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160 Cards in this Set
- Front
- Back
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What does TART stand for?
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Tissue texture changes
Asymmetry Restriction Tenderness |
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A patient extends their arm as far as they can. This is the what barrier?
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Physiologic barrier- how far the patient can actively move their arm
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The physician extends your leg to see ROM, this testing what barrier?
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Anatomical barrier- how far the joint can be passively moved.
This is further then the physiological barrier and any movement past this will causes injury |
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Define restrictive/ pathological barrier?
Is it before or after the physiological barrier? |
Before the physiological barrier due to injury of some kind.
Prevents full ROM |
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Upon palpating the patient you feel swelling with increase moisture.
Is this chronic or acute? |
Acute
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The patient describes an injury as severe and sharp and painful to move.
Is this chronic or acute? |
Acute
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You find the skin on your patient to be cool, dry with no edema.
Patient describes the area as dull achy with burning Is this chronic or acute? |
Chornic
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True or false?
The cervical vertebrae follow fryette's |
False
only thoracic and lumbar |
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When describing a type II fryette's you say the segment is FRrSr.
Are you comparing this segment to the one above or below it? |
Below it.
Example: L2 is restricted in motions compared to L3 |
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What is the facet orientation of the cervical vertebrae
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Backward, upward, medial
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What is the facet orientation of the thoracic vertebrae
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Backward, upward, lateral
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What is the facet orientation of the lumbar vertebrae
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backward, medail
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Whats the difference between isolytic contraction and eccentric contraction?
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Isolytic- the muscle is being forced to elongated while contracting
Eccentric- muscle lengthens while contracting (more of a choice) |
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The joints of Luschka are made up of the ____
They help protect against what? |
Made up by uncinate processes
support lateral side of cervical discs and protect cervical nerve roots from disc herniation |
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Cervical vertebrae rotate and side bend in the same direction or opposite direction? For C2-C7
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Same!
for C2-C7 |
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Which cervical segment is best evaluated by flexing the neck to 45 and rotating the head?
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C1!!!!!!!!!!!!!!!!!
Know this!!!! |
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Please explain the rule of three's in regards to the thoracic vertebrae
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t1-t3 spinous process is located at the same level as TP
t4-t6 spinous process is located half below TP t7-T9 spinous process is located at TP with vertebrae below T10- follows t7-t9 T11- follows t4-t6 T12 follows t1-t3 |
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the main motion of vertebrae is rotation? What section of vertebrae is this?
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Thoracic vertebrae main motion is roation
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In terms of Thoracic vertebrae movement the upper/middle main function is rotation. What about the lower thoracic vertebrae
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Flexion/extension over rotation.
same as lumbar vertebrae |
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Ribs 1,2,11 and 12 are atypical ribs. explain why each one is
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1- it articulates with t1 and has no angle
2- large tuberosity on the shaft for the serratus anterior 11,12- only articulate with corresponding vertebrae and lack tubercles |
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Which ribs are true, false and floating?
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1-7 true
8-12 false 11,12 floating |
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Rib motion has been described as
pump-handle bucket-handle caliper Which ribs and what does this mean? |
Pump- 1-5, anteriorly enlarge
Bucket 6-10 laterally enlarge caliper 11,12 |
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What does inhalation dysfunction mean in terms of restriction and somatic dysfunction?
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Inhalation somatic dysfunction while exhalation restriction
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Where would you expect to find changes with ribs the move in a pump-handle type motion?
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Costochondral junction
chondrosternal junction posterior rib angle |
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Where would you expect to find changes with ribs the move in a bucket-handle type motion?
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intercostal muscles
mid-axillary line posterior rib angle |
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All of the following are secondary muscles of respiration except?
a. scalenes b. pectoralis minor c. external intercostal d. quadratus lumborum e. latissimus dorsi |
C. external intercostals
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Why is the lumbar spine most susceptible to disc herniations?
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the posterior longitudinal ligaments starts to narrow at the lumbar region.
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Where does the nerve root in the thoracic and lumbar exit?
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In the interverbral foramen below its corresponding vertebrae
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A positive Thomas test is seen with what somatic dysfunction?
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iliopsoas somatic dysfunction
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Facet (zygopophyseal) trophism
What the hell does this mean? |
lumbar facet joints are more closely aligned to the coronal plane
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The main function of the lumbar spine is what?
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Flexion/extension
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An increase in fergusons angle which normally between 25 and 35 will lead to what?
