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OPP > OPP Exam #2 > Flashcards

OPP Exam #2 Flashcards

1
Q

ACUTE dysfunction

A
  • Recent history (injury)
  • Sharp or severe localized pain
  • Warm, moist, sweaty skin
  • Boggy, edematous tissue
  • Erythematous
  • Local increase in muscle tone, contraction, spasm, increased muscle spindle firing
  • Normal or sluggish ROM
  • May be minimal or no somatovisceral effects
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2
Q

Chronic dysfunction

A
  • Long-standing
  • Dull, achy diffuse pain
  • Cool, smooth, dry skin
  • Possible atrophy
  • Fibrotic, ropy feeling tissue
  • Pale/skin pallor
  • Decreased muscle tone, contracted muscles, sometimes flaccid
  • Restricted ROM
  • Somatovisceral effects more often present
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3
Q

What lead to tissue texture changes such as hypertonicity, moisture, erythema, etc?

A

-post ganglionic sympathetic fibers

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4
Q

viscerosomatic reflex. what synapses where?

A

Dorsal horn of the spinal cord is where somatic and visceral afferent nerves synapse

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5
Q

Myocardium, Thyroid, Esophagus, Bronchus

Chapman reflex point

A

Anterior: 2nd intercostal space near sternum
Posterior: Midway between the spinous process and tips of the transverse process at T2

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6
Q

Upper Lung Chapman reflex point

A

Anterior: 3rd intercostal space near sternum
Posterior: Midway between the spinous processes and tips of the transverse processes of T3 and T4

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7
Q

Chapman reflex point Lower Lung

A

Anterior: 4th intercostal space near sternum
Posterior: Midway between the spinous processes and tips of the transverse processes of T4 and T5

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8
Q

Liver Chapman reflex point

A

Anterior: 5th intercostal space near sternum on R

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9
Q

Stomach (Acid)

Chapman reflex point

A 
Anterior: 5th intercostal space near sternum on L 
Stomach Acid (think ulcers/NSAID use/Steroid use)
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10
Q

Liver, Gallbladder (think Cholecystitis)

Chapman reflex point

A

Anterior: 6th intercostal space near sternum on R

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11
Q

Stomach (Peristalsis): fuller longer than normal Chapman reflex point

A 
Anterior: 6th intercostal space near sternum on L            
Stomach Peristalsis (think of emptying time, food doesn’t go through stomach quickly)
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12
Q

Pancreas (think of Amylase/Lipase/Blood glucose)

Chapman reflex point

A

Anterior: 7th intercostal space near sternum on R

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13
Q

Spleen Chapman reflex point

A

Anterior: 7th intercostal space near sternum on L

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14
Q

Adrenal Glands

Chapman reflex point

A

Anterior: 1” Lateral and 2” Superior to Umbilicus Ipsilaterally
Posterior: Intertransverse Spaces of T11 and T12 Ipsilaterally Midway Between Spinous and Transverse Processes

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15
Q

Kidneys Chapman reflex point

A

Anterior: 1” Lateral and 1” Superior to Umbilicus Ipsilaterally
Posterior: Intertransverse Spaces Midway Between Spines and Transverse Tips of T12-L1

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16
Q

Urinary Bladder

Chapman reflex point

A

Anterior: Umbilical Area (Periumbilical)
Posterior: Intertransverse Spaces Midway Between Spines and Transverse Tips of L1-L2

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17
Q

Appendix Chapman reflex point

A

Anterior: Tip of the right 12th rib
Posterior: At the transverse process of T11

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18
Q

Chapman’s Reflexes of the Colon

A

Top is bottom

Iliotibial band

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19
Q

Iliolumbar Ligaments attachment

A

Originates from the iliac crest and inserts on the transverse process of L4 and L5.

