OPP Techniques Flashcards

1
Q

Year of “flung osteopathy to the breeze”

A

1874

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2
Q

Basic coordinated body functions

A
Control of posture and movement
Respiration
Circulation
Regulation of water and electrolyte balance
Digestion and absorption of nutrients elimination of wastes
Metabolism and energy balance 
Protective mechanisms
Sensory system 
Reproduction
Consciousness and behavior
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3
Q

Five models function

A

Provide framework for interpreting the significance of somatic dysfunction.

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4
Q

Biomechanical model

Structure/anatomy

A

Postural muscles, spine and extremities

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5
Q

Biomechanical model

Function/physiology

A

Posture and motion

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6
Q

Biomechanical model

Health

A

Efficient and effective posture and motion throughout the musculoskeletal system

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7
Q

Biomechanical disease

A

Somatic dysfunction, inefficient posture, joint motion restrictions
Alterations of postural mechanics affect dynamic function

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8
Q

Biomechanical model

Patient care

A

Alleviate somatic dysfunction with OMT to restore normal motion and function throughout the body

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9
Q

Respiratory circulatory model

Structure/ anatomy

A

Thoracic inlet and diaphragmas of the body, costal cage, heart, lungs, vasculature, lymphatics

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10
Q

Respiratory circulatory model

Function. Physiology

A

Respiration circulation

Venous and lymphatic drainages

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11
Q

Respiratory circulatory model

Health

A

Efficient and effective arterial supply
Venous and lymphatic drainage to and from all cells
Effective respiration

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12
Q

Respiratory circulatory model

Disease

A

Vascular compromise
Edema
Tissue congestion
Poor gas exchange

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13
Q

Respiratory circulatory model

Patient care

A

Removal of mechanical impediments to respiration and circulation
Relieve congestion and edema
Improve venous and lymphatic drainage

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14
Q

Metabolic energy model

Structure/ anatomy

A

Internal organs

Endocrine glands

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15
Q

Metabolic energy model

Function/ physiology

A
Metabolic processes 
Homeostasis
Energy balance
Regulatory processes
Immunologic activities and inflammation
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16
Q

Metabolic energy model

Health

A

Efficient and effective cellular metabolic processes
Energy expenditure and exchange
Endocrine and immune regulation and control

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17
Q

Metabolic energy model

Disease

A
Energy loss,
Fatigue
Ineffective metabolic processes
Toxic waste buildup
Inflammation
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18
Q

Metabolic energy model

Patient care

A

Restore efficient metabolic processes and bioenergetics
Alleviate inflammation infection
Restore healing

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19
Q

Neurological model

Structure/anatomy

A

Head, organs of senses
Brain
Spinal cord
Peripheral nerves

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20
Q

Neurological model

Funciton/ physiology

A

Control coordination and integration of body function
Protective mechanisms
Sensation

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21
Q

Neurological model

Health

A

Efficient and effective sensory processing
Neural integration and control
Autonomic balance

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22
Q

Neurological model

Disease

A

Abnormal sensation
Imbalance of autonomic functions
Pain syndromes

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23
Q

Neurological model

Patient care

A

Restore normal sensation
Neurological processes and control
Alleviate pain

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24
Q

Behavioral model

Structure/anatomy

A

Brain

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25
Q

Behavioral model

Funciton/ physiology

A

Psychological and social activities

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26
Q

Behavioral model

Disease

A

Ineffective function due to drug abuse, environmental exposures
Trauma
Poor lifestyle choices
Inability to adapt

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27
Q

Behavioral model

Patient care

A

Assess and treat the whole person

Collaborative partnership

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28
Q

Biomechanical model omt technique

A
Multiple omt modalities to the spine and extremities
Hvla
Me
Mfr
Cs
Still
Blt
Fpr
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29
Q

Respiratory circulatory omt technique

A

Treating the transverse diaphragms of the body
Cranial
Mfr
Lymphatic pumps

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30
Q

Metabolic energy omt technique

A

Lymphatic pump techniques

Focus on somatic dysfunction that could interfere with metabolic functions, visceral techniques

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31
Q

Neurological omt technique

A

Omt reduction of mechanical stress, balance of neural inputs, elimination of nocieptive drive
Inhibition techniques, counterstain, Chapman points

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32
Q

Behavioral omt technique

A

Omt to address reactions to biopsychosocial stresses

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33
Q

Hvla

A

Employs rapid therapeutic force of brief duration that travels a short distance within the anatomic range of motion of a joint
Engages restricts barrier to elicit a release.

