OTM- Exam 1 Flashcards
What is OMT?
The therapeutic application of manually guided forces by an
osteopathic physician to improve physiologic function and/or
support homeostasis that have been altered by somatic
dysfunction.
manual forces that address somatic dysfunction by improving physiological function and supporting homeostasis.
What are the goals of OTM?
- reduce pain
- improve function
What is somatic dysfunction?
Impaired or altered function of related
components of the somatic (body
framework) system: skeletal, arthrodial,
and myofascial structures, and their related
vascular, lymphatic, and neural elements.
Historically: Lesion, Still Lesion, Osteopathic Lesion
Mnemonic for Diagnosis Somatic Dysfunction
TART
- Tissue Texture Abnormalities
- Asymmetry of Structure
- Restriction in Motion
- Tenderness
Any one of which must be present for the
diagnosis of somatic dysfunction
What is the indication for OMT?
SOMATIC DYSFUNCTION
used to enhance homeostatic mechanisms (influence on nervous system)
Absolute Contraindication for OMT
OMT carries significant risk of a serious adverse event
that exceeds the expected benefit and should not be used
Relative Contraindication for OMT
caution should be exercised since there is a greater than usual chance of an adverse event
may need to exclude txs, body regions, risk vs benefit, communicate with patient
General Contraindications for OMT
- Lack of Consent
- Unstable condition
- if it will delay other tx that is more important
- w/o proper history and physical
- unstable anatomy
- OMT should not be used when the physician’s skill level makes it likely they will
apply a force that overwhelms the integrity of the tissues - Making changes that exceed the metabolic capacity of the patient’s system to
adapt (dosing)
What is an adverse event?
Any unfavorable and unintended sign (including an abnormal
laboratory finding), symptom, or disease temporally associated
with the use of a medical treatment or procedure that may or
may not be considered related to the medical treatment or
procedure.
Side Effect
unintended, secondary effect of the intended
effect; may be beneficial or harmful. No longer a recommended
term.
Grading of Adverse Events
- Mild
- Moderate
- Severe
- Life-threatening/Disabling (Serious)
- Death (Serious)
What are common adverse events following OTM?
most are mild and moderate (Non-serious)
What are patient responses following OTM?
What are two general considerations for OTM?
- constant feedback between hand and tissue
- how do the tissues respond
- one technique can treat 1+ dysfunction
- more than one tx required for one dysdunction
Two aspects of Dosing
- Limited by patient’s ability to respond to treatment
- Body must have adequate time to respond and change. (this is variable)
the sicker the patient, the less the dose
novices often err on side of overdose
concentrate on key areas
chronic diseases require chronic tx
acute cases have shorter interval between treatments, increase interval as patients respond
Geriatric Case Dosing Guidelines
- can be treated more frequently
- may need longer time to respond
2 major factors in determining technique choice
- ability of physician to execute technique
- ability of patient to respond to technique
2 barriers in Joint Motion
- physiologic
- anatomic
Joint/Tissue Tension
Somatic Dysfunction introduces what barrier?
Restrictive Barrier
3 classifications of OMT Techniques
- direct
- indirect
- combined
the goal of these is to restore lost motion
Direct Techniques
the joint/tissue is taken toward the restrictive barrier in one or more planes of motion (typically at the beginning of the technique)
It is then carried through the restrictive barrier.
Soft Tissue, articular, Sprining (LVMA), Myofasical Release, Muscle Energy, Thrust Techniques (HVLA)
Inidrect Techniques
- Away from the restrictive barrier (in the direction of ease, decreasing tension)
- maintain in position of ease
- release is to due to inherent forces rather than physician forces
- tensions gradually relax and mobility returns
Muscle: counterstrain, myofascial release
Joint Capsule and Ligamentous Structures: BLT, Facilitated positional release, functional technique
Combined Techniques
- Part of the technique is indirect and then a direct component is
added - Part of the technique is direct and then an indirect component
is added (less common) - Still technique
Common Technique Modalities
Indirect- BLT, Counterstrain
Direct- Soft Tissue, HVLA, Muscle Energy
BLT
- carry segment in the direction of ease to the PBLT
- Monnitor tissue response from inhalation to exhalation
- patient holds breathe as long as possible at point that provides best balance of ligamentous tension
Direction of Bind
Palpable resistance to motion of a joint or tissue (Resistance)
Direction of Ease
Relative palpable freedom of motion of a tissue or tissue
from the structure;s resting position, usually away from restr. barrier
synonyms: compliance, resilience, balance, breathing
What can be balanced with BLT?
- Facet Joint
- ligaments
- IV discs
- Myofascial structures
