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OMM Flashcards

1
Q

Scoliosis

  • what is it
  • levo
  • dextro
  • tx
A
  • lateral deviation of the spine when viewed from behind
  • apex of curve to left and concavity to right
  • apex of curve to right and concavity to left
  • less than 30 degrees, watch, 30-40 degrees brace, greater than 40 operate
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2
Q

Barriers

  • physiologic
  • anatomic
A
  • point to which pt can actively move

- point to which pt can passively move

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3
Q

Fryettes Principle

  • I: segments, rotation and side bending, position of spine
  • II: segments, rotation and side bending, position of spine
  • exception
A
  • mulitple, opposite, neutrial
  • single, same side, flexion/extension
  • cervical vert
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4
Q

Cervical vertebrae movement

  • OA
  • AA
  • 1-7
  • C2-4 vs 5-7
A
  • uncoupled
  • only rotation
  • coupled
  • 2-4 for rotation and 5-7 sidebending
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5
Q

Sympathetics

  • Head and neck
  • Heart
  • Lungs
  • GI
A
  • T1-T4
  • T1- T5
  • T2-T7
  • T5-L2; prox to lig of treitx T5-9, in between LOT and splenic flex is T9-12, distal to splenic flex T12-L2
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6
Q

Sequence of TX

  • Thoracic, ribs, cervical
  • extremities
A
  • treat spine before ribs and cervical dysfxns

- treat axial skeleton first then work prox to distal

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7
Q

Location of brachial plexus

A
  • between ant and middle scalenes
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8
Q

Torticollis

- muscle involved and usual fxn

A
  • SCM

- sidebend to same side, rotates to opp side, flexes; bilateral contraction flexes the neck

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9
Q

Rule of 3

  • T1-3
  • T4-6
  • T7-9
  • T10
  • T11
  • T12
A
  • same level
  • TP half segment above SP
  • TP whole segment above SP
  • TP whole segment above SP
  • TP half segment above SP
  • TP at same level of SP
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10
Q

Anatomic Landmarks

  • sternal nocth
  • sternal angle
  • nipple
  • inferior angle of scapula
  • umbilicus
  • termination of spinal cord
  • illiac crest sorresponds w/
  • PSIS correspons w.
A
  • T2
  • rib 2
  • T4 dermatome
  • T7
  • T 10 dermatome
  • L2
  • L4
  • S2
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11
Q

Muscles of respiration

  • primary
  • secondary
A
  • diaphragm and intercostals

- scalenes, pec minor, serratus ant

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12
Q

Ribs

  • typical
  • atypical
  • true
  • false
  • floating
  • pump handle
  • bucket handle
  • caliper
A
  • 3-10
  • 1,2,11,12
  • 1-7
  • 8-10
  • 11-12
  • 1-5
  • 6-10
  • 11-12
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13
Q

Rib dysfunction

  • Inhalation dysfunction
  • Exhalation dysfunction
  • Key rib
A
  • ribs are restricted in exhalation
  • ribs are restricted in inhalation
  • BITE
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14
Q

Disk herniation

  • most often location
  • direction
  • sequalae
  • sxs
  • DX
  • TX
A
  • between L4-5
  • posterior/lat
  • pressure on nerve root of vert below
  • pain at that vert and radiate down leg, sharp burning pain
  • MRI
  • No direct techniques
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15
Q

Spondylolysis

  • what is it
  • causes

Spondylolosthesis

  • what is it
  • sxs
A
  • defect in part interarticularis w/o ant displacement of vert body
  • extension injury
  • one vert body slips in relation to the one below
  • back pain that radiates posteriorly to or below the knee worse with standing
  • flexion exercises and observation, avoid activities that aggravate condition
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16
Q

Cauda equina syndrome

  • what is it
  • sxs
  • tx
A
  • large central disc herniation compressing the sacral nerve roots
  • similar to herniated disc but also include bowel and bladder dysfxn, decreased rectal tone
  • emergent surgical decompression, always order STAT MRI, no OMT
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17
Q

