Savarese Flashcards
1
Q
What does TART stand for?
A
T-Tissue texture changesA-AsymmetryR-RestrictionT-Tenderness
2
Q
What is the Physiologic Barrier?
A
Point at which a PATIENT can ACTIVELY move any given joint
3
Q
What is the Anatomic barrier?
A
Point at which a PHYSICIAN can PASSIVELY move any given joint
4
Q
Findings of ACUTE Tissue texture changes.
A
-Edematous-Erythematous-Boggy w/ increase moisture-Hypertonic muscles
5
Q
Findings of CHRONIC Tissue texture changes.
A
-Cool dry skin w/ slight tension-Decreased muscle tone (flaccid)-Ropy-Fibrotic-NO edema (or decreased)-NO erythema
6
Q
What are the findings of Asymmetry in Acute & Chronic conditions?
A
Acute - PresentChronic - Present w/ COMPENSATION in other areas of body
7
Q
Restriction findings in ACUTE condition.
A
Painful w/ movement
8
Q
Restriction findings in CHRONIC condition.
A
Decreased or NO Pain
9
Q
Tenderness findings in ACUTE condition.
A
Severe, Sharp
10
Q
Tenderness findings in CHRONIC condition.
A
Dull, Achy, Burning
11
Q
Orientation of Superior facets: -Cervical
A
“BUM”BackwardUpwardMedial
12
Q
Orientation of Superior facets: -Thoracic
A
“BUL”BackwardUpwardLateral
13
Q
Orientation of Superior facets: -Lumbar
A
“BM”BackwardMedial
14
Q
Flexion/Extension: -Axis: -Plane:
A
Flexion/Extension: -Axis: Transverse -Plane: Saggital
15
Q
Rotation: -Axis: -Plane:
A
Rotation: -Axis: Vertical -Plane: Transverse
16
Q
Sidebending: -Axis: -Plane:
A
Sidebending: -Axis: Anterior-Posterior -Plane: Coronal
17
Q
Describe DIRECT treatment.
A
Towards barrier
18
Q
Describe INDIRECT treatment.
A
Away from barrier
19
Q
Describe ACTIVE treatment.
A
Patient assists during treatment
20
Q
Describe PASSIVE treatment.
A
Patient RELAXES during treatment
21
Q
OA: -Main motion -Sidebending & Rotation
A
OA: -Main motion: Flexion/Extension -Sidebending & Rotation: Opposite
22
Q
AA (C1): -Main motion -Sidebending & Rotation
A
AA: -Main motion: Rotation -Sidebending & Rotation: Opposite
23
Q
C2-C4: -Main motion -Sidebending & Rotation
A
C2-C4: -Main motion: Rotation -Sidebending & Rotation: Same
24
Q
C5-C7: -Main motion -Sidebending & Rotation
A
C5-C7: -Main motion: Sidebending -Sidebending & Rotation: Same
25
What is the main motion of the Thoracic spine?
Rotation
26
True Ribs.
-Ribs 1-7-Attach to the sternum through costal cartilages
27
False Ribs.
-Ribs 8-12-Do NOT attach directly to the sternum
28
Floating Ribs.
-Ribs 11-12-Unattached anteriorly
29
Describe the attachment of Ribs 8-10.
-Each are connected by its costal cartilage to the cartilage of the rib superior*Example: The costal cartilage of Rib 9 attaches to the costal cartilage of rib 8
30
What are the 3 types of rib movements?
-Pump-handle-Bucket-handle-Caliper
31
Pump-Handle motion.
Ribs 1-5
32
Bucket-handle.
Ribs 6-10
33
Caliper motion.
Ribs 11-12
34
Describe Inhalation dysfunction.
Dysfunctional rib will move Cephalad during Inhalation, but will NOT move Caudad during Exhalation -Rib will appear to be "Held Up"
35
Describe Exhalation dysfunction.
Dysfunction rib will move Caudad during Exhalation, but will NOT move Cephalad during Inspiration -Rib will appear to be "Held Down"
36
Grouped Rib INHALATION dysfunction KEY RIB?
Lowest Rib of dysfunction
37
Grouped Rib EXHALATION dysfunction KEY RIB?
Uppermost Rib of dysfunction
38
Spina bifida occurs when there is a defect in what?
Closure of the Lamina of the vertebral segment
39
Where does Spina Bifida usually occur?
Lumbar spine
40
Spina Bifida Occulta.
-No herniation through defect-Course patch of hair over site-Rarely associated with neurological deficits
41
Spina Bifida Meningocele.
-Herniation of the Meninges through the defect
42
Spina Bifida Meningomyelocele.
