OPP Practical 1 Flashcards
attributed to Benjamin Rush (1745-1813)
Heroic Medicine
Benjamin Rush believed that the basis of all disease was
“physiologic tension,” particularly of the vasculature
“there is but one disease in the world” and treatment was by “depletion”
Rush: bloodletter, blistering, purging
a mercury-based cathartic that was commonly used for a variety of ailments
calomel
1864
Pivotal Year for AT Still
- personal tragedies (3 children died of spinal meningitis; infant daughter died of pneumonia; first wife died from childbirth)
- substance abuse in community (veterans addicted to alcohol/morphine)
- immersed hisself in anatomy and cadaveric dissection (grave robbing)
1874
Birth of Osteopathy
AT Still:
- “i was gradually approaching a science by study, research, and observation that would be a great benefit to the world.”
- “I flung to the breeze the banner of Osteopathy”
Four Tenets of Osteopathic Philosophy
- the body is a unit; person is a unit of mind, body, spirit
- body is capable of self-regulation, self-healing, health maintenance
- structure and function are reciprocally interrelated
- rational treatment is based upon an understanding of basic principles of body unity, self-regulation, and the interrelationship of structure and function
1892
American School of Osteopathy
- chartered May in Kirksville, Missouri
1918
“Spanish Flu” Pandemic
- over 500,000 Americans died
- OMM noted to be more effective than drug therapies
1961-62
The California Merger
- CaOA merged with CMA
- COPS in LA became CaCOM (UCI)
- DOs conferred MD degrees
complete system of medical care practiced by physicians with an unlimited license
Osteopathic Medicine
Osteopathic medicine emphasizes the ___ and has an appreciation of the body’s ___
interrelationship between structure and function; ability to heal itself
concept of health care supported by expanding scientific knowledge that embraces the concept of the unity of the living organism’s structure and function
Osteopathic Principles and Practices (OPP)
function
physiology
structure
anatomy
therapeutic application of manually guided forces by a DO to improve physiologic function and/or support homeostasis that has been altered by somatic dysfunction
Osteopathic Manipulative Treatment (OMT)
application of osteopathic philosophy, structural diagnosis and use of osteopathic manipulative treatment in the diagnosis and management of the patient.
Osteopathic Manipulative Medicine (OMM)
site of allopathic care
disease state
site of osteopathic care
host
hand you use most
dominant hand
exercise to determine dominant hand
clasp hands together, top hand is most likely dominant
exercise to determine dominant eye
both eyes open, circle an object, close each eye, the one with the object in the circle is dominant
why should we know the dominant hand and eye?
to know the “inherent bias” to minimize diagnostic inaccuracy
how can we minimize diagnostic inaccuracy
by knowing the inherent bias of hand and eye dominance
application of fingers to the surface of the skin or other tissues, using varying amounts of pressure, to selectively determine the condition of the parts beneath
palaption
diagnostic touching includes:
explanation of intention, nature of touching, its purpose, what the patient is likely to experience
feeling via psychomotor skills
detection
seeing structures being palpated and creating a visual mind-image
internal amplification
thinking and knowing functional anatomy, physiology, and pathophysiology (between normal and abnormal)
analysis and interpretation
part of the hand that has the most touch (kinesthetic) nerve endings
finger pads
parts of the hand that are most sensitive to train and use for palpation
thumb and first two finger pads
part of the hand that senses temperature
free nerve endings
part of the hand that senses vibrations
Pacinian Corpuscle
part of the hand that senses 2-point discrimination
Meisner Corpuscle
part of the hand that senses stretch
Ruffini Corpuscle
part of the hand that senses degree of pressure
Merkel Disc
sensitive to pressure and vibration (rapidly adapting)
Pacinian Corpuscles-mechanoreceptor
sensitive to light touch and very sensitive to vibration (rapidly adapting)
Meissner Corpuscles-mechanoreceptor
sensitive to vibration (slow adapting); receptive to sustained response to pressure
Merkel Disc-mechanoreceptor
sensitive to stretch (slow adapting); registers degree changes in joint position, and registers thermal changes for prolonged periods of time
Ruffini Terminals
what can you observe with very light touch
- temperature
- texture / topography
- thickness
- elasticity
- moistness (sweat gland)
- oiliness (sebaceous gland)
- tone
what can be found throughout the body’s tissues
- shape
- irritability
- tissue tension
- tenderness
- motion
use this part of the hand when checking temperature
dorsum of hand and volar aspect of wrist
use the dorsum of hand and volar aspect of wrist to test
