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OS1 MT Flashcards

1
Q

mesomorphic body type?

A

athletic, average guy, mid-range ROM, associated with high embryonic mesoderm

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2
Q

ectomorphic body type?

A

thin, high ROM, associated with high embryonic ectoderm

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3
Q

endomorphic body type?

A

heavy, lower ROM, associated with high embryonic endoderm

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4
Q

factors that could create asymmetry?

A 
bone/joint deformity
kyphoscoliosis
dress/occupation/mental attitude/habit
sacral base unleveling
LE defects
somatic disfunction
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5
Q

indications of pale skin?

A

anemia

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6
Q

indications of erythema?

A

inflammation

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7
Q

indications of jaundice?

A

cirrhosis

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8
Q

indications of cyanosis?

A

rxn to cold, Reynaud’s disease, Tertralogy of Fallot

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9
Q

things to consider in skin lesions?

A 
Assymetry
Border
Color
Diameter
Evolution
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10
Q

AT Still birth? parents?

A

8/6/1828 in Lee County, VA

father was minister/physician
mother was uneducated, wanted better

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11
Q

AT Still move to MO?

A

1830s

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12
Q

made rope swing to treat headache

A

1839

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13
Q

took over mission in Eudora, KS

A

1850

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14
Q

studied anatomy in indian cadavers after cholera epidemic

A

1855

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15
Q

Civil War? Rank?

A

1861-64

Major

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16
Q

3 kids die from spinal meningitis and daughter dies from pneumonia a month later, returns home to farm and formulate ideas on medicine

A

1864

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17
Q

AT Still flung the banner of osteopathy to the breeze

A

10 AM 6/22/1874

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18
Q

presents ideas at baker, removed from church, recorded first OM treatment

A

1874

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19
Q

moved to Kirksville

A

1875

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20
Q

becomes busy enough to stay in Kirksville and patients come to him

A

1886

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21
Q

American School of Osteopathy opens (17 men, 5 women) taught by Still and Smith

A

1892

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22
Q

vermont becomes first state to legally license DOs, then ND

A

1896

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23
Q

Still autobiography published, MO grants DO licensure, AAAO founded

A

1897

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24
Q

osteopathic principles?

A
  • body = unit, mind/body/spirit
  • body capable of self-reg/self-heal/health mantinance
  • structure and function reciprocally related
  • treatment based on principles of self reg and relationship of structure/function
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25
Q

osteopathic vs allopathic?

A

osteopathic host focused, allopathic disease focused

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26
Q

first osteopathic residencies

A

1947

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27
Q

acute somatic dysfunction characterizations

A 
vasodilation
edema
tenderness
pain
tissue contraction
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28
Q

chronic somatic dysfunction characterizations

A 
tenderness
itching
fibrosis
paresthesia
tissue contraction
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29
Q

anatomic barrier?

A

limit imposed by anatomic structure, limit of passive motion

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30
Q

physiological barrier?

A

limit of active motion

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31
Q

elastic barrier?

A

range b/w physiologic and anatomic barriers

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32
Q

restrictive barrier?

A

functional limit abnormally diminishing normal physiological range

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33
Q

tenderpoints?

A

small discrete hypersensitive areas, localized pain

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34
Q

trigger points?

A

small discrete hypersensitive areas w/i myofascial structures, palpation causes referred pain

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35
Q

somatic dysfunction?

A

impaired or altered funciton of related components of the somatic (body framework) system

impaired or altered functioning

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36
Q

OMT?

A

the therapeutic application of manually guided forces by an OM physician to improve physiologic function and/or support homeostasis that has been altered by somatic dysfunction

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37
Q

what do DOs treat?

A

whole patient

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38
Q

contraction vs contracture?

A

normal tone vs abnormal shortening of muscle

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39
Q

acute vs chronic vascular changes?

A

acute - inflamed vessel wall injury, endogenous peptide released

chronic - sympathetic tone increases vascular constriction

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40
Q

acute vs chronic sympathetic changes?

