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OS3 Final > Study Guide > Flashcards

Study Guide Flashcards

1
Q

OSE findings/dx/tx for piriforimis syndrome

A

Ext rotation of hip
+/- straight leg raise
MRI as last resort
OMT, PT

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2
Q

OSE findings/tx for Psoas syndrome

A

flexed posture
psoas TP
OMT, PT

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3
Q

OSE findings/dx/tx for Short Leg syndrome

A

Sacral base unlevel
Medial malleolus short after SDE is resolved
Postural Xray
Heel lift tx

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4
Q

OSE findings/dx/tx for spondylolysis/-listhesis

A

Step-off of sinus process in lumbar flexion
AP, Lat, Obliq Xrays
OMT/PT, bracing, lifestyle changes (lite duty)
Surgery if severe

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5
Q

Findings in spinal disc herniation

A 
\+ SLR, LE weakness
MRI to confirm
acute = RICE
post-acute = OMT
Surgery if severe
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6
Q

OSE findings/dx/tx for Cauda Equina syndrome

A

Bowel/bladder dysfunction, saddle anesthesia, bilat LE pain
MRI
SURGICAL EMERGENCY **must tx within 48 hrs

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7
Q

Treatment recommendations for Carpal Tunnel Syndrome

A 
Mild/Preg= usually self-limiting, wrist splints, NSAIDs, steroid inj
Moderate= OMT, splints, NSAIDs, steroid inj
Severe= signs of damage and muscle wasting--OMT at consult then surgical referral
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8
Q

S/SX of carpal tunnel

A

(repetitive flexion injury) nighttime numbness of lateral 3.5 digits, tingling, wrist pain, loss of grip, thenar atrophy
**common in pregnancy

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9
Q

DX for carpal tunnel

A

Gold-standard = EMG

+Phalen’s, +Tinel’s, two-point discrimination at 5mm

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10
Q

Findings for degenerative disc deisease

A

**Non-specific LBP dx with Xray
TX with OMT, PT, NSAIDs
Surgery if severe

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11
Q

Carpal Tunnel DX/TX

A

NSAIDs, OMT (MFR, ST, Lymph), Xray if concerned with fracture, MRI for ST injury (atrophy/severe/prolonged)
Surgical for severe or unresponsive

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12
Q

Spinal compensation in psoas strain

A

loss of LSpine lordosis

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13
Q

Spinal compensation in ageing

A

increased Tspine kyphosis

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14
Q

Spinal compensation in pregnancy

A

increased Lspine lordosis and Tspine kyphosis

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15
Q

Zink transition zones

A 
OA
cervicothoracic
thoracolumbar
lumbrosacral
Compensated = LRLR (common) or RLRL (uncommon)
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16
Q

General contraindications to OMT

A

PT refusal, acute fracture, surgical emergency, cranial OMT for acute head bleed (dural/subdural hematomas)

17
Q

OMT contraindications in LBP

A

Lumbar HVLA when Mets are present (avoid area)
HVLA w/ hx of osteoporosis
HVLA for acute lumbar herniation (relative contraind)
Direct tx for compression fracture (other than direct MFR)
HVLA in acute phase of RA

18
Q

Contraindications of OMT in pregnant pts

A

undx vaginal bleeding, preterm labor, placental abruption, ruptured membranes, incompetent cervix, eclampsia, ectopic, chorioamnionitis

19
Q

Contraindications for OMT in surgical PTs

A

Avoid direct manipulation over surgical sites for 2 weeks, abd plexus inhib if midline incision or AAA, sigmoid release if recent L hemicholectomy, mesenteric release if anterior abd incisions, rib raising if rib/spine fracture or surgery, pedal pump ABSOLUTE CI if DVT, LE fractures, or recent abd surgery, Lymph tx (relative) if osseous fx, bacterial infx w/ fever >102, abcess/local infx, TI relaease if upper rib fx/clavicle fx, liver or spleen if thoracotomy or chest tube

20
Q

Common SD in 2nd trimester of pregnant patient

A

pelvis rotating about R/L axis with forward torsion, increased pelvic tilt (ant innom rotation), increased lumbar lordosis, compensatory increase in T kyphosis (may lead to cervical strain)

21
Q

Alarm findings in pregnant patient

A

severe pain that interferes with function, particularly non-positional persistent pain at night, increased pain with cough, sneezing or valsalva maneuver; neuro deficits; bowel or bladder dysfunction; weakness, sensory deficits, abd reflexes