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20
Q

Iliolumbar Ligaments tender area

A

Superior and Medial to the PSIS

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21
Q

sup cervical facet

A
  • BUM

- Backward, Upward, Medial

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22
Q

sup thoracic facet

A
  • BUL

- Backward, Upward, Lateral

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23
Q

sup lumbar facet

A
  • BM

- Backward, Medial

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24
Q

inf. cervical facet

A
  • AIL

- Anterior, Inferior, Lateral

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25
Q

inf. thoracic facet

A
  • AIM

- Anterior, Inferior, Medial

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26
Q

inf. lumbar facet

A
  • AL

- Anterior, Lateral

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27
Q

Lumbarization

A

S1 dissociates with sacral region

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28
Q

Sacralization

A

L5 becomes part of the sacrum

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29
Q

Sitting with poor posture puts load where?

A
  • L3 70kg

- greatest load possible

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30
Q

Most common disc herniation

A

Posterolateral Lumbar Disk Herniation Most Common

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31
Q

what nerve will be pinched with herniation

A

x + 1 rule

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32
Q

most common segments for herniation

A

L4-L5

L5-S1

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33
Q

L4-L5 herniation causes

A

-extensor hallicus longus
-sensory = lateral side of
-leg and dorsum of foot
“Walk on your heels”

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34
Q

L5-S1 herniation causes

A

-motor = muscles responsible for eversion
-achilles tendon reflex
-sensory = lateral malleolus and lateral aspect of foot
-“Walk on your toes”
cant planter flex

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35
Q

L4 herniation

A
  • motor = muscles responsible for foot inversion
  • DTR = patellar reflex
  • sensory = medial aspect of leg and foot
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36
Q

Positive Babinski Reflex indicates

A
  • Indicates Upper Motor Neuron Problems

- Toes will sprawl instead of curl

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37
Q

Straight Leg Raise Test 0-35

A

Some Tension on the Sciatic Nerve

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38
Q

Straight Leg Raise Test 35-70

A

Maximally Involves Sciatic Nerve

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39
Q

Straight Leg Raise Test > 70

A

Most Likely Joint Pain

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40
Q

Straight Leg Raise Test

A

Patient in the supine position
The hip is medially rotated and adducted and with the knee extended, the examiner flexes the hip until the patient complains of pain in the back of the symptomatic leg

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41
Q

Bragard Test

A

Patient’s leg is lowered toward the table, until pain free

Patient’s ankle is dorsiflexed

If the dorsiflexion of the ankle reproduces the symptoms, the test is positive indicating radiculopathy

42
Q

Contralateral SLR Test

A

Physician lifts patient’s uninvolved leg

A positive test is when the patient experiences radicular symptoms down the involved leg.

43
Q

FABERE Test (Patrick Test)

A
  • flexion, abduction, external rotation, and extension of the knee
  • check SI joint or hip
44
Q

Ober’s Test

A

-Assessment for contracture/tightness of iliotibial band or tensor fascia latae
-With knee flexed, extend hip
Gently allow thigh to adduct toward table
Considered positive if thigh cannot adduct past midline

45
Q

Trendelenburg Test

A

-assessment of gluteus medius
-Pt stands on one foot while flexing opposite knee and lifting foot off floor
Gluteus medius muscle on opposite side of flexed knee should abduct leg, keeping pelvis level
Considered positive if pelvis tilts toward side of flexed knee

46
Q

Hip Drop Test

A
  • Assessment of lumbar spine compensation to sacral base declination (Screening test)
  • Patient bends one knee without lifting heel off floor and allowing hip to drop downward
47
Q

Positive hip drop test

A

Iliac crest does not drop 20-25 degrees on the non-weight bearing side and there is a poor lumbar spinal curve towards the weight bearing side. A positive test indicates that the lumbar and/or thoracolumbar spine has difficulty side-bending toward the weight bearing side of the body (ie, the side opposite the positive test)

48
Q

Thomas Test

A
  • Test for psoas muscle tension/hypertonicity (hip flexion contracture)
  • Test for psoas muscle tension/hypertonicity (hip flexion contracture)
  • If the iliopsoas muscle is shortened, or a contracture is present, the lower extremity on the involved side will be unable to fully extend at the hip (ie the thigh and popliteal region will not lay flat on the table
49
Q

Hoover Test

A

Tests for Malingerers (Drug seekers, someone looking for secondary gain)
Patient Supine
Physician Holds Beneath the Patient’s Calcaneus
When the patient tries to raise one leg, there should be contralateral pressure on the opposite heel, if that person is trying.

