Omm And Comat Material Final Spring

Front 1

When osteopathy founded?

Back 1

June 22 1874

Front 2

What was the significance of the spanish flu pandemic?

Back 2

1918
Ribraising dramatically reduces morbidity and mortality

Front 3

Who was the founder of the following OMM Technique:
Cranial

Back 3

William Sutherland

Front 4

Who was the founder of the following OMM Technique: Muscle Energy

Back 4

Fred Mitchell

Front 5

Who was the founder of the following OMM Technique: Counterstrain

Back 5

Lawrence Jones

Front 6

Who was the founder of the following OMM Technique: Facilitated Positional release

Back 6

Stanley Schiowitz

Front 7

Who was the founder of the following OMM Technique: "resdiscoverd" AT Still technique?

Back 7

Richard Van Buskirk

Front 8

What are the 4 Osteopathic Principles?

Back 8

1.The body is a unit, and represents a combination
of body, mind & spirit.
2.The body is capable of self regulation, self-
healing, and health maintenance.
3.Structure and function are reciprocally
interrelated.
4.Rational treatment is based on an understanding
of these principles: body unity, self-regulation,
and the interrelationship of structure and
function.

Front 9

What does this define:
Is an impaired or
altered function of related components of
the somatic (body framework) system;
skeletal, arthrodial and myofascial
structures, and related vascular, lymphatic
and neural elements.

Back 9

somatic dysfunction

Front 10

What does TART stand for?

Back 10

Tissue texture changes, Asymmetry,
Restricted motion &
Tenderness)

Front 11

Motion within the transverse plane about a
longitudinal or vertical axis is what motion?

Back 11

Rotation

Front 12

Motion within the coronal/frontal plane
about a AP axis is what motion?

Back 12

Sidebending

Front 13

Motion within the sagittal plane about a
transverse axis is what motion?

Back 13

Flex/Extension

Front 14

What is a Type I Fryette?

Back 14

Type I: Neutral position, sidebending and
rotation occur to opposite sides.

Front 15

What is a Type II Fryette?

Back 15

Type II: Non-neutral, sidebending and
rotation occur to the same side.

Front 16

What Fryettes Third Law?

Back 16

Type III: Motion in one plane alters motion
in other planes of motion.

Front 17

Where would you find the spinous process of the T1-T3? What other level behaves this way?

Back 17

T1-3 Spinous process of segment is with its
transverse process
T12 Also follows this rule

Front 18

Where would you find the spinous process of the T4-T6? What other level behaves this way?

Back 18

T4-6 Spinous process of segment is half
way, to t-process of segment below
T11 also

Front 19

Where would you find the spinous process of the T7-T9? What other level behaves this way?

Back 19

Spinous process of seg. is at level with
t-process of seg. below
T10 also

Front 20

What is the motion of the OA (C0-C1)?

Back 20

Motion of the occiput on the
atlas. Atypical motion. Sidebending and
rotation occur in opposite directions in a
non- neutral position

Front 21

What is the motion of the AA (C1/C2)?

Back 21

Motion of the atlas on the
axis. Atypical motion. Pure Rotation.

Front 22

What is the motion of C2-C7?

Back 22

Generally follow Fryette’s type II
motion. Non- neutral, rotation and
sidebending to the same side.

Front 23

If T4 is compared with T5. We notice that T4
moves into flexion freer and sidebending and
rotation is easier to the right. How do we name
this?

Back 23

T4FRSR

Rotation is listed FIRST in Type II Dysfunctions

Front 24

If segments T5 through T9 have
paravertebral humping noted on the right
side and the patient is restricted with right
sidebending without flexion or extension.
How would you name this?

Back 24

T5-T9NSLRR

Side-bending is listed FIRST in Type II Dysfunctions

Front 25

What is active motion testing?

Back 25

When the patient moves them selves - Quantitative

Front 26

What is passive motion testing?

Back 26

When the doctor moves the patient - Qualitative

Front 27

Name the Barrier: End range of joint motion
limited by bones, ligaments, and tendons.
Passively tested.

Back 27

anatomic

Front 28

Name the Barrier: Limit of end range of motion
produced by the patient. Actively tested.