-Herniation of the Meninges & Nerve roots through defect-Associated with neurological deficits
43
What is the main motion of the lumbar spine?
Flexion/Extension
44
A flexion contracture of the Iliopsoas m. is often associated with what type of dysfunction?
Nonneutral dysfunction at L1 or L2
45
Describe Spondylolisthesis.
-ANTERIOR displacement of one vertebrae in relation to the one below-Often occurs at L4 or L5-Usually from fatigue fractures of the Pars Interarticularis*Grading: -1 = 0-25% -2 = 25-50% -3 = 50-75% -4 = 75-100%
46
Describe Spondyloysis.
-Defect of the Pars Interarticularis withOUT anterior displacement of the vertebral body-Scotty Dog fracture on OBLIQUE X-ray
47
Describe Spondylosis.
-Radiographical term for degenerative changes within the INTERVERTEBRAL DISC and ANKYLOSING of adjacent vertebral bodies-Anterior Lipping of vertebral bodies
48
X-ray Diagnosis: -Spondylolisthesis -Spondylolysis
X-ray Diagnosis: -Spondylolisthesis: LATERAL view -Spondylolysis: OBLIQUE view
49
What ligament divides the Greater and Lesser Sciatic Foramen?
Sacrospinous L.
50
Sacral Motion Axis: Respiration
-Superior Transverse axis at S2
51
Sacral Motion Axis: Inherent (Craniosacral) motion
-Superior Transverse axis
52
Sacral Motion Axis: Postural motion
-Middle Transverse axis
53
Sacral Motion Axis: Dynamic motion
Engages 2 Sacral OBLIQUE Axes: -Left Oblique axis - weight bearing on Left leg (stepping forward with right leg) -Right Oblique axis - weight bearing on Right leg (stepping forward with left leg)
54
During Inhalation, what is the motion of the Sacral Base?
Inhalation - Sacral Base moves POSTERIOR
55
During Exhalation, what is the motion of the Sacral Base?
Exhalation - Sacral Base moves ANTERIOR
56
During Craniosacral Flexion, what is the motion of the Sacral Base?
Sacral Base rotates Posteriorly (COUNTERNUTATION)
57
During Craniosacral Extension, what is the motion of the Sacral Base?
Sacral Base rotates Anteriorly (NUTATION)
58
As person begins to bend Forward, what is the motion of the sacral base?
Moves Anteriorly
59
What happens to the Sacral Base as a person reaches Terminal Flexion?
Sacrotuberous ligaments become taut and the Sacral Base moves POSTERIORLY
60
Sacral Torsion definition.
Sacral rotation about an OBLIQUE axis with Somatic Dysfunction at L5
61
What are the Sacral Torsion Rules?
#1-When L5 is Sidebent, a Sacral Oblique axis is engaged on the Same Side as the Sidebending#2-When L5 is Rotated, the sacrum Rotates the Opposite way on the Oblique axis3#-The seated flexion test is found on the Opposite side of the Oblique Axis
62
Sacral Torsion Example: L5 F RrSr -Seated Flexion: -Sacrum findings:
Sacral Torsion Example: L5 FRrSr -Seated Flexion: Positive on LEFT -Sacrum findings: Rotated to the Left on a Right Oblique axis (L on R)
63
Sacral Torsion Example: L5 N SlRr -Seated Flexion: -Sacrum findings:
Sacral Torsion Example: L5 N SlRr -Seated Flexion: Positive on RIGHT -Sacrum findings: Rotated to the Left on a Left oblique axis (L on L)
64
In sacral torsions, L5 will ALWAYS rotate in the (same or opposite) direction of the sacrum.
Opposite
65
Due to birth mechanics, what is the most common Sacral dysfunction in the post-partum patient?
Bilateral Sacral Flexion
66
What are the Rotator Cuff muscles?
SupraspinatusInfraspinatusTeres minorSubscapularis
67
What is the primary action of Supraspinatus m.?
Abduction of arm
68
What is the primary action of Infraspinatus m.?
External rotation of arm
69
What is the primary action of Teres minor m.?
External rotation of arm
70
What is the primary action of Subscapularis m.?
Internal rotation of arm
71
What is the most common type of Brachial Plexus injury?
Erb-Duchenne's palsy -injury to C5&C6 nerve roots
72
Erb-Duchenne's plasy can result in paralysis of what muscles?
