OS1 Exam 1 Study Guide Flashcards

1
Q

What are the angles and ROMs for the Lumbar Spine?

A

Flexion ———> 40° - 90°

Extension ——> 20° - 45°

Side-bending –> 15° - 30°

Rotation ——–> 3° - 18°

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2
Q

What are the angles and ROMs for C-Spine?

A

Neck Side-bending –> 20° - 45°

Head Rotation ——-> 70° - 90°

Flexion ————–> 45° - 90°

Extension ————> 45° - 90°

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3
Q

What are the angles and ROMs for the Elbow?

A

Extension ———————> 0° - -5°

Flexion ————————> 140° - 150°

Supination (outward rotation) –> 90°

Pronation ———————-> 90°

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4
Q

What are the angles and ROMs for the Shoulder?

A

Flexion ⬆️ ——————————-> 180°

Extension ⬇️ —————————-> 60°

Horizontal Adduction (across the body) –> 130° - 140°

Horizontal Abduction (away the body) —> 40° - 55°

Internal Rotation ⤵️ ———————> 90°

External Rotation ⤴️ ———————> 90°

Arm Abduction ————————–> 180°

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5
Q

What are the angles and ROMs for the Wrist?

A

Flexion ————> 80° - 90°

Extension ———> 70°

Adduction ——–> 30° - 40°
(wrists inwards)

Abduction ——–> 20° - 30°
(Wrists outwards)

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6
Q

What are the angles and ROMs for the knee?

A

Flexion (kick butt) –> 145° - 150°

Extension ———-> 0°

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7
Q

What are the angles and ROMs for the Ankle?

A

Plantarflexion –> 55° - 65°

Dorisflexion —> 15° - 20°

Inversion ——> 20°

Eversion ——> 10° - 20°

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8
Q

What are the angles and ROM for the Hip?

A

Flexion (w/ knee extended) ————-> 90°
Extension (prone) ———————-> 15° - 30°
Adduction (prone) ———————-> 20° - 30°
Abduction (prone) ———————-> 45° - 50°
Flexion (w/ knee flexed) —————-> 120° - 135°
External Rotation (Knee ➡️) ————> 40° - 60°
Internal Rotation (Knee ⬅️) ————-> 30° - 40°

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9
Q

Who was the first women to receive a DO degree?

A

Dr. Jeanette Bolles

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10
Q

Who wrote a report stating that medical training was not sufficient and caused a major reform resulting in the opening of numerous new medical schools.

A

Abraham Flexner

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11
Q

What year did 3 AT Still children die and his brother became addicted to opioids causing him to start thinking about Osteopathic Medicine?

A

1864

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12
Q

What day and year did AT Still fly his DO banner?

A

June 22, 1874

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13
Q

When did the first osteopathy school open?

A

1892

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14
Q

What year was KCU first established?

A

1916

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15
Q

During What years was the Spanish Flu pandemic prevalent? Why was this noteworthy?

A

1917 - 1918

Profound difference in the outcomes of pts treated by DOs as compared to MDs

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16
Q

In what year could DOs begin serving in the military?

A

1957

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17
Q

What year did the California referendum take place and when was it resolved?

A

1961

1974

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18
Q

What is the first tenet of Osteopathic Medicine?

26, History 1

A

The body is a unit; the person is a unit of body, mind, and spirit

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19
Q

What is a mesomorphic body type? What is it derived from?

12, critical clinical observation

A

muscular/sturdy body build (average guy)

mid-range ROM

derived from embryonic mesoderm

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20
Q

What is an ectomorphic body type? What is it derived from?

14, critical clinical observation

A

thin body build and linear frame

high-range ROM

dervied from embryonic ectoderm

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21
Q

What is a Endomorphic body type? What is it derived from?

16, critical clinical observation

A

Heavy (fat) body build (obese, increased fatty tissue)

lower ROM

derived from embryonic endoderm

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22
Q

What is the second tenet of Osteopathic Medicine?

28, History 1

A

The body is capable of self-regulation, self-healing and health maintenance

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23
Q

What is the third tenet of Osteopathic Medicine?

30, History 1

A

Structure and function are reciprocally interrelated

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24
Q

What is the fourth tenet of Osteopathic Medicine?

32, History 1

A

Rational treatment is based on and understanding of the basic principles of body unity, self-regulation, and the interrelationship of structure and function

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25
Q

What does TART stand for?

A

T issue texture changes
A symmetry
R ange of motino
T enderness

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26
Q

Differentiate acute vs chronic somatic dysfunction?