Back 28

Physiologic

Front 29

Name the Barrier: Abnormal limited
motion within the physiologic range that is
altered by somatic dysfunction. OMM
deals with this.

Back 29

Restrictive/Pathological

Front 30

Treatment
consists of moving into the restrictive
barrier.

Back 30

Direct

Front 31

Treatment
consists of moving away from the
restrictive barrier.

Back 31

Indirect

Front 32

What Techniques are Direct

Back 32

HVLA, ME, Myofascial Release (both) Cranial on Kids

Front 33

What Techniques are INDirect

Back 33

Conterstrain
Cranial in adults
FPR
Still (Indirect to direct)

Front 34

Which are the true ribs?

Back 34

1-7 True ribs. Articulate with sternum.

Front 35

Which are the false ribs?

Back 35

8-10 False ribs. Articulate with cartilage

Front 36

Which are the floating ribs?

Back 36

11-12 Floating ribs. No anterior
articulation.

Front 37

What Ribs have a Pump handle motion

Back 37

1-5
AP diameter expansion with respirations.

Front 38

What Ribs have a bucket handle motion?

Back 38

Ribs 6-10
lateral
diameter expansion with respirations.

Front 39

If ribs 5-9 are inhaled you must treat which rib?

Back 39

Key rib is 9

Front 40

If ribs 5-9 are exhaled you must treat
which rib?

Back 40

5

Front 41

Viscerosomatic Reflexes head and neck?

Back 41

Head and Neck T1-4

Front 42

Viscerosomatic Reflexes Heart

Back 42

Heart T1-5

Front 43

Viscerosomatic Reflexes Lung

Back 43

Lung T2-5

Front 44

Viscerosomatic Reflexes Cervical Upper Esophagus

Back 44

Cervical Upper Esophagus T2-4

Front 45

Viscerosomatic Reflexes Thoracic Mid Esophagus

Back 45

Thoracic Mid Esophagus T3-T6

Front 46

Viscerosomatic Reflexes Lower Esophagus and Stomach

Back 46

Lower Esophagus and Stomach T5-T8

Front 47

Viscerosomatic Reflexes Spleen and Pancreas

Back 47

Spleen and Pancreas T5-11

Front 48

Viscerosomatic Reflexes Liver

Back 48

Liver T6-9

Front 49

Viscerosomatic Reflexes Gallbladder

Back 49

Gallbladder T9-10 R

Front 50

Viscerosomatic Reflexes Small Intestine

Back 50

Small Intestine T9-11

Front 51

Viscerosomatic Reflexes Appendix

Back 51

Appendix T12

Front 52

Viscerosomatic Reflexes Ovary/testes

Back 52

Ovary / Testes T9-10

Front 53

Viscerosomatic Reflexes Kidney, Ureter, Bladder

Back 53

Kidney, Ureter and Bladder ALL T10-L1

Front 54

Viscerosomatic Reflexes Prostate and Urethra

Back 54

Prostate and Urethra L1-2

Front 55

Viscerosomatic Reflexes Cervix

Back 55

Cervix L1-2

Front 56

Viscerosomatic Reflexes Ascending and transverse colon

Back 56

Ascend. and Trans. Colon T10-12

Front 57

Viscerosomatic Reflexes genitals

Back 57

Genitals T12

Front 58

Viscerosomatic Reflexes Uterus

Back 58

Uterus T10-L1

Front 59

Viscerosomatic Reflexes Descending and Sigmoid Colon and
Rectum

Back 59

Descending and Sigmoid Colon and
Rectum L1-2

Front 60

Viscerosomatic Reflexes Adrenals

Back 60

Adrenal T8-T10

Front 61

Lower extremity viscerosomatic reflex?

Back 61

LE T10-L2

Front 62

What re Chapmans reflexes?

Back 62

Neuro-lymphatic tissue texture abnormalities
that are reflections of visceral dysfunction or
pathology (viscerosomatic reflexes)

Front 63

What do Chapmans points indicate?

Back 63

Indicate increased activity of the
sympathetic nervous system.
NOT PARASYMP

Front 64

Where is the Chapmans Reflex for the heart?

Back 64

Cardiac- 2 nd anterior intercostal space

Front 65

Where is the Chapmans Reflex for Upper respiratory infections and the Lungs?

