Screening and Symmetry: Intro to SOAP note (Jons-Cox)

Question 1

what is in the osteopathic exam?

Answer 1

standard H and P with the palpatory diagnosis

start with taking patient history
then examine the patient using the osteopathic structural examination

Question 2

visual components of the OSE

Answer 2

gait analysis
landmark assessment
postural analysis
range of motion

Question 3

palpatory component of the OSE

Answer 3

TART changes

Question 4

sagittal plane

Answer 4

divides body into right and left

major motion:
flexion and extension

Question 5

coronal plane

Answer 5

separates body to anterior and posterior

motion:
sidebending

Question 6

transverse plane

Answer 6

divides body into the superior and inferior parts

motion: rotation

Question 7

center of gravity line

Answer 7

where we should be bearing our weight
-divides the body into 2 equal parts

straight down the middle

Question 8

midgravitational line

Answer 8

view patient laterally

lateral malleolus
mid-knee
femoral head
anterior third of sacral base
middle of body of L3 vertebrae
humeral head
external auditory meatus

Question 9

posture

Answer 9

distribution of body mass in relation to gravity over base of support

shifts depends on the body position

Question 10

center of gravity for a person?

Answer 10

body of L3 vertebrae

both lines go through this

Question 11

distribution of mass depends on:

Answer 11

energy requirements
integrity of musculoligamentous structures
compensations that occur

Question 12

lordotic curve

Answer 12

in the cervical and lumbar spine

backward bending

Question 13

kyphotic curve

Answer 13

in the thoracic spine

forward bending

Question 14

wolff’s law

Answer 14

force on bone causes bone to reinforce that portion of bone

-ex/ bone spurs and wedging

Question 15

type I motion

Answer 15

sidebending with opposite rotation

Question 16

type II motion

Answer 16

sidebending with same side rotation

Question 17

curves in coronal plane?

Answer 17

scoliotic curve

Question 18

areas of spinal facilitation

Answer 18

where there is a curve in the spine

more spinal damage

aka transition zones - more pathology present

Question 19

common compensatory pattern

Answer 19

occipito-atlantal rotated left
cervicothoracic rotated right
thoracolumbar rotated left
lumbosacral rotated right

sacrum left rotated on a left axis 80 percent

**in northern hemisphere
opposite in the Southern Hemisphere

Question 20

tensegrity model

Answer 20

body wants to expend smallest energy possible

have bony tension elements and elastic elements (fascia and muscles)
-balance between stability and strength

entire body is interconnected

Question 21

scoliosis

Answer 21

example of a compensated posture which becomes decompensated

greater than 5 degrees

Question 22

functional scoliosis

Answer 22

spinal curves occurring from unilateral muscle contractions
-curve disappears when muscle hypertonicity resolves

key to testing this is to move them to the side of the rib hump and if it goes away then it can be helped/reversed with OMM/therapy

Question 23

structural scoliosis

Answer 23

involves long-term adaptation with positional changes

over time tissues will change
-resist change to the neutral position

Question 24

postural decompensation

Answer 24

when homeostatic mechanism are overwhelmed or when the pathologic change is structurally incapable of resisting gravity

can also be traumatic

chronic postural strain and decompensation

intrinsic - age, tissue integrity, tissue health, host factors
extrinsic - traumas

Question 25

SOAP Note format

Answer 25

S - subjective - what the patient tells you (all of their history)
-symptoms
O - objective - physical exam findings
-signs, TART
A - assessment
-on structural level and functional level
P - plan
-both structural (sretches, meds) and functional (OMT)