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OSIII > OS3 Exam 1 > Flashcards

OS3 Exam 1 Flashcards

1
Q

What are the 5 characteristics of CRI?

What is the typical rate of CRI?

A

Rate, rhythm, amplitude, direction, strength

10-14 times per minute

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2
Q

What are the 5 components of the primary resp mechanism

A

CNS, CSF, dural membranes, cranial bones, sacrum

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3
Q

Explain the motions assoc w/ cranial F (include sacrum) (include dimensional changes)

A

SBS- sup
Sphenoid and vomer- ant/inf
Occiput and ethmoid- post/inf
Parietal bone- ext rotate
Interpalatine suture- inf
Sacrum (counternutation)- sacral base moves post
Ant/post dimension dec; transverse dimension inc

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4
Q

Explain motions assoc w/ cranial E (include sacrum) (include dimensions)

A 
SBS- inf
Sphenoid and vomer- post/sup
Occiput and ethmoid- ant/sup
Palatine- int rotate
Interpalatine suture- sup
Sacrum (nutation)- sacral base moves ant
A/P dimension inc; transverse dimension dec
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5
Q

Explain balanced membranous tension

A

Indirect treatment where you find the midpoint of movement of SBS in vault hold and hold at the midpoint until you reach a still point and continue to hold until CRI returns and is more symmetrical

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6
Q

Explain SBS Lateral Strain

A

Named for which sphenoid is more ant/sup- whichever hand rotates over the other
Sphenoid and occiput rotate in same direction on a vertical axis
Ex. R SBS lateral strain- right sbs shear where right sphenoid and occiput rotate left on vertical axis

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7
Q

Explain SBS vertical strain

A

Sphenoid and occiput F and E together but oppositely
Sup strain- sphenoid F and occiput E; thumbs point away
Inf strain- sphenoid E and occiput F; thumbs point toward

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8
Q

Explain SBS torsion

A

Named for side w/ more sup sphenoid (thumb points to you)
SBS rotates around an AP axis in the coronal plane; sphenoid and occiput rotate in opposite directions

R SBS torsion- R sphenoid rotates L, R occiput rotates R, R thumb points at you

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9
Q

What are the assoc changes w/ SBS torsion

A

Temporal and parietal- ext rotate on side of torsion
Orbit- smaller on side of torsion
Mandible- shifts to side of torsion
Falx cerebri- ant portion moves w/ sphenoid; post portion moves w/ occiput
Tentorium cerebelli- SB direction occiput R
Spinal dura- inf on side of torsion

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10
Q

Explain SBS SB and R

A

SBS R in AP axis and SB in vertical axis; sphenoid and occiput R same direciton but SB in opposite directions; named for side of convexity (hands move down and out)
R SBS SB/R- R sphenoid RR and SBL; R occiput RR and SBR; right hand moves down and out and left hand moves up and in

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11
Q

Explain assoc changes w/ SBS SB R

A

Temporal and Parietal- ext rotate on side of convexity
Orbit- moves ant on side of convexity
Mandible- shifts toward side of convexity
Falx cerebri- SB following direction of SBS SB
Tentorium cerebelli- follows occiput
Spinal dura- infection on side of convexity

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12
Q

Explain moves of parietal bone during cranial F and E; what axis and plane of motion; what are symptoms assoc w/ parietal bone SD; how do you treat

A 
Cranial F- ext rotate
Cranial E- int rotate
AP axis in coronal plane
Symptoms- HA and altered threshold for seizures
Treat- parietal lift
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13
Q

Explain frontal bone motions w/ cranial F and E; what axis and plane of motion; what are symptoms assoc w/ frontal SD; how do you treat

A 
Cranial F- ext rotate
Cranial E- int rotate
AP axis in coronal plane
Symptoms- HA, visual deficits, smell deficits (assoc w/ ethmoid)
Treat- frontal lift
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14
Q

Explain motion of temporal bone during cranial F and E; what are symptoms assoc w/ SD; how do you treat