temperature
planes of motion: bowing forward
sagittal plane
planes of motion: jumping jacks
coronal (frontal)
planes of motion: trunk twist
transverse (horizonal/axial)
superior
cranial
inferior
caudal
posterior
dorsal
anterior
ventral
top to bottom anterior mid-gravity line
glabella symphysis menti episternal notch mid-sternum xyphoid process umbilicus pubic symphysis mid-heel point
top to bottom posterior mid-gravity line
inion spinous processes of - cervical vertebrae - thoracic vertebrae - lumbar vertebrae - sacral vertebrae gluteal crease mid-heel point
anterior landmarks
coracoid process
clavicle
anterior superior iliac spine (ASIS)
posterior landmarks
vertebra prominens (C7) scapular spine medial border scapula interior angle scapula iliac crest posterior superior iliac spine
acromion
greater tubercle humerus
greater trochanter femur
top to bottom lateral mid-gravity line
external auditory meatus (canal)
greater tuberosity of humerus (on lateral head)
(radiographic observation only)
- mid-body of L3
- sacral promontory (anterior 3rd of sacrum)
greater trochanter of femur
lateral condyle of knee
lateral malleolus
use the 5 models in patient assessment and treatment for
- adaptation to stressors
- recovery and repair from illness and disease
reflects numerous signs relating to internal diseases
musculoskeletal system
provides framework for interpreting significance of somatic dysfunction within context of objective and subjective clinical information
5 Models
5 Models provides framework for interpreting significance of
somatic dysfunction
2006
WHO recognized osteopathic 5 model concept
the 5 models include:
- Biomechanical
- Respiratory-Circulatory
- Neurological
- Metabolic-Energy
- Behavioral
postural muscles, spine, extremities
anatomical correlates of biomechanical model
thoracic inlet, thoracic and pelvic diaphragms, tentorium cerebelli, costal cage
anatomical correlates of respiratory-circulatory model
internal organs, endocrine glands
anatomical correlates of metabolic-energy model
head (special sensing organs), brain, spinal cord, ANS, peripheral nerves
anatomical correlates of neurological model
brain
anatomical correlate of behavioral model
posture and motion
physiological function of biomechanical model
respiration, circulation, venous and lymphatic drainage
physiological function of respiratory-circulatory model
metabolic processes, homeostasis, energy balance, regulatory processes
physiological function of metabolic-energy model
control, coordination and integration of body functions
physiological function of neurological model
psychological and social activities
physiological function of behavioral model
digestion, absorption of nutrients, removal of waste
physiological function of metabolic-energy model
immunological activities, inflammation and repair
physiological function of metabolic-energy model
reproduction
physiological function of metabolic-energy model
protective mechanisms
physiological function of neurological model
sensation
physiological function of neurological model
habits
physiological function of behavioral model
values, beliefs, attitudes
physiological function of behavioral model
objective: optimize patient’s adaptive potential through restoring structural integrity and function
biomechanical model
objective: affect patient’s adaptive response and total homeostatic (health) potential
addresses dysfunction in respiratory mechanics, circulation, flow of body fluids
respiratory-circulatory model
central neural control, CSF fluid flow, pulmonary and cardiovascular function
central processes of the respiratory-circulatory model
arterial supply, venous and lymphatic drainage
peripheral processes of the respiratory-circulatory model
objective: focuses on impairments of neural function caused by pathophysiologic responses and the relationship btwn somatic/visceral autonomic systems
focus on reduction of mechanical stresses, balance of neural inputs, elimination of nociceptive drive
neurological model
objective: maintain balance between energy production, distribution, and expenditure
addresses dysfunction that can dysregulate production, distribution, or expenditure of energy; increase allostatic load; interfere with immunological and endocrine regulatory functions
metabolic-energy model
objective: improve body’s ability to effectively manage, compensate, or adapt to stressors
behavioral model
capable of modulating homeostatic rhythms; effecting appropriate changes necessary for promoting survival
neuroendocrine-immune system
greater pain sensation
primary hyperalgesia
non-noxious stimuli elicits sensation of pain
allodynia
most responsive system to novel or unwanted stimuli (somatic, visceral, emotional dysfunctions)
arousal system
prepares body for defense by facilitating healing, suppressing pain pathways, and modulating immune system
neuroendocrine-immune network
tendency of body to seek and maintain a condition of balance/equilibrium within its internal environment
