OMM exam 3
Terms
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- Superior facets of the atlas face _
-
Backward, upward, medially
-concave - Occipital condyles match_
- facets of atlas
- Occipital condylar compression
-
-Important for newborns
-Affecting CN IX, X, XI
-Can be cause of poor suck, swallowing difficulties, emesis, hickups, congenital torticollis, and pyloric stenosis - OA joint motion is limited by _
- Muscular and ligamentous attachments
- Primary motion of OA joint
- Flexion/Extension
- How does occiput move with OA joint
-
Flexion - posterior translatory slide
Extension - anterior translatory slide - Lateral atlanto occipital ligament
-
Ligament of OA joint
-SB and rotation always in opposite directions - If occiput rotates on left axis, it slides _, SB _
-
Slides left
SB right - Atlanto axial joint motion is almost 100 % _
- Rotation
- Is there flexion in AA joint
- No
- Describe AA joints facets
-
-There are 4 facets
-All are convex
-"wobble" in flexion-extension
-no true lateral flexion (SB) - In AA joint somatic dysfunction occurs in _
- Rotation
- In AA joint movement is limited by _
- -Except in rotation it is limited by dens and transverse ligament of atlas
- Describe rotation of AA joint to right
-
-Left facet of AA joint slides up
-Right facet of AA joint slides down - Common place for somatic dysfunction in cervical region
- C2-C3 - sustains tremendous stress - between final compensator and rest of the spine
- Describe suboccipital articulation
-
AA joint + OA joint
Final compensator of the spine - keeps eyes level, promotes binocular vision - Describe IV discs of C3-C7
-
-Thickest of spinal discs
-Disk height: vertebral body ration - 2:5
-Wedge shaped - thicker anteriorly, maintains flexible cervical lordosis - Rotation and SB in C3-C7 are _
- in same direction
- C3-C7 facets form_
- palpable articular pillars
-
Superior facets in C3-C7 face _
inferior face _ -
Superior - backward - upward
Inferior - forward - downward - C3-C7 move least in
- Flexion/extension
- Flexion C3-C7
-
-Inferior facet must slide up 45 degrees
-Rotation is primary motion when flexed - Extension C3-C7
-
-Normal lordotic curve
-SB is primary motion when extended - There is no neutral position in C3-C7 - T/F
- True
- Describe joints of Luschka
-
-Unciform joints
-Maintain stability while allowing motion
-Synovial joints
-Adaptation for upright posture
-Lateral edges of cervical vertebral bodies
-Develop at age 8-10
-Guide rails for flexion/extension
-Limit lateral translatory motion - Describe lateral translatory motion
-
-Limited by unciform joints
-Occurs with coupled motions of rotation and SB
-Would be excessive to the point of sublaxation if not for joints of Luschka
-Dysfunction of translatory motion causes complicated somatic dysfunction called "side slip" - Describe cervicothoracic junction
-
C7-T1 - transitional segment
-Cervical traits in upper portion, thoracic traits in lower portions - Describe articular pillars
-
"Lateral masses"
-Area between cervical facet joints -
Anterior TP is the one that is _
Posterior _ -
less prominent
more prominent - Major motion of occiput
- Flexion/extension
- In occiput rotation and SB are to _
- Opposite sides
- Motion in C2-C7
-
Type II mechanics
Rotation and SB to same side - Osteopathy in Cranial Field
- A form of osteopathic diagnosis and manipulative treatment of cranium, sacrum and related structures
- Who discovered cranial osteopathy and named it primary respiratory mechanism
- William Sutherland
- D.O who used cranial OMM for treatment of cerebral palsy
- Beryl Arbuckle
- Contemporary D.O who has Osteopathic Children center in California and uses cranial therapy in treatment
- Viola Frymann
- Skull and facial bones are fused - T/F
- False, they are NOT fused
- Types of sutures
-
1. Serrate - sawtooth
2. Squamous- overlapping
3. Harmonic - edge-edge
4. Squamoserrate - combination - Examples of serrate sutures
-
Saggital
Lambdoidal - Example of squamous suture
- Squamoparietal
- Example of harmonic suture
-
Nasomaxillary
Intermaxillary - Example of squamoserrate suture
- Sphenosquamous
- Functions of CSF
-
-Protection - floats CNS, provides mechanical buffer system
-Regulation of extracellular environment of neurons
-Spreads neuroactive hormones and substances through nervous system - Describe sinus drainage techniques
-
-Frontal sinuses
-Supraorbital notches
-Maxillary sinuses
-Infraorbital notches
-Lateral nasal bones/cartilage - Muscles of mastication
-
-Temporalis
-Masseter
-Medial pterygoid
-Lateral pterygoid - Sphenobasilar synchondrosis is located between _
-
Occiput and sphenoid bone
-Fuses with age - Nasion
- Junction of nasal and frontal bones
- Pterion
- Sphenoid, parietal, temporal and frontal bones come together
- Pivot points
- Points where bevels change
- Bevels
- Where you change orientation of suture interiorly and exteriorly
- Reciprocal tension membrane
- Dura - falx cerebri, falx cerebelli - thick and non elastic, when you pull one part of it, it affects everything that is connected to it - cranial bones for example or cranial nerves
- Muscles of mastication are innervatedby _
- Motor part of trigeminal nerve
- How do you get dysfunction of TMJ
- Articular disc gets caught up in condyle, and you can have pain and deviation