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Causes a shear stress placed on the lumbosacral joint often causing lower back pain
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A herniation of a disc between two vertebrae (x/y) with x being on top and y on bottom will affect which nerve root?
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Y (one on bottom)
herniation between L3 and L4 will affect root L4 |
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With psoas syndrome you will have a positive thomas test as well as a positive pelvic shift test to what side?
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contralateral side for positive pelvic shift test
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A flexion contracture of iliopsoas is associated with which dysfunction location?
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L1 and L2
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Spondylolisthesis
Spondylolysis Spondylosis All so similar but what do they mean? |
Spondylolisthesis- anterior slipping of one vertebrae on another
Spondylolysis- a fracture in the pars (scotty dog) Spondylosis- degenerative changes within the vertebral bodies and disc |
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Patient comes with loss of bowel and bladder control and generally cant feel the goods or the hiney. What do they have and what do you do?
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Cauda equina syndrome with saddle anesthesia
emergency! |
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How is scoliosis named?
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Named for the convex side
curve is sidebent to the left scoliosis to the right curve is side bent to the right scoliosis to the left |
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What does dextroscoliosis and Levoscoliosis mean?
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Dextroscoliosis- scoliosis on the right
Levoscoliosis- scoliosis on the left |
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What is the difference between a functional curve and a structural curve when it comes to Scoliosis?
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Structural curve will no correct with sidebending in the opposite direction
Functional curve can be partially or completely correct with sidebending to the opposite side |
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To determine the severity of scoliosis you would measure the?
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Cobb angle
horizontal line from the top veterbrae of the curve and the bottom vertebrae of the curve. Perpindicular lines from those that intersect-measure that angle |
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List the following angles for scoliosis when looking at the cobb angle
Mild? Moderate? Severe? |
Mild- 5-15
Moderate- 20-45 Severe- Greater than 50 |
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What is the main cause of scoliosis?
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80% of cases are idiopathic
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Konstancin exercises refer to what?
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exercises that have been proven to improve the aptient with scoliotic postural decompensation
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What is the most common cause of having a short leg?
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Hip replacement
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What ligament is most likely to get stressed with a short leg?
Isplateral or contralateral? |
SI ligament on the isplateral side
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With scoliosis what is affect first CV or Respiratory function?
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Respiratory goes first at around 50 with CV coming at 70+
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What ligament divides the great and lesser sciatic foramen?
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The sacrospinous ligament
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Respiratory motion seen in the sacrum occurs around which axis and which way does it move?
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Superior transverse axis
inhalation will move posterior Exhalation will move anterior |
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Explain Counternutates and nutates in terms of sacral movement
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Counternutates- sacral base rotates posteriorly with inhalation
Nutates- sacral base rotates anteriorly with exhalation |
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Postural movement occurs around which sacral axis?
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Middle transverse axis
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Craniosacral motion occurs around which sacral axis?
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Superior transverse axis
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Weight bearing with one leg will cause a sacral axis to be engaged isplaterally or contralaterly?
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Isplatearlly
left weight bearing will cause left sacral axis to be engaged |
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When L5 is sidebent, a sacral oblique axis is engaged on the same side as the sidebending
This is rule 1 |
Know this!
When L5 is sidebent, a sacral oblique axis is engaged on the same side as the sidebending When L5 is rotated the sacrum rotates the opposite way on an oblique axis The seated flexion test is found on the opposite side of the oblique axis |
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When L5 is rotated the sacrum rotates the opposite way on an oblique axis
This is rule 2 |
Know this!
When L5 is rotated the sacrum rotates the opposite way on an oblique axis |
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The seated flexion test is found on the opposite side of the oblique axis
this is rule 3 |
know this
The seated flexion test is found on the opposite side of the oblique axis |
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With a forward sacral torsion does the rotation happen on the same side of axis or on the opposite side of the axis?
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Same side
L on L or R on R |
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With a backwards sacral torsion does the rotation happen on the same side of axis or on the opposite side of the axis?
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Opposite sides
R on L or L on R |
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What makes a sacral roation on an oblique axis?
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L5 is rotated to the same side as the sacrum
Want to fix the lumbar dysfunction first |
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What sacral dysfunction are you most likely to see in a post-partum patient?
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bilateral sacral flexion
got to make room for that baby |
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How does the glenohmueral joint move with the scapulothoracic joint in abduction?
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For every 2 degrees the GH joint moves the ST joint moves 1 degree
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Positive adson's test is seen with what?
