OMM COMAT Flashcards
What is an isotonic concentric contraction?
approximate ends
What is an isotonic eccentric contraction?
further ends
What is an isometric contraction?
like muscle energy; patient makes a contraction against an outside force; no approximation or lengthening of the muscle
Explain the rule of 3s
T1-3 -> TP located at the same level as the SP
T4-6 -> TP located 1/2 level above SP
T7-10 -> TP located 1 full level above SP
T11 -> TP located 1/2 level above SP
T12 -> TP located at the same level as SP
Which way are the facets oriented in the cervical spine?
BUM (backwards, upwards, medial)
Which way are the facets oriented in the thoracic spine?
BUL (backwards, upwards, lateral)
Which way ware the facets oriented in the lumbar spine?
BM (backwards, medial)
What is the direction of treatment for counterstain of the anterior cervicals?
fSARA
What is the direction of treatment for counterstain of the anterior thoracic?
fSTRA
What is the direction of treatment for counterstain of the anterior lumbars?
fSART
What is the direction of treatment for counterstain of the anterior ribs?
fSTRT
What is the direction of treatment for counterstain of the posterior cervicals?
eSARA
What is the direction of treatment for counterstain of the posterior thoracic?
eSARA
What is the direction of treatment for counterstain of the posterior lumbars?
eSARA
What is the direction of treatment for counterstain of the posterior ribs?
fSARA
What is the treatment position for counterstain of AC1?
maverick point
Ra
What is the treatment position for counterstain of AC7?
maverick point
F STRA
What is the treatment position for counterstain of AT1-6?
maverick points
F
What is the treatment position for counterstain of AL1?
maverick point
AL1 F STRA
What is the treatment position for counterstain of AL5?
maverick point
F SARA
What is the treatment position for counterstain of PC1 midline?
maverick point
F
What is the treatment position for counterstain of PC3 midline?
maverick point
F SARA
What is the treatment position for counterstain of PT midline?
maverick points
E
What is the treatment position for counterstain of PR1?
maverick point
E SART
Where are AL1-5 points located?
AL1 - ASIS AL2 - AIIS AL3 - lateral to AL2 AL4 - inferior to AL2 AL5 - superior pubic ramus/pubic symphysis
What are some causes of psoas dysfunction?
bending forward over a work bench, standing up too quickly, or quickly jumping up from a chair; ureteral calculi, diverticulitis
What somatic dysfunctions/PE findings would you expect with psoas dysfunction?
contralateral pelvic shift, gait abnormalities, increased lumbar lordosis, positive Thomas test. Spine will flex, rotate, and sideband toward the hypertonic muscle.
What is the counterstain tender point for the psoas? How do you treat it?
2/3 distance from the ASIS to the umbilicus. Treat with flexion, SB toward, ER
What motion occurs around each of the sacral axes?
superior - respiration and cranial motion
midline - postural motion
oblique - weight shifting during gait
inferior - innominate rotation
What does the sacrum do during inhalation? Exhalation?
sacral extension during inhalation; sacral flexion during exhalation
What motion occurs at the SBS during cranial extension?
Flexion
What motion occurs at the SBS during cranial flexion?
Extension
What are the flexed sacral torsion somatic dysfunctions?
R on R or L on L
What are contraindications to HVLA?
osteoporosis, fractures, cancer, RA, Down syndrome
Where is AC7 located? What muscle is it associated with? What is the treatment?
Distal 1/3 of the clavicle; associated with the SCM (specifically the clavicular head); treat with F, SB towards, R away
If the spring test is positive, what kind of sacral dysfunction do you have?
Extension
If the sphinx test is positive, what kind of sacral dysfunction do you have?
Extension
If the spring test is negative, what kind of sacral dysfunction do you have?
Flexion
If the sphinx test is negative, what kind of sacral dysfunction do you have?
Flexion
What are the rules of L5 mechanics in relation to the sacrum?
L5 F/E = opposite sacrum
L5 rotation = opposite sacrum
L5 SB = same axis that the sacrum is on
What hypertonic muscle can cause an anterior innominate rotation? What muscle will you use to treat it with MET?
hypertonic quads; use hamstrings
What hypertonic muscle can cause a posterior innominate rotation? What muscle will you use to treat it with MET?
hypertonic hamstrings; use quads
Which ribs are typical ribs? Why?
3-10; contain head, neck, tubercle, angle, and shaft
Which ribs are atypical ribs? Why?
1 = no rib angle 2 = another tubercle 11-12 = no tubercle or neck
Which ribs are true ribs? Why?
1-7; Connect to the sternum
Which ribs are false ribs? Why?
8-10; connect to cartilage that connects to sternum
Which ribs exhibit pump handle motion?
1-5
Which ribs exhibit bucket handle motion?
6-10
What motion do ribs 11-12 exhibit?
caliper; move outward with inhalation, inward with exhalation
What are the primary muscles of respiration?
diaphragm, intercostals
Where does the diaphragm attach to the body?
