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OMM-1 > Practical 2 > Flashcards

Practical 2 Flashcards

1
Q

Steps of Isomeric Muscle Energy

A
  1. address and approach restrictive barrier
  2. patiently gently isometrically contracts muscle 3-5 seconds (pushes against physician’s equal resistance)
  3. pause 1-2 secs waiting for muscle to relax, engage next barrier
  4. repeat above steps for total 3X
  5. approach 4th restrictive barrier
  6. re-evaluate for increased range of motion and symmetry
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2
Q

iliacus

A

hip flexor

origin: iliac fossa
insertion: lesser trochanter of femur

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3
Q

psoas major

A

hip flexor

origin: vertebral bodies, transverse processes and discs of L1-5 vertebrae
insertion: lesser trochanter of femur

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4
Q

rectus femoris

A

hip flexor (also knee extensor)

origin: AIIS
insertion: patella via quadriceps tendon and through patellar ligament to tibial tuberosity

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5
Q

hip flexor diagnosis

A
  1. patient prone
  2. flex knee to less than 90 degrees
  3. stabilize IT, extend the hip until feel barrier
  4. compare both sides for asymmetry
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6
Q

hip flexor treatment

A
  1. use ME protocol, patient isometrically flexes hip by bringing down into table
  2. re-evaluate by extending hip and comparing to opposite side for increased range of motion and symmetry
    * *if do not improve ROM, patient may have tight anterior hip capsule
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7
Q

semimembranosus

A

knee flexor, hamstring (also hip extensor)

origin: ischial tuberosity
insertion: medial tibial condyle

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8
Q

semitendinosus

A

knee flexor, hamstring (also hip extensor)

origin: ischial tuberoscity
insertion: proximal medial tibia

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9
Q

biceps femoris

A

knee flexor, hamstring (also hip extensor)

origin: ischial tuberosity (long head) and lateral lip of linea aspera on femur (short head)
insertion: fibular head

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10
Q

knee flexors diagnosis

A
  1. patient supine
  2. flex hip and knee to 90 degrees; slowly extend knee until you feel a barrier
  3. compare both sides for asymmetry
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11
Q

knee flexors treatment

A
  1. use ME protocol, patient isometrically flexes knee by bringing heel towards table
  2. re-evaluate by extending knee and comparing to opposite side for increased ROM and symmetry
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12
Q

vastus lateralis

A

knee extensor, quadriceps femoris

origin: greater trochanter
insertion: on patella via quardiceps tendon and through patellar ligament to tibial tuberosity

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13
Q

vastus medialis

A

knee extensor, quadriceps femoris

origin: intertrochanteric line
insertion: on patella via quadriceps tendon and through patellar ligament to tibial tuberosity

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14
Q

vastus intermedius

A

knee extensor, quadriceps femoris

origin: anterior and lateral surface of femoral shaft
insertion: on patella via quadriceps tendon and through patellar ligament o tibial tuberosity

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15
Q

rectus femoris

A

knee extensor, quadriceps femoris

origin: AIIS and acetabulum
insertion: on patella via quadriceps tendon and through patellar ligament to tibial tuberosity

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16
Q

knee extensors diagnosis

A
  1. patient prone
  2. flex knee until you feel restrictive barrier
  3. compare both sides for asymmetry
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17
Q

knee extensors treatment

A
  1. using ME patient isometrically extends knee
  2. re-evaluate by flexing knees and comparing ROM and symmetry
    * *flexing both at same time is painful to those with lower back pain
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18
Q

gracilis

A

hip aDductor

origin: inferior ramus of pubis
insertion: proximal and medial surface of tibia

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19
Q

adductor magnus

A

hip aDductor

origin: body and inferior ramus of pubis
insertion: femoral linea aspera and aDductor tubercle of femur

20
Q

adductor longus

A

hip aDductor

origin: body and inferior ramus of pubis
insertion: middle 1/3 of femoral linea aspera

21
Q

adductor brevis

A

hip aDductor

origin: body and inferior ramus of pubis
insertion: proximal part of femoral linea aspera

22
Q

pectineus

A

hip aDductor

origin: superior ramus of pubis
insertion: distal to lesser trochanter of femur

23
Q

hip aDductor diagnosis

A
  1. patient supine
  2. aBduct hip without internally or externally rotating hip joint (keep toes pointed upward) until feel barrier
  3. to ensure opposite thigh does not move, stabilize opposite leg/thigh with hand
  4. compare sides for symmetry
24
Q

hip aDductor treatment

A
  1. using ME patient isometrically aDducts hip

2. re-evaluate by aBducting hip and comparing ROM and symmetry

25
Q

gluteus medius and minimus

A

hip aBductor/internal rotator

origin: lateral surface of ilium
insertion: greater trochanter of femur

26
Q

tensor fascia lata (TFL)

A

hip aBductor/internal rotator

origin: iliac crest just posterior to ASIS
insertion: iliotibial tract and proximal and lateral tibia

