M1T3 OMM Midterm Flashcards
1
Q
The ________ technique utilizes indirect and direct techniques.
A
Still
2
Q
What specific OMM techniques are useful in cardiac disease?
A
BLTIndirect myofascial release Indirect release of diaphragmOccipito-atlantal decompressionRib raising
3
Q
_________ test uses the scalenes to elevate the first rib. This test can identify scalene ________.
A
Adson’s, trigger points
4
Q
The lower ureters are innervated by what spinal cord level(s)? (sympathetics)
A
T12-L1
5
Q
The posterior Chapman’s point for the heart is located between ________ (between the ________ and the ________).
A
Vertebrae 2 and 3, spinous process, transverse process
6
Q
Any condition or procedure that damages the lymph nodes or vessels that can cause lymphedema is ________ lymphedema.
A
Secondary
7
Q
What are the three ways to increase lymphatic flow through osteopathic techniques?
A
1) reduction of primary tissue resistance (fibrotic/scarred/surgically altered)2) reduction of secondary tissue resistance (neurologic etiology)3) reduction of somatic dysfunction
8
Q
LAS is very good for treating ________ and ________ issues.
A
Upper, lower extremity
9
Q
What type of osteopathic medicine implements the use of oscillations?
A
Cranial
10
Q
Muscle involvement in viscerosomatic reflexes may cause ________ and ________ to the side of the involved organ as well as ________.
A
SB, rotation, extension
11
Q
Any cyclic change in the level of a bodily chemical or function is known as ________.
A
Biological rhythm
12
Q
The biomechanics of the 11th and 12th ribs exhibit ________ motion.
A
Caliper
13
Q
Although BLT/LAS are nearly identical, ________ has a greater diversity of techniques.
A
LAS
14
Q
Indications for lymphatic treatment are ________, ________, ________, or ________.
A
CHF, parenchymal disease, infections, tonic stimulation
15
Q
The biomechanics of ribs (6)7-10 are mainly ________ motion.
A
Bucket handle
16
Q
The lower extremeties are innervated by what spinal cord level(s)? (sympathetics)
A
T11-L2
17
Q
Dysfunctional rib motion can have ________, ________, and ________ effects.
A
Gastrointestinal, pulmonary, cardiovascular
18
Q
Pump handle motion is generally in the ________ plane whereas bucket handle motion is in the ________ plane.
A
Sagittal, coronal
19
Q
A ________ is a hyper-irritable spot in skeletal muscle associated with a hypersensitive palpable nodule, in a taut band.
A
Myofascial trigger point
20
Q
The key lesion indicating a psoas major issue is a ________ biomechanical diagnosis at the level of ________ or ________ (the side of the shortened psoas will be the side in which side bending and rotation occur.
A
Type II, L1, L2
21
Q
Viscerosomatic reflexes are ________ related to paraspinal muscle hypertonicity.
A
Segmentally
22
Q
Overuse of the wrist/finger flexors and pronator teres can lead to ________.
A
Carpel tunnel syndrome symptoms
23
Q
________ is an indirect technique that treats quickly within 3-5 seconds.
A
Facilitated positional release
24
Q
The ________ reflex is an example of a vicserovisceral reflex.
A
Gastro-colic (food in, poop out)
25
The heart and lungs both drain into the ________ lymphatic duct system. However, the pericardium drains into the ________ lymphatic duct system.
Right, thoracic
26
Tightness in the left shoulder/arm with the onset of an MI is an example of a ________ reflex.
Viscerosomatic
27
In viscerosomatic reflexes of the GI tract, rib somatic dysfunctions will relate to foregut, midgut, and hindgut sympathetic innervation. The levels are ________, ________, and ________ respectively.
T5-T9, T10-T11, T12-L2
28
To perform FPR, the physician places the region of treatment into a ________ position or “flattens the curve.” Then an ________ is applied. The region is then placed further into its ________ and held for 3-5 seconds.
Neutral, activation force, direction of ease
29
________ demonstrated the existence of a circadian rhythm in plants.
Jean-Jacques D’ortous de Mairan
30
The innervation of the ________ side of the heart has more influence on heart rate via the SA node.
Right
31
________ sympathetic tone occurs with CHF and leads to an increased afterload. OMT has been shown to ________ sympathetic tone.
Increased, decrease (balance more so)
32
As fluid pressure increases in the interstitium, the fenestrations of the lymphatics ________.