Ribs 6-12, L1-L3, xyphoid process
What are the secondary muscles of respiration?
scalene, pec minor, serratus anterior, latissimus dorsi
What muscle do you target with MET of exhalation dysfunction of rib 1?
anterior + middle scalene
What muscle do you target with MET of exhalation dysfunction of rib 2?
posterior scalene
What muscle do you target with MET of exhalation dysfunction of rib 3-5?
pec minor
What muscle do you target with MET of exhalation dysfunction of ribs 6-8?
serratus anterior
What muscle do you target with MET of exhalation dysfunction of ribs 9-10?
latissimus dorsi
How do you treat a superior dysfunction of the AC joint with MET?
supinate hand, patient will pull arm down against physician’s force
How you treat an inferior dysfunction of the AC joint with MET?
pronate hand, patient will pull arm down against physician’s force
How do you treat a superior dysfunction of the SC joint with MET?
use subclavius m. -> pt moves elbow backward (set up position) and tries to punch fist forward against physician’s force
How you treat an inferior dysfunction of the SC joint with MET?
use SCM -> pt rotates away from side of dysfunction (set up position) and tries to sideband head toward side of dysfunction against physician’s force
What are the seven stages of Spencer’s technique?
Every Fine Cat Takes An (x2) Indoor Piss
(Extension, Flexion, Compression w/ circumduction, Traction w/ circumduction, ABduction, Adduction with ER, Internal rotation, Pump)
What is the action of the supraspinatus m.? Innervation? Nerve roots?
ABduction; suprascapular nerve; C5-C6
What is the action of the infraspinatus m.? Innervation? Nerve roots?
External rotation; suprascapular nerve; C5-C6
What is the action of the teres minor n.? innervation? Nerve roots?
External rotation; axillary n.; C5-C6
What is the action of the subscapularis m.? Innervation? Nerve roots?
Internal rotation; major and minor nerves to sub scapular m.; C5-C7
What is the treatment position for counterstain of the supraspintatus muscle?
Abduction (mostly), external rotation, flexion (slight, to adjust)
What is the treatment position for counterstain of the infraspinatus m.?
External rotation (mostly); Abduction, Flexion (slight, to adjust)
What is the treatment position for counterstain of the teres minor m.?
External rotation (mostly); Abduction, Flexion (slight, to adjust)
What is the treatment position for counterstain of subscapularis m?
Internal rotation (mostly); Extension (slight, to adjust)
When you have a valgus carrying angle (>15 deg), what are the actions at the ulna and wrist?
Ulna is abducted, wrist is adducted (elbow close to body)
When you have a varus carrying angle (<3 deg), what are the actions at the ulna and wrist?
Ulna is adducted, wrist is abducted) (elbow away from body)
When you pronate your arm, where does the radial head go?
posterior
When you supinate your arm, where does the radial head go?
anterior
What is the treatment position for counterstain of the long head of the biceps?
Flex, abduct, internally rotate
What is the treatment position for counterstain of medial epicondylitis?
flexion, pronation, adduction (medial epicondylitis = golfer’s elbow, all flexors attach here)
What is the treatment position for counterstain of lateral epicondylitis?
extend, supinate, ABduct (lateral epicondylitis = tennis elbow, all extensors attach here)
What are the steps of treatment for Spencer’s technique of the hip?
Felines Eating Catnip Trip Into Everything Around Austin
Flexion, Extension, Compression with circumduction, Traction with circumduction, Internal rotation, External rotation, Abduction, Adduction
What is the origin and insertion of the piriformis m?
origin = posterior sacrum insertion = greater tubercle of the femur
What is the action of the piriformis m.?
LE external rotation
What is the treatment position for counterstain of the MCL and medial meniscus?
Flexion, Adduction, Internal rotation
What is the treatment position for counterstain of the LCL and lateral meniscus?
Flexion, ABduction, External rotation
What is the treatment position for counterstain of the ACL?
pillow behind femur, tibia posterior
What is the treatment position for counterstain of the PCL?
pillow behind tibia, push femur posterior
What is the treatment position for counterstain of the piriformis m.?
External rotation (mostly), Abduction, flexion (slight, to adjust)
What is the treatment position for counterstain of the glut muscles?
Extension (mostly), can add Abduction and external rotation slightly to adjust
What is the counterstain point and treatment position for psoas m.?
2/3 between ASIS and umbilicus; treat with flexion, external rotation, SB toward
What is the counterstain point and treatment position for iliacus m.?
1/3 between ASIS and umbilicus; treat with flexion, external rotation, ABduction
What is the motion of pronation at the foot? What motions do the talus and tibia do during pronation of the foot?
Pronation of foot = dorsiflexion, eversion, external rotation; talus and tibia externally rotate, talus also moves posteriorly
What is the motion of supination at the foot? What motions do the talus and tibia do during supination of the foot?
