M2T1 OMM Final Flashcards
1
Q
For Zink patterns, name the associated dysfunction for each level:
OA: C2-C6: T1-T5: T6-T12: L1-L2: L3-L5: Left innominate:
A
OA: F SR RL C2-C6: F SR RR T1-T5: N SL RR T6-T12: N SR RL L1-L2: N SR RL L3-L5: N SL RR Left innominate: posterior
(note: the normal Zink pattern is left, right, left, right for the OA, CT, TL, LS junctions, respectively)
2
Q
Physiological locking occurs when ________ (number) motions have been introduced.
A
Three
3
Q
PRP aids in healing by releasing ________ of which the two main ones are ________ and ________.
A
Growth factor, PDGF, TGF-β
4
Q
What two axes are mainly involved in sacral dysfunctions?
A
Oblique and transverse
5
Q
If a patient asks what exercises will help them with their pain and function, you would tell them that ________ and ________ are best.
A
Stretching, strengthening
6
Q
Good exercises for core strengthening include ________, ________, ________ and ________.
A
Planks, quadruped, bridges, clamshells
7
Q
When instructing a patient to do exercises for musculoskeletal pain, what aspect is critical on your part?
A
Supervision
8
Q
Instability can result from ________ of the facet joints or ________ of the intervertebral disc.
A
Capsular laxity, internal disruption
9
Q
The most common benign tumor of the spine is called a ________.
A
Osteoid osteoma
10
Q
Hypersympathetic tone to the uterus can lead to ________.
A
Dysrhythmic ineffective contractions
11
Q
Contraindications for prolotherapy and PRP include:
A
Metastatic cancerNon-musculoskeletal painSpinal anatomical defectsSystemic inflammationMorbid obesityBleeding disorders Low pain thresholdWhole body painHepatic disorders
12
Q
MRIs are used mainly to evaluate ________ and ________ associated with spinal column trauma.
A
Ligaments, soft tissues
13
Q
Bone scans are typically followed by a ________ or a ________ to characterize lesions found.
A
CT, MRI
14
Q
With unilateral or bilateral sacral extension or flexion, you _______ predict the motion of L5.
A
CANNOT
15
Q
The ________ is the most important core muscle to strengthen.
A
Transversus abdominus
16
Q
Unlike in psoas dysfunction, the pelvis shifts ________ the symptomatic side (long leg side) in short leg syndrome.
A
Towards
17
Q
On a T2 MRI, a dark disc usually means the disc is ________.
A
Dehydrated
18
Q
________ is used to treat relaxed or incompetent connective tissue (ligaments, veins, etc.) by inducing the formation of new fibro-elastic connective tissue.
A
Prolotherapy
19
Q
________ is the hydrostatic skeleton of support of the body, and together with bones and joints are organized into a ________ format.
A
Fascia, tensegritous
20
Q
Symptoms that are related to increased volume include ________, ________, ________, ________, and ________.
A
Edema, headache, GERD, constipation, varicosities
21
Q
A chronic inflammatory arthritis that can affect the SI joints and hips and is usually seen in people in their early 20’s is known as ________.
A
Ankylosing spondylitis
22
Q
With shooting pain or weakness in the low back, differential diagnoses fort the peripheral nervous system should include: Anterior horn cell - \_\_\_\_\_\_\_\_ Axon/myelin - \_\_\_\_\_\_\_\_ Root - \_\_\_\_\_\_\_\_ Plexus - \_\_\_\_\_\_\_\_ NMJ - \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
A
ALS (presents in vesiculations on the tongue in a 25 y/o)
Guillane Barre
Radiculopathy
Traumatic plexopathy
Myasthenia gravis, Lambert Eaton syndrome
Peripheral nerve
Muscle, bone, tendon, ligament
23
Q
What treatment is generally good to try initially for a psoas dysfunction?
A
Counterstrain (AL1, AL2)
24
Q
In an older patient with progressive low back pain (over the course of weeks), weight loss, and decreased appetite, you should be concerned about ________.
A
Spinal metastasis
25
What should you treat when someone has a UTI?
The pubes (pubic shears are linked to urinary function problems)
26
Sacral motion is defined by motion of ________ (sacral level).
S1 (the top)
27
Good OMM techniques to alleviate symptoms generated from increased volume in pregnancy are ________, ________, and ________.
Lymphatic pumps, myofascial release, release of diaphragms
28
Which pelvic floor muscles are responsible for ejecting a bolus of feces?
Pubococcygeus, iliococcygeus
29
One of the earliest responses to musculoskeletal pain is change in ________.
Muscle tone (use it or lose it)
30
What fascia interconnects all areas of the body?
Thoracolumbar fascia
31
Pain does not always tell you where the dysfunction is. Often times it will present at areas of ________ and not the restricted area.
Hypermobility
32
The final complication of the degenerative cascade is one level stenosis which may progress to multilevel. This can occur if the facet joints undergo ________ or if the intervertebral disc develop ________.
