Omm Semester 3 Exam 2

Front 1

Range of motion with respect to physiologic barrier is limited by

Back 1

the muscle's ability to shorten on its own

Front 2

range of motion with respect to anatomic barrier is limited by

Back 2

physical barriers such as ligament and bone

Front 3

anatomic barrier is the limit of this type of motion

Back 3

passive

Front 4

neutral point

Back 4

point where tissue tension is balanced, usually roughly half way between pyhsiologic barriers, unless there is a restriction such that the neutral point becomes halfway between the restrictive barrier and physiologic barrier

Front 5

alpha motor neuron

Back 5

transmitts motor impulses to muscle tissue resulting in contraction of a group of muscle fibers

Front 6

gamma motor neuron

Back 6

transmit motor impulses to small intrafusal muscle fibers in the spindle to maintain tension in the spindle at different muscle lengths

Front 7

muscle spindle apparatus

Back 7

sends information about absolute length and rate of length change in muscle

Front 8

golgi tendon sends information to nervous system about

Back 8

tension or rate of change in tension

Front 9

load reflex

Back 9

muscle spindles mediate response to load placed on muscle

Front 10

nuclear bag fibers

Back 10

innervated by group 1a and group II

Front 11

nuclear chain fibers

Back 11

innervated by group 1a only

Front 12

Ia fibers known as

Back 12

annulospiral endings

Front 13

type II fibers known as

Back 13

flower spray endings

Front 14

both fiber types react to

Back 14

rate of length change

Front 15

Ia fibers react more to

Back 15

absolute length change

Front 16

stretching of muscle spindle (muscle getting longer) does this

Back 16

increases rate of firing

Front 17

golgi tendon does this to muscle contraction if tension gets too high

Back 17

it inhibits further alpha contraction to protect muscle from damage

Front 18

physician who formulated muscle energy technique

Back 18

Fred Mitchel Sr. DO

Front 19

isometric contraction

Back 19

static contraction where constant muscle length is maintained, Dr. applies equal force to patient

Front 20

isotonic contraction

Back 20

concentric contraction where muscle length is reduced because force applied by physicican is less than by patient

Front 21

isolytic contraction

Back 21

eccentric contraction where muscle length increases, physician applies a greater force than the patient

Front 22

muscle energy takes advantage of this reflex

Back 22

golgi tendon reflex

Front 23

6 steps of muscle energy technique (different from 8 essential steps he mentions 2 slides later)

Back 23

diagnose, engage dysfunctional barrier and hold, patient contracts against holding force for 3-5s, pt relaxes for 2 seconds, new barrier is engaged, sequence is repeated asappropriate (~3-5x)

Front 24

role of golgi tendon reflex in ME

Back 24

golgi tendon reflex is activted by the resisted contraction

Front 25

neuromuscloskeletal apparatus role in ME

Back 25

allows muscle to relax and be relatively inhibited by golgi tendon, such that it can be passively lengthened by physicial without recripicol activation of stretch receptors

Front 26

muscle energy 8 essential steps

Back 26

accurate structural diagnosis ; engage restrictive barrier in 3 planes ; unyielding counterforce in form of isometric resistance ; appropriate pt muscle effort ; complete relaxation after muscle effort ; repositioning to new restrictive barrier in all 3 planes ; repeat 3-6 ; retest region after

Front 27

mistakes made during ME

Back 27

physician doesn’t monitor accurately, pt contracts too forcefully, muscle contraction too short, pt doesn’t totally relax, examiner doesn’t reevaluate

Front 28

articulatory techniques

Back 28

direct, passive and do not involve a thrust

Front 29

thrusting techniques

Back 29

direct, passive and involve a thrust

Front 30

5 essentials for thrust techniques

Back 30

relax soft tissue ; engage restrictive barrier ; maintain lockout ; don’t use excessive force ; localize treatment

Front 31

Contraindications to HVLA

Back 31

fractures ,neurologic symptom worsening during evaluation ; severe RA; cancer; osteoporosis; hypermobility or instability; medicolegal situations

Front 32

Developed FPR

Back 32

Stanley Schiowitz DO

Front 33

FPR is what type of technique

Back 33

passive, indirect

Front 34

positioning in FPR is similar to

Back 34

counterstrain ; indirect positioning in still technique

Front 35

physiolgic mechanism for FPR

Back 35

by applying compressing force and moving into position of freedom, the muscle spindle is unloaded and will decrease its rate of firing, lowering the rate of firing in the alpha neurons and allowing the muscle to lengthen

Front 36

technique styles for FPR

Back 36

myofacial and articular

Front 37

3 basic steps for FPR

Back 37

flatten AP curve, add a facilitaing force, move into freedom

Front 38

why flatten the AP curve

Back 38

when you put a spinal segment in neutral it opens the facets and the articulation moves freely

