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COMLEX STEP 1 2017 > OMM > Flashcards

OMM Flashcards

1
Q

which segment innervates the prostate and genitalia

A

T12-L2

pelvic splanchnic nerves

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2
Q

How does the muscle energy treatment differ for the sacrum:

  1. backward torsion (ie L on R)
  2. forward torsion (ie R on R)
A
  1. axis side down, face up

2. axis side down, face down

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3
Q

Osteopathic exam shows ribs 6-9 with an exhalation dysfunction

which muscle should muscle energy be performed on?

A

Serratus anterior

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4
Q

Where is the tenderpoint located corresponding to dysfunction with the Spine at T2?

A

AT2 - Angle of Louis on the manubrium

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5
Q

What segment should you find viscerosomatic dysfunction associated with the appendix?

A

T12

T9-T12

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6
Q

What is the anterior and posterior chapmans point for the appendix?

A

anterior: tip of the right 12th rib
posterior: tip of transverse process of T11

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7
Q

Pt with history of chronic heart failure presents with new onset lower extremity edema

the most appropriate initial osteopathic treatment is:

A

Thoracic inlet release

–all lymphatic drainage techniques should s tart with thoracic inlet

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8
Q

What is a/w a chapmans point in the 4th intercostal space?

A

Lower lung

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9
Q

What is a/w a chapmans point in the 7th right intercostal space?

A

Pancreas

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10
Q

What is a/w a chapmans point in the 7th left intercostal space

A

Spleen

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11
Q

What 4 things are a/w a chapmans point in the 2nd intercostal space?

A

Esophagus
thyroid
bronchi
myocardium

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12
Q

What is the posterior chapmans point for the adrenals?

A

Between spinous and transverse processes of T11 and T12

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13
Q

What is the posterior chapmans point for the kidneys?

A

Between the spinous and transverse processes of T12 and L1

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14
Q

What is the posterior chapmans point for the bladder

A

Superior edge of transverse process of L2

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15
Q

What is the posterior chapman’s point for the pancreas?

A

Between the transverse process of T7 and T8 on the right

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16
Q

Chapmans point at the clavicles just lateral to where they cross the ribs are a/w with what?

A

Middle ear

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17
Q

Chapmans point at the first rib is a/w?

A

Sinuses, sometimes middle ear

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18
Q

Chapmans point in the first intercostal space is a/w?

A

tonsils

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19
Q

Chapmans point a/w second rib is?

A

Tongue

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20
Q

Patient presents with cataracts what is the associated anterior chapman’s point

A

lateral humerus

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21
Q

What is the most appropriate OMM technique to alleviate IBS symptoms?

A

Superior Mesenteric Ganglion Release (T10-T11)

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22
Q

What happens at the sacrum during cranial flexion?

A

Sacral counternutation (sacral base posterior)

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23
Q

A chapmans point over the less trochanter is associated with what?

A

rectum

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24
Q

what is associated with chapmans point along the lateral and posterior margin of the iliotibial band?

A

prostate

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25
Q

What is the chapmans point associated with a patient with colon cancer?

A

anterior iliotibial band

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26
Q

What is the parasympathetic viscerosomatic reflex points for the uterus?

27
Q

17 year old presents with lower abdominal pain and cramping occuring at the onset of her menstrual cycle each month.
What is the most appropriate osteopathic technique to initiate at the onset of her menstrual cycle?

A

Dysmenorrhea - sacral inhibition

—treatment of S2-S4 (pelvic splanchnic nerves)

28
Q

What OMM treatment can be used to treat post operative bowel ileus

A

Paraspinal inhibition of the thoracolumbar junction

29
Q

What is the sympathetic viscerosomatic reflex points for the kidneys?

parasympathetic?

A

sympathetic: T9-L1 ipsilaterallly
parasympathetic: OA, C1-C2

30
Q

What sympathetic segments correspond to the proximal and distal ureters?

What is the parasympathetic reflex for the proximal and distal ureter?

A

Sympathetic:
prox + distal = T11-L3

Parasympathetic:

prox: OA, C1-C2
distal: S2-S4

31
Q

Child presents with bilateral acute otitis media. what is the associated anterior chapman’s point

A

Above prox third of clavicle

32
Q

What is the chapmans point associated with the uterus?

A

transverse process of L5

33
Q

What axis does the sacrum move on during

  1. intrinsic cranial movement?
  2. which axis for sacral nutation/counternutation during standing
A
  1. Superior transverse axis

2. Middle transverse axis (postural sacral axis)

34
Q

What is the correction positioning for the treatment of an anterior first cervical tender point?

A

Rotation of head away from the side of tender point - located at posterior aspect of the ascending ramus of the mandible

pressure is applied in anterior direction

35
Q

What is the correct placement for the cranial vault hold:

  1. thumb
  2. pointer finger
  3. middle finger
  4. ring finger
  5. pinky
A
  1. meet/cross above cranium or rest on frontal bone
  2. greater wing of the sphenoid
  3. squamous portion of the temporal bone (zygomatic process)
  4. petrous portion of the temporal bone (near mastoid process)
  5. squamous portion of the occiput, medial to the occipitomastoid suture
36
Q

What are the steps of Balanced ligamentous tension?

A

Disengage - eliminate tension in strained ligament

Exaggerate - using patient positioning or respiratory cooperation

Balance - holding segment at the balance point

37
Q

What type of dysfunction at L5 is associated with

  1. forward sacral torsions
  2. backward sacral torsions?
A
  1. type 1 dysfunctions at L5

2. type 2 dysfunctions at L5

38
Q

Pt has tender point located on the inion? what is the counterstrain treatment?