Nerve Root Dysfxn

  • L4
  • L5
  • S1
A
  • lat thigh to medial calf, no patellar reflex
  • lateral thigh and calf, no dorsiflexion
  • posterior thigh and calf, no plantar flexion or achilles reflex
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18
Q

Standing vs seated flexion test

- what do they test

A
  • Standing is a illial sacral dysfxn

- Seated is a sacral illial dysfxn, because inominates are locked when sitting

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19
Q

Sacral dx

  • seated flexion
  • L5
  • post ILA and deep sulcus
  • spring/sphinx
A
  • axis is on opp side of the positive side
  • rotated opp for torsion
  • should be opp in torsion and if on same side it is unilateral
  • if + it means it is extended
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20
Q

sacral torsion

  • side bending
  • rotation
  • forward
  • backward
A
  • axis is on same side
  • sacrum rotated to opp direction
  • physiologic
  • non-physiologic
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21
Q

Sacral shear (unilateral sacral flexion or extension)

  • deep sacral sulcus and post ILA
    • seated flexion test
  • L5

Bilateral Sacral flexion or extension

  • flexion: superior sulci deep; lumbar curve; ILA shallow; spring/sphinx; seated flexion
  • extension: superior sulci deep; lumbar curve; ILA shallow; spring/sphinx; seated flexion
A
  • on same side
  • on same side
  • rotated opp deep sacral sulcus
  • right and left sup sulci deep, increased lumbar curve, ILAs shallow bilaterally; negative spring and sphinx; negative seated flexion
  • right and lef sup sulci shallow; decreased lumbar curve; ILA deep bilaterally; positive sping/sphinx; negative seated flexionb
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22
Q

Thoracic Outlet Syndrome

  • what is it
  • sxs
A
  • compression of subclavian a, v and brachial plexus

- neck pain radiating to arm

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23
Q

Erb-Duchenne

  • what is it
  • presentation
A
  • upper arm paralysis bc of injury to C5 and C6

- waiters tip

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24
Q

craniosacral

  • flexion
  • exension
A
  • counternutation (base is post), hands inferior and wider

- nuation (base is ant), hands superior and narrow

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25
Q

Osteo tx: direct vs indirect and active vs passive

  • Myo release
  • counterstrain
  • FPR
  • ME
  • HVLA
  • Lymph
  • Cranial
A
  • both, both
  • indirect, passive
  • indirect, passive
  • direct, active
  • direct, passive
  • direct, passive
  • both, passive
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26
Q

Tension headaches caused by

A
  • capitis muscles
27
Q

Scalenes

  • ant and middle
  • post
  • importance
A
  • attach to rib 1
  • attach to rib 2
  • brachial plexus and subclavian a lie between ant and middle scalenes
28
Q

Spurling test

  • used for
  • what is it
A
  • cervical nerve root compression
  • patient seated, physician extends, side bends c spine and pushes odwnward on top of patients head
  • positive if pain radiates into ipsi arm
29
Q

Scoliosis

  • most common cause
  • most common curve
  • tx
A
  • idiopathic
  • dextro, right shoulder forward and right scapula medial border protrudes posterior
  • less than 30 observe, 30-40 is bracing, and > 40 surgery
30
Q

Lower muscles

- iliopsoas: function, psoas syndrome

A
  • ## flexes the hip and externally rotates; pt unable to stand up straight and prefers flexed and sidebent to one side, better seated, + thomas test
31
Q

Innominate Dysfunction

  • ant rotation
  • posterior rotation
  • sup shear
  • inf shear
  • inflare
  • outflare
  • sup PUBIC shear
  • Inf PUBIC shear
A
  • ASIS inferior and medial; PSIS superior and lateral
  • ASIS superior and lateral, PSIS inferior and medial
  • ASIS and PSIS superior on one side
  • ASIS and PSIS inferior on one side
  • ASIS medial and PSIS lateral
  • ASIS more lateral and PSIS more medial
  • Pubic tubercle superor ipsi
  • Pubic tubercle inf ipsi
32
Q

