Readings + Random Stuff for Exam 2

Question 1

Who first described the interdependent processes of responding to stress?

Answer 1

Seyle - described as the general adaptation syndrome

Question 2

What is expected calcaneus inversion and eversion?

Answer 2

5 degrees either direction

Question 3

What still remains the backbone of clinical decision making?

Answer 3

good history taking

Question 4

What are lacteals and what do they do?

Answer 4

part of GALT
lymphatic capillaries of the small bowel that help large chylomicrons get into the lymphatic system –> thoracic duct –> venous system

Question 5

What does rotatores do?

Answer 5

bilateral: extends thoracic spine
unilateral: rotates thoracic spine to opposite side

Question 6

What is progressive relaxation?

Answer 6

premise the muscle tension is closely related to anxiety
teach muscles to relax –> reduction in experienced anxiety
have pts maintain tension in one muscle grp for 10 sec –> then relax
keep going to diff muscle groups so pt knows what it feels like and can employ in their daily life

Question 7

If a patient has an anterior fibular head, what coupled motion do they like?

Answer 7

APPS

Anterior fibular head likes pronation (opposite of elbow) = dorsiflexion, eversion, abduction/ER

Question 8

What is assertiveness training?

Answer 8

teaching a patient to be more confident to effectively deal with excessive and unfair demands from bosses, spouse, etc

Question 9

Who first described the type A personality?

what has it been linked to?

Answer 9

Friedman and Rosenman

linked to coronary artery disease (sounseling and education can lower risks)

Question 10

What is spondylosis?

Answer 10

bony spurs/aging

Question 11

What is spondylolisthesis?

Answer 11

slipping of one vertebra on another

can occur from spondylolysis

Question 12

If a patient has diarrhea, SD at which level is most likely due to parasympathetic facilitation contributing to symptoms?

Answer 12

OA

Question 13

What is the main risk of persistent insomnia?

Answer 13

not life threatening, but bad sleepers experience more somatic complaints, anxiety, depression, and have greater propensity for alcohol and other substance abuse

Question 14

What type of questions are more likely to lead to patient-centered answers?

Answer 14

open-ended questions

Question 15

When physicians collaborate with other physicians, what two factors can influence their decision making?

Answer 15

pre-discussed knowledge of the patient and problem

awareness of each other’s knowledge and talents

Question 16

What does multifidus do?

Answer 16

bilateral: extends spine
unilateral: flexes spine to same side, rotates it to opposite side

Question 17

What is the example listed that demonstrates the importance of spiritual support?

Answer 17

for patients undergoing elective open heart surgery, those experiencing strength or comfort from spiritual feelings are 3x more likely to survive than those without

Question 18

What are symptoms of disc herniation at L4-L5?

Answer 18

pain at sacroiliac joint, hip, lateral thigh, leg
numbness at lateral leg, first 3 toes (L5 distribution)
weakness in foot dorsiflexion, difficulty walking on heel

Question 19

What are the things included in the OMT of stress (11)?

Answer 19

OMT
cognitive behavioral counseling
Problem solving
patient education
assertiveness training
insomnia management
muscular relaxation
biofeedback
social support
spiritual support
group support

Question 20

What is hangman’s fracture?

Answer 20

fracture of the vertebral arch of C2

due to hyperextension of head on neck

Question 21

What does cognitive-behavioral counseling do?

Answer 21

identifies ways in which pts distort information and teaches pts to identify, evaluate, and respond to their dysfunctional thoughts and beliefs to change mood and behavior

Question 22

What are the 4 cervical vertebral lines visible on lateral view?

Answer 22

anterior vertebral line
posterior vertebral line
spinal laminar line
posterior spinous process line

Question 23

What is stress defined as?

Answer 23

condition experienced when the physical, mental, emotional, or social environment makes unwanted inescapable demands
person under stress responds as a unit

Question 24

What is the most common initial presentation of insomnia?

Answer 24

inability to remain asleep
soon followed by difficulty falling asleep
then by abnormal early morning awakening

Question 25

What are the advantages of a lateral C spine XR?

Indications?

Answer 25

easy to use on a backboard, can see a lot of vertebrae
emergent indications: trauma, MVA
office use indications: chronic neck or head pain despite conservative treatment, neurologic changes

Question 26

What viscerosomatic reflexes are influenced by the vagus N?

Answer 26

all the ones that don’t involve L2

Question 27

What are the 3 lumbar lines visible on lateral film?

Answer 27

anterior lumbar
posterior lumbar
spinous processes

Question 28

What 2 realities must a doc keep in mind when treating a stressed patient?

Answer 28

1. Pt’s response to stress-inducing eventrs produces biopsychosocial consequences
2. Pt’s long-term stress management style is an important factor determining health or disease and an area in which the doc must intervene for long-term adaptive change

Question 29

What are symptoms of disc herniation at L5/S1?

Answer 29

S1 distribution:
Pain: sacroiliac joint, hip, posterolateral thigh, leg to heel
numbness: back of calf, lateral heel, foot to toe
weakness: plantar flexion of foot and great toe
difficulty walking on toes
calf atrophy
achilles reflex diminished

Question 30

What does semispinalis do?

Answer 30

bilateral: extends thoracic and cervical spines and head
unilateral: bends head, cervical, and thoracic spines to same side, rotates to opposite side

Question 31

If a patient has a posterior fibular head, what coupled motion do they like?

Answer 31

APPS

Posterior fibular head likes supination (opposite of elbow) = plantarflexion, foot inversion, adduction/IR

Question 32

What does the osteopathic primary care treatment strategy include?

Answer 32

palpatory diagnosis
manipulative treatment
exercise, diet, smoking, alcohol, drug cessation
appropriate medication
coping strategy education

Question 33

What did Holmes and Rahe do in 1967?

Answer 33

verified the stress of adaptation by developing a scale and assigning points to 43 common life events to correlate with illness

Question 34

How long does insomnia last to become ingrained?

Answer 34

more than 3 weeks –> requires specific behavioral strategies to counteract

Question 35

What is Seyle’s general adaptation syndrome?

Answer 35

continually stressed –> 3 response stages:

1. startle response and orientating reflex = adrenal, CV, respiratory, and MSK fxns increase
2. Attempt to cope and problem-solve biologically, psychologically, and socially. Pt meets to resist the stressor –> if successful, mastery and learning occur, if failed, exhausted
3. Exhaustion = dysfunctional signs and Sx you see clinically

Question 36

What is expected knee internal and external rotation?

Answer 36

10 degrees either direction

Question 37

What spinal level is involved with the pelvic splanchnic nerve?

Answer 37

L2

Question 38

What percentage of primary care somatic complaints are related to stress?
What percentage of the population is susceptible to ocute or chronic stress?

Answer 38

20-35%

33%

Question 39

what are the 4 most common behavioral consequences of stress?

Answer 39

depression
anxiety
substance abuse
insomnia

Question 40

What did the Holmes and Rahe 1967 Social Readjustment Scale demonstrate?

Answer 40

greater # of points a person scored over a 1 yr period = greater probability of illness occurring within next 2 years
Later research found that if the person perceived events as negative, the impact was more severe

Question 41

What is spondylolysis?

Answer 41

fracture of the pars interarticularis (scotty dog fracture)

Question 42

How do sleep habit strategies compare to sedatives?

Answer 42

as affective for acute treatment and more effective for long-term therapy