OPP review 1 Flashcards
Osteopathic structural examination reveals a positive seated flexion test on the right, a shallow right sacral sulcus, a deep left inferior lateral angle, and a positive lumbosacral spring test. The most likely intersegmental dysfunction present at L5 is
Flexed SDL RL
A 10-year-old female presents to the office with the complaint of headaches. History reveals the patient was hit in the left ear during a softball game six months prior. There were no neurological deficits after the injury and a CT of the head was negative. Physical examination reveals tenderness and restriction over the coronal suture on the left. The most appropriate osteopathic manipulative technique for the patient’s somatic dysfunction is
V-spread technique is the most appropriate osteopathic technique for treating isolated somatic dysfunctions at any cranial suture.
What is the indication for a parietal lift?
The parietal lift is used to correct dysfunction chiefly in the squamous suture. Gentle traction is applied upward to “lift” the parietal bone relative to the rest of the skull. This technique does not address the coronal suture.
Chapman point for appendix Anterior Posterior
Anterior tip of the 12th rib on the right. Posterior T11 intertransverse space. Treatment of a Chapman’s point consists of firm rotary motion over the point.
Sixth intercostal space mid clavicular on the right
This is the anterior Chapman’s point for the gallbladder. It would be present in cholecystitis
While palpating the cranium in the vault hold, you notice that the greater wings of the sphenoid seem to shift to the right, while base of the sphenoid deviates left in relation to occiput. What strain pattern is this?
Left Lateral strain Named for the base
When treating with an “Articulation technique” what structure must be stabilized? Ex: L2 FRLSL,
In seated articulatory technique to the lumbar spine, the vertebra BELOW the dysfunctional segment must be stabilized: using the torso as a lever. Dysfunctional vertebra is L2 so L3 should be stabilized at the spinous process. If you were treating this in the lateral recumbent position, utilizing the legs as the lever, you would stabilize L2 to move L3 through full range of motion in order to treat the L2 segment. Remember that when diagnosing L2 dysfunction, you are really diagnosing dysfunction in how well L2 articulates on L3.
On physical examination, there is a chronic, fibrotic appearance to the thoracolumbar fascia on the right, with an ease in cephalad and clockwise motion. You decide to treat with direct myofascial release treatment. What is the correct treatment position?
Going direct means going into the restriction. Since “ease” is cephalad and clockwise, you go the opposite the engage the dysfunction. Apply a force down to the fascial layer and hold caudad and counterclockwise until a release is felt.
Mneumonic BITE
Bottom Inhalation top exhalation
For a pt who is T4 to T8 neutral, side-bent right, rotated left with HVLA,
What is the correct hand placement and vertebral segment to address first when performing supine, short-lever, rotational emphasis HVLA for T4 to T8 neutral, side-bent right, rotated left?
Right thenar eminance under the Pt T6 Transverse process.
The physician side-bends the patient left, down to the T6-T7 junction, and the side-bending and rotation forces are localized at the T6 fulcrum by adjusting accordingly
(HVLA) T1:
- Treat the middle vertebral segment in the first.
- T6 should be addressed first when performing HVLA.
- HVLA of the mid-thoracic vertebrae and ribs–>Kirksville crunch
- Uses thenar eminence of the opposite hand to localize and apply a HVLA thrust to the desired treatment area.
SF +L
ILA+ L
Sacral Sulcus R
Spring Tst +
What is L5 doing?
L torsion on right oblique axis
A 1-week-old male presents after requiring vacuum suction. Physical examination reveals a well-appearing infant with a parallelogram-shaped cranium with the base of the sphenoid deviated to the left in relation to the base of the occipital bone
What are the axes of rotation for the patient’s dysfunction at the sphenobasilar synchondrosis?
Question is asking what the axis for lateral strain is:
2 vertical axis
Physical examination reveals a well-appearing infant with a parallelogram-shaped cranium with the base of the sphenoid deviated to the left in relation to the base of the occipital bone.
left lateral strain
19
You position the patient in the right lateral recumbent position and stand facing the patient. You position the patient’s left leg so that it drops over the side of the table. You rotate the patient’s left shoulder posterior towards the left and rotate the pelvis anteriorly, inducing further left rotation and right side-bending. After all slack is taken up, you induce a small thrust and find, after reassessment, that the somatic dysfunction has improved. What is the exact diagnosis for this patient’s L5 somatic dysfunction?
?
HVLA for Type I lumbar somatic dysfunctions:
Pt put lateral recumbent position involves positioning the patient rotational side down, dropping the upper leg off the table, rotating the pelvis anteriorly and the upper shoulder posteriorly. This induces opposite directions of rotation and side bending. In a Type II lumbar somatic dysfunction, the upper leg is dropped off the table with the foot in the popliteal fossa. The upper hip and shoulder are then approximated together to induce rotation and side bending the same direction.
The occipito-atlantal (OA) joint is restricted in translation to the left; however, sidebending is symmetric when the OA is placed in the extended position. The most likely diagnosis is
OA is extended and Sd L rotated right
A Foosh injury will result in what type of radial head dysfunction?
What is the patient falls back?
Posterior radial head–> stuck in pronation and posterior glide
Treatment: MET: Put to restriction barrier in supination. Ask patient to pronate arm then move to new supination barrier.
Anterior Radial head
