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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
Q

Examples of Indirect Techniques

A

Counterstrain
Facilitated Positional Release (FPR)
Balanced Ligamentous Tension Technique (BLT)
Functional Technique

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26
Q

Examples of Direct Techniques

A 
Myofascial Release
Soft tissue 
Articulatory
Muscle Energy
High velocity, low amplitude (HVLA)
Springing
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27
Q

OA diagnosis (deep sulcus on L/R)

A

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

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28
Q

Cervical HVLA Set Up (C2 E RL SL: Rotational correction emphasis)

A
  • 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
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29
Q

Cervical HVLA Set Up (C2 E RL SL: Side-bending correction emphasis)

A
  • 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
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30
Q

Indications and Contraindications

A
  • 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
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31
Q

Neurological Exam (sensation, motor, reflex)
C6
C7
T1

A

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

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32
Q

Deep tendon reflex scale

A

2/4: normal

4/4: Brisk w/clonus, UMN injury

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33
Q

muscle strength scale

A

5/5: normal

0/5: no contractility

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34
Q

neurological influence versus biomechanical influence to diaphragm

A

Neurologically: Phrenic Nerve/C3, C4, C5

Biomechanically: Where the thoracoabdominal diaphragm attaches: lower ribs, thoraco-lumbar junction, T10-L3 are examples.

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35
Q

Rotator Cuff muscles and movements

A

Supraspinatus – Abduction
Infraspinatus - External rotation
Teres Minor – External rotation
Subscapularis – Internal rotation

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36
Q

Falling forward on an outstretched hand leads to a

A

posterior radial head

-Forearm resists supination

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37
Q

Falling backward on an outstretched hand leads to

A

anterior radial head

-Forearm resists pronation

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38
Q

Abducted Ulna

Adducted Ulna

A

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

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39
Q

Lateral epicondylitis

Medial epicondylitis

A

Lateral epicondylitis- “Tennis elbow”

Medial epicondylitis- “Golfer’s elbow”

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40
Q

psoas syndrome somatic dysfunction

A

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
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41
Q

Seated Flexion Test +R

A

LOL
ROL
RUF
RUE

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42
Q

Seated Flexion Test +L

A

ROR
LOR
LUF
LUE

43
Q

ROR or LOL

A

lay on side of oblique axis
hub table
flex greater than 90

44
Q

ROL or LOR

A

lay on side of oblique axis
face ceiling
flex less than 90

45
Q

Unilateral Sacral Flexion ME

A
  • 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
Q

Unilateral Sacral Extension: ME

A

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
Q 
Anterior Lumbar Counterstrain Points
AL1
AL2
AL3
AL4
AL5
A 
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
Q

type I vs type II thoracic HVLA set up (flexed vs extended)

A

Type I: smiley face
Type II: frowney face

Flexed: downward thrust
Extended: thrust directed 45 degrees cephalad (towards head)

49
Q

Pump handle
Bucket handle
Caliper motion

-which ribs, direction of movement, and where to palpate

A

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
Q

Inhalation Rib Somatic Dysfunction

A 
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
Q

Exhalation Rib Somatic Dysfunction

A 
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
Q 
Rib 1
Rib 2
Ribs 3 – 5
Ribs 6 – 8
Ribs 9 – 11
Rib 12
Associated muscle
A 
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
Q

ME Inhalation Dysfunction Ribs 1 - 10 set up

A

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
Q

Rib HVLA 2-10

A

posterior aspect of rib angle instead of transverse process
Inhalation: push sup
Exhalation: push inf

55
Q

Counterstrain Treatment of AR1-2 Tender Points

A

F STRT

-laying down

56
Q

Counterstrain Treatment of AR3-10 Tender Points

A

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
Q

Counterstrain Treatment of PR1 Tender Point

A

E SART

-extends and side-bends the head and neck away from the tender point, rotates the head toward the tender

58
Q

Counterstrain Treatment of PR2-10 Tender Points

A

F SARA

  • side bending away (translation towards) and rotation away from the tender point
  • only position with doctor leg under same side armpit
59
Q