23,24, sd and barriers

A

Acute:

  • -> Vasodilation
  • -> Edema

Chronic:

  • -> Itching
  • -> Fibrosis
  • -> Paresthesias
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27
Q

How do we name somatic dysfunction?

A

based off the position of ease

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28
Q

When performing Unilateral Forearm Fulcrum Forward Bending how do we stretch the trapezius vs the posterior scalenes?

(7, ST MFR Lab)

A

Trapezius stretch –> head rotated towards elbow

Posterior scalenes stretch –> head rotated towards hand

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29
Q

What is a physiologic barrier?

A

Limit of active motion

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30
Q

What is an elastic barrier?

A

The end of the passive ROM, slightly before anatomic barrier

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31
Q

What is an anatomical barrier?

A

Limit imposed by anatomic structure

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32
Q

What is a restrictive barrier?

A

Functional limit that abnormally dismisses the normal physiological range

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33
Q

Is a restrictive barrier the same thing as a physiological barrier?

A

No, there is either a restriction or not

If there is a restriction then you will not have a physiologic or anatomical barrier, just the restrictive barrier

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34
Q

With regards to the lumbar region, what motion occurs in the mid-saggital plane?

A

Flexion and Extension

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35
Q

With regards to the lumbar region, what motion occurs in the frontal/coronal plane?

A

side-bending

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36
Q

With regards to the lumbar region, what motion occurs in the transverse plane?

A

rotation

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37
Q

What is linkage?

A

linking of multiple structures together increases their ROM - we don’t want this

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38
Q

What are the 5 different types of end feel?

A

Elastic

Abrupt

Hard

Empty

Crisp

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39
Q

What are examples of an abrupt end feel?

A

Osteoarthritis or hinge joint

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40
Q

What are examples of a hard end feel?

A

Somatic dysfunction

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41
Q

What are examples of an empty end feel?

A

Motion stops due to guarding

Patient doesn’t allow motion due to pain

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42
Q

What is an example of a crisp end feel?

A

Involuntary muscle guarding as is the case with a pinched nerve

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43
Q

What is fascia?

11, ST MFR

A

a complete system with blood supply, fluid drainage, and innervations

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44
Q

What does fascia not include?

11, ST MFR

A

Tendons
Ligaments
Aponeuroses

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45
Q

Differentiate stress vs strain

29, ST MFR

A

Stress –> the force that attempts to deform a CT structure

Strain –> % of deformation of CT

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46
Q

What is tissue creep?

31, ST MFR

A

CT under a sustained constant load (but below failure) will elongate (deform) in response to that load

47
Q

Which direction is the ease of motion?

32, ST MFR

A

The direction in which the connective tissue is most easily moved

48
Q

What is Hooke’s Law?

36. ST MFR

A

The strain (deformation) placed on an elastic body is in proportion to the stress (force) placed upon it

49
Q

What is Wolffs Law?

37, ST MFR

A

Bone will develop according to the stresses put on it

also applies to fascia

50
Q

What will be impaired or altered in somatic dysfunction?

38, ST MFR

A

Skeletal, arthroidal, or myofascial structures (and their VLN)

51
Q

What is AROM equal to?

A

Physiological barrier

52
Q

What is PROM equal to?

A

Anatomic barrier

53
Q

What end feel would you see with a restrictive barrier?

A

A hard-end feel

54
Q

What occurs in a direct technique?

A

applied force is done so away from the restrictive barrier

55
Q

What is the common compensatory pattern that 80% of healthy people have?
(47, ST MFR)

A

L - R - L - R

56
Q

What is the uncommmon compensatory pattern that 20 % of healthy have?

(47, ST MFR)

A

R - L - R - L

57
Q

What are the transition zones along the spine?

50, ST MFR

A

OA, C1, C2

C7, T1

T12, L1

L5, Sacrum

58
Q

What kind of tissue texture abnormalities might you find during your TART assessment?

(57, ST MFR)

A
boggy
indurated
tense
dry 
dense
59
Q

What are the indications for Soft Tissue (ST)

58, ST MFR

A

Enhance circulation

Provide relaxation

Feedback/diagnostics of tissue response for diagnosis by the physician

60
Q

What are relative contraindications of soft tissue technique?

(59, ST MFR)

A

Severe osteoporisis (don’t want to do things such as prone pressure)

Acute injuries (don’t want to stretch/damage already damage tissue)

61
Q

What are the absolute contraindications of soft tissue technique?

(60, ST MFR)

A

bleeding disorder

local infection/malignancy

Neurologic entrapement syndromes

62
Q

What are principles of soft tissue (ST) technique?