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34
Q

Muscle energy

A

Direct treatment

Muscles employed upon request in controlled position and manner against counterforce

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35
Q

Lymphatic techniques

A

To remove impediments to lymphatic circulation and promote and help flow

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36
Q

Counterstain

A

Diagnosis and indirect treatment in which patient’s somatic dysfunction is treated by using spontaneous tissue release while simulataneously monitoring the tenderpoint

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37
Q

Myofascial release

A

Described by at still
Continual palpitory feedback to alleviate restriction of somatic dysfunction and its related fascia and musculature
Direct or indirect

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38
Q

Soft tissue

A

Direct technique
Involves kneading, stretching, deep pressure, inhibition and/or traction
Monitoring tissue response and motion changes

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39
Q

Visceral

A

Diagnosis and treatment directed to viscera and/or supportive structures to improve physiologic function

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40
Q

Osteopathic cranial manipulative medicine

A

Diagnosis and treatment using primary respiratory mechanisms and balanced membranous and ligamentous tension

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41
Q

Theories of joint dysfunction

A

Alteration in opposing joint surfaces
Articular capsule problems
Neural control mechanisms

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42
Q

Why dysfunctional segment wont move

A

Joint inhibited from completing its full normal motion
Irritation creates edema and swelling> tightening of fascial structures> articular distortion results in hypertonicity of muscle crossing joint> decrease of ROM

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43
Q

Joint play

A

Small movements at synovial joints

John mennell

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44
Q

How much movement does the body’s synovial joints have

A

1/8”

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45
Q

Tensegrity and articulatory technique affects

A

Joint surfaces
Tensile elements related to them
Everything that passes through those tensile elements

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46
Q

Secondary effects of articulatory techniques

A

Alter length and tone of connective tissue
Remove inappropriate compression of blood vessels and lymphatics
Remove compression on nerves

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47
Q

Articulatory technique

A

Direct joint focused group of techniques which use LVHA movements

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48
Q

Articulatory technique walk through

A

Physician gently carries body region being treated through the restrictive barrier

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49
Q

Indications of articulatory techniques

A

Joint restriction due to localized joint somatic dysfunction

Joint restriction due to periarticuluar tissue somatic dysfunction

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50
Q

Absolute contraindications of articulatory techniques

A
Fracture/dislocation
Neurological entrapment syndromes
Serious vascular compromise
Malignancy
Infection
Bleeding disorders
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51
Q

Relative contraindications for articulatory techniques

A

Acute herniated nucleus pulposa
In upper cervical region due to possibility of vertebral artery compromise - avoid combo of repetitive extension and rotation

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52
Q

Short lever technique

A

Force is imparted through your body which is close to the dysfunctional joint to which you are imparting the corrective forces

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53
Q

Long lever technique

A

Force is imparted through tour body which is far away from the dysfunctional joint to which you are imparting corrective forces

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54
Q

Myofascial release

Functions

A

To treat somatic dysfunctions involving Myofascial tissues or other connective tissues

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55
Q

Myofascial release

Indications

A

Enhance circulation to local Myofascial structures
Improve local tissue nutrition, oxygenation and removal of metabolic wastes
Improved local and systemic immune responsiveness

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56
Q

Myofascial release

Indications as adjunct

A

Identify other areas of somatic dysfunction
Observe tissue response to the application of manipulative technique
Provide general state of relaxation
Prepare tissue for other types of manipulation

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57
Q

Myofascial release

Contraindications absolute

A

Lack of consent/cooperation

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58
Q

Myofascial release

Relative contraindications

A
Fractures
Open wounds
Soft tissues/bony infections
Abscesses
DVT
Anticoagulation, disseminated or focal neoplasm
Recent post operative conditions
Aortic aneurysm
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59
Q

Soft tissue

Somatic dysfunction

A

Characterized/inferred by asymmetry, restriction of motion, tissue texture changes, and tissue tenderness

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60
Q

Soft tissues

Indications

A

Hypertonic muscles
Excessive tension in fascial structures
Abnormal somato somatic and somato visceral reflexes.

