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