A

Cranial F- ext rotate (low pitched tinnitus)
Cranial E- int rotate (high pitched tinnitus)
Symptoms- migraine, bells palsy, tinnitus, OM
Treat- temporal rocking

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15
Q

What is V spread used for

A

Release of any suture

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16
Q

Explain CV4 treatment

A

Volleyball hold just medial to occipitomastoid suture

Encourage E and resist F

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17
Q

Explain eval of TMJ

A

Symmetry (break face into 3rds)
Malocclusions (class 1 nml, class 2 overbite (B>A), class 3 underbite)
Palpate and muscle testing
Open and close mouth (C vs S shaped)

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18
Q

Explain TMJ ME for C and S shaped SD

A

C shaped- thenar eminence on body of mandible on side of SD, have pt slightly depress mouth, press toward oppo side and have pt resist, repeat
S shaped- warm cloth on TMJ 15 min, open/close, side/side, protract/retract against R for 20 sec, sets of 10, twice a day

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19
Q

explain TMJ MFR (u/l and b/l)

A

U/l- turn pt head so SD is up, apply caudad force on angle of mandible w/ thenar eminence and hold till tissue creep
B/l- apply caudad force on both angles of mandible w/ thenar eminences and hold until tissue creep

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20
Q

Explain counterstrain for masseter and TMJ

A

Masseter- monitor tender point inf to zygoma in belly of masseter; push on other side of jaw towards you

TMJ- tender point is behind angle of ramus; turn head so SD side is up

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21
Q

Explain how to reduce ant disc for TMJ

A

Digits 4 and 5 on angle of ramus, digits 2 and 3 on body of mandible, and other hand thenar eminence on contralat body of mandible

Lift digit 4/5 ant -> lift digit 2/3 sup -> apply lateral force w/ thenar eminene

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22
Q

What are the 5 models of OMM

A 
Biomechanical
Neuro
Resp/circ
Metabolic/nrg/immune
Behavioral
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23
Q

What are some treatments that deal w/ sympathetics

A 
Paraspinal inhibition (t10-l2)-hold for 90 seconds
Collateral ganglia inhibition (xiphoid to belly button- celiac, SMG, IMG)- press during exhale and resist inhale
Rib raising (supine or seated- normalize symp tone)
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24
Q

What are treatments involved in parasympathetics

A

Suboccipital release
OA/AA ME (normalize parasymp tone- inc tone)
Sacral rocking (inc tone)
Sacral inhibition (dec tone)

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25
Q

List the ANT chapman points on the right

A 
R 2 ICS- esophagus
R 5 ICS- liver
R 6 ICS- gb
R 7 ICS- pancreas
R 8-10 ICS- small bowel
R tip of rib 12- appendix
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26
Q

List ANT chapman points on the sternum, left side, and legs

A

Sternum- pylorus
L 5 ICS- stomach acidity
L 6 ICS-stomach
L 7 ICS- spleen
R leg- sup is cecum and inf is transverse colon
L leg- inf is transverse colon ad sup is sigmoid

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27
Q

List the post chapman points

A 
R T2- esophagus
R T5-6- liver and GB
L T5-6- stomach acidity and GB
R T7-8- pancreas 
L T7-8- spleen
R T8/9, T9/10, T11/12- small bowel
R rib 10 pylorus
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28
Q

Explain soft tissue for GI:
Lower thoracid under shoulder lat recumbent
Prone P counterpressure

A

Lower thoracic: pt lat recumbent w/ side to be treated up; doc facing pt; reach under shoulders and grab just lat to SP on paravert muscles and apply an anterolateral force and hold

Prone P w/ counterP- pt prone w/ doc on side of table; thenar eminence of caudad hand on oppo side paravert m; hypothenar eminence of ceph hand on same side paravert m; move hands in direction they are facing

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29
Q

Explain lymphatic treatments for GI pt

A 
Thoracic inlet
Dome diaphragm 
Ischiofossal release (pelvic diaphragm)
Rib raising
Pedal pump
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30
Q