-Deltoid-External rotators-Biceps-Brachioradialis-Supinator
73
INCREASED carrying angle of the elbow (>15˚). -is called: -ulna movement: -wrist movement:
Increased carrying angle of the elbow (>15˚). -is it called: Cubitus Valgus -ulna movement: ABduction -wrist movement: ADDuction
74
DECREASED carrying angle of the elbow (<3˚). -is called: -ulna movement: -wrist movement:
DECREASED carrying angle of the elbow (<3˚). -is called: Cubitus Varus -ulna movement: ADDuction -wrist movement: ABduction
75
Cubitus Valgus is associated with what Ulnar movement?
ABduction
76
Cubitus Varus is associated with what Ulnar movement?
ADDuction
77
Describe Pronation of the ankle.
-Dorsiflexion-Eversion-Abduction
78
Describe Supination of the ankle.
-Plantarflexion-Inversion-Adduction
79
Fibular head glide w/: -Pronation: -Supination:
Fibular head glide w/: -Pronation: Anterior glide -Supination: Posterior glide
80
The common peroneal nerve (common fibular n.) lies directly _________ to the proximal fibular head.
Posterior
81
What nerve would most likely be involved with a posterior fibular head dysfunction?
Peroneal n. (aka Common fibular n.)
82
What structures are involved in O'Donahue's traid (aka Terrible Triad)?
-ACL-MCL-Medial meniscus
83
The ankle is more stable in Dorsiflexion or Plantarflexion?
Dorsiflexion
84
What is the most common injured ligament in the foot?
Anterior Talofibular ligament
85
What makes up the Primary Respiratory Mechanisms (PRM)? (5 things)
-CNS-CSF-Dural membranes-Cranlal bones-Sacrum
86
Where along the skull/spinal does the Dura Mater attach? (4 places)
-Foramen magnum-C2-C3-S2
87
What 4 things are associated with Craniosacral Flexion?
1-Flexion of the midline bones2-Sacral base Posterior (counternutation)3-Decreased AP diameter of the cranium4-External rotation of the paired bones
88
What suture is present at birth till around 6 y/o and separates the frontal bone into 2 halves?
Metopic suture
89
What is the Pterion?
Junction of these bones: -Temporal -Parietal -Spenhoid -Frontal
90
What 4 things are associated with Craniosacral Extension?
1-Extension of the midline bones2-Sacral base Anterior (nutation)3-Increased AP diameter4-Internal rotation of the paired bones
91
What is the result of a compression strain of the Sphenobasilar Synchondrosis (SBS)?
Severely DEcreased CRI*usually d/t trauma, especially to the back of the head
92
Vagal somatic dysfunction can be due to what dysfunctions?
-OA-AA-C2
93
Dysfunction of CN VIII can cause what symptoms?
-Tinnitus-Vertigo-Hearing loss
94
What dysfunctions can cause suckling dysfunctions in newborns?
-CN XII (condylar compression)-CN IX & CN X (at the jugular foramen)
95
What effect does the CV4 treatment have on CRI?
Increase amplitude
96
What midline bones of the cranium?
-Sphenoid-Occiput-Ethmoid-Vomer
97
A condylar compression in a newborn might cause difficulty in what?
Suckling
98
Where is the appendix chapman's point?
Tip of the Right 12th Rib
99
Do Tenderpoints or Trigger points refer pain when pressed?
Trigger points
100
What is the myofascial release procedure?
1-Palpate restriction2-Apply compression (indirect) or traction (direct)3-Add twisting or transverse forces4-Use enhancers5-Await release
101
Where is the anterior tenderpoint for L5?