Rotator cuff

  • made up of
  • most injured, positive test
A
  • supraspinatus, infraspinatus, teres minor, subscapularis

- supraspinatus, beer can test

33
Q

Nerves of brachial plexus

  • c5: sensation, motor, relfex
  • c6: sensation, motor, relfex
  • c7: sensation, motor,
  • c8: sensation, motor,
  • T1: sensation, motor,
A
  • lateral arm and elbow, deltoid and bicep, biceo reflex
  • lateral forearm and thumb, bicep, wrist extensor (radial N), briachioradlialis
  • middle finger, wrist flexor (median N) and interossi (ulnar N)
  • medial elbow and medial arm, interossi
34
Q

Motion testing of shoulder

  • apley: how? what does it mean?
  • arm drop
  • apprehension
  • yergason
  • adson
A
  • pt attempts to reach scapula of opp shoulder; labral issue
  • bring pts arm up to abduct 90 degrees and then let go to see if it drops; full rotator cuff tear
  • put patients arm abducted, extended and externally rotated; pt should feel dislocation coming and become apprehensive
  • physician externally rotate elbow while pt internally rotate to check if bicep tendon pops out of bicipital groove; asess stability of bicep tendon
  • pt shoulder extended, externally rotated and mildly abducted while monitoring pulse and pt is asked to turn head toward side being tested and take deep breath; decreased absent or radial pulse
35
Q

Radial Head Motion

  • pronation
  • supination
A
  • guide posteriorly; falling on pronated forearm; restricted in supination freedom toward pronation
  • guide anteriorly; falling on supinated forearm; restricted in pronation and freedom toward supination
36
Q

Anatomincal snuff box

  • tenderness on floor
  • caused by
  • imaging
  • tx; consequences
A
  • possible fracture of scaphoid
  • FOOSH
  • assume fracture even if not visible on xray
  • thumb spica splint; avascular necrosis
37
Q

Lateral epicondylitis vs medial

  • other name
  • strain
  • location of pain
  • test
A
  • lateral: tennis elbow medial: golfers elbow
  • lateral: extensor muscles in forearm; medial: flexor muscles in forearm
  • lateral: lateral epicondyle; medial: medial epicondyle
  • lateral: pt extend wrist and physician pushes against; medial: pt flex wrist
38
Q

Forearm and Wrist complaints

  • Ape hand: presentation, N affected
  • Hand of benediction
  • Claw hand
  • wrist drop (saturday night palsy)
  • waiters tip
A
  • thenar wasting, adducted thumb, loss thumb opposition; carpal tunnel syndrome; median N at wrist
  • when making fist digits 2 and 3 remain extended; median N at forearm
  • pinky and ring stay bent when extended; ulnar N at wrist
  • paralysis of wrist extensor; Radial N
  • arm hangs at side, medial rotation; upper trunks C5-6
39
Q

Tibiofibular joint

  • pronation
  • supination
A
  • external rotation; anterior

- internal rotation; posterior

40
Q

Lower Nerves

  • L2-4
  • L4- S3
A
  • M: quad, iliacus, sartorius, pectineus; S: anterior thigh, medial leg
  • Sciatic into tibial and peroneal; tibial -> M: hamstring, plantar flexor, toe flexor; S: lower leg and plantar aspect of foot; peroneal -> M: bicep femoris, evertors and dorsiflexor of foot, extensor of toes; S: lower leg and dorsum of foot
41
Q

Hip tests

  • FABERE
  • FADIR
  • Ober
  • Thomas
  • Trendelenburg
  • Straight leg
A
  • pt supine, physician moves leg into flexion and extension; tests ROM of hip
  • pt supine, physician moves leg into flexion and then adducts and internally rotates; tests ROM of hip
  • pt lying on side, knee is flexed and lifted toward ceiling to let fall, look for delay; contracture of tensor fascia lata
  • supine, pt asked to flex knees and hips and hug both legs, then release leg and let it fall on table, should be able to have knee lie flat on table; psoas contraction
  • pt standing and lifts one leg off floor, looking for hip to drop towards side of leg picked up; assess for weak glut med
  • pt supine, phsician raises patients extended leg and will have sharp shooting pain down post aspect of raised leg assess for radiculopathy,
42
Q

