Ortho - Overview Flashcards
(77 cards)
1
Q
What are the four stages Of Ortho Acup. Process?
A
- Questioning
- Performing
- Thinking
- Applying
2
Q
An important part of determining tx effectiveness?
A
Outcome Measures
ie: Pain Scales, ROM, MMT
3
Q
What is the most important part of the patients intake?
A
History
4
Q
Five key questions to ask of Main Complaint after history of patient?
A
- Any Dx? What is story
- When? Timeline, when it started
- How? Mechanism of Injury
- Where? Structures involved
5
Q
What is pain?
A
An unpleasant sensory and emotional experience associated with actual or potential tissue damage.
6
Q
What does HIPS stand for?
A
- History - WM or TCM (root and/or branch)
- Inspection/Observation - muscle imb. ab. posture
- Palpation - meridian/Zangfu, tg, pulse
- Special Testing - ROM, MMT(manual muscle test), OPA (orthopedic Physical Assessment
7
Q
What are dermatomes?
A
A skin area innervated by the sensory fibers of a single nerve root.
8
Q
What are myotomes?
A
A group of muscles primarily innervated by the motor fibers of a single nerve root.
9
Q
What are six different pain types?
A
- Somatic
- Neuropathic
- Psychogenic
- Visceral
- Sympathetic
- Phantom
10
Q
Name three different types of pain quality?
A
- Paroxysmal - shooting, electric
- Superficial - itchy, tingling
- Deep-achy - heavy, cramping
11
Q
Name four types of diagnostic imaging?
A
- X-ray
- CT-scan
- MRI
- Ultrasound
12
Q
Do sinew channels connect to the internal organs?
A
A: No
13
Q
Name five External Pathogenic Influences?
A
Wind, Cold, Damp, Heat/Fire, Dryness
14
Q
The main physical clinical manifestations of Bi Syndrome (Painful Obstruction) are?
A
- Pain
- Aching
- Numbness
- Heaviness
- Reduced ROM
15
Q
What is radiculopathy?
A
Pain that radiates down.
16
Q
In Cross Syndrome which two muscle groups are deficient?
A
Rhomboids and neck flexors.
17
Q
When checking ROM what is degree for side flexion of neck?
A
20-45 degrees
18
Q
What TCM pattern does tissue tension indicate?
A
Wind, Blood, Stagnation, Cold or Deficiency.
19
Q
What does AROM stand for?
A
Active Range of Motion
20
Q
What does TCM pattern does tissue thickness indicate?
A
Dampness
21
Q
What does TCM pattern does palpable, fibrous tissue texture indicate?
A
Blood stagnation, cold
22
Q
What WM conditions do cold vs hot indicate?
A
Poor blood circulation vs inflammation
23
Q
What does PROM stand for?
A
Passive Range of Motion
24
Q
What does RROM stand for?
A
Resisted Range of Motion
25
What are tests for neck ROM?
R / L Rotation, Neck Flexion, Lateral Flexion
26
What does MMT stand for?
Manual Muscle Testing
27
What is the difference between Break Test and Active Resistance Test?
BT: manual resistance applied to limb after movement complete. Tests myotomes/muscle/tendon lesions. Locked feeling.
RT: manual resistance applied to limb against actively contracting muscle. Also tests myotomes/muscle/tendon lesions.
28
What types of Outcome Measures can be used?
Pain Scales, ROM, MMT, ADL (Activity of Daily Living)
29
What diagnostic imaging is best to show tendon, ligaments, and spinal chord?
MRI
30
Name the five criteria that dictate prognosis?
1. Condition duration
2. Structures involved
3. Age of patient
4. Degree dysfunction
5. Clinical experience tx condition
31
What is the dosage (#of treatments) in the beginning of treatment?
1-3/week
32
How many treatments to create a measurable change?
3-5 treatments (4-6tx for complex)
33
How many treatments for 80-95% resolution?
6-8 treatments (8-12 for complex)
34
What is the average treatment time?
30 minutes
35
What is nociception?
A noxious, potentially damaging biological kind of pain.
36
What are the five diagnostic descriptors of pain?
1. Location
2. Type
3. Intensity
4. Frequency
5. Duration
37
These channels have a horizontal flow of energy, are prone to EPFs and are where most blood stasis occurs?
Luo Channels
38
These channels are more like regions and are responsible for muscle aches and stiffness?
Sinew Channels
39
1. For severe pain you focus your energy first where? 2. And then when the pain is under control where?
1. Meridian
| 2. Organ pathology
40
Special Tests confirm an idea of what a condition is. Specials tests must demonstrate these four qualities:
1. Reliability - consistent results
2. Validity - does what its supposed to
3. Interrater Reliability - group of practitioners gets consistent results
4. Intrarater reliability - one practitioner gets consistent results
41
Name five different types of tests?
1. Joint and muscle function
2. Joint stability Tests
3. Special Tests
4. Neurological Assessment
5. Vascular Assessment
42
What are trigger points?
Palpable nodules or bands that when compressed will refer pain that is reproducible and predictable.
43
What is an innervation zone?
