Spring 2016 written Flashcards
if a woman has h/o pelvic or back pain during previous pregnancies, then?
up to 2/3 may continue to suffer from back pain after delivery
what are radicular sx during pregnancy due to?
direct pressure on nerve root/lumbar plexus by uterus
which paraspinal muscle will shorten the most in pregnancy?
iliopsoas
in pregnant patients with pre-existing scoliosis, if the curvature is >____ then there is a link to pregnancy
25 degrees
what effect on birth is assc’d with scoliosis
premature birth
target of relaxin hormone (3)
cervix, uterus, ligamentous structures of pelvis
effect of progesterone on fluid in pregnancy
promotes fluid retention
viscero-somatic level of uterus
T10-L1
what is crucial during congestive stage (28th-36th week)
restoring motion of diaphragms
what should you be sure to tx postpartum?
sacrum (sacroilitis, coccydynia)
frog technique txs?
treats incr lordosis of lumbar spine
the ABCs of treating hospitalized patients
Autonomics
breathing
circulation
how to know if a person has a viscerosomatic reflex?
when 2+ spinal segments have evidence of SD within an autonomic reflex area
ppl with CAD have mechanical problems involving____ that involve rotation to the ____
T3 & T4; left
sequence of treating hospitalized patient: centrally or peripherally first?
- central
2. peripheral
OMT can decr what in patients with pneumona (3)
- length of stay
- duration of IV Abx
- incidence of respiratory failure/death
why tx areas of fascial distortion?
b/c it poses a restriction to free flow or low pressure fluids
in copd or URTI, tx which viscerosomatics
T1-6
in diabetes, tx which viscerosomatics
T5-11
in HTN, tx which viscerosomatics
heart (T1-5), adrenals (T10-11), kidneys (T10-L1)
what systems to use to tx elderly?
- CCP
2. respiratory circulatory model
8 important CCP TP
- R levator scap
- R upper trap
- L T12 anterior
- L Lat dorsi
- L lower trap
- L psoas
- R quad lumborum
- R hammie
goal of OMT in GI tx
remove excessive synaptic drive from PAN
where does prolonged visceral afferent input manifest (3)
- segmental paraspinal tissues
- collateral ganglia
- visceral motion
c/o of HA, N/V, diarrhea, cramps may be due to?
parasympathetic dominence
rib raising targets which type of ganglia
sympathetic trunk ganglia (paravertebral)
unpaired, abdominopelvic (preverterbral) ganglia
collateral ganglia
inhibition of collateral ganglia will result in what?
reduce sympathetic hyperactivity of organs
indications for linea alba tx (celiac ganglion inhibitiion)
abdominal distension, slow GI motility
normal physiological motion of visceral sphincters
clockwise
which sphincter: 1/3 way on a line
from R ASIS to umbilicus (McBurney’s Point) then a little superior
ileo-cecal valve
which sphincter: On a line from L mid-clavicle to umbilicus, then 2-3 cm on line up from umbilicus
duodenal jejunal jxn
which sphincter: On a line from R mid clavicle to umbilicus, then 2-3 cm on line up from umbilicus
sphincter of oddi
which sphincter: 6-7 cm above umbilicus
(May be L or R side
of midline)
pylorus
which sphincter: ½-1 inch above
xiphoid process
cardiac/gastro esophageal jxn
folds of peritoneum
mesentery
indications for mesenteric lift
IBS, constipation, ileus, abdominal distension or adhesions
which systems are fully formed at time of birth?
CV, lymphatic
which systems mature during teh first 12 months of life?
renal, hematopoetic
which systesms take many years to develop?