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Thoracic outlet syndrome
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With supraspinatus tendinitis, the tendon is getting pinched between what two structures?
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Between the greater tuberosity and the acromion
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When checking the bicep tendon in the bicipital groove, which head of the biceps are you checking?
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Long head of the biceps
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What is the most common type of brachial plexus injury?
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Erb-Duchenne's palsy
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An increase in the carrying angle of the elbow greater than 15 is called what?
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Cubitus valgus
Abduction of the unla More common in women |
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A decrease in the carrying angle of the elbow is less than 3 is called what?
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Cubitus varus
adduction of the unla More common in men |
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An increase in the carrying angle at the elbow will do to what to the wrist?
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Will cause the wrist to adduct more because the increase angle forces the radius forward
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An decrease in the carrying angle at the elbow will do to what to the wrist?
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Will cause the wrist to abduct more because the decrease angle forces the radius back
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The radial head moves in which directions with pronation and supination?
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Pronation- glide posteriorly
Supination- glide anteriorly |
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What deformity is seen with rupture of the extensor tendon at the pip?
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Boutonniere deformity
Flexion at the PIP, extension at the DIP |
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With dupuytren's contracture you have changes where?
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Contracture of the palmar fascia
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Which nerve only carries fibers from C5
What muscle does this nerve innervate? |
Dorsal Scapular
Rhomboids and Levator |
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Capits femoris ligaments connects what?
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connects the head of the fumur to the acetabular fossa
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What motions make up pronation of the ankle?
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Dorsiflexion, eversion, abduction
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What motions make up supination of the ankle?
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Plantarflexion, inversion and adduction
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Will supination or pronation cause the fibular head to glide anteriroly?
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Pronation
Think posterior glide causes damage to CF nerve which is an issue with ankle sprains which happen in supination (plantarflexion) |
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Will supination or pronation cause the fibular head to glide posteriorly?
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Supination
causes damage to the common fibular nerve possibly Think posterior glide causes damage to CF nerve which is an issue with ankle sprains which happen in supination (plantarflexion) |
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The term coxa such as coxa valgus or coxa varus refers to which joint?
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The hip
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What angle are you looking at to determine coxa valgus vs varus and what are the degrees?
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angle between the neck and shaft of the femur
less then 120- vara more then 135 valga |
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The term Genu such genu valgum and genu varum refers to which joints?
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The knee
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What would the foot be like with an anterior fibular head
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everted and dorsiflexed
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What would the foot be like with a posterior fibular head?
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Inverted and plantarflexed
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What muscle imbalance leads to patello-femoral syndrome?
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Strong vastus lateralis and a weak vastus medialis
need to strengthen the vastus medialis |
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What compartment is most often affected with compartment syndrome in the lower leg?
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The anterior compartment (dorsiflexors)
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What makes up the medial longitudinal arch of the foot?
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talus, navicular, cuneiforms, 1-3rd metatarsals
supported by the spring ligament |
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What makes up the lateral longitudinal arch of the foot?
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Calcaneus, cuboid, 4-5th metatarsals
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What makes up the transverse arch of the foot?
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Navicular, cuneiforms, cuboid
Most likely to have a somatic dysfunction of all the arches |
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Which arch of the foot is most likely to have a somatic dysfunction?
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Transverse arch
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What is a heel spur?
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Calcium collects in the plantar aponeurosis
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A decreased Q angle is associated with which one of the following conditions?
A. genu valgum B. Patello-femoral angle C. a bow-legged appearance D. Cox vara |
Answer: C. a bow legged appearance
also known as genu vara |
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What 5 things make up the Primary respiratory mechanism (craniosacral motion)
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CNS + CSF+ Dural membranes + cranial bones + sacrum= PMR
that kind of sums up cranial opp |
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What is a normal rate for cranial rhythmic impulse?
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10-14 cycles per minute
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Name 4 factos that will decrease the rate and quality of the cranial rhythmic impulse?
Hint: SDCC |
Stress
Depression Chronic fatigue Chronic infection |
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Name 3 factos that will increase the rate and quality of the cranial rhythmic impulse?
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Exercise
Systemic fever OMT to the craniosacral mechanism |
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Name 3 vertebrae that the dura attach to.
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C2 C3 S2
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If a question starts talking about the Reciprocal Tnesion membrane. What is this?
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How the dura is inelastic and connects to the cranial bones so when it moves it moves everything with it.