Back 65

3 rd and 4 th anterior intercostal
space

Front 66

Where is the Chapmans Reflex for otitis Medai

Back 66

Middle clavicle

Front 67

Where is the Chapmans Reflex for sinusitis

Back 67

1st Rib

Front 68

Where is the Chapmans Reflex for eye pathology

Back 68

Lateral Humerus

Front 69

Where is the Chapmans Reflex for Colon and prostate pathology?

Back 69

IT Band

Front 70

Where is the Chapmans Reflex for the Appendix

Back 70

Tip of right 12 th rib

Front 71

Where is the Chapmans Reflex for the Rectum?

Back 71

Lesser trochanter

Front 72

Anterior chapmans points are for diagnosis... Where do you treat?

Back 72

Can treat both anterior and posterior points

Front 73

What is piriformis insertion?

Back 73

GREATER trochanter

Front 74

Where does illiopsoas insert?

Back 74

Lesser troch

Front 75

Finish the following sentence: When L5 is sidebent, a sacral oblique axis is engaged to the same side as the ____________

(chose sidebending or rotation)

Back 75

Sidebending

Front 76

Finish the following sentence:
When L5 is rotated, the sacrum rotates the _____________ way on an oblique axis
(choose same or opposite)

Back 76

Opposite

Front 77

The seated flexion test is found on the ____________ side of the oblique axis.
(choose same or opposite)

Back 77

Opposite

Front 78

If L5 is FRSR, what side is the seated flexion test positive on?
How is the sacrum rotates?

Back 78

+SFT on the LEFT
Sacrum rotated to the left on a right oblique axis or L on R

Front 79

What type of torsion is a L on L?

Back 79

Forward
It would have a negative spring test indicating that the sacrum DID moce

Front 80

What type of torsion is a R on L?

Back 80

backwards
Spring test would be positive indicating LACK of movement

Front 81

What is a shear?

Back 81

The slippage of one sacroiliac joint about a
vertical axis with translation of the sacral
base.

Front 82

Diagnosis?
Positive spring test
Sulcus is shallow on the same side as an
anterior ILA
Positive seated flexion test on shallow
sulcus side.

Back 82

Unilateral Sacral Extension

Front 83

What happens in Cranial/sacral flexion:

Back 83

1. midline bones flex.
2. Paired bones externally rotate.
3. SBS rises.
4. Sacral base moves posterior / counternutation.
5. Respiratory inhalation encourages flexion.

Front 84

What happens in Cranial/sacral extension:

Back 84

1.Midline bones extend
2.Paired bones internally rotate.
3. SBS lowers
4. Sacral base moves anterior / nutation.
5. Respiratory exhalation encourages
extension.

Front 85

Cranial Pearls -Part I
Torsion: Named for the high greater wing
of the sphenoid.
Sidebending Rotation: Named for the side
of the produced convexity. Convexity side
is rotated toward the feet.
Vertical Strain: Named for the position of
basisphenoid. Superior/inferior shearing of
the BSB.

Back 85

Cranial Pearls Part II
Vertical strain associated with trauma such
as an uppercut.
Lateral Strain: Named for the position of
basisphenoid. Side to side shearing of the
BSB. Caused by trauma such as a hook.
Seen in infants with a “parallelogram
shaped head”
Compression: No motion, caused by
trauma.

Front 86

What is the Spencer technique used to treat? What motion is NOT part of the technique?

Back 86

Adhesive Capsulits
Not included: external rotation

Front 87

Grading Deep Tendon Reflexes
What is Normal?

Back 87

Grade 2 is normal

grade 0--no response;
grade 1--minimal response;
grade 2--mid-range normal
response;
grade 3--slightly hyperactive
response;
grade 4--hyperactive response
with clonus.

Front 88

Muscle Strength Grading
What is normal?

Back 88

5 is normal

Grade 0: Total Paralysis
Grade 1: Palpable or visible contraction
Grade 2: Full range of motion with
gravity eliminated
Grade 3: Full range of motion against
gravity
Grade 4: Full range of motion with
decreased strength
Grade 5: Normal Strength

Front 89

What is a ligament injury called? Muscle injury (tendon)?

Back 89

A sprain for ligament
strain=muscle

Front 90

What are the Grades of Sprains?