homeostasis
maintenance of stability through change
allostasis
suppresses levels of allostatic compounds to return body to normal function
feedback control systems
convergence of multiple pathways on a common mechanism facilitate summation of differing drives to obtain
a more intense response
trauma or injury including somatic dysfunction
somatic stressors
traumatic injury, infection, or inflammation of visceral organs (subtle, diet-related events)
visceral stressors
stress response
emotional stressors
frequent activation of stress response damages the body chronically through activation of
hypothalamic-pituitary adrenal (HPA) axis
price paid for chronic exposure to stress-mediated neuroendocrine adaptations
allostatic load
long term activation of allostatic mechanism leads to
gradual destruction of organ systems
gradual loss of effectivess of feedback pathways reestablish
normal homeostasis
degenerative and inflammatory disease
correlated to increased occurrence of cardiovascular risk
memory and depression (CNS)
multiple, complex effects on immune system
disease processes affected by allostatic load
less room for further adaptation in compensated state (structural/metabolic) to increased or new stressor
chronic compensatory state
observation of skin, static landmarks, asymmetry
static postural exam (OSE)
gait, range of motion (cervical, thoracic, lumbar, ribs, sacrum), special tests
dynamic postural exam (OSE)
designed to determine rapidly where the most significant somatic dysfunctions reside
sensitive to the discovery of the presence of dysfunction, but not specific for tissues responsible for creating/maintaining dysfunction
OSE
movement produced voluntarily by the patient
active motion
motion that induced by the practitioner while patient remains relaxed
passive motion
patient actively fully abducts both arms in coronal plane over head (physician stands in front or behind)
overhead upper extremity quick test
patient raises arms 90 degrees and squats down as far as possible with feet flat on the floor (physician stands with posterolateral view)
squat test
what is a positive squat test
patients heels lifting off the floor and patient unable to bend knees past 90 degrees
thumbs under surface of PSIS, patient bends forward with legs straight, follow PSIS movement
standing flexion test
side of pelvis restriction
PSIS stops moving superiorly last (standing flexion)
side of sacrum restriction
PSIS stops moving superiorly last (seated flexion)
___ is the process of enabling individuals, groups, or societies to ___ over and to ___ their physical, mental, social, and spiritual health.
This could be reached by ___ and societies characterized of ___ and ___ who are able to ___ internal and external resources, ___ and ___ them to ___, to ___, and to ___ or ___ with ___ in a ___
Salutogenesis:
health/life promotion; increase control; improve
creating environments; clear structures; empowering environments; active participating subjects; identify; use; reuse; realize aspirations; satisfy needs; perceive meaningfulness; change; cope; the environment; health promoting manner
goals of osteopathic care include:
remove restrictions or optimize function
impaired or altered function of related components of the somatic (body framework) system; skeletal, arthrodial, and myofascial structure, and related vascular, lymphatic and neural elements
somatic dysfunction
of, relating to, or affecting the body, especially as distinguished from a body part, the mind, or the environment; corporeal or physical
somatic
abnormal or impaired functioning, especially of a bodily system or organ
dysfunction
somatic dysfunction that maintains a total pattern of dysfunction including other key lesions
primary somatic dysfunction
primary somatic dysfunction is the initial somatic dysfunction to appear
temporally
somatic dysfunction arising in response from a primary somatic dysfunction
secondary somatic dysfunction
somatic dysfunction arising as a consequence of other etiology
secondary somatic dysfunction
impairment or altered function of related components of the body framework system that is characterized in early states by one or more of the following: pain, erythema, palpable sense of relative warmth, moisture and bogginess, vasodilation, edema, tenderness, and tissue contraction (TART)
acute somatic dysfunction
impairment or altered function of long-standing duration of related components of the body framework system characterized by one or more of the following: itching, paresthesias, palpable sense of tissue dryness, coolness, tissue contracture, fibrosis, tenderness and pallor
chronic somatic dysfunction
increased temperature, boggy/rough texture, increased moisture, board-like/rigid tension, greatest tenderness, edema, congested vessels
acute tissue texture changes
slight increase or decrease in temperature, thin/smooth texture, dry, ropy/stringy tension, present or absent tenderness, neovascularization of vessels