Lower Nerves

  • L1: motor, sensation
  • L2: motor, sensation
  • L3: motor, sensation
  • L4: motor, reflex, sensation
  • L5: motor, sensation
  • S1: motor, reflex, sensation
A
  • iliopsoas; ant thigh below inguinal ligament
  • iliopsoas, adductor, quad; middle ant thigh
  • adductor, quad; ant thigh above knee
  • ant tibialis, patella reflex, medial malleolus
  • extensor hallicus longus, quads; dorsal aspect of foot and big toe
  • peroneus longus and brevis gastroc; achilles; lateral malleolus
43
Q

Arches

  • dropped cuboid
  • dropped navicular
  • dropped cuneiform
A
  • medial edge glide toward plantar surface
  • lateral edge glide toward plantar surface
  • secon cunifrom toward plantar surface
44
Q

Ankle sprains

  • lateral stabilizers
  • medial stabilizers
  • grade 1
  • grade 2
  • grade 3
A
  • prevent supination; anterior talofibular, calcaneifibular, posterior talofibular
  • deltoid lig
  • ATF, stretched or partial tear
  • ATF, CFL partially teared
  • complete tear of all 3
45
Q

Cranial strains

  • torsion
  • sidebending-rotation
  • lateral
  • vertical
  • compression
A
  • rotation of base of sphenoid and occiput in opposite directions, named for higher wing of sphenoid
  • sphenoid and occiput sidebend and rotate to one direction, creating convex
  • lateral displacement of base of sphenoid to base of occiput and both rotate in same direction, parallelogram; named for direction of base of sphenoid
  • base of sphenoid is carried superior or inferior relative to base of occiput; named for direction of base of occiput
  • base sphenoid is compressed to base of occiput; amplitude is makedly decreased
46
Q

CN somatic dysfunction and sxs

  • III
  • IV
  • VI
  • VII
  • VIII
  • X
  • XII
A
  • sphenobasilar, facial; dipopia, ptosis
  • sphenobasilar, facial; diplopia when looking down
  • sphenobasilar, facial; diplopia
  • sphenobasilar, facial; sx similar to bells palsy
  • sphenobasilar, temporal; tinnitus, vertigo, hearing loss
  • temporal, occiput, OA; headache, arrythmia, GI upset, resp problems
  • sphenobasilar, compression of condylar parts in infants
47
Q

Sucking problems

  • CN
  • somatic dysfxn
  • tx
A
  • IX, X, XII
  • OA, AA, C2
  • OA decompression, distract occipital condyles from atlas
48
Q

Contraindications for craniosacral tx

  • absolute
  • relative
A
  • brain bleed, intracranial pressure, skull fracture

- pts w/ seizure hx or TBI

49
Q

Auto Innervation

  • eye: parasympathetic (N and effect) vs sympathetic
  • glands
  • heart
  • lungs
  • GI
  • Arteries: symp only
  • GU
  • Penis
  • Adrenal medulla: symp only
  • Liver: symp only
A
  • CN III: constricts, T1-4: dilates
  • CN VII: stimulates secretion; T1-4: vasoconstriction for slight secretion unless sweating, then increases
  • CN X: decrease contractility and conduction; T1-5: increase contractility and conduction
  • CN X: contracts; T2-7: dilates
  • CNX: contracts SM, and increases secretion; T5-L2 relaxes lumen, contracts spincters, decreases secretion
  • contracts vessels, and relaxes skeletal muscles
  • S2-4: contract bladder wall and relaxes sphincter; T10-L2: contracts bladder sphincter
  • S2-4: erection; T10-L2: ejaculation
  • T10-L1: secrete catecholamines
  • T5-9 gluconeo and glycolysis
50
Q

