OSM III Midterm Flashcards
What are enthesopathies and what is a common example?
- weakness of attachment point of tendon or ligament to bone (heals in 8 wks)
ex: plantar fasciitis heel pain
What are 4 common Muscular (also Tendinous) causes of Neck Pain? (S/LC/SC/LS)
Scalene, Longus Coli, Splenius Capitis, and Levator Scapulae SD
What are common neurological causes of Neck Pain?
- Scalene and Pec Minor can compress the Brachial Plexus
- Facet or disc damage
What are release enhancing maneuvers and integrated neuromuscular release maneuvers that can be added to Myofascial Release?
REM: breathing
NRM: activating related muscles to more quickly/effectively release myofascial restrictions
- becomes ACTIVE if this is added
What is the most common type of Muscle Energy Technique?
post-isometric relaxation
- only technique that requires ACTIVE force (pt. is actively moving)
What must you ALWAYS remember to do when using Facilitated Positional Release techniques?
FLATTEN THE CURVE!!!
- flatten curve and add compression, THEN place in indirect position and hold for 5 seconds before release
How are Still’s Techniques executed?
- place pt. in indirect position, THEN add COMPRESSION (5 lbs) or traction, and move them THROUGH the restrictive barrier to the physiological barrier
What are two major contraindications for HVLA that ONLY apply to CERVICAL HVLA?
Rheumatoid Arthritis and Down’s Syndrome
- due to Alar ligament that surrounds the dens of C2
How does the OA like to move?
How does the AA like to move?
How do C2-7 like to move?
OA: check flexion/extension
-sidebending and rotation are in OPPOSITE direction
AA: ONLY ROTATION
C2-7: check flexion/extension
- sidebending and rotation are in SAME direction
How does a Type 1 Thoracic Mechanic differ from a Type 2 Thoracic Mechanic?
Type 1: TONGO
- NEUTRAL, group, opposite directions (ex: RR/SL)
Type 2: single segment, either FLEXED or EXTENDED
- sidebend and rotate in the SAME direction
What are the Thoracic Rule of 3’s?
T1-3 : spinous/transverse processes at SAME LEVEL
T4-6: spinous process 1/2 segment BELOW transverse
T7-9: spinous process FULL segment below transverse
T10: spinous FULL segment below transverse
T11: spinous 1/2 segment below transverse
T12: spinous and transverse process at SAME LEVEL
What are the 5 structures used to diagnose innominate dysfunction and what are the two motion tests utilized?
structures: ASIS, PSIS, Iliac Crest, pubic bone, medial malleolus
motion tests: ASIS compression and STANDING forward bending test
What does the Seated Forward Bending Test tell you when diagnosing the Sacrum?
- side that is (+) will be opposite the axis if TORSION or on same side if UNILATERAL
What is the BITE mnemonic and what is it used for?
What are the normal motions of the ribs?
- used for Rib treatments
BITE = treat BOTTOM rib if INSPIRED SD, treat TOP rib is EXHALED SD
Ribs 1/2, 8-10 - Bucket Handle Motion
Ribs 3-7 - Pump Handle Motion
Ribs 11/12 - Caliper Motion
What muscles are utilized for treating Exhaled Rib Dysfunctions?
Rib 1 - Ant/Med. Scalene Rib 2 - Post. Scalene Rib 3-5 - Pec. Minor Rib 6-8 - Serratus Ant. Ribs 9/10 - Latissimus Dorsi Ribs 11-12 - Quadratus Lumborum
What is the common Compensated Zink Pattern?
L/R/L/R is COMMON, R/L/R/L is UNCOMMON
What do these Parasympathetics control:
- CN3
- CN7
- CN9
- CNX
- S2-S4
- eye
- lacrimal, palatine, submandibular glands
- parotid
- cardiopulmonary and GI
- colon, rectum, GU
What are the Sympathetic lvls for:
- Head/neck/upper esophagus
- Heart
- Lungs
- Upper GI/lower esophagus
- Small Intestine/Ascending Colon
- Descending Colon and Sigmoid Colon/Rectum
- T1-T5
- T1-T6
- T1-T7
- T5-T10
- T9-T11
- T12-L2
What are the Sympathetic lvls for:
- Adrenal
- Genitourinary Tract and Bladder
- Ureters (Upper and Lower)
- Upper and Lower Extremities
- T5-T10
- T10-L2
- Upper: T10-T11 and Lower: T12-L2
- Upper: T2-T7 and Lower T11-L2
What do the Vagus N. and S2-S4 Pelvic Splanchnic Ns. innervated?
