Special Populations Flashcards
Name the foot bones on an XR
(been told this is HY, why? because 2020 sucks)
*specifically know navicular bone
Know what spinal stenosis with spondylosis looks like on MRI
Know what L4 on L5 spondylolisthesis with disc space narrowing and sondylosis looks like on MRI
What is the location and positioning for pectoralis minor counterstrain?
f-F ADD
located inferior and medial to the coracoid process
Pt: supine
Doc: ipsilateral
Pt’s arm across chest, shoulder pulled anterior, inferior and medial to shorten muscle fibers
What are the three steps of LAS?
- Disengagement
- Exaggeration
- Balance and maintain balance until release occurs
What is the seated innominate BLT/LAS position for posterior innominate?
Pt rotates toward affected side
Cephalad force to affected side
*note moving the left into abduction may help find the balance point
What is the seated innominate BLT/LAS for anterior innominate?
patient rotates away
may add cephalad or caudad force to enhance balance
What factors stay the same regardless of treating special populations or typical populations?
Careful and thorough evaluation and diagnosis
somatic dysfunction diagnosis
techniques
plan
addressing acute issues
What things will change when treating special populations?
Palpation positioning and expected findings
Treatment technique may vary
Plan may include preventing further decline and addressing sequela of underlying disease
What is the goal of treating special populations?
allow patient to function in their daily life with optimal comfort, safety, participation and QOL
What is the incidence of MS?
What is the basic pathology?
3/1000
typically white young women
autoimmune attack on myelin sheath in brain and SC leading to permanent damage
What kind of compensation patterns are seen in pt’s with MS?
What is the goal of treatment then?
loss of or shifting capacity leads to unusual compensation patterns and overuse strains
Modify these compensation patterns (may require pt to have help at home or work)
Since the abnormal compensation patterns are likely to recur in MS due to the nature of the disease, what is recommended?
rehab PT to restore normal patterns by re-strengthening muscles
What techniques are recommneded for MS?
MFR and ST
can try HVLA, ART, ?MET
diaphragm treatments may help improve lymphatic flow and fatigue
What is the incidence of CVA?
What are the two types?
2nd major cause of death is US with 30% of pts having persistent deficits
hemorrhagic and ischemic
What is the most common outcome of stroke?
hemiplegia
can also see spastic paralysis within one week
What OMT is indicated hyperacutely for stroke (first 24hrs)?
What OMT is indicated acutely?
none
PT may help movement
increase cerebral perfusion, O2
reduce head associated strain patterns, treat upper thoracics, cervical and cranial
reduce sympathetic tone
What is the goal of treatment subacutely, within 7 days?
reduce tissue reorganization to avoid contractures
What is the treatment goal post-subacute, once the patient is home after a stroke?
improve sensorimotor integration
improve brain and peripheral function
reduce stroke associated strain patterns
reduce sympathetic tone
What are the OMM treatment considerations for CVA?
may be a benefit of OMM in acute phase
integrated care with neurology, OT, and PT
choose direct MFR as collagen fibers are fragile
What are some techniques that can treat a CVA patient?
direct MFR
HVLA (may improve sensorimotor integration…?)
ART (ROM, circles, figure 8s)
Sympathetic inhibtion
craniosacral
What is the goal of treatment in patients who are wheelchair bound?
what is something to consider?
typically seek care for pain control
consider access limitations (ability to get to facility, get into facility, and may require extra time on the physician’s part that she might not have)
What are some good techniques for the WC bound patient?
integratio with OT, PT
joint releases while seated
ME, ART, Still;s
Cervical HVLA, MET, ART, Stills
Soft tissue inhibition, MFR, MET, ST
Lymphatics, E/P, Thoracic outlet, diaphragm.
NO pedal pump, maybe thoracic pump
The diaphragm may be restricted in the WC bound patient, why?
due to increased abdominal pressure
When treating a trauma patient with OMT, what must be considerED?
timing has a major influence on technique selection
What is the main treatment consideration for the trauma pt?
tension is the enemy of healing
reduce and maintain reduced global tension
What treatments should be selected for in the trauma pt?
gentle ones
gentle ART
indirect BLT
Stills
Counterstrain
Proximal effleurage