Front 39

advantages to FPR

Back 39

easy, fast, you can repeat if nesissary

Front 40

contraindications to FPR

Back 40

joint instability, HNP, foramenal stenosis, severe sprain, vertebrobasilar instability, certain congenital anomalies

Front 41

6 steps of FPR

Back 41

relaxed position, flatten AP curve, apply facilitating force, place vertebra into position of freedom, hold 3-5 s, release and recheck

Front 42

developed Still Technique

Back 42

AT Still DO

Front 43

first published Still Technique

Back 43

Richard Van Buskirik DO

Front 44

Still Technique steps

Back 44

place pt into dysfunction (freedom), apply compression/traction, guide dysfunctional segment into barrier, collect $200

Front 45

indication for still technique

Back 45

any somatic dysfunction

Front 46

contraindications to still technique

Back 46

severe structural loss of intersegmental motion, foramenal stenosis, joint instability, severe strain/sprain

Front 47

differences between FPR/Still

Back 47

in still you don’t flatten AP curve, apply compression after moving into dysfunction, and you guide into barrier after that

Front 48

Cranial Lecture 1

Back 48

Cranial Lecture 1

Front 49

cranial osteopathy was established by

Back 49

William Garner Sutherland DO

Front 50

how many bones in adult skull

Back 50

29 bones

Front 51

cranial group of bones

Back 51

occiput, sphenoid, ethmoid, frontal, temporal (2), and parietal (2)

Front 52

facial group of bones

Back 52

vomer, mandible, maxillae (2), palatines (2), zygomatics (2), lacrimals (2), nasals (2), inferior conchae (2)

Front 53

coronal suture

Back 53

joins frontal and parietal bones

Front 54

bregma

Back 54

junction of coronal suture and saggital suture

Front 55

lamboid suture

Back 55

joins parietal bones with occiput

Front 56

lambda

Back 56

junction of saggital suture and lamboid suture

Front 57

saggital suture

Back 57

seperates parietal bones, runs from bregma to lambda

Front 58

pterion

Back 58

junction of frontal, parietal, temporal, and sphenoid

Front 59

asterion

Back 59

junction of parietal, temporal, occiput

Front 60

1st prinicple of cranial motion

Back 60

inherit mobility of brain and spinal cord

Front 61

2nd principle of cranial motion

Back 61

fluctuation of CSF

Front 62

3rd principle of cranial motion

Back 62

mobility of intracranial and intraspinal membranes

Front 63

4th principle of cranial motion

Back 63

articular mobility of cranial bones

Front 64

5th principle of cranial motion

Back 64

involuntary mobility of sacrum between the illia

Front 65

inherant motility of CNS due to

Back 65

coordinated contraction of oligodendroglia

Front 66

Flow of CSF

Back 66

lateral ventricles, foramen of monro, 3rd ventricle, cerebral aqueduct, 4th ventricle, Lateral formaen of lushika (2) or medial foramen of magendie into subarachnoid space

Front 67

seperates the cerebral hemispheres

Back 67

falx cerebri

Front 68

sepreates the cerebellar hemispheres

Back 68

falx cerebelli

Front 69

sepreates the cerebrum from the cerebellum

Back 69

tentorium cerebelli

Front 70

common origin of dural membranes

Back 70

straight sinus

Front 71

dural attachment points

Back 71

foramen magnum, C2, C3, and S2

Front 72

sutherland fulcrum

Back 72

another name for straight sinus?

Front 73

recripricol tension membrane

Back 73

inelastic dura are being moved by CSF flow and have fixed attachments to cranial bones, therefore the dura acts as a rope that causes cranial bones to move in response to these fluctuations

Front 74

how is it that cranial bones are able to move

Back 74

they arent….but to get this question right on the test we would say the cranial sutures are joints that allow motion

Front 75

rocking motion of the sacrum occurs about what axis

Back 75

a transverse axis that runs through the superior transverse axis of sacrum at S2

Front 76

2 phases of CRI

Back 76

flexion and extension

Front 77

cranial rhythmic impulse

Back 77

palpable wave of CSF

Front 78

CRI is distinct from

Back 78

pulmonary respirations and pulse

Front 79

articulation between sphenoid bone and occiput

Back 79

sphenobasillar syncondrosis (sBS)

Front 80

defines flexion and extension phases

Back 80

angle of SBS

Front 81

rotation of sphenoid in flexion

Back 81

anterior

Front 82

basoocciput moves this way in flexion

Back 82

anterosuperiorly

Front 83

foramen magnum moves this way in flexion

Back 83

superiorly

Front 84

transverse diameter in flexion

Back 84

increases

Front 85

AP diameter in flexion

Back 85

decreases

Front 86

sacral base in flexion

Back 86

drawn posteriorly

Front 87

in flexion midline structures do this

Back 87

flex

Front 88

midline cranial bones

Back 88

occiput, sphenoid,ethmoid

Front 89

midline facial bones

Back 89

vomer

Front 90

midline vertebral structures

Back 90

vertebrae, sacrum

Front 91

paired structures do this in flexion

Back 91

externally rotate

Front 92

extension motion

Back 92

reverse of flexion

Front 93

head diameter in extension

Back 93

increased longitudinal diameter

Front 94

forehead in extension

Back 94

vertical

Front 95

eyes in extension

Back 95

receeded

Front 96

paired bones in extension

Back 96

internally rotated

Front 97

ears in extension

Back 97

close to head

Front 98

BEEF

Back 98

bert (the one with the tall head) extended ; Ernie Flexed

Front 99

typical cranial cycle (per minute)