chronic tissue texture changes
red, hot, swollen, pain, decreased function
acute
white, cool, thin, ?pain, decreased function
chronic
TART stands for:
T - tissue texture abnormality
A - asymmetry
R - restriction of motion
T - tenderness
limit of passive range of motion; point past which tissue disruption occurs
anatomic barrier
limit of active motion; as far as the patient can go without assistance
physiologic barrier
range between the physiologic and anatomic barrier of motion in which passive ligamentous stretching occurs before tissue disruption
elastic barrier
functional limit (within the anatomic range of motion) that abnormally diminishes the normal physiologic range
restrictive barrier
restriction of joint motion associated with a pathologic change of tissues
pathologic barrier
joint restriction, muscular contracture, ischemic contracture, fascia
causes of restrictive barrier
any limitation of movement before the physiologic barrier establishes a restrictive barrier
pathologic barrier
irritation and neuro-circulatory changes (red reflex) indicate somatic dysfunction
erythema friction rub
flexion: ___ movement in a ___ plane about a(n) ___ axis
anterior; sagittal; transverse
extension: ___ movement in a ___ plane about a(n) ___ axis
posterior; sagittal; transverse
sidebending: movement in a ___ plane about a(n) ___ axis
coronal; anterior-posterior
rotation: movement in a ___ plane about a(n) ___ axis
transverse; vertical
motion of a vertebrae is described relative to
the vertebrae below it
motion reference point is on the ___ and ___ part of the ___
superior; anterior-most; vertebral body
motion is limited by the orientation of the
zygapophyseal joints
A point of tissue or articular balance from which all motions physiologic to that structure may take place
neutral
The range of sagittal plane spinal positioning in which the facets are not yet engaged
neutral
Facets articulatory surfaces are stretched away from each other, termed “open”
flexion
Facet articulatory surfaces are pushed into each other, termed “closed”
extension
Fryette’s Principle:
I. when the thoracic and lumbar spine are in ___ position, the coupled motions of ___ and ___ for a ___ are such that both motions occur in ___ directions
neutral; sidebending; rotation; group of vertebrae; opposite
Fryette’s Principle:
II. when the thoracic and lumbar spine are ___ or ___, the coupled motions of ___ and ___ in a ___ occur in the ___ direction
sufficiently forward; backward bent (non-neutral); sidebending; rotation; single vertebral unit; same
Fryette’s Principle:
III. initiating motion of a vertebral segment in any plane of motion will modify the movement of that segment in
other planes of motion
Type 1 ___ (Fryette’s)
in a ___ position, if one direction of motion is introduced, sidebending or rotation will occur in the ___ direction
mechanics
neutral; opposite
Type 1 ___ (Fryette’s)
tends to occur in ___ of ___ consecutive vertebrae
somatic dysfunction
groups; 3+
Type 2 ___ (Fryette’s)
when a ___ thoracic or lumbar vertebral unit flexes or extends beyond the ___ position the coupled motions of sidebending and rotation occur in the ___ direction
mechanics
single; neutral; same
acute process maintained by restrictions in short paraspinal muscles
Type 2 somatic dysfunctions
If motion is restricted in any one direction, the other two directions will be restricted as well
Fryette’s 3rd Principle
dysfunctions that can exist within a Type I segmental group curve
Type II segmental
describe a dysfunctional segment
Type 2 mechanics
describe either a dysfunctional group curve or normal physiologic motion of the spine with rotation and sidebending in opposite directions while moving in a neutral plane
Type I mechanics
multiple segments, opposite sidebending/rotation, neutral spine, lateral curve appearance, gradual onset
Type I mechanics
single segment, same sidebending/rotation, flexion or extension spine, flattening or exaggeration of anteroposterior curve appearance, abrupt onset
Type II mechanics
Somatic dysfunction is maintained by the facet joint itself; often accompanied by a reflex muscle guarding response that will not relax until the articular “lock” is release
Arthrodial restrictions
hypertonicity causes asymmetry and restricted motion
muscular restrictions
muscle restriction that crosses one vertebral segment/joint and alters position and motion of a single vertebra (type II)
short restrictor muscles
deep segmental spinal muscles
short restrictor muscles
muscle restriction that crosses more than one vertebral segment/joint and alters position and motion of groups of vertebrae (type I)
long restrictor muscles
intermediate spinal muscles
long restrictor muscles
variable (type I or II) and often painful
superficial muscles
causes fascial distention that leads to pain and guarding
edema
causes less slack (“give”) in the tissues
edema
increased local fluid
