M2T2 OMM Midterm Flashcards by Gregory Skedros

The median nerve innervates the majority of the ________ antebrachium and the majority of the ________. Injury can cause issues with ________.

Anterior, thumb, grasping

How well did you know this?

Not at all

Perfectly

The final step of Still technique consists of taking the joint through an ________ of motion to where the restriction barrier had been.

Arc

How well did you know this?

Not at all

Perfectly

A good approach for a whiplash patient is:________________________

Suboccipital releaseAddress upper thoracic and rib dysfunctionsAddress cervical dysfunctions

How well did you know this?

Not at all

Perfectly

Neurologic thoracic outlet syndrome typically presents with ________ paresthesia due to involvement of the lower brachial plexus.

Ulnar

How well did you know this?

Not at all

Perfectly

Clinical testing of C5:Motor: ________Reflex: ________

DeltoidBiceps tendon

How well did you know this?

Not at all

Perfectly

The second most common source of cervicogenic headaches is the ________joint.

Atlantoaxial (AA)

How well did you know this?

Not at all

Perfectly

The sphenopalatine ganglion (via other nerve pathways) is responsible for innervating ________ gland and the ________.

Lacrimal, nasal mucosa

How well did you know this?

Not at all

Perfectly

The most frequent source of cervicogenic headaches is the ________ zygopophyseal joint.

C2/C3

How well did you know this?

Not at all

Perfectly

Lumbar facet syndrome is a common source of low back pain is is generally caused by facet ________.

Arthropathy

How well did you know this?

Not at all

Perfectly

Red flags for headaches:“Thunderclap” headache or “worst headache of my life” = ________Acute neck pain with Horner syndrome = ________Fever, altered mental status, and +/- nuchal rigidity = ________Headache with focal neurologic deficit, or papilledema = ________Headache with visual impairment, periorbital pain, or ophthalmoplegia = ________Headache secondary to head trauma = ________

Subarachnoid hemorrhageCervical artery dissectionMeningitis/encephalitisIncreased intracranial pressureAcute angle closure glaucomaEpidural/subdural hematoma

How well did you know this?

Not at all

Perfectly

FPR is an ________ technique with the patient remaining ________ throughout.

Indirect, passive

How well did you know this?

Not at all

Perfectly

Common causes of referred ear pain are ________, ________, ________, ________, and ________.

TMJ disorder, dental causes, pharyngitis/tonsillitis, temporal arthritis, Ramsay Hunt syndrome (herpes zoster oticus)

How well did you know this?

Not at all

Perfectly

Still technique is described as ________ and then ________.

Indirect, direct

How well did you know this?

Not at all

Perfectly

________ was the PCOM alumnus who developed the facilitated positional release technique.

Stanley Schiowitz

How well did you know this?

Not at all

Perfectly

Even when a somatic dysfunction in the cervical region is extended, the cervical lordosis still needs to be _______ in order to reach neutral when utilizing FPR.

Flexed

How well did you know this?

Not at all

Perfectly

________ is the traditional “gold standard” for the diagnosis of foraminal compression.

CT myelography

How well did you know this?

Not at all

Perfectly

The two major ways in which nerve root impingement can occur is via ________ and ________.

Disc herniation, osteophyte formation (spondylosis)

How well did you know this?

Not at all

Perfectly

Radiculopathy, specifically cervical, can be due to either of two mechanisms: ________ or ________.

Spondylosis, disc herniation

How well did you know this?

Not at all

Perfectly

There is NO male predominance in ________, unlike cluster headaches.

Chronic paroxysmal hemicrania

How well did you know this?

Not at all

Perfectly

Ulnar nerve entrapment can occur at the level of the elbow in the ________ tunnel or at the level of the wrist in ________ canal.

Cubital, Guyon’s

How well did you know this?

Not at all

Perfectly

The imaging tests ordered for cervical myelopathy are ________ and ________.

MRI, X-ray

How well did you know this?

Not at all

Perfectly

A few of the contraindications to FPR are ________, ________, ________, ________, ________, and ________.

Joint instability, herniated disc, intervertebral foraminal stenosis, severe sprains/strains, congenital anomalies, vertebrobasilar insufficiency

How well did you know this?

Not at all

Perfectly

The most common level of nerve root impingement in the neck is ________.

C5-C6

How well did you know this?

Not at all

Perfectly

Radiculitis is almost always associated with ________ and usually resolves with conservative intervention within ________.

Pain, 1 month

How well did you know this?

Not at all

Perfectly

The cubital tunnel is located posterior to the ________ epicondyle.

Medial

One of the best therapies for cluster headaches is ________ therapy.

