OMM Flashcards
Four principles of Osteopathy
- The body is a unit
- It has its own self –protecting and self-regulating mechanisms
- Structure and function are reciprocally interrelated
- Treatment considers the preceding three principles
Somatic Dysfunction
Impaired or altered function of related components of the somatic (body framework) system: skeletal, arthrodial, and myofascial structures, and related vascular, lymphatic and neural elements
Sherrington’s Law
- Every posterior spinal nerve root supplies a specific region of skin through fibers from adjacent segments
- When nerve receives an impulse to contract (agonist) then the antagonist relaxes
Head’s Law
When a painful stimulus is applied to a body part of low sensitivity that is in close central connection with a point of higher sensitivity, the pain is felt at the point of higher sensitivity rather than at the point where the stimulus is applied
Hilton’s Law
Any nerve stimulating a muscle producing movement at a joint, also innervates the joint and skin over it
Hooke’s Law
Any strain (deformation) placed upon an elastic body is in proportion to the stress (force) placed upon it
Wolf’s Law
Bones tend to deform along lines of force placed upon them, this is also true for soft tissues
Facilitation
The maintenance of a pool of neurons in a state of sub-threshold excitation; in the state, less afferent stimulation is required to trigger the discharge of impulses
What three things could help the operator make an accurate clinical diagnosis?
- Studying functional anatomy need to know anatomy and how it is supposed to function
- Understanding normal and pathological physiology so you understand what is considered normal and how it can go wrong
- Ability to find somatic dysfunction
What does TART stand for?
T – tissue texture change
A – asymmetry
R – restriction of motion
T – tenderness
A.T. Still’s date of birth and death
Born 6 Aug 1828 in Virginia; died in 12 Dec 1917 in Kirksville, Missouri
Year that Still “Flung to the breeze the banner of Osteopathy”
1874
Coined the term Osteopathy
1889
1864
Three of his children died of spinal meningitis
Year the ASO was chartered
1892
William Smith was granted the first diploma
15 Feb 1893
2 March 1894
First class graduated
Nov 1896
Vermont became the first state to legally license DO’s, the second is North Dakota
George Still
- Still’s nephew
- Taught surgery at the ASO
- One of the first people to say that they should separate surgery patients from other patients; separate staff; separate buildings to avoid contamination
Fred Still
- Born 1874, died 1894
- Crushed by horse and sent to California where he succumbed to injuries
- Graduated with the first class; dedicated to osteopathy – even fixed girl’s wrist before dying
- Still said when Fred died, future of Osteopathy died with him
Arthur Hildreth
- Became the second principal of ASO in 1889, resigned in 1900
- Comes from a poor background
- Dedicated to osteopathy and thus not liked by the Littlejohns
Direct method
Take the tissue or joint to the restructure barrier (“pathologic barrier”, “direct barrier”) and work through the barrier using some activating force. To reach the barrier, the joint or the joint tissues are moved in the direction in which there is restriction of motion.
Indirect method
Take the tissues or joint away from the restrictive barrier to a point of ease and let the intrinsic forces, respiratory force and/or traction or compression activate release of the somatic dysfunction
Ease
The way the fascial tissue will move
Drag
The sensation of resistance felt when the fascial tissues are moved in the direction of their restriction
What is the functional thoracic inlet?
The functional thoracic inlet is a clinical inlet; its borders are defined as being the manubrium with the joint of Louis, the first two ribs on each side and the first four thoracic vertebrae. it is an important static landmark that will be used in torsion of the fascias at the thoracic inlet.
What is the rule of threes?
SP 1-3 are at the same level of their TVPs
SP 4-6 are 1/2 vertebral level below their TVP
SP 7-9 are one full vertebral level below TVP
SP 10-12 gradually return to the same plane as the TVP whose spine is being palpated
What are the mechanical requirements for effective breathing?