62, ST MFR

A

Hands should never scrape/carry the skin

Discomfort should be described as a “good” discomfort by patient

Forces applied gently w/ low amplitude at first

Pt should identify any discomfort as a “good discomfort”

continue until desired effect is obtained (amplitude of excursion maximum reached)

63
Q

What is a type of INR?

70, ST MFR

A

REM (releasing enhancing mechanism)

64
Q

What is an REM?

70, ST MFR

A

Release enhancing mechanism that speeds up treatment processes

65
Q

What are the indications for MFR?

71, ST MFR

A

Somatic dysfunction

When HVLA or Muscle Energy is contraindicated

When pt. is unable to relax muscle

66
Q

What are the absolute contraindications of MFR?

72, ST MFR

A

absence of somatic dysfunction

67
Q

What are the relative contraindications of MFR?

72, ST MFR

A

infection of soft tissue/bone

metastatic disease

DVT

fracture or dislocation

68
Q

For Unilateral Forearm Fulcrum Forward Bending when do stretch the trapezius and when do we stretch the posterior scalenes?

(7, ST MFR)

A

Trapezius - head rotated towards elbow

Posterior Scalenes - head rotated towards hand

69
Q

What was the mortality ratio of MD: DO for the World Wide Influenza Pandemic?

(4, Lymphatics)

A

500,000:73,500

DO - 0.486% (illinois board 6.94%)
MD - 1.08%

70
Q

What was the secondary infection to influenza seen in patients during the World Wide Influenza Pandemic?

(4, Lymphatics)

A

pneumonia (1:16)

71
Q

When does the lymphatic system begin to develop? When does it have a pronounced prevalence?

(8, Lymphatics)

A

5th week of gestation

significance - 20th week

72
Q

What is the progression of the prominence of the lymphatic system from birth on?

(8, Lymphatics)

A

system increases until puberty and regresses until death

73
Q

What is the organization of the lymphatic system?

9, Lymphatics

A

organized lymph tissue

lymph fluid

collecting ducts

74
Q

What lines lymphatic vessels?

21, Lymphatics

A

endothelium (no basement membrane)

75
Q

How does lymph flow through vessels?

21, Lymphatics

A

unidirectional flow w/ valves

compression via arterial pulsations

76
Q

What tissue do lymphatics not perfuse?

21, Lymphatics

A

epidermis

endomysium of muscles and cartilage

bone marrow

peripheral nerves (some)

77
Q

What are the two different thoracic ducts?

23, Lymphatics

A

Thoracic Duct

Right Lymphatic Duct

78
Q

What does the Thoracic Duct drain? where does it drain to?

23, Lymphatics

A

drains the majority of the body

drains to:

  • -> L internal jugular vein
  • -> L Subclavian vein
79
Q

What does the Right Lymphatic Duct drain? where does it drain to?

(23, Lymphatics)

A

drains:

  • -> R side of head
  • -> R side of neck
  • -> R side of thorax
  • -> R upper limb

drains to:

  • -> R internal jugular vein
  • -> R subclavian vein
80
Q

What is the Cisterna Chyli?

23, Lymphatics

A

a dilated collecting sac of the abdomen where the lymphatic trunks draining the lower half of the body merge (ascends as the thoracic duct into the thorax)

81
Q

Where does the Thoracic duct lie?

27, Lymphatics

A

lies against the vertebral column anteriorly

deviates left @ T4

82
Q

What increases interstitial fluid pressure?

31, Lymphatics

A

increase arterial pressure (HTN/increased BP)

increased capillary permeability

Increased interstitial fluid protein

Decreased plasma oncotic pressure

83
Q

What are the different lymphatic pumps?

31, Lymphatics

A

Intrinsic pump

extrinsic pump

84
Q

What is the intrinsic pump of the lymphatic system?

31, Lymphatics

A

Pressure gradients (large and small vessel disstension)

85
Q

What is the extrinsic pump of the lymphatic system?

31, Lymphatics

A

direct pressure on lymphatic vessels (thoracic/pelvic diaphragm)

86
Q

What is the Thoracic Inlet?

44, Lymphatics

A

the junction between the thoracic duct and the venous system (at the internal jugular/L subclavian junction)

87
Q

What is Sibson’s Facia?

44, Lymphatics

A

suprapleural membrane

thoracic duct travels cephalic through the fasicia until C7

88
Q

What are indications for lymphatic treatment?

A

Edema

Acute somatic dysfunction

Pregnancy

89
Q

What are the relative contraindications for lymphatic treatment?

