OMM Final Block 1

How much motion is in the SI joint?

1 mm

Describe the Atlanto-Odontal Articulation:

1. Horizontal portion of cruciform ligament = Down's 2. Tectoral Membrane

Describe the stages for readiness to change:

1. Pre-contemplation - pt in denial, physician educates on risks 2. Contemplation - pt ambivalent/ weighs options, physician identifies barriers 3. Preparation 4. Action 5. Maintainance

Describe the cervical motion test

80 degrees

What joint are you testing when you cross your arm over your body?

AC joint

What does the Lachman and AP drawer tests assess?

ACL-PCL integrity

How do you evaluate and and name scoliosis?

Adam's test, name by convexity

Coxa Vara

Angle < 120

Coxa Valgrum

Angle > 135

What makes up the femoral triangle?

Boarders: Inguinal ligament Sartorius muscle Adductor longus muscle Contents= (NAVEL) Femoral Nerve Femoral Artery Femoral Vein Lymphatic Vessel

Describe the joints of Luschka:

C2-C7

Describe the cervicothoracic jx:

C7-T3

Important hip ligaments that prevent hyperextension:

Iliofemoral ligament Pubofemoral ligament Ischiofemoral ligament

Describe the landmarks: Between the tops of the iliac crest

L4-5

What is the restrictive barrier in L5 FRS left?

L5 extension, right rotation, right side-bending

If when motion testing L5 you find that the L transverse process is more more prominent in extension and becomes more symmetrical in flexion, what is the diagnosis and SD?

L5 flexed, rotated left, side bent left (L5 FRS left)

What is O'Donoghue's unhappy triad?

MCL-ACL-Medial Meniscus

What orthopedic screens can assess for meniscal integrity?

McCurry Medial Meniscal Test Fouche Variation Thessaly Test

Describe a tender point:

NO radiation; in muscle, tendons, ligaments, and fascia

Describe the major motions of the gluteus maximus?

Primary Extensor Inhibited with ipsilateral SIJ-- "dumb butt syndrome"

Describe the major motions of the iliopsoas?

Primary Flexor If hypertonic, it can cause a posteriorly rotated hip and inhibit gluteus maximus, which will cause SIJ SD

Describe the landmarks: PSIS

S2

What are the shoulder muscles and their functions?

SITS Muscles Supraspinatus- Abduction (near impingement sign) Infraspinatus- External rotation (resistance test) Teres minor- External rotation Subscapularis- internal rotation

Describe the thoracolumbar jx:

T10-L2

Describe the landmarks: Jugular Notch

T2

Describe the landmarks: Spine of the scapula

T3

What is the restrictive barrier for T3-12 N, SB left, R right?

T3-12 right side bending and left rotation restrictive barrier

Describe the landmarks: Inferior angle of the scapula

T8

What orthopedic measure is useful in defining genu valgrum vs varum?

The Q angle

Describe how to name a Type II dysfunction:

Vertebrae #, Flexion/Extension, Rotation, Side bending L F/E R, SB

Describe how to name a Type I dysfunction:

Vertebrae #, Normal, Side bending, Rotation L N SB, R

What kind of reflex is seen when you have GI distention that increases your peristalsis?

Viscero-visceral reflex

What is the Spruling's Test?

a test to passively evaluate the neck

What are the tendons of the thumb?

abductor pollicis longus and extensor pollicis brevis tendons

What is an anechoic signal?

absent

Principle III

applies to entire axial spine

Principles I and II

apply to thoracic and lumbar motion only

If a patient were involved in trauma that resulted in motion restriction, what model would you use to assess them?

biomechanical model

Describe a plumb line:

bisects your body, makes sure anatomical structures are centered

What is a hyperechoic signal?

bright image, looks white

Describe echnogenicity:

capacity of structure to reflect waves

Describe gain:

contrast (TCG) - help tissue differentiation, turn down lights

Scoliosis compensates in what plane?

coronal plane

Describe genu vara:

decreased Q angle, <10 degrees, bow legged

Describe attenuation:

decreases intensity as it passes through a medium contains: absorption, reflection, refraction, and diffraction

Pronation of the foot and ankle are comprised of what 3 motions?