Back 90

Grade I sprain: stretch of ligament
Grade II sprain : partial tear.
Grade III sprain: complete tear.

Front 91

What is O'Donahue's triad?

Back 91

Pop goes the ACL, Medial meniscus, and
medial collateral ligament

Front 92

Which is the most common mechanism of injury of the ACL, contact or noncontact?

Back 92

non contact. a planted foot with subsequent twisting motion is the usual cause

Front 93

What is the best test for a torn ACL? What other tests can you do?

Back 93

Lachman is the best

Other options re anterior drawer and pivot shift

Front 94

Torn Meniscus Facts
Pain often localized to the joint line and
popliteal region with knee flexion.
Locking of the joint, which prevents full
knee extension.
Buckling or “ giving out” sensation.
Knee pain often worse with full knee
flexion or extension.

Back 94

Torn Meniscus Facts
Pain often localized to the joint line and
popliteal region with knee flexion.
Locking of the joint, which prevents full
knee extension.
Buckling or “ giving out” sensation.
Knee pain often worse with full knee
flexion or extension.

Front 95

What tests/physical exam findings would you anticipate with a torn meniscus

Back 95

Joint line tenderness with bent knee
+Apley Grind Test
+McMurray
+Pain and instability with walking, pt may "baby" leg by keeping knee bent
Knee effusion and pain with full flexion or extension

Front 96

What is the most common type of ankle
sprain?

Back 96

Inversion injury

Front 97

What ligaments are injured with inversion? List in order of how they tear

Back 97

ATF
CFL
PTF

(In that order)

Front 98

What are the rotator cuff muscles?
What are the motions of each muscle?

Back 98

SITS
Supraspinatous=Abduction
Infraspinatus=EX Rot
Teres MINOR= EX Rot
Subscapularis = Internal Rotation

Front 99

Jobe’s Test?

Back 99

Supraspinatous

Front 100

Speed’s Test?

Back 100

Biceps brachii

Front 101

Hawkin’s Test?

Back 101

Impingement

Front 102

Neer’s Test?

Back 102

Impingement

Front 103

Yergeson’s Test?

Back 103

Long head of biceps

Front 104

Cross Arm Test?

Back 104

AC Joint dysfunction

Front 105

Patrick’s Test?

Back 105

Hip Joint Dysf

Front 106

Straight Leg Raise?

Back 106

nerve root impingement
(

Front 107

Thomas Test?

Back 107

Illiopsoas

Front 108

Thompson Test?

Back 108

Torn Achillies

Front 109

Ober’s Test?

Back 109

IT Band

Front 110

Stork Test?

Back 110

Apondylolysis

Front 111

Trendelenberg Test?

Back 111

Superior gluteal nerve/Glut Med on side opposite the fallen side

Front 112

Common Features of Herniated Disks:

What levles/direction?
More males or Females?

Back 112

L4/5 or L5/S1 most common in posterior lateral direction (due to posterior Longitudinal Ligament)

Males more ofter and pain is worse with increasing intrathecal pressure

Front 113

What are the possible treatments for a Herniated nucleus pulposus?
What imaging to diagnose

Back 113

Treatment: Local heat/ice, OMT,
Corticosteroids, NSAIDS, Opioids, epidural injection, Surgery ( last resort ).
Tricyclic antidepressants and gabapentin are
often used for neuropathic pain unresponsive
to opioids.

Diagnosis: MRI, CT, Myelogram.

Front 114

Connective tissue and bone overgrowth
reducing the size of the vertebral foramina =

Back 114

Spinal Stenosis
Normal aging proocess most common in peopl over 60

Front 115

How does spinal stenosis present?

Back 115

Chronic and progressive
Bilateral and poorly locaized
Pain that RADIATES wo butt thigh or legs
Worse with Extension (standing or walking)
Better with flexion (sitting or stooping.)
Stopping ambulation may not improve sx like it would if the problem were vascular claudication

Front 116

What are the risk factors for peripheral vascular disease/claudication?

Back 116

Smoking, DM, hyperlipidemia, FMHX

Front 117

What is the presentation of peripheral vascular disease/claudication?

