) + OMT or just PRResults: PR + OMT group showed an increased 6 min walk test and a significant difference in decreased RV when compared to the other groupConclusions: PR + OMT improves exercise capacity and reduces RV in severely impaired COPD patients compared to PR alone

A

Study: OMT effectiveness in severe COPD

51
Q

The most common type of scoliosis is ________.

A

Adolescent Idiopathic Scoliosis (AIS)

52
Q

On the osteopathic structural exam, ________ and ________ should be used to evaluate if someone has scoliosis.

A

Gait, static asymmetries

53
Q

OMT directed at ________ can help reduce hypertension in certain situations.

A

T1-T5

54
Q

Trigger points on the anterior right pectoralis muscle can be associated with ________.

A

SVTs

55
Q

In nonstructural/functional scoliosis, the curve is ________ and the curve corrects itself when side bending ________ the convexity.

A

Flexible, towards

56
Q

Methods: 400 pregnant women in third trimester received OMT or placeboResults: Back pain was significantly improved in OMT group compared with usual care groupConclusions: OMT was effective for mitigating pain and functional deterioration compared with usual care group

A

Study: Pregnancy Research on Osteopathic Manipulation Optimizing Treatment Effects (PROMOTE)

57
Q

20% of the Vagus nerve is ________ while the remaining 80% is ________.

A

Efferent, afferent

58
Q

Of the three causes of scoliosis, ________ is the worst one to have.

A

Neuromuscular

59
Q

Adolescent scoliosis affects mainly ________ and is mainly a ________ convexity (90%).

A

Girls, right sided thoracic

60
Q

A major etiology of scoliosis is thought to be ________.

A

Genetics

61
Q

The goal of treatment for those with pulmonary disease is to maximize ________.

A

Homeostasis

62
Q

In ________, there is no swelling of the anterior rib/sternal joints, however, this swelling is seen in ________.

A

Costochondritis, Tietze Syndrome

63
Q

Within an area of autonomic innervation, facilitated segments should be treated ________.

A

First

64
Q

Abnormalities in the ________ often lead to congenital scoliosis.

A

Chondrification centers

65
Q

In thoracic outlet syndrome, symptoms caused by ________ are less common than those caused by neural/arterial etiologies.

A

Venous compression

66
Q

How is Roos test performed? Result?

A

Hold both elbows at shoulder height and retract shouldersOpen and close fists for 3 minsOnset of severe heaviness/fatigue, test is positive

67
Q

Methods: 39 subjects got Hep B vaccine with lymphatic pump or notResults: 50% of those who received pump had a response with average titer of 374 mlU/mL. Those who did not receive pump had an average of 96 mlU/mLConclusions: Lymphatic pump may result in higher titers after vaccination

A

Study: Effect of lymphatic and splenic pump techniques on the antibody response to hepatitis B vaccine

68
Q

A ScoliScore™ of ≤50 equates to ________ risk of curve progression. A score of 51-180 equates to ________ risk and a score of 181-200 equates to ________ risk.

A

Low, intermediate, high

69
Q

The anterior Chapman’s point for the upper lung is at the ________ parasternally, while the lower lung is at the ________ parasternally.

A

3rd intercostal space, 4th intercostal space

70
Q

What are the clinical anatomical borders of the thoracic outlet?

A

Clavicle, rib 1 and 2 (superior)Manubrium to sternal angle (anterior)Lower cervical vertebrae/T1-T4 (posterior)

71
Q

Progression of the curve in scoliosis can be increased in:

A

Patients <12GirlsPremenarchal womenCurves with initial Cobb ≥20˚Double/thoracic curvesRisser grade 0 or 1

72
Q

________ is defined as a lateral curve of the spine greater than 10 degrees associated with vertebral rotation.

A

Scoliosis

73
Q

Intersegmental motion testing will reveal rotation ________ the convexity (ALWAYS).

A

Towards

74
Q

Failure of formation can result in a ________ or a ________.

A

Hemivertebra (30%), wedge vertebra

75
Q

________ can be described as an anterior convexity or a posterior concavity.

A

Lordosis

76
Q

The Milwaukee brace is also known as the ________. The goal of this brace is to ________.

