OMM Flashcards
Rotator cuff muscles
Supraspinatus
Infraspinatus
Teres Minor
Subscapularis
Supraspinatus- Origin/Insertion, Innervation: Action:
Origin/Insertion: Medial border of scapula to greater tubercle of the humerus
Innervation: Suprscapular nerve (C5-C6)
Action: Abduction
Infraspinatus- Origin/Insertion, Innervation: Action:
Origin/Insertion: medial border of scapula to greater tubercle of humerus
Innervation: Suprascapular nerve (C5-C6)
Action: External Rotation
Teres Minor- Origin/Insertion, Innervation: Action:
Origin/Insertion: Medial border of scapula to greater tubercle of the humerus
Innervation: Axillary nerve (C5-C6)
Action: External Rotation
Subscapularis- Origin/Insertion, Innervation: Action:
Origin/Insertion: Subscapular fossa to lesser tubercle of the humerus
Innervation: Major and minor nerves to Subscapularis (C5- C7)
Action: Internal Rotation
Treatment for adhesive capsulitis
Spencer technique
Spencer Technique
Every Fine Cat Takes An Indoor Piss
Extension Flexion Compression w/ circumduction Traction W/ circumduction Abduction and Adduction w/ External Rotation Internal Rotation Pump
Acromioclavicular joint dysfunction
Dx: Spring of compression test- Hard end feel will be side of dysfunction. Also Measure spine of scapula B/L
Tx: ME-same setup for superior and inferior dysfunction
Patient abducts arm and doc puts knee under it. Pt lifts arm while doc pushes it down.
Superior dysfunction- Palm up/ supine
Inferior dysfunction- Palm down/ pronate
BITE
Bottom Inhaled
Top Exhaled
Exhaled Rib dysfunction
Rib can go down into exhalation but can’t go up into inhalation
Treat Top rib to allow ribs to move up
Treatment for Exhaled Rib dysfunction
Muscle Energy
Rib 1- Ant and Middle scalene Rib 2- Posterior scalene Rib 3-5- Pec Minor Rib 6-8- Serratus Anterior Rib 9-10- Lats dorsi
Rib Motion
Pump 1-5
Bucket 6-10
caliper 11-12
Posterior Radial Head dysfunction
Forearm pronated- Radial head posterior
Fall forward injury will cause radial head to move farther posterior
Treatment of Posterior Radial Head dysfunction
Muscle Energy
Place pt into barrier (supination) and ask them to move hand into freedom (Pronation)
Anterior Radial Head dysfunction
Forearm Supination will cause anterior radial head
Fall backwards injury on supinated arm will cause radial head to move more anteriorly
Treatment of Anterior Radial Head dysfunction
Muscle Energy
Place hand in barrier (Pronation) and ask pt to move into freedom (supination)
Arm counterstain- long head of biceps
Flex, abduct and internally rotate biceps
Arm counterstain- Medial epicondylitis (Golfer’s elbow)
Flexion, pronation and ADduction
Arm counterstain- Lateral Epicondylitis ( Tennis Elbow)
Extension, Supination, and ABduction
Piriformis
Origin: Posterior sacrum to greater trochanter of femur
Action: External Rotation
Dysfunction of piriformis will cause it to become hypertonic and stuck in external rotation and impinge sciatic nerve
Muscle Energy for Piriformis
Muscle Energy- Move muscle into barrier (internal rotation) and ask pt to move into freedom (external rotation)
ACL and PCL
ACL originates on posterior femur inserts on anterior tibia- Tx: Pillow under femur and Push tibia posterior
PCL originates on anterior femur inserts on Posterior tibia - Tx: Pillow under tibia and Push femur posterior
Tx: Above is counterstrain
Counterstrain for piriformis
External rotation, ABduction, Flexion (Peeing dog)
Tender point for psoas
2/3 ASIS and umbilicus
Tender point for Iliacus
1/3 ASIS and umbilicus
Foot Pronation
Dorsiflexion (towards sky) Eversion ABduction Talus will move posteriorly Fibular head will move Anteriorly
Foot Supination
Planterflexion Inversion Addcution Talus moves anteriorly Fibular head moves Posteriorly
Tx for Anterior Fibular head
ME- Foot likes pronation
So bring foot to barrier (supination) and ask pt to move into freedom (pronation)
Tx for Posterior Fibular head
ME- Foot likes supination
bring foot into barrier (pronation) and ask pt to move into freedom (supination)
Cranial Flexion
Paired bones externally rotate
Short AP axis
Wide Transverse Axis
Sacral Counternutation/ extension
Cranial Extension
Paired bones Internally rotate
Long AP axis
Narrow Transverse axis
Sacral Nutation/ flexion
V spread technique
A V-spread technique at the occipitomastoid suture is performed to affect the vagus nerve to address the parasympathetic nervous system.
The most common sprain of the ankle is of the anterior talofibular ligament, involving excessive supination
Supination of the foot involves plantarflexion, inversion, and adduction of the ankle and is the least stable position.
What drains to the right lymphatic duct?
Right side of the head and neck, the right upper extremity, the heart, and a portion of the lungs
Rest of the body drains to the thoracic duct.
Anteriorly rotated innominate
Isolate the hamstrings and use their force to help pull the anteriorly rotated innominate posteriorly and back into its normal function position
Type I Somatic Dysfunctions
Neutral
Rotation and sidebending are in opposite directions
Type II Somatic Dysfunctions
Flexion or extension
Rotation and sidebending are in the same direction.
What test is this?
With the patient seated, the physician extends and sidebends the neck to the side being tested, and pushes downward on the top of the patient’s head
Spurling test
To test for cervical nerve root compression
What test is this?