Explain mesenteric release and where doc stands

A 
Small intestine (doc on R side)
Ascending colon (doc on L side)
Descending colon (doc on R side)
Cecal lift (doc on L side pulls toward belly button from ASIS)
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31
Q

With regards to compression neuropathy explain the following:

  • compression test
  • spurlings test
  • neck distraction
A

Compression- apply caudad force on pt head (positive to reproduce symptoms)
Spurlings- neutral, extend, SB towards (positive if reproduce symp)
Neck distraction- positive if it relieves pain/symptoms

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32
Q

What direction does a herniated disc typically occur in?

A

Postero-laterally

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33
Q

What are the boundaries of the thoracic outlet; what are the 3 areas w/in?

A

Boundaries- 1st rib, T1, and manubrium

Scalene triangle, costoclavicular space, and pec minor

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34
Q

What are some special tests for thoracic outlet syndrome and what do they indicate if positive

A

East test (subclavian a compression)
Adson- look at rib; look away scalene
Halstead/military- compressed between 1st rib and clavicle
Wrights hyperABduct- compressed by pec minor

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35
Q

What is an example of ME used to treat thoracic outlet syndrome and how do you perform

A

Rib 1 ME (pump or bucket)
Pump- flex pt head; resist inhale and force exhale
Bucket- flex head and SB toward SD; resist inhale and force exhale

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36
Q

What nerve is compressed during cubital tunnel syndrome and what are 2 tests to look for it?

A

Ulnar N
Tinels sign at elbow
Froments sign (thumb flexes- tests strength ofadductor pollicis)

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37
Q

What are 2 different treatments for cubital tunnel syndrome

A

Radial Head ME (post/pronate, ant/supinate)- pronate or supinate against resistance

Proximal Ulnar ME- varus/valgus force

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38
Q

What nerve is compressed in carpal tunnel syndrome and where is it typically compressed? What are 2 tests for it?

A

Median nerve entrapped under flexor retinaculum
Tinels wrist test
Phalens test

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39
Q

What are two treatments used for carpal tunnel syndrome

A

MFR at flexor retinaculum

Articulatory squeeze

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40
Q

What are 3 treatments used for common fibular n compression

A

Post fibular head ME/HVLA- dorsiflex, evert, and ext rotate; MCP on post fibular head; bring into hyperflexion and pull ant

Gastrocnemius ME
Biceps femoris ME

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41
Q

What nerve is compressed in anterior tarsal tunnel syndrome

A

Deep fibular n

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42
Q

What are 2 treatments for anterior tarsal tunnel syndrome

A 
MFR of extensor retinaculum 
Hiss whip (cuboid-navicular)
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43
Q

What nerve is compressed in tarsal tunnel syndrome

A

Posterior tibial n

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44
Q

What are 2 treatments for tarsal tunnel syndrome

A

MFR for flexor retinaculum ( evert calc and dorsiflex)

evert ankle SD- invert and pull HVLA

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45
Q

What nerve is compressed in meralgia paresthetica and by what?

A

Lateral fem cutaneous n compressed under the inguinal ligament

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46
Q

What are treatments for meralgia paresthetica

A

Ant innominante- ME (supine or prone)

Hip F ME or MFR

47
Q

Where are tender points typically located?

Do they radiate?

A

In the belly of the muscle or near the tendinous insertion

Do not radiate

48
Q

Explain what type of treatment counterstrain is and the general process (8 steps)

A

Counterstrain is a passive indirect treatment for tender points
Steps: ID SD, find TP, establish pain scale, move into direction of ease, reduce tenderness 70%, hold for 90 sec, SLOWLY return to neutral, re-eval

49
Q

What are some general rules of counterstrain treatments

A

Ant TP- F and SB toward
Post TP- E and SB away
Hold for 90 seconds (120 for ribs)
Must reduce by at least 70%

50
Q

What are the anterior TP for cervical spine

What are the post TP for cervical spine

A

Ant- Lateral masses (F SARA)

