OPP Exam #1 Flashcards
dextroscoliosis
- convexity to the right
- side bend to the left, rotated to the right
levoscoliosis
- convexity to the left
- side bend to the right, rotated to the left
left lateral convexity
sidebent to the right
right lateral convexity
sidebent to the left
If there is a group disfunction with OMT for? ex. T10-T12
apex (middle)
T11
Type II dysfunction usually occurs where?
apex (middle) of group
Translation to the right
left side-bending
translation to the left
right side-bending
AT Still birth
1828
Year osteopathy was founded
1874
1st DO school
1892
AT Still died
1917
How did AT Stills children die
meningitis
Best for feeling temp
dorsum of hand
Pad of thumb, index, and middle finger
most kinesthetic nerve endings
Principle 1
The body is a unit; the person is a unit of mind, body, and spirit (gastric ulcer causes thoracic tissue texture changes)
Principle 2
The body is capable of self-regulation, self-healing, and health maintenance (healed fracture)
Principle 3
Structure and function are reciprocally interrelated
Principle 4
Rational treatment is based upon an understanding of the basic principles of body unity, self-regulation, and the inter-relationship of structure and function
5 Osteopathic Models
Biomechanical Neurological Respiratory/Circulatory Metabolic/Nutritional Behavioral
Orientation of Superior Facets Cervical
Backward, Upward, Medial
Orientation of Superior Facets Thoracic
Backward, Upward, Lateral
Orientation of Superior Facets Lumbar
Backward, Medial
Orientation of Inferior Facets Cervical
Anterior, Inferior, Lateral
Orientation of Inferior Facets Thoracic
Anterior, Inferior, Medial
Orientation of Inferior Facets Lumbar
Anterior, Lateral
ANATOMIC BARRIER
The limit of motion imposed by anatomic structure; the limit of passive motion
PHYSIOLOGIC BARRIER
The limit of active motion
ELASTIC BARRIER
Range between physiologic and anatomic barrier of motion in which passive ligamentous stretching occurs before tissue disruption.
RESTRICTIVE BARRIER
- A functional limit that abnormally diminishes the normal physiologic range
- Motion stops before the joint reaches its physiologic barrier
PATHOLOGIC BARRIER
A restriction of joint motion associated with pathologic change of tissues
somatosomatic reflex
localized somatic stimuli producing patterns of reflex response in segmentally related somatic structures. For example, rib somatic dysfunction from an innominate dysfunction.
somatovisceral reflex
localized somatic stimulation producing patterns of reflex response in segmentally related visceral structures. For example, triggering an asthmatic attack when working on thoracic spine.
viscerosomatic reflex
- localized visceral stimuli producing patterns of reflex response in segmentally related somatic structures. For example gallbladder disease affecting musculature.
- Dorsal horn of the spinal cord is where somatic and visceral afferent nerves synapse giving a viscerosomatic reflex
viscerovisceral reflex
localized visceral stimuli producing patterns of reflex response in segmentally related visceral structures. For example, myocardial infarction and vomiting.
somatic dysfunction
is defined as the impaired or altered function of related components of the somatic (bodywork) system including: the skeletal, arthrodial, and myofascial structures, and their related vascular, lymphatic, and neural elements.
Spine of Scapula
T3
Inferior angle of scapula
SP of T7, TP of T8
Iliac Crest
L4/L5 area
Umbilicus
L3/L4 area
Xiphoid Process
T9
Angle of Louis
T4 and Rib 2
Suprasternal Notch
T2
OA, C1, C2 (Vagus) parasympathetic
Heart, lungs, stomach, gallbladder
S2-S4 parasympathetic
Blader, prostate
Sympathetic heart
T1-T5
sympathetic lungs
T1-T6
sympathetic stomach and gallbladder
T5-T9
sympathetic bladder and prostate
T12-L2
Vertebral bodies usually rotated towards
The side of dysfunction
Gallbladder issues will cause
T5 - T9 on the right [Stones]***
Stomach (Ulcers, Gastritis) issues will cause
T5 -T9 on the left
Dorsal horn of the spinal cord is where somatic and visceral afferent nerves synapse give what kind of reflex?
viscerosomatic reflex
Transverse plane movement
rotation
coronal plane movement
sidebending
sagittal plane movement (anterior and posterior)
flexion and extension
Diagnosis of somatic dysfunction (T.A.R.T.)
T: Tissue Texture Changes
A: Asymmetry
R: Restriction of motion
T: Tenderness (subjective)
Fryette’s 1st Principle
- When side-bending is attempted from neutral (anatomical) position, rotation of vertebral bodies follows to the opposite direction.
- N,SR,RL
- N,SL,RR
- side bending comes before rotation
- a group of vertebrae or a single vertebrae
- usually not traumatic etiology
Fryette’s 2nd Principle
When side-bending is attempted from non-neutral (flexed or extended) position, rotation must precede side-bending to the same side.
- rotation comes before side bending
- NN (F/E) RxSx
- single vertebrae
- usually traumatic etiology
Fryette’s 3rd Principle
Motion introduced in one plane limits and modifies motion in the other planes.