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61
Q

Soft tissue indications

Adjunct

A

Identify other areas of somatic dysfunction
Observe tissue response to the application of manipulative technique
Provide general state of relaxation
Prepare tissue for other types of manipulation

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62
Q

Soft tissue

Absolute contraindications

A

Lack of patient consent/cooperation

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63
Q

Soft tissue

Relative contraindications

A

Skin disorders that would preclude skin contact
Acute muscle disorders (myositis, strains) or muscle neoplasm
Acute fascial injuries
Acute ligamentous or bone injury
Infection
Vascular abnormalities (DVT, coahulopathy, hematoma)

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64
Q

Patient complaints when cervial/ thoracic soft tissue/ MFR would be indicatred

A
Headache - tension, sinus, migraine
Neck pain
Throat pain
Globus
Cough
Upper and lower thoracic back pain
Shoulder pain
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65
Q

Palpable tissue texture abnormalities in somatic dysfunction

Acute

A
Warm
Sweaty
Erythematous
Boggy
Rigid/tissue contraction
Painful
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66
Q

Palpable tissue texture abnormalities in somatic dysfunction

Chronic

A
Cool
Dry
Pale/blanched
Strophic 
Fibrotic
Tissue contracture
Painful
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67
Q

Position of danger for cervical spine

A

Hyperextension

With hyper rotation

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68
Q

Cranialcervical MFR release indications

A

Acute cervical sprains/strains,
Mild cervical degenerative diseases
URIs
Sinusitis

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69
Q

Craniocervical MFR release indirect

Tart changes

A

Occipital to C4

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70
Q

Craniocervical MFR release indirect treatment

A

Pt on back. Hands cradled.
Stacked in position of ease
Add compression
Breathe reassess

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71
Q

Compression

A

Inferior motion

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72
Q

Traction

A

Superior motion

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73
Q

Contralateral traction

A
Stand contralateral 
Cephalad hand on forehead
Caudal hand on lateral to spinous processes 
Rotate head away
Don’t scissor 
Pull toward you
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74
Q

Cradling with traction/ longitudinal traction

A

Start at c7.
Circular pressure
Move up to occipital

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75
Q

Forward bending traction

A

Cross forearms under patient and contact anterior surface of shoulders with palms
Lift patients head.

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76
Q

Lateral traction

A

One forearm under patients head and contact anterior surface of opposite shoulder with palms
Apply lateral stretch to neck muscles
Don’t rotate head

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77
Q

Diagnose tissue texture abnormalities in cervial region

A

Cup patients occipital
Slowly and gently bend the head to the left and right along coronal plane, paying attention to the tension in the lateral neck musculature and overall cervical ROM
Bend head and neck forward paring attn to tension in posterior neck musculature and overall cervical ROM

78
Q

Suboccipital release

A

Focus is to release tension in muscles and connective tissue so they have a full range of motion

79
Q

Suboccipital decompression

A

If goal is to increase relaxation around occipitoatlantal joint

80
Q

Suboccipital inhibition

A

Goal is to inhibit muscle tension
One of effects is to enhance the parasympathetic aspect of ANS balance
Parasympathetic influence increases as sympathetic influence decreases

81
Q

Suboccipital inhibition

A

Fingers below occipital
Inferior to inferior nucal line in soft tissues of suboccipital triangle
Balance head with cranium off palms
Maintain until head falls

82
Q

Suboccipital release/inhibition

Indication

A

Suboccipital TART changes
Muscle tension headaches
Neck ache or tension

83
Q

Indirect upper thoracic MFR supine

A
Place one hand underneath so contact upper thoracic spinous processes with fingers spread
Place opposite hand on sternum
Assess separately
Stack in direction of ease and hold 
Respiratory cooperation
84
Q

Thoracic prone pressure/ prone pressure with thumb

A

Place thumb and the air eminence of one hand on opposite side of thoracic spine in gutter
Place other hand to reinforce it
Exert anterolateral pressure on soft tissues away from spine

85
Q

Thoracic prone pressure with counter pressure

A

Head turned toward you
One hand on one side of spine fingers toward head
Other on other side finger pointing caudad
Simultaneous longitudinal pressure

86
Q

Upper thoracic lateral recumbent traction

A

Caudad hand under patients arm.
Grasp paravertebral muscles lateral to spinous processes. Draw laterally until resistance noticed
Work wat up and down from cervical thoracic junction to mid thoracic spine

87
Q

Trapezius prone traction

A

Grasp superior trap with cephalad hand
Pt head toward you
Caudad hand on gh joint
Pull trap in caudal direction diagonally toward your body.