- Mechanical respiratory actions provided through the special arrangement of the rib cage with the thoracic spine
- Special muscle attachments
- Presence of a strong, well-domed abdominal diaphragm
- Motion capabilities of approximately 146 joints of the thoracic, costal and sternal structures
- A closed chest cage and intact phrenic nerve (C3,4 ,5) innervation to the diaphragm
What are the seven joints and joint-like structures of the shoulder?
- Acromioclavicular joint
- Suprahumeral “joint”
- Glenohumeral joint
- Scapulocostal “joints” (Serratoscapular and Serratocostal)
- Costosternal joint
- Vertebral joints (Costotransverse and costovertebral)
- Sternoclavicular joint
Four axis of the femur
Transverse axis
AP axis
Anatomical longitudinal axis
Functional longitudinal axis
What are the minor motions allowed in the hip joint?
Posterior and anterior glide of the femoral head in relations to internal and external rotation of the femur
Major motions of the hip
Flexion
Extension
Abduction
Adduction
Internal rotation glides the femoral head __________ into the acetabulum
deeper/posteriorly
Ligaments of the hip joint
Anteriorly
- Iliofemoral ligament
- Pubofemoral ligmament
Posteriorly
-Ischiofemoral ligament
Anteromedial glide occurs with full _________and posteriormedial glide occurs with full ____________ of the knee.
flexion, extension
Flexion of the knee brings the ______condylar surface to its physiological barrier sooner than the _____ condyle.
lateral, medial
Muscles that cause inversion of the ankle
Tibialis anterior
Tibilais posterior
Muscles that cause eversion of the ankle
Fibularis longus
Fibularis brevis
Fibularis tertius
Muscles that cause dorsiflexion
Tibialis anterior
Extensor hallicus longus muscle
Extensor hallicus digitorium muscle
Fibularis tertius
Muscles that cause plantar flexion
Gastrocnemius
Soleus
Plantaris
Flexors of the knee
Hamstrings (Biceps femoris, semitendinous, semimembranosus)
Gastrocnemius
Gracilis
Sartorius
Extensors of the knee
Quadriceps femoris (Rectus femoris, vasus medialis, intermedius and lateralis)
What combined motions of the tibia are most likely to injure the medial meniscus?
flexion, abduction and external rotation
What characteristics are noted with forward bending or (flexion) of the cervical spine?
The spines separate
The facets of the superior vertebra glide anterior on the facets of the vertebra below it
The intervertebral foramen open up
The nucleus pulposus pushes posteriorly
Neurologic symptoms may be produced by this maneuver, especially in patients with structural changes, permitting the nucleus pulposus to press on nerve root structures
Forward bending or (flexion) of the typical cervical spine is also known as regional extension. Why?
Cervical forward bending (FB) is generally called “flexion”. Some older texts however will refer to this as Fryette extension, or regional extension because the two ends of the curve separate.
Backward bending or (extension) of the typical cervical spine is also known as what?
Backward bending (BB) of the cervical spine is generally called “extension” (even though Fryette defined this as regional “flexion” because the two ends of the curve approximated).
What common characteristics does BB or extension of the cervical spine exhibit?
The spines approximate
The facets of the superior vertebra glide posterior on the facets of the vertebra below it
The intervertebral foramen are narrowed
The nucleus pulposus of the intervertebral disks push anteriorly
Neurological symptoms may be produced by this manoeuvre, especially in patients with osteoarthritis which structurally reduces the size of the intervertebral foramen
The angle formed by the intersection of the anatomical axis of the shaft of the femur and the longitudinal axis of the neck of the femur is called the __________ and normally measures 120-135 degrees
Angle of inclination
If the angle of inclination is larger than 135 degrees
Coxa valgus
If the angle of inclination is smaller than 120 degrees
Coxa varus
Genu valgum
Knocked knees
Genu valgus
Bow-legged
Valgus force
Force coming from lateral direction; forces a joint medially
Varum force
Force coming from medial direction; forces a joint laterally
What level of the spine are the following structures found? Vena cava, esophagus, and the aorta.