A

acute - local vasoconstriction overpowered by chemical release, net vasodilation

chronic - vasoconstriction, hypertonic

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41
Q

acute vs chronic muscular changes?

A

local increase in tone, contraction, spasms, increase to spindle activity

decreased tone, flaccid, mushy, limited ROM due to contracture

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42
Q

AROM vs PROM?

A

AROM goes to physiologic barrier, PROM goes to anatomic (farther)

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43
Q

end feel?

A

palpatory experience or perceived quality of motion when joint is moved to its limit

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44
Q

early muscle spasm end feel?

A

empty, guarding, protective after injury

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45
Q

late spasm end feel?

A

chornic spasm, chronic tissue changes

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46
Q

hard capsular end feel?

A

frozen shoulder

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47
Q

soft capsular end feel?

A

synovitis

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48
Q

acute vs chronic pain

A

acute - sharp

chronic - dull, ache, tingle

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49
Q

acute vs chronic TTA?

A

a - red, swollen, boggy, increased tone

c - dry, cool, ropy, pale, decreased tone

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50
Q

Characteristics of motion?

A 
direction
range
quality (smooth, ratcheting, restricted, resistance)
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51
Q

abrupt end feel?

A

osteoarthritis or hinge joint

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52
Q

hard end feel?

A

somatic dysfunction

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53
Q

crisp end feel?

A

involuntary guarding as in a pinched nerve

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54
Q

static vs dynamic ROM?

A

static - maximal ROM w/ external force

dynamic - max ROM naturally produced and speed it can be produced at

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55
Q

Beighton score?

A

test for hypermobility

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56
Q

Ehler-Danlos?

A
  • major criteria = BS > 4, athralgia longer than 3 months in 4+ joints
  • minor criteria = BS 1-3, athralgia in 1-3 joints, dislocations, etc

requirement for diagnosis = 2 major, 1 major + 2 minor, 4 minor, or 2 minor and FH of EDS

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57
Q

flexion/extension plane?

A

saggital

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58
Q

sidebending plane?

A

coronal/frontal

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59
Q

rotation, horizontal add/abd plane?

A

horizontal/transverse

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60
Q

coupled motion?

A

association of motion along or about one axis, with another motion about or along another axis; principle motion cannot be produced w/o associated motion as well

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61
Q

fascia?

A

complete system w/ blood supply/drainage, innervations; largest organ system in body

involved in tissue protection and healing of surrounding systems

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62
Q

fascia is not?

A

Ts, Ls, aponeuroses

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63
Q

fascia is? (3)

A

omnipresent - continually throughout body
omnipotent - provides mobility/stability of MSK, contractile and healing functions
omniscient - “knowing everything” 75% stretch receptors in fascia, mechanoreceptors

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64
Q

pannicular fascia?

A

outermost layer; adipose outer layer and membranous inner layer, surrounds everywhere but orifices

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65
Q

axial/appendicular fascia?

A

“investing layer,” internal to pennicular; surrounds muscles/periosteum/peritendon

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66
Q

viscoelastic material?

A

material that deforms according to the rate of loading and deformity

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67
Q

stress/strain in ct?

A

force attempting to deform ct, and percentage of ct deformation

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68
Q

hysteresis?

A

diff b/w loading and unloading characteristics that represents energy lost in ct system; energy lost = hysteresis

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69
Q

creep?

A

ct under constant load will elongate

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70
Q

ease?

A

direction in which ct is moved easily

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71
Q

bind?

A

palpable restriction of ct mobility

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72
Q

fascial sweater?

A

restrictions in one area create ct restrictions at distances away

73
Q

newton’s 3rd law?

A

when 2 bodies interact, force exerted by one creates equal/opposite force in other

74
Q

hooke’s law?

A

strain/deformation placed on elastic body is in proportion to stress/force placed upon it

75
Q

wolff’s law?

A

bone will develop according to stresses placed upon it; also applies to fascia

76
Q

sherrington’s law?

A

when a muscle receives a nerve impulse to contract, its antagonists receive a simultaneous impulse to relax

77
Q

compensatory patterns?

