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OPP > OPP 2 Exam #3 > Flashcards

OPP 2 Exam #3 Flashcards

1
Q

Tight piriformis muscle would lead to reduced hip

A

internal rotation

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2
Q

Sympathetic innervation to the Head and Neck:

A

T1-T4

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3
Q

Upper cervical area and sacrum are connected by

A

dural connections

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4
Q

AA (C1 on C2) accounts for 50% of

A

the cervical spine’s rotational motion

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5
Q

OA (C0 on C1) accounts for 50% of the

A

cervical spine’s flexion/extension motion

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6
Q

Spurling test assesses for

A

neural foraminal narrowing

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7
Q

Underburg/Wallenburg tests for patency in the

-position

A

vertebral arteries
If you extend the neck and rotate left/side-bend left you are checking the patency of right vertebral artery
If you extend the neck and rotate right/side-bend right you are checking the patency of the left vertebral artery

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8
Q

Diagnosed by T.A.R.T.

A

T: Tissue Texture Changes
A: Asymmetry
R: Restriction of motion
T: Tenderness

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9
Q

Fryette Law 1

A
  • group of vertebra

- Side-bending before rotation

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10
Q

Fryette Law 2

A
  • single vertebra

- Rotation before side-bending

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11
Q

Orientation of Superior Facets (cervical, thoracic, lumbar)

A

BUM
BUL
BM

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12
Q

Orientation of Inferior Facets (cervical, thoracic, lumbar)

A

AIL
AIM
AL

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13
Q

Cholecystitis segment

A

T5-T9 rotating right

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14
Q

Gastritis segment

A

T5-T9 rotating left

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15
Q

Sympathetic levels

A 
Heart:		    T1 – T5
Lungs:		    T1 – T6 (T2-T7)
Stomach:	    T5 – T9
Gallbladder:	    T5 – T9
Upper Ureters:	    T10 – T11
Lower Ureters:	    T12 – L1
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16
Q

Parasympathetic levels

A 
Heart:		  OA, C1, C2 (Vagus)
Lungs:		  OA, C1, C2 (Vagus)
Stomach:	  OA, C1, C2 (Vagus)
Gallbladder:	  OA, C1, C2 (Vagus)
Upper Ureters:	  OA, C1, C2 (Vagus)
Lower Ureters:	    S2 – S4
  • vagus till splenic flexure
  • S2-S4 rest plus reproductive organs, and external genitalia
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17
Q

Sympathetic Innervation

A

Greater Splanchnic Nerve (T5-9)

  • Synapses at the Celiac Ganglion
  • Stomach, Liver, Gall Bladder, Pancreas, Parts of Duodenum
  • Lesser Splanchnic Nerve (T10-11)*
  • Synapses at the Superior Mesenteric Ganglion
  • Small Intestines and Right Colon (appendix is found here)

Least Splanchnic Nerve (T12) and Lumbar Splanchnic Nerve (L1-2)

  • Synapses at the Inferior Mesenteric Ganglia
  • Innervates the Left Colon and Pelvic Organs
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18
Q

sympathetic innervation to the appendix

A

Lesser Splanchnic Nerve (T10-11)

Synapses at the Superior Mesenteric Ganglion

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19
Q

OA
AA
C2-C7

-motion

A

OA: type I
AA: rotation
C2-C7: type II

-Cervical spine follows Fryette’s III

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20
Q 
Oculomotor nerve (CN III)
Glossopharyngeal (CN IX)
Facial Nerve (CN VII)

-ganglion

A

-Oculomotor nerve (CN III)
Ciliary Ganglion

-Glossopharyngeal (CN IX)
Otic ganglion

-Facial Nerve (CN VII)
Pterygopalatine Ganglion
Submandibular Ganglion

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21
Q

Jugular Foramen

  • formed by
  • CN that exit
A

Formed by Temporal Bone and Occiput

  • formed by Temporal Bone and Occiput forming the occipitomastoid suture
  • CN that exit CN IX, X, and XI
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22
Q

