OPC Comprehensive Flashcards
What is the movement of the sacral base during inhalation
Sacral base moves posterior
ILA moves anterior
During treatment of sacrum with a torsion dysfunction, how do you know if treat with 1 leg vs. 2?
2 leg: is L on L or R on R
1 leg: is R on L or L on R
What is the sacral base doing during exhalation
Sacral base moves anterior
ILA moves posterior
In the sacrum, what is the purpose of testing the MTA
- MTA should match the seated flexion test
- Evaluating the heights
What does a pathologic dysfunction of the sacrum indicate about L5?
Pathologic dysfunction on sacrum = L5 Type II
What does a physiologic dysfunction of the sacrum indicate about L5
Physiologic dysfunction of the sacrum indicates there is a Type I dysfunction
What does nutation mean?
Sacral flexion
What does counter nutation mean?
Sacral extension
What does TART stand for?
T: Tissue Texture Changes
A: Asymmetry
R: Range of Motion
T: Tenderness
What level of the vertebrae is the sternal notch?
T2
What is the rib associated with the sternal angle?
Rib 2
What is the level of the spine associated with spine of the scapula?
T3
What level of the spine is associated with the inferior angle of the scapula?
T7
What level of the spine is associated with the iliac crest?
L3-L4
What level of the spine is associated with PSIS?
S1-S2
What dermatome is associated with the nipple line?
T4 Dermatome
Which dermatome is associated with the umbilicus?
T10 Dermatome
What anatomic landmark is associated with T2?
Sternal notch
What anatomical landmark is associated with Rib 2?
Sternal angle
What anatomic landmark is associated with T3?
Spine of scapula
What anatomical landmark is associated with T7?
Inferior angle of the scapula
What anatomical landmark is associated with L3-L4?
Iliac crests
What anatomical landmark is associated with S1-S2?
PSIS
What anatomical landmark is associated with T4 dermatome?
Nipple line
What anatomical landmark is associated with T10 dermatome?
Umbilicus
What is the difference between the physiologic vs anatomic barrier of motion?
Physiologic: max point to which a patient can actively move a joint
Anatomic: max point to which a patient’s joint can be move passively
What is the difference between restrictive and pathologic motion barrier?
- Restrictive: what is diagnosed for somatic dysfunction within physiologic ROM
- Pathologic: result of disease/trauma/surgery/arthritis etc.
What axis and plane does flexion/extension occur in?
Flexion/Extension
- Axis: Transverse
- Plane: Sagittal
What axis and plane does rotation occur in?
Rotation
- Axis: vertical
- Plane: transverse plane
What axis and plane does sidebending occur in?
Sidebending
- Plane: Coronal
- Axis: Anterior/Posterior axis
List 5 possible tissue texture changes
- Temperature
- Texture
- Moisture
- Tension
- Edema
What tissue temperature change occurs in acute conditions?
Warm/Hot/Increased Temperature
What tissue temperature changes occur in chronic conditions?
Cool/slight change
What tissue texture changes occur in acute conditions?
Boggy/Spongy/Edematous
What tissue texture changes occur in chronic conditions?
Thin/Smooth
What tissue moisture changes occur in acute conditions?
Increased/moist
What tissue moisture changes occur in chronic conditions?
Dry
What tissue tension changes occur in acute conditions?
Rigid/board like
What tissue tension changes occur in chronic conditions?
Ropy/stringy/fibrotic
What tissue tenderness changes occur in acute conditions?
Sharp/intense/stabbing/throbbing
What tissue tenderness changes occur in chronic conditions?
Achy
Dull
Burning
Gnawing
What tissue edema changes occur in acute conditions?
Edema occurring
What tissue edema changes occur in chronic conditions?
No edema present
What tissue erythema changes occur in acute conditions?
Redness that lasts
What tissue erythema changes occur in chronic conditions?
Pale,redness fades quickly or blanching occurs
What is Fryette’s 3rd principle?
Motion in any one plain limits motion in the others
What portions of the spine do Fryette’s principles apply to?