Enlargement of the articular processes, osteophytes
33
On palpatory examination, ________ movements should be used.
Slow sweeping
34
Lumbar radiculitis in younger patients is usually due to ________ and due to _______ in older patients.
Disk protrusion, osteophytes (or other degenerative changes)
35
In the designation “L/R”, the L informs you of ________ and the R informs you of the ________.
Rotation of the sacrum, axis
36
What is the treatment sequence for UTIs?
1) thoracolumbar junction2) diaphragm redome or psoas counterstrain3) immune pump
37
Progressive lower back pain in an older patient that also affects the calfs bilaterally and is relieved by leaning forward is most likely ________.
Lumbar spinal stenosis
38
Regional range of motion is used to determine where the ________ restriction occurs.
Greatest
39
Ossification of the ________ in the lumbar spine can result in syndesmophytes and is called “bamboo spine” in ankylosing spondylosis.
Annulus fibrosus
40
Prolotherapy injections are typically composed of ________ and ________.
Lidocaine, 50% dextrose
41
With shooting pain or weakness in the low back, differential diagnoses fort the central nervous system should include ________ for the brain and ________ for the spinal cord.
MS, myelopathy
42
For chronic low back pain, the most important muscles to strengthen are the ________ muscles.
Core
43
The sacrum naturally ________ in the sphinx position, and therefore will make anterior torsions more ________.
Flexes, symmetrical
44
When treating unilateral or bilateral flexion or extension, the type of muscle energy you use is ________.
Respiratory assist
45
In a patient that has lower back pain (consolidated to one side) that gets worse throughout the day and with prolonged standing, is relieved by rest, and has no other issues, you should be thinking about a ________.
Short lower extremity
46
Pain is usually located where the body is attempting to ________ and not at the area of greatest restriction.
Compensate
47
Regional and intersegmental motion evaluations are the most important ________ test for somatic dysfunction.
Functional
48
Physiologic motion will demonstrate “spring” at the lumbosacral junction and therefore will have a ________ lumbosacral spring test.
Negative
49
An increased lumbar lordosis can ________ the pelvic floor.
Flatten
50
________ and ________ are more sensitive than plain film for detecting infection, cancer, disc pathology, and spinal stenosis.
CT, MRI
51
Shopping cart sign or “Wal-Mart” sign is associated with ________.
Lumbar spinal stenosis (flexing the spine opens the vertebral canal)
52
One fo the most common injection sites of prolotherapy is at the ________ ligament and ligaments of the ________ and ________.
Iliolumbar, shoulder, ankle
53
The ________, ________, and ________ are key muscles to stretch.
Pectoralis, hamstrings, iliopsoas
54
Lymphatic drainage of the GU system drains into the ________.
Left thoracic duct
55
The foramina for which the sacral plexus exits are ________ (between or in line with) segments (S1, S2, etc.) ?
Between
56
The biomechanical model focuses mainly on the presentation of ________ in a pregnant patient.
Musculoskeletal pain
57
Due to posterior torsions having non-physiologic motion, L5 will display ________ mechanics.
Type II
58
What is the treatment sequence for ureterolithiasis?
1) thoracolumbar inhibition - sacral rock combo2) psoas counterstrain3) OA-C2 indirect
59
The degenerative cascade includes the following: dysfunction leading to ________, which then causes instability leading to ________, which can lead to one level stenosis, which may progress to ________.
Herniation, lateral nerve entrapment, multilevel spondylosis and stenosis
60
Intradiscal pressure is highest in what position?
Seated, bending forward, lifting weight
61
Low back pain could potentially arise from cervical dysfunction due to tension on the ________, which runs from the skull to the sacrum.
Dura
62
With a dysfunctional psoas, hypermobility will develop between the ________ and ________ vertebral levels.
L5, S1
63
Facilitated segments should be treated ________.
First (note: I’m not sure if they should be treated before non-physiologic dysfunctions. Facilitated segments may be non-physiologic)
64
What are some of the red flags when taking a functional history?
Gait ataxia, upper motor neuron signs, night pain/weight loss, cooler lower limbs/feet
65
L5 and S1 always rotate in the ________ direction.
Opposite
66
A patient with lumbar spinal stenosis can present with ________ which is characterized by leg pain during ambulation that improves with rest and my include numbness and pain radiating to the foot.
Pseudoclaudication
67
A good way to measure patient improvement is to see if they have cut down on their use of ________.
Pain medications
68
A collar on the Scotty dog is indicative of a ________.
Pars interarticularis defect
69
Prolotherapy ideally induces a proliferative response at the ________.
Enthesis
70
When percussing musculature, higher pitches equate to areas of ________ tension.
Increased (tighter muscles)
71
Pain that is described as shooting, burning, or pins and needles is usually descriptive of a ________ problem.
Neurologic
72
Referred pain from the bladder can present near the ________.
Sacrum (gluteal fold area)
73
Anterior torsions have physiologic motion and therefore, the two diagnoses they can have are ________ or ________.
L/L, R/R
74
Imbalance of the autonomics in various organs can be balanced using ________ and ________.