CNS, GU, endocrine, MSK
how do fryettes principles apply to children?
they do not (bones are not fully formed)
barlow test for ____of femoral head
displacement
ortolani manuever to ____femoral head ____acetabulum
reduce; back into
in kids with asthma, when do you tx OA, AA?
after everything else is completed
which code is used to tell insurance about your treatment utilized
CPT codes
which code is used to define dx
ICD-10
cranial is what type of technique
myofascial
where the occipital, temporal, parietal bones come together
asterion
squamoparietal suture is where?
b/w parietal and temporal bones
sagittal suture is…?
serrated
temporal suture is….
gliding squamous suture
nasal bone is….?
sliding plane suture
primary respiratory motion: Inherent ______ of the CNS
Motility
primary respiratory motion: ____of the CSF
fluctuation
primary respiratory motion: ______of the reciprocal tension membrane
mobility
primary respiratory motion: articular ____ of the cranial bones
mobility
primary respiratory motion: articular _____of the sacrum b/w the ilia
mobility
_____is where the falx cerebri, falx cerebelli, tentorium cerebelli come together
straight sinus
what is sutherland’s fulcrum
the straight sinus
where is the motion of the sacrum
around the transverse axis at second sacral segment
where does the dura attach on the sacrum
anterior surface of sacral canal at the level of S2
in flexion/extension of sphenoid and occiput, what do they move around?
sphenobasilar synchondrosis (SBS)
when the midline bones go into flexion, the paired bones go into_____
external rotation
when the midline bones go into extension, the paired bones go into_____
internal rotation
physiologic strain cranial bones move ___direction, pathologic strain move ____direction
opposite; same
if looking at the falx cerebri, what is the name of the sinus that runs through it?
superior sagittal sinus
falx cerebelli = which sinus?
occipital sinus
tentorium cerebelli = which sinus?
transverse sinus
how to tx a child with colic?
drain occipital sinus
in a superior vertical strain, when the occiput is in extension, the temporals are in ______
internal rotation
in an inferior vertical strain, when the occiput is in flexion, the temporals are in____
external rotation
how to tx a HA at the vertex
parietal lift
what to use to initiate labor in woman past her due date
compression of the 4th ventricle
what to use to release any peripheral suture in a patient presenting with HA or sinus pressure
V-spread
a collection of compensatory changes that occur when there is sacral base unleveling
short leg syndrome
most common presenting complaint of short leg syndrome
LBP
what landmarks cue you into short leg syndrome
- iliac crest,
2. greater trochanters
when can you dx anatomic short leg?
after treating with OMT a few times
when to prescribe heel lift for a patient with suspected short leg
after 1-3 trials of OMT and still have uneven landmarks (thus anatomic short leg)
x-ray dx of short leg
standing postural x-ray series
left height guidelines: add ____inch for every _____of sacral base unleveling
1/8 inch; 1 degree
what is the most sensitive clinical test for finding scoliosis
adams forward bend test
gold standard for radiographic eval of scoliosis
cobb angle
what degree of curvature defines a scoliosis?
> 10 degrees = scoliosis
scoliosis is named by the side of_____
convexity
curves measuring____at the end of growth do not progress
under 30 degrees
cobb angle 10-19
mild scoliosis
cobb angle >50 degrees
severe scoliosis
sphenopalatine syndrome
worsens cases of asthma
poor lymphatic drainage of the eye
glaucoma
menieres disease (tinnitus, hypoacusia, vertigo) may be attributed to
decr absorption of endolymph in inner ear
tinnitis: low pitched roar = _________ rotation of temporal bone; high pitches whine = _____rotation of temporal bone
external; internal
most common type of recurrent HA
tension HA
which type of HA is thought to be caused by inflammation of cavernous sinus
cluster HA
galbreath manuever is indicated when?
open up eustachian tube
what is caused by a hypersensitivity in a muscle and its fascia
myofascial trigger point
trigger points in which 2 muscles very commonly refer pain to the head?
- upper trap
2. SCM
which type of trigger point is induced by key trigger point
satellite TrP
cause pain and tenderness at rest or with motion that stretches/loads muscle
active myofascial TrP
what can serratus posterior superior TrP mimic?
C8 radiculopathy or ulnar neuropathy
gluteus minimus trigger point mimics?
L5 or S1 radiculopathy
what defines an active trigger point?
pain recognition