- Alternative systems
-
"Osteopathy"
Naturopathic
Chiropractic
Homeopathy
Oriental Medicine
Ayurveda - Energy medicine
-
OMT
Acupuncture
Meridian regulation
Qi Gong
Reiki
Chakra - Movement therapies
-
Alexander technique - works with posture
Pilates - dancers
Yoga
Tai Chi
Watsu - water therapy, person floats in water while you unwind their fascial tissues
Dance therapy - Chelation therapy
- Pulling heavy metals out of system - these heavy metals can affect whole system - arterial plaques. Chelation is medically indicated if you have heavy metal toxicity - you can do blood and urine tests for this
- Founder of chiropractic medicine
- DD Palmer
- 3 main types of chiropractic care
-
-Straight - focus on spinal subluxation
-Mixers - delve into other treatments like nutrition or other types of physiotherapy
-Network chiropractic - network spinal analysis - coming unwound - How many naturopathic schools are there
- 4
- Founder of naturopathic schools
- Benedict Lust - emphasizes natural healing - nutrition, prevention, herbalism, manipulation, homeopathy
- 3 principles of naturopathic medicine
-
-Body is self healing
-Symptoms are sign that body is striving to eliminate toxins and return to homeostasis
-Holistic approach of mind body spirit - What is homeopathy
- Sugar pills that contain small amounts of homeopathic substances
- Law of similars
- Prescribing minute doses of substance causes similar symptoms of illness
- Law of cure
-
Remedies work from
-top to bottom
-inside to outside
-from major organs to minor organs
-symptoms clear in reverse order of appearance - How is homeopathy different from allopathy
- In homeopathy less concentrated a substance is, the greater effect it has on body, in allopathy increased dose has increased effect
- 5 elements of Ayurveda
-
Ether
Air
Fire
Water
Earth - Three principles tri dosha
-
Kapha
Pitta
Vata - Active range of motion tests _ while passive range of motion tests _
-
Active - tests muscular limitations of motion
Passive - tests ligamentous limitations of ranges of motion - Inversion and eversion of ankle occur at which joint
- Subtalar
- If you have inversion sprain, which ligament is damaged most often
- Anterior talofibular ligament
- Unhappy triad
-
Medial collateral ligament
ACL
Medial meniscus - Flexion of the knee
- 135 degrees
- Extension of knee
- 0 degrees
- Medial and lateral rotation of knee
- Passive 10 degrees in 90 degrees flexion
- When your foot is on the ground last 30 degrees of extension is accompanied by _
- Medial femoral rotation
- When your foot is off ground extension is accompanied by _
- Lateral tibial rotation
- Varus/valgus tests for knee check for _
- Stablity of medial and lateral collateral ligaments
- Drawer tests check _
- ACL/PCL tear
- Lachman test
- Same as drawer test bu in 25 degrees of flexion to take out quadriceps out of equation
- Positive recurvatum test means _
- Arcuate ligament, popliteus and fibular collateral ligament damage
- Positive McMurray test means _
- Meniscus tear
- Patellar grind test means_
-
-Chondromalacia of patella
-Palpable crepitation is positive - Positive Apley compression test means _
- Meniscal tear
- Positive Apley distraction test means _
- Ligamentous strain
- Plantar flexion of ankle ROM _
- 50
- Dorsi flexion of ankle ROM
- 20 degrees
- Anterior drawer test of ankle tests _
- Integrity of anterior talofibular ligament
- Varus test of ankle tests _
- Lateral (talofibular) ligament
- Valgus test of ankle tests_
- Deltoid ligament
- Flexion of neck ROM
- 60
- Extension of neck ROM
- 75
- Lateral flexion of neck ROM
- 45
- Rotation of neck ROM
- 80 degrees
- Main motion of occiput
- Flexion - extension
- Rotation and SB of occiput is to _
- opposite sides
- C2 C7 have what kind of motion
- type II mechanics - SB and rotation to the same side
- Right posterior occiput
-
-Translates better to the right
-Rotated right and SB left
-Right OA joint will not move anterior in extension
-Right OA has palpable tissue texture changes - Left anterior occiput
-
-Occiput is SB to left and rotated to right
-Left OA joint will not move posterior in flexion
-Left OA joint has palpable tissue texture changes - Occiput that is SB left and rotated right can be named _ or _
- Posterior right or anterior left
- Occiput that is SB right and rotated left can be named _ or _
- Posterior left or anterior right
- Describe C3 F SB and R to L
-
-Translation is free to right
-Translation right is equivalent to SB left
-Rotation is free to left
-TP is prominent of left
-Rotation and SB is free in flexion more then extension - Suboccipital-Thoracic connection
- Suboccipital symptoms almost always connected to upper thoracic and rib dysfunctions. First treat upper thoracic region and retest - suboccipital symptoms should reduce
- Cervical thoracic connection
- Chronic cervical dysfunction is usually associated with sacral dysfunction
- Benign cervical vertigo
- Cervical spasms cause temporal bone assymetry which causes vestibular vertigo
- Sequence of treatment of whiplash injury
- Thoracics - suboccipital - neck
- What innervates thumb
- C6 (can get cervical root compression and loose feeling in that finger)
- Osteophytes best seen on
- oblique cervical Xrays