Vena cava is to the right of midline at T8
Esophagus is to the left of the midline at T10
Aorta sits slightly to the left of the median plane at T12
In the case of the first rib, what usually dictates its preference of position?
First vertebra
What is rib raising and what effect does it have?
Thoracic sympathetic chain ganglia are segmentally located in the fascias over each rib head. Because of this relationship, a manipulative technique called rib raising initially stimulates the thoracic sympathetic outflow, but gives rise a longer lasting effect of decreasing sympathetic tone by reflexly inhibiting the higher sympathetic centers in the medulla.
What are the two important mechanical functions of the thorax?
- Respiration
- Lymphatic pump
What are the dimensions and boundaries of the thorax?
The thorax is a bony cylinder composed of 12 thoracic vertebrae, 12 ribs, 12 costocartilages, a sternum and a right and left interchondral mass. Since there are 12 thoracic vertebrae and the poseterior dimension of the thorax is 12 inches in length, each vertebra and its disk accounts for about 1 inch of this border.
What are 3 examples of fascial chains in the body?
- Cervical prevertebral fascias continue into the thorax as the prevertebral fascia
- The fascias which attach to the sphenoid and pterygoid areas at the base of the skull appear to continue down through the neck to become the visceral fascias
- The pharyngeal fascias and those fascias attaching to the inferior portion of the mandible seem to become the fascias of the arm and the anterior chest wall in the thorax
Three influential women in osteopathy
Louisa Burns
Nerdy Bowles
Viola Frymann
What is the inferior thoracic aperture?
The inferior thoracic outlet is the inferior boundary of the thorax and the abdominal diaphragm closes it. Functionally, this outlet is defined as the attachments of the abdominal diaphragm (xiphoid process, lower six ribs, and L1, 2, 3).
Names of sons of Still that graduated from ASO
Fred Still
Charles E Still
Harry Still
Henry Still
Year the ASO was rechartered
October 30, 1894
Ligaments of the SC joint
- Sternoclavicular ligament
- Interclavicular ligament
- Costoclavicular ligament
What are the four ligaments that stabilize the AC joint?
- Acromioclavicular ligament
- Coracoacromial ligament
- Medial coracoclavicular ligament
- Lateral coracoclavicular ligament (trapezoid and conoid)
Still Hildreth Osteopathic Sanatorium, Macon, Missouri
o 1913 Hildreth’s wife dies from cancer
o Hildreth was in a very bad state, thought about quitting
o The property was bought and built so that Arther Hildreth could stay with osteopathy
o Able to cure 55% of insanity
o Stayed open till 1960s when the psycho active drugs started coming out
o Not just an institution, had a music room, atrium, restaurant – not just boxing people into rooms but treating them as people
Louisa Burns
o Graduated in 1903 from the Pacific College of Osteopathy
o Wrote four books in early 1900s
o Induced lesions in animals and then dissected them to see what the lesions led to (used a lot of rabbits)
o Kirksville is now going to prove Louisa’s findings
o Born 1870, died Jan 19, 1958
o Trading card was issued in 1995
Marion Clarke
- Stuck to osteopathy
- Born in 1874, died in 1959 June 22
- Wrote an osteopathic anatomy textbook
- Wrote a book on diseases of women – OB at ASO
- Graduated 1899
- Stayed on teaching staff to 1908
Carl Philip McConnell
o Like Hildreth, Still’s right hand man
o After graduating ASO, he went to study homeopathy
o Born 1874 in Mendora, Wisconsin
o “Throughout the history of osteopathy, the one outstanding man next to A.T. Still, was and is, Carl P. McConnell- a quiet, lovable, clear-minded, scientific thinker, with a rare understanding of the human body, its structure and function, and the significance of the osteopathic concept and art of practice”
o wrote a lot of papers
Dane Tusker
- Went to pacific school
- Studied anatomy
- Studied osteopathy
- Moved to Kirksville to do graduate study in the early 1990s
- Wife was osteopath
- Tried x-ray photography
