Opp Test 4

Front 1

superior articular facet is (concave/convex)

Back 1

concave

Front 2

inferior articular facet is (concave/convex)

Back 2

convex

Front 3

facets of lumbar spine are at this angle

Back 3

45 degrees

Front 4

most common complaint in a family practitioner's office

Back 4

lower back pain

Front 5

acute low back pain

Back 5

less than 3 months duration

Front 6

cauda equina syndrome

Back 6

medical emergency. secondary to massive central disc herniation (disc has herniated straight back). Symptoms: saddle anesthesia, urinary retention/incontinence, anal sphincter laxity, neurological defecits in lower extremities, motor weakness

Front 7

research - hospital stay

Back 7

when OMT added to treatment, hospital stay length decreased by 24% for pts admitted with low back pain.

Front 8

this nerve root crosses 2 discs

Back 8

L5. (L4-5, L5-S1)

Front 9

this nerve root crosses only one disc level

Back 9

S1. (L5-S1)

Front 10

motor test for S1?

Back 10

toe walk

Front 11

reflex test for S1?

Back 11

achilles reflex

Front 12

sensation test for S1?

Back 12

outside of foot

Front 13

motor test for L5?

Back 13

extensor digitorum longus, extensor hallucis longus

Front 14

sensory test for L5?

Back 14

dorsal foot - strip down the middle

Front 15

motor test for L4?

Back 15

tibialis anterior - have pt internally rotate foot. OR walk on heels --> foot drop

Front 16

reflex test for L4?

Back 16

patellar tendon

Front 17

straight leg-raising test

Back 17

if positive, indicates neuritis. Possible compression. Check neurologic signs to rule out radiculopathy.

Front 18

red flags for back pain

Back 18

tumor, kidney stone, infection, cauda equina (herniated disc)

Front 19

neurogenic claudication

Back 19

leg symptoms worsen when walking and improve by squatting, sitting, lying down

Front 20

how do you rule out a herniated disc?

Back 20

herniated disc will cause neurologic malfunction

Front 21

spondylosis

Back 21

osteoarthritis of the spine. Can see bridging

Front 22

vertebral hyperostosis causesq

Back 22

ankylosing spondylitis, arthritis (psoriatic, reactive, gouty) Vitamin A toxicity, repetitive microtrauma, diffuse idiopathic skeletal hyperostosis (DISH)

Front 23

benefits of professional touch

Back 23

decreased HR, decreased BP, decreased muscle tension, decreased pain perception, improved immune function

Front 24

bilateral UPL5 tenderpoints indicate

Back 24

iliolumbar ligament syndrome

Front 25

spondylolisthesis

Back 25

spondylolysis leads to anterior slippage of one vertebral body on another. Can lead to lumbar spinal stenosis

Front 26

spondylolysis

Back 26

pars interarticularis defect. Can lead to spondylolisthesis

Front 27

step-off sign

Back 27

one vertebral body = so anterior to another, the spines are not continuous. One is "missing'

Front 28

lumbar strain

Back 28

spasm of mm. most common cause of lower back pain, "mechanical" non-radiating back pain, secondary to overuse, muscle strain, or HNP. Treatment: bed rest for 2 days, stretch first, then strengthen

Front 29

piriformis

Back 29

superior to the sciatic nerve

Front 30

syndrome

Back 30

set of detectable characteristics that occur together.

Front 31

coccydynia

Back 31

tender coccyx that creates pelvic pain, coccyx flexion. Can be due to glut max strain, pelvic floor spasm, coccyx flexion.

Front 32

hyperlordosis

Back 32

exaggerated lower back curve. Can be due to postural decompensation

Front 33

iliolumbar ligament syndrome

Back 33

either unilateral or bilateral. Can present with radiating pain in pelvis. Unilateral due to short leg (anatomical or func.) or sacroiliitis. Bilateral due to hyperlordosis (due to postural decomp), overuse strain, spondylolysis/spondylolysthesis

Front 34

pelvic tilt

Back 34

stretching exercise, helps iliolumbar ligament syndrome

Front 35

pelvis pain

Back 35

indicated by anterior pelvic tenderpoints. Can be a cause of chronic back pain.

