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Year 1: OS Exam 1 > OS Fall 2019 Midterm > Flashcards

OS Fall 2019 Midterm Flashcards

1
Q

What are the 7 components of the lateral gravitational line?

A
  1. external auditory canal
  2. lateral humeral head
  3. 3rd lumbar vert
  4. Anterior 1/3 sacrum
  5. Greater trochanter
  6. Lateral condyle of knee
  7. Lateral malleolus
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2
Q

What plane and axis are used in side bending?

A

plane: frontal/coronal
Axis: AP/sagittal

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3
Q

What plane and axis are used in flexion and extension?

A

Plane: sagittal/AP
Axis: Transverse

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4
Q

What plane and axis are used in rotation?

A

Plane: horizontal/transverse
Axis: longitudinal/vertical/superior to inferior

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5
Q

What are the 4 ROM qualities?

A
  1. Smooth- normal
  2. Ratcheting (ex: Parkinson’s)
  3. Restricted- contracture or SD
  4. Resistance to motion (ex: cerebral palsy)
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6
Q

Whats static flexibility?

A

maximal ROM from external force

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7
Q

what is the definition of flexibility

A

ROM in which joint(s) can effectively and completely move

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8
Q

What is dynamic flexibility?

A

ROM of athletic in which they apply speed

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9
Q

What is the concept of coupled motion in regards to joints? What joint specifically?

A

Consistent association of motion along 1 axis with another motion along a 2nd axis. The principle motion can’t be produced without associated motion occurring as well
-spine, each motion differs along different spinal segments

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10
Q

What is the functional unit of the spine?

A

2 vertebrae (joint b/t vertebral bodies and joint b/t articulating processes) and their associated neuromuscular and soft tissue structures

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11
Q

What is the flexion and extension ROM values for the cervical spine?

A

Flex: 45-90
E: 45-90

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12
Q

What is the flexion and extension ROM values for the thoracic spine?

A

F: 25
E: 30

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13
Q

What is the flexion and extension ROM values for the lumbar spine?

A

F: 40-90
E: 20-45

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14
Q

What should be the normal arm span to height difference?

A

Height should be longer/taller than arm span

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15
Q

Osteogenesis Imperfecta

A

genetic bone disorder characterized by fragile bones that break easily. It is also known as “brittle bone disease.”

  • Pt has blue sclera indicating multiple fractures
  • fractures in utero
  • bone has calus formation
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16
Q

Alport syndrome

A

genetic condition characterized by kidney disease, hearing loss, and eye abnormalities
-can have CT issues

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17
Q

Menkes disease

A

X-linked recessive disorder caused by mutations in genes coding for the copper-transport protein ATP7A, leading to copper deficiency
-kinky hair, growth failure, and nervous system deterioration

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18
Q

Ehler-Danlos syndrome

A

-collagen synthesis dysfunction: joint abnormality and stretchy skin

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19
Q

Beighton scale: hyper mobility score

A

Points: 0-9
1 pt for Touching palm to floor
1 pt for each Pinky hyperextends to 90 degrees
1 pt for each thumb that touches forearm
1 pt for -10 hyperextend knee of each knee
1 point for each elbow that bends backwards to -10

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20
Q

Breighton criteria scale, major

A

Major:

  • Beighton score >4
  • Arthralgia for > 3 months in 4+ joints
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21
Q

Marfanoid habitus

A

wing span > 1.03 ration, upper segment less than lower segment >0.89 ratio, or arachnodactyly

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22
Q

occular signs

A

drooping eyelids, myopia, antimongoloid slant

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23
Q

Breighton criteria scale, minor

A

Minor:

  • Beighton score 1-3
  • Arthralgia >3 months in 1-3 joints, back pain >3 months, or spondylosis/spondylolysis/spondylolisthesis
  • dislocation or sublimation in 1+ joints on more than 1 occasion
  • 3+ ST lesions (epicondylitis, tenosynovitis, bursitis)
  • marfanoid habitus
  • skin striae, hyperextend, thin skin, abnorm scarring
  • occular signs
  • varicose veins, hernia, uterine or rectal prolapse, mitral valve prolapse
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24
Q

What are the requirements for Ehler-Danlos

A

Any two of following:

  • 2 major criteria
  • 1 major, 2 minor
  • 4 minor
  • 2 minor criteria and affected 1st degree relative
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25
Q

Treatment plan for Ehler-Danlos

A
  1. PT: strengthen muscles around joints
  2. medications to control pain (non-narcotic)
  3. surgery to repair joints
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26
Q