Rib raising, OA release (or OM release/sacral rock)
75
If any of the vertebrae are affected with a psoas dysfunction, they are usually flexed with their rotation and sidebending ________ the side of the tight psoas.
Towards
76
CT is most useful for diagnosing spinal column injury at the ________ junction.
Thoracolumbar
77
Ossification along the anterior longitudinal ligament of the thoracic and lumbar spine is typically seen in ________.
Diffuse idiopathic skeletal hyperostosis
78
After prolotherapy or PRP, a patient cannot take ________ to help with the pain.
NSAIDs
79
When treating an anterior torsion, the types of muscle energy used are ________ for the top leg and ________ for the bottom leg.
RI, PIR
80
Referred pain from ________ is one of the most common things that presents with low back pain.
Hip osteoarthritis
81
Hyperparasympathetic tone to the uterus can cause ________.
Vascular congestion
82
Each transverse axis is related to a specific function. The superior is related to ________, the middle is related to ________, and the inferior is retaliated to ________.
Respiration, posture, iliosacral motion
83
Complications of prolotherapy and PRP include:
Vascular or neurologic injectionPneumothoraxInfectionPersisting symptoms
84
Numerous white densities of similar size seen throughout bone is a genetic condition called ________.
Osteopoikilosis
85
An imaging test that utilizes radioactive substance and deposits in areas of high bone turnover is known as a ________.
Bone scan
86
The axis is always ________ of the restricted side.
Opposite
87
You happen to walk in on a physician treating a patient for sacral somatic dysfunction. You see the patient lying on their right side with their chest on the table and the physician is pushing their ankles down. What is the diagnosis? What is the motion of L5?
R/R anterior torsion, N SR RL
88
When exercising, strengthening, and stretching muscles, they must be worked in ________ planes.
All three
89
If the sacral sulcus and inferior lateral angle on the same side are both depressed or protruding (relative to the other side) the diagnosis is a _______.
Torsion
90
The key dysfunction is designated as the area with the ________.
Greatest restriction
91
A nerve root cyst commonly found in the sacral nerve roots is known as a _______ cyst.
Tarlov
92
The center of L3’s vertebral body should line up within 2-3 mm of the ________.
Sacral promontory
93
Differential diagnosis for shooting pain or weakness in the low back should include ________ and ________ nervous systems.
Central, peripheral
94
Sciatica (versus S1 radiculitis) typically is located in the posterior thigh and does not ________.
Radiate
95
When treating the area of greatest restriction, ________ dysfunctions should be treated first if both types of dysfunctions are present.
Non-physiologic
96
Acute pain is carried on ________ fibers and chronic pain is carried on ________ fibers.
Aδ, C
97
If a physician was treating a patient in the prone position, had the base of their hand evenly distributed over the bottom of the sacrum, and was resisting the motion produced upon the patient’s exhalation, what would they be treating?
Bilateral sacral flexion
98
Dysfunction (in the degenerative cascade) can either be caused by ________ of the facet joints or ________ of the intervertebral disc.
Synovitis hypomobility, circumferential tears
99
The key rib in an inhalation dysfunction is the ________ of the group.
Lowest
100
Sympathetic stimulation of the bladder causes it to ________ urine, whereas parasympathetic stimulation causes it to ________ it.
Store, expel
101
The number one cause of referred pain to the perineal region is the ________ muscles.
Levator ani
102
In a psoas muscle dysfunction, the pelvis will shift ________ from the side of the dysfunctional muscle.
Away
103
If the facet joints have become so lax that they subluxate, ________ may occur. Likewise, this may occur if the intervertebral disc undergoes ________.
Lateral nerve entrapment, disc resorption
104
The most common cause of lumbar spinal stenosis is ________.
Disk degeneration (which is why its seen in older patients)
105
What are the two axes that a unilateral flexion or extension could pivot around?
Transverse or vertical
106
Generally, contraindications to OMM in pregnancy are serious complications. These include (8 total):
Ectopic pregnancyPlacental abruptionDVTHTN (preeclampsia)Preterm laborUnstable vitalsFetal distressUndiagnosed vaginal bleeding
107
When prescribing exercise, the patient should work out ________ days a week and for at least ________ mins.
5, 30-60
108
The respiratory/circulatory model mainly focuses on hematologic and lymphatic changes due to the ________ in volume during pregnancy.
Increase
109
What are the four dynamic tests that are used to diagnosis SI joint motion and which two always need to be done together?
ASIS compression, Passive SI joint motion (prone jiggle), Standing flexion, Seated flexionStanding and seated flexion
110
Continuing degeneration of facet joints or radial tears can cause ________.
Herniation
111
The sympathetics for the kidney, ovaries, testes, upper ureters, and adrenal glands come from ________.
T10-T11
112
Pain that is sharp, burning, and radiates from the buttock to the posterior thigh, posteriolateral leg, and lateral foot is indicative of ________.
Lumbar disk protrusion (causing lumbar radiculitis at S1)
