Study your flashcards anywhere!

Download the official Cram app for free >

  • Shuffle
    Toggle On
    Toggle Off
  • Alphabetize
    Toggle On
    Toggle Off
  • Front First
    Toggle On
    Toggle Off
  • Both Sides
    Toggle On
    Toggle Off
  • Read
    Toggle On
    Toggle Off
Reading...
Front

How to study your flashcards.

Right/Left arrow keys: Navigate between flashcards.right arrow keyleft arrow key

Up/Down arrow keys: Flip the card between the front and back.down keyup key

H key: Show hint (3rd side).h key

A key: Read text to speech.a key

image

Play button

image

Play button

image

Progress

1/174

Click to flip

174 Cards in this Set

  • Front
  • Back
Articular pillars
1. The columnar arrangement of the articular portions of the cervical vertebrae
2. Those parts of the lateral arches of the cervical vertebrae that contain a superior and inferior articular facet
Biomechanics
Mechanical principles applied to the study of biological functions; the application of mechanical laws to living structures; the study and knowledge of biological function from an application of mechanic principles
Circumduction
1. The circular movement of a limb
2. The rotary movement by which a structure is made to describe a cone, the apex of the cone being a fixed point (e.g. the circular motion of the shoulder)
Contraction
Shortening and/or development of tension in muscle
Concentric contraction
Contraction of muscles resulting in approximation of attachments
Eccentric contraction
Lengthening of muscle during contraction due to an external force
Isolytic contraction
1. A form of eccentric contraction designed to break adhesions using an operator-induced force to lengthen the muscle
2. The counterforce is greater than the patient force
Isometric contraction
1. Change in the tension of a muscle without approximation of muscle origin and insertion
2. Operator force equal to patient force
Elevated rib
Inhalation rib dysfunction
ERS
A descriptor of spinal somatic dysfunction used to denote a combination of extended (E), rotated (R) and sidebent (S) vertebral position.
ERS left
Somatic dysfunction in which the vertebral unit is extended, rotated and sidebent left; usually preceded by a designation of the vertebral unit(s) involved
ERS right
Somatic dysfunction in which the vertebral unit is extended, rotated and sidebent right, usually preceded by a designation of the vertebral unit(s) involved
Extension
1. Accepted universal term for backward motion of the spine in a sagittal plane about a transverse axis; in a vertebral unit when the superior part moves backward
2. In extremities, it is the straightening of a curve or angle (biomechanics)
3. Separation of the ends of a curve in a spinal region
FRS
A descriptor of spinal somatic dysfunction used to denote a combination flexed (F), rotated (R) and sidebent (S) vertebral position.
FRS left
Somatic dysfunction in which the vertebral unit is flexed, rotated and sidebent left; usually preceded by a designation of the vertebral unit(s) involved.
FRS right
A somatic dysfunction in which the vertebral unit is flexed, rotated and sidebent right; usually preceded by a designation of the vertebral unit(s) involved
Forward bending
Reciprocal of backward bending; flexion
Hypertonicity
1. A condition of excessive tone of the skeletal muscles
2. Increased resistance of muscle to passive stretching
Intersegmental motion
designates relative motion taking place between two adjacent vertebral segments or within a vertebral unit that is described as the upper vertebral segment moving on the lower
-ion
A suffix describing a process of movement.
Lateral masses
The most bulky and solid parts of the atlas that support the weight of the head.
Lymphatic treatment
Techniques used to optimize function of the lymphatic system
Massage
Therapeutic friction, stroking and kneading of the body
Neutral
1. The range of the sagittal plane spinal positioning in which the first principle of physiologic motion of the spine applies.
2. The point of balance of an articular surface from which all the motions physiologic to that articulation may take place.
Non-neutral
The range of sagittal plane spinal positioning in which the second principle of physiologic motion of the spine applies.
NSR
A descriptor of spinal somatic dysfunction used to denote a combination neutral (N), sidebent (S) and rotated (R) vertebral positions.
Lymphatic pump
1. A term used to describe the impact of intrathoracic pressure changes on lymphatic flow. This was the name originally given to the thoracic pump technique before the more extensive physiologic effects of the technique were recognized.
2. A term coined by C. Earl Miller, DO
Mandibular drainage technique
soft tissue manipulative technique using passively induced jaw motion to effect increased drainage of middle ear structures via the eustachian tube and lymphatics
Muscle energy
1. A system of diagnosis and treatment in which the patient voluntarily moves the body as specifically directed by the osteopathic practitioner. This directed patient action is from a precisely controlled position against a defined resistance by the osteopathic practitioner.
2. Refers to a concept first used by Fred Mitchell, Sr, DO, originally called muscle energy treatment.
Pedal pump
A venous and lymphatic drainage technique applied through the lower extremities; also called the pedal fascial pump or Dalrymple treatment
Spencer technique
A series of direct manipulative procedures to prevent or decrease soft tissue restrictions about the shoulder.
Thoracic pump
1. A technique that consists of intermittent compression of the thoracic cage
2. Developed by C. Earl Miller, DO
Post-isometric relaxation
Immediately following an isometric contraction, the neuromuscular apparatus is in a refractory state during which enhanced passive stretching may be performed. The osteopathic practitioner may take up the myofascial slack during the relaxed refractory period.
