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OPP COMAT U WORLD REVIEW > OPP MISSED U WORLD > Flashcards

OPP MISSED U WORLD Flashcards

1
Q

A patient with cirrhosis along with fever and ascites + abdominal tenderness is concerning for

A

a bacterial infection of the ascitic fluid known as sponataenous bacterial peritonitis

caasued by enteric bacteria like ecoli and klebsiella

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2
Q

what is the first best step in treatment of someone with spontaneous bacterial peritonitis

A

uregnt evaluation in the ER with a paracentesis

diagnosis is made when the ascitic fluid neutrophil count is greater than 250mm

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3
Q

after urgent evaluation of SBP what is the next step?

A

starting IV broad spectrum antibiotics

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4
Q

Acute back pain usually resolves in 6 weeks if MSK in nature what is the best step to treating

A

exluding red flags (malingnacy, constituional symptoms)

Anaglesgics, OMT(gentle)- reciprocal inhibition)

anaglescis like NSAIDS are contraindicated in CKD and GI bleeding so topical ones can be used or a lidocain patch would also work

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5
Q

lateral femoral cutatneous nerve distribution

A

upper lateral thigh

L2-L3

LFCN runs lateral to the psoas underneath the inguinal ligament

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6
Q

Meralgia paresthetica

A

leg pain and decreased sensation in the distrubution of the lateral femoral cutaneous nerve

pain, parathetias, numbness but strength is normal

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7
Q

Meralgia Paresthetics treatment

A
  1. decrease nerve compression (weight loss)
  2. address somatic dysfunctions
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8
Q

a radial head fracture should be considered in patients with?

A

limited forearm range of motion and tenderness over the lateral aspect of the elbow

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9
Q

evaluation of a radial head fracture?

A
  1. plane radiographs
  2. pain control, orthopedic evaluation, potential surgery, OMT
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10
Q

chapman point of the kidney

A

anterior: 1 inch lateral and above umbillicus

posterior: between the spinous and transverse process of T12-L1

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10
Q
A
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11
Q

what lies at the chapman point between the sinous process and transverse process of T9-T11

A

ovary

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12
Q

thomas test is positive in

A

psoas syndrome

tender point: 2/3 between the ASIS and midline

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13
Q

chapman point for anterior lumbar 1

A

just medial to the ASIS

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14
Q

piriformis chapman point

A

7cm medial to the greater trochanter

treatment: FABER

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15
Q

lower pole L5 tenderpoint

A

just below the PSIS

treatment: prone, extend hip, adduct and rotate

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16
Q

upper pole L5 tenderpoint

A

just above the PSIS

treatment: prone, extend at hip, adduct and internally rotate

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17
Q

rotator cuff tendinopathy symptom involving the supraspinatus

A

painful shoulder abduction

point tenderness at the acromion

remodeling of the tissue

preserved strangth and ROM

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18
Q

adhesive caspulitis

A

glenohumeral joint caspule contracture that causes decreased ROM in the shoulder

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19
Q

bicipital tendonitis

A

inflammation of the long head of the biceps tendon

anterior shoulder pain with painful arm flexion or supination

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20
Q

labral tears of the gelnohumoral joint

A

reduced ROM and crepitus

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21
Q

Rotator Cuff tendiopathy diagnosis and treatment

A
  1. clinical diagnosis unless you suspect something else then imaging (tear)
  2. conservative management -NSAIDS, PT, OMT
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22
Q

shoulder immobilization should be avoided after most shoulder injuries because

A

there is a risk of developing capular adhesions (spencer techniques can aid in breaking up capsular adhesions)

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23
Q

patient with dysuria, urinary frequency, isolated pyuria (WBC) but no bacteruria most likely has?

A

infectious urethritis

STD

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24
Q

chapman point of the urethra

A

anterior: on the pubic symphysis

posterior: on the transverse process of L3

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25
Q

Lumbosacral spring test

A

determines whether of not the sacral sulci have moved anteriorly or posteriorly

normal: pressing on the lumbosacral junction will cause a springing motion of the sacrum in relation to L5 (NEGATIVE TEST)

Positive test: decreased springing and the sacral sulci have moved posteriorly into EXTENSION relative to L5

negative= flexion
postivie= extension

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26
Q

psoas syndrome symptoms

A

LBP
lumbar somatic dysfunctions
positive thomas test (painful hip extension)

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27
Q

innominate inflare treated with direct muscle energy cause the patient to contract which muscle

A

adductor magnus (medial rotator of the hip)

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28
Q

innominate outflare treated with direct muscle energy causes the patient to contract which muscle

A

gluteus maximus

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29
Q

schapoid frfacture pain

A

lateral wrist pain and tenderness in the snuff box

confirm by X ray!!