So dysfunction affecting the vagus nerve could come from

A

occipitomastoid suture compression

-CN X is involved with vomiting

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23
Q

Sternocleidomastoid muscle (SCM) refers pain

A

lateral to and behind the eye

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24
Q

Splenius Capitus muscle refers pain to

A

vertex of the head

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25
Examples of Indirect Techniques
Counterstrain Facilitated Positional Release (FPR) Balanced Ligamentous Tension Technique (BLT) Functional Technique
26
Examples of Direct Techniques
``` Myofascial Release Soft tissue Articulatory Muscle Energy High velocity, low amplitude (HVLA) Springing ```
27
OA diagnosis (deep sulcus on L/R)
A deep sulcus on the right would indicate that the OA is rotated right A deep sulcus on the left would indicate that the OA is rotated left -If you have an OA with a deep sulcus on the left which is worse in extension, you would assume the dysfunction is OA F SR RL
28
Cervical HVLA Set Up (C2 E RL SL: Rotational correction emphasis)
- Rotate C2 to the right - Metacarpal phalangeal joint is positioned over POSTERIOR aspect of C2 left articular pillar - Lock out C3-C7 by side-bending those segments to the left
29
Cervical HVLA Set Up (C2 E RL SL: Side-bending correction emphasis)
- Side-bend C2 to the right - Metacarpal phalangeal joint is positioned over LATERAL aspect of C2 right articular pillar - Lock out C3-C7 by rotating those segments to the left
30
Indications and Contraindications
- too young or is not able to follow commands - a patient has lax ligaments such as Rheumatoid Arthritis or Trisomy 21, you do not want to do HVLA, or ANY type of articulatory techniques in the upper cervical spine
31
Neurological Exam (sensation, motor, reflex) C6 C7 T1
C6: Sensation: Thumb,Index Finger Motor: Wrist Extensors Reflex: Brachioradialis C7: Sensation: Mid Finger Motor: Triceps Reflex: Triceps T1: Sensation: Medial Elbow Motor: Interossi Reflex: None
32
Deep tendon reflex scale
2/4: normal | 4/4: Brisk w/clonus, UMN injury
33
muscle strength scale
5/5: normal | 0/5: no contractility
34
neurological influence versus biomechanical influence to diaphragm
Neurologically: Phrenic Nerve/C3, C4, C5 Biomechanically: Where the thoracoabdominal diaphragm attaches: lower ribs, thoraco-lumbar junction, T10-L3 are examples.
35
Rotator Cuff muscles and movements
Supraspinatus – Abduction Infraspinatus - External rotation Teres Minor – External rotation Subscapularis – Internal rotation
36
Falling forward on an outstretched hand leads to a
posterior radial head | -Forearm resists supination
37
Falling backward on an outstretched hand leads to
anterior radial head | -Forearm resists pronation
38
Abducted Ulna | Adducted Ulna
Abducted Ulna: (olecranon process glides medially), radius glides distally & wrist is pushed into increased adduction Adducted Ulna: (olecranon process glides laterally), radius glides proximally and wrist is pulled into abducted position
39
Lateral epicondylitis | Medial epicondylitis
Lateral epicondylitis- “Tennis elbow” | Medial epicondylitis- “Golfer’s elbow”
40
psoas syndrome somatic dysfunction
type II, L1 or L2 vertebral unit - pelvis shifts to the opposite side - Pelvic shift to the opposite side of the greatest psoas spasm - Hypertonicity of the piriformis muscle contralateral to the side of greatest psoas spasm
41
Seated Flexion Test +R
LOL ROL RUF RUE
42
Seated Flexion Test +L
ROR LOR LUF LUE
43
ROR or LOL
lay on side of oblique axis hub table flex greater than 90
44
ROL or LOR
lay on side of oblique axis face ceiling flex less than 90
45
Unilateral Sacral Flexion ME
- hypothenar eminence on patient’s right ILA on side of dysfunction - inhale and hold breath, while you push anterior and superior on the ILA