1 cm lateral to pubic symphysis on the superior ramus
102
What are the ABSOLUTE contraindications to HVLA? (6)
-Osteoporosis-Osteomyelitis (+ Pott's dz)-Fractures in the area of thrust-Bone metastasis-Severe Rheumatoid Arthritis-Down's syndrome
103
What are the RELATIVE contraindications to HVLA? (6)
-Acute whiplash-Pregnancy-Post-surgical -Herniated nucleus pulposus-Pts on Anticoagulation therapy or Hemophiliacs-Vertebral artery ischemia (+ Wallenbergs's test)
104
Pupil: -Parasympathetic: -Sympathetic:
Pupil: -Parasympathetic: Constricts (miosis) -Sympathetic: Dilates (mydriasis)
105
Lens: -Parasympathetic: -Sympathetic:
Lens: -Parasympathetic: Contracts for Near vision -Sympathetic: Relaxation for Far vision
106
Glands: -Parasympathetic: -Sympathetic:
Glands: -Parasympathetic: Stimulates Secretion (copious) -Sympathetic: Vasoconstriction for slight secretion
107
Sweat glands: -Parasympathetic: -Sympathetic:
Sweat glands: -Parasympathetic: Sweating on palms of hands -Sympathetic: Copious sweating (cholinergic)
108
Heart: -Parasympathetic: -Sympathetic:
Heart: -Parasympathetic: Decreases contractility & conduction velocity -Sympathetic: Increases contractility & conduction velocity
109
Bronchiolar smooth muscle: -Parasympathetic: -Sympathetic:
Bronchiolar smooth muscle: -Parasympathetic: Contracts -Sympathetic: Relaxes
110
Respiratory epithelium: -Parasympathetic: -Sympathetic:
Respiratory epithelium: -Parasympathetic: Decreases # of goblet cells to Enhance THIN secretions -Sympathetic: Increase # of goblet cells to produce THICK secretions
111
GI-Smooth muscle-Lumen: -Parasympathetic: -Sympathetic:
GI-Smooth muscle-Lumen: -Parasympathetic: Contracts -Sympathetic: Relaxes
112
GI-Smooth muscle-Sphincters: -Parasympathetic: -Sympathetic:
GI-Smooth muscle-Sphincters: -Parasympathetic: Relaxes -Sympathetic: Contracts
113
GI-Secretion & Motility: -Parasympathetic: -Sympathetic:
GI-Secretion & Motility: -Parasympathetic: -Sympathetic:
114
Systemic arterioles-Skin & Visceral vessels: -Parasympathetic: -Sympathetic:
Systemic arterioles-Skin & Visceral vessles: -Parasympathetic: None -Sympathetic: Contracts
115
Systemic arterioles-Skeletal muscle: -Parasympathetic: -Sympathetic:
Systemic arterioles-Skeletal muscle: -Parasympathetic: None -Sympathetic: Relaxes
116
Bladder wall (detrusor): -Parasympathetic: -Sympathetic:
Bladder wall (detrusor): -Parasympathetic: Contracts -Sympathetic: Relaxes
117
Bladder sphincter (trigone): -Parasympathetic: -Sympathetic:
Bladder sphincter (trigone): -Parasympathetic: Relaxes -Sympathetic: Contracts
118
Penis: -Parasympathetic: -Sympathetic:
Penis: -Parasympathetic: Erection -Sympathetic: Ejaculation
119
Kidneys: -Parasympathetic: -Sympathetic:
Kidneys: -Parasympathetic: Unknown -Sympathetic: Vasoconstriction of afferent arteriole > DEcreased GFR > DEcreased urine volume
120
Ureters: -Parasympathetic: -Sympathetic:
Ureters: -Parasympathetic: Maintains normal peristalsis -Sympathetic: Uterospasm
121
Liver: -Parasympathetic: -Sympathetic:
Liver: -Parasympathetic: Slight glycogen synthesis -Sympathetic: Glycogenolysis (release glucose into bloodstream)
122
Uterus-Body (Fundus): -Parasympathetic: -Sympathetic:
Uterus-Body (Fundus): -Parasympathetic: Relaxation -Sympathetic: Constricts
123
Uterus-Cervix: -Parasympathetic: -Sympathetic:
Uterus-Cervix: -Parasympathetic: Constricts -Sympathetic: Relaxes
124
What are the CNS components of the Parasympathetic Nervous system?
-CN III (midbrain)-CN VII (pons)-CN IX (medulla)-CN X (medulla)-Pelvic Splanchnic (S2-S4)
125
Parasympathetic Innervation: -CN III (midbrain)
Pupils -Ciliary ganglion
126
Parasympathetic Innervation: -CN VII (pons)
Lacrimal & Nasal glands -Sphenopalatine ganglionSubmandibular & Sublingual glands -Submandibular ganglion
127
Parasympathetic Innervation: -CN IX (medulla)
Parotid gland -Otic ganglion
128
Parasympathetic Innervation: -CN X (medulla)
HeartBronchial treeGI System-Esophagus (lower 2/3)-Stomach-Sm. intestine-Liver-Gallbladder-Pancreas-Ascending colon-Transverse colonReproductive system-Ovaries-TestesUrinary system-Kidney-Upper ureter
129
Parasympathetic Innervation: -Pelvic Splanchnic (S2-S4)
GI system-Descending colong-Sigmoid colon-RectumReproductive system-Uterus-Prostate-GenitaliaUrinary System-Lower ureter-Bladder
130
Ascending & Transverse Colon.
CN X
131
Descending colon, sigmoid, rectum.
