OMM 2

Question 1

lungs innerv by? know that thorax has lots of lymphatics. how to chk by OMM?

Answer 1

cervical nn, thoracic nn T1-6, CN10. chk OA, AA & C2, Chapman’s ant & post

Question 2

Chapman’s ant vs post for PNA & bronchitis

Answer 2

PNA: up lung 3ICS near sternum, low lung 4ICS near sternum; bronchitis: 2ICS near sternum vs PNA: up lung T3 sup facet, low lung T4 sup facet; bronchitis: T2 just lat to spinous process

Question 3

symph vs parasymph pathway to lungs

Answer 3

preganglion T2-7 -> sup/mid/inf ganglion T1-4 -> postganglion pulm plexus -> bronchodil, more viscous fluid vs preganglion vagal nuclei in medulla -> parasymph ganglia in airway -> postganglion smooth mm/glands/vessels -> bronchoconstrict, vasodil, hypersecrete

Question 4

FPR vs still technique. FPR & still vs BLT?

Answer 4

indirect; FLATTEN, compression, position to ease, hold 3-5s, let go compression, neutral vs combined; slightly exaggerate position to ease, compression or distraction, hold 3-5s, go to barrier, let go compression/distraction, neutral. myofascial ease & introduces motion vs lig around joint and holds balance (no motion)

Question 5

MOA of FPR vs HVLA

Answer 5

stretch past neutral -> dec gamma & stretch stimuli -> dec alpha neurons -> dec mm hypertonicity (stretching out a tight mm doesn’t work b/c mm thinks the stretch = new nml) vs stretch or change in joint alters afferent mechanoreceptors -> neutral change -> reset hypertonicity

Question 6

indic vs CI of FPR

Answer 6

myofascial or articular somatic dysfxn, all ages vs fx, joint instability, recent surg/trauma, pt can’t tolerate, radicular pain

Question 7

indic vs absolute vs relative CI HVLA

Answer 7

hypomobile joints, dec pain, reset CNs, actual joint motion restriction (not soft tissue restrict), disrupt connective tissue adhesions vs fx, joint instability, surg/infxn/malig, ank/spondylosis w/ fusion, Klippel-Feil syndrome vs acute herniated disc/radiculopathy/whiplash/mm strain or sprain, spondylolisthesis, osteopenia/porosis/bone dz, inflam joint dz, hypermobile joint

Question 8

how to approach pt’s pulm complaints?

Answer 8

symph -> viscerosomatic (Chapman, paraspinal); parasymph -> OA, C2; lymphatics -> thoracic inlet, abd/pelvic diaphragm; mech/structural -> thoracic vert, ribs, +/- cervical (phrenic, scalenes, lev scap), clavicle, sternum, lumbar, ilia, UE. dx by viscerosomatic, tx by somatovisceral changes

Question 9

what are Chapman reflex points?

Answer 9

ant & post fascial tissue texture abnlities reflecting visceral dysfxn; ganglioform ctx blocking lymphatic drainage -> inflam in tissue distal to blockage

Question 10

heave vs thrill

Answer 10

palpable/visible pulse thru chest wall -> aneurysm, regurg, pressure overload, RVH vs palpable grade 4+ murmur

Question 11

indic vs CI still technique

Answer 11

same as FPR vs fx <6wks old, joint instability, recent surg/trauma, OA, RA, spondylosis