Myofascial dysfunction

A

tight elastic end point

-scar tissue

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27
Q

lymphatic dysfunction

A

empty, boggy end feel

  • lymphedema
  • visceral dysfunction (CHF)
  • acute injury (sprained ankle)
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28
Q

neural somatic dysfunction

A

crisp, empty end feel

  • herniated disc
  • thoracic outlet syndrome
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29
Q

ulnar-humeral (elbow) flexion ROM degree

A

140-150

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30
Q

ulnar-humeral (elbow) extension ROM degree

A

0 to -5

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31
Q

ankle dorsiflexion ROM degree

A

15 to 20

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32
Q

ankle plantar flexion ROM degree

A

55-65

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33
Q

ankle inversion ROM degree

A

20

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34
Q

ankle eversion ROM degree

A

10 to 20

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35
Q

wrist flexion ROM degree

A

80-90

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36
Q

wrist extension ROM degree

A

70

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37
Q

wrist adduction/ulnar deviation ROM degree

A

30-40

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38
Q

wrist abduction/radial deviation ROM degree

A

20-30

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39
Q

knee flexion ROM degree

A

145-150

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40
Q

knee extension ROM degree

A

0

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41
Q

c-spine rotation ROM degree

A

70-90

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42
Q

c-spine sidebending ROM degree

A

20-45

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43
Q

c-spine extension ROM degree

A

45-90

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44
Q

c-spine flexion ROM degree

A

45-90

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45
Q

lumbar spine sidebending ROM degree

A

15-30

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46
Q

lumbar spine flexion ROM degree

A

40-90

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47
Q

lumbar spine extension ROM degree

A

20-45

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48
Q

lumbar spine rotation ROM degree

A

3-18

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49
Q

hip flexion (knee extended) ROM degree

A

90

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50
Q

hip extension ROM degree

A

15-30

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51
Q

hip flexion (knee flexed) ROM degree

A

120-135

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52
Q

hip adduction ROM degree

A

20-30

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53
Q

hip abduction ROM degree

A

45-50

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54
Q

hip external rotation ROM degree

A

40-60

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55
Q

What are 4 outside environmental stressors to the 5 systems?

A
  1. trauma
  2. infection
  3. nutrition
  4. social
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56
Q

disease states associated with biomechanical system

A
  • SD
  • ineffective posture
  • joint motion restriction or hyper mobility
  • instability
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57
Q

disease states associated with resp-circ system

A

vascular compromise, edema, tissue congestion, poor gas exchange

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58
Q

disease states associated with neuro system

A

abnormal sensation
imbalance of ANS function
Central and peripheral sensitization/malfunction
pain syndrome

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59
Q

disease states associated with metabolic energy

A 
fatigue
ineffective metabolic processes 
toxic waste build
inflammation
infection, poor wound healing
poor nutrition
adverse med response 
loss of endocrine control
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60
Q

disease states associated with behavioral systems

A
  • ineffective secondary to drug abuse
  • environmental chemical exposure or trauma
  • poor lifestyle choices (inactivity, dietary)
  • inability to adapt to stress or environment
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61
Q

How is energy loss determined?

A

hysteresis

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62
Q

____ CT into it’s ____will bring about a ___ of the tissue?

A

stretching, plastic deformational range, lengthening

63
Q

CT under a _____will elongate (deform) in response to the load

A

sustained, constant load

64
Q

What is the resile of fascial restriction?

A

abnormal myofascial and joint abnormality

65
Q

For every tightness, there is a 3D related looseness. Commonly, the looseness is in exactly the ___direction from the tightness.

A

opposite

66
Q

What is strain (deformation) proportional to?

A

stress (force) placed upon it

67
Q

direct myofascial technique

A

towards and through restrictive barrier (against name of SD)

-engage w/ loaded, constant, directional force

68
Q

indirect myofascial technique

A

away from restrictive barrier and towards name of SD

  • tissue position of ease ID
  • engage with direct pressure
  • guide tissues along line of least resistance until free movement of all tissues occurs
69
Q

integrated neuromusculoskeletal release (INR)

A

treatment system in which combined procedures are designed to stretch and reflexively release patterned soft tissue and joint related restrictions

70
Q

soft tissue, direct

A
  • directly applied to muscular and fascial structures
  • also affects neural and vascular
  • improves articular motion (historically fundamental to OMT)
  • wide range of force applications: perpendicular, longitudinal, inhibitory
71
Q

the ___is the place to look for the cause of disease, the place to consult and begin action of remedies in all diseases. Who said this

A

fascia

-AT Still

72
Q

tendons, ligaments, aponeurosis - what are these 3 things not?