A

normal fascial planes of ease
common comp = LRLR
uncommon comp = RLRL
uncompensated = LLLL/LRRL/etc (usually symptomatic)

78
Q

ideal compensatory pattern transition zones?

A

transition zones of spine

79
Q

soft tissue technique?

A

system of diagnosis and treatment directed towards tissues other than skeletal or arthrodial elements

ONLY direct treatments (towards RB)

80
Q

severe osteoporisis and ST spinal treatment?

A

don’t use prone pressure, use lateral recumbent techniques

81
Q

acute injuries and soft tissue techniques?

A

should never do direct techniques into acute injuries, use things like indirect MFR

82
Q

kneading vs inhibition?

A

kneading - repetitive pushing perpendicular

inhibition - pushing and holding perpendicular

83
Q

MFR?

A

direct or indirect, engaging release of MF tissues

84
Q

Integrated Neuromusculoskeletal Release?

A

combined procedures stretch ST and joint restriction

85
Q

Inherent forces?

A

using patient’s primary respiration mechanism (PMR) to assist w/ manipulation

86
Q

MFR treatment endpoint?

A

warmth, softening, or increase ROM

87
Q

health?

A

complete state of mental, physical, and social well-being; not merely the absence of disease

88
Q

manipulation?

A

use of hands and instructions to achieve maximum painless movement of the MSK system

89
Q

disease driven vs health driven treatments?

A

dd - stabilize, manage, black and white, epidemiology, has an endpoint

hd - complex, unique, variable, grey, ongoing

90
Q

5 models of osteopathic treatment?

A 
postural/structural
neurological
respiratory/circulatory
bioenergy
psychosocial

somatic dysfunction overlaps all of these realms

91
Q

history of MET?

A

Ruddy used contractions for spine treatments in 1950s, Mitchell wrote about it in 1948 and taught courses/developed it

92
Q

what type of technique is MET?

A

active and direct; patient contributes and is positioned in RB

93
Q

isometric contraction?

A

contraction of muscle w/ no change in distance b/w origin and insertion

94
Q

concentric isotonic contraction?

A

contraction w/ approximation of origin/insertion (biceps curl)

95
Q

eccentric isotonic contraction?

A

contraction w/ separation of origin/insertion (relaxation of curl)

96
Q

isolytic contraction?

A

non physiologic; attempted concentric contraction w/ external force causing separation of origin/insertion

97
Q

post-isometric relaxation?

A

most common form of MET

contraction -> tension in golgi tendon organ -> inhibition of contraction -> relaxation

98
Q

joint mobilization using muscle force?

A

maximum contractions restores motion in compressed joint

99
Q

oculocephalogyric reflex?

A

eye movements affect cervical/truncal muscles

gentle contraction

100
Q

reciprocal inhibition vs crossed extensor reflex?

A

same side flexor vs extensor contraction/relaxation

opposite side flexor/flexor or extensor/extensor contraction/relaxation

ounces of force, not pounds

101
Q

isokinetic strengthening?

A

lengthening hypertonics which shortens antagonist

sustained gentle pressure (10-20 lbs)

102
Q

isolytic lengthening?

A

lengthening a muscle shortened by contracture/fibrosis

max contractions

103
Q

isometric vs isotonic

A

isometric - light contraction, unyielding counter force

isotonic - hard to maximal contraction, counter force permits controlled motion

104
Q

situations bad for MET?

A

post-op
following MI
eye surgery and oculocephalogyric

105
Q

when to use MET vs ART

A

ART is best in elderly/frail, critically ill, post-op, youth

MET must have strength and be able to follow commands

106
Q

ST/MFR/INR/MET/ART

  • direct?
  • indirect?
  • single action?
  • repetitive?
A

direct = all
indirect = MFR/INR
single action = MFR/INR
Repetitive = all but MFR

107
Q

ST/MFR/INR/MET/ART activating forces?

A 
ST = physician
MFR = physician
INR = physician and patient
MET = patient
ART = physician
108
Q

When did Still coin the term Osteopathy?