27
Q

hip aBductor diagnosis

A
  1. patient supine
  2. lift leg not testing to create space
  3. aDduct leg testing without internally or externally rotating hip joint (keep toes pointed upward) until feel barrier
  4. compare both sides for asymmetry
28
Q

hip aBductor treatment

A
  1. using ME patient isometrically aBducts hip

2. re-evaluate by aDducting hip and compare for increased ROM and symmetry

29
Q

piriformis

A

external rotator

origin: anterior surface of sacrum
insertion: greater trochanter of femur

30
Q

external rotator diagnosis

A
  1. patient supine
  2. . grasp ankle and internally rotate hip until feel restrictive barrier
  3. evaluation noted by looking at hips, NOT knee, ankle, or foot
  4. compare sides for asymmetry
31
Q

external rotator treatment

A

flex knee above 90 degrees or below if knee pain or hip pain

32
Q

Steps of strain/couterstrain

A
  1. locate tender point
  2. place patient passively into position that results in reduction of tenderness and tissue texture abnormality
  3. ask patient if they have 75-100% reduction of pain
  4. maintain position for 90 seconds (may feel pulse)
  5. slowly and passively return patient to pre-treatment position KEEP CONTACT WITH TENDER POINT
  6. reevaluate
33
Q

iliacus tender point

A
  • location: 1/3 of distance from ASIS to midline pressing in posterior-lateral direction towards ilacus
  • treatment: patient supine, flex hips and knees bilaterally to shorten ilacus, cross ankles to aBduct and externally rotate hips
34
Q

aDductor tender point

A
  • location: anywhere along aDductor muscle (medial thigh)

- treatment: slightly flex hip and knee with aDduction of hip and slight external rotation

35
Q

piriformis tender point

A
  • location: midpoint between lower half of lateral aspect of sacrum and ILA and greater trochanter
  • treatment: patient is prone, flexion of hip (greater than 90) and aBduction
36
Q

psoas tender point

A
  • location: starting at 2/3 of distance from ASIS to midline and pressing deep in posterior direction toward psoas
  • treatment: patient supine, stand on side of dysfunction, knees flex with ankles resting on physician’s thigh, flex and sidebend pelvis toward side of tender point
37
Q

anterior hip capsule tightness related to hip flexion

A
  • **ask about hip instability or surgery

- diagnosis: patient prone, flex knee to 90, apply gentle pressure anteriorly on proximal femur to assess for tightness

38
Q

posterior hip capsule tightness related to hip external rotators

A
  • **ask patient about history of knee trauma or hip issues
  • diagnosis: patient supine flex hip to 90 ad flex knee, apply gentle pressure posteriorly through femur to assess for tightness
39
Q

evaluation of pelvis

A
  1. standing flexion test
  2. evaluate muscle imbalances and strain patterns
  3. evaluate innominate for inflares and outflares
  4. treat pubic compression if standing flexion test positive
  5. evaluate for superior or inferior pubic shears
  6. evaluate ASIS (inferior or superior)/ anterior or posterior rotation
  7. repeat standing flexion test (if positive–>upslip)
  8. evaluate upslip (IT, PSIS, iliac crest, ASIS, pubic tubercle)–>3 or more superior on side of positive flexion (one must be IT) then treat
  9. repeat standing flexion test
40
Q

naming torsions

A

first name: side of rotation or inferior/posterior ILA

last name: side of oblique axis (same side if forward, opposite if backward)

41
Q

steps to diagnose sacral dysfunction

A
  1. history and/or positive seated flexion test
  2. land marks: deep sulcus and inferior/posterior ILA
  3. sphinx test (worsen asymmetry is positive)
  4. name torsion or unilateral sacral flexion or extension
  5. confirmatory test: S2/S4 tender points, fascial drag, spring test
  6. Treat SD and re-check
  7. seated flexion test
42
Q

sphinx test diagnosis

A

flexion–>negative
extension–>positive
forward torsion–>negative
backward torsion–>positive

43
Q

treatment of forward sacral torsion

A
  • ischial tuberosity spread

- muscle energy: lateral sims or mirror image

44
Q

confirmatory tests for sacral dysfunction

A

fascial drag: cephalad–>forward torsion/unilateral flexion
caudad–>backward torsion/unilateral extension
tender point: S2–>backward sacral torsion
S4–>unilateral sacral flexion
spring test: negative–>no resistance–>forward/flexed
positive–>resistance–>backward/extended

45
Q

Treatment of backward sacral torsion

A
  • lateral recumbent technique with ME

- alternate positioning for lateral recumbent treatment with ME

46
Q

treatment of unilateral sacral flexion (sacral downshear)

A

ME/respiratory treatment

3 I’s: internal rotation, ILA, inhalation

47
Q

treatment of unilateral sacral extension (sacral upshear)

A

ME/respiratory treatment

3 x’s: external rotation, extension, exhale

OMM-1 (3 decks)

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