Front 36

postural decompensation

Back 36

gradual loss of fast twitch fibers. Worse with postural immobility, causes increased lordosis, increased thoracic kyphosis. Stretch (pelvic tilt, lumbar extensor), then strengthen (abs and lower back)

Front 37

psoriatic arthritis

Back 37

autoimmune problem that affects joints and the skin

Front 38

retinoid toxicity

Back 38

vitamin A can cause vertebral hyperostosis

Front 39

sacroilitis

Back 39

ASIS compression worsens, diffuse SI tenderness

Front 40

LVHA

Back 40

low velocity high amplitude. Goal is to increase range of mvmt. Activating force is either repetitive springing motion or concentric mvmt of joint through restrictive barrier. E.g. OB roll

Front 41

cavitation

Back 41

articular release. Immobility of joint creates a partial vacuum, increased pressure causes gas bubbles (CO2, N2) to form in joint fluid. Joint separation causes collapse of vapor cavities

Front 42

HVLA contraindications

Back 42

lumbar spinal stenosis, acute sprain or fracture, DVT, vascular instability, radiculopathy

Front 43

radiculopathy

Back 43

nerve root pathology/disorder. Caused by herniated discs.

Front 44

research - manipulation and medication use

Back 44

patients who received OMT in low back pain treatment required fewer medications and used less physical therapy. (Outcomes such as pain, range of motion, leg raising were the same as std med therapies)

Front 45

herniated disc

Back 45

can cause lumbar spinal stenosis.

Front 46

low back pain

Back 46

most common cause of disability in people less than 45

Front 47

lumbar spinal stenosis

Back 47

narrowing of the spinal canal with impingement of the cord and/or spinal roots. Presents in males, nonspecific low back pain with parethesias in both legs. Neurogenic claudication. HVLA = contraindicated

Front 48

neurologic examination

Back 48

do on every patient first presenting with low back pain. DTR, straight leg raise, sensory and motor testing

Front 49

fryette's law 3

Back 49

initiating motion of a vertebral segment in any plane of motion will modify the mvmt of that segment in other planes of motion. Corrective force only needs to apply in one plane of motion.

Front 50

iliopsoas muscle

Back 50

psoas + iliacus mm.Psoas origin: T12-L4 vertebral bodies. Iliacus origin: iliac crest Insertion: lesser trochanter of the femur.

Front 51

latissimus dorsi muscle

Back 51

origin: thoracolumbar fascia, transverse processes of T7-T12 insertion: intertubercular groove of humerus. Adducts, extends, internally rotates arm

Front 52

multifidus muscle

Back 52

origin: sacrum, erector spinae aponeurosis, PSIS, iliac crest. Insertion: spinous processes. Spans 3 joint segments, stabilizes spine at each level.

Front 53

non-neutral SDs

Back 53

type II. Occur in extreme flexion and extreme rotation

Front 54

locked open facet

Back 54

SD flexion. Type II. Opposite of the rotated segment

Front 55

quadratus lumborum muscle

Back 55

origin: iliac crest insertion: 12th rib

Front 56

rectus abdominus muscle

Back 56

origin: pubic symphysis, insertion: xiphoid process, costal cartilages of ribs 5-7. enclosed in rectus sheath

Front 57

restrictive barrier

Back 57

initial patient positioning for ME.

Front 58

tri-planar motion

Back 58

flexion/extension/neutral, rotation, sidebending

Front 59

type I and type II SDs

Back 59

type I = group curve, occurs with "neutral" flexion and extension. Type II = single segment, occurs in extreme flexion or extension.

Front 60

viscerosomatic reflex, L1 and L2

Back 60

in lumbar spine - L1 and L2 = sympathetic innervation of distal colon, pelvic organs, lower extremity

Front 61

if you find a capsular pattern on a patient

Back 61

patient needs further diagnosis and treatment beyond OMT

Front 62

capsular pattern

Back 62

motion is restricted in both right and left rotation or in multiple planes. Seen in pathologic conditions such as arthritis

Front 63

locked closed facet

Back 63

SD extension. Type II - causes rotation and sidebending to same side. Same side as rotation.