A

fascia

73
Q

What is fascia made of?

A
  1. collagen
  2. elastin fibers
  3. hydrated proteoglycans (link together collagen network)
    - 95% ECM and 5% cells
74
Q

endomysial fascia

A

investing muscle fibers

75
Q

fascia functions (2)

A
  1. mobility and stability

2. support/stabilize

76
Q

contractile cells of fascia

A

myofibroblasts–>fibroblasts

77
Q

healing cells of fascia

A

macrophage and mast

78
Q

c-fibers

A

unmyelinated, small diameter, low conduction velocity

79
Q

piezoelectric

A

generate electric charge in response to mechanical stress

80
Q

indications for soft tissue technique

A
  • ID restricted motion, tissue texture change, sensitivity
  • feedback regarding OMT tissue response
  • improve local and systemic immune response
  • relaxation
  • enhance circulation
  • tonic simulation
81
Q

indications for MFR/INR

A
  • SD: all soft tissues or joint restrictions
  • HVLA or muscle energy contraindicated
  • counterstain may be difficult secondary to pt being unable to relax
82
Q

Goals of soft tissue technique for tissue texture abnormalities

A
  1. stretch and increase elasticity of shortened myofascia to return symmetry
  2. improve local tissue nutrition, oxygenation, removal of metabolic waste
83
Q

Goals of soft tissue technique for asymmetry of muscle

A

(hypertonis muscles and muscle spasms)

-return symmetry and normalize tone

84
Q

Goals of soft tissue technique for tenderness (myofascial restriction)

A

release fascia

85
Q

Goals of soft tissue technique for restricted ROM (abnormal neuro activity)

A

normalize neurologic activity (pain, guarding, proprioception) and improve abnormal somato-somatic and somato-visceral reflexes

86
Q

How are soft tissue forces applied?

A
  • gentle and low amplitude, can increase amplitude in response to tissues but rate remains same
  • rhythmically for 1-2 sec
87
Q

knead

A

repetitive pushing of tissue perpendicular to muscle fibers

88
Q

inhibition

A
  • push or hold perpendicular to fibers at musculotendinous part of hypertonic muscles
  • hold until tissue relax
89
Q

what are the 3 planes of restriction assessment for thoracolumbar MFR release?

A
  1. flex/extend
  2. rotation
  3. side-bending
90
Q

3 activating forces

A
  1. inherent: using body primary respiratory mechanisms
  2. resp cooperation: inhalation, exhalation, or holding breath to assist with manipulation
  3. patient cooperation: move in specific directions to aid in mobilizing areas of restriction
91
Q

3 palpable MFR treatment endpoints?

A
  1. 3D release: warmth, softening, increased compliance/ROM
  2. continuous application no longer produce change
  3. symmetry after re-check
92
Q

what does inherent (intrinsic) force work to improve?

A

bodys homeostasis (hydrodynamic and bioenergetic factors) around restricted tissues and articulations

93
Q

4 types of respiratory force used for activating force during MFR

A
  1. full cycle effort
  2. particular phase of respiration: enhance position of treatment area
  3. breath holding: release for general relaxation
  4. coughing or sniffing: produces respiratory impulse to assist in tissue release
94
Q

who is William Budd and what years was he alive?

A

1811-80

epidemiology to prove cholera came from contaminated water source in Bristol

95
Q

John Snow

A

1813-58

-epidemiology to trace source of cholera outbreak in London in 1854

96
Q

Ingaz Semmelweiss

A

1818-65

-obstetrical clinic decreased mortality by 90% through hand washing, ironically died of infection

97
Q

Joseph lister

A

1827-1912

  • father of antiseptic surgery
  • reduced surgical mortality from 45 to 15%
98
Q

Robert kosh

A

isolated anthrax

99
Q

Louis pasteir

A

discredited spontaneous generation

100
Q

Nils Finsen

A

1860-1904

-UV light in medicine

101
Q

Wilhelm Rontgen

A

first to systematically study xrays

102
Q

When were x-rays first used diagnostically?