Reciprocal inhibition
The inhibition of antagonist muscles when the agonist is stimulated.
Axis of rib motion
An imaginary line through the costotransverse and costovertebral articulations of the rib.
Bucket handle motion
Movement of the ribs during respiration such that with inhalation, the lateral aspect of the rib moves cephalad resulting in an increase of transverse diameter of the thorax. This type of rib motion is predominantly found in lower ribs, increasing in motion from the upper to the lower ribs.
Exhalation rib restriction
Involves a rib or group of ribs that first stops moving during exhalation. The key rib is the bottom rib in the group.
Inhalation rib restriction
Involves a rib or group of ribs that first stops moving during inhalation. The key rib is the top rib in the group.
Pump handle motion
Movement of the ribs during respiration such that with inhalation the anterior aspect of the rib moves cephalad and causes an increase in the anteroposterior diameter of the thorax. This type of rib motion is found predominantly in the upper ribs, decreasing in motion from the upper to the lower ribs.
Rib somatic dysfunction
A somatic dysfunction in which movement or position of one or several ribs is altered or disrupted. For example, an elevated rib is one held in a position of inhalation such that motion toward inhalation is freer, and motion toward exhalation is restricted. A depressed rib is one held in a position of exhalation such that motion toward exhalation is freer and there is a restriction in inhalation.
Exhalation rib dysfunction
1. Somatic dysfunction characterized by a rib being held in a position of exhalation such that motion toward exhalation is more free and motion toward inhalation is restricted
2. An anterior rib tender point in counterstrain
Inhalation rib dysfunction
A somatic dysfunction characterized by a rib being held in a position of inhalation such that motion toward inhalation is more free and motion toward exhalation is restricted
Segmental diagnosis
The final stage of the spinal somatic examination in which the nature of the somatic problem is detailed at a segmental level
Segmental dysfunction
Dysfunction in a mobile system located at explicit segmental mobile units. Palpable characteristics of a dysfunctional segment are those associated with somatic dysfucntion. Responses to regional motor inputs at the dysfunctional segment support the concepts of complete motor asymmetry and mirror-image motion asymmetries.
What are the four basic principles of osteopathic medicine?
1. The body is a unit.
2. The body is self-regulating and self-healing.
3. Structure and Function are reciprocally related.
4. Rational treatment is based on this philosophy and these principles.
What does TART stand for?
T - tenderness
A - asymmetry
R - restriction of motion
T - tissue texture changes
What are the four types of motion?
Active - patient initiated
Passive - physician initiated, patient is relaxed
Regional - a specific area of the body
Segmental - a specific vertebral level
What are some indications of acute somatic dysfunctions?
muscle spasm, warm to touch, tender, increased muscle mass
What are some indications of chronic somatic dysfunctions?
fibrotic, cool to touch, not tender, decreased muscle mass
What is the treatment for somatic dysfunction?
OMM
Define somatic dysfunction
1. Impaired or altered function or related components of the somatic system
2. Motion restriction within the normal range of motion
What are some things that can cause somatic dysfunction?
Trauma, reaction to stress, muscle spasms, postural imbalance, visceral problems or disease
What is a visceral-somatic reflex? Can you give an example?
A dysfunction of the visceral system that produces a somatic dysfuntion. Ex: gall baldder disease refers pain to the right shoulder blade.
What is a somato-visceral reflex? Can you give an example?
A somatic dysfunction that produces a stimulus that generates a dysfunction of the viscera. Ex: chronic somatic dysfunction in the mid-thoracic region can lead to gastritis
Anatomic barrier
the limits imposed by bony structures
Elastic barrier
The limits imposed by "elastic" structures (ligaments, tendons, joint capsules). Tested by how far the physician can passively move a joint or area.
Physiologic barrier
The limit of active motion imposed by voluntary muscle tone. Tested by how far the patient can actively move a joint or area.
Restrictive barrier
loss of normal motion due to pain, muscle spasm, edema, bony abnormality, fusion, etc.
Sagittal Plane
Anterior - Posterior axis
Divides the body into left and right.
Coronal Plane
Frontal axis
Divides the body into anterior and posterior halves.
Transverse Plane
Horizontal axis
Divides the body into upper and lower halves.
What can cause a restrictive barrier?
Loss of motion due to pain, muscle spasm, edema, bony abnormality, fusion of bones, etc.
Describe a direct osteopathic manipulative technique.
A treatment in which the restrictive barrier is engaged. These techniques involve movement directly through the restrictive barrier.
Name five direct techniques.
Soft tissue, myofascial release, articulation, muscle energy, HV/LA
Describe an indirect osteopathic manipulative technique.
A treatment in which movement is away from the restrictive barrier. Movement is in the direction of freedom to indirectly treat the restriction.
Give six examples of indirect technique
strain-counterstrain, Still technique (starts indirect, ends direct), myofascial release, functional techniques, facilitated positional release, osteopathy in the cranial field
List some factors that might influence what type of technique you would use to treat a patient.
Age, acute v. chronic, physical condition, operator size and skills, location, previous treatment
Who founded the osteopathic profession?
Dr. A.T. Still, MD
The rule of the _____ is supreme.
artery
In what year and where was the first college of osteopathic medicine opened?