Close
33
Metronomes are able to communicate and synchronize by transferring ________ or put another way, communicating through ________ forces.
Kinetic energy, mechanical
34
Viscerosomatic reflexes respond well to ________ and/or ________ techniques.
ME, BLT
35
Cardiac plexus fibers that come from the right tend to innervate the ________.
SA node
36
The appendix is innervated by what spinal cord level(s)? (sympathetics)
T12
37
Prolonged poor posture that leads to palpitations is an example of a ________ reflex.
Somatovisceral
38
In viscerosomatic reflexes of the GI tract, tissue texture changes that are likely to occur are paraspinal and intercostal muscle ________.
Hypertonicity
39
With CHF, you have to be careful to not ________ the pump when increasing fluid return with OMT.
Overload
40
________ is the most important Zeitgeber in nature.
Light
41
A useful osteopathic mantra for care consists of which models?
Neurologic (autonomics per Dr. Noto-Bell)Fluid (lymphatics per Dr. Noto-Bell)Mechanics (biomechanics per Dr. Noto-Bell)
42
For a targeted area, you should treat lymphatics in a ________ to ________ pattern.
Central, peripheral
43
One of the main differences between FPR and Still technique is that FPR does not utilize an _______ with a continuous vector towards the barrier.
Arc of motion
44
If hypertonicity is identified within a recurrent postural muscle pattern, treat the underlying ________.
Postural problem
45
The prostate is innervated by what spinal cord level(s)? (sympathetics)
T12-L2
46
In appendicitis, where are you likely to see hypertonicity?
Peri-umbilical, tip of 12th rib, McBurney’s point and rebound tenderness
47
The main treatment goal of lymphatic techniques is to ________.
Control limb swelling
48
What are the most common techniques used for rib dysfunctions?
PIR (less common)Respiratory assist (best for inhalation dysfunctions)Joint mobilization using muscle force (best for exhalation dysfunctions)
49
The upper ureters are innervated by what spinal cord level(s)? (sympathetics)
T10-T11
50
The three steps to perform BLT/LAS are ________, ________ and ________.
Disengagement, exaggeration (in the direction of ease), balance
51
Some of the treatments for hypertonicity consist of ________, ________, ________, and ________.
Soft tissue, myofascial release, counterstrain, ME
52
________ can be described as the normal joint state of ligaments in which they are equally balanced (similar to tensegrity)
Balanced ligamentous tension
53
The vital cycle depends on vibration or “waves of vibration” was an idea introduced by ________ in 1902.
J.M. Littlejohn
54
Chapman’s points around the umbilicus are viscerosomatic reflexes from the ________, ________, and ________.
Bladder, kidneys, and adrenal glands
55
In PIR costal ME, the hand anchoring the rib should ________ the rib to move in the inhalation direction.
Not allow
56
Extrinsic pumping of the lymphatics can be caused by ________ and ________.
Contraction of the surrounding muscles, movement of body parts
57
Pectoralis trigger points in patients with cardiac disease may be associated with ________.
Coronary artery insufficiency
58
What is the leading precipitating and perpetuating factor of myofascial trigger points?
Postural imbalance
59
The ________ and ________ are principle muscles in inhalation.
External intercostals, diaphragm
60
One of the major applications of OMT in the respiratory-circulatory model is ________.
Freeing restricted diaphragms
61
60% of patients with coronary artery disease have been found to have ________ trigger points.
Pectoralis major
62
In BLT/LAS you serve as a ________ vs providing a direct action.
Facilitator
63
The ribs can be palpated just ________ to the thoracic transverse processes.
Lateral
64
For inhalation dysfunctions, the key rib will be the ________ rib of the group.
Lowest
65
________ describes the somatic dysfunction that occurs in the ligamentous structures that surround a joint.
Ligamentous articular strain
66
Always treat ________ dysfunctions first and then costal dysfunctions, unless the costal dysfunction is ________.
Thoracovertebral, non-physiologic
67
Other techniques that can incorporate oscillations include ________, ________, ________, and ________.
BLT, counterstrain, ME, and soft tissue
68
With ME treatments, ________ is used for an acute painful muscle and utilizes reflex relaxation. ________ is used for a tight muscle (usually chronic) and causes intramuscular change.
Reciprocal inhibition, post-isometric relaxation
69
Best performance on thinking tests occurs at ________.
12:00
70
The sharpest rise in blood pressure occurs in the ________.
Early morning
71
________ causes the greatest increase in lymph flow (15-20 times greater flow rate).
Exercise
72
Facilitated segments require ________ stimulation than normal to trigger an action potential.
