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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
chapman point of the urethra
anterior: on the pubic symphysis posterior: on the transverse process of L3
25
Lumbosacral spring test
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
26
psoas syndrome symptoms
LBP lumbar somatic dysfunctions positive thomas test (painful hip extension)
27
innominate inflare treated with direct muscle energy cause the patient to contract which muscle
adductor magnus (medial rotator of the hip)
28
innominate outflare treated with direct muscle energy causes the patient to contract which muscle
gluteus maximus
29
schapoid frfacture pain
lateral wrist pain and tenderness in the snuff box confirm by X ray!!
30
treatment of scaphoid fracture
immbolization and orthopedic evaluation
31
progressive and chronic low back pain that radaites down the leg and sensory loss (numbness and tingling) is caused by
spinal stenosis (narrowing of the spinal canal or intervertebral foramen) | facet joint oeteophytes and ligamentum flavum hypertrophy
32
in spinal stenosis symptoms are worse with
lumbar extension and relieved by lumbar flexion (leaning on stroller)
33
L5 nerve root compression | L5-S1 affects L5
anterior lower leg sensory loss and dorsal doot
34
iliotibial band syndrome findings
lateral knee pain, tenderness over the right lateral femoral epicondyle positive ober test
35
treatment of iliotibilar band syndrome
rest/ice/NSAIDS PT Stretching
36
how do you stretch the IT band
sit on the floor and cross the affected leg over the unaffected leg, pull affected leg medially hold for 30 seconds and then repeat
37
how to stretch the hip adductor muscle
felx, abduct and externally rotate
38
how to stretch the hamstrings and gluteal muscles
flex the hip. extend the knee in the supine position
39
standing with the right leg over the left leg and bending at the torso whoucl stretch what muscle
left IT band along the hamstring
40
contraction of the SCM
sidebending of the neck to the same side and rotation of the neck to the opposite side
41
in sacral torsions L5 rotates in the _ direction of the sacrum and sidebends _ the oblique axis
opposite SB towards
42
direct reciprocal inhibition
direct muscle energy technique that causes reciprocal antagoinist contraction to relax the hypertonic agonist muscle
43
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?
acute diverticulitis which is common in the sigmoid colon ## Footnote 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
44
esophagus chapman point
ICS between ribs 2-3 between spinous process and transverse process of T2 posteriorly ## Footnote esophagitis: thrush and burning chest pain- common in immunocompromised
45
wrist flexion = _ bone glide
dorsal
46
wrist extension = _ bone glide
ventral
47
axillary nerve injury
lateral shoulder sensory loss, deltoid muscle weakness (cant hold abducted position)
48
difficulty maintaing hand grip
ulnar nerve
49
lateral forearm sensory loss
musculoskeletal nerve injury + weakened elbow flexion
50
order in which ligaments are hurt in a lateral ankle sprain
Anterior talofibular Calcaneofibular Posterior talobibular
51
foot pronation (eversion and dorsiflexion)
distal fibula posterior fibular head anterior
52
foot supination (pnatarflexion and inversion)
distal fibular anterior fibular head posterior ## Footnote treat with muscle energy
53
swan neck deformition MCP PIP DIP
MCP: flex PIP: Extension DIP: flexion ## Footnote swans flex their neck
54
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?