Oxygen

________ is an itching below the scapula that may include pain, paresthesia, hyperesthesia, and hyperpigmentation.

Notalgia paresthetica

Migraines are thought to be due to a release of ________ molecules that lead to vasodilation of intracranial arteries, which in turn triggers nociceptive fibers.

Pro-inflammatory

An anatomical structure that is considered in Osteopathic treatment of cluster headaches is the ________.

Sphenopalatine ganglion

________ rediscovered Still’s techniques and revamped them.

Richard L. Van Buskirk

Anterior thigh pain is commonly caused by ________ dysfunction or irritation of the ________.

Psoas, lumbar plexus

Treatments for tension-type headaches include ________ and ________, and are generally conservative.

Lifestyle changes, home exercises/stretching

The true facilitation of FPR comes at the end with a on and off ________ or “jiggle”. This last step was initially withheld by Schiowitz.

Articulatory motion

Common fibular nerve entrapment can cause ________ (motor).

Foot drop

In Still technique, It is common for the dysfunction to be corrected ________ meeting the barrier.

Before

The Spurling maneuver has a high ________ for cervical radiculopathy, but a low ________.

Specificity, sensitivity

The largest contribution to the sphenopalatine ganglion is the ________ root, which comes mainly from the ________ nerve.

Parasympathetic, greater petrosal

________ and ________ is indicated when localizing signs and symptoms suggest a nerve root injury or symptoms are persistent.

Neuroimaging, electrodiagnostic testing

The anatomical locus for cervicogenic headaches is the ________ in the upper cervical spinal cord.

Trigeminocervical nucleus

One of the biggest triggers for migraines is ________.

Emotional stress

In cubital tunnel syndrome, tingling and numbness can be felt in the ________ and ________ fingers.

Little, ring

Clinical testing of T1:Motor: ________Reflex: ________

InterosseiNone

The throbbing during a migraine is due to ________.

Pulsation of arteries

The radial nerve innervates the ________ of the brachium and antebrachium and may be injured in a ________ fracture of the humerus or improper use of ________.

Extensors, mid shaft, crutches

A nerve commonly affected in tension-type headaches is the ________.

Greater occipital nerve

A common comorbidity with upper crossed syndrome is ________.

Thoracic outlet syndrome (especially lower brachial plexus)

In ulnar tunnel syndrome, tingling will be felt in the little and ring fingers, however, sensation to the ________ is preserved.

Dorsal hand

The ulnar nerve innervates the majority of the ________ muscles. Injury can cause a characteristic ________ and ________.

Hand, clawing, guttering

Clinical testing of C8:Motor: ________Reflex: ________

Finger flexionNone

________ consists of radiating symptoms due to compression of a nerve root.

Radiculopathy

A clinically applicable way to define radiculitis and radiculopathy is the following:________ = sensory involvement of a nerve________ = loss of function

Radiculitis, radiculopathy

Clinical testing of C6:Motor: ________Reflex: ________

Wrist extensionBrachioradialis

Which muscles are phasically inhibited in upper crossed syndrome?

Middle/lower trapezius, serratus anterior, rhomboids, supraspinatous, infraspinatous, deep neck flexors

The number one treatment for migraines is ________.

Avoidance of triggers

Diagnosis of radiculopathy is usually confirmed by ________.

Needle electromyography (EMG)

A common cause of radial nerve dysfunction is the improper use of ________.

Crutches

________ can also be used as an activating force in Still technique. Especially in the cervical spine.

Traction

The ________ test is performed by extending and rotating the neck towards the symptomatic side.

Spurling

A good OMT technique for nerve root compression is _______.

Suboccipital traction

The second step of FPR is to apply an ________. This can be ________ or ________.

Activating force, compression (usually), traction (rarely)

There are a number of osteopathic considerations for the cause of migraines. They are:________ (causes vasoconstriction and decreased cerebral blood flow)________ (causing a nerve reflex to the trigeminal spinal nucleus)________ (causing pressure on the dura and trigeminal neve)________ (compromising the middle meningeal artery)________ (causing reflex vasodilation of the internal and external carotids)________ (causing decreased venous drainage through the jugular foramen)

Increased sympatheticsC1-C3 somatic dysfunctionElevated sphenoid bone (greater wing)Sphenosquamous compressionTemporal bone somatic dysfunctionOccipitomastoid compression

Clinical testing of C7:Motor: ________Reflex: ________

Wrist flexionTriceps tendon

The upper thoracics and associated rib dysfunctions are commonly associated with _______.

Nerve root compression

Lateral femoral cutaneous nerve entrapment due to obesity, heavy utility belts, or tight pants can cause ________.

