Random ECOS Midterm learn quick info Flashcards
Red free is used to look for what when using opthalmoscope?
visualize vessels and hemorrhages, makes retina look black and white
Slit beam in opthalmoscope is used for what?
examine contour abnormalities of cornea lens and retina
Blue light in the opthalmoscope is used for what?
look for corneal abrasions and ulcers after fluorescein staining
In child <12 months how do you look in their ear?
pull outer ear down and back
In adults/ >12 months, how do you look in ears?
outer ear up and back
Which lasts longer air or bone conduction?
Air conduction
What makes up the stance phase?
- Heel strike: establish stable contact
- loading response: absorb ground reaction to weight
- mid stance –> terminal stance–> Pre-Swing: body weight carried forward
(Heel strike and pre swing the first and last parts of stance phase are double support, Middle three are single support)
What makes up the swing phase?
Toe off mid swing and terminal swing, all are single support and the goal is to clear the foot, advance the lower extremeity, and prepare lower extremity for loading
Describe ataxic gate? Include etiology, limbs affected, cause and description
- Neurologic Etiology
- Bilaterally impacts legs
- Wide base with irregular steps and lack of balance
- Can be due to drunkeness or damage to balance centers
Describe Hemiparesis gate? Include etiology, limbs affected, cause and description
- Neurologic etiology
- Unilaterally impacts one side including arm and leg
- Arm is flexed and leg is extended (circumduction)
- Due to damage to motor control of brain commonly seen in stroke patients
Describe scissor gate? Include etiology, limbs affected, cause and description
- Neurologic etiology
- bilaterally impacts legs
- leg muscles are stiff due to spasm with the knees pointing inwards causing legs and feet to cross at the midline
- Due to damge at motor part of spinal cord
Describe steppage gait/foot drop? Include etiology, limbs affected, cause and description
- Neurologic etiology
- Unilateral
- Patient will flex their knee and hip to raise their leg higher in orderf to clear their foot from the ground –> “hiking”
- Due to weakness in common fibular nerve
Describe Parkinsobnian gate? Include etiology, limbs affected, cause and description
- Neurologic etiology
- Bilateral
- Patient will have a shuffle with fenestration as well as stiff and hunched over
- Due to damage muscle tone and movement initiation center in the brain
Describe waddling/Trendelenburg gate? Include etiology, limbs affected, cause and description
- MSK etiology
- Bilateral
- patients hip will drop towards the uneffected side and torso leans towards the effected side. DUCK LIKE WADDLE
- More techinical way to say it: trunk shifts to stance leg and hip drops on swing leg
- Due to trunk and leg muscular weakness
- Gluteus minimus and medius
Describe antalgic gate? Include etiology, limbs affected, cause and description
- MSK etiology
- Unilateral
- Shorten gait to prevent putting weight on one limb, decrease the stance phase on one side
- Usually due to pain in LE causes concern for trauma, joint damage or inflammation
Osteopathic tenants?
- Body is a unit
- Body possesses self reg mechanisms
- Structure and fxn reciprocally interrelated
- Rational thetrapy is based on understanding body unity, self reg mechanisms and structure fxn relationship
Characteristics of a Chronic SD?
- Pallor
- Ropey texture
- Coolness
- Tissue contracture
- Paresthesia
- Itching
- Palpable sense of tissue dryness
Contraction vs Contracture?
Contraction is process of shortening and tightening a muscle
Contracture is abnormal or permanent contraction of a muscle
Words to describe Acute TTA vs chfronic
Acute:
- erythematouos
- Hot
- Boggy
- Edema
- Spasm
- Tissue contraction
Chronic:
- Pale/Blanching
- Cool
- Ropey
- Stringy
- Scar
- Doughey
What are the five osteopathic models?
- MSK: mm bones tendons ligaments fascia integument
- Nervous system: brain and sc
- Respiratory and Cicrulatory: cardiovascular including lymphatics, respiratory, nose throat, genitourinary
- Metabolic/Energetic/Immune: GI, Lymph organs, Endocrine organs
- Behavioral: behaviors influencing health and health decisons
What kind of end feel will a SD have?
Haard
What kind of end feel will a patient with a pinched nerve exhibit?
Crisp- involuntary muscle guarding
What kind of end feel will a patient with OA or at a hinge joint exhibit?
Abrupt
What kind of end feel will a patienet with 9/10 knee pain exhibit?
empty- stops due to voluntary guarding
patient is in pain and does not want to continue movement
Coupled motion?
motion along or about one axis with a second motion occuring about a second axis
Drop a pen from your chair you will flex torso to begin to pick up and side bend to reach pen. Movement along two different axes
What is a functional unit of the spine?
Two vertebra and their associated disc, neurovasculature and soft tissues
What is linkage?
LInk multiple structures to increase ROM
Skeletal SD?
Myofascial SD?
Arthrodial SD?
Vascular SD?