Front 64

erector spinae muscles

Back 64

iliocostalis, longissimus, spinalis. Originate from sacrum, iliac crest, spinous processes of lower lumber vertebrae. Insertion: lower ribs, transverse processes of thoracic vertebrae

Front 65

tinnitus

Back 65

ringing in the ears, caused by CNVIII entrapment

Front 66

TMJ compression/decompression

Back 66

don’t do if there's pain with compression, inflammation. Compression - indirect. Decompression - direct

Front 67

trigeminal neuralgia

Back 67

CNV neuropathy. SBS strain, temporal rotation, maxilla rotation, manible rotation.

Front 68

trigeminal stimulation

Back 68

treats congestion by watering down mucus secretions (stimulates tear production)

Front 69

main causes of dizziness

Back 69

hypoglycemia (acc. By feeling faint), ataxia (w. mvmt), vertigo (spinning in space)

Front 70

OMT helps these kinds of headaches

Back 70

tension, migraine, mixed, post-concussive, cervicogenic, congestive (rhinitis, sinusitis)

Front 71

migraine headache: spinal manipulation more effective than __ for ___ treatment

Back 71

drugs (amitriptyline), prophylactic

Front 72

chronic tension headache: spinal manipulation more effective than __ for ____ treatment

Back 72

drugs, short-term treatment

Front 73

cervicogenic headache: spinal manipulation more effective than no treatment or massage for _______ treatments

Back 73

prophylactic and short-term

Front 74

TMJ syndrome

Back 74

jaw pain with eating, facial pain, headache. Restricted mobility, cartilage degeneration, subluxation. Treatment includes NSAIDs, orthodontic evaluation, OMT for cervical and cranial SD

Front 75

neuropraxia

Back 75

compression of nerve with NO neurological defecits. Structural problem

Front 76

axonotmetsis

Back 76

severe injury, causes neuropathy - nerve death. Abnormal neural exam. Can be regeneration.

Front 77

neurotmesis

Back 77

injury, degeneration, neuroma formation. Nerve = cut, no regeneration

Front 78

site for vesitbulocochlear nerve entrapment

Back 78

internal acoustic meatus

Front 79

headache treatment

Back 79

suboccipital inhibition, venous sinus drainage, CV-4. Ganglion stimulation for sinus headaches

Front 80

Meniere's syndrome

Back 80

treatable functional dysfunction. CNVIII neuropathy accompanied by tinnitus, vertigo, deafness

Front 81

benign positional vertigo

Back 81

feeling of spinning in space

Front 82

cephalagia

Back 82

headache

Front 83

cranial neuropathy

Back 83

trigeminal neuralgia, bell's palsy (VII), CNVIII (tinnitus, vertigo, deafness)

Front 84

facial effleurage

Back 84

soft tissue technique. Compress vascular structures to move fluid. Start by releasing thoracic inlet and treating neck. Then forehead, maxilla and mandible

Front 85

facial palsy

Back 85

CN VII neuropathy. Temporal rotation, SBS strains

Front 86

colic

Back 86

treat with occipital decompression, MFR abdomen. Could be due to entrapment or vagus overstimulation.

Front 87

cranial entrapment neuropathy

Back 87

skull bones become locked (cranial base compression)

Front 88

occipitomastoid decompression

Back 88

treats entrapment neuropathies - torticollis, otitis media, colic, plagiocephaly

Front 89

otitis media

Back 89

middle ear infection. Caused by impaired Eustacian tube drainage

Front 90

parallelogram head deformity

Back 90

positional plagiocephaly (benign). Can be due to SBS lateral strain. Named for side of flattened occiput

Front 91

plagiocephaly, deformational

Back 91

rule out synostotic plagiocephaly. Can lead to vision problems, TMJ, learning disorders.

Front 92

torticollis

Back 92

can cause plagiocephaly. Caused by ischemic SCM or entrapment. Treat with SCM MFR, cranial base compression

Front 93

OMT has cosmetic benefits for plagiocephaly until age

Back 93

6

Front 94

treat toricollis with

Back 94

occipital decompression, SCM MFR

Front 95

treat colic with

Back 95

occipital decompression, MFR abdomen

Front 96

treat otitis media with

Back 96

Galbreath mandibular drainage, temporal decompression, rib raising, MFR abdomen