88
Q

Active motion

A

Voluntary movement by patient

89
Q

Passive emotion

A

Movement performed by practitioner while patient is relaxed

90
Q

Physiologic barrier

A

End point of active ROM

Can be increased with warm up exercises or stretches

91
Q

Anatomic barrier

A

Limit of motion by anatomic structures

92
Q

Elastic barrier

A

Felt at end of active range of motion between the physiologic and anatomic barriers
Where ligamentous stretch occurs

93
Q

Restrictive barrier

A

Obstacle to movement within physiological range of motion that will reduce the amount of active motion available

94
Q

Pathological barrier

A

Permanent restriction of active and passive range of motion with permanent changes in the tissues

95
Q

Somatic dysfunction

A

Impaired / altered function of related components of the somatic body system

96
Q

Somatic dysfunction happens

A

Any stress on body that alters the tissues so they are unable to return to their neutral states
Functional and positional change
Muscle length and tone are unable to return to physiologic neutral

97
Q

Tart

A

Tissue texture abnormalities
Asymmetry
Restriction of ROM
Tenderness

98
Q

Tissue texture abnormalities

A
Temperature
Moisture
Bogginess
Rolpiness
Red reflex
99
Q

Direct techniques

A

Moves tissues towards barrier
Directly confronts barrier
Myofascial structures are stretched and then relaxed
Replaced tissues allow for better blood and lymph flow

100
Q

Indirect techniques

A

Tissues taken away from barrier
Tissues relax as tension taken off
Blood and lymph flow improve

101
Q

Goals of soft tissue treatment

A

Relax hypertonic muscles
Stretch passive fascial structures
Enhance circulation to local Myofascial structures
Improve local and systemic immune responsive
Provide general state of relaxation

102
Q

Absolute contraindications

A

Lack of patient cooperation/consent
Inability to position patient appropriately
No somatic dysfunciton identified
Inability of patient to respond to treatment
Malignancy

103
Q

Relative contraindication

A
Acute injury
Fracture/dislocation
Neurological compromise 
Osteopenia or osteoporosis
Malignancy
Infection
104
Q

Traction

A

Origin and insertion and held stationary

Central portion stretched like bowstring perpendicular

105
Q

Inhibition

A

Sustained deep pressure and compression of hypertonic Myofascial structures

106
Q

Fascia originates from

A

Mesoderm

107
Q

Fascia contains:

A
Mechanoreceptors 
Golgi tendon organs
Pacinian corpuscles
Ruffini endings
Free nerve endings
108
Q

Functions of fascia

A
Packaging
Protection
Posture
Passageways
Fascial continuity
109
Q

Diagnosis of fascia

A

Passive motion testing of fascia in region is performed to identify a restrictive barrier and a position of ease

110
Q

Inhalation respiratory component

A

Spinal curves flatten/ decrease

Extremities tend toward external rotation

111
Q

Exhalation respiratory component

A

Spinal curves increase

Extremities toward internal rotation

112
Q

Indications for soft tissue treatment

A

Relax hypertonic muscles and reduce spasms
Stretch and increase elasticity of shortened fascial structures
Enhance circulation
General state of relaxation

113
Q

Absolute contraindications of soft tissue treatment

A
Fractures. Dislocation 
Neurological entrapment syndromes
Serious vascular compromise
Malignancy
Local infection
Bleeding disorders
Patient refusal
114
Q

Prone traction

A

Cephalad hand on base of sacrum pointing caudad
Other palm straddling spinous processes of lumbar vertebrae
Exert separating force using traction

115
Q

Prone pressure with counter leverage

A

Grasp ASIS with caudad hand lifting toward ceiling
Contact lumbar paravertebral muscles on contralateral side of spine with heel of hand.
Apply anterior and lateral force to stretch lumbar paravertebral tissues like bowstring
Return to table

116
Q

Seated lumbar soft tissue

A

Strand behind and contralateral to patient
Grasp pt arm
Heel of caudal hand over paravertebral muscles on contralateral spine
Drop weight onto your arm
Rotate patient toward you with anterior hand
Use posterior hand to provide lateral and anterior force

117
Q

Prone lumbosacral Myofascial release

Indication

A

Pt complains of low back pain, stiffness, difficulty bending and turning

118
Q

Prone lumbosacral Myofascial release

A

Face feet
Place caudad hand on sacrum with heel over sacral base
Place other hand over thoracolumbar junction with fingers over lumbar region
Stack in position of ease
Test with inspiration

119
Q

Indirect mfr and respiratory cooperation

A

Hold breath at end of phase which relaxes the tissues being treated

120
Q

Direct mfr and respiratory cooperation

A

Ask patient to hold breath at end of phase which tightens tissues being treated

121
Q

Sacral rock

A

Cephalad hand on base of sacrum with fingers pointing toward feet
Put caudla hand over top with fingers toward head
Follow sacrum as repiration moves
Follow and enhance slightly each time

122
Q

Sacral rock inhalation

A

Extension.

