Omm 11-01-07 Omm And Cardiovascular Disease

Front 1

If posterior wall of the heart is involved, you may not have usual "chest pain" and left arm referral.. Where is the pain referral?

Back 1

b/w the shoulder blades

Front 2

When the Ventricles are involved in production of pain, it tends to refer to the ____ dermatomes

Back 2

C8 to T3

Front 3

When the Atria are responsible for the pain, it tends to occur lower in the chest wall in the ______ dermatomes

Back 3

T4 to T6

Front 4

Numerous studies have demonstrated that ischemic myocardial disease causes palpable changes in the soft tissues in the _______ region

Back 4

upper thoracic paraspinal

Front 5

Anterior Chapman's Reflexes for cardio

Back 5

Close to the sternum in the second intercostal space bilaterally
(between the second and third ribs)

Front 6

Posterior chapman's reflexes for cardio

Back 6

Midway between the spinous process and the tips of the transverse processes in the space between the transverse processes of T2 & T3 bilaterally

Front 7

Severe Scoliosis with thoracic curve greater than ____ degrees seriously compromises cardiac function

Back 7

60-75

Front 8

Severe Kyphosis measuring greater than ___ degrees likewise compromises cardiac function

Back 8

60

Front 9

Patients with flattening of the thoracic kyphosis or with postural crossovers in the upper thoracics, tend to develop ______ when subjected to other stressors

Back 9

tachyarrhythmias

Front 10

Travell documented the presence of a triggerpoint located in the _____ pectoralis major muscle which serves an initiating or perpetuation role in Supraventricular tachyarrhythmias.

Back 10

right

Front 11

Abnormal gait patterns may increase cardiac work by up to _____%

Back 11

300

Front 12

In the healthy heart, increased sympathetic tone
_______ the force of contraction

Back 12

Increases

Front 13

In the healthy heart, increased sympathetic tone

_______ the time of systole

Back 13

Shortens

Front 14

Sympathetic Innervation of the heart emanates from cord segments ____

Back 14

T1-T6

Front 15

Not totally ipsilateral, but left side definitely predominates
Right sided fibers innervate the right heart and _____node

Back 15

sinoatrial (SA)

Front 16

Hypersympathecotonia in these right sided fibers predisposes to supraventricular _____

Back 16

tachyarrhythmias

Front 17

Left sided sympathetic fibers
Innervate the left heart and ____ node.

Back 17

atrioventricular (AV)

Front 18

Hypersympathecotonia in left fibers predisposes to ectopic foci and _____

Back 18

ventricular fibrillation

Front 19

Normal sympathetic tone keeps vessels at approx. ____what fraction of their normal diameter

Back 19

one half

Front 20

Increased sympathetic tone _____ morbidity following myocardial infarction

Back 20

Increases

Front 21

Vasculature of the arms receives its sympathetic supply from the _______ levels

Back 21

T1 to T8

Front 22

Vasculature of the legs receives its sympathetic supply from the ________levels

Back 22

T10 to L2

Front 23

Vagus nerves have fibers course to them from the What cervical nerve roots

Back 23

C-1 & C-2

Front 24

Observation of patients has demonstrated that correction of high cervical somatic dysfunction results in a transient increase in vagal tone followed by what?

Back 24

a reduction in vagal effect

Front 25

Right Vagus innervates the ____ Node

Back 25

Sino Atrial

Front 26

Vagal Hyperactivity predisposes to sinus ______-arrythmias

brady or tachy

Back 26

brady

Front 27

Left Vagus innervates the _____ Node

Back 27

Atrio Ventricular

Front 28

Vagal Hyperactivity predisposes to _____

Back 28

AV Blocks

Front 29

The heart may be reflexly slowed by stimulating Vagal afferents of selected sites in the body
Irritation of the ______ branches of Vagus produce the most profound effects

Back 29

pulmonary

Front 30

Pressure on the carotid body or the globe of the eye (Oculocardiac Reflex) will also ____ the heart

speed
slow

Back 30

slow

Front 31

Pressure on the carotid body or the globe of the eye (Oculocardiac Reflex) will also slow the heart. What pts will not show this effect?