50
Q

“Red Flags”Lumbar Pain

A
  • Age 50 years or older
  • Previous history of cancer
  • Unexplained weight loss
  • Failure to improve with 1 month of therapy
  • No relief with bed rest
51
Q

Worrisome Severe low back pain of sudden onset and without history of trauma

A

Dissecting aortic aneurysm

52
Q

Pain that wakes the patient from sleep

A

Malignancy until proven otherwise

53
Q

Rapidly progressing neurological deficits

A

Epidural abscess/ infection

54
Q

Claudication (limping) symptoms with back pain

A

Spinal stenosis

55
Q

Somatic Dysfunction diagnoses by TART

A

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

56
Q

Fryette 1st Principle

A

When side-bending is attempted from neutral (anatomical) position, rotation of vertebral bodies follows to the opposite direction.

57
Q

Fryette 2nd Principle

A

When side-bending is attempted from non-neutral (hyperflexed or hyperextended) position, rotation must precede side-bending to the same side.

58
Q

Fryette 3rd Principle

A

Motion introduced in one plane limits and modifies motion in the other planes.

59
Q

If a segment translates to the right

A

this induces left side-bending

60
Q

If a segment translates to the left

A

this induces right side-bending

61
Q

dextroscoliosis

A

would have the convex side pointing to the right

62
Q

levoscoliosis

A

would have the convex side pointing to the left

63
Q

Reciprocal Inhibition

A

Patient is Instructed to GENTLY Push TOWARD the Barrier

64
Q

Postisometric Relaxation

A

Patient is Instructed to GENTLY Push AWAY From the Barrier

65
Q

L1 N SRRL Muscle Energy

-neutral disfunction

A
  • Physician’s right hand passes underneath the patient’s right arm and grasps the patient’s left upper arm
  • if side bent left rotated right
  • patient to rotate gently to the left while physician applies an equal counterforce (if using post-isometric muscle energy)
  • patient to rotate gently to the right while physician applies an equal counterforce (if using reciprocal inhibition muscle energy)
66
Q

L1 E SLRL Muscle Energy

A
  • Patient placed in the “Osteopathic Salute” where their left hand grasps their neck posteriorly and their right hand grasps their left elbow
  • Physician’s right hand passes above the patient’s right arm and grasps the patient’s left upper arm
  • Physician’s left hand monitors the L1 transverse processes
  • L1 is side-bent right and rotated right by the physician lowering the physician’s right arm and pulling the patient’s left arm anteriorly. L1 is flexed.
67
Q

Tender Point

A
  • Specific discrete areas of local tenderness

- No radiation of pain

68
Q

Absolute contraindications

A

A. Manifestation of abnormal neurological and/or vascular symptoms brought on by the treatment position.
B. Exacerbation of potentially life-threatening symptomatology by treatment position )EKG changes, drop in oxygen saturation in a monitored patient.

69
Q

relative contraindications

A

A. Patient who cannot voluntarily relax, or severely ill patient.
B. Upper cervical hyperrotation and hyperextension in patients with known vertebral artery disease and/or upper cervical ligamentous instability, dens malformation, or severe osteoporosis.
C. Inability to tolerate the classic treatment position, meaning that the treatment position must be modified.
D. Inability to effectively communicate.
E. Patient with severe acute rheumatological flare.
F. Signs of apprehension while approaching the treatment position.

70
Q

Counterstrain

A

Assess the “this is a 10” pain level
Maintain finger contact at all times (NOT PRESSING FIRM constantly, only 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)

71
Q

AL1

A

medial ASIS

72
Q

AL2

A

Medial AIIS

73
Q

AL3

A

Lateral AIIS

74
Q

AL4

A

Inferior AIIS

75
Q

AL5

A

Ant. Sup. aspect of pubic s rams

76
Q

Psoas Major CounterstrainSupine

A
  • The patient lies supine, and the physician stands at the side of the tender point
  • The physician markedly flexes the patient’s hips/knees and adds slight external rotation of the hips. Pulling the ankles toward the tender point to side
77
Q