Sacral base goes posteriorly

123
Q

Sacral rock exhalation

A

Flexion

Sacral base goes anteriorly

124
Q

Si joint decompression

A

One hand under sacrum so fits in palm
Other hand under hip to grasp psis
Gentle lateral traction on psi’s

125
Q

Indirect thoracolumbar mfr prone

A

Face cephalad with dominance eye closet to patient b
Place hands on thoracolumbar junction with fingers spread. On either side of spinous process
Stack all in ease
Respiratory cooperation

126
Q

Seated lumbar flexion

A

Stand behind with your Axilla over shoulder hand on the other. Pt grasps you
Stabilize spinous processes of lower involved vertebrae using downward pressure
Use other hand to flex spine to level you’re working on
Spring the barrier

127
Q

Seated lumbar extension

A

Stand behind pt hugging themself grasp elbows with hand
Place other hand below joint to be treated
Use long lever arm to induce extension
Use other hand as wedge to induce anterior translation
Spring barrier

128
Q

Which vertebrae does seated articulatory lumbar flexion work on

A

Above

129
Q

Which vertebrae does seated articulatory lumbar extension work on

A

Below joint

130
Q

Seated articulatory technique lumbar sidebending

A

Standing behind and to side of patient place Axilla on one shoulder hand is on opposition shoulder
Place fingers on ipsilateral side
Press down with axilla and up with hand translating shoulders away from you.
Use other hand as wedge
Spring barrier

131
Q

Seated articular technique lumbar rotation

A

Place thumb on contralateral gutter
Pull patients arm to induce rotation and accentuated it to the joint level by taking sensing hand and soft tissues more laterally

132
Q

Lateral recumbent articulatory technique lumbar flexion

A

Face lateral recumbent patient
Flex knees and rest them against anterior thigh. Grab legs as lever
Using your thigh flex pt’s lumbar spine by brining knees cephalad
Use cephalad hand to stabilize superior lumbar vertebrae as motion pulls inferior lumbar vertebrae causally

133
Q

Lateral recumbent articulatory technique lumbar flexion treats where

A

Treats joint below stabilized hand

134
Q

Lateral recumbent articulatory technique lumbar sidebending

A

Stand facing lateral recumbent pt
Flex pt’s knees and rest them against your anterior thigh
Grasp pt ankles to use as long lever
Lift ankles to induce sidebending
Use cephalad hand to place downward vector that increases sidebending

135
Q

Allopathy

A

Hahnemann
System of therapeutics with diseases are treated by producing a condition incompatible with or antagonistic to the condition to be cured

136
Q

Year flung osteopathic banner to the breeze

A

1874

137
Q

Year at still officially the branded term osteopathy

A

1889

138
Q

Who received the first diploma

A

William smith

139
Q

Flexner report 1910

A

Harshly criticized medical schools and osteopathic schools
Marginal schools closed
In 1910 only 8 of osteopathic schools remained in operation

140
Q

California merger

A

1960 COA began negotionation with CMA.
AOA revoked COA charter approved new assoc OPSC
1961 COA merged with CMA
CA voted to stop DOs from practicing in CA
1962 DOs could apply for MD degree licensure

141
Q

WWI and DOs

A

DO could serve as regular soldiers but couldn’t use medical training.

142
Q

WWII. And DOs

A

Were deferred not drafted

Stayed at home and treated the home citizens

143
Q

11963

A

Acceptance of DOs as medical officers in US civil service

144
Q

First commissioned officer

A

Harry Walter USAF

145
Q

1967

A

AMA withdrew longstanding opposition and DOs included in doctor draft

146
Q

1974

A

CA Supreme Court decided licensure of DO s must resume

147
Q

2011

A

ACGME announced in 2016 would restrict access from moving from non ACGME program to ACGME program

148
Q

Unified path for post grad med trading in

A

2012 AOA began talking to ACGME to create single pathway for GME programs

149
Q

Osteopath

A

Person with limited practice rights who has achieved nationally recognized standards within country to independently practice diagnosis and treatment

