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69 Cards in this Set
- Front
- Back
def. of somatic dysfuncion
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an impairment or altered function of related components of the somatic system: skeletal, arthrodial, and myofascial structures and related vascular, lymphatic, and neural elements
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TART
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tissue texture changes, asymmetry, restriction, tenderness
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physiologic barrier
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where patient can actively move any given joint
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anatomic barrier
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where physician can passively move any given joint (any movement beyond anatomical barrier will cause ligament, tendon, or skeletal injury)
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restrictive (pathologic) barrier
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before the physiologic barrier
-prevents full ROM of joint |
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one subjective component of TART
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tenderness
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tissue texture changes
1. acute 2. chronic |
1. edematous, erythematous, boggy with increased moisture
-muscle hypertonic 2. decreased or no edema, no erythema, cool dry skin, with slight tension -decreased muscle tone, flaccid, ropy, fibrotic |
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asymmetry
1. acute 2. chronic |
1. present
2. present with compensation in other areas of the body |
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restriction
1. acute 2. chronic |
1. present, painful with movement
2. present, decreased or no pain |
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tenderness
1. acute 2. chronic |
1. severe, sharp
2. dull, achy, burning |
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Fryette's Law #1
1. what is it? 2. which vertebrae |
1. in neutral position: SB precedes rotation, SB and rotation occur to opposite sides
2. group of vertebrae |
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Fryette's Law #2
1. what is it? 2. which vertebrae? |
1. in non-neutral (flexed or extended) position: rotation precedes sidebending, sidebending and rotation occur at same side
2. singe vertebral segment |
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Fryette's laws 1 and 2 apply to what levels of the spine
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thoracic and lumbar (NOT cervical)
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when referring to segmental motion, or restriction, it si traditional to refer to excessive motion of vertebrae where?
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ABOVE in a functional vertebral unit (2 vertebrae)
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if L2 is restricted in motions of flexion, sidebending to the right and rotation to the right
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L2 E RL SL
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if T5 is restricted in motions of extension, SB to the left and rotating to the left
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T5 F RR SR
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if T5-T10 is not restricted in flexion or extension, but is restricted in SB to the left and rotating to the right
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T5-T10 N RR SL
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cervical orientation of superior facet
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BUM
backward, upward, medial |
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thoracic orientation of superior facet
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BUL
backward, upward, lateral |
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lumbar orientation of superior facet
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BM
backward, medial |
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flexion/ extension
1. axis 2. plane |
1. transverse
2. sagittal |
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rotation
1. axis 2. plane |
1. vertical
2. transverse |
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sidebending
1. axis 2. plane |
1. anterior-posterior
2. coronal |
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isotonic contraction
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muscle contraction that results in approximation of the muscle's origiun and insertion without change in its tension
-operator's force is less than patient's force |
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isometric contraction
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muscle contraction that results in the increase in tension without an approximation of origin and insertion
-operator's and patient's force are equal |
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islytic contraction
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-muscle contraction against WHILE FORCING the muscle to lengthen
-operator's force is more than patient's force |
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concentric contraction
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-muscle contraction that results in approximation of muscle's origin and insertion
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eccentric contraction
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-lengthening of muscle during contraction due to an external force
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direct treatment
1. what is it? |
-engage restrictive barrier
--body tissues and/or joints are eventually moved through restrictive barrier |
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direct treatment
1. treat T3 was F RR SR 2. if abdominal fascia moved more freely cephalad than caudad |
1. would extend, rotate and sidebend T3 to the left
2. hold the tissue caudad allowing tissues to stretch |
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indirect treatment
1. what is it? |
1. practitioner moves tissue and/or joints away from restrictive barrier into direction of freedom
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Indirect treatment
1. treat T3 F RR SR 2. if abdominal fascia moved more freely cephalad than caudad |
1. flex, sidebend and rotate T3 to right
2. hold the tissue cephalad allowing tissue to relax |
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active treatment
1. what is it? |
1. patient will assist treatment, usually in form of isometric or isotonic contraction
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passive treatment
1. what is it? |
1. patient will relax and allow practitioner to move body tissues