Iliacus CounterstrainSupine

A
  • The patient lies supine, and the physician stands at the side of the table.
  • The physician, while flexing the patient’s hips/knees, places his/her foot on the table and lays the patient’s knees on his/her thigh.
  • The physician crosses the patient’s ankles and externally rotates both of the patient’s hips (ankles are crossed with knees out to the sides)
78
Q

Piriformis CounterstrainProne

A
  • The patient lies prone, and the physician stands or sits on the side of the tender point
  • The patient’s leg (on the side of the tender point) is off the edge of the table; the hip is markedly flexed and abducted. The patient’s leg rests on the physician’s thigh/knee
79
Q

Lateral Trochanter (Iliotibial Band) CounterstrainSupine

A
  • The patient lies supine or prone, and the physician stands or sits at the side of the tender point.
  • The patient’s hip/thigh is abducted and slightly flexed until the tenderness is completely alleviated
80
Q

Hip Drop Test is for checking

A

Thoracolumbar/Lumbar Side-Bending Abnormality

81
Q

Trendelenburg Test is for checking

A

Gluteus Medius Weakness

82
Q

Straight Leg Raising (SLR) Test is for checking

A

Herniated Lumbar Disc (L1-L5, S1)

83
Q

Contralateral Straight Leg Raising is for checking

A

Test Herniated Lumbar Disc (L1-L5, S1)

84
Q

Bragard Test is checking for

A

Herniated Lumbar Disc (L1-L5, S1)

85
Q

Thomas Test is checking for

A

Hip Flexion Contracture (Psoas Muscle Hypertonicity)

86
Q

Patrick/FABERE Test is checking for

A

Pathology of SI Joint or Hip

87
Q

Babinski Reflex is checking for

A

Upper Motor Neuron Pathology

88
Q

Hoover Test is checking for

A

Malingerer

89
Q

Femoral triangle

A

(L) Nerve, (Artery, Vein, Lymphatics) (M)

90
Q

Psoas Syndrome symptoms

A
  • nonneutral (type II) somatic dysfunction at L1 and/or L2
  • Pelvic shift to the opposite side of the greatest psoas spasm
  • Hypertonicity of the piriformis muscle contralateral to the side of greatest psoas spasm
  • Sciatic nerve irritation on the side of the piriformis spasm
91
Q

Piriformis Syndrome causes and characteristics

A
  • Condition that results from hypertonicity/spasm of the psoas muscle
  • Characterized by aching pain in the gluteal region, especially at the attachment sites of the piriformis muscle. Increasing pain after sitting for longer than 15 to 20 minutes
92
Q

Piriformis Syndrome symptoms

A

-Hip and buttock pain that may radiate down the back of the thigh (not past knee)
-Low back pain - not a major component
-Lack of neurologic deficits
-Piriformis tender point
(This is how you make the diagnosis!!)
-Decreased internal rotation of the hip on affected side

93
Q

Inguinal Ligament Somatic Dysfunction is also implicated in Meralgia Paresthetica

A
  • Paresthesia in the distribution of the Lateral Femoral Cutaneous nerve due to compression of the nerve as it passes between the inguinal ligament and sartorius
  • numbness and pain just below beltline that extends along the anterior/lateral aspect of thigh approximately 2/3 of the way to the knee
94
Q

Bursitis

A

is generic term for an inflammation of the small sacs of fluid (bursae) that cushion and lubricate the areas between tendons and bones.

95
Q

BAMBOO SPINE

A

fusion of vertebra and other bones (Ankylosing Spondylitis)

96
Q

Psoas syndrome effect on spine

A

nonneutral (type II) somatic dysfunction at L1 and/or L2

97
Q

Viscerosomatic Considerations Kidney

Upper Ureters

A

T10-T11

98
Q

Viscerosomatic Considerations Lower Ureters

A

T11-L1

99
Q

Viscerosomatic Considerations Lower Extremities

A

T11-L2

100
Q

Viscerosomatic Considerations Left Colon
Bladder
Prostate

A

T12-L2

101
Q

dextroscoliosis or levoscoliosis follows what fryette principle

A

Fryette Type 1

OPP (6 decks)

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