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OPP 2 FINAL > OPP FINAL > Flashcards

OPP FINAL Flashcards

1
Q

What plane and axis does ROTATION occur on?

A

Transverse Plane
Vertical Axis

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2
Q

What plane and axis does SIDEBENDING occur on?

A

Coronal Plane
Anterior-Posterior Axis

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3
Q

What plane and axis does FLEXION occur on?

A

Sagittal Plane
Transverse Axis

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4
Q

What plane and axis does EXTENSION occur on?

A

Sagittal Plane
Transverse Axis

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5
Q

The spinous process of T8 moves superiorly with which motion of the T8 vertebra?

A

FLEXION

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6
Q

The LEFT transverse process of T5 moves posterioly with which motion of the T5 vertebra?

A

LEFT ROTATION

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7
Q

Which Fryette law is responsible for a group curve?

A

TYPE 1

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8
Q

Which Fryette Law?

a single vertebra that exhibits asymmetry in flexion or extension, with sidebending and rotation to the SAME sides

A

TYPE 2

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9
Q

This cervical joint always exhibits sidebending and rotation in OPPOSITE directions

OCCIPITOATLANTAL joint

A

C0 C1

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10
Q

This cervical joint only exhibits ROTATION

Atlantoaxial Joint

A

C1 C2

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11
Q

What cervical joint exhibits rotatino and sidebending to the SAME side

Joints of Luschka

A

C2 – C7

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12
Q

Facet Orientation
Cervical, Thoracic, and Lumbar Spine

A

BUM BUL BM

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13
Q

Three adjacent vertebra have posterior TPs on the left and they exhibit worse asymmetry in flexion and extension. What type of dysfunction are they?

A

TYPE 1 – group curve

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14
Q

What is made up of three parts: spinalis, longissimus, and iliocostalis and EXTENDS and ipsilaterally sidebends the spine

A

ERECTOR SPINAE

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15
Q

Short Restrictors are likely to create what type of fryette dysfunction?

rotatores, levatores costarum, interspinalis, and intransversarii

A

type 2

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16
Q

Long Restrictors are likely to create what type of fryette dysfunction

Multifidus, semispinalis thoarcis, spinalis, longissimus, iliocostalis

A

TYPE 1

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17
Q

What is the main muscle of the lumbar spine which provides stability?

A

MULTIFIDUS

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18
Q

These somatic dysfunctions you may see asssociated to what muscle?

Inhalation dysfunction (rib 12), L1-L4
Superior Shear of the innominate
Iliolumbar ligament tightness/tenderness

A

Hypertonic Quadratus Lumborum

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19
Q

When the psoas muscle goes into SPASM what what happenes to the lumbar spine?

A

FLEXION

Fryette Type 2 dysfunction

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20
Q

What 3 major structures pierce the diaphragm?

A

Aorta
Inferior Esophagus
Inferior Vena cava

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21
Q

These somatic dysfunctions are associated to?

L1,2,3 somatic dysfunctions
Lower 6 Rib somatic dysfunction
Thoracic somatic dysfunction of the lower 6 thoracic vertebrae

A

Diaphragmatic tightness

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22
Q

Ipsilateral or Contralateral?

Internal Obliques
External Obliques

A

Internal – Ipsilateral
External – Oblique

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23
Q

The orientation of what facet of a vertebra determines spinal motion?

A

SUPERIOR Facets

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24
Q

What is the preferred motion of the lumbar spine?

A

FLEXION and EXTENSION

BM
Right Left AXIS
Sagittal Plane

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25
Q

What is the preferred motion of the Thoracic Spine?

A

ROTATION

BUL
Superior-Inferior Axis
Transverse Plane

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26
Q

Etiologies of what?

Ruptured or herniated Disk
Bone or Cord tumors
Exostoses (bOne spurs)
Spinal Stenosis
Infection and Inflammation
Systemic Dx – Diabetes Mellitus

A

RADICULOPATHY

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27
Q

Patient comes in complaining of unilateral pain below the knee
Dull, burning, or lancing

A

Lumbar Radiculopathy

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28
Q

Where are herniations most frequent?

A

L4-L5

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29
Q

At what segment does the spinal cord end?

A

L2

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30
Q

A herniated disc (HNP) will typically affect the nerve root named for the segment ABOVE or BELOW?

A

BELOW

31
Q

a herniated L5-S1 disc will affect which nerve root?

A

S1

32
Q

Due to large central disc herniation or other space- occupying lesion compressing the cauda equina
 Bilateral or unilateral sciatica
 Saddle anesthesia
 Lower extremity weakness

A

Cauda Equina Syndrome

33
Q

Neurologic Exam for Radiculopathy

Deep tendon reflexes with patient seated
Patellar(?)
Achilles (?)

A

 Patellar(L4)
 Achilles (S1)

34
Q

Motor function testing of lower extremities

Hip flexors(?)
extensors(?)

A

Hip flexors(L1-L2) extensors(L4-L5)

35
Q

Motor function testing of lower extremities

Knee flexors (?)
extensors(?)

A

Knee flexors (L5-S1)
extensors(L3-L4)

36
Q

Motor function testing of lower extremities

Dorsiflexion (?)
plantarflexion (?)
Great toe extension(?)

A

Dorsiflexion (L4-L5)
plantarflexion (S1-S2)
Great toe extension(L5-S1)

37
Q

What are these associated to?

 Psoriatic arthritis
 Ankylosing Spondylitis
 Inflammatory Bowel Disease
 Reactive Arthritis (aka Reiter’s Syndrome)

PAIR

A

Ankylosing spondylitis

FLATTENED in AP curvature

38
Q

What joint is first affected in patients with Ankylosing spondylitis

A

Sacroiliac Joint

39
Q

What antigen is diagnosed in about 90% patients with Ankylosing spondylitis

A

HLA-B27

40
Q

What is the diagnosis?