Post- SP or just lateral to the inbetween TP (E SARA)

51
Q

What are the ant TP for thoracic spine

A

Ant- AT1-6- at sternocostal joints just lat to sternal border
Ant- AT7-12- just lateral to midline in rectus abdominus m
Ant- AL7 and 8- 1 and 2 inches from xiphoid on costal cartilage

F SARA

52
Q

What are the post TP for thoracic spine

A

Post- inbetween SP and TP

E SARA

53
Q

What are the ant TP for ribs

A

Ant- Rib 1- just inf to medial aspect of clavicle
Ant- Rib 2- 1.5 inch lat to sternum
Ant- Rib 3-6- mid axillary line

F STRT

54
Q

What are the post TP for ribs

A

Post- rib angles along the medial border of the scapula

F SARA

55
Q

What are the ant TP for lumbar spine

A

Ant- AL1- medial to ASIS
Ant- AL2-4- medial, lateral, inf to AIIS
Ant- AL5- just lat to pubic symphysis and tubercle

56
Q

What are the post Tp for lumbar spine

A 
Post- L1-5- SP
Post- L1-3- TP
Post- UPL5- superior PSIS
Post- LPL5- inferior PSIS
Post- lat PL3- between PSIS and TFL
Post- lat PL4- TFL
57
Q

What bones make up the pterion (3)

What fontanelle was it

A

Frontal
Parietal
Sphenoid

Sphenoid fontanelle

58
Q

What bones make up the asterion (3)

What fontanelle was it

A

Occipital
Parietal
Temporal

Mastoid fontanelle

59
Q

What bones make up the bregma (2)

what fontanelle was it

A

Parietal
Frontal

Ant fontanelle

60
Q

What bones make up the lamba

What fontanelle did it make

A

Parietal
Occipital

Posterior fontanelle

61
Q

What are 4 major sutures

A

Coronal
Sagittal
Squamous (parieto-squamous and parieto-mastoid)
Lamboidal

62
Q

What was Dr Sutherlands contribution to OMM, what make him research it, and when did it publish

A

Thought sutures looked like fish gills and wanted to know there purpose

Discovered CRI and PRM

Published in 1943/1944

63
Q

Describe Sutherlands vs Modern (moskalenko) in terms of:

  • cause of bone mobility
  • what drives the PRM
A

Sutherland:
Bone mobility- due to reciprocal tension membranes
Brain drives the PRM

Modern:
Bone mobility due to CSF flow
Change in blood vol and CSF flow drive PRM

64
Q

Explain the significance of cranial research?

  • Heisey Adams
  • Frymann
  • Zinakis
A

Heisey Adams- cat model- cranium moves w/ internal and external forces

Frymann- found SBS SD are common, often out of synch w/ breathing, and the rhythm varies between individuals

Zinakis- confirmed movement and showed it was palpable

65
Q

What are the unpaired midline cranial bones (6)

A

Occiput, sphenoid, ethmoid, frontal, vomer, mandible

66
Q

What are the paired cranial bones (9)

A

Parietal, temporal, zygoma, “frontal”, maxilla, lacrimal, nasal, palatine, inf nasal concha

67
Q

What direction and axis do the midline and paired bones move in w/ cranial movements

A

midline unpaired- transverse axis, sagittal plane (ant/post)

Paired bones- AP axis, coronal plane (ext/int rotation)

68
Q

What bones does the parietal bone articular w/ (5)
What is special about it w/ regards to fontanelles
What are 2 osteological features that have anatomic relationships?

