OPP 2 PIAT Study Guide Written Exam 3: Osteopathic Concepts

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Questions and Answers

What is the primary consideration for performing OMT on a patient with a disease state?

The patient's age

The patient's stability (correct)

The patient's diagnosis

The patient's medical history

At which level can somatic dysfunction occur?

Only at parasympathetic levels

Only at sympathetic levels

At sympathetic, parasympathetic, and soma levels (correct)

Only at autonomic levels

Viscerosomatic reflexes occur at which levels?

At soma levels

At both sympathetic and parasympathetic levels (correct)

Only at parasympathetic levels

Only at sympathetic levels

What type of contraction is most commonly used in muscle energy?

Isometric contraction Signup and view all the answers

What term describes the perceived quality of motion at the restrictive barrier?

Feather's Edge Signup and view all the answers

What is an indication for HVLA?

A solid, distinct barrier Signup and view all the answers

Which of the following is responsible for 50% of the cervical spine's rotational motion?

AA (C1 on C2) Signup and view all the answers

What is the primary function of the sternocleidomastoid muscle in the neck?

To rotate and sidebend the neck in opposite directions Signup and view all the answers

What is the purpose of the Spurling test?

To assess for neural foraminal narrowing Signup and view all the answers

In which conditions should upper cervical direct manipulation be avoided?

Rheumatoid arthritis, Down Syndrome, and ligamentous instability Signup and view all the answers

What is the reference point for diagnosing somatic dysfunction in the axial spine?

The superior/anterior aspect of the vertebra Signup and view all the answers

What is the criteria for diagnosing somatic dysfunction?

Tissue Texture Changes, Asymmetry, Restriction of motion, and Tenderness (T.A.R.T.T.) Signup and view all the answers

Which osteopathic model emphasizes the anatomy of muscles, spine, and extremities, as well as posture and motion?

Biomechanical model Signup and view all the answers

What is the primary focus of the Neurological osteopathic model?

CNS, PNS, and ANS functions Signup and view all the answers

Which of the following is a characteristic of acute somatic dysfunction?

Sharp or severe localized pain Signup and view all the answers

What is the phrase that guides the palpation of somatic dysfunction?

Old is cold, hot is not Signup and view all the answers

Which osteopathic model focuses on the mental, emotional, social, and spiritual dimensions of health and disease?

Behavioral model Signup and view all the answers

What is the primary goal of OMT directed towards normalizing mechanical somatic dysfunction?

Normalizing mechanical somatic dysfunction, structural integrity, and physiological function Signup and view all the answers

What is characterized by normal or sluggish range of motion (ROM)?

Acute somatic dysfunction Signup and view all the answers

Which of the following is a characteristic of chronic somatic dysfunction?

Fibrotic, ropy feeling tissue Signup and view all the answers

What is a common bodily expression of Cylinder Distortions (CYD)?

Squeezing or rubbing with hands Signup and view all the answers

How would you describe the pain associated with Cylinder Distortions (CYD)?

Intermittent, with numbness and tingling Signup and view all the answers

What is a key aspect of Tectonic Fixations (TF) treatment?

Restoring the gliding quality of the affected tissue Signup and view all the answers

What is a potential side effect of FDM treatment?

Pain or discomfort during treatment Signup and view all the answers

What is a relative contraindication to FDM?

Pregnancy in the abdomen or pelvis Signup and view all the answers

Which of the following is NOT a characteristic of Cylinder Distortions (CYD)?

Looks and feels stiff Signup and view all the answers

What is unique about Tectonic Fixations (TF) compared to other distortions?

They may not have specific body language Signup and view all the answers

How does heat application affect Tectonic Fixations (TF)?

It may help, but only after movement Signup and view all the answers

What is the characteristic body language associated with Triggerbands?

Sweeping motion with the fingers Signup and view all the answers

What is the primary goal of Triggerband treatment?

To iron out twisted fascial bands Signup and view all the answers

What is a key word associated with Herniated Trigger Points?

Feels tight Signup and view all the answers

What is the primary focus of the treatment for Herniated Trigger Points?

Reducing protruding tissue below the fascial plane Signup and view all the answers

What is characteristic of Continuum Distortions?

Hurts in one spot Signup and view all the answers

What is the goal of treatment for Continuum Distortions?

Applying pressure to shifted continuum material Signup and view all the answers

What is characteristic of Folding Distortions?

Places hand over a joint Signup and view all the answers

What is important to note about the treatment of Folding Distortions?

It should be painless Signup and view all the answers

Study Notes

Osteopathic Concepts

For any disease state, the patient must be stable before performing OMT.
Gentler techniques (e.g., rib raising, BLT, MFR, soft tissue) should be used for sicker/weaker/more injured patients.
Somatic dysfunction can occur at sympathetics, parasympathetic, and soma levels.
Viscerosomatic reflexes occur at sympathetics and parasympathetic levels.
Facilitated segments only occur at sympathetics levels.