A

PC1 Inion

-Flexion at the OA junction

39
Q

what is the treatment for most posterior cervical spine midline points? (PC2 midline/lateral, PC4-8 midline, PC3-7 lateral)

40
Q

What is the treatment of pelvic tenderpoints AL3 (lateral to AIIS) and AL4 (inferior to the AIIS)

A

pt is supine, with lumbar flexion, sidebend away from tender point

41
Q

Where is the counterstrain tenderpoint of the calf muscle?

A

A one centimeter area of tenderness in the muscle belly located at the lower popliteal margin

42
Q

What is the treatment for a posterior tenderpoint a/w rib 5 on the right?

A

seated pts torso is sidebent to the LEFT and rotated to the LEFT and treated for 90 secs before returning to neutral

Posterior rib tenderpoints = rotate and sidebend away

43
Q

What is the most appropriate therapy for McArdle disease?

A

Oral ingestion of sucrose before exercise

44
Q

What part of the vertebrae is fractured in Spondylolysis (“scotty dog” sign on oblique views)

A

Par interarticularis

45
Q

An injured pt with Galeazzi fracture cant make the A-OK sign. what nerve is damaged?

A

Anterior interosseous nerve
–branch of Median N that provides only momtor innervation to the deep muscles of the hand (flexor pollicis longus, lateral half of the flexor digitorum profundus, and pronator quadratus)

46
Q

What is the spinal levels is the sympathetic innervation to the lower extremity?

47
Q

How are dysfunctions possibly orientated at the Occipitoatlantal joint?

A

Rotation and sidebending occur in OPPOSITE direction

diff from Freyette’s because this can occur in Flexion or Extensio`n

48
Q

How do you treat a tender point a half-inch medial to the inferior aspect of the PSIS on the right?

A

S1 tenderpoint - Place the patient prone - apply posterior to anterior pressure on the left inferior lateral angle of the sacrum for 90 seconds

treat the location diagonally opposite of tenderpoint

49
Q

6 year old with frontal headaches after hitting soccer ball with front of his head. palpation of head reveals occiput resists flexion and sphenoid resists extension

what is dx? what is the axis of movement of the dysfunction?

A

Superior vertical strain
–traumatic flexion of the sphenoid = resistant to extension. also prevents occiput from flexing

2 parallel transverse axes, sphenoid and occiput move in same direction

50
Q

During flexion phase of cranial motion, what motion do the paired bones (temporal, parietal, maxillae, zygoma, Frontal) do?

A

Paired bones go through external rotation while in flexion phase

51
Q

what is the suture that allows the Frontal bone to move as a paired bone?

A

Metopic suture - runs vertically through center of frontal bone - usually closes by age 6

52
Q

What are the 5 components of the primary respiratory mechanism of cranial motion?

A
  1. Inherent motion of brain + spinal cord
  2. Fluctuation of CSF
  3. Mobility of intracranial and intraspinal membrane
  4. Articular mobility of the cranial bones
  5. Involuntary mobility of the sacrum between the ilia
53
Q

What are the attachment points of the dura?

A

Foramen Magnum, C2, C3

S2

54
Q

How is decompression of the fourth ventricle performed?

A

encourage extension while discouraging flexion

55
Q

What is the treatment position for a tenderpoint in the Tensor fascia lata?

A

supine, hip flexed, abducted

56
Q

What would be the innominate findings in a pt with a short left leg from a childhood Salter-Harris type I fracture?

A

ASIS inferior and PSIS superior on the left - compensation

57
Q

Where would a counterstrain point be found in the injury of the ATFL of the ankle?

A

distal to the MEDIAL malleolus

58
Q

Where should muscle energy be applied for somatic dysfxns of:

  1. Rib 1
  2. Rib 2
  3. Rib 3-5
  4. Rib 6-9
  5. Rib 10-11
A
  1. Anterior and Middle Scalene
  2. Posterior Scalene
  3. Pectoralis minor
  4. Serratus anterior
  5. Latissimus dorsi
59
Q

What is the location of the following sacral tenderpoints:

  1. PS1
  2. PS2
  3. PS3
  4. PS4
  5. PS5
A
  1. two points bilateral on each sacral sulcus
  2. Midline on sacrum on spinous process of S2
  3. Midlien on sacrum on spinous process of S3
  4. midline on sacrum on the spinous process of S4
  5. two points bilaterally on each ILA of sacrum
60
Q

What is the treatment for iliacus tenderpoints?

A

Hip flexion and external rotation

61
Q

Where would texture changes be found:

pt w pain and swelling in right leg. Sx have been worsening over few days and a/w fever. Leg has erythema, edema, warmth

A

T10-L2

Pt has Cellulitis
Lower extremity has sympathetic innervation from T10-L2

62
Q

What is the OMM technique that utilizes the relaxation of antagonist muscles when an agonist muscle is activated

A

Reciprocal Inhibition

63
Q

where is the location of the anterior counterstrain tender point associated with T12?

A

inner ala of the ilium in the midaxillary line bilaterally

64
Q

What anatomic landmark is at the level of:

  1. T2
  2. T3
  3. T4
A
  1. Sternal notch
  2. Scapular Spine
  3. sternal angle

COMLEX STEP 1 2017 (19 decks)

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