Osteopathic Approach to Cardiac Disease

Question 1

The heart and lungs both drain into the ________ lymphatic duct system. However, the pericardium drains into the ________ lymphatic duct system.

Answer 1

Right, thoracic

Question 2

Viscerosomatic reflexes that arise from cardiac arrhythmias will occur at ________.

Answer 2

T2

Question 3

________ angina is precordial chest pain that resembles true cardiac angina and results from cervical pathologies affecting the cervical spinal nerves.

Answer 3

Cervicogenic

Question 4

CHF is associated with increased venous pressure. Treatment of the lymphatics ________ lymphatic return and ________ central venous pressure.

Answer 4

Increases, decreases

Question 5

Metabolic neuropathies, such as ________, can cause there to be less nociceptive input and mask an MI.

Answer 5

Diabetes

Question 6

The anterior Chapman’s point for the heart is located in the ________ space between ________.

Answer 6

Intercostal, ribs 2 and 3

Question 7

The posterior Chapman’s point for the heart is located between ________ (between the ________ and the ________).

Answer 7

Vertebrae 2 and 3, spinous process, transverse process

Question 8

The AV node is innervated by the ________ vagus nerve.

Answer 8

Left

Question 9

________ sympathetic tone occurs with CHF and leads to an increased afterload. OMT has been shown to ________ sympathetic tone.

Answer 9

Increased, decrease (balance more so)

Question 10

A useful osteopathic mantra for care consists of which models?

Answer 10

Neurologic (autonomics per Dr. Noto-Bell)

Fluid (lymphatics per Dr. Noto-Bell)

Mechanics (biomechanics per Dr. Noto-Bell)

Question 11

Viscerosomatic reflexes that occur via the vagus nerves will present at the ________, ________, and ________.

Answer 11

Occiput, C1, C2

Question 12

Sympathetic innervation of the heart comes from the ________ plexus and arises from ________ of the sympathetic trunk.

Answer 12

Cardiac, T1-T5

Question 13

Cardiac plexus fibers that come from the right tend to innervate the ________.

Answer 13

SA node

Question 14

60% of patients with coronary artery disease have been found to have ________ trigger points.

Answer 14

Pectoralis major

Question 15

What specific OMM techniques are useful in cardiac disease?

Answer 15

BLT

Indirect myofascial release

Indirect release of diaphragm

Occipito-atlantal decompression

Rib raising

Question 16

With CHF, you have to be careful to not ________ the pump when increasing fluid return with OMT.

Answer 16

Overload

Question 17

The myocardium is generally innervated more so by the ________ side of the cardiac plexus.

Answer 17

Left

Question 18

The SA node is innervated by the ________ vagus nerve.

Answer 18

Right

Question 19

Cardiac plexus fibers that come from the left tend to innervate the ________.

Answer 19

AV node