22
Q

Radicular pain in pregnancy

A

10% herniated disc
40% bulging disc
likely d/t mechanical pressure of ligamentous structures on nerve root – presents as parasthesias in ILIOINGUINAL AND GENITOFEMORAL NN distrobution (“lightning pains”)

23
Q

Reason for increase in LBP at night in pregnancy

A

stagnant hypoxia of neural and vertebral tissues
dependent edema moves back into the vasculature d/t osmotic gradient plus direct pressure on IVC by the uterus leads to decreased flow in pelvis therefore stagnant hypoxia of tissues and delayed LBP

24
Q

Hormonal cause for LBP in pregnancy

A

Relaxin leads to widening of SI joints and pubic symphesis beginning at 10-12 weeks; progesterone causes changes in mechanics of thoracic cage leading to increased circumference and widening of subcostal angle from 68* to 103*

25
Q

Results of scoliosis, RA and ankylosing spondylitis during pregnancy

A 
Scoliosis = no increase in curve, may develop increase in pain, possible preterm labor
RA = improves sx from conception to 6 wks PP
AS = aggrivated d/t increased mechanical stress
26
Q

Reason carpal tunnel is common in pregnancy

A

Common in 2nd trimester d/t fluid retention and congestion

27
Q

DX/TX of ruptured pubic symphesis in pregnancy

A

Separation >1cm (<10mm); occurs <1%; audible crack heard; acute pain radiating to back or thighs, palpable gap w/ edema, waddling gait with pain
Conservative TX…bed rest (lat recumb), pelvic binder, OMM (indirect tx), pain may recur in later pregnancies

28
Q

CS for PC tenderpoints

A

PC1 inion = F StRa
PC3 = FSaRa
Remaining = E SaRa

29
Q

CS tx for Posterior thoracic TPs

A 
midline = E
PT1-3 = E SaRa
PT4-9 = E SaRt
PT10-12 = E SaRa
30
Q

Anterior cervical CS

A

AC1 mandible and AC1 TP = SaRa
AC 7 = F StRa (clav head)
Remaining = F Sara

31
Q

Heel lift therapy

A

Typically tx only if length discrepancy is > 5mm (0.19685”)
o Max ¼” heel lift in shoe, ¼” may be added to outside as well; ½” total
o May add full 1/2 “ outside
o Final lift height should be ½-3/4 of measured discrepancy, unless recent cause apparent
o Replace full discrepancy w/ acute change in leg length

32
Q

UE and LE dermatomes

A

C5: motor to deltoid & biceps; sensation to lateral arm; bicep reflex

  • C6: wrist extension & elbow flexion; sensation to radial forearm, thumb and index finger; brachioradialis reflex
  • C7: Wrist flexion, elbow extension, finger extension; sensation to middle finger; triceps reflex
  • C8: finger flexion; sensation to ulnar forearm and small finger
  • T1: finger abduction; sensation to medial arm
33
Q

Role of ANS in disease

A

o 2 neuron chain connecting preganglionic neurons through ganglia  visceral target tissues : cardiac & sm m, secretory glands, CT,
immune cells
o Involuntary; regulated by hypothalamus, limbic system & brainstem; limbic forebrain  hippocampus, amygdala, prefrontal &
cingulate cortex  SNS or PNS

34
Q

Describe clinical signs of viscerosomatic reflex dysfunction

A

Exhibit non-neutral Type II SD, increase in moisture (skin drag), increase in temp, poorly defined end point (rubbery), affects small rotators (rotatores)

35
Q

When to refer to PT

A

Techniques Used for Injuries
 US: tendon injuries, pain relief
 Phonophoresis: US medication delivery, inflammatory conditions
 Iontophoresis: electric current, inflammatory conditions
 Laser Therapy: ↓ PGE2
 Electric Stimulation: generates AP; neuropathic pain, spasm

36
Q

when to refer to OT

A

Services Provided:
 An individualized evaluation, during which the client, family, and OT determine the person’s goals
 Customized intervention to improve person’s ability to perform ADL and reach goals
 An outcome evaluation to ensure that goals are being met and/or to modify the intervention plan based on the pt’s needs
& skills

37
Q

When to refer to surgery

A

cauda equina syndrome, spondylolisthesis, severe spinal stenosis, etc; pain is not indication for surgery, nerve compression is 
EMG performed

38
Q

When to refer to massage

A

Techniques: Swedish massage (hypertonicity), deep tissue (trigger points), Shiatsu (rhythmic pressure on precise points of body),
lymphatic (edema), Rolfing (ten-step approach to align structure)
o Great for people with lots of chronic muscle tightness, stress, etc

OS3 Final (2 decks)

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