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116 Cards in this Set
- Front
- Back
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Somatic dysfunction can present as TART. What does each letter stand for?
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T: Tissue Texture Changes
A: Asymmetry R: Restriction T: Tenderness |
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Under normal physiological conditions, a joint has two barriers. What are they?
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Physiological and Anatomic barrier
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Describe physiologic barrier
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point at which a patient can actively move any given point
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Define anatomic barrier
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point at which a physician can passively move any given point on a patient
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What happens if you move someone beyond their anatomical barrier?
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possible injury to ligament, tendon, or skeletal system
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What kind of barrier does a joint encounter when it has a somatic dysfunction?
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restrictive (or pathologic) barrier
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What's another name for restrictive barrier?
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pathologic barrier
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What is the only subjective component of TART?
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tenderness
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Are the following tissue texture changes for acute or chronic conditions: cool dry skin with slight tension, decreased muscle tone, flaccid?
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Chronic
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Are the following tissue texture changes for acute or chronic conditions: boggy, hypertonic muscles, increased moisture
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Acute
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Is asymmetry present in acute somatic dysfunctions?
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Yes
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How does asymmetry present in chronic conditions?
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presents with compensation in other areas of the body
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Is the following description of Tenderness considered acute or chronic: dull, achy, burning
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Chronic
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What if the tenderness is described as severe or sharp, is this a description of acute or chronic dysfunction?
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Acute
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What part of the spine does Fryette's Laws pertain to?
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thoracic and lumbar regions
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Law 1: in the neutral position sidebending and rotation occur to the same side or to opposite sides?
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opposite sides
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In Law 1, which precedes the other when speaking of sidebending and rotation
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sidebending procedes rotation
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How many vertebral segments does Fryette Law II refer to?
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one
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How many vertebral segments does Fryette law 1 refer to?
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more than two vertebral segments (a group of vertebrae)
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Fryette Law II, when the spine is either flexed or extended and rotation is introduced, which way will the single vertebral segment sidebend?
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the same direction
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In Fryette law II, what precedes the other? sidebending and rotation
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rotation precedes sidebending, sidebending and rotation occur to the same side
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What is Fryette law III?
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initiating a motion at anyone verterbral segment in any one plane of motion will change the mobility of the segment in the other two planes of motion
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How is somatic dysfunction diagnosed?
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TART
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How are somatic dysfunctions of the spine named?
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They are named for their freedom of motion
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Where do you place your thumbs to assess rotation of the thoracic and lumbar spine?
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on the transverse processes of each segment
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If the right thumb is more posterior than the left, which way is your patient rotated?
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right
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If the thumb is no longer posterior when you place your patient in flexion, what does this say about the vertebral segment?
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It is flexed
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If the thumb is no longer posterior when you place your patient in extension, what does this say about the vertebral segment?
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It is extended
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How would the segment be designated if the rotation does not change when you flex or extend your patient?
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It is neutral. Sidebend and rotation are in opposite directions
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What is the facet orientation in the cervical spine?
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BUM: backward, upward, medial
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What is the facet orientation in the Thoracic spine?
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BUL: backward, upward, lateral
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What is the facet orientation in the Lumbar spine?
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BM: backward, and medial
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What axis does flexion and extension move in?
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Transverse
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What axis does Rotation move in?
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Vertical
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What axis does sidebending move in?
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anterior-posterior
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Name the contraction: muscle contraction that results in the approximation of the muscle's origin and insertion without a change in its tension? Operator's forces is less than the patient's force
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Isotonic contraction
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Name the contraction: muscle contraction that results in the increase in tension without an approximation of origin and insertion. Operator's force and the patient's force are equal.
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isometric contraction
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Name the contraction: muscle contraction against resistance while forcing the muscles to lengthen. Operator's force much be more than the patient's force
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isolytic contraction.