Effleurage
Petrissage
Tapotement

A

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
Q

Tenderness to palpation of the medial foot distal to the talus

A

medially rotated navicular

61
Q

Tenderness to palpation of the lateral foot distal to the calcaneous

A

laterally rotated cuboid

62
Q

positive patellofemoral grind test

A 
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
Q

Effect on Distal Fibula Pronation

A

distal fibula posteromedial movement

64
Q

Effect on Distal Fibula Supination

A

distal fibula anterolateral movement

65
Q

Foot inversion
Foot eversion
-effect on distal fibula

A

Foot inversion = anterior distal fibula

Foot eversion = posterior distal fibula

66
Q

Anterior Fibular Head dysfunction

A

Dorisflexed Ankle/Foot
Everted Ankle/Foot
Externally (Abducted) rotated Ankle/Foot

67
Q

Posterior Fibular Head dysfunction

A

Plantar flexed Ankle/Foot
Inverted Ankle/Foot
Internally rotated Ankle/Foot

68
Q

Trendelenburg Test

A
  • gluteus medius

- lift one leg to test gluteus medius of the contralateral side

69
Q

Hip Drop Test

A
  • 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
Q

Posterior Fibular Head HVLA

A

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
Q

Anterior Fibular Head HVLA

A

Posterior thrust is applied at the fibular head

-caudad hand plantar flexes, inverts, and internally rotates patient’s ankle

72
Q

HVLA to the neck and double vision

A

vascular issue

73
Q

give you a deep sulcus and superior ILA what other test is needed to figure out the issue

A

spring test, backward bending, seated flexion test

74
Q

posterior innominate

A

quad (rectus femoris, vastus lateralis, vastus medialis, and vastus intermedius)

75
Q

anterior innominate

A

hamstrings (Semitendinosus, semimembranosus, biceps femoris)

76
Q

gastritis segments

A

T5-T9

OA C1 C2

77
Q

most commonly used form of contraction

A

isometric

78
Q

tender point on post aspect of ascending ramus of the mandible

A

rotate away

79
Q

parasympathetic to the lungs

A

oa c1 c2

80
Q

numbness on medial elbow

A

T1

81
Q

sidebend and rotate to the right what artery is being checked

A

left vertebral

82
Q

index finger issue

A

T6

83
Q

sympathetic nerve to the head/neck

A

1-4

84
Q

tender point to vertex

A

splenious capitis

85
Q

diminished tricep reflex and diminished sensation to middle finger

A

C7

86
Q

nausea and vommiting

A

vagus, jug foramen, occipitomastoid suture

87
Q

asthma check innervation for diaphragm functioning

A

innervation C3, C4, C5

88
Q

PC2 midline spinous process

A

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
Q

Viscerosomatic reflexes occur at

A

Sympathetics levels

Parasympathetics levels

90
Q

Somatic dysfunction can occur anywhere in the body at

A

Sympathetics levels
Paraysmpathetic levels
Soma (not autonomic related)

91
Q

Facilitated segments ONLY occur at

A

Sympathetics

92
Q

stone in the ureter or appendicitis

A

cause the psoas to become hypertonic (Positive Thomas test)

93
Q

upper (proximal) ureters sympathetic and parasympathetic

A

sympathetic: T10 - T11
parasympathetic: vagus (so OA, AA (C1), C2

94
Q

are more susceptible to somatic dysfunction

A

Transition zones: OA, C7-T1, T12-L1, L5-S1

95
Q

triggering an asthmatic attack when working on thoracic spine

A

somatovisceral reflex

96
Q

rib somatic dysfunction from an innominate dysfunction

A

somatosomatic reflex

97
Q

gastritis affecting musculature

A

viscerosomatic reflex

98
Q

pancreatitis and vomiting

A

viscerovisceral reflex

99
Q

Anterior Cervical 1

A

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
Q

Anterior Cervical 2-6

A

location: anterolateral aspect of the corresponding anterior tubercle of the transverse process
position: Flexed, side-bent away, rotated away (F SARA)

101
Q

Anterior Cervical 7

A

location: clavicular attachment of the SCM
position: Flexed, side-bent toward, rotated away (F STRA)

102
Q

Anterior Cervical 8

A

location: sternal attachment of the SCM on the medial end of the clavicle
position: Flexed, side-bent away, rotated away (F SARA)

103
Q

torticollis is caused by

A

compression of CN XI

OPP (6 decks)

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