Important Concepts

Most commonly used form of contraction in muscle energy is isometric contraction.
Translation to the right = left side-bending, and translation to the left = right side-bending.
C3,4,5 keeps the diaphragm alive, and innervates the thoracoabdominal diaphragm.
Soft tissue techniques are diagnostic as well as therapeutic.
Feather's Edge refers to the perceived quality of motion at the restrictive barrier.
Indication for HVLA is a distinct, solid barrier, requiring a firm end-feel.
Sympathetic innervation to the head and neck is T1-T4.
Upper cervical area and sacrum are connected by dural connections.
AA (C1 on C2) accounts for 50% of the cervical spine's rotational motion.
OA (C0 on C1) accounts for 50% of the cervical spine's flexion/extension motion.
Spurling test assesses for neural foraminal narrowing.
Sternocleidomastoid muscle will rotate and side-bend the neck in opposite directions.
Occiptomastoid suture dysfunction can cause nausea and vomiting.
Avoid upper cervical direct manipulation (HVLA, articulatory, etc.) on upper cervical spine in rheumatoid arthritis, Down Syndrome, and ligamentous instability.

Somatic Dysfunction

Somatic dysfunction is an impaired or altered function of related components of the somatic system.
Diagnosed by T.A.R.T.T: Tissue Texture Changes, Asymmetry, Restriction of motion, Tenderness.
Always named for the way it likes to go.
In axial spine, the reference point is the superior/anterior aspect of the vertebra.
Not all somatic lesions are somatic dysfunctions; fractures, sprains, degenerative processes, and inflammatory processes are not somatic dysfunctions.

Osteopathic Models

Biomechanical (structural, postural): focuses on anatomy, posture, motion, and normalizing mechanical somatic dysfunction.
Neurological: emphasizes CNS, PNS, and ANS that control, coordinate, and integrate body functions.
Respiratory/circulatory: emphasizes pulmonary, circulatory, and fluid systems.
Metabolic/Nutritional: regulates through metabolic processes.
Behavioral (psychobehavioral): focuses on mental, emotional, social, and spiritual dimensions related to health and disease.

Palpating Somatic Dysfunction

Acute: recent history, sharp/severe pain, warm/moist skin, boggy tissue, erythematous, increased muscle tone, normal/sluggish ROM.
Chronic: long-standing, dull/achy pain, cool/smooth skin, atrophy, fibrotic tissue, decreased muscle tone, restricted ROM.

Triggerbands (TB)

Body language: sweeping motion with fingers.
Verbal description: burning, pulling, tethering, restricted motion, tightness.
Key words: "pulls", "heard it snap".
Treatment: recognize body language, find discrete starting and ending points, use thumb tip to "iron out" twisted fascial band, treat the entire pathway.

Herniated Trigger Points (HTP)

Body language: pushes with fingers or fist into non-jointed area.
Verbal description: aching or tightness in soft tissue.
Key words: "feels tight", "stiff", or "pinches".
Treatment: observe patient gesture, palpate HTP, verify most tender area, reduce protruding tissue below fascial plane, palpate for firm residual edges.

Continuum Distortions (CD)

Body language: points to one or more spots of pain.
Verbal description: hurts in one spot.
Key word: "just that one spot".
Treatment: reduction of shifted continuum material by application of pressure from the tip of thumb.

Folding Distortions (FD)

Body language: places hand over a joint; cupping area.
Verbal description: aches deep in the joint, feels unstable.
Key words: "unstable", "changes with the weather".
Treatment: recreates the mechanism of injury, should be painless.

Cylinder Distortions (CYD)

Body language: squeezes or rubs with hands.
Verbal description: pain that wakes me up, comes and goes, numbness, tingling, paresthesias.
Key words: "weakness", "feels numb", "weird", "spaghetti legs".
Treatment: recognizes body language, verbal description, and treats separate coils via manual techniques and/or assistive devices.

Tectonic Fixations (TF)

Body language: difficulty moving joint, looks and feels stiff.
Verbal description: feels like it's stuck, feels like it needs to pop.
Key words: "stiff", "tight", "in joints".
Treatment: recognizes may not have specific body language, restores the gliding quality of the affected tissue, may help with heat application.

Side Effects of Treatment

Pain/discomfort during treatment.
Erythema of the skin.
Bruising.
Hemorrhagic petechiae.
Rebound tenderness.

Relative Contraindications to FDM

Poor doctor/patient rapport.
Bleeding disorders.
Open wounds.
Skin infections.
Previous stroke.
Pregnancy (abdomen or pelvis treatment).
Vascular diseases.
Arteriosclerosis.
Collagen vascular disease.
Aneurysms.
Edema.
Phlebitis.

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Description

This study guide covers osteopathic concepts, including patient stability, gentle techniques for somatic dysfunction, and viscerosomatic reflexes. Prepare for the Written Exam 3 of OPP 2 PIAT.