S2-S4 = descending colon, rectum, reproductive organs, bladder, pelvis, lower ureter
Vagus N. = does everything else
there is NO innervation of the EXTREMITIES or VASCULAR SYSTEM by parasympathetics
What are the differences in set-up and force for Supine HVLA Type 1 SD, Type 2 F SD, and Type 2 E SD?
Type 1: sidebend pt. AWAY from doctor
- thrust down to segment on hand
Type 2 F: sidebend pt. TOWARDS doctor
- thrust down to segment on hand
Type 2 E: sidebend pt. TOWARDS doctor
- thrust on segment ABOVE hand
- hand supports vertebrae BELOW dysfunction
What are the differences in set-up and hand-placement for Prone HVLA Type 1 and Type 2 SD ?
Type 1: stand on SAME side as PTP
- PTP hand facing CAUDAD
Type 2 F: stand on OPPOSITE side as PTP
- PTP hand facing CEPHALAD
technique NOT used for EXTENSION SD
What is Compression Neuropathy?
What are 3 systemic causes of neuropathy? (P/H/D)
- functional or pathological change in the peripheral nervous system due to nerves becoming entrapped as they pass through a narrow passage
- pregnancy, hypothyroidism, diabetes
What is the difference between 1st, 2nd, 3rd, 4th, and 5th degree nerve damage? (N/A/N)
1: Neuropraxia (focal damage of myelin fibers)
- least severe
2. Axonotmesis (injury to axon, myelin sheath intact)
- Neurotmesis (injury to axon and endoneurium)
- Neurotmesis (injury to axon, endoneurium, perineur)
- Neurotmesis (injured axon, endo, peri, epineurium)
- most severe; surgery required to restore neurons
What does C5 Root innervate in the arm (motor, sensation, reflex)?
M: deltoids and biceps
S: lateral arm
R: bicep
What does C6 Root innervate in the arm (motor, sensation, reflex)?
M: wrist extension and elbow flexion
S: radial forearm and thumb/index fingers
R: brachioradialis
What does C7 Root innervate in the arm (motor, sensation, reflex)?
M: wrist flexion, elbow/finger extension
S: middle finger
R: triceps
What do the C8 and T1 Roots innervate in the arm (motor and sensation)?
C8: finger flexion; ulnar forearm and small finger sense
T1: finger abduction; medial arm sensation
What is radiculopathy?
- pain caused by compression of the spinal nerve that radiates in the distribution of the defined nerve root
How are these tests performed and what are they used to diagnose?
Spurlings Test
Adson Test
Hoffman Test
Testing Cervical Nerve Roots
S: extend/rotate neck toward symptomatic side
- look for exacerbation of pain
- Dx: cervical radiculopathy
A: elevate chin/head toward affected side while inspiring; look for obliteration of radial pulse
- Dx: Thoracic Outlet Syndrome
H: firmly grasp middle finger and snap dorsal side, look for flexion of thumb and index finger
- Dx: cervical myelopathy
What are 3 locations for Radial Nerve Entrapment?
- High on Humerus (usually humerus fracture)
- wrist drop, tricep involvement, weak elbow flexion
- Radial Tunnel (repetitive rotatory movements)
- also heavy manual labor
- pain/tenderness of lateral epicondyle
- wrist drop/pain with resisted supination
- At Wrist (sensory branch pinch by brachioradialis)
- sensation change over posterolateral hand
What is Wartenberg’s Syndrome or “Handcuff Neuropathy”?
- compression of superficial radian nerve in the forearm (where handcuffs would be placed)
- causes numbness, tingling, pain in nerve distribution
AKA Cheiralgia Paresthetica