Osteopathic Approach to the Hospitalized Patient (Sandman)

Question 1

OPP is good

Answer 1

-Dr. Sandhouse

Question 2

Don’t be afraid of your patients yo!

Answer 2

-Dr. Sandhouse

Question 3

Try and get as much……as you can.

Answer 3

History.

Question 4

The radiologist has reviewed your pts x ray, do you still need to?

Answer 4

Yes! Radiology may not be looking for same things you are.

Question 5

What do you need to emphasize in your exam?

Answer 5

Thoracoabdominal diaphragm (fluid flow), Rib fxn, and paraspinal myofascial elements (OA, sacral, T/L)

Question 6

For acutely ill patients, what kind of exam is recommended?

Answer 6

Supine exam.

Question 7

How can you diagnose pelvis on a supine pt?

Answer 7

AP compression test rather than standing flexion.

Question 8

Karin is so

Answer 8

Pretty

Question 9

Typically for pretty sick patients, what kind of techniques do you want to use?

Answer 9

Indirect. (Gentle direct techniques may be used to patient tolerance)

Question 10

OMT promotes…..

Answer 10

Healing and homeostasis

Question 11

OMT can help prevent the following complications…..

Answer 11

PAIN, Post op Ileus, Atalectasis, Fluid stasis, other consequences of somatovisceral reflexes. Shown to decrease morbidity and mortality.

Question 12

OMT treatment should address….

Answer 12

Structural issues, autonomic nervous system issues, diaphragmatic motion/venous/lymphatic flow.

Question 13

You must ……your OMT treatments/findings

Answer 13

DOCUMENT

Question 14

If the hospital does not have a form to document structural dx/tx…….

Answer 14

Write up findings in progress notes. DON’T add forms to the patient record.

Question 15

What areas do you treat for SNS?

Answer 15

Thoracic, upper lumbars, ribcage

Question 16

What areas do you treat for PNS?

Answer 16

Sacral, Suboccipital, cranial

Question 17

What areas do you treat for lymphatics?

Answer 17

Transverse diaphragms, rib motion

Question 18

Which test is most appropriate to use to assess iliosacral motion/restriction in a hospitalized patient?

Answer 18

ASIS Compression test

Question 19

Patient is on a ventilator, how would you assess for restriction in his lumbars?

Answer 19

Alternate anterior pressure on his transverse processes.

Question 20

Can you evaluate ribcage motion on somebody with a chest tube?

Answer 20

YES. (It’s an old TQ)

Question 21

What is the recommended method of SI joint assessment in a hospitalized patient?

Answer 21

Alternating anterior pressure on ILA an ipsilateral sacral base?

Question 22

You are evaluating a patient on a ventilator who has pulmonary edema. You find chronic tissue texture change in his upper thoracics. Why?

Answer 22

Changes secondary to a viscerosomatic reflex