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OS FINAL Flashcards

1
Q

Are carrying angles greater in men/women?

A

women

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2
Q

Ulnar ABduction leads to a dec/inc in carrying angle

A

increase

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3
Q

Ulnar ADduction leads to a dec/inc in carrying angle

A

decrease

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4
Q

Flexion in elbow degrees and muscles

A

140-150

biceps and brachioradilais

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5
Q

extension in elbow

A

triceps 0- -5 degrees

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6
Q

supination muscles in elbow

A

supinator and biceps

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7
Q

pronation muscles in elbow

A

pronator teres and pronator quadratus, 90 degrees

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8
Q

strength scale

A

– 0-5
– 5 Full movement against normal resistance
– 3 Full movement against gravity
– 0 No movement

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9
Q

Ulnar Abduction testing

A

Provide a Valgus force at the Elbow, motion is coupled

with wrist ADduction

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10
Q

Ulnar ADduction Testing:

A

Provide a Varus Force at the Elbow, motion is coupled

with wrist ABduction

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11
Q

Reference point for dysfunction in elbow

A

distal ulna

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12
Q

ROM for arm

Flexion,Extension ,ADduction,ABduction

A

Flexion 80-90
• Extension 70
• ADduction (Ulnar Deviation): 30-40
• ABduction (Radial Deviation): 20-30

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13
Q

Wrist flexion motion is coupled with ____

A

dorsal carpal glide

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14
Q

wrist extension motion testing is coupled with ___

A

ventral carpal glide

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15
Q

Cervical Spine ROM for flexion extension, sidebending and rotation

A

Flexion 45-90°
Extension 45-90°
Sidebending 45°
Rotation 70-90°

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16
Q

C1:

A

Atlas

  • No vertebral body
  • Rotates around DENS
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17
Q
  • OA Joint:
A

Atypical - Modified Type I Mechanics

  • Can be F or E d/t shape
  • Nicole’s trick: Type 1 = C1; Think TONGO → what changes? → N
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18
Q

Diagnosis of OA joint

A

Contact posterior aspect of occiput → assess in N, F, E

  • Translation = SB
  • Lifting anterior = R
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19
Q

AA (or C1-C2):

A

Atypical - Rotation ONLY

  • Diagnosis:
  • FULLY FLEX head/neck to take out rotatio nof vertebra below AA
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20
Q
  • C2-7 mechanics
A
  • Type 2 if single vertebrae

- modified type 2 if grouped

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21
Q

Dianosis for c2-c7 (rotational)

A
  • Rotational - Rotoscloliosis testing
  • Transverse plane
  • Ex: push on Left lateral mass anterior → Right TP moves posteriorly = Rotated R
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22
Q

Dianosis for c2-c7 (translation)

A
  • Translation - Moving segments laterally
  • Coronal plane
  • Ex: push Left to Right → Left ear to shoulder = SB L
  • Do R and SB in N, F, E
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23
Q
  • Documenting DTRs:
A

Normal: 2+/4

  • 3 is BRISK
  • 4 is CLONUS
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24
Q
  • Segmental motion: cervical spine segments
A

OA - modified type 1

  • AA - rotation only
  • C2-C7 - modified type 2
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25
Q

DTR

A

Biceps: C5

  • Brachioradialis: C6
  • Triceps: C7
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26
Q
  • Spurling’s Maneuver
A

3 stages: if symptoms are found at any stage → do NOT proceed to the next stage

  • Neutral compression
  • Extension compression
  • SB away from affected side; SB toward affected side
  • (+) = pain down the arm in nerve root compressed
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27
Q

OA joint- put fingers over ___ for lateral translation

A

occipital articulation

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28
Q

OA joint- put fingers over ____ for rotational test

A

occipital ridge

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29
Q

AA joint testing techniques

A

flex c spine to isolate atlas and do not test F,E, SB

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30
Q

C2-7- palpalte ____ for lateral translation

A

lateral borders of the articular pillars

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31
Q

Palate ___ for rotation of c2-7

A

posterior surface of articular pillars

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32
Q

PTP on L for c2-7 is what rotation

A

L rotation

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33
Q

Upper Cervicals- Towards eye

Lower Cervicals-Towards opposite ASIS (NOT in horizontal plane)

A

????