Located in the belly of the muscle, these are zones where nerve enters muscle then branches.
44
True or false: Innervation zones can treat trigger points, but trigger points don't treat innervation zones.
True
45
What kind of needle do you use to treat periosteum?
Osteoacupuncture (periosteal needle)
46
True or False: All Ashi points are Trigger Points, but not all Trigger Points are Ashi.
False. All Trigger Points are Ashi Points.
47
Ashi Points can bring about better results of myofascial and joint pain than Acupuncture Points.
True
48
What are different types of trigger points?
Primary & Active - (reproduce pain referral)
Latent - (tender and limits PROM)
Satellite - (activated b/c in ref. zone of another trigger pt)
49
What causes a trigger point?
1. Repetition/overload
2. Trauma
3. Psycho-emotional
4. Another trigger pt
5. Infections
50
What is a SOAP note?
Subjective/Objective/Assesment/Plan
51
What is a key ingredient to determining improvement at your follow-up exam?
Recording pain data: (location/intensity/frequency/duration)
52
Name some special considerations to think of if your treatment is not effective after 24 hours?
- change thickness of needle
- point stimulation
- point selection
- intensity of modalities
53
How do you treat a trigger point?
Locate tender point, "dry needle" and get twitch.
54
What are some things to notice upon observing client?
1. crepitus (joint noise)
2. muscle atrophy or spasm
3. scarring
4. temperature/swelling
5. color/texture
6. any deformities/contour
55
Two types of postural assessment?
Static and Dynamic.
56
What number correlates to Maximal Resistance 0-5?
```
5 = (100% normal)
4 = (is moderate 75%)
3+ = (is minimal 50%)
```
57
What does the dark areas on an X-ray indicate?
Degeneration.
58
What are factors that determine treatment strength?
1. Stimulation method (lift/thrust/rotate)
2. Acute vs Chronic
3. Treatment time
4. Needle gauge
5. Tissue type
59
Acute Tx vs Chronic Tx?
Acute:
1. Mild technique
2. Less time (15-20 minutes)
3. Thinner gauge (0.18-0.22mm)
Chronic:
1. Stronger technique
2. Longer Tx (30 minutes)
3. Thicker gauge (0.22-0.30mm)
4. Source Point of effected channel w/ Luo Point on paired meridian
60
What must you identify before you treat a musculoskeletal condition?
A) Disharmony (int/ext, Root/Branch)
B) Meridians Involved
C) Where Pain Is
D) Treatment Approach
61
What are four different treatment approaches?
1. Point selection
2. Manual Therapy
3. Int/Ext herbal medicine
4. Adjunctive therapies
62
What are four things you look for in a point selection?
```
1. Energetics
(TCM theory, Luo/Source etc.., Special)
2. Properties
(Actions and Effects)
3. Location
(distal, mirror etc..)
4. Anatomical
(Trigger Points, Inn. Zones, osteoacup., anatomical needling)
```
63
What are Luo Points good at treating?
* Yin/Yang of related channel
* Qi and Blood Stagnation
* Stop Bleeding
* Edema
* Invasion of EPF
* To Reinforce Treatment
64
What Luo point would be good for treating lateral epicondylitis?
Li6 (Luo)
65
What Guest/Host points would be good to treat stiff neck, shoulder pain on lateral upper arms?
Si4 + HT5
66
If the meridian is DEFICIENT how would you needle the Guest/Host points?
- Tonify the meridian's Source Point
| - Disperse the paired meridians Luo Point
67
What point for chronic Bone Bi?
BL11 (Hui Point)
68
What point for weakness and stiffness of the joints?
GB34 (Hui Point)
69
What Point for marrow?
GB39 (Hui Point)
70
What point category is good for acute conditions involving pain and inflammation?
XiCleft Point
71
What area of the body does Zone Acupuncture refer to?
Wrist and Ankle
72
Can you name the 5 Systems of Dr. Tan?
1. Name Sharing Meridian - (LU/SP)
(ex: sick: Hand Tai Yin, Tx opp: Foot Tai Yin)
2. Branching Channels - (LU/BL)
(ex: sick: Hand Tai Yin, Tx either: Foot Tai Yin)
3. Int/Ext
4. Clock Opposites
5. Clock Neighbors
73
Distinguish between:
1. Wandering Bi
2. Painful Bi
3. Fixed Bi
4. Febrile Bi
1. Wind - numb/tingling
2. Cold - sharp
3. Damp - heavy/low body/stenosis
4. Heat - rheumatoid arthritis/hot to touch
74
Wandering Bi point prescription?
Expel Wind: GB20, 21, GV16, BL12, Li4
| also: TW6, GB39, GV14
75
Painful Bi point prescription?
Warm channels: ST36, CV6 Moxa
Move Qi and Blood: Li11, Si5
CV4, BL10, GV14
76
Fixed Bi point prescription?
Invigorate Spleen and resolve damp.
| ST36, SP6, SP9, ST40, BL20, BL21, SP5
77
Febrile Bi Point prescription?
Clear heat, dispel wind, resolve damp, nourish yin.
| ST43, Li4, GV14, Li11