Meralgia paresthetica

The ________ cervical roots are most frequently affected by compression.

Lower (C7)

Common fibular (peroneal) nerve entrapment can occur due to its shallow course over the neck of the ________.

Fibula

Inter-scapular pain with cervical radiculitis is due to a ________ reflex set up by the radiculitis.

Somatosomatic

The ________ test is performed by flicking the dorsal surface of the middle finger.

Hoffmann

The intersection of the ________ and the ________ sensory pathways allows for bidirectional transmission of pain signals between the neck and the face/head.

Upper cervical, trigeminal

________ is cervical spinal cord pathology causing dysfunction.

Cervical myelopathy

________ sign is an involuntary flexion of the the fingers, especially the thumb, after flicking the middle finger’s DIP.

Hoffmann’s

The two main causes of non-compressive radiculopathy are ________ and ________

Diabetes, herpes zoster

The Spurling test is performed by placing the patients neck in ________ and ________ towards the affected side.

Extension, sidebending

Which muscles are tonically facilitated in upper crossed syndrome?

Pectorals, upper trapezius, levator scapulae

Due to OMT being indicated for facet-mediated pain and myofascial pain, it is very useful for treating ________ headaches.

Cervicogenic

Ulnar tunnel syndrome is commonly seen in ________ due to constant pressure on the wrist.

Cyclists

Headaches that are non-throbbing, with tightness in a “band-like” distribution around the head are classified as ________.

Tension-type

_______ tunnel syndrome can be caused by ankle sprain edema, pes planus, cyst, or bone spur and affects the ________ nerve.

Tarsal, tibial

The first step of Still technique is to put the joint into its ________.

Ease

The first step of FPR is to ________.

Flatten the curve (put into neutral)

Unlike tension-type headaches, ________ headaches are unilateral and are typically a result of articular dysfunction.

Cervicogenic

The second step of Still technique is to apply a ________ force at a right angle to the plane of restriction.

Compressive

The axillary nerve innervates the _______ and the _______ and may be injured in a ________ fracture of the humerus.

Deltoid, teres minor, surgical neck

Although imaging studies help with diagnosis of radiculopathy, it can be a ________ diagnosis.

Clinical

“Release of somatic dysfunction with the use of a sustained low amplitude off-axis force vector as a 3D rotation lever” describes what technique?

Still

Cervical myelopathy will generally present with _______ motor neuron symptoms.

Upper

In Still technique, the vector of force applied must be directed through the ________.

Dysfunction

________ is a disease process in which nerve root dysfunction is due to compression of a nerve root. It can result in sensory changes, motor changes, or ________.

Radiculopathy, both

________ is the current imaging study of choice for initial evaluation of the cervical spine.

MRI

________ is a disease process causing inflammation of a spinal nerve root. It generally results in ________ changes.

Radiculitis, sensory

Upper medial scapular pain is commonly found with ________.

Nerve root impingement

The musculocutaneous nerve innervates the ________ compartment of the brachium and innervates skin on the ________ antebrachium.

Anterior, anterolateral

Chronic paroxysmal hemicrania can be differentiated from cluster headaches in that it responds absolutely to ________, whereas cluster headaches do not.

Indomethacin

The major causes of cervical myelopathy are ________ and ________.

Spinal stenosis, herniated discs

Lumbar facet syndrome pain can be ________ or it can be referred along its related ________.

Paraspinal, sclerotomes

Most people with radiculitis state that the pain ________ diminishes.

Never completely

The second most common level of nerve root impingement in the neck is ________.

C6-C7

Unlike radiculitis, which is almost always ________, radiculopathy can be ________.

Painful, Painless

Lateral foot pain may be due to ________ and is usually caused by ________ or ________.

S1 radiculitis, radiculopathy, herpes zoster

________ nerve dysfunction will typically present with pain or numbness in the dorsal thumb, index and middle fingers.

Radial

________ consists of radiating symptoms due to nerve root irritation.

Radiculitis

In Still technique, the patients limbs are used as ________ for articulation and for introduction of a compressive force.

Levers

FPR is best utilized for ________ somatic dysfunction, although Schiowitz claims it can also be used for abnormal ________.

Articular, muscle tension

Tension type headaches may be due to biomechanical issues. In particular is ________, which is commonly seen in students and office workers.

Upper cross syndrome

Swollen or droopy eye, miosis, reddened conjunctiva, tearing, and nasal discharge/congestion are all symptoms of a ________ headache.

Cluster

The activation position in FPR is held for ________ and then a very quick oscillating movement is added (the true facilitation).

3-5 seconds