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COMLEX - Savarese > Trigger Points (HY) > Flashcards

Trigger Points (HY) Flashcards

1
Q

What does TART stand for?

A

T-Tissue texture changes
A-Asymmetry
R-Restriction
T-Tenderness

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2
Q

What is the Physiologic Barrier?

A

Point at which a PATIENT can ACTIVELY move any given joint

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3
Q

What is the Anatomic barrier?

A

Point at which a PHYSICIAN can PASSIVELY move any given joint

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4
Q

Findings of ACUTE Tissue texture changes.

A
  • Edematous
  • Erythematous
  • Boggy w/ increase moisture
  • Hypertonic muscles
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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
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6
Q

What are the findings of Asymmetry in Acute & Chronic conditions?

A

Acute - Present

Chronic - Present w/ COMPENSATION in other areas of body

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7
Q

Restriction findings in ACUTE condition.

A

Painful w/ movement

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8
Q

Restriction findings in CHRONIC condition.

A

Decreased or NO Pain

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9
Q

Tenderness findings in ACUTE condition.

A

Severe, Sharp

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10
Q

Tenderness findings in CHRONIC condition.

A

Dull, Achy, Burning

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11
Q

Orientation of Superior facets:

-Cervical

A

“BUM”

Backward
Upward
Medial

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12
Q

Orientation of Superior facets:

-Thoracic

A

“BUL”

Backward
Upward
Lateral

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13
Q

Orientation of Superior facets:

-Lumbar

A

“BM”

Backward
Medial

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14
Q

Flexion/Extension:

  • Axis:
  • Plane:
A

Flexion/Extension:

  • Axis: Transverse
  • Plane: Saggital
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15
Q

Rotation:

  • Axis:
  • Plane:
A

Rotation:

  • Axis: Vertical
  • Plane: Transverse
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16
Q

Sidebending:

  • Axis:
  • Plane:
A

Sidebending:

  • Axis: Anterior-Posterior
  • Plane: Coronal
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17
Q

Describe DIRECT treatment.

A

Towards barrier

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18
Q

Describe INDIRECT treatment.

A

Away from barrier

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19
Q

Describe ACTIVE treatment.

A

Patient assists during treatment

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20
Q

Describe PASSIVE treatment.

A

Patient RELAXES during treatment

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21
Q

OA:

  • Main motion
  • Sidebending & Rotation
A

OA:

  • Main motion: Flexion/Extension
  • Sidebending & Rotation: Opposite
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22
Q

AA (C1):

  • Main motion
  • Sidebending & Rotation
A

AA:

  • Main motion: Rotation
  • Sidebending & Rotation: Opposite
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23
Q

C2-C4:

  • Main motion
  • Sidebending & Rotation
A

C2-C4:

  • Main motion: Rotation
  • Sidebending & Rotation: Same
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24
Q

C5-C7:

  • Main motion
  • Sidebending & Rotation
A

C5-C7:

  • Main motion: Sidebending
  • Sidebending & Rotation: Same
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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 axis 3#-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?
Supraspinatus Infraspinatus Teres minor Subscapularis
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 bones 2-Sacral base Posterior (counternutation) 3-Decreased AP diameter of the cranium 4-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 bones 2-Sacral base Anterior (nutation) 3-Increased AP diameter 4-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 restriction 2-Apply compression (indirect) or traction (direct) 3-Add twisting or transverse forces 4-Use enhancers 5-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)

COMLEX - Savarese (5 decks)

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