46
Unilateral Sacral Extension: ME
hypothenar eminence on the patient’s right sacral sulcus on side of dysfunction -exhale and hold breath, while you push anterior and caudad on the superior sulcus *extension - exhale
47
``` Anterior Lumbar Counterstrain Points AL1 AL2 AL3 AL4 AL5 ```
``` AL1: Medial to ASIS AL2: Medial to AIIS AL3: Lateral to AIIS AL4: Inferior to AIIS AL5: Anterior, superior aspect of pubic ramus, lateral to symphysis pubis ```
48
type I vs type II thoracic HVLA set up (flexed vs extended)
Type I: smiley face Type II: frowney face Flexed: downward thrust Extended: thrust directed 45 degrees cephalad (towards head)
49
Pump handle Bucket handle Caliper motion -which ribs, direction of movement, and where to palpate
Pump handle: 1-5 (anterior and superior with inhalation) -midclavicular line Bucket handle: 6-10 (laterally and increase transverse diameter with inhalation) -mid-axillary line Caliper motion: 11, 12 -
50
Inhalation Rib Somatic Dysfunction
``` Motion toward inhalation is more free Motion toward exhalation is restricted -Patient may complain of pain with EXHALATION **BOTTOM RIB **prominent anteriorly **Posterior Rib Counterstrain Points ```
51
Exhalation Rib Somatic Dysfunction
``` Motion toward exhalation is more free Motion toward inhalation is restricted -Patient may complain of pain with INHALATION **TOP RIB **prominent posteriorly **Anterior Rib Counterstrain Points ```
52
``` Rib 1 Rib 2 Ribs 3 – 5 Ribs 6 – 8 Ribs 9 – 11 Rib 12 Associated muscle ```
``` Rib 1: Anterior and mid scalene Rib 2: Posterior Scalene Ribs 3 – 5: Pectoralis Minor Ribs 6 – 8: Serratus anterior Ribs 9 – 11: Latissimus Dorsi Rib 12: Quadratus Lumborum ```
53
ME Inhalation Dysfunction Ribs 1 - 10 set up
Pump-handle ribs: Flex the patient’s head and neck | Bucket-handle ribs: Flex the patient’s head and neck and side-bend the patient toward dysfunctional rib
54
Rib HVLA 2-10
posterior aspect of rib angle instead of transverse process Inhalation: push sup Exhalation: push inf
55
Counterstrain Treatment of AR1-2 Tender Points
F STRT | -laying down
56
Counterstrain Treatment of AR3-10 Tender Points
F STRT - rotation toward and translation away (side-bending toward) the tender point - patient sitting up, doctor behind patient with leg under opposite armpit
57
Counterstrain Treatment of PR1 Tender Point
E SART | -extends and side-bends the head and neck away from the tender point, rotates the head toward the tender
58
Counterstrain Treatment of PR2-10 Tender Points
F SARA - side bending away (translation towards) and rotation away from the tender point - only position with doctor leg under same side armpit
59
Effleurage Petrissage Tapotement
Effleurage – Gentle stroking of congested tissue used to encourage lymphatic flow Petrissage – Involves pinching or tweaking one layer and lifting it or twisting it away from deeper areas Tapotement – striking the belly of a muscle with the hypothenar edge of the open hand in rapid succession in order to increase it’s tone and arterial perfusion. A hammering, chopping percussion of tissues to break adhesions and/or encourage bronchial secretions
60
Tenderness to palpation of the medial foot distal to the talus
medially rotated navicular
61
Tenderness to palpation of the lateral foot distal to the calcaneous
laterally rotated cuboid
62
positive patellofemoral grind test
``` Patellofemoral tracking syndrome (Chondromalacia) Contributing Factors: Coxa Varus Genu Valgus Pronated foot Pes Planus (Flat Feet) Tight/Hypertonic Vastus Lateralis Muscle Tight Tensor Fascia Latae Weak Vastus Medialis Muscle ```
63
Effect on Distal Fibula Pronation
distal fibula posteromedial movement
64
Effect on Distal Fibula Supination
distal fibula anterolateral movement
65
Foot inversion Foot eversion -effect on distal fibula