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30
Q

treatment of scaphoid fracture

A

immbolization and orthopedic evaluation

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31
Q

progressive and chronic low back pain that radaites down the leg and sensory loss (numbness and tingling) is caused by

A

spinal stenosis (narrowing of the spinal canal or intervertebral foramen)

facet joint oeteophytes and ligamentum flavum hypertrophy

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32
Q

in spinal stenosis symptoms are worse with

A

lumbar extension and relieved by lumbar flexion (leaning on stroller)

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33
Q

L5 nerve root compression

L5-S1 affects L5

A

anterior lower leg sensory loss and dorsal doot

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34
Q

iliotibial band syndrome findings

A

lateral knee pain, tenderness over the right lateral femoral epicondyle

positive ober test

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35
Q

treatment of iliotibilar band syndrome

A

rest/ice/NSAIDS
PT
Stretching

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36
Q

how do you stretch the IT band

A

sit on the floor and cross the affected leg over the unaffected leg, pull affected leg medially hold for 30 seconds and then repeat

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37
Q

how to stretch the hip adductor muscle

A

felx, abduct and externally rotate

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38
Q

how to stretch the hamstrings and gluteal muscles

A

flex the hip. extend the knee in the supine position

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39
Q

standing with the right leg over the left leg and bending at the torso whoucl stretch what muscle

A

left IT band along the hamstring

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40
Q

contraction of the SCM

A

sidebending of the neck to the same side and rotation of the neck to the opposite side

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41
Q

in sacral torsions L5 rotates in the _ direction of the sacrum and sidebends _ the oblique axis

A

opposite

SB towards

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42
Q

direct reciprocal inhibition

A

direct muscle energy technique that causes reciprocal antagoinist contraction to relax the hypertonic agonist muscle

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43
Q

fever, nausea, LLQ pain that radiates to the groin with a chapman point midway between the left transverse process of L3 and the highest point of the left iliac crest has?

A

acute diverticulitis which is common in the sigmoid colon

posterior chapman point is a triangular area between the transverse processes of L2-L4 and the highest point of the iliac crest

anterior: IT band

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44
Q

esophagus chapman point

A

ICS between ribs 2-3

between spinous process and transverse process of T2 posteriorly

esophagitis: thrush and burning chest pain- common in immunocompromised

45
Q

wrist flexion = _ bone glide

A

dorsal

46
Q

wrist extension = _ bone glide

A

ventral

47
Q

axillary nerve injury

A

lateral shoulder sensory loss, deltoid muscle weakness (cant hold abducted position)

48
Q

difficulty maintaing hand grip

A

ulnar nerve

49
Q

lateral forearm sensory loss

A

musculoskeletal nerve injury + weakened elbow flexion

50
Q

order in which ligaments are hurt in a lateral ankle sprain

A

Anterior talofibular
Calcaneofibular
Posterior talobibular

51
Q

foot pronation (eversion and dorsiflexion)

A

distal fibula posterior
fibular head anterior

52
Q

foot supination (pnatarflexion and inversion)

A

distal fibular anterior
fibular head posterior

treat with muscle energy

53
Q

swan neck deformition

MCP
PIP
DIP

A

MCP: flex
PIP: Extension
DIP: flexion

swans flex their neck

54
Q

a patient who has a interscalence brachial plexus nerve block that now has dyspnea and an elevated left hemidiaphragm on x ray is indicative of?

A

unilateral diaphragmatic paralysis

(black of the phrenic nerve)

55
Q

diaphrgam attachment points

A

xiphoid process of the sternum anteriorly

ribs 6-12 laterally

L1-L3 vetebral bodies posteriorly

56
Q

innominate shear

A

ASIS, PSIS, and pubic ramus all move on the same side

57
Q

pubic shear

A

pubic shear: only the pubic ramus moves

58
Q

rib 1-5 motion

A

pump handle

59
Q

rib 6-10 motion

A

bucket handle

60
Q

rib 11-12 motion

A

caliper

61
Q

true ribs

A

1-7

62
Q

false ribs

A

8-10

63
Q

floating ribs

A

11 and 12

64
Q

compression of condyles in infants can affect what

A

hypoglossal. nerve (XII)- difficulty latching

glossopharyngeal and vagus - difficulty swallowing and reflux

65
Q

what OMT technique can treat condylar compression and improve poor latching and suck in an infant

A

myofascial release of the occipital condyles

66
Q

HVLA is contraintidacted in patients with RA because

A

there can be atlatoaxial subluxation due to ligamentous instability of the transverse ligament and resultant spinal cord compression

inflammatory process leasts to ligament instability

67
Q

shoulder external rotators

A

infraspinatus and teres minor

68
Q

external rotation of the shoulder testing

A

flex the arm at the elbow 90 decrees and push the forearm laterally against resistance

69
Q

internal rotators of the shoulder

A

subscapularis and teres major

70
Q

internal rotation of the shoulder testing

A

patient place dorsum of hand behind back and ask them to lift their hand off the back against resistance

71
Q

what are the two longitudinal arches of the foot

A

medial and lateral

one transverse arch

72
Q

what bones are. in the lateral longitudinal arch

A

calcacenous, cuboid, talus, 4th and 5th metatarsal bones

73
Q

what bones are in the medial longitudinal arch

A

calcaenous, navicular, talus, cuneiform bones and 1st and 3rd metatarsal bones

74
Q

what bones are in the transverse tarsal arch

A

cuboid, navicular and cuneiform bones

75
Q

arches of the foot

A

medial and lateral longitudinal

transverse tarsal

76
Q

psoas syndrome findings

A

pelvic shift to the opposite side

nonneutral lumbar dysfunction

positive thomas test

medial ASIS tenderpoint 2/3 from midline

77
Q

iliolumbar ligament sprain has. atender point where

A

on the posterior iliac crest

78
Q

mild scoliosis without rapid curve progression is treated how?