Supination of foot = plantar flexion, inversion, internal rotation; talus and tibia will internally rotate, talus also moves anteriorly
What is the motion of the fibular head with dorsiflexion of the foot?
fibular head moves anterior with dorsiflexion; lateral malleolus moves posterior
What is the motion of the fibular head with plantar flexion of the foot?
fibular head moves posterior with plantar flexion; lateral malleolus moves anterior
What bones make up the transverse arch of the foot?
navicular, cuneiforms, cuboid
What bones make up the medial longitudinal arch of the foot?
navicular, cuneiforms, metatarsals 1-3, talus
What bones make up the lateral longitudinal arch of the foot?
cuboid, metatarsals 4-5, calcaneus
What is the counterstain position for treatment of the lateral ankle ligaments? (anterior talofibular, calcaneofibular, posterior talofibular)
Eversion of foot
What is the Cobb angle for a mild scoliotic curve? What’s the treatment?
5-15; OMM
What is the Cobb angle for a moderate scoliotic curve? What’s the treatment?
20-45; OMM + brace
What is the Cobb angle for a severe scoliotic curve? What’s the treatment?
> 50 compromises respiration; >75 compromises heart function; surgery
What is the difference between a functional and structural scoliotic curve?
functional curve goes away with movement of the spine; a structural curve is always present
What findings on exam suggest an acquired short leg syndrome?
posterior innominate rotation, superior shear, psoas syndrome
What findings on exam suggest a congenital short leg syndrome?
anterior innominate rotation, inferior shear, inferior sacral base on side of short leg, lumbar spine convex on side of short leg
How do you treat short leg syndrome with heel lifts?
1/8”, increase by 1/8” every 2 weeks for healthy patient; older patient = 1/16”, increase by 1/16” every 2 weeks; trauma = give all length back at once (no time for the body to compromise)
What are contraindications to treating with lymphatics?
cancer, fractures, severe infection
What is the order of treatment locations for lymphatics?
- thoracic outlet (clavicle, ribs 1-2)
- diaphragm or axilla (dome, ribs 6-12, L1-L3, xyphoid, pec minor)
- hip (psoas, quads, innominate)
- posterior knee (hamstrings, gastroc)
- any distal dysfunction
What structures receive sympathetic innervation from T1-T6?
head, neck, esophagus, heart, lungs
What structures receive sympathetic innervation from T5-T9?
(think of celiac ganglia); stomach, duodenum, pancreas, liver, gallbladder, spleen
What structures receive sympathetic innervation from T10-T11?
(think of superior mesenteric ganglia); remainder of small intestines, cecum, appendix, ascending colon, first 1/2 of transverse colon, kidneys, upper ureters, gonads
What structures receive sympathetic innervation from T12-L2?
(think of inferior mesenteric ganglia); rest of the colon, lower ureters, bladder, prostate, rest of sex organs
Where is each finger located in the vault hold?
Index finger = greater wing of the sphenoid
Middle = temporal bone anterior to ear
Ring = temporal bone posterior to ear
Little = squamous occiput
How is a cranial torsion dysfunction named? What/how many axes does it rotate around? In what directions?
named for the more superior greater wing of the sphenoid; rotates OPPOSITE directions around 1 AP axis
How is a cranial SB + rotation dysfunction named? What/how many axes does it rotate around? In what directions?
Named for which direction the sphenoid is rotating; rotate in the SAME direction around 1 AP axis and then rotate in OPPOSITE directions around 2 vertical axes
How is a cranial shear dysfunction named? What/how many axes does it rotate around? In what directions?
Named for which direction the sphenoid is rotating; rotate in the SAME direction around 2 horizontal axis.
How is a cranial lateral dysfunction named? What/how many axes does it rotate around? In what directions?
Named for the direction the sphenoid is moving. Rotate in opposite directions around one vertical axis?
What is a normal CRI?
8-12 per minute
Where is the dura mater attached to the spine?
foramen magnum, C2, C3, and S2
What are factors that can increase the PRM?
systemic fever, strenuous physical exercise, OMT directed at the PRM/CRI
What are factors that can decrease the PRM?
emotional or physical stress, depression, chronic infection, chronic fatigue
What five factors make up the PRM?
- Flow of CSF
- Mobility between sacrum and ilia
- Motility of the brain and spinal cord
- Mobility of the intracranial and intraspinal membranes
- Involuntary mobility of the cranial bones
Describe the mobility of the brain and spinal cord in relation to the PRM.
Coiling during flexion/inhalation and uncoiling during exhalation/extension
Impingement of the sciatic nerve between the piriformis and what ligament is a common cause of lower back/leg pain?
sacrospinous ligament
What are the four rules of the interaction between L5 and the sacrum?
- Clinically significant interactions between L5 and the sacrum only occur during sacral torsions (not shears).
- L5 will always be sideband to the same side as the axis of the torsion
- Seated flexion test is positive on the OPPOSITE side as the axis of the torsion
- L5 will always be rotated to the opposite of the direction of the sacral torsion