Parasymp innervation

  • GI
  • Kidney
  • repro
A
  • upper GI w/ ascending and transverse colon is vagus while descending and rectosigmoid is pelvic splnchnic
  • kidney and upper ureter is vagus, while lower urter and bladder is pelvic splanchnic
  • everything is innervated by pelvis splanchnic except gonads
51
Q

Chapmans

  • appendix
  • adrenals
  • kidneys
  • bladder
  • colon
  • ovaries vs uterus
A
  • tip of R 12th rib
  • 2 inches super and 1 inch lat to umbilicus
  • 1 in sup and 1 inch lat from umbilicus
  • at umbilicus
  • along femur
  • O on top of pubic symph and uterus below
52
Q

Trigger points

- what are they

A
  • taught band SkM, causes referred pain
53
Q

Counterstain

  • type
  • time
  • ant cervical: location, tx
  • post cervical: location, tx
  • ant thoracic: location, tx
  • post thoracic: location, tx
A
  • indirect, fold and hold
  • 90 sec
  • on articular pillars; 1: away, 2-6: flexion and SARA, 7-8: flexion and STAR
  • on spinous process; 2: ext; 3: flexion and SARA; 4-8: Ext SARA
  • T1-6, midline sternum at attchment of rib (tx with flexion and minor rotation or sidebending) and 7-12 in rectus abdominus muscle one inch lateral to midline bilaterally (tx with flexion, STAR)
  • On either side of TP ( tx with extension and SART)
54
Q

Ant rib counter strain

  • caused by
  • time
  • 1: location, tx
  • 2: location, tx
  • 3- 6: location, tx
A
  • ant is caused by ant deperessed rib;
  • 120 seconds instead of 90
  • 1: below medial clavicle; F, RTST
  • 2: 6-8 cm lat to sternum on rib 2; F, RTST
  • 3-6: along mid axillary line of corresponding rib; F, STRT
55
Q

Post Rib counterstain

  • location
  • tx
A
  • post is caused by post depressed rib

- 1: E, SART; 2-6: F SARA

56
Q

Lumbar counterstrain

  • Ant: location, tx
  • Post
A
  • 1: medial to ASIS, 2-4: on AIIS, 5: 1 cm lat to pubic symphysis; F, RA
  • On TP; ext, SA
57
Q

Muscle energy

- mechanism

A
  • golgi tendon senses increase in tension and sends impulse back to SC allowing extrafusal fibers to relax
58
Q

Exhalation dysfxn

  • rib 1: muscle affected and tx position
  • rib 2
  • rib 3-5
  • rib 6-9
  • rib 10-12
A
  • ant and middle scalenes; pt raises head to ceiling
  • post scalene; pt head rotated away and lift head to ceiling
  • pec minor; pt pushes elbow of affected side toward opp ASIS
  • serratus ant; push arm ant
  • lat dorsi; pt adducts arm
59
Q

Sacral muscle energy

  • flexion
  • extension
A
  • pt prone, heel on ILA, follow inhale and resist exhalation

- pt prone, heel on sacral sulcus, follow exhale resist inhale

60
Q

Radial head ME

  • posterior
  • anterior
A
  • arm is suppinated and pt asked to pronate

- arm is pronated and pt asked to supinate

61
Q

Cervical HVLA

  • OA
  • AA
  • C2-C7
A
  • cervical spine extended, rotate towards and side bend towards
  • head flexed, rotate towards
  • lock out neck and side bend toward
62
Q

Thoracic HVLA

  • positioning
  • hands
A
  • supine

- thenar eminence on one TP and MCP under other TP

63
Q

Articulatory

- what is it

A
  • springing technique or low velocity toward restrictive barrier with gentle repetitive forces to increase ROM
64
Q

Articulatory

  • what is it
  • most common
A
  • springing technique or low velocity toward restrictive barrier with gentle repetitive forces to increase ROM
  • spencer: extension, flexion, circumduction with compression, circumduction with distraction, abduction, adduction with ex rotation, abduction with internal rotation, extension and stretching tissues

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