A

Other parietal, frontal, temporal, sphenoid, occipital
Contacts all 4 fontanelles (sphenoid, mastoid, post, and ant)
Sagittal sulcus for sagittal sinus
Groove for middle meningeal a

69
Q

What are examples of SD assoc w/ parietal bone (5)

A

Cranial synostosis (premature closure of suture), middle meningeal trauma, and Head/neck/tooth pain

70
Q

With regards to cranial synostosis explain:

  • sagittal synostosis
  • lambdoid synostosis
  • bicoronal synostosis
  • unicoronal synostosis
A

Sagittal synostosis (long thin head)

Lambdoid synostosis (u/l fusion of lambdoid suture-compensatory mastoid process grown on ipsilateral side, tilted base of skull so that its “downhill” on side of SD, and flat back of head)

Bicoronal synostosis (brachycephaly-wide head)

Unicoronal synotsosis (c shaped head)

71
Q

W/ regards to temporal bone what do newborns lack

A

Mastoid process

72
Q

Eustachian tube exits which bone and forms what border?

A

Eustachian tube exits temporal bone and forms medial wall of middle ear

73
Q

Explain tinnitus w/ regards to temporal bone movement

A

Cranial F- ext rotate- low pitch tinnitus

Cranial E- int rotate- high pitch tinnitus

74
Q

What bone drives motion of the temporal bone

A

Occiput drives motion of temporal bone

75
Q

What are temporal bone SD (6)

A

TMJ/head/neck pain, tinnitus, ear infections (OM), bells palsy

76
Q

What suture is patent in 10% of population w/ regards to frontal bone

A

Metopic suture

77
Q

Frontal bone motion is drive by what cranial bone (kind of the opposite of what drives the temporal bone)

A

Sphenoid drives frontal bone motion

78
Q

What are frontal bone SD? (4 w/ 2 assoc)

A

head pain (assoc w/ dec PRM), sinusitis, visual deficits, anosmia (assoc w/ ethmoid)

79
Q

Eustachian tube leaves the temporal bone via what exit?

A

Auditory canal

80
Q

What are infants more prone to ear infections/otitis media?

A

Shorter eustachian tube and the tube is more AP

81
Q

At what time are infants extremely prone to ear infections? Why?

A

Infants are especially prone to ear infections while teething b/c of extra fluid

82
Q

At what location is the eustachian tube most likely to be constricted?

A

Where the temporal bone and sphenoid meet

83
Q

HA can be assoc w/ what two things and what bone do we treat for them?

A

Arteries (middle meningeal)
Veins (dural venous sinuses)

Treat the parietal bone

84
Q

What are the exits for CN 3, 4, 5 (all 3), 6

What bones are involved

A 
CNIII- superior orbital fissure
CNIV- superior orbital fissure
CNV1- SOF
CNV2- foramen rotundum 
CNV3- foramen ovale
CN6- superior orbital fissure

Temporal and sphenoid

85
Q

What is the path that CNVII goes through and what hole does it exit? What bones are involved and what condition is it assoc w/

A

CN7- internal auditory meatus -> stylomastoid foramen

Temporal bone - bells palsy

86
Q

What does CN8 exit? What bone is assoc w it

A

CN8- internal auditory meatus

Temporal bone

87
Q

Where is the trigeminal ganglia typically compressed and by what structure; what is the condition called

A

In meckels cave by dura

Trigeminal neuralgia

88
Q

What type of joint is TMJ; what bones make it up and what structure stabilizes it

A

TMJ is synovial joint
Biconvex mandible and saddle temporal bone
Stabilized by meniscus

89
Q

What direction does the TMJ move when the jaw is depressed

A

Anteriorly

90
Q

Muscles of mastiction and what they do
2 muscles open
3 muscles close
2 muscles involved in moving mouth forward and to oppo side

A

Open- digastric and suprahyoid
Close- temporalis, masseter, medial pterygoid
Forward and to side- lateral and medial pterygoid

91
Q

Muscles of mouth

  • buccinator
  • depressor labii inf
  • depressor anguli oris
  • mentalis
  • orbicularis oris
  • levator angularis oris
  • zygomatic major
  • rosorius
A 
Buccinator- blow
Depressor labii inf- pout lower lip
Depressor anguli oris- draw out corner of lips/frown
Mentalis- chin up
Orbicular oris- kiss
Levator anguli oris- draw up corner/twoface
Zygomatic major- smile
Rosorius- grimmace/show teeth
92
Q

Does TMJ affect M or F more?
What condition is it assoc w/?
What are clicks typically due to?
Trauma w/ mouth closed causes what injury?