150
Q

Osteopathic physician

A

Person with full unlimited medical practice rights who has achieved nationally recognized standards within country to diagnosis and provide treatment

151
Q

Osteopathic medicine countries

A

Limited to US except Germany/France

152
Q

Level of suprasternal notch

A

T2

153
Q

Level of sternal angle

A

T4/t5

154
Q

Xiphoid process

A

T9

155
Q

Spine. Of scapula level

A

T3

156
Q

Inferior angle of scapula level

A

T7

157
Q

Umbilicus

A

L3

158
Q

Iliac crest level

A

L4

159
Q

Normal red reflex

A

Initial blanching
Followed by reddending
Slow fading of redness back to normal

160
Q

Abnormal red reflex

A

Remaining pale
Remaining red
Becoming red initially instead of pale

161
Q

Meissner corpsuscle

A

Sense light touch

Initial part of stimulation dynamic

162
Q

Merkel cells

A

Sense light touch

Sustained stimuli

163
Q

Pacinian corpuscle

A

Deep pressure

Rapid indentation of skin

164
Q

Ruffini endings

A

Detection of stretch

165
Q

Proprioceptors

A

Golgi tendon organs
Muscle spindle
Joint receptors

166
Q

fascial symmetry landmarks

A
General 
Supraciliary arches
Orbits
Nasal deviation
Angles of math
Symphysis menti 
Rotation and sidebending
167
Q

Shoulder landmarks

A

Muscle mass

Neck/shoulder angle

168
Q

Upper extremity postural landmarks

A

Shoulder heights
Shoulder rotations
Clavicle prominence

169
Q

Arm postural landmarks

A

Internal external rotation
Anterior posterior
Fingertip heights

170
Q

Thorax postural assessment landmarks

A

General symmetry
Precuts
Sternal angle
Costal arches

171
Q

Pelvis postural assessment landmarks

A

Skin folds/angulation
Iliac crest height
ASIS
Rotation

172
Q

Lower extremity postural assessment landmarks

A
Musculature
Knees (valgum vs varum)
Patella
Tibial tuberosity 
Fibulae heads
Rotation
Feet rotation
Feet inversion
Pes planus/pes cavus
173
Q

Posterior postural assessment

Head landmarks

A

Earlobe
Mastoid process
Rotation and sidebending

174
Q

Posterior postural assessment

Neck landmarks

A

Muscle mass

Shoulder angle

175
Q

Posterior postural assessment

Upper extremity

A

Shoulder height

Shoulder rotator

176
Q

Posterior postural assessment

Scapurale

A

Prominence
Protected / retracted
Inferior angle

177
Q

Posterior postural assessment

Arms

A

Internal external rotation
Anterior posterior
Fingertip heights

178
Q

Posterior postural assessmentthorax

A

Scoliosis

179
Q

Posterior postural assessment

Pelvis

A
Skin folds
Iliac crest heights 
PSIS
Rotation
Greater trochanters
180
Q

Posterior postural assessment

Lower extremity

A
Glut, thigh, calf muscles
Popliteal fossa
Achilles’ tendon
Rotation
Feet inversion
Pes planus pes cavus
181
Q

Lateral postural assessment gravity line points

A
EAM
Acromion process
Body of l3
Anterior 1/3 of sacrum
Lateral femoral condyle 
Lateral malleotlus
182
Q

Lateral postural assessment

Head

A

Position - rotation, ant or post

Position of neck - exten/flex

183
Q

Lateral postural assessment

Upper extremity

A

Position rot/ ant/ post

Elbow flexion

184
Q

Lateral postural assessment Thorax

A

Pectus

Sternal angle

185
Q

Lateral postural assessment

Spinal curves

A

Cervical lordosis
Thoracic kyphosis
Lumbar lordosis
Lumbosacral angle

186
Q

Lateral postural assessment

Lower extremity

A

Knees (recurvatum)
Leg rotation
Feet everted/inverted
Arches

187
Q

Articulatory general principles

A

Direct technique
Passive technique
To increase regional motion restriction in general manner
To obtain addl info

188
Q

Articulatory contraindications

A
Severe osteoporosis 
Compression fracture
Ruptured disk or disk bulge
Cancer or structurally weakening diseases
Acute inflammatory disease
189
Q

Articulatory diagnosis

A

Locate 12th thoracic vertebrae and l1.
Place finger on spinous process of l1
Ask to bend only to where motion reached finger.
Observe which side is more restricted

190
Q

If patient cannot sidebending left

A

Induce left sidebending