omm Flashcards
TART stands for
Tissue text changes, asymmetry, restriction, tenderness
Physiologic barrier
The end point of active range of motion (the point to where the patient can move themselves)
Acute TART changes
Edematous, erythematous, boggy, hypertonic, symmetric, painful restriction, severe/sharp pain
Chronic TART changes
No edema or erythema, cool skin Decreased muscle tone, flaccid, ropy, fibrotic Asymmetry with compensation Non-painful restricted range of motion Dull, achy, burning pain
Freyettes
For TL spine:
N SxRy (typically grouped)
E/F SxRx (typically single)
Somatic dysfunctions are named for their freedom of motion
Just a reminder :)
Facet orientation
BUM BUL BM
Scalenes
Originate from posterior tubercle of transverse process and insert on rib 1 (ant and middle) and rib 2 (posterior)
SB neck to same side (unilateral contraction)
Flex neck (bilateral contraction)
Elevate the rib during inhalation
SCM
Unilateral contraction: SB toward, R away
Bilateral contraction: flexion
Alar and transverse ligaments
Weak in RA and Downs -> atlantoaxial subluxation
C-spine nerve roots
Exit above corresponding vertebrae
OA
Primary motion: F/E (SB occurs opposite)
AA
Primary motion: rotation (this is its ONLY motion)
Motion of C2-C7
SxRx regardless of F/E
Cervical stenosis
Increased pain with extension, + Spurlings
Thoracic spinous processes
Rule of 3’s
Primary motion of thoracic spine
Rotation
Atypical ribs
1s and 2s
1, 2, 11, 12 (10ish)
True/false/floating ribs
1-7: true
8-12: false
11-12: floating
Rib movement
1-5: pump handle
6-10: bucket handle
11-12: caliper
Grouped rib dysfunction
BITE
Primary motion of lumbar spine
F/E
Herniated nucleus pulposus
Narrowing of posterior longitudinal ligament -> posterolateral herniation
Usually L4L5 or L5S1; will put pressure on nerve root BELOW
Shooting pain down back and leg; worse with flexion
+ straight leg test
Psoas syndrome
Prolonged contraction of psoas (sitting)
LBP to groin; increased with standing/walking
+Thomas test
TP: medial to ASIS
Non-neutral dysfunction of L1 or L2, + pelvic shift to CL side, oblique sacral dysfunction
Spinal stenosis
Narrowing of spinal canal
Pain worse with extension: standing/walking/supine
Spondylolisthesis
Anterior displacement of a vertebra (pars interarticualris)
Increased pain with extension
Tight hammies, stiff-legged, short-stride, waddling gait
Cauda equina syndrome
Pressure on nerve roots due to massive central disc herniation
Saddle anesthesia, decreased DTRs, loss of bowel/bladder
Structural vs Functional scoliosis
Structural: fixed curve; doesnt correct with SB (vertebral wedging and short ligaments on concave side)
Functional: flexible; will correct with SB
Severity of scoliosis
Mild: 5-15
Moderate: 20-45
Severe: >50 (respiratory compromise at this level)
CV compromise at >75
Causes of scoliosis
Idiopathic: Who knows. Maybe genetic. ~80% of cases
Congential: malformation of vertebrae; progressive
NM: Muscle weakness/spasm (polio, cerebral palsy, DMD)
Aquired: tumors, infection, osteomalacia, psoas syndrome
Treatment of scoliosis
Mild: PT, Konstancin exercises, OMT
Moderate: same but with bracing
Severe: surgery
Short leg syndrome
Scaral base lower on short leg side
Anterior rotation on same side/ posterior on opposite
Lumbar S away, R toward side of short leg
Iliolumbar ligaments stressed on same side
Heel lift short leg: final lift 1/2-3/4 total discrepancy unless acute loss (hip fx or prosthesis), then full amount;
True pelvic ligaments
(SI ligaments): anterior, posterior and interosseous
Accessory pelvic ligaments
Sacrotuberous, sacrospoinous, iliolumbar
Craniosacral motion
Craniosacral flexion: sacral base rotations posteriorly/counternutates
Sacrum and L5
L5 and sacrum rotate to opposite sides
(Oblique axis will be on the same side as the SB of L5)
Neutral will be neutral (ie NL5 = forward torsion)
Most common dysfunction post-partum
Sacral flexion