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Name the contraction: muscle contraction that results in the approximation of the muscle's origin and insertion
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Concentric contraction
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Name the contraction: Lengthening of muscle during contraction due to an external force
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Eccentric contraction
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What type of treatment engages the restrictive barrier?
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Direct treatment
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Where does the practitioner move tissues or joints during an indirection treatment?
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away from the restrictive barrier into the direction of freedom
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Name some direct treatment techniques.
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Muscle energy, HVLA, lymphatic treatment and Chapman's flexes
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Name a treatment type in which the patient is an active participant.
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Muscle Energy
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What is the definition of active treatment?
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patient assists during the treatment
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What treatment type has both direct and indirect techniques?
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Myofascial release, and osteopathy in the Craniel Field
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True or False: Acute cases should have a shorter interval between treatments; as they respond to the treatment, the interval can be increased.
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true
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What is the order of treatment when a patient has dysfunction at the cervical spine, ribs, and upper thoracic spine?
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Treat thoracic spine before treating rib dysfunctions and then treat the cervical spine
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What comes first in treatment? thoracic spine or rib
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treat the thoracic spine before treating rib dysfunctions
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What is the order of treatment for an extremity problem?
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treat the axial skeleton first (spine, sacrum and ribs)
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What makes C1 an atypical cervical spine
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it has no spinous process or vertebral body
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What makes C2 atypical?
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it has a dens that projects superiorly from its body and articulates with C1.
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What part of the neck do we use to evaluate cervical vertebral motion?
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articular pillars (lateral masses)
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What muscle lifts up the first rib during forced inhalation?
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anterior and middle scalene muscles
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what muscle lifts up the second rib during forced inhalation?
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posterior scalene
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Where is the common tenderpoint in a first or second inhalation rib dysfunction?
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TP is in one of the scalenes
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Which ribs are the True Ribs?
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Ribs 1-7 : They are attached to the sternum by their costal cartilage
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Which ribs are called False Ribs
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Ribs 8-10; Ribs 11 and 12 are false ribs by definition
False ribs are attached to costal cartilage of ribs above forming anterior costal margin |
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Which ribs are the Floating Ribs
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Ribs 11 and 12: they have no anterior connection.
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What is the motion of the upper ribs (Ribs 1-3 although ribs 4-10 have some of this motion too)?
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Pump Handle where anterior part of ribs move upward during inspiration and the posterior part moves down.
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What is the motion of the lower ribs (ribs 8-10 although ribs 1-7 also have some of this motion)?
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Bucket handle where the lateral parts of the ribs move upward with inspiration.
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What is the motion of ribs 11 and 12 called?
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Caliper or pincer motion. External rotation with inspiration
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How are rib dysfunctions named?
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Named for what it can do.
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An inhaled rib is stuck in what position?
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inhalation or stuck up
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An exhaled rib is stuck in what position?
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exhalation or stuck down
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What is considered the key rib?
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Bottom rib if inhalation dysfunction and Top rib if exhalation dysfunction (BITE)
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What muscle is attached to ribs 3-5?
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pectoralis minor
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what muscle is attached to rib 12?
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posterior origin of diaphragm and quadratus lumborum
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How does rib raising affect the patient's nervous system?
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normalizes sympathetic outflow from the thoracic region due to the sympathetic ganglion chain being so close to the head of the ribs
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Where is the anterior tenderpoint for rib 1?
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where the rib articulates with the manubrium
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Where is the tenderpoint for rib 2?
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midclavicular line of second rib
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Where are the anterior tenderpoints for ribs 3-6?
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on the rib at the anterior axillary line
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Where are the posterior tenderpoints for the ribs 2-6?
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at the rib angle.
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Where is the tenderpoint of the supraspinatus?
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within the muscle belly
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Where is the tenderpoint for the subscapularis?
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anteriorlateral surface of the scapula
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Where are the anterior tenderpoints for the cervical spine?
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anterior surface of transverse processes of vertebrae.
