Omm First Year Second Semester Exam I

Front 1

Goals of muscle energy technique

Back 1

- Strengthen the weaker side of asymmetry
- Decrease hypertonicity
- Lengthen muscle fibers
- Reduce the restraint of movement
- Alter related respiratory and circulatory function

Front 2

2 physiological principles of muscle energy

Back 2

- Postisometric relaxation - increased tension on Golgi organ proprioceptors in the tendons - inhibits active muscles contraction
- Reciprocal inhibition - used when antagonistic muscles are contracted

Front 3

Contraindications for muscle energy technique

Back 3

- Painful muscle or muscle group
- Patient with low vitality who could further be compromised by adding active muscular exertion - post surgical patient or patient on monitor in ICU who is post MI

Front 4

Muscle energy technique is direct/indirect?

Back 4

Direct

Front 5

Describe lumbar vertebral bodies

Back 5

- Largest vertebra
- Wider transversely
- Wedge shaped - higher in front, maintains lordosis

Front 6

Lumbar spinous processes

Back 6

- Long
- Quadrangular
- Directed dorsally

Front 7

Lumbar transverse processes

Back 7

- Long and thin
- Directed laterally

Front 8

Body and processes all in same spinal level - T/F

Back 8

True

Front 9

Angle of joints between vertebrae is _

Back 9

almost vertical

Front 10

Flexion/extension is coupled with _

Back 10

ventral /dorsal translatory slide

Front 11

Lateral flexion couples with _

Back 11

contralateral translatory slide

Front 12

Rotation is coupled with _

Back 12

Disc compression

Front 13

Which motion is greatest at all levels

Back 13

Flexion/extension

Front 14

Is there lateral flexion in lumbar spine

Back 14

Some lateral flexion with limited rotation

Front 15

Latissimus dorsi - origin, insertion, action, innervation

Back 15

ORIGIN - humerus
INSERTION - T 7-12, iliac crest, thoracolumbar fascia
ACTION - humerus motion and raises body to arms during climbing
INNERVATION - Thoracodorsal nerve (C6-8)

Front 16

Gluteus maximus - origin, insertion, action, innervation

Back 16

ORIGIN - thoracolumbar fascia, dorsal sacrum
INSERTION - iliotibial band and femur
ACTION- extends hip and stabilizes torso
INNERVATION - Inferior gluteal nerve (L5, S1-S2)

Front 17

Erector spinae - origin and insertion, includes _ , action

Back 17

ORIGIN and INSERTION - sacrum to cervical
INCLUDES - spinalis, longissimus, iliocostalis
ACTION - bilateral contraction extension, unilateral contraction extension, ipsilateral sidebending

Front 18

Quadratus Lumborum - origin, insertion, action, innervation

Back 18

ORIGIN - inferior border of 12th rib and tips of lumbar transverse processes
INSERTION - iliolumbar ligament and iliac crest
ACTION - bilateral contraction creates extension, unilateral contraction causes extension with ipsilateral sidebending
INNERVATION - T12, L1-4 ventral rami

Front 19

Multifidus and rotatores

Back 19

ORIGIN + INSERTION - vertebrae to vertebrae
ACTION - control individual vertebral motions, bilateral contraction - local extension, unilateral contraction-lateral flexion with contralateral rotation

Front 20

Abdominal muscles

Back 20

- Work antagonistically with lumbar muscles
- Synergistic action creates forward bending
- Coordinated mechanism for controlling dangerous torque, bending, and shear stresses in lumbar spine

Front 21

Psoas major

Back 21

- ORIGIN - TP of T12-L5
- COURSE - along pelvic brim behing inguinal ligament in front of hip joint
- INSERTION - lesser trochanter of femur
- ACTION - flexes and internally rotates hip
- INNERVATION - L1-3 (2-4) ventral rami

Front 22

Iliacus

Back 22

ORIGIN - superior 2/3 of iliac fossa, inner lip of iliac crest, ventral sacroiliac and iliolumbar ligaments, upper lateral sacrum
COURSE - iliac spines & capsule of hip joint
INSERTION - lateral tendon of psoas