A

1896

103
Q

Conquer disease

A

if enough force were used, it would cast out demons

104
Q

heroic medicine

A
  • stimulants if patient was drowsy
  • hypnotics if patient was agitated
  • purgatives and cathartics were high as well as blood letting
105
Q

AT still bday

A

august 6, 1828 in lee county, Virginia

106
Q

AT still parents

A

father: abram (doctor)
mother: Martha (uneducated)

107
Q

When did AT still make a rope swing to treat headache

A

1839

108
Q

1849 AT still significance

A

married Mary Margaret Vaughn

109
Q

1850 AT still significance

A

took over mission in Eudora, KS

110
Q

1855 AT still significance

A

studied anatomy in Indian kadavers after cholera epidemic

111
Q

1857 AT still significance

A

elected to Kansas legislature and active in anti-slavery movement

112
Q

1859 AT still significance

A

Mary Margaret dies leaving him with 3 kids (2 died within days of birth)

113
Q

1860 AT still significance

A

marries Mary Elvira turner

114
Q

1861-64 AT still significance

A

flights in civil war (union) highest rank a major

115
Q

1864 AT still significance

A

battle of Westport (KC) and 3 kids died from spinal meningitis and another from pneumonia so he returned home to farm to formulate change for medicine

116
Q

10 AM June 22, 1874

A

AT Still flung banner of osteopathy to the breeze, spread news

117
Q

1874 AT still significance

A
  • presents new ideas to Baker university
  • formally removed from Methodist church
  • 1st “recorded” OM treatment in Macon, MO
118
Q

1875 AT still significance

A

moved family to Kirksville, worked as traveling dr

119
Q

1885 AT still significance

A

coins term “osteopathy”

-continued to advertise as bone setter until 1890

120
Q

1886 AT still significance

A

busy enough that he was able to stay and practice in Kirksville, unsuccessful apprentice of assistants

121
Q

1892

A

American school of osteopathy opens

122
Q

How many students were in first osteopathic class

A

22, 5 included his children

123
Q

who were the first osteopathic class professors?

A

AT Still and Dr. William Smith

124
Q

how many females were in the 1st osteopathic class

A

5

125
Q

1894 AT Still significance

A

2nd class begins, 2nd year course was $500

126
Q

How large was enrollment in 1895

A

28

127
Q

how large was enrollment in 1896

A

102

128
Q

how large was enrollment in 1900

A

700 students with 18 faculty

-12+ sister schools started by graduates

129
Q

1897 AT Still significance

A

AT still autobiography published

130
Q

1899 AT Still significance

A

Philosophy of Osteopathy published

131
Q

1910 AT Still significance

A

Research and Practice published and Mary Elvira dies (married 50 years)

132
Q

1917 AT Still significance

A

death @ age 89

133
Q

1953 AT Still significance

A

consensus statement of osteopathic philosophy

134
Q

What year did MO grant DO licensure?

A

1897

135
Q

What year and state was first legal DO license granted? Which state followed?

A

1896 in Vermont, followed by ND

136
Q

What year was American Association for Advancement of Osteopathy (AAAO) founded?

A

1897

137
Q

When did AAAO become American Osteopathic Association

A

1901

138
Q

When did AOA adopt standards for approving osteopathic colleges?

A

1902

139
Q

When did AOA start inspecting schools?

A

1903

140
Q

What year was KCU founded? What 2 men established it? What was its original name?

A

1916 as KC College of Osteopathy and Surgery

-established by AA Kaiser, DO and George Conley, DO

141
Q

What feud happened in 1922?

A

AMA declares unethical for MD to associated with DO “cult”

142
Q

When were student loan funds established and osteopathy sealed?

A

1931

143
Q

What year was a low-point for DO enrollment?

A

1945 with 556 students

144
Q

When were DO residencies first approved?

A

1947

145
Q

What was the last state to grant DO licensure?>

A

Mississippi

146
Q

What did KCCOS change its name to in 1980

A

KCCOS to University of Health Sciences College of Osteopathic Medicine

147
Q

How many DO schools are there today?

A

33, 48 teaching locations, 27500 students

148
Q

Today, how many DOs are there in the US?

A

102,200 (56% in PC)

149
Q

What year were DO’s accepted as equals to MD?

A

1963

150
Q

Who first commissioned DOs into armed forces?

A

Harry J Walter in 1966

151
Q

Who was the 1st Woman to receive DO degree?

A

Jeanette Bolles (also VP of AAAO)

152
Q

Who was the 1st women graduate from KCU?

A

Mamie Johnston in 1917, but graduated in 1918 because curriculum changed to 4 year

  • joing faculty in 1919, taught gyn and peds
  • retired in 1981 (92! years old)
153
Q

Who was the first female dean of a medical college?

A

Barbara Ross-Lee at Ohio University and 1st DO to win Robert Wood Johnson Health Policy Fellowship

154
Q

What year was the National osteopathic Women Physician Association established?

A

1988

Year 1: OS Exam 1 (39 decks)

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