1892 in Kirksville, MO
What was the first state to grant licensure?
Vermont, 1896
What was the last state to grant licensure?
Mississippi, 1973
What monumental report changed medical education in the US, and in what year was it released?
Flexner, 1910
When might soft tissue of the cervical spine be appropriate?
headache, upper respiratory infection, muscle spasm, tissue preparation for HV/LA, etc.
What are some important technique tips to remember when performing soft tissue?
Avoid spinous processes, use slow rhythmic force, use enough pressure to avoid slipping across skin, etc.
What is a functional spinal unit?
Two adjacent vertebra with shared ligaments, muscles and joints.
What is Fryette's First Law of Spinal Mechanics?
When the lumbar or thoracic spine is in neutral, sidebending and rotation will occur in opposite directions.
Does Fryette's First Law deal with a single vertebral segment or a group of vertebrae?
group
What is Fryette's Second Law of Spinal Mechanics?
In the non-neutral position, when rotation is introduced, sidebending occurs to the same side.
Does Fryette's Second Law deal with a single vertebral segment or a group of vertebrae?
single
While you are palpating T7, you notice that the right transverse process is more posterior than the left. What is the direction of rotation?
T7 is rotated right.
What year was our college established?
1972
What year did OCOMS become part of OSU?
1988
What was the first war that allowed DOs to be commissioned as physicians?
Vietnam
What are the three natural arches of the foot?
medial longitudinal arch, lateral longitudinal arch, transverse arch
What nerve can be entrapped by the pronator teres muscle?
median nerve (pronator syndrome)
What motion of the elbow and motion of the radial head accompany forearm supination?
Adduction of the elbow, anterior glide of the radial head
What is the carrying angle of the elbow?
Angle of intersection of longitudinal line through humerus and longitudinal line through ulna (in anatomic position).
Normally 5-15 degrees.
What structures form the top and bottom of the carpal tunnel?
Flexor retinaculum (top)
Distal row of carpal bones - trapezium, trapezoid, capitate, hammate (bottom)
Where is the Tunnle of Guyon and what passes through it?
Lateral to the pisiform and hook of hamate.
Ulnar nerve and artery pass through this tunnel.
What carpal bone is most often fractured?
Scaphoid
What are the major motions that occur at the wrist?
flexion, extension, ulnar deviation, radial deviation
What are the four bones of the shoulder?
clavicle, scapula, humerus, sternum
Which bone is the only connection between the shoulder and the axial skeleton?
The clavicle connects the scapula (at the acromion) to the manubrium of the sternum.
What four muscles comprise the rotator cuff?
Supraspinatus
Infraspinatus
Teres Minor
Subscapularis
Is muscle energy a direct or indirect technique?
direct
Who is credited with developing muscle energy techniques?
Fred Mitchell, Sr., DO
What kind of muscle contraction is utilized in muscle energy?
isometric
What landmarks can be used to find T1?
At or below vertebral prominence, articulates with 1st rib.
What landmarks can be used to find T3?
Spinous process is at the level of the scapular spine.
What landmarks can be used to find T7?
Rib 7 is at the level of the inferior angle of the scapula.
What landmarks can be used to find T12?
Rib 12
What are the three planes of motion for the thoracic spine?
Flexion/extension in the sagittal plane, sidebending (lateral flexion) in the coronal plane, rotation in the transverse (horizontal) plane.
Define type 1 dysfunction.
Somatic dysfunction consisting of three or more consecutive vertebrae following Fryette's 1st Law (rotation and sidebending in opposite direction in a neutral spine).
Define type II dysfunction.
Somatic dysfunction consisting of a single vertebra following Fryette's 2nd Law (rotation and sidebending in the same direction in flexion/extension).
How does treatment of the thoracic spine affect sympathetic flow from the thoracic region?
Sympathetic innervation is delivered through spinal nerves T1 to L2/L3. These trunk and ganglia lie lateral to the vertebral bodies near the pedicles. Treatment of thoracics normalizes sympathetic outflow.
What are the primary motions of the O/A joint?
Flexion/Extension
What is the primary motion of the A/A joint?
Rotation
C2-7 follow which type of Spinal Mechanics, Type I or Type II?
Type II (non-neutral with sidebending and rotation occurring in the same direction)
What is the joint of Luschka?
The articulation between the vertebral body of the cervical vertebra and the uncinate process of the vertebra below it.
What is the purpose of the joint of Luschka?
To prevent lateral translation of the vertebral bodies while allowing flexion/extension.
Which direction do the facets face in the cervical spine?
Up and back.
What nerve innervates the abdominal diaphragm?
Phrenic nerve, arising from C3-5.
What are the primary muscles of respiration?
Diaphragm and intercostals.
Which ribs are typical?
3-10
Which ribs are atypical?
1, 2, 11, 12
What's the difference between true, false and floating ribs?
True ribs (1-7) attach directly to the sternum through costal cartilages; false ribs (8-10) connect to the rib above; floating (11, 12) are unattached.
What is the primary type of motion of ribs 1-5?
pump handle -- increase A-P diameter
What is the primary type of motion of ribs 6-10?
bucket handle -- increase transverse dimension
What is the primary type of motion of ribs 11 and 12?
caliper -- horizontal plane motion, open up anteriorly
_____ dysfunction describes ribs that are held inspired (up), having restricted motion as the patient breaths out.
Inhalation
_____ dysfunction describes ribs that are held exhaled (down), having restricted motion as the patient breathes in.
Exhalation
What is the mnemonic that describes which rib (the KEY rib) to treat with rib dysfunction?
BITE