Back 31

Will not slow at all in sympathecotonic patients

Front 32

Deep pressure over the _______ suture on the skull will reflexly slow the heart

Back 32

occipitomastoid

Front 33

Parasympathetics cause peripheral arteriolar vasodilation in select situations. Which of the following is not correct?

Vessels of Submaxillary Gland
Vessels of Parotid Gland
Vessels in the Blush Region of the Face
Vessels of the Thyroid Gland
Vessels in the tongue
Vessels of the penis & clitoris (erection & engorgement)

Back 33

Vessels of the Thyroid Gland

Front 34

Heart drains predominantly to the _____lymphatic duct

Back 34

right

Front 35

Consequences of Impaired Lymphatic Drainage

Reduced development of collateral circulation
Increased morbidity and mortality from ischemia and infection
Arrhythmogenic
And what else? (SS syndrome)

Back 35

Sick Sinus Syndrome

Front 36

Use indirect methods or soft tissue techniques for at least how long
post MI

Back 36

first 72 hours

Front 37

Acute MI:
Search for which trigger point

Back 37

Search for right Pectoralis Major trigger point

Front 38

Acute MI:

Techniques are directed at dysfunctions located at _______

Back 38

OA, C1, C2, T1 to T4 and R1 to R4

Front 39

Acute MI:
Paraspinal soft tissue techniques may be performed from T1 to L2 to do what?

Back 39

to generally diminish sympathetic tone and decrease peripheral vascular resistance

Front 40

Acute MI:

What cranial techniques are possible?

Back 40

Cranial: Treat dysfunction of the skull base and occipitomastoid suture, if present

Front 41

Acute MI:

what lymphatic techniques can you do?

Back 41

Apply indirect techniques to the thoracic inlet
Apply pectoral traction to assist inhalation and promote lymphatic flow
Redome diaphragm using indirect AP diaphragm technique

Front 42

HTN:

Where do you direct your attention with OMM techniques?

Back 42

Treatment is directed to the entire sympathetic bed (T1 to L2) to generally decrease peripheral vascular resistance

Front 43

Percent of HTN that is essential?

percent secondary?

percent of secondary that is curable?

Back 43

85

15

33.3 (5% overall HTN)

Front 44

HTN:

Chapman’s Reflexes treatment?

Back 44

Treat Posterior Adrenal Points


Drop of 15 mm Hg Systolic
Drop of 8 mm Hg Diastolic
Serum Aldosterone decreased for 36 hours post-treatment

Front 45

In CHF, lymphatic flow through the thoracic duct increases _____ times the resting level

Back 45

3-40

Front 46

CHF:

Manipulative medicine approach is largely directed to the _______

Back 46

lymphatics

Front 47

Types of lymphatic treatment for CHF

Back 47

Treat any restriction at the thoracic inlet
Treat dysfunctions of the thoracic spine, L1 to L3, and rib cage
Redome the diaphragm
Apply thoracic, abdominal and pedal lymphatic pumps

Front 48

Which technique should you withhold if you are unsure that the patient’s cardiovascular system can handle the increased fluid load

Back 48

Thoracic, Abdominal and Pedal pumps

Front 49

CHF:

OMT to Thoracic Spine and Ribs Only. What were the effects on HR, Syst BP, CO, systolic ventricular reserve, thoracic fluid content?

Back 49

Decreased Heart Rate (p<0.027)
Decreased Systolic Pressure (p<0.031)
Increased Cardiac Output (p<0.033)
Increased Systolic Ventricular Reserve (p<0.027)
Decreased Thoracic Fluid Content (p<0.03)
(Scheunemen, et al)

Front 50

Know about the one study regarding CABG.

Back 50

Okay