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When the midline cranial bones flex
How do the bones rotate? What is the movement at the sacrum? What happens to the AP and lateral dimensions? |
external rotation of the paired bones
sacral extension aka counternutation decrease AP and widening of the head |
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When the midline cranial bones extend
How do the bones rotate? What is the movement at the sacrum? What happens to the AP and lateral dimensions? |
Internal rotation of the paired bones
sacral flexion aka nutation Increas in the AP diameter of the cranium |
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WIth midline cranial bone flexion, is the sphenoid rotating clockwise or counterclockwise?
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Counterclockwise while the occiput rotates clockwise
vice versa for extension |
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With a craniosacral torsion
How is the torsion named? What axis is the rotation around? |
The torsion is named for the higher greater wing of the sphenoid
The rotation is around an AP axis Note: occiput and sphenoid rotate in opposite directions |
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With craniosacral sidebending/ rotation
How is the dysfunction named? What are the axis that rotation occur around? |
There are two verticle axis (one through each bone) as well as an AP axis
Note: both bones rotate in the same direction Named for the side the two bones are rotating to. Example: it will be feel like the right side is shrinking with a right sidebend/rotation |
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What the difference between a flexion/extension strain and a vertical/inferior strain with the craniosacral motion
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With vertical/inferior strain, you have the sphenoid moving in the opposite direction as the occiput as they rotate on transverse axis
WIth flexion/extension strain is when the bones do not move through the motion equally (really need to see this done) |
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What is main MOA that causes Compression of the CRI?
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trauma, such getting hit in the back of the head
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Where in the body do you check for a vagal somatic dysfunction?
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OA AA and S2
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Name two absolute contraindications for CRI OMT
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acute intracranial bleed
Increased intracranial pressure Relative for bonus: traumatic brain injury, seizure, dystonia history |
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Dysfunction of which cranial nerve can cause symptoms similar to Tic Douloureux?
a. CN V V1 B. CN V V2 C. CN V V3 |
Answer: B CN V V2 aka the maxillary branch of the trigeminal nerve
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What can cause facilitation
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Sustained increase in afferent input or changes within the affected neurons themselves or their chemical environments
needs less afferent stimulation to trigger the discharge of impulses |
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Acute cholecystitis often refers pain the shoulder or right scapula region.
this is example of viscero-somatic or somato-visceral? Your welcome! |
Viscero-somatic
viscero issue causing somatic changes |
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The lower urter and bladder receive their parasympathetic innervation from where?
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From the pelvic splanchnic S2-S4
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THe uterus, prostate and genitalia receive their parasympathetic innervation from where?
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From the pelvic splanchnic S2-S4
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What parts of the large intestine receive their innervation from the pelvic splanchnic S2-S4
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the descending colon, sigmoid and rectum
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The gonads are having issues. Where would you look for their parasympathetic innervation
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Vagus so look at OA AA and C2
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The ureters, 2cm from the kidney junction have a stone lodged in them (yes bilateral)
Where would you check for parasympathetic innervation to this area? |
Vagus so look at the OA AA and C2
vagus innervates the kidney and upper urteres |
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Check what spinal cord levels for the following issue?
head and neck? |
T1-T4
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Check what spinal cord levels for the following issue?
Heart? |
T1-T5
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Check what spinal cord levels for the following issue?
respiratory system? |
T2-T7
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Check what spinal cord levels for the following issue?
Esophagus? |
T2-T8
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Check what spinal cord levels for the following issue?
Upper Gi (up to what portion?) |
T5-T9
up to duodenum, celiac ganglion, greater splanchnic n. |
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Check what spinal cord levels for the following issue?
Middle GI (up to what portion?) |
T10-T11
2/3 transverse colon, superior mesenteric ganglion, Lesser splanchnic nerve |
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Check what spinal cord levels for the following issue?
Lower GI |
T12-L2
least splanchnic Nerve, inferior mesenteric ganglion |
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Check what spinal cord levels for the following issue?
Appendix |
T12
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Check what spinal cord levels for the following issue?
Kidney |
T10-T11
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Check what spinal cord levels for the following issue?
Adrenal medulla |
T10
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Check what spinal cord levels for the following issue?
Upper urters |
T10-T11
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Check what spinal cord levels for the following issue?
Lower Urters |
T12-L1
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Check what spinal cord levels for the following issue?
Bladder |
T11-L2
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Check what spinal cord levels for the following issue?
Gonads |
T10-T11
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Check what spinal cord levels for the following issue?
