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OMM > OMM Spring Exam Weeks 31-35 > Flashcards

OMM Spring Exam Weeks 31-35 Flashcards

1
Q

Describe Dr. Littlejohns background

A

Founder of ACO/ CCOM
president of Amity College
Graduated in 1900
Foudned British School of Osteopathy

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2
Q

What is the lifetie incidence of LBP?

A

> 70% for adults

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3
Q

What is the average ehalthcare cost for LBP?

A

38-50 billion dollars

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4
Q

What is the main etiology of LBP?

A

mechanical (97%)

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5
Q

What etiology would ‘hip problems’ be categorized in for LBP?

A

visceral-referral pain

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6
Q

For waht duration of LBP is it considered a red flag?

A

greater than 1 month of pain,

also if treatment for a month does not help

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7
Q

What are some red flags for LBP and infection?

A

faver
IV drug use
steroid use

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8
Q

What are red flags for LBP and fracture?

A

> 70 years old
steroid use
bladder dysfunction
trauma

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9
Q

What are characteristics of cauda equina syndrome?

A 
saddle anesthesia
uni/bilateral  motor weakness
bowel/bladder dysfunction
reduced anal sphincter tone
radiculopathy
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10
Q

A red flag for spinal stenosis?

A

pseudoclaudification

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11
Q

What are some psychosocial factors for LBP?

A

low social status
low level employment
depression
work problems

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12
Q

What is LeSagues test?

A

aka straight leg test
Positive if pain is present at 30-70 deg of leg raising
Not specific
moderately sensitive

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13
Q

What are Bragard’s and Bruzinski’s tests?

A

Bragard: during straight leg test, if dorsiflexion causes pain
Bruzinski: during straight leg test, if flexion of head causes pain

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14
Q

What is the cross over test?

A

When the opposite leg is raised, pain occurs in the symptomatic side
Very specific
less sensitive

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15
Q

When would you use a MRI or CT for low ack pain?

A 
neuropathy
tumor
fracture
infection
unimproved sciatica
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16
Q

What type of scan would you use for a spondyloarthropathy?

A

ANA, ESR

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17
Q

When are lumbar X-rays NOT used?

A

for soft tissue problems

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18
Q

What are the advantages of MRI in LBP?

A

shows soft tissue problems

esp. disc disease and spinal cord/canal problems

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19
Q

What is a myelogram?

A

Contrast added to subarachnoid space
usually a pre-op exam
followed up by post CT

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20
Q

What is a triple phase bone scan?

A

added radioactive marker can be scanned to sense for increased bone turnonver and blood supply
Sensitive but not specific

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21
Q

When is surgical treatment resommended for LBP?

A

cauda equnia syndrome
nerve root compressoin
spinal instability

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22
Q

What nerve roots does the lumbar plexus contain?

A

T12-L4

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23
Q

In what structure does the lumbar plexus actualy come together?

A

psoas

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24
Q

If a patient cmoplains of nubness in anterior thigh and groin region, what might you expect?

A

tight psoas

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25
Q

What is the presentation of a bilateral psoas spasm?

A

patient is bending forward

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26
Q

What s the presentation of a unilateral psoas spasm?

A

patient bending forward and bent towards tight side

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27
Q

What type of somatic dysfunction is common in a tight psoas?

A

Type II L1 or L2 on same side as tight psoas

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28
Q

What are some causes of lumbosacral radiculopathy?

A

disc on nerve root
tumor
tenosis
infection

29
Q

Which discs are at the greatest risk for rupture? Why?

A

L4 and L5
greatest motion here
narrow posterior longitudinal ligament

30
Q

What is piriformis syndrome?

A

piriformis pain can cause SI joint pain, buttock and posterior thigh pain
10% of people have n passing through primiformis m

31
Q

What are some clinical presentations of piriformis syndorme?

A

functionally longer leg

positive pelvic sideshift on same side

32
Q

What is iliolumbar ligament syndrome? What kind of pain can it mimic?

A

irritated with postural strain

mimics hip arthritis, trochanteric bursitis, inguinal hernia

33
Q

Which clinical finding can yield false positve and false negative results?

A

tight hamstrings

34
Q

What percent of LBP patients require surgery?

A

5%

35
Q

What is the stance phase in normal gait?

A 
60% of normal gait
begins with heel strike/pronation
foot flat
mid stance
push off
36
Q

Where is the tripod weight distribution in normal gait?

A

1st MCP, 5th MCP, heel

37
Q

What is a good test to determine lumber flexion?

A

Schobers test

38
Q

What is the slump test?

A

Determines neuromeningeal tract tension

in neck extension

39
Q

What motions produce L4 innervation? L5 and S1?

A

L4: ankle dorsiflxion
L5: big toe extension
S1: ankle plantarflexion

40
Q

What nerve does the patella reflex activate?

A

L4

41
Q

What is patricks test?

A

Figure 4, Fabers

positive when pain on lowering

42
Q

What is facet syndrome?

A

problem w z-jionts

lumbar nerve entrapment

43
Q

What is the number one cause of sacroiliac dysfunction?

A

(70% idiopathic)

psoas

44
Q

What do the Cochrane review tel us?

A

SMT is a good treatment for LBP

lots of the trials were biased tho

45
Q

When was pharmacology added to the curriculum?

A

1929

In 1915-material medica failed to be added

46
Q

Name the axes of teh sacrum and where they are located?

A

respiartory- S2
postural axis - bending
inferior - ilial rotation

47
Q

of TART, what does the mitchell model focus on in sacrum?

A

asymmetry

48
Q

what are the three types of dysfunctions of the sacrum?

A

unilateral flexion
torsion
respiratory restriction

49
Q

Copare rotation of L5 and teh sacrum in dysfjctnios

A

rotation of L5 and the sacrum occurs in oopposite diresctions

50
Q

What is a normla adaptation to a sacroiliac dysfunction?

A

neutral group curve with roation towards deeper sulcus

51
Q

What is the most comon torsiton dysfucntion?

A

L on L

52
Q

When can you see an increase in the lumabr lordosis?

A

unliateral flexed sacrum

forward torsion

53
Q

What is the point of reference for naming the sacrum?

A

anterior sacrum base

promontory

54
Q

When does pain from a short leg arise?

A

age 40

55
Q

what is the fist sympto associated with an anatomic short leg?

A

sacroiliac discomfort
anterior sacrum on the short leg side
tenderness at sacral sulcus

56
Q

what are some findings of an anatomic short leg?

A

low iliac crest

low greater trochanter

57
Q

what clinical things can cpme about form a short leg

A

GU problems
headache
Temporomandibular symptoms

58
Q

CCOM andgle + fergusons angle = ?

A

90 degrees

59
Q

primary purpose of a heel lift?

A

level the sacral base

60
Q

what is max dose of heel lift?

A

1/4 inch

61
Q

when is the term lateral curve used?

A

<10 degrees

62
Q

What is the Heilig lift therapy?

A

ultimate amount of lift for chronic
problems is often about 1/2 of the total leg length discrepancy.
However, if the short leg is sudden (fracture, for example), the lift
should correct the entire distance.

63
Q

What is the Cobb ethod?

A

to measure lateral curvature degrees

64
Q

What is Wlfs law?

A

bone remodels over time to the forces applied on it

65
Q

average rate of scoliosis progression?

A

1.3 degrees per year

66
Q

average change for infant per day?

A

5 degreees

67
Q

what is vital capacity with cobb values of 25-50 degrees?

A

70% of normal

68
Q

What are some clincial things w scoliolis?

A

right ventricular pain
cor pulmonale
hypoxemia
pulmonary hypertension

OMM (6 decks)

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