Lymphatic SD?
Neural SD?
- Hard end point
- Tight elastic end pint
- Hard end point
- Empty end feel
- Empty or boggy end feel
- Crisp or empty end feel
What are the components of soft tissue? How does it relate to Fascia?
- Fascia
- Muscles
- Organs
- Nerves/Vasculature/Lymphatic vessels
- Tendons
- Ligaments
- Aponeuroses
Fascia does not include the three bolded underlined
During MFR, if you move your hands superiorly, to the left, and right hand inferior and left superior what are you doing?
Flexion, right rotation, and Sidebending right
Where would you find the SP of T1-3 and T12?
Located at same level of corresponding TP
Where would you find the spinous process of T4-6 and T11?
1/2 segment below corresponding TP
Where would you find SP of T7-10?
Level of TP of vertebra one below
What is Fryette’s third principle?
Initiating movement of a vertebral segment in any plane of motion will modify the movement of that segment in other planes of motion.
Other two are TONGO and TOSS
How to calculate pack years?
packs per day X years
Appropriate alcohol amounts?
- Beer 12 oz
- Wine 5 oz
- Liquor 1 oz
What are the five P’s?
- Partner
- Practices
- Prevent pregnancy
- Protection from STI’s
- Past history of STI’s
What is the recommendation for an adult on veggies and fruits servings?
6-9 fruits and veggies
Describe what the following means:
- Very low sodium
- Low sodium
- Reduced sodium
- Lightly salted
- No salt added
- Sodium free
- <35 mg of sodium or less per serving
- 140 mg of sodium or less per serving
- at least 25% less sodium than original product
- at least 50% less sodium than original
- no salt added during processing doesn’t mean no salt present
- <5mg of sodium per serving
Describe the following:
- fat free
- low fat
- reduced fat
- trans fat free
- less than 0.5 g of fat per serving
- 3 g of fat or less per serving
- at elast 25% less fat than the original product
- less than 0.5 g trans fat per serving
Sources for vitamin A?
- Milk
- FIsh oil
- liver
- eggs
- carrots
- squash
- greens
Fat solulble vitamin, required for epithelial functions, part of rhodopsin
What caloric deficit is needed to lose 1 lb/week
500
Wheat germ is a good source of what vitamins?
- E
- B2/Riboflavin
Your lunch consists of a spinach salad, with salmon, dark green and yellow veggies, eggs, broccoli, mushrooms, and lastly avocado. What vitamins/minerals is this lunch rich in?
- Spinach: Vit K, Ca,
- Dark green/yellow veggies: Vitamin A
- Eggs: B12/Cobalamin
- broccoli: Ca, Fe,
- Mushrooms: Vitamin D
- Avocado: Vitamin E
(Legumes are B3/niacin)
What aids in the absorption of non heme iron and where does that come from?
Vitamin C helps with absorption of non heme iron which comes from plants sources.
Heme iron comes from animal sources and is readily absorbed
- B1 uses and other name?
- B 2 uses and name
- B3
- B6
- B9
- B12
- Thiamine, used in carb metabolism and aa metabolism
- Riboflavin, used in oxidoreductases and FMN,FAD
- Niacin, Oxidoreductases NAD, NADP
- Pyridoxine, carb, lipid and aa metab. synthesis of NT and sphingolipids and heme
- Folic acid, choline synthesis of aa, synthesis of purines and pyrimidines
- Cobalamin, heme structure folate recycling
BMI calculation and ranges?
BMI=kg/m^2
Obesity >30
25.1-29.9 overweight
18-25 healthy
Names of ideal diets for those with Diabetes, Htn, Hyperlipidemia
- Low carb
- DASH
- DASH
Isotonic contraction and Isokinetic contraction?
Tonic: concentric or eccentric contraction against steady counterforce allwoing constatnt tone
Isokinetic: concentric contracction in which joint motion is at a constant rate/speed
Isolytic contraction and Isometric
- Isolytic: eccentric contraction where muscles concentric contraction is overpowered by stronger counterforce, leading to lengthening of muscle
- Isometirc: distance btw origin and insertion is maintained at constant length
- Wall squats
Post isometric relaxation? Set up?
most common form of muscle energy
Inhibit alpha motor neuron to result in reflexive relaxation of muscle
Dr. passively moves patient to direct barrier, patient contracts away from direct barrier and dr resists for 3-5 seconds no movement occurs
Reciprocal inhibition?
Goal: Lengthen muscle shortened by a cramp or acute spasm
When contraction is initiated in agonist muscle the antagonistic group will reflexively relax
Ounces of pressure applied
- Patient contracts towards the restrictive barrier and dr resists the restrictive barrier no movement occurs
Crossed Extensor reflex?
Learned cross pattern locomotion reflexes in CNS, when flexor of one leg or arm si contracted voluntarily the flexor in contralateral relaxes and extensor contracts. Ounces of pressure
Isolytic lengthening?
