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OSIII > OS3 Exam 1 > Flashcards

OS3 Exam 1 Flashcards

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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
List the ANT chapman points on the right
``` 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 ```
26
List ANT chapman points on the sternum, left side, and legs
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
27
List the post chapman points
``` 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 ```
28
Explain soft tissue for GI: Lower thoracid under shoulder lat recumbent Prone P counterpressure
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
29
Explain lymphatic treatments for GI pt
``` Thoracic inlet Dome diaphragm Ischiofossal release (pelvic diaphragm) Rib raising Pedal pump ```
30
Explain mesenteric release and where doc stands
``` 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) ```
31
With regards to compression neuropathy explain the following: - compression test - spurlings test - neck distraction
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
32
What direction does a herniated disc typically occur in?
Postero-laterally
33
What are the boundaries of the thoracic outlet; what are the 3 areas w/in?
Boundaries- 1st rib, T1, and manubrium | Scalene triangle, costoclavicular space, and pec minor
34
What are some special tests for thoracic outlet syndrome and what do they indicate if positive
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
35
What is an example of ME used to treat thoracic outlet syndrome and how do you perform
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
36
What nerve is compressed during cubital tunnel syndrome and what are 2 tests to look for it?
Ulnar N Tinels sign at elbow Froments sign (thumb flexes- tests strength ofadductor pollicis)
37
What are 2 different treatments for cubital tunnel syndrome
Radial Head ME (post/pronate, ant/supinate)- pronate or supinate against resistance Proximal Ulnar ME- varus/valgus force
38
What nerve is compressed in carpal tunnel syndrome and where is it typically compressed? What are 2 tests for it?
Median nerve entrapped under flexor retinaculum Tinels wrist test Phalens test
39
What are two treatments used for carpal tunnel syndrome
MFR at flexor retinaculum | Articulatory squeeze
40
What are 3 treatments used for common fibular n compression
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
41
What nerve is compressed in anterior tarsal tunnel syndrome
Deep fibular n
42
What are 2 treatments for anterior tarsal tunnel syndrome
``` MFR of extensor retinaculum Hiss whip (cuboid-navicular) ```
43
What nerve is compressed in tarsal tunnel syndrome
Posterior tibial n
44
What are 2 treatments for tarsal tunnel syndrome
MFR for flexor retinaculum ( evert calc and dorsiflex) evert ankle SD- invert and pull HVLA
45
What nerve is compressed in meralgia paresthetica and by what?
Lateral fem cutaneous n compressed under the inguinal ligament
46
What are treatments for meralgia paresthetica
Ant innominante- ME (supine or prone) | Hip F ME or MFR
47
Where are tender points typically located? | Do they radiate?
In the belly of the muscle or near the tendinous insertion | Do not radiate
48
Explain what type of treatment counterstrain is and the general process (8 steps)
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
What are some general rules of counterstrain treatments
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
What are the anterior TP for cervical spine | What are the post TP for cervical spine
Ant- Lateral masses (F SARA) | Post- SP or just lateral to the inbetween TP (E SARA)
51
What are the ant TP for thoracic spine
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
What are the post TP for thoracic spine
Post- inbetween SP and TP E SARA
53
What are the ant TP for ribs
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
What are the post TP for ribs
Post- rib angles along the medial border of the scapula F SARA
55
What are the ant TP for lumbar spine
Ant- AL1- medial to ASIS Ant- AL2-4- medial, lateral, inf to AIIS Ant- AL5- just lat to pubic symphysis and tubercle
56
What are the post Tp for lumbar spine
``` 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
What bones make up the pterion (3) | What fontanelle was it
Frontal Parietal Sphenoid Sphenoid fontanelle
58
What bones make up the asterion (3) | What fontanelle was it
Occipital Parietal Temporal Mastoid fontanelle
59
What bones make up the bregma (2) | what fontanelle was it
Parietal Frontal Ant fontanelle
60
What bones make up the lamba | What fontanelle did it make
Parietal Occipital Posterior fontanelle
61
What are 4 major sutures
Coronal Sagittal Squamous (parieto-squamous and parieto-mastoid) Lamboidal
62
What was Dr Sutherlands contribution to OMM, what make him research it, and when did it publish
Thought sutures looked like fish gills and wanted to know there purpose Discovered CRI and PRM Published in 1943/1944
63
Describe Sutherlands vs Modern (moskalenko) in terms of: - cause of bone mobility - what drives the PRM
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
Explain the significance of cranial research? - Heisey Adams - Frymann - Zinakis
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
What are the unpaired midline cranial bones (6)
Occiput, sphenoid, ethmoid, frontal, vomer, mandible
66
What are the paired cranial bones (9)
Parietal, temporal, zygoma, "frontal", maxilla, lacrimal, nasal, palatine, inf nasal concha
67
What direction and axis do the midline and paired bones move in w/ cranial movements
midline unpaired- transverse axis, sagittal plane (ant/post) Paired bones- AP axis, coronal plane (ext/int rotation)
68
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?
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
What are examples of SD assoc w/ parietal bone (5)
Cranial synostosis (premature closure of suture), middle meningeal trauma, and Head/neck/tooth pain
70
With regards to cranial synostosis explain: - sagittal synostosis - lambdoid synostosis - bicoronal synostosis - unicoronal synostosis
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
W/ regards to temporal bone what do newborns lack
Mastoid process
72
Eustachian tube exits which bone and forms what border?