dorsiflexion-eversion-abduction

Describe zinc-compensatory patterns:

fascia rotates in opposite directions

What is a segmental diagnosis?

find and treat SD

What is the McCurry Medial Meniscal Test?

flex leg to 90 -> foot and tibia are externally rotated -> place tibia into abduction -> while externally rotating the foot -> slowly extend the leg while holding this position *pain with palpable click indicates a positive test

What is the major motion of the OA joint?

flexion and extension think nodding "yes"

What does the Patrick Fabre test assess?

flexion-abduction-external rotation-extension

Describe B-mode:

gray-scale imaging

Describe focal points:

horizontal resolution - 3 points if possible

What makes up the true elbow?

humerus and ulna

How is vertical motion described?

in relation to the inferior vertebra

Describe genu valgum:

increased Q angle, >12 degrees, knock knee

Why is the superior articular facet orientation important and what are their rotations?

it plays a key role in how the vertebrae move C: BU T: BUL L: BUM

What is the translatory bind associated with T8-12 side bent left rotated right?

left translation consistent with right side-bending

What is the translatory bind in L5 FRS left?

left translatory bind

What occurs first when walking into a room?

make eye contact

If a patient presented with uncontrolled diabetes that resulted in a frozen shoulder, what model would you use to assess them?

metabolic model

Supination of the foot and ankle does what to the fibular head?

move posteriorly

Pronation of the foot and ankle does what to the fibular head?

moves anteriorly

Supination of the foot and ankle does what to the distal fibular lateral malleolus?

moves anteriorly

Pronation of the foot and ankle does what to the distal fibular lateral malleolus?

moves posteriorly

If a patient presented with an acute herniated disc that was impinging on the nerve root, what model would you use to assess them?

neurological model

Describe Fryette's Principles: Type I

neutral; side-bending and rotation in opposite directions, involves 3 or more segments

Describe Fryette's Principles: Type II

non-neutral; side-bending and rotation in the same direction, 1 segment

What is an isoechoic signal?

normal, looks blank

Which nerve is at risk of compression with proximal fibular head SD from supination?

peroneal nerve

Describe frequency:

pick the highest; vertical resultion

Supination of the foot and ankle are comprised of what 3 motions?

plantar flexion-inversion-adduction

Describe a trigger point:

radiates pain when pressed; MUSCLE only

What are transition zones?

regions of most restriction

If a patient presented with a respiratory issue, what model would you use to assess them?

respiratory-circulatory to optimize ventilation and fluid homeostasis

What is the translatory ease associated with T8-12 side bent left rotated right?

right translation consistent with left side-bending

What is the translatory ease in L5 FRS left?

right translatory ease is consistent with left side-bending

Describe zinc-uncompensated patterns:

rotate same way, trauma, abnormal gait, personal conditions; more likely to be symptomatic

What is the major motion of the AA joint?

rotation think shaking your head "no"

What plane do lordosis and kyphosis compensate in?

saggital plane

Describe T12:

same as T1-3 spinous process is same level below body

Describe T11:

same as T4-6 spinous process is 1/2 level below body

Describe T10:

same as T7-9 spinous process is a whole level below body

What is the job of knee menisci?

shock absorber

Describe dextro scoliosis

side bent left with convexity to the right

What kind of reflex is seen when you touch a hot pan?

somato-somatic reflex

What kind of reflex is seen when you increase your HR?

somato-visceral reflex

Describe T4-6:

spinous process is 1/2 level below body

Describe T7-9:

spinous process is a whole level below body

Describe T1-3:

spinous process is same level below body

Describe strength based praise:

substance use, diet, exercise

Describe the anatomical snuff box

suspect scaphoid fx

How would you evaluate carpel tunnel?

the carpel tunnel test: it is the most sensitive and specific measure

Describe the articulatory facets on C3-C7:

they form the palpable articular pillars

What is a secondary screen?

use TART here, determine dysfunctional regions

What kind of reflex is seen when you have pain in L shoulder during an MI?

viscero-somatic reflex

What is the Piezoelectric Effect?

waves generated by crystals -> transmitter and receiver

What is a hypoechoic signal?

weak, looks darker, but not as structured as the anaechoic

What is a primary screen?

you look at general appearance

Describe depth:

zoom in when possible