A

Cervico-Thoraco-Lumbo-Scaral Orthosis (CTLSO), prevent progression in skeletally immature patients

77
Q

How is Adson’s test performed? Result?

A

Abduct/externally rotate affected shoulderFeel radial pulseExtend/rotate head towards affected side.If decreased, test is positive

78
Q

What are the two major complications of randomized controlled trials?

A

Noncompliance and missing outcomes

79
Q

Failure of segmentation can result in a _______ or a ________.

A

Congenital bar (40%), block vertebra

80
Q

In structural scoliosis, the curve is ________ and the curve ________ be voluntarily straightened.

A

Not flexible, cannot

81
Q

Infantile scoliosis affects mainly ________ and is mainly a ________ convexity.

A

Boys, left sided thoracic

82
Q

Treating viscerosomatic reflex changes from T1-T6 will improve ________, ________, and ________.

A

Venous return, lymphatic drainage, biomechanics of breathing

83
Q

Both the Boston brace and the Charleston bending brace are types of ________.

A

Thoracic-Lumbar-Sacral Orthoses

84
Q

The lymph of the right lung drains into the ________ lymphatic duct. The lymph of the left lung drains into the ________ lymphatic duct (except for the left inferior lobe).

A

Right, thoracic

85
Q

Ventricular pain refers to the ________ dermatomes.

A

C8-T3

86
Q

The two main types of scoliosis are ________ and ________.

A

Nonstructural/functional, structural

87
Q

The ________ is used to assess skeletal maturity and evaluates the degree of ossification and fusion of the iliac apophysis.

A

Risser Sign

88
Q

How do you calculate a Cobb angle?

A

Identify the most cranial vertebra that has the greatest tilt from horizontal, draw a line parallel to superior end plateIdentify the most caudal vertebra that has the greatest tilt from horizontal, draw a line parallel to inferior end plateDraw lines perpendicular to both parallel lines and measure angle between the intersection

89
Q

The only group that suggests that screening for scoliosis has insufficient evidence regarding benefits/harms is the ________.

A

US Preventative Services Task Force

90
Q

Methods: Healthy adults assigned to rib raising or light touchResults: Significant decrease in α-amylase activity in those who received rib raising compared to those who did notConclusions: SNS activity may decrease immediately after rib raising, but HPA and parasympathetic activity are not altered

A

Study: Effects of rib raising on the autonomic nervous system

91
Q

The ________ brace targets neuromuscular dysfunction, growth asymmetry, postural disorganization, and spinal deformation. The best results are seen in patients who are ________ and who have Cobb angles of less than ________ degrees.

A

SpineCor, skeletally immature, 30

92
Q

Congenital spine deformities can be caused by failure of ________ development.

A

Bone

93
Q

The heart drains into the ________ lymphatic duct.

A

Right

94
Q

________ can be described as a posterior convexity or an anterior concavity.

A

Kyphosis

95
Q

Atrial pain refers to the ________ dermatomes.

A

T4-T6

96
Q

Instead of documenting pain, ________ or ________ can be followed.

A

Financial outcomes, hospital length of stay

97
Q

The Hueter-Volkmann principle states that increased ________ on a vertebral growth plate retards growth.

A

Pressure

98
Q

Methods: Subjects with FEV1% <70% received OMT or shamResults: OMT group had significant decrease in forced expiratory flow and a significant increase in residual volume and TLC compared to the sham groupConclusion: Overall worsening of air trapping 30 mins after OMT sessionDo these results mean that OMT is bad for those with COPD?

A

Study: Immediate effects of OMT in elderly patients with COPDNo, it shows that the techniques used may not be suitable for this specific age group with this disease

99
Q

The biomechanical theory of scoliosis is based on the ________ principle that suggests unequal ________ will cause change in vertebral bodies and cause wedging of the vertebrae.

A

Hueter-Volkmann, pressure

100
Q

Sympathetic innervation for the lower extremity vasculature comes from ________.

A

T10-L2

101
Q

________ analysis looks at all individuals in a study, regardless of whether they dropped out or not.

A

Intention to treat