(47, Lymphatics)

A

circulatory disorders

coagulopathies

osteoporosis

certain infections

90
Q

What are the absolute contraindications for lymphatic treatment?

(48, Lymphatics)

A

anuria (kidney failure)

necrotizing fasciitis in treatment area

91
Q

What are the principles of diagnosis?

50, Lymphatics

A

fluid pumps

spinal involvement

central myofascial pathways (assess transition zones)

risk-to-benefit ratio

peripheral/regional pathways

92
Q

What are the principles of lymphatic treatment?

58, Lymphatics

A

remove impediments to lymphatic flow

enhance respiratory-circulatory mechanisms of homeostasis

93
Q

What is the treatment technique order for lymphatic treatments?

(60, Lymphatics)

A

open myofascial pathways at transition points within the body

maximize the normal diaphragmatic motions

increase pressure differentials/increase fluid flow beyond normal levels

mobilize targeted tissue fluids into the lymphaticovenous system

94
Q

What do you always do first before lymphatic treatment?

61, Lymphatics

A

open the thoracic inlet

95
Q

What are you doing when you open the thoracic inlet?

61, Lymphatics

A

you’re releasing the restriction of Sibson’s fascia (can impede lymph flow)

96
Q

What is an active muscle energy technique?

5, DSA Muscle Energy and Articulatory

A

The patient contributes the corrective force

97
Q

What are the four types of muscular contraction?

7, DSA Muscle Energy and Articulatory

A

Isometric

Concentric (bicep flexion)

Eccentric (bicep relaxation)

Isolytic

98
Q

What is the most important muscular contraction in muscle energy?

(7, DSA Muscle Energy and Articulatory)

A

Isometric

99
Q

What are the indications for muscle energy?

33, DSA Muscle Energy and Articulatory

A

balance muscle tone

strengthen reflexively weakened musculature

lengthen a shortened/contractured/spastic muscle

100
Q

What are the sequential techniques for muscles energy?

35, 36, 37 DSA Muscle Energy and Articulatory

A

body part placed at position of resistance

pt. instructed to contract (what muscle, duration)

SD applies counterforce (3-5 secs)

pt. relaxes

SD restacks

repeats 2-3 times

101
Q

What factors negatively influence successful muscle energy by the patient?

(41, DSA Muscle Energy and Articulatory)

A

pt contracts too hard or in wrong direction

pt contracts for too short of time

102
Q

What factors negatively influence successful muscle energy by the student doctor?

(46, DSA Muscle Energy and Articulatory)

A

failure to control joint position

failure to provide counterforce in right direction

103
Q

What are the contraindications for muscle energy?

51, DSA Muscle Energy and Articulatory

A

local fracture or dislocation

unstable cervical spine

evocation of neurological symptoms

104
Q

What words are synonymous with Articulatory Approach?

54, DSA Muscle Energy and Articulatory

A

spring technique

low velocity/high amplitude technique

Direct technique

105
Q

What is an articulatory approach?

55, DSA Muscle Energy and Articulatory

A

gentle and repetitive motions through the restrictive barrier to restore motion

106
Q

What is a good target group for Articulatory Techniques (Spring Technique)?

(56, DSA Muscle Energy and Articulatory)

A

arthritic patients

elderly/frail patients

infants

post-op patients

107
Q

What are the relative contraindications of the Articulatory Technique?

(62, DSA Muscle Energy and Articulatory)

A

vertebral artery compromise

108
Q

What are the absolute contraindications of the Articulatory Technique?

(62, DSA Muscle Energy and Articulatory)

A

local fracture or dislocation

local infection

bleeding disorders/serious vascular compromise

109
Q

Compare Muscle Energy Technique (MET) vs Articular Technique (ART)?

(63, DSA Muscle Energy and Articulatory)

A

MET:

  • -> Direct technique
  • -> pt. contracts for 3-5s, 3-5x
  • -> pt. participation

ART:

  • -> Direct technique
  • -> physician directed motions
  • -> pt. doesn’t participate
110
Q

What are the normal spinal curvatures?

Observation & Palpitation

A

cervical - lordosis
thoracic - kyphosis
lumbar - lordosis
sacral - kyphosis

111
Q

What is the abnormal spinal curvature?

Observation & Palpitation

A

scoliosis

112
Q

What receptors are concentrated in the pads of the fingers (not the tips)?

(Observation & Palpitation)

A

touch receptors

113
Q

What receptors are deep in the skin and have a higher sensitivity on the back of the hand?

(Observation & Palpitation)

A

temperature receptors

114
Q

What is scoliosis?

A

a sideway curvature of the spine