Elmer D. Barber
o first person to write a book in osteopathy
o class of 1895
o wrote the book in 1896
o founded the national school of osteopathy 1898 in Kansas City
o stole everything from Still
o Still felt his school was a diploma mill and sent William Smith to investigate because he doesn’t know William Smith
o Still sued Barber for being a diploma mill
o Lost the lawsuit because his charter was for different state
o Wrote a letter apologizing to A.T. Still and then killed himself
Morris Fishhalm
o Says that Palmer’s son (B.J. Palmer) says his father stole chiropractor from A.T. Still
o Saw the guestbook with Palmer’s signature
Elva Gregory
o Started early chiropractor school
o Connected to Strudders
o Realized that Palmer knew nothing of anatomy, canned Palmer
Blanche Still
- A.T. Still’s youngest daughter
- Married to George Laughlin
D.D. Palmer
o Treated by A.T. Still
o Ate at Stlll’s table
o Talked to students and were treated by them
o Founded first school of chiropractics 1895
o Claimed to receive chiropractic visions from the beyond
o School was in debt by 1896 and left it to his son and went west
o B.J. Palmer ran over his father during a parade with a float → tried to pin murder on him but nothing stuck
Strothers
o No documentation he graduated
o Part of first class 1892
o Practiced in Davenport, Iowa
o Never formally graduated in 1894
A.P Davis
o Osteopathy grad, chiropractor then neuropathy
o First student of D.D. Palmer
Gordon ZInk
o Died 1981 by ALS
o Pennsylvania College of Osteopathic Medicine in the 1930s
o Contributed to osteopathic education through tireless and inspired teaching, emphasized the respiratory circulatory model; common compensatory patter of “Zink”
• Believed it could be influenced even in childhood
• Stuck to original philosophy
George Laughlin
o Graduated 1900 • Hildreth became dean for a short time • 1900-1906, 1908-1910, 1912-1918 o Married Blanche Still o Opened Laughlin hospital o Founded the A.T. Still School o Bought out ASO and merged Kirksville Osteopathic College • Served as the president until 1926
John Wernham
- Born 1907, around the time Littlejohn was in Chicago
- Early 1930s, started in BSO
- Photographer during WWII, came back after war and completed studies
- Became faculty member in BSO
- Founded the school John Wernham of Ostopathy
- Died in 2007
John Martin Littlejohn
o Had a terrible throat condition, in the states, Still fixed him up
o Dean for six months of ASO
o Then there was a falling out; wrote a nasty letter to Still about how Hildreth was not an educated man
o Wanted less deans, Still kicked Smith out
o Founded the Chicago school
o 1913 he went to UK to talk about opening school, 1917 was when he opened the school
Frank Millard
o Wrote a book of the lymphatic system; written in 1922; wrote it while at UT
o Moved up here in 1922
o Original members of the OOA
o D.O.
Charlotte Weaver
o Graduated in 1912 from ASO
o Up until that point Still has done a lot up to the cranium but gave task to Weaver to treat it
o She deduced it as three separate ways → 3 vertebrae
o Had all the talks with still
o Sutherland is Weaver’s assistant; Sutherland never talked to Still
o Her first article was presented in 1935 to osteopathic association
o Presented in 1936
o Publishing 13 articles up to 1938
William Sutherland
o Published a book in 1939 and took all the credit
o Never had a private convo with Still
o Weaver’s assistant; stole everything from Weaver
Viola Fryman
o Born in 1921
o Dedicated her life to cranial
o Advanced it, works with children
o 1949 graduate of osteopathic physicians and surgeons of Los Angeles
o still alive
o story that she used to pay a pianist to come every day to play for the children who went to her clinic
What happens if there is no drainage? Why?
- Disease
- Stagnation
Lovett’s Law
A spinal segment at the bottom of the spine will have a correlated effect at the top of the spine
Types of collagen
+/- 15
Most abundant type of collagen
Type 1
Name the six key myofascial diaphragms
o Pelvic o Oral (Hyoid) o Abdominal o Respiratory o STA o Cerebellar o Falx