with skeletal maturity (tanner stage 5)

A

symptomatic treatment with excersices and OMT- does not treat curve just help with symptoms

do not need surviellance imaging

5-19 is mild

79
Q

moderate scoliosis

A

20-49 uses spinal bracing

progression would be >5 degrees in 6 months

80
Q

severe scoliosis

A

greater than 50 degrees

surgical correction

81
Q
A
82
Q

symptoms of acute prostatitis

A

fever, chills, dysuria, and rectal pain

83
Q

testes innervation

A

sympathetic: lesser splanchinic T10-T11

parasympathetic: vagus

84
Q

testicular torsion symptoms

A

scrotal pain, swelling, high riding testicle, absent cremasteric reflex

85
Q

rib 1-2 which mucsle and how do you activate it

A

scalenes

rotate the head 30 degrees away from the side of the dysfunction and lift the head toward. theceiling

86
Q

rib 3-5 what muscle and how do you activate it

A

pectoralis minor

pusg elbow on the side of the affected rib toward the opposite ASIS

87
Q

rib 6-8 what muscle and how do you activate it

A

serratus anterior

place the forearm on the affected side on the forehead and push the arm anteriroly

88
Q

rib 9-10 what muscle and how do you activate it?

A

latissimus dorsi

move the abducted arm. onthe affected side towards the torso

89
Q

rib 11-12 what muscle and how to activate it

A

quadratus lumborum

move the hip toward the torso

90
Q

spondylolisthesis

A

anterior displacement of a lumbar vertebrae relative to. the one below it

**usually at L4, par interarticularis fracture, point tenderness, LBP, buttock pain

positive step off sign

confirmed by X-RAY

91
Q

spondylolysis

A

fracture. ofthe pars interarticularis

92
Q

sympathetic innervation to the kidneys and proximal ureter (uteropelvic junctino)

A

lesser splanchnic T10-T11

parasympathtic: vagus

93
Q

_ should be used to confrim a rotator cuff tear (pain and weakness) vs tedinopathy (pain)

A

MRI

94
Q

pheochromocytoma releases

A

metaneprhines

adrenal medulla tumor (2 inch superior 1 inch lateral) chapman point

95
Q

specialty test to differentiate between organic causes. andmalingering

A

hoover test

Patient is supine and. isasked to lift the affected leg off the table in flexion with the other knee kept in extension . if you feel the extended leg have downward pressure it is a positive test with a lack of true effort, if there is no reciprocal downward pressure of the extended leg this is a negative test

96
Q

direct muscle energy to treat anterior inominate rotation dysfunction would require. thepatient to contract what msucle

A

biceps femoris (puts into anterior rotation)- hamstring

rectus femoris puts it into posterior rotation)- quad

97
Q

HVLA of rib somatic dysfunctions is what type of pressure located where

A

anterior pressure directed at the costal angle

98
Q

chapman points. ofthe stomach

A

ICS 5-7 on the left

between spinous and transverse processes T5-T7 on the left

99
Q

upper adbominal pain + early satiety + widespread seborrheic keratosis is suggestive of?

A

gastric cancer

100
Q

cecum and ascednign colon sympathetics

A

SMA (t10-t11)

101
Q

distal 1/3 of transverse colon, desencing colon, sigmoid colon sympathtics

A

T11-L2 (IMA)

102
Q

supination of the forearm does what

A

radial head: anterior

distal radius “ posterior

103
Q

pronation of the radius does what

A

radial head: posterior

distal radius: anterior

104
Q

chronic pancreatitis symptoms

A

foul smelling diarrhea, weight loss, abdominal pain, history of tobacco and alcohol use

chapman points- between ribs 7-8 ICS on the right and between spinous and transverse processes. of T7-T8 on the right posteriorly

105
Q

right upper extremity lymphatic drainage

A

right lymphatic duct, right internal jugular vein, right subclavian vein, right brachiocephalic

drainage for right upper extremity, right side of head, and part of heart and lungs

106
Q

thoracic duct drainage

A

remainder of the body the right lymphatic duct doesnt get

thoracic duct, left internal jugular vein, left subclavian vein, left brachiocephalic

107
Q

the left and right subclavian vein drains combines to form

A

the SVC and drains into the atrium

108
Q

X-ray findings of aortic anureysm

A

widened aortic notch and mediastinum

109
Q

aorta hiatus

A

T12

110
Q

axillary nerve complications

A

SCM- sidebend towards and rotate away

trapezius- shoulder depression and winging of the scapula

111
Q

ovarian torsion

A

unilateral abdominal pain that worsens acutely , twists around the suspensory ligament

can lead to ischemia of the ovary

OPP COMAT U WORLD REVIEW (1 decks)

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