Uterus and cervix? |
T10-L2
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Check what spinal cord levels for the following issue?
Penis and Clitoris |
T11- L2
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Check what spinal cord levels for the following issue?
Prostate |
T12-L2
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Check what spinal cord levels for the following issue?
Upper extremities |
T2-T8
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Check what spinal cord levels for the following issue?
Legs |
T11-L2
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A chapman's point is found at the tip of the 12th right rib
This correlates with what? |
Appendix
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A champman's point is found at the transverse process of T11 vertebrae
This correlates with what? |
Appendix
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If you were looking for a chapman's point for the Adrenals, where would you look?
Anterior and Posterior |
2in superior and 1in lateral to the umbilicus
Betwen the spinous and transverse processes of T11 and T12 |
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If you were looking for a chapman's point for the Kidneys, where would you look?
Anterior and Posterior |
1in superior and 1 inch lateral to umbilicus
On the spine between T12 and L1 |
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A chapman's point is found on the lateral thigh within the iliotibial band from the greater trochanter to just above the knee
What is this related to? |
Colon
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With myfoascial release you can either do direct or indirect
Which one has traction and which one had compression? |
Compression-indirect
Traction-direct |
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In most healthy individuals which way would you expect the OA fascial diaphragm to be rotated
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To the left
its ok if its rotated to the right as long as then the cervicothoracic one is rotated to the left |
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What parts of the body drain into the right (minor) lymphatic duct?
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The hemi head, the heart, the lobes of the lungs except for the left upper lobe
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The cisterna chyli is innervated by what?
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sympathetics via intercostal n. T11
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Do tenderpoints radiate pain?
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Nope
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What is a maverick point?
Any answer involving Sarah Palin gets partial credit |
Tenderpoint that when treated does not get better but instead put it in the opposite position of treatment. This opposite position will treat the point.
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When checking tender points for L3,L4,L2 anteriorly.
Where and how do you check for each |
Alll are AIIS
L2- push Laterally L3- push medially L4- push superiorly Bonus: L5 is on the pubic symphysis |
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When doing Rib ME, you use certain muscles to raise up the ribs. Name the muscles for the following groups
rib 1 rib 2 rib 3-5 rib 6-9 rib 10-11 rib 12 |
1- anterior and middle scalenes
2- posterior scalenes 3-5- pec minor 6-9- serratus anterior 10-11- lats 12- quadratus lumborum |
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Why would you do HLVA in a patient with down syndrome?
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Laxity may develop in hte tansxverse ligament of the dens
results in atlantal-axial subluxation |
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Rib raising will affect what?
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will normalize sympathetic hyperactivity
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Describe the following test and what you would use it for?
wallenberg test |
Test for vertebral artery insufficiency
Move the patients neck in all directions and see if they complain of dizziness or visual changees |
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Describe the following test and what you would use it for?
Adson's test |
extend the elbow and shoulder with external rotation and abduction
positive test if you have a diminished radial pulse neurovascular bundle is compromised by tight scalenes |
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Describe the following test and what you would use it for?
Wright test |
Hyperabduct the arm above the head with slight extension
checking to see if radial pulse changes due to pressure between pec minor and coracoid proccess |
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Describe the following test and what you would use it for?
Speed Test |
assesses the biceps tendon in the groove
flex shoulder, extend elbow and supinate check for tenderness |
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Describe the following test and what you would use it for?
yergason's test |
stability of the bicep tendon in the groove
internal and external rotation of the shoulder check for tenderness or popping |
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Describe the following test and what you would use it for?
Allen's test |
check circulation in the wrist by cutting off unlar and radial a.a.
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Describe the following test and what you would use it for?
Finkelstein test |
make a fist around your thumb and adduct wrist
checking for De Quervain's disease |
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Describe the following test and what you would use it for?
Hip-drop test |
Checking for sidebending in the lumbar spine!!!!
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Describe the following test and what you would use it for?
Seated flexion test |
assesses sacroiliac motion aka the pelvis
positive on superior PSIS side |
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Describe the following test and what you would use it for?
Standing flexion test |
assesses iliosacral motion
positive on supeiror PSIS side |
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Describe the following test and what you would use it for?
Ober's test |
checking for a tight tensor fascia lata and IT band
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Describe the following test and what you would use it for?
Thomas Test |
checking for iliopsoas tightness such as if you lift a leg in flexion at the hip and the other one comes off the ground
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