unilateral diaphragmatic paralysis (black of the phrenic nerve)
55
diaphrgam attachment points
xiphoid process of the sternum anteriorly ribs 6-12 laterally L1-L3 vetebral bodies posteriorly
56
innominate shear
ASIS, PSIS, and pubic ramus all move on the same side
57
pubic shear
pubic shear: only the pubic ramus moves
58
rib 1-5 motion
pump handle
59
rib 6-10 motion
bucket handle
60
rib 11-12 motion
caliper
61
true ribs
1-7
62
false ribs
8-10
63
floating ribs
11 and 12
64
compression of condyles in infants can affect what
hypoglossal. nerve (XII)- difficulty latching glossopharyngeal and vagus - difficulty swallowing and reflux
65
what OMT technique can treat condylar compression and improve poor latching and suck in an infant
myofascial release of the occipital condyles
66
HVLA is contraintidacted in patients with RA because
there can be atlatoaxial subluxation due to ligamentous instability of the transverse ligament and resultant spinal cord compression ## Footnote inflammatory process leasts to ligament instability
67
shoulder external rotators
infraspinatus and teres minor
68
external rotation of the shoulder testing
flex the arm at the elbow 90 decrees and push the forearm laterally against resistance
69
internal rotators of the shoulder
subscapularis and teres major
70
internal rotation of the shoulder testing
patient place dorsum of hand behind back and ask them to lift their hand off the back against resistance
71
what are the two longitudinal arches of the foot
medial and lateral ## Footnote one transverse arch
72
what bones are. in the lateral longitudinal arch
calcacenous, cuboid, talus, 4th and 5th metatarsal bones
73
what bones are in the medial longitudinal arch
calcaenous, navicular, talus, cuneiform bones and 1st and 3rd metatarsal bones
74
what bones are in the transverse tarsal arch
cuboid, navicular and cuneiform bones
75
arches of the foot
medial and lateral longitudinal transverse tarsal
76
psoas syndrome findings
pelvic shift to the opposite side nonneutral lumbar dysfunction positive thomas test medial ASIS tenderpoint 2/3 from midline
77
iliolumbar ligament sprain has. atender point where
on the posterior iliac crest
78
mild scoliosis without rapid curve progression is treated how? ## Footnote with skeletal maturity (tanner stage 5)
symptomatic treatment with excersices and OMT- does not treat curve just help with symptoms | do not need surviellance imaging ## Footnote 5-19 is mild
79
moderate scoliosis
20-49 uses spinal bracing ## Footnote progression would be >5 degrees in 6 months
80
severe scoliosis
greater than 50 degrees surgical correction
81
82
symptoms of acute prostatitis
fever, chills, dysuria, and rectal pain
83
testes innervation
sympathetic: lesser splanchinic T10-T11 parasympathetic: vagus
84
testicular torsion symptoms
scrotal pain, swelling, high riding testicle, absent cremasteric reflex
85
rib 1-2 which mucsle and how do you activate it
scalenes rotate the head 30 degrees away from the side of the dysfunction and lift the head toward. theceiling
86
rib 3-5 what muscle and how do you activate it
pectoralis minor pusg elbow on the side of the affected rib toward the opposite ASIS
87
rib 6-8 what muscle and how do you activate it
serratus anterior place the forearm on the affected side on the forehead and push the arm anteriroly
88
rib 9-10 what muscle and how do you activate it?
latissimus dorsi move the abducted arm. onthe affected side towards the torso
89
rib 11-12 what muscle and how to activate it
quadratus lumborum move the hip toward the torso
90
spondylolisthesis
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
spondylolysis
fracture. ofthe pars interarticularis
92
sympathetic innervation to the kidneys and proximal ureter (uteropelvic junctino)
lesser splanchnic T10-T11 ## Footnote parasympathtic: vagus
93
_ should be used to confrim a rotator cuff tear (pain and weakness) vs tedinopathy (pain)
MRI
94
pheochromocytoma releases
metaneprhines adrenal medulla tumor (2 inch superior 1 inch lateral) chapman point
95
specialty test to differentiate between organic causes. andmalingering
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
direct muscle energy to treat anterior inominate rotation dysfunction would require. thepatient to contract what msucle
biceps femoris (puts into anterior rotation)- hamstring rectus femoris puts it into posterior rotation)- quad
97
HVLA of rib somatic dysfunctions is what type of pressure located where
anterior pressure directed at the costal angle
98
chapman points. ofthe stomach
ICS 5-7 on the left between spinous and transverse processes T5-T7 on the left
99
upper adbominal pain + early satiety + widespread seborrheic keratosis is suggestive of?
gastric cancer
100
cecum and ascednign colon sympathetics
SMA (t10-t11)
101
distal 1/3 of transverse colon, desencing colon, sigmoid colon sympathtics
T11-L2 (IMA)
102
supination of the forearm does what
radial head: anterior distal radius " posterior
103
pronation of the radius does what
radial head: posterior distal radius: anterior
104
chronic pancreatitis symptoms
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
right upper extremity lymphatic drainage
right lymphatic duct, right internal jugular vein, right subclavian vein, right brachiocephalic ## Footnote drainage for right upper extremity, right side of head, and part of heart and lungs
106
thoracic duct drainage
remainder of the body the right lymphatic duct doesnt get thoracic duct, left internal jugular vein, left subclavian vein, left brachiocephalic
107
the left and right subclavian vein drains combines to form
the SVC and drains into the atrium
108
X-ray findings of aortic anureysm
widened aortic notch and mediastinum
109
aorta hiatus
T12
110
axillary nerve complications
SCM- sidebend towards and rotate away trapezius- shoulder depression and winging of the scapula
111
ovarian torsion
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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