Goal: lengthen a muscle shhortened by contracture and fibrosis
Vibtationused has some effect on myotatic units in additon to mechanical and circulatory effects
Contracture of bicep the maximal contraction that can be comfortably resisted by doctor –> 30-50 lbs pressure
What is Nelson’s III (1948)?
Motion in one plane limits available motion in other planes
What is the physiologic barrier?
End ROM achieved during active motion
What is restrictive barrier
Functional limit that abnormallly diminishes normal physiologic range
What is anatomic barrier?
End ROM achieved during passive motion in absence of somatic dysfunction
What are the absolute contraindications for HVLA?
- RA
- Down Syndrome
These lead to Alar Ligament Instability
Others include:
- local cancer
- severe OA
- lack consent
- Osteomyelitis
- spinal cord diseases
What are the three principles of BLT according to Dr. Sutherland?
- Disengagament of dysfunctional area
- Exaggeration of dysfunctional pattern
- Balanced tension of ligaments
When using BLT inhalation will ___ the spine in the ___ direction while exhalation will increase ____.
- flatten
- anterior posterior direction
- AP spinal curves
FPR Steps
- Diagnose
- Flatten the curve
- Add compression
- Indirect positioning
- Hold 3-5 seconds
- Return to neutral
- Reassess
During FPR what happens to the 1-alpha afferent signals and tension in the extrafusal fibers?
Both decrease allowing muscles to achieve normal length and tone
Other effects of FPR are improved lymp drainage, venous drainage, and fluid dynamics
Steps to Stills Technique?
- Place dysfunctional segment in the shifted neutral position
- Add localizing force <5lbs compression or traction
- Move through restrictive barrier while keeping localizing force
- End in the direct position
- return to neutral
- reassess TART
What is counterstrain and what is the focus on for diagnosing?
Gentle passive indirect OMM for MSK pain
Diagnosis process is different than others the focus is on tenderness not preference of motion
This was in red on slides
What is the difference between trigger point and tenderpoint?
- Trigger points are only located in muscle and they can be locally tender or radiate pain, and they present with taut band of tissue that twitches upon palpation, Characteristic pain pattern
- Tenderpoints are in muscle, tendon,ligaments, and fascia, they have a characteristic pain pattern and are only locally tender, no tatut band or twitch
What are the phases of counter strain?
- Relaxaton phase:
- Monitoring tenderpoint is in this phase (step 3)
- also place pt in position of ease fold and hold (step 4)
- Normalize the nociceptive and neuro input pahse
- Washout phase:
- consists of steps 5-7 hold 90 sec, slow return to neutral recheck tenderness
- Slow return to neutral: see phase 3 for steps
What is the treatment in coutnerstrain for all PTSP?
- e-E
- extend T1-4 off the table and use knee or table to increase extension in lower T5-12
- Imagine shortening the interspinalis mucles
Treatment for PT 1-3 TP?
- E Sa Ra
- Ex: Right PT 2 TP you would use neck as a lever to E SB left and R left
Imagine shortening the multifidus and rotatores
Counterstrain treatment for TTP 4-9?
- E Sa RT
- ex: left PT 5 TP
- Retract left shoulder for rotation left and esxtension towards elevate the left shoulder for sidebending away
Counterstrain treatment for PT 10-12 TP?
- e-E Sa Ra for the torso OR e-E Sa Rt for pelvis
- The pelvis will rotate opposite to the lumbar and thoracic spine, so if the pelvis rotates left the lumbar and thoracic will rotate right
- Moving pelvis superior and inferiorly induces side bending, if you pull pelvis inferior you side bend right
PL 1-5 SP counterstrain treatment
- e-E Adduction RA for torso OR e-E Adduction RT for pelvis
- Shortening Multifidus
PL 1-5 TP coutnerstrain treatment?
- E Sa RA for torso OR E Sa RT for pelvis
- Shortening intertransversarii muscles
UPL 5 counterstrain treatment?
Located on the superior medial surface of PSIS
- E Adduct ir/er
- Stand on opposite side play with ir/er OR on the same side use your knee as leverage. Shorten the iliolumbar ligament*
LPL5
On ilium inferior to PSIS.
- F IR Adduction
- Same side as TP patient lying prone. Flex ipsilateral leg off table and use ipsilateral knee to IR and adduct the leg. Shorten the sacroiliac ligament.*
HISI coutnerstrain treatment and location?
2-3 cm lateral to PSIS
- e-E Abd ER
- Stand on the same side and use ipsilateral leg to extend abduct and ER the leg. Gluteus maximus.*
PL 3 Glut and PL4 Glut treatment and locations?
- PL3: 2/3 lateral from PSIS to tensor fascia latate
- PL4: Posterior margin of tensor fascia latae
- Treatment E Abd er
Same side use ipsilateral leg to extend abduct and er the leg