Congenital increase in thoracic A-P curvature
Vertebral body grows unevenly; see wedging of vertebrae

A

Scheuermann’s disease

41
Q

What segments are most commonly affected in patients with Scheuermann’s disease

A

T7-T10

42
Q

What disease is associated with wedge factures?

A

Osteoporosis

43
Q

Whats the diagnosis?

Most common fx. at T12 and apex of thoracic spine
“Dowager’s hump”

A

Osteoporosis

44
Q

Patients with a flattened lumbar curvature typically have a non neutral dysfunctional at what segments?

A

L1-L2

45
Q

Patients that have a psoas spasm with sacral torsion usually have:

A

Backward Sacral Torsion
3. Contralateral Piriformis Spasm
4. Contralateral Sciatic Nerve Irritation

46
Q

Spondylolisthesis is secondary to what kind of fracture?

A

Pars interarticularis

47
Q

Reversing the Curve

This is commonly caused by

A

Spasms of paraspinal muscles

**Must treat INDIRECTLY
in acute settings/rule out fracture
prior to OMT

48
Q

Numbness, tingling, weakness, or bowel and bladder dysfunction suggest what?

A

nerve root or spinal cord injury

49
Q

Pain which radiates down the leg, below the knee seen in patients with :

A

Herniated Lumbar discs

50
Q

Pain which is worsened by changes in position vs. exertion is likely ______
Pain with deep breathing without shortness of breath is likely _____

A

SOMATIC

51
Q

outward curve vs inward curve

A

Outward = KYPHOTIC - thoracic
Inward = LORDOTIC – lumbar

52
Q

facetogenic pain is felt in what type of movements

A

Extension and rotation movements

53
Q

Lumbosacral pain is felt in what sort of movements

A

Upon standing and sitting

54
Q

Differential Diagnosis of What region

R/o cauda equina, malignancy
Dx. of the spine/facets
Muscular: Quadratus lumborum, psoas, paraspinals
Ligamentous: Iliolumbar ligament, interspinous, A/P longitudinal
Neural: Sciatic and cluneal nerve

A

LUMBAR REGION

55
Q

Differential diagnosis for what region?

R/o fracture, malignnacy, multiple myeoloma
Consider osteoporotic or traumatic compression fracture/causes of osteoporosis
Consider visceral causes
* Aortic dissection, MI, pneumonia, pneumothroax, pericarditis, hepatobiliary dx referral pattern
* nephrolithiasis or renal disease

A

THORACIC Region

56
Q

scolosis is named for direction of what

A

CONVEXITY

57
Q

scolosis severity greater than 50 degrees compromises what, and at 75 degrees

A

50 - resp function
75 - cardiovascular function

58
Q

Osteopathic considerations

How do the vertebrae rotate and sidebend in regards to convexity

A

rotate INTO
sidebend AWAY from convexity

59
Q

osteopathic considerations

How do the ribs on the convex and concave side move

A

Convex – seperate and move posterior
Concave – closer and anterior
* disc spaces narrow on concave side

60
Q

What is the most clincially relevant element of short leg syndrome biomechanics

A

Sacral Base Unleveling

spine compenstates – rotoscoliosis
innominates rotate to compensate

61
Q

Early Compensation of Short Leg Syndrome

The head and should depress to which side
Sacral Base, Iliac Crest and Spinal Convexity tilt towards what side?

A

Shoulder depresses opposite the side of pelvic depression
Sacrum, Iliac Crest and Spinal Convexity are on the side of the SHORT LEG

62
Q

Guiding principles for progressive compensation

Which way do the innominates on the short side vs long side rotate

A

Short Side rotates ANTERIORLY to LENGTHEN
Long Side rotates POSTERIORLY to SHORTEN

63
Q

iliolumbar ligament on which side of the short leg syndrome becomes stressed

A

on the side of the CONVEXITY

64
Q

What OMT treatment option can be utilized if patient has an anatomic short leg (growth or trauma)

A

Heel Lift Therapy
Flexible spine – 3mm heel lift
Fragile spine – 1.5mm

65
Q

LIFT THERAPY

If the patient had a sudden loss of leg length on one side and the pt had a level sacral base prior to developing the short leg, how much do you lift

A

lift the FULL fractional amount that was lost

66
Q

Most common location of compartment syndrome

A

Anterior compartment of lower leg

67
Q

As compartment pressure rises, what happens to venous outflow and venous pressure?

A

Venous outflow DECREASES
Venous Pressure INCREASES

DEC in arteriovenous pressure gradient

68
Q

Pathogenesis of Compartment Syndrome

What gets released due to hypoxia

A

release of vasoactive substances
serotonin, histamine – allows capillatires to release more fluid in already tight compartment

69
Q

What happens sooner nerve ischemia or muscle ischemiA

A

NERVE ischemia – after one hour

70
Q

What is the most common measurement technique for compartment syndrome

A

Stryker Device
Simple Needle Manometer system
The wick
silt catheter

71
Q

overuse injury that typically affects young endurance athelets. result from inc pressure within muscle compartments

A

Chronic Exertional Compartment Syndrome CECS

72
Q

What is the prevalance of fibromyalgia in the US/Canada

A

2%

73
Q

What neurotransmitter is inhibitory in the pain pathway?

A

GABA

74
Q

How many tenderpoints are needed to establish a diagnosis of fibromyalgia using the 1990 ACR criteria?

A

11

OPP 2 FINAL (1 decks)

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