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34
Q

fucntion divisions of SNS

A

T1-4: sympathetic innervation to the head and neck (T1-6 (sic) heart and lungs)
■ T5-9: sympathetics to the upper abdominal viscera
■ T10-11: most of the lower abdominal viscera
■ T12-L2: the rest of the abdominal viscera (left colon and pelvic organs)

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35
Q

landmarks of thoracic vertebrae

A

○ T3: spine of scapula
○ Spinous process T7, transverse process
T8: inferior angle of scapula
○ T12: rib 12

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36
Q

Rule of 3

A

T1-3: Spinous process at the same level as the transverse processes
T4-6: SP halfway between the same TP and the one of the lower vertebra
T7-9: SP one level below TP of same vertebra
T10: same as T7-9
T11: same as T4-6
T12: same as T1-3

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37
Q

Wolff’s law

A

bones and soft tissue deform according to the stresses put on them

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38
Q

● Type 1 (TONGO):

A

○ No sagittal plane motion (neutral)
○ Sidebending and rotation are opposite
○ Groups of vertebrae

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39
Q

● Type 2:

A

○ Flexion or extension
○ Sidebending and rotation are the same
○ Singular units

40
Q

where is rotation greatest in spine

A

Rotation greater in the T-spine than anywhere else besides the AA joint

41
Q

what is sidebending limited by

A

ribs

42
Q

Cat back is __

A

flexion

43
Q

sphynx/tv watching is

A

extension

44
Q

where would somatic dysfunction of T spine go in SOAP note

A

assessment

45
Q

Attachment points for ribs

A

2-9 articulate above and below

1, 10-12 articulate only with the corresponding vertebrae

46
Q

Landmarks for Rib 1

A

○ Anteriorly: inferior to the clavicle

○ Posteriorly: cephalad to the border of the scapula

47
Q

Landmarks for rib 2

A

○ Articulates with the manubrium and body of the sternum

48
Q

Landmarks for rib 3

A

○ Posteriorly: level of the scapular spine

49
Q

Landmarks for rib 7

A

○ Anteriorly: xyphosternal junction

○ Posteriorly: level of the inferior angle of the scapula

50
Q

landmarks for rib 10

A

○ Cartilage of the lowest part of the thoracic cage on the mid-clavicular line

51
Q

typical ribs (which ones and characteristics)

A

(3-9)
● Head, neck, tubercle, and body are all thin
and flat
● Head has 2 facets for the costovertebral
articulations
● Tubercle articulates with the transverse
process at the costotransverse articulation

52
Q

Rib 1 atypical because __

A

Flattest, shortest, and greatest curve
● Subclavian groove on the superior surface
● Head only articulates with T1

53
Q

Rib 10 atypical because

A

● Only articulates with T10

54
Q

ribs 11-12 atypical because ___

A

● No neck or tubercles

● Articulates only with associated vertebra

55
Q

Pectoralis muscles can cause what with issues with breathing

A

inhalation dysfunction

56
Q

muscles used in exhalation

A

normally none because passive, but when active: ● Rectus abdominus muscle; internal/external obliques; transverse abdominus

57
Q

Pump handle motion

-ribs and movment

A

Rib 1 is 50%; Rib 2
○ Analogous to flexion/extension
○ Increase in A-P diameter

58
Q

Bucket handle

-ribs and movement

A

○ Rib 1 is 50%; Ribs 7-10 predominant
○ Analogous to abduction/adduction
○ Increase transverse diameter

59
Q

Calliper motion

-ribs and motion

A

Ribs 11-12
○ Analogous to internal/external rotation
○ Pivoting motion

60
Q

ribs 3-6 motion

A

The lecture states that they are pump handle,
OSCE states mixed, with it being more pump
handle towards the upper ones and getting
progressively more bucket handle as you go
down

61
Q

how to assess rib 1-2

A

● Bucket handle: thumbs on the angle of rib 1, forefingers in the supraclavicular fossa, over the superior lateral aspect of
rib 1
● Pump handle: forefinger posterior to clavicle on the superior aspect of rib 1, middle/ring finger on anterior aspect of rib
2

62
Q

how to assess ribs 3-10

A

Bucket handle: contact midaxillary line of each rib with fingertips
● Pump handle: monitor at the costochondral margins with the ulnar aspects of each hand

63
Q

how to assess ribs 11-12

A

Patient prone, use thumb and 2nd/3rd finger to monitor motion
● **Restriction of motion is due to quadratus lumborum muscle

64
Q

elevated rib 1 dysfunction

A

rib is prominent, painful, and less springy

65
Q

Bite mnemoic

A

during an inhalation dysfunction, treat
the bottom rib with dysfunction first; during an exhalation dysfunction, treat the top
rib with dysfunction first

66
Q

inhalation dysfunction

A

Inhalation: one rib stops moving before the others during exhalation (prominent
feeling)

67
Q

exhalation dysfunction

A

one rib stops moving before the others during inhalation (sunken
feeling)

