Renal: Jons-Cox

Question 1

Anterior Bladder Chapman’s Points (2)

Answer 1

1. B/L around the umbilicus

2. B/L On the pubic symphysis close to the median line

Question 2

Anterior Urethra Chapman’s point

Answer 2

B/L medial pubic symphysis, on the upper edge

Question 3

Posterior Chapman’s Point for both Bladder and Urethra

Answer 3

Upper edge of the Transverse Process of L2 (B/L)

Question 4

3 forms of treatment to facilitate respiratory/circulatory function:

Answer 4

1. Open thoracic inlet
2. Treat abdominal diaphragm
3. Treat pelvis, esp the pubic symphysis and pelvic diaphragm

Question 5

Sympathetics to the Bladder:

Answer 5

T10-L2

Question 6

Parasymathetics to the Bladder:

Answer 6

Pelvic splanchnic nerves (S2-S4)

Question 7

Treatment to balance the autonomics of the bladder

Answer 7

1. Treat thoracics and lumbars - sympathetics to the bladder originate in the T10-L2 region
2. Treat sacrum, SI joints- parasympathetics to the bladder originate in S2-4 (pelvic splanchnic nerves)

Question 8

OMM Plan for a UTI (3)

Answer 8

1. facilitate respiratory/circulatory function
2. Treat bladder Chapman’s Points
3. Balance Bladder autonomics

Question 9

Still Technique is a _____, combined ____ technique.

Answer 9

Passive….direct/indirect

Question 10

Still Technique step 1:

Move the Tissue/Joint into the _____, then _____ this position to ______.

Answer 10

position of ease…..exaggerate….relax the tissue.

Question 11

Still Technique step 2:

Introduce a ______ through the affected tissue.

Answer 11

vector force no greater than 5 lbs

Question 12

Still Technique Step 3:

Using the force vector as a lever,________. The force vector is then ____ and the tissue is _______ and retested.

Answer 12

carry the affected tissue towards and through the initial restriction…released…returned to neutral

Question 13

Still Technique:

A palpable release is often felt as the _____takes the tissue past its _____.

Answer 13

coupled vector force and tissue motion….area of previous restriction

Question 14

MET for Diaphragm SD:

Answer 14

• place hand B/L over the lower 6 ribs; thumbs should be just inferior to costal margin; pt is supine with hips and knees flexed
• apply a slight compressive force down to the level of the diaphragm and take it to the feather edge of the restriction via SB and rotation
• pt holds breath in inhalation while you resist downward for 3-5 s; wait 1-2 s refractory period
• take up the slack in exhalation and repeat

Question 15

Diaphragm MFR “the osteopathic hug”

Answer 15

• stand behind the seated pt
• wrap your arms around the pt’s torso with their arms overlying your hands
• place your finger pads underneath the anterior costal margin to palpate the diaphragm
• instruct the pt to slump forward while you apply a compressive force to engage the diaphragmatic fascia
• use your body to support pt while you asses fascial restrictions (F/E/SB/R)
• hold fascia in position of greatest ease or restriction until release is felt

Question 16

MET of the thoracic spine

Answer 16

• monitor the vertebra being treated via its transverse process
• engage the feather edge of the barrier by inducing F/E/SB/R at the level of the SD
• instruct pt to sit up straight while you provide an isometric counterforce for 3-5 s
• wait 2 s then re-engage the feather edge of the restricted barrier and repeat 2-4 times or until no further change is noted