Front 23

Iliopsoas actions

Back 23

- Important in function and stability
- ACTION - flexes thigh on pelvis, flexes trunk forward, lateral trunk flexion (unilateral contraction), constant activity in erect posture, prevents hyperextension of hip in standing

Front 24

Psoas minor

Back 24

ORIGIN - TP of T12-L1
INSERTION - pectineal line
ACTION - flexes hip
INNERVATION - L1 ventral rami

Front 25

Name deep lumbar musculature

Back 25

- Transversospinalis
- Interspinalis
- Spinalis
- Serratus posterior inferior
- Longissimus
- Iliocostalis
- Lat dorsi aponeurosis

Front 26

Anterior longitudinal ligament

Back 26

- From base of the occiput to anterior sacrum

Front 27

Posterior longitudinal ligament

Back 27

- From posterior body of the axis down to sacrum

Front 28

Anterior and posterior longitudinal ligaments are attached to _

Back 28

Discs

Front 29

Iliolumbar ligament attaches _

Back 29

TP of L4 and L5 and iliac crest

Front 30

First lumbar ligament to become tender with lumbar posture changes

Back 30

Iliolumbar ligament

Front 31

Function of iliolumbar ligament

Back 31

- Increase stability at lumbosacral junction - commonly strained in traumatic injuries

Front 32

Severe low back pain with sudden onset and without history of trauma indicates

Back 32

Dissecting aortic aneurysm

Front 33

Pain that wakes patient from sleep indicates _ unless proven otherwise

Back 33

Malignancy

Front 34

Rapidly progressing neurological deficits together with low back pain indicate _

Back 34

Epidural abscess /infection

Front 35

Claudication symptoms with back pain indicate _

Back 35

Spinal stenosis

Front 36

Type I lesion

Back 36

- Neutral
- SB and Rotation in opposite directions
- Group curve

Front 37

Type II lesion

Back 37

- Flexed or SB
- SB and Rotation in same directions
- Single segment

Front 38

3 planes of motion taken into account in muscle energy treatment

Back 38

- Coronal (SB)
- Horizontal (rotation)
- Sagittal (forward or backward bending)

Front 39

Seated flexion test shows what_

Back 39

- Lateralizes dysfunction (which side is in trouble)
- Also confirms that it is SACRAL problem and not necessarily a problem with ilium

Front 40

Standing flexion test shows _

Back 40

Problem is with ilium

Front 41

Positive Sphinx test shows what _

Back 41

Unilateral sacral flexion
Unilateral sacral extension

Front 42

Describe anterior sacral base

Back 42

- Also called bilateral sacral flexion or flexed sacrum
- LANDMARKS
Sacral base - anterior
Sacral sulci - deep bilateral
ILA - bilateral posterior
ST ligament - tight bilaterally
SPHINX TEST - negative
SPRING TEST - negative
SACRAL BASE - bilaterally positive (will move)
ILA - bilaterally negative (will not move)

Front 43

Bilateral sacral flexion usually occurs when + common findings

Back 43

- Following birth
- Look for discontinuity at lumbo-sacral junction
- Low back pain is main complaint
- Increased lumbar curve - lumbar is forced to extend to compensate sacrum

Front 44

Describe posterior sacral base

Back 44

- Also called posterior sacral base, bilateral sacral extension, extended bent sacrum
- LANDMARKS - sacral base posterior bilaterally, sacral sulci are bilaterally shallow, ILA are bilaterally anterior, sacrotuberous ligament is bilaterally loose
SPHINX TEST - positive
SPRING TEST - positive
SACRAL BASE - bilaterally negative - will not move
ILA - bilaterally positive - will move

Front 45

Bilateral sacral extension is commonly found in _

Back 45

- Post op patients
- Low back pain worse with forward bending
- Decreased lumbar curve - lumbar is forced into flexion to compensate for sacrum