A

TMJD F>M
TMJD assoc w/ RA
Clicks due to disc displacement
Trauma w/ mouth closed = post capsule injury

93
Q

Describe the 3 classes of malocclusions

A

Class 1- nml bite; slight overbite
Class 2- overbite (2b>2A)
Class 3- underbite

94
Q

What is the best diagnostic imaging to use for TMJD?

A

MRI

95
Q

Describe pain assoc w/ tension HA

The classes based off frequency

A

Tension HA- band like b/l mild to mod non-throbbing pain

Infrequent 1 per month, frequent <15 per month, chronic >15

96
Q

Explain theories of tension HA pain (2 theories one regarding periodic and one chronic)

A

Periodic- peripheral sensitization to myofascial nociceptors

Chronic- CNS sensitization

97
Q

What 3 muscles are very commonly assoc w/ tension HA

A

Trapezius, levator scapulae, and SCM

98
Q

What are some general treatment areas for tension HA?

A

OA, AA, any SBS, TMJ, t spine, ribs, l spine, sacrum

99
Q

Describe pain assoc w/ migraine HA

A

U/l throbbing severe pain w/ assoc symptoms and aura maybe

100
Q

Describe in general the theory of migraines

A

serotonin -> vasoconstrict -> dec blood flow -> vasodilate

101
Q

What is the PRIMARY form of treatment for migraines? When do you typically perform OMT?

A

Primary- meds

Perform OMT between attacks

102
Q

Where should you focus OMT for migraines (w/ regards to what nerve); where else should you perform OMT

A

Sphenoid and temporal bones (CN5)
T spine- paraspinal inhibition and counterstrain
Suboccipital release
Ribs

103
Q

What is a cervicogenic HA; what are common triggers; what is the major cause; who does it affect more

A

HA caused by referred pain from C-spine
Triggers- movement or sustained posture
Caused by trauma
F>M

104
Q

What are the 3 muscles of the suboccipital triangle and their motions

A

Obliquus capitis sup- SB
Obliquus capitis inf- R
Rectus capitis post sup- SB and R

105
Q

What is the importance of the myodural bridge?

A

Directly links MSK to dura

106
Q

AA joint assoc w/ what neuralgia- where is the pain

C3 neuralgia- what trauma is it assoc w/-where is pain

A

AA- C2 neuralgia- occipital pain

C3 neuralgia- whiplash- frontal and orbital pain

107
Q

Explain:
Bulging disc- uneven or even compression?
Herniated- protrusion vs extrusion- what direction

A

Bulging disc- even compression
Herniated protrusion- no leakage
Herniated extrusion- leakage
Herniation- postero-laterally

108
Q

What is facilitation?

A

A pool of neurons are maintained at a subthreshold level of excitation; requires less input to stimulate an impulse; once created can be maintained by the CNS

109
Q

Explain:
Viscero-somatic reflex
Somato-visceral reflex

A

Viscero-somatic reflex- visceral stim causes reflex in segmentally related somatic structure

Somato-visceral reflex- somatic stim causes reflex in segmentally related visceral structure

110
Q

Explain:

Percutaneous reflex of morley

A

Direct organ to peritoneal inflammation

111
Q

Explain drainage of lymphatics from GI all the way to veins

A

GI lymph -> cisterna chyli (L2) -> thoracic duct -> left subclavian v

112
Q

Lymphatic congestion interferes w/ what?

A

Medications

113
Q

Explain the abdominal tension test and what the result indicates

A

Pt supine and lifts feet just off table- doc presses down on abdomen - if pain dec then it indicates the pain is likely visceral in origin

114
Q

Explain mesenteric lift treatment and where the doc stands

A

Small bowl- doc on right side
AC- doc on left side
DC- doc on right side
Cecal lift- doc on left side pull from ASIS towards belly button

OSIII (1 decks)

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