Type I and II only apply to
T and L
L3 neutral position side bent left and rotate right on L4
L3 N,SL,RR
L3 in flexed position, rotated left, side-bent left on L4
L3 F SL,RL
Type III applies to
C, T, L spine, all other joints
OA (occipitoatlantal joint) is what type?
type I like even if sagittal component is present
AA (atlantoaxial joint) is primarily
rotational
C2-C7 are like which type
Type II whether there is a sagittal component or not
Tripositional Diagnosis
- find posterior transverse process
2. have patient flex and extend
If a posteriorly rotated process moves anteriorly with flexion
it is F RxSx
a posteriorly rotated process moves anteriorly with extension
it is E RxSx
If rotational component does not change with either maneuver (or gets worse with flexion and extension),
it is neutral: N SxRy
Direct
the restrictive barrier is engaged and a final activating force is applied to correct somatic dysfunction
Indirect
the dysfunctional body part is moved away from the restrictive barrier until tissue tension is equal in one or all planes and directions
Active method
Technique in which the person voluntarily performs a motion
Passive method
Based on techniques which the patient refrains from voluntary muscle contraction
HVLA
Direct/Passive
ME (patient straightens out body against resistance):
Direct/Active
Counterstrain
Indirect/Passive
Balanced ligamentous technique (BLT)
Indirect/Passive
Facilitated Positional Release (FPR)
Indirect/Passive
Direct treatment setup
Reverse the somatic dysfunction. Take it the way it doesn’t like to go. Engage the barrier.
Indirect treatment setup
Exaggerate the somatic dysfunction. Take it the way it likes to go. Disengage the barrier.
Kneading
a perpendicular traction technique in which a rhythmic, lateral stretching of a myofascial structure, where the origin and insertion are held stationary and the central portion of the structure is stretched like a bowstring.
Stretching
a longitudinal or parallel traction technique in which the origin and insertion of the myofascial structures being treated are longitudinally separated.
Inhibition
a deep inhibitory pressure, which is a sustained deep pressure over a hypertonic myofascial structure.
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
Muscle Energy technique (post isometric relaxation) patient does?
Patient is Instructed to GENTLY Push AWAY From the Barrier
Muscle Energy Technique the physician positions the patients
feathers edge
How many times should muscle energy technique be used?
3-5 times for 3-5 seconds, 2 second relaxation
Muscle Energy Technique (reciprocal inhibition) the patient?
Patient is Instructed to GENTLY Push TOWARD the Barrier
Examples of Indirect Techniques
Counterstrain
Facilitated Positional Release (FPR)
Balanced Ligamentous Tension Technique (BLT)
Functional Technique
Counterstrain: Steps of Treatment
Assess the “this is a 10” pain level
Maintain finger contact at all times (NOT PRESSING FIRM constantly, only monitoring!)(***continuous monitoring)
this is to monitor tension, not to treat
Find the position of comfort
Retest by pressing with contact finger
This is a passive treatment
Hold it for 90 seconds (that’s the time for ALL counterstrain points, including ribs)
monitor tension and response
Return patient to neutral position SLOWLY!!
Recheck pain level
should be a 3 or less
Facilitated Positional Release
Body part in NEUTRAL position
COMPRESSION applied to shorten muscle/muscle fibers (some cases may have TRACTION instead)
Place area into EASE of motion (INDIRECT) for 3-5 seconds
Return body part to neutral
THIS TECHNIQUE IS INDIRECT!!!!
Still Technique
Tissue/joint placed in EASE of motion position (augments the somatic dysfunction)
Compression (or traction) vector force added
Tissue/joint moved through restriction (into and through the restrictive barrier) while maintaining compression (or traction) and force vector
THIS TECHNIQUE GOES FROM INDIRECT TO DIRECT!!!!
Center of mass
S2
Optimal weight bearing line in sagittal plane
- External auditory meatus
- Through lateral humeral head
- L3 body
- Anterior 1/3 sacrum
- Sacral level 2 (Center of Mass=COM)
- Greater trochanter
- Through lateral femoral condyle
- Just anterior to lateral malleolus
COG/COM during pregnancy
anterior
Common Compensatory Pattern
OA- 80% rotated Left the other 20% - if compensated reverse this L/R/L/R pattern
CT “ Right
TL “ Left
LS ‘ Right
Junctional/Transition Zones
Occipitocervical (OA)
Cervicothoracic (CT) C7-T1
Thoracolumbar (TL) T12-L1
Lumbosacral (LS) L5-S1
Antalgic Gait
painful gait, a limp is adopted to avoid pain on weight bearing structures (hip, knee, ankle) It is a form ofgaitabnormality where the stance phase ofgaitis abnormally shortened relative to the swing phase. It can be a good indication of pain with weight-bearing.
Ataxic Gait
an unsteady, uncoordinated walk, a wide base of support is seen. Often due to cerebellar disease
Fenestrating Gait
short, accelerating steps are used to move forward, often seen in people with Parkinson’s disease **
Hemiplegic Gait
involves flexion of the hip because of inability to clear the toes from the floor at the ankle and circumduction at the hip
Spastic Gait
walk in which the legs are held close together and move in a stiff manner. Ex: scissor gait of cerebral palsy
Trendelenburg Gait
an abnormalgaitcausedby weakness of the abductor muscles of the lower limb: gluteus medius and gluteus minimus
steppage gait
the gait in footdrop in which the advancing leg is lifted high in order that the toes may clear the ground. It is due to paralysis of the anterior tibial and fibular muscles, and is seen in lesions of the lower motor neuron, such as multiple neuritis, lesions of the anterior motor horn cells, and lesions of the cauda equina.
Mild Scoliosis
(less than 20 degrees).
Moderate Scoliosis
between 20 and 45 degrees
Severe Scoliosis
between 45 and 70 degrees
Very Severe Scoliosis
Over 100 degrees