Bottom - Inspired
Top - Exhaled
Name the muscle group responsible for treatment of exhaled ribs 1 and 2.
scalenes
Name the muscle group responsible for treatment of exhaled ribs 3-5.
pectoralis minor
Name the muscle group responsible for treatment of exhaled ribs 6-10.
serratus anterior
Which phase of respiration should be accentuated to treat inspired ribs?
Exhalation
Which phase of respiration should be accentuated to treat exhaled ribs?
Inspiration
What is lymph?
clear, yellowish, slightly alkaline, coagulable fluid containing WBC in a liquid resembling blood plasma.
What are the muscles of passive inhalation?
Diaphragm, external intercostals.
What are the muscles of active/labored breathing?
scalene, sternocliedomastoid, serratus anterior, pectoralis minor, latissimus dorsi
What muscle actions occur during passive exhalation?
Passive recoil, gravity -- relaxing inspiration muscles
What are the muscles of active exhalation?
Internal intercostals, abdominals.
Embryiologically, _____ develop in the third month and are tied very closely to _____.
lymphatics, vasculature.
2/3 of lymph is produced by _____ and _____.
liver, intestines
_____ is de facto lymph to brain and spinal cord.
CSF
What is drained by the right lymphatic duct?
The right half of the body from the top of the head to the navel.