Less
73
Posterior Chapman’s points are used more so for ________.
Treatment
74
Sonoelastography imaging is utilized to identity trigger points by measuring ________ within muscle.
Stiffness
75
A shortened psoas major leads to a positive ________.
Thomas test
76
Which muscle is the most overlooked cause of myofascial low back pain?
Quadratus lumborum
77
An ________ is a mechanical or electronic device that works on the principles of oscillation.
Oscillator
78
The anterior Chapman’s point for the heart is located in the ________ space between ________.
Intercostal, ribs 2 and 3
79
When treating ribs, PIR is used to treat dysfunction in which the restriction is secondary to ________.
Muscle hypertonicity
80
Anterior Chapman’s points are used more so for assistance with ________.
Diagnosis
81
Lymphedema is distinct from generalized edema by its ________, ________, and ________.
Localization, gradual progression, absence of generalized edema causes
82
Cardiac plexus fibers that come from the left tend to innervate the ________.
AV node
83
In the Still technique, ________ has profound effects on the effectiveness of the technique.
Maintaining the force vector
84
For costal dysfunctions, treatments should last ________ seconds.
5-7
85
The upper extremeties are innervated by what spinal cord level(s)? (sympathetics)
T2-T6
86
In viscerosomatic reflexes of the GI tract, ________ reflexes or ________ may be present.
Chapman’s, myofascial trigger points
87
Of the numerous scenarios in which hypertonicity can occur, ________ and ________ are special conditions that have associated pain, decreased range of motion, and N-V-L entrapment.
Myofascial trigger points, viscerosomatic reflexes
88
Sympathetic innervation of the heart comes from the ________ plexus and arises from ________ of the sympathetic trunk.
Cardiac, T1-T5
89
The myocardium is generally innervated more so by the ________ side of the cardiac plexus.
Left
90
The kidneys are innervated by what spinal cord level(s)? (sympathetics)
T10-T11
91
BLT is very good for treating ________ and ________ vertebral segmental dysfunctions.
Cervical, lumbar
92
To perform the Still technique, place the structure in its ________, apply a ________, move the structure through an arc into the ________, and release the ________.
Position of ease, force vector, barrier, force vector
93
Chapman’s points on the posterolateral thighs are viscerosomatic reflexes from the ________.
Prostate/broad ligament
94
Upon palpation of a myofascial trigger point, you may feel a ________, ________ and the patient may experience ________.
Taut band, twitching, radiating pain
95
Highest alertness occurs at ________.
10:00
96
Which ME technique contracts the symptomatic muscle without lengthening or shortening to internally increase range of motion through the barrier?
Post-isometric relaxation
97
The uterus/cervix are innervated by what spinal cord level(s)? (sympathetics)
T10-L2
98
________ lymphedema is a rare and inherited condition.
Primary
99
________ reflexes are tapioca bead like points that block lymphatic drainage, causing inflammation.
Chapman’s
100
An active trigger point is one in which pain occurs at ________ with muscle activity or palpation.
Rest
101
Although balanced ligamentous tension and ligamentous articular strain were developed by different groups, the techniques are almost ________.
Identical
102
LAS can be caused when distribution and vectors of tension between and within ligaments are ________.
Altered
103
Besides carrying excess fluid back to the heart, the lymphatics are responsible for carrying ________ and ________.
Proteins, large particulate matter
104
When identified, the key rib is the rib that should be treated ________.
First
105
Peri-umbilical pain is a _______ reflex, tip of the 12th rib is a ________ reflex, and McBurney’s point and rebound tenderness are ________ reflexes.
Visceral, viscerosomatic, peritoneocutaneous
106
The ________ reflex and ________ are examples of somatosomatic reflexes.
Righting, myofascial trigger points
107
A latent tigger point is one in which pain only occurs when probed with ________.
Steady pressure
108
The stimuli that cause external changes in biological rhythm and synchronize us to the Earth’s cycles are known as ________.
Zeitgebers (time givers)
109
The mechanics of the first and second rib can be described as ________ like.
Pump handle
110
Which ME technique contracts an asymptomatic muscle in order to inhibit a tight muscle so that it can be lengthened?
Reciprocal inhibition
111
The muscle tissue around the thoracic duct is innervated by ________.
Sympathetics
112
An upper motor neuron lesion can lead to ________ and a lower motor neuron lesion can lead to ________.