A

1889 (bone, to suffer)

109
Q

AOA adopts standards for approving OM colleges

A

1902

110
Q

Flexner?

A

Authored a report on medical education in 1910

111
Q

Spanish flu

A

1917-1918

112
Q

DOs seek recognition in military

A

1917 (legalized 1957)

113
Q

First DO in armed forces?

A

Harry Walter

114
Q

Jeanette Bolles?

A

First woman DO degree

115
Q

Louisa Burns?

A

First researcher in OM w/ Ann Perry

116
Q

Babara Ross?

A

First african-american women appointed dean of medical school in US

117
Q

Oliva?

A

Cuban, first minority president of AOA 1988-1989

118
Q

W. Anderson?

A

first african-american president of AOA 1994-1995

119
Q

Cline Committee?

A

determined DO educaiton is comparable to MD but worse facilities (1955)

120
Q

California incident?

A

1961

121
Q

Last state to extend full rights to DOs? When?

A

Mississippi 1973

122
Q

Plumb Line?

A
  • External Auditory Canal
  • Acromion Process
  • Greater Trochanter
  • Anterior Medial Malleolus
123
Q

Factors affecting symmetry?

A

somatic dysfunction
acute disease process
normal/genetic

124
Q

components of observation?

A

look, feel, move, function

125
Q

acute vs chronic SDs?

A

vasodilation/edema

itching/fibrosis/paresthesias

126
Q

spine curvatures?

A

cerv lordosis
thor kyphosis
lumb lordosis
sacral kyphosis

127
Q

fascia function?

A
  • healing
  • mobility/stability
  • elastic/contractile
128
Q

Release Enhancing Maneuvers (REMs)?

A
  • inhalation/exhalation
  • leg extension/flexion
  • arm abd/adduction
129
Q

one hand cradles occiput, other hand on chin; exert cephalad force

A

cervical traction

130
Q

one hand flexes patient’s neck other hand under patient’s head with palm on opposite shoulder; head is rotated towards and away from elbow of the arm under the head

A

unilateral fulcrum forward bending

131
Q

arms crossed under patients head, neck is flexed for longitudinal stretch of paravertebral Ms

A

bilateral fulcrum forward bending

132
Q

physician at opposite side being treated, caudad hand reaches across and contacts paravertebral Ms and cephalad hand on patients forehead; tissue engaged w/ ventral force

A

cervical contralateral traction

133
Q

fingers under patient’s neck bilaterally on parapsinal Ms, cephalad force applied

A

cervical cradling w/ traction

134
Q

fingers placed on suboccipital region and upward pressure into tissues is applied and held

A

suboccipital release

135
Q

physician opposite of prone patient, hands placed on each other on opposite muscles and engaged

A

prone pressure

136
Q

physician on side of table to prone patient, one had on opposite side one hand on same side and muscles engaged in opposite directions (finger directions)

A

thoracic prone pressure w/ counterpressure

137
Q

physician on side to be treated of prone patient, patients arm behind back and fingers are placed on medial border of scapula and engaged upward

A

subscapular stretch

138
Q

physican at side of table to lateral recumbent patient, caudad hadn under patients arm contacting thoracic paravertebral Ms and cephalad hand contacts anterior shoulder, patients arm draped over physicians arm; ventral force engaged

A

upper thoracic w/ shoulder block

139
Q

physician at side of table of lateral recumbent patient, fingers placed on thoracic paravertebral Ms and engaged w/ ventral force

A

lower thoracic under the shoulder

140
Q

one hand on paravertebral Ms, one hand on ASIS for counter force

A

lumbar prone pressure w/ counterleverage

141
Q

physician at side of table facing lateral recumbent patient, lumbar tissues engaged w/ lateral force creating

A

paraspinal perpindicular stretch

142
Q

patient prone, physician engages back w/ ventral force in all directions and treats into or away from restriction

A

D/I thoracolumbar MFR

143
Q

patient lateral recumbent, physican engages medial erector spinal muscles while spreading elbows

A

throacic longitudinal and lateral MFR

144
Q

patient seated and pysicians palm on medial erector spinal msucles and other hand across patients chest and applies anterior/lateral force on back Ms while depressing shoulder