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myofascial release
1. direct or indirect 2. active or passive |
1. both
2. both |
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counterstrain
1. direct or indirect 2. active or passive |
1. indirect
2. passive |
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facilitated positional release
1. direct or indirect 2. active or passive |
1. indirect
2. passive |
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muscle energy
1. direct or indirect 2. active or passive |
1. direct (rarely indirect)
2. active |
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HVLA
1. direct or indirect 2. active or passive |
1. direct
2. passive |
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osteopathy in the cranial field
1. direct or indirect 2. active or passive |
1. both
2. passive |
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lymphatic treatment
1. direct or indirect 2. active or passive |
1. direct
2. passive |
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Chapman's reflexes
1. direct or indirect 2. active or passive |
1. direct
2. passive |
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elderly patients and hospitalized patients
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-indirect techniques
-gentle direct techniques |
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HVLA in patient with osteoporosis or mets
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no b/c possible pathologic fracture
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acute neck strain/sprains
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indirect techniques to precent further strain
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guidelines for dose and frequency of treatment
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1. sicker patients- limit OMT to few key areas
2. allow pt's body to respond 3. peds can be treated more frequently, geriatric pts. need longer to respond 4. acute cases- shorted interval b/w treatments |
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sequencing for psoas syndrome
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treat lumbar or thoraco-lumbar spine first
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sequencing for acute somatic dysfunctions
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treating peripheral areas will allow accessto acute area
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appearance of C1
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atypical
-no spinous process or vertebral body |
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appearance of C2
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atypical
-has a dens that projects superiorly from its body and articulates with C1 |
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cervical articular pillars
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portion of bone of cervical vertebral segments that lie between superior and inferior facets
-posterior to cervical transverse processes |
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scalenes
1. location 2. aid in what? 3. anterior and middle scalenes help with what? 4. common dysfuction 5. posterior scalene help with what? |
1. posterior tubercle of TP to rib 1 and rib 2
2. sidbending neck and flexing neck; respiration 3. elevate first rib during forced inhalation 4. tenderpoint in one of the scalenes with 1st or 2nd inhalation rib dys. 5. elevate 2nd rib during forced inhalation |
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SCM
1. location 2. unilateral collection 3. bilateral contraction 4. shortening or restrictions within SCM |
1. from mastoid process and lateral 1/2 of superior nuchal line to medial 1/3 of the clavicle and sternum
2. sidebend ipsilaterally and rotate contralaterally 3. flex the neck 4. torticollis |
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alar ligament
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from sides of dens to lateral margins of foramen magnum
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transverse ligament
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atlast attaches to lateral masses of C1 to hold dens in place
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what can weaken ligaments in cervical? can lead to what?
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RA and Down's
-atlanto-axial sublaxation |
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joint of Luschka
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-articulation of superior unicinate process and superadjacent vertebrae
-degenerative changes or hypertrophy can lead to foraminal stenosis and nerve root compression |
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upper 7 cervical nerve roots exit where?
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above their corresponding vertebrae
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C8 nerve root exit where
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b/w C7 to T1
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OA
1. motion |
1. flexion and extension
-SB and R occur to opposite sides with either flexion or extension -motion of occipital condyles on atlas (C1) |
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AA
1. motion where 2. movement |
1. C1 motion on C2
2. only rotation |
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OA
1. main motion 2. SB and R |
1. flexion and extension
2. opposite side |
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AA
1. main motion 2. SB and R |
1. rotation
2. opposite sides |
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C2-C4
1. main motion 2. SB and R |
1. rotation
2. same sides |
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C5-C7
1. main motion 2. SB and R |
1. sidebendnign
2. same sides |
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OA motion testing
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1. translation- (right translation=left SB
2. rotation- 3. SB |
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AA motion testing
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1. rotation
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C2-C7 motion testing
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1. translation
2. rotation |
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Cervical formaminal stenosis
1. most common cause of cervical nerve root pressure symptoms 2. location of pain 3. quality of pain 4. signs and symptoms 5. radiology 6. TX |
1. degenerative changes within the joints of Luschka and hypertrophy of interverebral joints
2. neck pain radiating into UE 3. dull ache, shooting pain, paresthesias 4. increased pain with neck extension, pos. Spurling's test, paraspinal muscle spasm, posterior and anterior cervical tenderpoints 5. osteophyte formation and degenerative joint changes 6. OMT to maintain optimal ROM |