OSPE 2

Question 1

NMT definition

Answer 1

Combined diagnostic and therapeutic technique
Seeks out and treats areas of somatic dysfunction
Cross fibre, longitudinal or inhibitory

Question 2

Effect of NMT

Answer 2

General compression reduces sensitivity of muscle spindles, leading to a decreased tendency to muscle shortening

Direct pressure/longitudinal stretch of Golgi Tendon bodies leads to muscle relaxation

Question 3

Cautions of NMT

Answer 3

Pregnancy
Diabetes
Osteoporosis

Question 4

Contraindications

Answer 4

No diagnosis
Infectious skin condition
Open wounds

Question 5

Biomechanics response to NMT

Answer 5

Reduced tissue adhesion
Increased ROM
Increased muscle compliance

Question 6

Physiological response to NMT

Answer 6

Increased arterial supply- increase O2 delivery
Increased serotonin, reduced cortisol
Increased lymphatic drainage

Question 7

Neurological response to NMT

Answer 7

Reduced neuromuscular excitability

Reduced muscle tension- through activating muscle spindles (longitudinal)

Question 8

Psychological response to NMT

Answer 8

Increased relaxation

Reduced anxiety

Question 9

Things that move lymph

Answer 9

Contraction of smooth muscles
Thoracic: abdominal gradient
Exercise
Manual therapy

Question 10

Pedal pump

Answer 10

Dorsiflexion= lymphatic vessels compressed between gastrocnemius and soles
–> pushes lymph towards heart
Release= -ve pressure = sucking more lymph upwards

Question 11

Knee drainage

Answer 11

Milks local lymphatics, subsequent techniques drain

Question 12

Thigh twist

Answer 12

Wringing effect= suction effect

Question 13

Femoral triangle

Answer 13

Superior side= inguinal ligament
Medial= adduction longus
Lateral= border of sartorial

Question 14

Inguinal pump

Answer 14

Drains deep + superficial inguinal nodes
–> between inguinal ligament and femoral artery
Circumduction of hip with alternating pressure + release over femoral triangle drains nodes

Question 15

Cisternae chyli

Answer 15

PSIS- L4- TPs of L1/2
Receives lymph from legs + gut
Left rotation + traction (extends lumbar spine)= lymph moves upwards

Question 16

Hepatic pump

Answer 16

RIGHT, below rib 5

Rhythmical compression/release of lower rib + traction/release of upper extremity helps drain liver

Question 17

Splenic pump

Answer 17

LEFT, level with rib 9, 10, 11

Rhythmical compression/release of lower rib + traction/release of upper extremity helps drain spleen

Question 18

Clavicular pump

Answer 18

Supraclavicular fossa= supraclavicular nodes
Drainage= circumduction of GH + compression/release over supraclcavicualr fossa
Lymph drains to left/right subclavian vein to superior vena cava

Question 19

Sibsons fascia

Answer 19

Connective tissue that covers apex of lungs

Question 20

Shoulder pump

Answer 20

Assists drainage of clavicular nodes

Rhythmical depression= natural elastic recoil

Question 21

Thoracic pump

Answer 21

Increased tension + sudden release upon inspiration= produces sudden -ve intrathoracic pressure= suction= opens thoracic duct

Question 22

Right lymphatic drainage

Answer 22

Right lymphatic duct drains right side of head, chest + right arm

Question 23

Left lymphatic drainage

Answer 23

Left thoracic duct receives lymph from rest of body

Question 24

Example of OSD

Answer 24

OSD to Sibsons Fascia can cause reduced lymphatic drainage anywhere in body

Question 25

OSD definition

Answer 25

Impaired or altered function to the somatic systems

START- symptom reproduction, tension, asymmetry, restriction, tenderness

Question 26

5Ds

Answer 26

Diplopia- double vision 
Dizziness 
Drop attacks 
Dysarthria- difficulty speaking 
Dysphagia- swallowing problems

Question 27

3Ns

Answer 27

Nausea
Numbness
Nystagmus- involuntary side-to-side, up and down movements,ent of the eyes

Question 28

A

Answer 28

Ataxia- effect coordination/balance

Question 29

Cervical facet orientation

Answer 29

Coronal, 45 deg

Question 30

Cervical limiting factors

Answer 30

Flexion + extension- brings facet joint too close together
Side bending- no LF
Rotation- contact too close, potential limiting factor if muscles are too tight

Question 31

Thoracic facet orientation

Answer 31

Coronal, 60 deg

Question 32

Thoracic limiting factors

Answer 32

Flexion- anterior ribs, brings facets too close together
Extension- posterior ribs, brings facets too close together
Side bending- ribs and TPs
Rotation- only ribs, as long as no paraspinal limitation

Question 33

Lumbar facet orientation

Answer 33

Sagittal until L5/S1
Flexion + extension- no limitation until L5
Side bending- sagittal plane restricts
Rotation- unless paraspinal limitation, no limitations

Question 34

Basic standing observation points to remember

Answer 34

Constant communication/consent

Muscle tone, appearance of skin, alignment of spine and pelvis

Question 35

Posterior observation

Answer 35

Mid-gravitational line 
Levels of mastoid Ps
Ears
Angle of neck on shoulders
Shoulder levels (acromion process)
Arm, elbow, forearm, fingertip levels
Iliac crest levels 
PSIS levels 
Greater trochanter 
Prominence of erector spinae- SYMMETRY 
Spinal curves 
Position of feet 
Achilles tendon 
Inversion/eversion of ankles

Question 36

Lateral plumb line

Answer 36

Lateral plumb line- external auditory meats, head of humerus, body of L£ vertebrae, ant 1/3rd of sacrum, greater trochanter of femur, lat condyle of knee, lat malleolus of foot

Question 37

Lateral observation

Answer 37

Lateral plumb line 
Head- ant, post, flexed, extended?
Thoracic cage shape 
Sternal angle
Spinal curves- hyper-kyphosis/lordosis?
Relation of ASIS to PSIS
Knee flexion or extension?
Feet: pectus planus/cavous?

Question 38

Anterior observation

Answer 38

Levels of eyes
Symmetry of face
Mandible
Symmetry of neck
Musculature
Clavicles
Prominence of sternal angle- pectus exavatum/carinatum
Relation of forearm to lateral body
Prominence of greater trochanter
Wiggle patella to see which leg is weight bearing
Feet- pes planus/cavous, weight bearing through which foot?