Back 117

Chronic, progressive
bliateral or unilateral, poorly localized
worse with any lower extremity exertion
Diminished puses, delayed cap refill and cyanotic cool extremities are classic clues on physical exam

Front 118

A Separation of the pars interarticularis of the
vertebral arch =

Back 118

Spondylolysis

Front 119

Slippage of one vertebral body onto the next. =

Back 119

Spondylolithesis
(must be lilateral for slippage to occur, most common L5/S1)

Front 120

What type of injuries or athletes are most prone to Spondylolithesis?

Back 120

Hyperextension injuries as seen in football lineman and gymnastic participants

Front 121

Common Features of Herniated Disks:

What levles/direction?
More males or Females?

Back 121

L4/5 or L5/S1 most common in posterior lateral direction (due to posterior Longitudinal Ligament)

Males more ofter and pain is worse with increasing intrathecal pressure

Front 122

What are the possible treatments for a Herniated nucleus pulposus?
What imaging to diagnose

Back 122

Treatment: Local heat/ice, OMT,
Corticosteroids, NSAIDS, Opioids, epidural injection, Surgery ( last resort ).
Tricyclic antidepressants and gabapentin are
often used for neuropathic pain unresponsive
to opioids.

Diagnosis: MRI, CT, Myelogram.

Front 123

What % of 20-80 yr olds have bulging or protruding discs on MRI and are ASYMPTOMATIC!!!

Back 123

52

Front 124

Connective tissue and bone overgrowth
reducing the size of the vertebral foramina =

Back 124

Spinal Stenosis
Normal aging proocess most common in peopl over 60

Front 125

How does spinal stenosis present?

Back 125

Chronic and progressive
Bilateral and poorly locaized
Pain that RADIATES wo butt thigh or legs
Worse with Extension (standing or walking)
Better with flexion (sitting or stooping.)
Stopping ambulation may not improve sx like it would if the problem were vascular claudication

Front 126

What are the risk factors for peripheral vascular disease/claudication?

Back 126

Smoking, DM, hyperlipidemia, FMHX

Front 127

What is the presentation of peripheral vascular disease/claudication?

Back 127

Chronic, progressive
bliateral or unilateral, poorly localized
worse with any lower extremity exertion
Diminished puses, delayed cap refill and cyanotic cool extremities are classic clues on physical exam

Front 128

A Separation of the pars interarticularis of the
vertebral arch =

Back 128

Spondylolysis

Front 129

Slippage of one vertebral body onto the next. =

Back 129

Spondylolithesis (scotty dog)
(must be lilateral for slippage to occur, most common L5/S1)

Front 130

What type of injuries or athletes are most prone to Spondylolithesis?

Back 130

Hyperextension injuries as seen in football lineman and gymnastic participants

Front 131

What is the grading scale for Spondylolithesis? What grades is atpropriate to monitor the injury?

Back 131

Grade I – 0-25% displacement.
Grade II – 25-50 % displacement.
Grade III – 50-75 % displacement.
Grade IV -75-100% displacement.
Grade III and IV are often surgical.
Grade I and II monitoring is appropriate.

Front 132

What is the disorder based on the following description?
Pain in the back, in the facet region with no
radiation below the knee
Signs of spasm at segmental level
Paravertebral tenderness
Pain is felt in the morning upon rising, tending
to lessen with physical activity.
Painful motion especially hyperextension
Normal neuro exam

Back 132

Facet joint syndrome

Front 133

Who gets Fibromyalgia? What is the criteria?

Back 133

Incidence in ambulatory edicine, 3-10% population
Over 75% are women between 20-60 years of age
Characterized by diffuse aches,
stiffness, and fatigue
American College of Rheumatology: at
least 11/18 tenderpoints for greater then 3 months duration

Front 134

What sould be ruled or or a DDx when considering Fibromyalgia?

Back 134

Rule out thyroid disease, lupus,
rheumatoid arthritis, malignancy, infectious
disease, etc.

Front 135

What things exacerbate Fibromyalgia?

Back 135

Pain and fatigue are worse with stress,
cold, and physical activity.

Front 136

Greater than 70% of people with fibromyalgia have problems with this normal activity...

Back 136

Sleep!

70% of patients have alpha
wave intrusion into non-REM delta wave sleep.

Assocaiated with IBS, depression and headaches