Eustachian tube exits temporal bone and forms medial wall of middle ear
73
Explain tinnitus w/ regards to temporal bone movement
Cranial F- ext rotate- low pitch tinnitus | Cranial E- int rotate- high pitch tinnitus
74
What bone drives motion of the temporal bone
Occiput drives motion of temporal bone
75
What are temporal bone SD (6)
TMJ/head/neck pain, tinnitus, ear infections (OM), bells palsy
76
What suture is patent in 10% of population w/ regards to frontal bone
Metopic suture
77
Frontal bone motion is drive by what cranial bone (kind of the opposite of what drives the temporal bone)
Sphenoid drives frontal bone motion
78
What are frontal bone SD? (4 w/ 2 assoc)
head pain (assoc w/ dec PRM), sinusitis, visual deficits, anosmia (assoc w/ ethmoid)
79
Eustachian tube leaves the temporal bone via what exit?
Auditory canal
80
What are infants more prone to ear infections/otitis media?
Shorter eustachian tube and the tube is more AP
81
At what time are infants extremely prone to ear infections? Why?
Infants are especially prone to ear infections while teething b/c of extra fluid
82
At what location is the eustachian tube most likely to be constricted?
Where the temporal bone and sphenoid meet
83
HA can be assoc w/ what two things and what bone do we treat for them?
Arteries (middle meningeal) Veins (dural venous sinuses) Treat the parietal bone
84
What are the exits for CN 3, 4, 5 (all 3), 6 What bones are involved
``` CNIII- superior orbital fissure CNIV- superior orbital fissure CNV1- SOF CNV2- foramen rotundum CNV3- foramen ovale CN6- superior orbital fissure ``` Temporal and sphenoid
85
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/
CN7- internal auditory meatus -> stylomastoid foramen Temporal bone - bells palsy
86
What does CN8 exit? What bone is assoc w it
CN8- internal auditory meatus Temporal bone
87
Where is the trigeminal ganglia typically compressed and by what structure; what is the condition called
In meckels cave by dura Trigeminal neuralgia
88
What type of joint is TMJ; what bones make it up and what structure stabilizes it
TMJ is synovial joint Biconvex mandible and saddle temporal bone Stabilized by meniscus
89
What direction does the TMJ move when the jaw is depressed
Anteriorly
90
Muscles of mastiction and what they do 2 muscles open 3 muscles close 2 muscles involved in moving mouth forward and to oppo side
Open- digastric and suprahyoid Close- temporalis, masseter, medial pterygoid Forward and to side- lateral and medial pterygoid
91
Muscles of mouth - buccinator - depressor labii inf - depressor anguli oris - mentalis - orbicularis oris - levator angularis oris - zygomatic major - rosorius
``` 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
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?
TMJD F>M TMJD assoc w/ RA Clicks due to disc displacement Trauma w/ mouth closed = post capsule injury
93
Describe the 3 classes of malocclusions
Class 1- nml bite; slight overbite Class 2- overbite (2b>2A) Class 3- underbite
94
What is the best diagnostic imaging to use for TMJD?
MRI
95
Describe pain assoc w/ tension HA | The classes based off frequency
Tension HA- band like b/l mild to mod non-throbbing pain | Infrequent 1 per month, frequent <15 per month, chronic >15
96
Explain theories of tension HA pain (2 theories one regarding periodic and one chronic)
Periodic- peripheral sensitization to myofascial nociceptors | Chronic- CNS sensitization
97
What 3 muscles are very commonly assoc w/ tension HA
Trapezius, levator scapulae, and SCM
98
What are some general treatment areas for tension HA?
OA, AA, any SBS, TMJ, t spine, ribs, l spine, sacrum
99
Describe pain assoc w/ migraine HA
U/l throbbing severe pain w/ assoc symptoms and aura maybe
100
Describe in general the theory of migraines
serotonin -> vasoconstrict -> dec blood flow -> vasodilate
101
What is the PRIMARY form of treatment for migraines? When do you typically perform OMT?
Primary- meds | Perform OMT between attacks
102
Where should you focus OMT for migraines (w/ regards to what nerve); where else should you perform OMT
Sphenoid and temporal bones (CN5) T spine- paraspinal inhibition and counterstrain Suboccipital release Ribs
103
What is a cervicogenic HA; what are common triggers; what is the major cause; who does it affect more
HA caused by referred pain from C-spine Triggers- movement or sustained posture Caused by trauma F>M
104
What are the 3 muscles of the suboccipital triangle and their motions
Obliquus capitis sup- SB Obliquus capitis inf- R Rectus capitis post sup- SB and R
105
What is the importance of the myodural bridge?
Directly links MSK to dura
106
AA joint assoc w/ what neuralgia- where is the pain | C3 neuralgia- what trauma is it assoc w/-where is pain
AA- C2 neuralgia- occipital pain | C3 neuralgia- whiplash- frontal and orbital pain
107
Explain: Bulging disc- uneven or even compression? Herniated- protrusion vs extrusion- what direction
Bulging disc- even compression Herniated protrusion- no leakage Herniated extrusion- leakage Herniation- postero-laterally
108
What is facilitation?
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
Explain: Viscero-somatic reflex Somato-visceral reflex
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
Explain: Percutaneous reflex of morley
Direct organ to peritoneal inflammation
111
Explain drainage of lymphatics from GI all the way to veins
GI lymph -> cisterna chyli (L2) -> thoracic duct -> left subclavian v
112
Lymphatic congestion interferes w/ what?
Medications
113
Explain the abdominal tension test and what the result indicates
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
Explain mesenteric lift treatment and where the doc stands
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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