edema
Rule of 3s
Thoracic Spine:
T1-3: spinous and transverse at same level
T4-6: spinous is 1/2 level below transverse
T7-9: spinous is one full v level below transverse
T10: one full
T11: 1/2
T12: same
somatic dysfunctions are named for the ___, not the ___
direction of ease; restriction
one transverse process is superficial, other is deep
rotation
one transverse process is superior (further away) from transverse below it, and one will be inferior (closer)
sidebending
engage the restrictive barrier
direct techniques
disengage the restrictive barrier
indirect techniques
treatment that is both direct and indirect, and both active and passive
myofascial release
treatment that is direct and passive
soft tissue technique
tissues that connect, support, or surround structures and organs of the body (connective and non connective tissue)
soft tissue
tendons, ligaments, fascia, fibrous tissues, fat, synovial membranes
connective tissue
muscles, nerves, blood vessels
non-connective tissue
direct technique that involves kneading, stretching, deep pressure, traction and/or inhibition while monitoring tissue response and motion changes by palpation
soft tissue technique
hypertonic muscles, excessive tension in fascial structures, abnormal vicerosomatic / somatosomatic / somatovisceral reflexes
any clinical conditions that would benefit from improving circulation
indications for soft tissue technique
lack of patient consent and/or cooperation
absolute contraindications for soft tissue technique
caution for local applications/ the area being tested (fractures, open wounds, etc)
relative contraindications for soft tissue technique
Traction, Linear stretching, Lateral stretching, Deep pressure
principles of soft tissue technique
sustained linear force acting to draw structures apart
traction
origin and insertion of the myofascial structures are longitudinally separated
traction
traction is the sustained ___ force acting to draw structures apart; origin and insertion of the myofascial structures are ___ separated
linear; longitudinally
linear and lateral stretching consist of a rhythmic, ___ motion
kneading
direction of force is applied parallel to the long axis of the structure
linear stretching
origin and insertion are stationary, central portion is stretched perpendicularly to the long axis (bowstring)
lateral stretching
sustained inhibitory pressure over a hypertonic myofascial
deep pressure
stroking movement used to move fluid
effleurage
deep kneading or squeezing action to express fluid
petrissage and skin rolling
striking the belly of a muscle with the hypothenar edge of the open hand in rapid succession in an attempt to increase its tone and arterial perfusion
tapotement
a myofascial release massage technique used to break adhesive bands from the skin to deeper tissue
skin rolling
A-P curves
kyphosis and lordosis
lateral curves
paravertebral humping
performed passively for upper thoracics (T1-4) use head and neck, lower thoracics (T5-12) use shoulder and torso
thoracic segmental motion testing
backward bending position
sphinx position
treatment force applied to correct a somatic dysfunction
activating force
treatment force external to the patient
extrinsic force
voluntary or involuntary force from within the patient that assists in the manipulative treatment process
intrinsic force
nature’s tendency toward balance and homeostasis
inherent force
technique with more emphasis on extrinsic/intrinsic forces, with limited range of applicability in patients with comorbidities and low levels of vitality
direct technique
treatment with more emphasis on inherent forces, with wide range of applicability in patients of all ages and levels of health
indirect technique
A direct treatment method which the patient’s muscles are employed upon request, from a precisely controlled position, in a specific direction, and against a distinctly executed physician counterforce
muscle energy technique (MET)
A group of direct techniques that usually involve lateral stretching, linear stretching, deep pressure, traction &/or separation of muscle origin and insertion while monitoring tissue response and motion changes by palpation.
soft tissue technique
An osteopathic method in which the restrictive barrier is engaged in one or more planes or motion and then a rapid, therapeutic force of brief duration traveling a short distance is applied within the anatomic range of motion of a joint.
high velocity low amplitude (HVLA)
thrust treatment method
high velocity low amplitude (HVLA)
A direct treatment method employing a low velocity/moderate to high amplitude force applied to a dysfunctional joint through either A repetitive springing motion or A single movement of the joint through the restrictive barrier
articulatory low velocity high amplitude (LVHA)
A treatment method which utilizes continual palpatory feedback to alleviate restriction of the somatic dysfunction and its related fascia and musculature.