A

seated paraspinal lumbar MFR

145
Q

patient prone and physician places one hand lumbar one hand sacral and moves in all directions

A

lumbosacral MFR

146
Q

patient prone physicians hands placed on one another on sacral region and moved in all directions

A

prone I-sacral release

147
Q

patient prone w/ arm dangling, physician engages humeral head through all motions

A

shoulder MFR

148
Q

patient lateral recumbent physician caudal hand beneath axilla and grasps inferior medial scapula and cephalad hand on superior medial scapula and lateral traction applied

A

lateral stretch rhomboid region

149
Q

patients hand held and other hand on elbow region and tested in all directions

A

elbow MFR

150
Q

hands grasp carpal bones and tested in all directions

A

Still’s wrist MFR

151
Q

patient lateral recumbent and physician contacts scapula w/ both hands; ease/restriction assessed and treated

A

Scapulothoracic MFR

152
Q

7 stages of movement of shoulder, patient lateral recumbent

A

Spencer’s Technique

153
Q

stages of Spencers Technique?

A 
Extension
Flexion
Compression circumeudction
Traction circumduction
Adduction and ER
Abduction
Internal rotation
Traction w/ inferior glide
154
Q

arm is tested for flexion/exension/IR/ER/ab/ad against force

A

GH MET treatment

155
Q

physician engages SC joint during shrugging

A

SC ab/adduction diagnosis

156
Q

physician engages SC joint during arm flex/ext

A

SC joint flex/extension diagnosis

157
Q

patient supine laying on elevated surface and clavicle engaged downward

A

SC elevated/adducted SD joint ART

158
Q

patient supine and SC joint engaged downward while arm is flexed and resisted

A

SCelevated/adducted SD joint MET

159
Q

patient supine and pulls down on physicians shoulder while SC is engaged towards sternum

A

SChorizontal extension SD MET

160
Q

physician on opposite side of SD and engages SC downward while abducting the opposite arm

A

SC ART

161
Q

clavicle “step-off?”

A

shifted clavicle, reveals AC joint problem

162
Q

physician monitors AC joint and patient horizontally adducts arm

A

Cross-Arm/Adduction test

if painful, AC or GH problem

163
Q

patient supine and physician engages AC w/ caudad force and flexes the arm

A

AC joint ART for superior clavicle SD

164
Q

normal carrying angle of elbow joint?
ecessive cubitus valgus?
cubitus varus?
gun stock deformity?

A
  • males 5-10, females 10-15
  • ECV = 30
  • CV = 0
  • GS = -15
165
Q

Ulnohumeral ad/ab ROM?

A

5/5

166
Q

elbow joint SDs?

A

in gliding motions not major motions

ulnohumeral joint is usually primary and radioulnar secondary

167
Q

radial head movements?

A

anterior glide w/ supination (anterior SD = supination SD)

posterior glide w/ pronation (posterior SD = pronation SD)

168
Q

patient supinates against force while physician resists and pushes radial head and resists

A

anterior radial head SD / supination MET

169
Q

patient pronates against force against resistance and physician pushes radial head

A

posterior radial head SD / pronation MET

170
Q

carpal bones movement in wrist flexion/extension?

A

dorsal/posterior glide in flexion

caudal/anterior glide in extension

171
Q

fingers crossed on palm and resistance is applied while patient flexes wrist; physician allows movement

A

wrist isotonic MET

172
Q

crisp end feel?

A

guarding of muscles

173
Q

elastic end feel?

A

normal

174
Q

empty end feel?

A

stopping due to pain

175
Q

4 stages of MFR?

A

engage barrier
apply tx
wait for creep
reasses

176
Q

isotonic vs isometric?

A

isotonic allows motion

isometric no motion (unyielding)

177
Q

MET vs ART

A

Direct/Active vs. Direct/Passive

178
Q

Fascial Barrier

A

Barrier to stop at in MET

179
Q

Spencer’s Order

A

.

OS1 (4 decks)

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