Back 99

8-12 cycles per minute

Front 100

1 cycle is

Back 100

one flexion, one extension with pauses in between

Front 101

F/E phases should be

Back 101

smooth and forceful

Front 102

amplitude of F/E should be

Back 102

equal

Front 103

still point

Back 103

pause in CRI, thereputic and within typical motion

Front 104

midline bones should follow

Back 104

flexion/extension

Front 105

paired bones should follow

Back 105

internal/external rotaion

Front 106

sacrum follows

Back 106

occiput

Front 107

temporals follow

Back 107

occiput

Front 108

facial bones follow

Back 108

sphenoid

Front 109

keystone of all cranial movement

Back 109

SBS

Front 110

sacral counternutation occurs in

Back 110

flexion, means base of sacrum moves posterior

Front 111

sacral nutation occurs in

Back 111

extension, means base of sacrum nods anteriorly

Front 112

index finger in vault hold

Back 112

posterior to orbit

Front 113

middle and ring fingers in vault hold

Back 113

opposite sides of ear

Front 114

5th finger in vault hold

Back 114

behind mastoid process

Front 115

hands in vault hold are

Back 115

shaped over cranium

Front 116

thumbs in vault hold

Back 116

off cranium or touching very lightly

Front 117

SBS decompression can help relieve symptoms in these patients

Back 117

concussion patients

Front 118

Physiologic strains (3)

Back 118

flexion extension, torsion, sidebending &rotation

Front 119

Non physiologic strains (3)

Back 119

vertical, lateral, compression

Front 120

strains are named for

Back 120

the way they like to go

Front 121

in flexion the SBS deviates

Back 121

cephlad

Front 122

in extension the SBS deviates

Back 122

caudad

Front 123

in a torsion strain what is the axis of movement

Back 123

an AP axis through the SBS

Front 124

in a torsion strain the sphenoid and occiput rotate about the AP axis in __________ directions

Back 124

opposite

Front 125

torsion strain is named based on what

Back 125

whatever greater wing is superior

Front 126

motion in S&R strains occurs in ____ axes

Back 126

AP axis ; 2 vertical axes (one through sphenoid and one through foramen magnum)

Front 127

S&R strains are named for the side of

Back 127

convexity

Front 128

rotation in S&R strain occurs about what axis

Back 128

A to P axis

Front 129

sidebending in S&R strain occurs about what axis

Back 129

occiput and sphenoid sidebend about two vertical axes

Front 130

vertical strain pattern

Back 130

vertical deviation of sphenoid relative to occiput

Front 131

superior strain

Back 131

cephlad deviation of base of sphenoid relative to base of occiput

Front 132

inferior strain

Back 132

caudad deviation of base of sphenoid relative to base of occiput

Front 133

motion in vertical strain pattern occurs on what axes

Back 133

2 transverse axes

Front 134

lateral strain pattern

Back 134

lateral deviation of sphenoid relative to occiput

Front 135

lateral strain named for

Back 135

direction of base of sphenoid

Front 136

lateral strain motion occurs among what axes

Back 136

2 vertical axes

Front 137

lateral strain can be likened to a

Back 137

parallelogram head

Front 138

compression strain

Back 138

bowling ball strain, SBS pushed together

Front 139

amplitude of F/E in compression strain

Back 139

diminished

Front 140

indications of cranial tx (4)

Back 140

all systemic dysfunctions, birth, trauma to PRM, dentistry

Front 141

complications of cranial tx

Back 141

dizziness, headache, tinnitus, alternations of autonomic functions

Front 142

absolute contraindications of cranial (4)

Back 142

acute intracranial bleed, increased ICP, skull fracture, acute CVA

Front 143

relative contraindications of cranial (4)

Back 143

known siezure history or dystonia, traumatic brain injury, coagulopathies, space occupying lesion of cranium

Front 144

purpose of vault hold

Back 144

to adress strains at SBS

Front 145

purpose of V spread

Back 145

to separate restricted or impacted sutures

Front 146

purpose of lift technique

Back 146

frontal and parietal lifts are commonly used to aid in balance of membranous tension

Front 147

purpose of CV4 bulb decompression

Back 147

increase amplitude of CRI

Front 148

in CV4 bulb decompression you resist this and encourage this

Back 148

resist extension and encourage flexion