OAT Post Surgical Pt. Flashcards

1
Q

OMT is directed towards improving what?

A

physiologic function

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2
Q

Five models in context of: Health, Disease, Patient care

A

probably don’t need to memorize, but might be helpful background

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3
Q

What should you assess in a post surgical pt?

A

viscerosomatic reflexes

somatosomatic reflexes

Jones tender points

trigger points

chapman reflexes

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4
Q

What are good techniques for post surgical pts? what must you do?

A

MFR, FPR, stills, indirect, soft tissue, lympathics

adapt to supine treatment

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5
Q

What are the contraindications for a post surgical patient?

A
  1. Avoid direct manipulation on surgical sites for 2 wks
  2. Ab. Plexus inhibition if midline abdominal incision or aortic aneurysm
  3. Sigmoid release if recent left hemicolectomy
  4. Mesenteric release if anterior abdominal incisions
  5. Rib raising if fracture of rib/spine or recent spinal surgery
  6. Pedal pump absolutely if DVT, lower extremity fractures, or recent abdominal surgery
  7. Lymphatic treatment relatively if osseous fx, bacterial infections with fever >102, abscess/local infection, or certain stages of carcinoma
  8. TI release if upper rib fx/clavicle fx
  9. Liver/spleen pumps if thoracotomy, chest tube, or trauma
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6
Q

In early postop days 1-3, a pt is in the ____ stage. How do we treat?

A

inflammatory

focus on circulatory and pulmonary (prevent atelectasis)

facilitate lymph flow, improve mobility, restore biodynamic vitality

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7
Q

What is the second stage of early post op?

A

Diuresis stage - days 4-6

Retained fluids are lost from intra and extracellular spaces

focus on lymphatic, GI, renal, ANS

ensure mobility of thoracic cage and outlet

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8
Q

What do we call weeks 1-3?

A

late postop

tx fascia, tissues, SD, viscerosomatic reflex

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9
Q

In a hospitalized pt, what are the goals of OMT?

A
  1. promote homeostasis and ability to cope with disease
  2. sleep, ambulation, eating, defecation, pain relief
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10
Q

If you notice has a SD that is relevant to their hospitilization AND they have a SD that is unrelated, but still present. Should you treat one, both, or neither?

A

probaby treat only the relevant one

“treat dysfunctions that impede homeostatic processes instead of long-standing and unrelated problems since it takes patient energy to incorporate changes”

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11
Q

What are common issues with OMT in hospitalized pts?

A

modesty

privacy

turn off TV

objects in way (tubes, trays…)

surgical incisions/dressings

decubitus ulcers

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12
Q

What spine SD go along with the following:

a. too stiff
b. too squishy

A

a. flexed type 2
b. extended type 2

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13
Q

Viscerosomatic and somatovisceral reflexes are initiated through _______.

A

pain-carrying fibers

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14
Q

What do you treat first?

A

facilitated areas

neurons in facilitated segments have decreased APs and fire easily

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15
Q

The muscle has a high/low? concentration of nociceptors

A

low

joint capsules have a high concentration

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16
Q

What are the biomechanical benefits of OMT?

A

removal of SD
restoration of posture and balance

pain free ROM

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17
Q

Why perform postop OMT?

A

Shorten hospital stay

Decrease morbidity and mortality

Decrease post-op pain

Facilitate lymphatic flow & improve diaphragmatic mobility

Increase patient satisfaction

18
Q

What may be included in the neurological model?

A

Somatic facilitated segment

ANS (SNS and PNS)
Nociception

19
Q

Sympathetic Innervation

A
20
Q
A
21
Q
A
22
Q

What is included in the respiratory - circulatory model?

A

delivery of O2 and nutrients

drainage of waste products

CSF flow/PRM

23
Q

What is included in a lymphatic evaluation?

A
24
Q

What are contributing factors to biomechanical SDs?

A

duration of surgery

position during surgery

inactivity/prolonged bedrest

25
Q

What is a problem with prolonged bed rest?

A

SD can develop

26
Q

What is postop fever?

A
27
Q

What are the rule of Ws in postop fever and management?

A
28
Q

Restricted motion in one phase can suggest different pathologies. What examples were given in lecture?

A
  • Pneumonia will reduce the excursion of the thorax toward inhalation
  • Asthma and other obstructive diseases will reduce the excursion of the thorax toward exhalation
29
Q

What are both medical and OMT managements of resp-circulatory for atelectasis?

A
30
Q
A

B

31
Q

What contributes to pretibial edema?

A
  • Immobility due to bedrest
  • Systemic inflammation secondary to surgery
  • Insufficient circulation & lymphatic drainage
32
Q

What is both the medical and OMT management of pretibial edema?

A
33
Q
A

E

34
Q

What are both medical and OMT managements of resp-circulatory for post op ileus?

A
35
Q
A

D (cecum)

36
Q

Why is pain tolerance lowered after surgery?

A

hyperactivity of SNS (fight or flight mode after surgery)

37
Q

What are both medical and OMT neurological managements of post op pain?

A
38
Q
A

C

39
Q

What are both medical and OMT managements of behavioral for anxiety/delirium?

A
40
Q
A

D

41
Q

What is the most common manipulative method to modify sympathetic acitivty in the upper GI tract and SI?

A

rib raising T5-11