Spasticity, flaccidity
113
20% of patients have 2-3 separate lymphatic trunks emptying into the junction of the ________ vein and the ________ vein.
Jugular, subclavian
114
FPR is used to decrease muscle ________ or to ________ motion to a restricted articulation/structure.
Hypertonicity, restore
115
There are two terms that are related to the term “spasm.” ________ refers to an upper motor neuron lesion whereas ________ refers to tight muscles.
Spasticity, hypertonicity
116
________ liters/day of fluid returns back into circulation via the lymphatics.
3
117
Cytoplasm (neuroplasm) of an axon that encloses the neurofibrils is known as ________.
Axoplasm
118
Best coordination/time to work out is in the ________.
Afternoon
119
Rib springing is a ________ technique.
Non-physiologic/mechanical
120
BLT/LAS, Still technique, and FPR are all ________ techniques.
Indirect
121
Metabolic neuropathies, such as ________, can cause there to be less nociceptive input and mask an MI.
Diabetes
122
In costal ME, the respiratory assist technique is most useful in ________ dysfunctions (primary joint restriction with minimal muscle involvement).
Articular costal
123
The adrenal medulla is innervated by what spinal cord level(s)? (sympathetics)
T10
124
The ________ and ________ aid in active breathing (exhalation).
Internal intercostals, abdominal musculature (rectus abdominis, external/internal oblique, transversus abdominis)
125
________ can result from a number of stimuli such as local trauma, compensation, functional demand/overuse, visceral dysfunction, and reflex mechanisms.
Hypertonicity
126
The innervation of the ________ side of the heart has more influence on cardiac output and myocardial contractility.
Left
127
The AV node is innervated by the ________ vagus nerve.
Left
128
In both BLT and LAS, the physician’s contact serves as a ________ to balance out the strain across the ligaments of a joint.
Fulcrum
129
The SA node is innervated by the ________ vagus nerve.
Right
130
Where is it easiest to palpate rib motion?
The location at which the rib traverses through its greatest arc.
131
________ are the primary site of vascular resistance.
Arterioles
132
Chapman’s points on the tip of the 12th ribs are viscerosomatic reflexes from the ________.
Appendix
133
The ________ system facilitates the clearance of substance from the brain.
Glymphatic
134
Facilitated segments can be maintained by ________ CNS activity.
NORMAL
135
Lymphatic OMT in malignancy is ________ other than treating directly on the tumor.
Not contraindicated
136
For exhalation dysfunctions, the key rib will be the ________ rib in the group.
Upper most
137
________ angina is precordial chest pain that resembles true cardiac angina and results from cervical pathologies affecting the cervical spinal nerves.
Cervicogenic
138
Rib palpation utilizing respiration is a ________ technique.
Physiologic
139
The biomechanics of ribs 3-5(6) are a combination of ________ and ________ motions.
Pump handle, bucket handle
140
Chapman’s points on the anterolateral thighs are viscerosomatic reflexes from the ________.
Large intestine
141
The tissue texture change will be greater than the change in range of motion in ________ reflexes.
Viscerosomatic
142
Viscerosomatic reflexes that occur via the vagus nerves will present at the ________, ________, and ________.
Occiput, C1, C2
143
The Chapman’s point in the second intercostal space is a viscerosomatic reflex from the ________.
Myocardium
144
________ occurs from overlap of visceral afferent neurons and somatic efferent neurons.
Referred pain
145
There are three main categories in the spectrum of muscle tone. Muscle tone can either be ________ (tension), ________ (contracted), or _________(contracture).
Functional, dysfunctional, pathological
146
The bladder is innervated by what spinal cord level(s)? (sympathetics)
T11-L2
147
A ________ is defined as all the muscle fibers that receive innervation from the same nerve.
Myotactic unit
148
Viscerosomatic reflexes that arise from cardiac arrhythmias will occur at ________.
T2
149
Overuse of the scalenes/pectoral is minor can lead to ________.
Thoracic outlet syndrome
150
The main site for lymphatic emptying is in the anatomic ________.
Superior thoracic aperture
151
The ________ and ________ are accessory muscles that aid in inhalation.
Sternocleidomastoid, scalenes
152
________ is the idea that treatment for certain conditions at specific times of the day/night can be either more or less effective. This was first suggested by ________.
Chronotherapy, Franz Halberg
153
CHF is associated with increased venous pressure. Treatment of the lymphatics ________ lymphatic return and ________ central venous pressure.
Increases, decreases