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What direction does sidebending and rotation occur at the Occipito-atlanto joint?
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sidebend and rotate at the OA in opposite directions
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What direction does rotation and translation occur at the OA joint?
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to the same side
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What is the main motion at the atlanto-axial joint?
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rotation.
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What nerve root is responsible for the biceps deep tendon reflex?
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C5
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What nerve root is responsible for the triceps deep tendon reflex?
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C7
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Where is Guyon's canal?
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lateral to the pisiform and the hook of hamate
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What nerve runs through Guyon's canal?
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ulnar nerve
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What bones and artery can be felt at the anatomic snuff box?
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radial styloid process, scaphoid, and trapezium, and radial artery
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What nerve may be injured when the surgical neck of the humerus is fractured?
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axillary nerve
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what nerve may be injured when the shaft of the humerus is fractured?
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radial nerve
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What nerve may be injured when the distal humerus is fractured?
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median nerve
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What nerve may be injured when the medial epicondyle of the humerus is fractured?
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ulnar nerve
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What nerve is damaged if there is a winging of the scapula?
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long thoracic nerve
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What muscles may be paralyzed if the axillary nerve is damaged?
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deltoid and teres minor muscle
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How may Saturday night palsy/ crutch palsy present and what nerve may be injured?
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wrist drop with injury to the radial nerve
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What nerve is damaged if the patient comes in with complaint of thenar wasting, loss of sensation in the first 3 digits, as well as flexor weakness in these digits and wrist flexor weakness?
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median nerve
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What type of hand fracture would a boxer present with?
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fracture of the neck of the 4th and 5th metacarpal bones
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What disease is associated with Heberden's node?
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osteoarthritis (osteophytic overgrowth at the DIP)
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What disease is associated with Bouchard's node?
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Rheumatoid arthritis (osteophytic overgrowth at the PIP)
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What spinal segments are associated with the autonomics of the upper extremities?
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T2-T8 for sympathetics. No parasympathetic supply to the UE
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What does the Apley scratch test screen for?
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active ROM of the shoulder joint
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What constitutes a positive Adson's test and what does it imply?
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diminished radial pulse when examiner abducts patient's arm to 90 degrees, turns the patient's head to the abducted arm and extends the neck gives a positive test and it may indicate thoracic inlet syndrome.
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What is the arm drop test for?
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rotator cuff test
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What does a positive valgus stress test of the upper arm tell you?
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MCL injury
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Where is the force placed for the valgus stress test?
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the force is directed medial and applied to the lateral part of the elbow
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What does a positive varus stress test of the upper arm tell you?
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LCL injury
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Where is the force placed for the varus stress test?
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The force is directed laterally and applied to the medial part of the elbow
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What muscle is used for muscle energy treatment of ribs 6-9?
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Serratus anterior
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What muscle is used for muscle energy treatment of ribs 10-11?
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Latissimus dorsi
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What dysfunction is associated with grasping something with the hand and twisting at the elbow?
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Lateral epicondylitis (tennis elbow)
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What is the sympathetic autonomic innervation of the foregut?
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T5-9
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What is the sympathetic autonomic innervation of the midgut?
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T10-11
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What is the sympathetic autonomic innervation of the hindgut?
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T12-L2
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What is the best initial treatment for plantar fasciitis?
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ice, stretch and strengthen. Orthotics may help too
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What grade ankle sprain is described? ATF partial tear and CFL is stretched
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Grade 2
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What is the sequence of ligamentous injury of the ankle?
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1. anterior tabofibular
2. calcaneofibular 3. posterior talofibular |
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When a foot is in supination, what is the position of the fibular head?
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posterior
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when a foot is in pronation, what is the position of the fibular head?
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anterior
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What are some contraindications for the pedal pump?
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recent surgery to the abdomen, patient with a DVT, and fractures to lower extremity
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If a patient is not able to adduct or abduct fingers, what nerve has been damaged at the elbow?
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ulnar nerve
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