OMM/viscerosomatics Flashcards
head and neck
T1-T4
heart
T1-T5
respiratory
T2-T7
esophagus
T2-T8
upper GI
T5-T9
middle GI
T10-T11
lower GI
T12-L2
appendix
T12
arms
T2-T8
kidneys
T10-T11
upper ureters
T10-T11
lower ureters
T12-L1
bladder
T11-L2
gonads
T10-T11
uterus/cervix
T10-L2
erectile tissue
T11-L2
prostate
T12-L2
legs
T11-L2
posterior appendix chapman point
transverse process of T11
anterior appendix chapman point
tip of 12th rib
gallbladder chapman point
6th right intercostal space at the mid-clavicular line
pancreas chapman point
7th right intercostal space mid-clavicular line
spleen chapman point
7th left intercostal space mid-clavicular line
parasympathetic innervation of proximal vs distal ureter?
proximal = OA distal = pelvic splanchnic
parasympathetic to distal transverse colon, descending colon, sigmoid colon, rectum, distal ureter, bladder, and reproductive organs?
S2-4 (pelvic splanchnic)
Parasympathetic innervation to the kidneys and proximal ureter?
OA (vagus nerve)
tenderpoint midway between the inferior lateral angle (ILA) of the sacrum and the greater trochanter
piriformis
tenderpoint 1 cm lateral to pubic symphisis
anterior L5
tenderpoint on the ilium, inferior to PSIS
lower pole L5
tenderpoint at superior medial surface of PSIS
upper pole L5
tenderpoint at inner ala of the ilium in the midaxillary line bilaterally
AT12
tenderpoint halfway between the umbilicus and pubic symphysis
AT11
tenderpoint one-fourth of the distance from the umbilicus to the pubic symphysis
AT10
chapman point at surgical neck of the humerus
eye
what technique increases amplitude of CRI?
CV4
tenderpoint on the superior aspect of the popliteal fossa either medial or lateral to the hamstring tendons
ACL
tenderpoint in the center or slightly below the popliteal fossa
PCL
vault hold finger placements
- Fifth digit (pinky) on squamous portion of the occiput, medial to the occipitomastoid suture.
- Fourth digit (ring finger) on the petrous portion of the temporal bone, near the mastoid process
- Third digit (middle finger) should lie on the squamous portions of the temporal bone (approximating the zygomatic process of the temporal bone)
- Second digit (index finger) on the greater wing of the sphenoid
- Thumbs can be in one of two positions: they can either meet and cross above the cranium, or they can rest on the frontal bone. Either is appropriate
what drugs have been found to cause lupus-like symptoms?
hydralazine, isoniazid, procainamide, and phenytoin
what tenderpoint is found on the inferolateral tip of C2 spinous process?
PC3
- PC3-8 are found on the spinous process of the vertebra ABOVE (PC4 is on tip of C3)
- PC2 is located superolateral to C2
posterior cervical TP’s are all E SaRa except which two?
- PC1 onion (flex OA)
- PC3 (F SaRa)
what TP is on ilium just inferior to PSIS?
L5 lower pole
what TP is on the superior medial surface of PSIS?
L5 upper pole
what TP is 2-3 cm lateral to PSIS?
High Ilium Sacroiliac
initial tx for thoracic outlet syndrome with positive Adson’s test?
MFR to scalenes
- positive Adson’s tells you compression is either from scalenes or a cervical rib
what are the anterior and posterior chapman’s points for the rectum?
ant: proximal inner thigh on lesser trochanter
post: S2
any time you see phenytoin, what should you think?
CYP450 inducer!
- increases catabolism of lots of things (like VitD!)
- Vitamin D is responsible for increasing calcium and phosphate absorption in the intestine and resorption in the bone -> leads to soft bones -> osteomalacia
- low vitD, low serum Ca -> secondary hyperPTH
chronic fatigue, nonspecific muscle pain, increases lumbar lordosis, wide-based gait
- elevated alk phos
- low urine calcium
osteomalacia
- vitamin D deficiency results in decreased absorption and resorption of phosphate, leading to decreased phosphate levels
what nerve provides sensory innervation to the first three digits and the radial half of the fourth digit?
medial nerve
why is sensation to the thenar eminence spared in carpal tunnel?
it is innervated by the palmar cutaneous branch, which branches just proximal to the carpal tunnel
young males (4-10 y/o) and can present with hip pain and a limp of either acute or insidious onset. Pain in the knee occurs due to referred pain from the obturator nerve
- decreased hip ROM
- pain worse after exertion
- Xray might show femoral head collapse (femoral head looks widened/flattened)
Legg-Calvé-Perthes disease
- interruption of blood supply to head of the femur
- NOT obese (like Osgood-Schlatter, and SCFE)
crutch paralysis?
radial nerve palsy, wrist drop
FOOSH?
fall prone, hands pronated, radial head posterior
posterior fibular head?
foot is plantarflexed
inability to make OK sign shows weakness in what muscles?
flexors of the pollex and distal interphalangeal joint of the 2nd digit
- damage to anterior interosseous nerve
- will see a flattening of the 1st and 2nd digit rather than a true circle
positive Apley scratch test?
rotator cuff dysfunction
- shows decreased function of all 4 rotator cuff muscles
positive empty can test?
specific for supraspinatus injury
carrying angle < 3° degrees is considered cubitus varus and can be caused by what?
abduction restriction
- ex of woman carrying too many bags of groceries
what TP does this treat?
- left is hip and knees flexed to 90 degrees, side bend the ankles away, and rotation toward (accomplished by rotating the knees away)
AL2-4
what type of relfex occurs when abnormal somatic stimuli (e.g. tissue texture changes, muscle strains, muscle spasms, or any changes in a non-visceral structure) enters the spinal cord at a specific level and results in altered function of a visceral organ at the same level (heart problem)
somatovisceral
- vs viscerosomatic: when heart problems cause tissue texture changes
strain that occurs when there is cephalad or caudad movement of the base of the sphenoid in relation to the occiput
- named after the direction of the base of the sphenoid
vertical strain
base of the sphenoid moves caudad in relation to the occiput, and the greater wings of the sphenoid move cephalad
inferior vertical strain
base of the sphenoid moves cephalad in relation to the occiput while the greater wings of the sphenoid move caudad
superior vertical strain
when the base of the sphenoid deviates laterally in relation to the occiput
lateral strain
- causes the cranium to have a parallelogram shape.
base of the sphenoid deviates left in relation to the occiput
left lateral strain
base of the sphenoid deviates right in relation to the occiput
right lateral strain
occurs often with head trauma along the AP axis, and is denoted by a decreased CRI amplitude as it prevents true flexion and extension from occurring
- often times it may present as an alternating vertical strain
SBS Compression
The temporal and occipital bones come together to form the what?
jugular foramen and the occipital-mastoid suture
- cranial nerves exit the cranium through the jugular foramen are IX, X, and XI