Patient will make a fist with the thumb tucked inside the fingers. The physician will stabilize the patient’s forearm and deviate the wrist ulnarly.
Finkelstein test
Used to evaluate tenosynovitis in the abductor pollicis longus and extensor pollicis brevis tendons at the wrist
The patient opens and closes the hand several times and then makes a fist. The physician then occludes the radial and ulnar arteries. The patient opens his hand, and the palm should be pale. The physician will then release either the radial or the ulnar artery and evaluate the flushing of the hand.
Allen’s test
Assesses the adequacy of blood supply to the hand by the radial and ulnar arteries
Scoliosis Treatment
10° or greater curve = scoliosis
< 20° = observe, serial radiographs
20°-45° = brace
> 45° = surgical fusion
What test?
In this test you have the patient stand on one leg, if the opposite pelvis drops below the stance leg pelvis this is a positive test.
Weak Gluteus medias
Innervated by superior gluteal nerve (L4-S1)
Which nerve innervates the gluteus maximus?
Inferior gluteal nerve
The “hamstring” muscles
Semitendinosus, semimembranosus, and biceps femoris
Ober’s test
used for detecting tightness in the tensor fascia lata and iliotibial band.
Apley’s compression test
Evaluates meniscus and ligamentous structures of the knee.
Most appropriate osteopathic technique to treat compression or malalignment of a cranial suture
V-spread technique
Movements at the OA
Sidebending and rotation occur in opposite directions at the occipitoatlantal joint.
Chapman point for pancreas
Lateral to the costal cartilage between ribs 7 and 8 on the right.
Chapman point for bladder
Periumbilical region
Technique of FPR?
Indirect and passive
V-spread technique performed at the occipitomastoid suture will decrease restriction at the jugular foramen
The temporal and occipital bones come together to form the jugular foramen and the occipitomastoid suture.
The cranial nerves that exit the cranium through the jugular foramen are IX, X, and XI.
Myasthenia Gravis vs Lambert Eaton Syndrome
MG: Postsynaptic Ach receptors; Weakness worsens with use
LES: Presynaptic Ca channels; Weakness improves with use
Guyon canal syndrome (ulnar entrapment at the wrist)
presents with pain and sensory loss along the 4th and 5th digits of the hand. Anatomically, the ulnar nerve is entrapped as it passes through the tunnel formed by the palmar carpal ligament forming the roof of the tunnel.
Most common compensatory pattern
LRLR
occipitoatlantal to the left, rotation at the cervicothoracic to the right, rotation at the thoracolumbar to the left, and lumbosacral rotation to the right.
Treatment of a posterior innominate rotation using muscle energy
induces an isometric contraction of the rectus femoris muscle.
Target muscles for anterior innominate dysfunction
The hamstring is primarily used—as is the gluteus maximus—to mobilize an anterior innominate rotation during muscle energy treatment.
Superior labral anterior to posterior tears
frequently encountered in athletes. Clinical evaluation with special provocative maneuvers (O’Brien’s test) and diagnostic imaging (MRI arthrogram) can help make a definitive diagnosis. Surgical repair is required in most cases.
Organophosphate poisoning antidote
Pralidoxime
Atropine (for bradycardia)
Lateral strain
Occurs when the sphenoid and occiput rotate in the same direction around 2 vertical axes
Newborn- parallelogram head
Torsion strain
Sphenoid and occipital bones rotate in opposite directions around an anterior-posterior axis (1 AP axis)
Flexion and extension SBS
Occur when the sphenoid and occiput rotate in opposite directions around two transverse axes
2 transverse axis on sagittal plane
Measuring fetal age by uterus size
12 Weeks
12 weeks- Fundal height is located at the level of the pubic symphysis and remains a pelvic organ.
Measuring fetal age by uterus size
16 Weeks
Midway to the umbilicus from pubic symphysis
Measuring fetal age by uterus size
20 Weeks
fundus of the uterus is located at approximately the level of the umbilicus
Measuring fetal age by uterus size
After 20 Weeks
symphysis-to-fundal height in centimeters should correlate with the number of weeks of gestational age.
Sequence of ligamentous injury that occurs during inversion ankle injuries
1) Anterior talofibular
2) Calcaneofibular
3) Posterior talofibular
Lateral/ Tennis epicondylitis
pain with resisted wrist extension
Medial/ Golf epicondylitis
pain with resisted wrist flexion
Squamous cell carcinoma of Lung
Smokers
Increased Ca due to bone metastasis or from the release of Parathyroid Hormone related peptide (PTHrP) from the squamous cell carcinoma
Adenocarcinoma of the lung
More likely located on the lung periphery, more common in women, and less commonly associated with smoking and hypercalcemia.
Small cell carcinoma of the lung
Can cause Lambert-Eaton syndrome by producing antibodies against the pre-synaptic calcium channels
Counterstrain
Anterior tenderpoints are typically treated with flexion and sidebending toward the lesion.
Posterior tenderpoints are typically treated with extension and sidebending away from the lesion.
Right jaw deviation can be treated with muscle energy by
Move pt jaw to the left and asking pt to move her jaw to the right causing increased muscle tension with no change in length (isometric)
Counterstrain muscle for right TMJ
Right masseter
To treat anterior tenderpoints T1 - T6
Position the patient in flexion and with arms internally rotated.
Compression of Hypoglossal nerve (CN XII)
The Hypoglossal nerve, CN XII, passes through the hypoglossal canal in the occipital bone and can become compressed and irritated in the case of OA compression leading to Poor latching on and suckling of the newborn during breastfeeding.
Muscle energy- Post isometric
Setup into barrier
Pt moves towards freedom
Used often, in chronic
Muscle Energy- reciprocal Inhibition
Setup into barrier
Pt moves into barrier
Used in acute/ painful
