OPP Exam #2 Flashcards

Question

inf. thoracic facet

Answer 1

- AIM | - Anterior, Inferior, Medial

Answer 2

- AL | - Anterior, Lateral

Answer 3

S1 dissociates with sacral region

Answer 4

L5 becomes part of the sacrum

Answer 5

- L3 70kg | - greatest load possible

Answer 6

Posterolateral Lumbar Disk Herniation Most Common

Answer 7

x + 1 rule

Answer 8

L4-L5 | L5-S1

Answer 9

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

Answer 10

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

Answer 11

- motor = muscles responsible for foot inversion - DTR = patellar reflex - sensory = medial aspect of leg and foot

Answer 12

- Indicates Upper Motor Neuron Problems | - Toes will sprawl instead of curl

Answer 13

Some Tension on the Sciatic Nerve

Answer 14

Maximally Involves Sciatic Nerve

Answer 15

Most Likely Joint Pain

Answer 16

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

Answer 17

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

Answer 18

Physician lifts patient’s uninvolved leg A positive test is when the patient experiences radicular symptoms down the involved leg.

Answer 19

- flexion, abduction, external rotation, and extension of the knee - check SI joint or hip

Answer 20

-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

Answer 21

-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

Answer 22

- 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

Answer 23

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)

Answer 24

- 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

Answer 25

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.

Answer 26

- 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

Answer 27

Dissecting aortic aneurysm

Answer 28

Malignancy until proven otherwise

Answer 29

Epidural abscess/ infection

Answer 30

Spinal stenosis

Answer 31

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

Answer 32

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

Answer 33

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

Answer 34

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

Answer 35

this induces left side-bending

Answer 36

this induces right side-bending

Answer 37

would have the convex side pointing to the right

Answer 38

would have the convex side pointing to the left

Answer 39

Patient is Instructed to GENTLY Push TOWARD the Barrier

Answer 40

Patient is Instructed to GENTLY Push AWAY From the Barrier

Answer 41

- 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)

Answer 42

- 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.

Answer 43

- Specific discrete areas of local tenderness | - No radiation of pain

Answer 44

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.

Answer 45

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.

Answer 46

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)

Answer 47

medial ASIS

Answer 48

Medial AIIS

Answer 49

Lateral AIIS

Answer 50

Inferior AIIS

Answer 51

Ant. Sup. aspect of pubic s rams

Answer 52

- 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

Answer 53

- 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)

Answer 54

- 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

Answer 55

- 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

Answer 56

Thoracolumbar/Lumbar Side-Bending Abnormality

Answer 57

Gluteus Medius Weakness

Answer 58

Herniated Lumbar Disc (L1-L5, S1)

Answer 59

Test Herniated Lumbar Disc (L1-L5, S1)

Answer 60

Herniated Lumbar Disc (L1-L5, S1)

Answer 61

Hip Flexion Contracture (Psoas Muscle Hypertonicity)

Answer 62

Pathology of SI Joint or Hip

Answer 63

Upper Motor Neuron Pathology

Answer 64

Malingerer

Answer 65

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

Answer 66

- 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

Answer 67

- 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

Answer 68

-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

Answer 69

- 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

Answer 70

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

Answer 71

fusion of vertebra and other bones (Ankylosing Spondylitis)

Answer 72

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

Answer 73

Fryette Type 1