Pelvic splanchnic
132
Uterus
Pelvic splanchnic (S2-S4)
133
Ovaries/Testes
CN X
134
Kidney
CN X
135
Bladder
Pelvic splanchnic (S2-S4)
136
Lower ureter
Pelvic splanchnic (S2-S4)
137
Pancreas
CN X
138
Pupils
CN III (ciliary ganglion)
139
Parotid gland
CN IX (otic ganglion)
140
Lacrimal & Nasal glands
CN VII (sphenopalatine ganglion)
141
Small intestines
CN X
142
Bronchial tree
CN X
143
Genitalia
Pelvic splanchnic (S2-S4)
144
Heart
CN X
145
Head & Neck
T1 -T4
146
Heart
T1 - T5
147
Respiratory System
T2 - T7
148
Esophagus
T2 - T8
149
Upper GI Tract:-Stomach-Liver-Gallbladder-Spleen-Portions of Pancreas & Duodenum
T5 - T9*Before ligament of Treitz
150
Middle GI Tract:-Portions of Pancreas & Duodenum-Jejunum-Ilium-Ascending colon-Transverse colon (proximal 2/3)
T10 - T11*Btwn L. of Treitz and Splenic flexure
151
Lower GI Tract:-Transverse colon (distal 1/3)-Descending colon-Sigmoid colon-Rectum
T12 - L2*After Splenic flexure of large intestine
152
Appendix
T12
153
Kidneys
T10 - T11 -Superior Mesenteric Ganglion
154
Adrenal medulla
T10
155
Upper ureters
T10 - T11 -Superior Mesenteric Ganglion
156
Lower ureters
T12 - L1 -Inferior Mesenteric Ganglion
157
Bladder
T11 - L2
158
Gonads
T10 - T11
159
Uterus & Cervix
T10 - L2
160
Erectile tissue of penis & clitoris
T11 - L2
161
Prostate
T12 - L2
162
Arms
T2 - T8
163
Legs
T11 - L2
164
Upper GI tract: -Nerve & Ganglion
Greater Splanchnic N. -Celiac ganglion
165
Middle GI tract: -Nerve & Ganglion
Lesser Splanchnic N. -Superior Mesenteric ganglion
166
Lower GI tract: -Nerve & Ganglion
Least Splanchnic N. -Inferior Mesenteric ganglion
167
What divides the duodenum & jejunum?
Ligament of Treitz
168
What divides the transverse colon and descending colon?
Splenic flexure of large intestines
169
Appendix: -Anterior
Tip of Right 12th rib
170
Appendix: -Posterior
Transverse process of T11**this point directs differential diagnosis more toward ACUTE APPENDICITIS
171
Adrenals: -Anterior
2" superior and 1" lateral to the Umbilicus
172
Adrenals: -Posterior
Bwtn the Spinous and Transverse process of T11 and T12
173
Kidney: -Anterior
1" Superior and 1" Lateral to the umbilicus
174
Kidney: -Posterior
Btwn the Spinous and Transverse process of T12 and L1
175
Bladder: -Anterior
Periumbilical region
176
Colon
Lateral thigh within the Iliotibial band from Greater Trochanter to just above the Knee
177
Pancreas: -Anterior
Lateral to costal cartilage btwn Ribs 7 and 8 on the RIGHT
178
Asthma (acute)
T2 on Left
179
Prostate
Posterior margin of Iliotibial band
180
2nd Intercostal space
ThyroidEsophagusMyocardiumBronchi
181
1st Intercostal space
Tonsils
182
4th Intercostal space
Lung disease
183
6th Intercostal space on Left
Stomach Peristalsis
184
6th Intercostal space on the Right
LiverGallbladder
185
5th Intercostal space on Left
Stomach Hyperacidity
186
5th Intercostal space on the Right
Liver
187
7th Intercostal space on the Left
Spleen
188
7th Intercostal space on the Right
Pancreas
189
Periumbilical
Bladder
190
8-10 Intercostal
Small Intestines
191
Middle Ear Chapman point
1st Rib & Clavicles, Lateral to where they cross the 1st rib
192
Between the Spinous and Transverse process of:- T7-8 on Right
Pancreas
193
Between the Spinous and Transverse process of:- T11-12
Adrenals
194
Between the Spinous and Transverse process of:- T12-L1
Kidney
195
Superior edge of L2 Transverse process
Bladder
196
Eyes (anterior point)
Surgical neck of the Right Humerus
197
Tonsils
1st Intercostal space
198
Esophagus, Bronchi, Thyroid, Myocardium
2nd Intercostal space
199
Upper lung and Upper Extremities
Third Intercostal space
200
Middle ear (otitis media)
First rib and Clavicles, lateral to where they cross first rib