R brachiocephalic vein, R internal jugular, R subclavian vein
What is drained by the thoracic duct?
Everything in the body that isn't drained by the R lymphatic duct...

Begins at L2, extends to C7. Drains L internal jugular, SC junction
What are some indications for lymphatic treatment?
Basically, anything that doesn't feel right, but isn't a contraindication.
Name four functions of lymph.
1. Police body for antigenic material.
2. Cleanse extracellular spaces.
3. Return interstitial fluid to blood.
4. Conserve plasma protein.
What intrinsically controls lymph?
Smooth muscle contraction, interstice fluid pressures.
What extrinsically controls lymph?
Skeletal muscle contraction, breathing, pulsation, OMM.
What are the goals of lymphatic OMM?
Decrease fascial binds, muscle spasm, diaphragmatic restrictions.

Increase ease of breathing, activity levels, lymphatic flow.
What are some contraindications for lymphatic OMM?
Broken bone, active bacterial infection with a fever >102, abscess or localized infection, active cancer with lymphatic metastasis.
What are some advantages of Muscle Energy Treatment?
Patient controlled, atraumatic, specific, understand mechanics
When should you use Muscle Energy?
Shortented or contracted muscles, desire strengthening of muscles, mobilize any joint that is crossed by voluntary muscle, reduces localized edema and relieves passive congestion.
What are some contraindications for Muscle Energy?
Lack of patient control, infection involved in muscle, dislocation or fracture, rheumatologic conditions, undiagnosed joint swelling, positioning that compromises vasculature.
Name the bones of the shoulder.
Clavicle, humerus, sternum, scapula.
What is Muscle Energy?
A form of Osteopathic Manipulative diagnosis and treatment in which the patient's muscles are actively used upon request, from a precisely controlled position, in a specific direction and against directly executed physician counter-force.
Why are Muscle Energy techniques used?
Used to mobilize joints where there is restriction stretch tight muscles and fascia, improve local circulation, balance neuromuscular relationships with muscle tone.
Golgi Tendon Organs
respond to tension changes in muscle
Muscle Spindle Organs
monitor muscle length
What is oculocephalogyric reflex?
Effecting muscle contractions using eye movement.
When might you use crossed extensor reflex?
Used in extremities where the muscle that requires treatment is so severely injured that manual contact is inadvisable.
In the Hoover Test, when one leg is lifted, what is the action of the other?
the other leg goes down
What are the three synovial joints of the shoulder?
1. Sternoclavicular
2. Acromioclavicular
3. Glenohumeral
Movement of the sternoclavicular joint is reciprocal with _____ motion.
acromioclavicular
What action tests ROM for the sternoclavicular joint?
shoulder shrugging
Name the four muscles of the rotator cuff.
1. Supraspinatus
2. Infraspinatus
3. Teres Minor
4. Subscapularis
The brachial plexus (C5-T1) emerges between the anterior and middle _____ and over the _____ rib.
scalenes, 1st
What is the vascular supply for the shoulder and axilla?
L and R subclavians, which become axillary aa after 1st rib, and brachial aa after teres minor.
Explain Type I spinal mechanics.
Side bending and rotation occur in opposite directions.
In neutral, groups of vertebrae move in concert.
Longer muscles are used.
Apex is area of concentration.
Named NS(R)R(L).
Explain Type II spinal mechanics.
Occurs in flexion and extension.
Side bending and rotation occur in the same direction.
Involves one functional spinal unit.
Involves short, segmental muscles.
What suffix designates motion?
-ion
What suffix designates restriction?
-ed
What two things do you look for in static evaluation of the spine?
1. spinous process asymmetry
2. transverse process asymmetry
What are the components of the thoracic cage?
thoracic spine, sternum, ribs and costal cartilages, clavicles and scapulas
Where does the quadratus lumborum insert?
ribs 11-12
The cervical spine is highly mobile, but at what cost?
Lower intrinsic stability.
Vulnerable to excess dynamic loading (flex/ext injuries).
Restriction often results in compensatory mobility elsewhere.
In flexion, the occiput glides _____ on the atlas.
posteriorly
In extension, the occiput glides _____ on the atlas.
anteriorly
Does the atlas have a spinous process?
NO!
Inferior atlas facets are _____ to recieve the slightly _____ superior facets of the axis.
concave, convex
How does one evaluate the atlantoaxial joint?
flex head 45 degrees and rotate