Thoracic
Lumbar vertebrae only
List the common compensatory pattern:
- OA: Sidebent R, Rotated L
- Thoracic Inlet: Rotated R
- Thoraco-lumbar: Sidebent R, Rotated L
- Lumbosacral Junction: Sidebent L, Rotated R
- Sacrum: Rotated L
Describe the biomechanical model of osteopathic treatment
Focuses on removing structural dysfunction hindering normal motion
Describe the Respiratory-Circulatory model of osteopathic treatment
Focuses on removing restriction with a goal of improving the motion of air, venous & lymphatic drainage as well as the flow of CSF
Describe the Metabolic/Energetic model of osteopathic treatment
Focuses on improving structural relationships with the goal of decreasing physiologic work
Describe the Neurologic model of osteopathic treatment
- Focuses on removing dysfunction with a goal of restoring appropriate autonomic balance
- Viscerosomatic reflexes
Describe the Behavioral model of osteopathic treatment
- Focuses on the actions/lifestyle of the patient with a goal of normalizing emotion/stress to decrease musculoskeletal manifestations
On cervical spine where does the vertebral artery not pass through?
Does not pass through C7
What innervates the sternocleomastoid?
CN XI
In C spine, what does translation to the Left do?
Induces sidebending to the R
In C spine, what does translation to the R do?
Indues sidebending to the L
What is the superior facet orientation of the C spine?
BUM
Backwards
Upwards
Medial
What does the transverse ligament of the atlas do?
Holds the dens in place
- Weakened in persons with Down’s syndrome & RA
Describe sidebending and rotation in OA
Sidebending and rotation occur in opposite directions
Describe the direction of sidebending and rotation in the lower cerical spine
Sidebending and rotation occur in the same direction
How to screen AA in the neck?
- Flex to 45 degrees to lock out rotation in the lower vertebrae
- Rotation only
What is the main motion of T spine?
Rotation
What are the three joints found at the thoracic spine?
- Costovertebral: head of rib and vertebral body
- Costotransverse: articular part of the tubercle & TP
- Costochondral: anterior end of rib & costal cartilage
What form the thoracic inlet?
T1
1st rib
Manubrium
What forms the thoracic outlet?
Scapulae
1st rib
Clavicles
What is the difference between Functional scoliosis and Anatomic scoliosis?
Functional scoliosis: changes with sidebending into the convexity
Anatomic scoliosis: does not change with sidebending into the convexity (often related to undiagnosed anatomic short let)
How to evaluate Adams Test?
Curve bends opposite side of high shoulder
How many cervical vertebrae are there?
7
How many thoracic vertebrae are there?
12
What is the orientation of the superior facets of the thoracic vertebrae?
BUL
Backwards
Upwards
Lateral
When are muscles used in respiration?
Forced Exhalation
What secondary muscles are associated with rib 1 for forced respiration?
Rib 1: Anterior and middle scalene
What secondary muscles are associated with rib 2 for forced respiration?
Rib 2: Posterior scalene
What secondary muscles are associated with ribs 3-5 for forced respiration?
Pectoralis minor
What secondary muscles are associated with ribs 6-8 for forced respiration?
Serratus anterior
What secondary muscles are associated with ribs 9-10 for forced respiration?
Ribs 9-10: Latissimus dorsi
What secondary muscles are associated with ribs 11-12 for forced respiration?
Ribs 11-12: Quadratus lumborum
What does nutation mean?
Flexion of the sacrum occurring during exhalation
What does counternutation mean?
Extension of the sacrum occurring during inhalation
Which ribs are typical?
3-9
Which ribs are false ribs?
8-10
Which ribs are true ribs?
1-7
What are ribs doing during inhalation
- IOU
- Inhalation: Out and Up
What ribs are doing during exhalation:
- EID
- Exhalation: Down and In
Which ribs are predominantly pump-handle?
1-5
Which ribs are predominantly bucket handle?
6-10
What does + standing flexion test mean?
Dysfunction of innominant occurs on the side of the + standing flexion test
What does a hard end feel on a particular ITA indicate?
- Hard end fell is to confirm which side is dysfunctional
- ITA should match side of + standing flexion text
Describe a viscerosomatic reflex?
Viscerosomatic reflex occurs when organ pathology manifests in somatic tissue
What is the sympathetic innervation of the head and neck from?
T1-T4
What bones make up the innominate?
Ilium
Ischium
Pubic bones
The innominate articulates with the femur at the _____________ and the sacrum at the _____________.
Innominate articulates with the femur at the acetabulum
Innominate articulates with the sacrum at the SI joint