68
Q

lumbar SP are where in relation to TP

A

same plane

69
Q

iliac crest is same level as ___

A

l4

70
Q

DTR L4 nerve root

A

L4-5 disc → patellar reflex

71
Q

DTR S1 nerve root

A

S1-2 disc → Achilles Reflex

72
Q

Motor exam L4 nerve root

A

Ankle Dorsiflexion

73
Q

motor exam l5 nerve root

A

big toe dorsiflexion

74
Q

motor exam s1 nerve root

A

ankle plantarflexion

75
Q

Random ROM stuff about lumbar spine

A

Patient = standing feet 4-6in apart
⦿ Physician = kneeling behind, eyes level with Lumbar spine
⦿ Hands on iliac crest monitoring ASIS ant.
⦿ Flexion = 105º
⦿ Extension = 60º
⦿ SB = 40º
⦿ R = 90º

76
Q

Hip drop test tests for __

A

lateral lumbar flexion

77
Q

describe hip drop test

A

Pt. Stands with BOTH feet on the ground but one is bent (=displaces weight
to WB leg)
› Look at the amount of hip drop that the bent leg (non-WB) has
› If it drops 25º = normal test = negative test
› If it does not drop 25º = + test on that side
⚫ Indicates restriction to SB on opposite side
⚫ Be sure to check B/L always

78
Q

⦿ Pt. stands and bends Left leg. You notice that her left iliac crest drops 15º.
Now you instruct her to bend the right leg, and right iliac crest drops 25º.
What is the pt’s restriction?

A

She has + hip drop on the Left = Restricted to

SB on the RIGHT!!!

79
Q

SLR test (lasegue test)

A

Tests for Sciatic Nerve irritation
⦿ Pt. position: Supine
⦿ Dr. Position: extends knee and medially rotates and adducts pt’s hip.
Maintain extension and flex hip
› Continue flexion until pt. feels pain in BACK of symptomatic leg
› Should NOT feel pain until raised to 30-35º

80
Q

SLR test pain felt at angle less than 30, 30-70 and above 70

A

At a lesser angle OR in opposite leg = large disc protrusion or herniation
⦿ Between 30-70º = dura stretched
⦿ Above 70º = Sciatic N root irritation

81
Q

Examining pt. and find they have a hard-end
feel on the L when palpating L1. Does not get
better in Extension, but there is ease of
motion to L2 felt when in flexion. Diagnosis of
the somatic dysfunction?

A

L1 F RLSL

82
Q

A 65yo male pt. comes in for evaluation after
a fall on ice. Examination of patient’s Lumbar
spine reveals L2-L5 rotated right. Does not
get better in either flexion or extension.
Diagnosis?

A

L2-L5 N RR

SL

83
Q

Louisa Burns, DO

A

○ Pioneer career osteopathic researcher
○ Experimentally, made spinal lesions and reported the effect on brain, heart, GI, repro, lungs,
kidney → Somatic-Visceral reflexes

84
Q

J.S. Denslow, DO

A

○ studies on muscle, muscle reflex and autonomic changes in areas of somatic dysfunction

85
Q

I.M. Korr, Ph.D

A

Studies with galvanic skin resistance and the changes associated with autonomic function
○ Nerve function
○ Sympatheticotonia → sympathetic overdrive
○ Took Still’s anatomic foundation and added physiologic function to it

86
Q

William L. Johnston, DO

A

○ reliability studies, validity studies, VS reflexes

87
Q

Influenza epidemic

A

1918

○ mortality with pneumonia complications less with OMT

88
Q

● LA County Hospital

A

DO’s care only → decreased mortality percentage and 6 days less average length of stay then
under MD + DO care
1932

89
Q

Low back pain patients study

A

○ OMT + PT + meds had less NSAID use, muscle relaxer and PT then just PT+ meds
1999

90
Q

OMT pancreatitis

A

general mobilization of hospital patients

○ decreased length of stay, decreased analgesic, increased patient satisfaction

91
Q

OMT ankle sprain

A

general mobilization of hospital patients

○ decreased length of stay, decreased analgesic, increased patient satisfaction

92
Q

OMT elderly with pneumonia

A

decreased antibiotic use and decreased length of stay

93
Q

OMT otitis media in children

A

for 6 mo-6yo

○ few episodes of AOM, fewer surgical procedures, increased frequency of normal tympanograms

94
Q

OMT spleen pump

A

○ OMT splenic pump increased immune cell count

95
Q

Look at practice ?s

A

fzddadfva

96
Q

supination is coupled with

A

anterior movement of radial head

OS (3 decks)

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