Foot inversion = anterior distal fibula | Foot eversion = posterior distal fibula
66
Anterior Fibular Head dysfunction
Dorisflexed Ankle/Foot Everted Ankle/Foot Externally (Abducted) rotated Ankle/Foot
67
Posterior Fibular Head dysfunction
Plantar flexed Ankle/Foot Inverted Ankle/Foot Internally rotated Ankle/Foot
68
Trendelenburg Test
- gluteus medius | - lift one leg to test gluteus medius of the contralateral side
69
Hip Drop Test
- Assessment of lumbar spine compensation to sacral base declination - cock hip - Positive=Iliac crest does not drop 20-25 degrees --> indicates lumbar/thoracolumbar spine has difficulty side-bending
70
Posterior Fibular Head HVLA
An anterior thrust is applied at the fibular head -close leg down on hand or -patient lay on back anterior thrust + dorsiflexes, everts, and externally rotates the ankle
71
Anterior Fibular Head HVLA
Posterior thrust is applied at the fibular head | -caudad hand plantar flexes, inverts, and internally rotates patient’s ankle
72
HVLA to the neck and double vision
vascular issue
73
give you a deep sulcus and superior ILA what other test is needed to figure out the issue
spring test, backward bending, seated flexion test
74
posterior innominate
quad (rectus femoris, vastus lateralis, vastus medialis, and vastus intermedius)
75
anterior innominate
hamstrings (Semitendinosus, semimembranosus, biceps femoris)
76
gastritis segments
T5-T9 | OA C1 C2
77
most commonly used form of contraction
isometric
78
tender point on post aspect of ascending ramus of the mandible
rotate away
79
parasympathetic to the lungs
oa c1 c2
80
numbness on medial elbow
T1
81
sidebend and rotate to the right what artery is being checked
left vertebral
82
index finger issue
T6
83
sympathetic nerve to the head/neck
1-4
84
tender point to vertex
splenious capitis
85
diminished tricep reflex and diminished sensation to middle finger
C7
86
nausea and vommiting
vagus, jug foramen, occipitomastoid suture
87
asthma check innervation for diaphragm functioning
innervation C3, C4, C5
88
PC2 midline spinous process
location: On the superior or superior lateral aspect/tip of the spinous process of C2 position: Extended, side-bent away, rotated away (E SARA)
89
Viscerosomatic reflexes occur at
Sympathetics levels | Parasympathetics levels
90
Somatic dysfunction can occur anywhere in the body at
Sympathetics levels Paraysmpathetic levels Soma (not autonomic related)
91
Facilitated segments ONLY occur at
Sympathetics
92
stone in the ureter or appendicitis
cause the psoas to become hypertonic (Positive Thomas test)
93
upper (proximal) ureters sympathetic and parasympathetic
sympathetic: T10 - T11 parasympathetic: vagus (so OA, AA (C1), C2
94
are more susceptible to somatic dysfunction
Transition zones: OA, C7-T1, T12-L1, L5-S1
95
triggering an asthmatic attack when working on thoracic spine
somatovisceral reflex
96
rib somatic dysfunction from an innominate dysfunction
somatosomatic reflex
97
gastritis affecting musculature
viscerosomatic reflex
98
pancreatitis and vomiting
viscerovisceral reflex
99
Anterior Cervical 1
location: Mandible=Posterior aspect of the ascending ramus of the mandible at the level of the earlobe Transverse process=Lateral aspect of the transverse process of C1 position: Markedly rotated away (RA)
100
Anterior Cervical 2-6
location: anterolateral aspect of the corresponding anterior tubercle of the transverse process position: Flexed, side-bent away, rotated away (F SARA)
101
Anterior Cervical 7
location: clavicular attachment of the SCM position: Flexed, side-bent toward, rotated away (F STRA)
102
Anterior Cervical 8
location: sternal attachment of the SCM on the medial end of the clavicle position: Flexed, side-bent away, rotated away (F SARA)
103
torticollis is caused by
compression of CN XI

OPP (6 decks)

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