myofascial release (MFR)
The dysfunctional myofascial tissues are loaded and restrictive barrier is engaged with a constant force
direct MFR
The dysfunctional myofascial tissues are loaded and then guided toward the position of greatest ease
indirect MFR
a generalized term for the sheets and layers of connective tissue that envelop specific structures and segregate one structure, organ, or area from another
fascia
outermost later, just underlying the epidermis and dermis; contains adipose tissue
superficial / pannicular fascia
surrounds muscles, tendons, bones, ligaments, and aponeuroses of the body; creates tubes of fascia surrounding muscles; connects torso to the extremities
deep / investing (axial and appendicular) fascia
surrounds the neural structures (dura, arachnoid, pia maters); terminates into the epineurium of peripheral nerves
meningeal fascia
surrounds body cavities (pleural, pericardial, peritoneal)
visceral fascia
packaging, protection, position, passageways
function of fascia
divides body into compartments
packaging
stabilizes structures and establishes limits of motion
protection
contain proprioceptors that sense movement
positioning
75% of proprioception occurs in
fascial sheaths
25% of proprioception occurs in
ligaments, tendons, joint capsules, and muscle spindle activity
channel for arteries, veins, nerves, and lymphatics to pass through
passageways
release of energy
hysteresis
“The fascia is the place to look for the cause of disease and the place to consult and begin the action of remedies in all diseases”
AT Still
looseness, ease, freedom
compliance
stiffness, tightness, binding
restriction
palpable resistance to motion of an articulation or tissue
bind
relative palpable freedom of motion of an articulation or tissue
ease
the capacity of fascia and other tissue to lengthen when subjected to a constant tension load resulting in less resistance to a second load application
creep
thoracic inlet/outlet MFR
“steering wheel”
direct and active technique
muscle energy
somatic dysfunction of myofascial origin or of articular origin
primary muscle energy indication
improve local circulation and respiratory function; balance neuromuscular relationships by altering muscle tone; increase tone in hypotonic or weak muscles
secondary muscle energy indication
fracture or dislocation in region being treated
absolute contraindication
moderate to severe strains, severe osteoporosis, severe illness
relative contraindications
the point where the restrictive barrier is just beginning to be engaged
feather’s edge
the point where the practitioner just begins to palpate the tension in the tissues
feather’s edge
muscle energy procedures
“3 to 5” rule
- ounces of force
- seconds
- times repeated
muscle energy technique Reduces ___ activity in the tight muscle by activating ___
extrafusal muscle mass; Golgi stretch reflexes;
muscle energy technique inhibits/resets the ___ to the ___
gamma gain; muscle spindles
Contraction of agonist muscle causes reciprocal inhibition of antagonist, allowing antagonist to relax and lengthen, so joint motion can occur under influence of agonist
reflex inhibition (relaxation) of antagonist
Golgi tendon apparatus, in series with extrafusal muscle fibers, senses muscle tension
Active contraction of muscle (such as in an isometric fashion with MET) increases tension on Golgi tendon apparatus, resulting in reflex relaxation of that agonist muscle in the post-isometric period
golgi receptor reflex inhibition of agonist
This post-isometric period allows the opportunity for passive stretching of tightened muscles, returning them to normal resting length
neuromuscular refractory period post contraction (Mitchell’s view)
Activation of muscles used to move a dysfunctional segment back into alignment
“rope and pulley” mechanism
Under a fixed tension, the distance between muscle’s origin & insertion is unchanged
isometric muscle contraction
most common type of muscle contraction used in MET
isometric
While a contracting muscle, under a constant load, experiences a decrease in the distance between that muscle’s origin & insertion points (approximation)
concentric isotonic muscle contraction
patient “wins,” muscles shorten
concentric isotonic muscle contraction
physician “wins,” muscles lengthen
eccentric isotonic muscle contraction
While a contracting muscle, under a constant load, experiences an increase in the distance between that muscle’s origin & insertion points (separation)
eccentric isotonic muscle contraction
under an external tension greater than the intrinsic muscle force, the distance between muscle’s origin and insertion is increased
isolytic muscle contraction
MET to accomplish muscle relaxation
post-isometric relaxation
MET to lengthen a muscle shortened by cramp or acute spasm
reciprocal inhibition
MET to augment a corrective force toward a restrictive barrier
respiratory assistance
“a release enhancing maneuver”
respiratory assistance
MET to affect reflex muscle contractions using eye motion
oculocephalogyric reflex
enables humerus to achieve 180 abduction
sternoclavicular joint
saddle shaped joint made up of the medial end of the clavicle, manubrium of sternum, and cartilage of first rib
sternoclavicular joint
joints with cartilaginous articular disc
sternoclavicular joint
only attachment for upper extremity to axial skeleton
sternoclavicular joint
made up of the acromion process of scapula and lateral edge of clavicle
acomioclavicular joint
radius “crosses over” ulna
pronation
radiocarpal > midcarpal joint
flexion
midcarpal > radiocarpal joint
extension
glenohumeral joint treatment
spencer technique
stages of spencer technique
Extension
Flexion
Circumduction Compression
Circumduction Traction
Abduction, Adduction/External Rotation
Internal Rotation
Distraction in Abduction (Joint Pump)
