OAT GI patient

Question 1

most common GI disorder in adulst seeking medical help

Answer 1

IBS

Question 2

GI OMT is directed towards what mechanisms of improving QoL

Answer 2

improving blood/lymphatic flow

balancing autonomics

Question 3

ddx for LUQ pain

Answer 3

splenomegaly
splenic infarct
splenic abcess
splenic rupture

Question 4

DDX for epigastric pain

Answer 4

acute MI 
acute pancreatitis
chronic pancreatitis
PUD
GERD
gastritis/gastropathy
fuctional dyspepsia 
gastroapresis

Question 5

DDX for RUQ pain

Answer 5

biliary colic 
acute cholecystitis
acute cholangitis
sphincter of oddi dysfunction 
acute hepatitis
perihepatitis
liver abscess
budd-chiaris syndrome
portal vein thrombosis

Question 6

how to determine whether SD is primarily MSK or secondary to viscerosomatic refelx

Answer 6

FAILURE OF SD TO RESPOND TO OMT POINTS TO VISCEROSOMATIC PROBLEMS

Question 7

prolonged afferent activiyt leads to _______ of hte neurons and corresponding spinal segments

Answer 7

facilitation
abnormal sensory stimulus from ovverstreched visceral organ spindle sensitizes two interneurosn in spinal cord
exaggerated output to initiating site (increase in muscle tension) as well as brain (increased pain awareness) and lcoal cutaneous changes (tissue texture changes)

Question 8

visceral disturbances cause activation of _______ and results in somatic hcanges _______

Answer 8

activates somatic muscle activity

results in somatic changes paraspinally

Question 9

direct transfer of inflammatory irritation from viscer to peritoneum - not reflexing through visceral afferent reflex

Answer 9

percutaneous reflex of morley
appendicits –> peritonitis
responsible for abodminal wall rigidity and pain/ rebound tenderness

Question 10

sympathetic components in the GI system

Answer 10

thoracic splachnic nerve –> the celiac and superior mesenteric ganglion

Question 11

parasympathetic component in the GI system

Answer 11

vagus n - CN X

pelvic splachnic n S2-S4

Question 12

sympathetics to distal esophagus, stomach, proximal duodenum, liver, gall bladder, spleen, portions of pancreas

Answer 12

celiac ganglion (t5-T9)

Question 13

sympathetics to distal duodenum, portions of the pancreas, jejunum, ascending colon, proximal 2/3 of the transverse colon

Answer 13

superior mesenteric ganglion T10 - T11)

Question 14

sympathetics to distal 1/3 of the trasnverse colon, descending colon, sigmoid colon, rectum

Answer 14

inferior mesenteric ganglion T12-L2

Question 15

parasympathetics to lesser curvature of stomach, liver/gallbladder; small bowel, right colon to mid-transverse colon

Answer 15

right vagus n

Question 16

parasympathetics to greater curvature of stomach, ends at duodenum

Answer 16

left vagus n

Question 17

parasympathetics to descending colon, sigmoid colon, rectum

Answer 17

pelvic splachnic nerve - S2-S4

Question 18

gastroparesis, GERD, achalassia, cyclic vomiting syndrome, IBS, reflux esophagitis are all under

Answer 18

autonomic neuropathy

Question 19

anti-inflammatory foods

Answer 19

olive oil
tomatoes
walnuts and almonds
spinach and kale 
salmon and mackerel
blueberries and oranges

Question 20

when to stop OMT

Answer 20

relaxation of soft tissue in treated area is noted
altered autonomic tone has occured
pierpheral vasodilation - increase in skin temperature/redness/sweating
increasein HR or RR
urgency to use the restroom

Question 21

neurological mode tx includes

Answer 21

paraspinal inhibition 
AA muscle energy
OA muscle nergy 
SI gapping 
sacral rocking and inhibtiion

Question 22

CI for Soft tissue

Answer 22

fracture or dislocation
neurologic entrapment syndromes 
serious vascular compromise
local malignancy
local infection
bleeding disorders

Question 23

CI for luympahtics

Answer 23

malignancy of the lympahtics system

Question 24

CI for ME

Answer 24

fracture, avulsion, dilocaiton of involved joint
infection, hematoma, or tera of invovled muscle
severe osteoporosis
metastatic dz of bone or muscle
cervical spine instability (rheumatologic conditions)