Front 46

Which axes are axes of ambulation

Back 46

OBLIQUE

Front 47

Sacral motion about oblique axis results in

Back 47

- Neutral or non-neutral dysfunctions (compensatory) of L5

Front 48

Describe right unilateral sacral flexion

Back 48

- Right side of sacral base is stuck anteriorly
- Positive seated flexion test on the right
- Right sacral sulcus will be deep
- Right sacral base will be anterior
- RIght ILA is posterior and inferior

Front 49

Motion testing for right unilateral sacral flexion

Back 49

- There will be no motion at the right inferior ILA - its locked down
- The base on the same side is likely to have adequate motion
- There is generally good motion at any of other locations
- Negative spring and sphynx test

Front 50

Describe right unilateral sacral extension

Back 50

- Right side of sacral base is stuck anteriorly
- Positive seated flexion on the right
- Right sacral sulcus are shallow
- Right sacral base is posterior
- RIght ILA is anterior/superior
- Positive spring and sphinx test

Front 51

Motion testing for right unilateral sacral extension

Back 51

- Restricted spring of right superior pole
- Good motion at other location

Front 52

Degree of kyphosis varies with _

Back 52

-Age
- Postural habits
- Pathologic conditions (osteoporosis)

Front 53

Splenius capitis and cervicis difficulties lead to _

Back 53

Decrease of motion in cervical spine and distal dysfunctions in thoracic spine

Front 54

Internal and external oblique muscles attach to _ and serve as _

Back 54

- Lower ribs
- Trunk rotators

Front 55

Difficulties with internal and external oblique muscles lead to

Back 55

- Diaphragmatic problems and difficulties breathing

Front 56

Erector spinae muscles unilateral contraction does _
bilateral contraction _

Back 56

Unilateral - SB trunk
Bilateral - extend trunk

Front 57

Head and neck sympathetics levels

Back 57

T1-T4

Front 58

Heart and lungs sympathetics levels

Back 58

T1-T6

Front 59

Upper abdominal viscera – liver, gallbladder, stomach, pancreas, spleen and duodenum sympathetic levels

Back 59

T5-T9

Front 60

Rest of small bowel, kidney, ureter, gonads and right colon - sympathetics levels

Back 60

T10-T11

Front 61

Left colon and pelvic organs - sympathetics

Back 61

T12-L2

Front 62

Greatest motion in thoracic spine

Back 62

ROTATION

Front 63

What dictates degree of rotation in thoracic spine

Back 63

Articular facets

Front 64

Second greatest motion in thoracic spine

Back 64

Lateral bending

Front 65

Least motions in thoracic spine

Back 65

Flexion/extension

Front 66

Lateral bending in thoracic spine is restricted by _

Back 66

- Articular impingement
- Ligamentous attachments
- Resistance by costal cage

Front 67

T 1-T4 - type _ dysfunction

Back 67

Type I

Front 68

T5-T9 - type _ dysfunction

Back 68

Mix - type I and type II

Front 69

T10-T11 - type _ dysfunction

Back 69

Mix - type I and type II

Front 70

T12 - type dysfunction

Back 70

Type II

Front 71

Pectus carinatum

Back 71

Abnormal prominence of the sternum - pigeon chest

Front 72

Pectus excavatum

Back 72

Abnormal depression of the chest - funnel breast

Front 73

Level for sternal notch

Back 73

T2

Front 74

Level for sternal angle

Back 74

T4

Front 75

Level for xiphisternal junction

Back 75

T9

Front 76

Levels for scapular spine and scapular inferior angle

Back 76

T3; T7

Front 77

Inhalation somatic dysfunction

Back 77

- Rib is in position of inspiration
- Exhalation restriction
- Rib is ELEVATED

Front 78

Exhalation somatic dysfunction

Back 78

- Rib is in position of exhalation
- Inhalation restriction
- Rib is DEPRESSED

Front 79

Depressed rib

Back 79

- Space between it and the rib below is narrowed
- Space between it and one above is increased

Front 80

Elevated rib

Back 80

- Space between it and one above is narrowed
- Space between it and one below is increased