Section 1
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When did AT Still flung the banner of osteopathy to the breeze?
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Section 1
(50 cards)
When did AT Still flung the banner of osteopathy to the breeze?
June 22, 1874 @ 10AM
When did the American school of Osteopathy open?
1892
Chronic Somatic Dysfunction
Impairment or altered function of related components of the somatic system
How are somatic dysfunctions named?
position of ease
Diagnostic Criteria for Somatic Dysfunction
TART T - Tissue texture Abnormalities A - Asymmetry of structure or motion R - Restriction of motion T - Tenderness
father of antiseptic surgery
Joseph Lister
Osteopathic Manipulative Treatment (OMT)
The therapeutic application of manually guided forces by an osteopathic physician to improve physiologic function and/or support homeostasis that has been altered by somatic dysfunction.
OMT adverse reactions
Soreness similar to workout or massage soreness and other symptoms of acute illness Could exacerbate current complaint
What do DOs treat?
The whole patient
First to use sterile rubber gloves in surgery in 1890
William Halstead
Homeostasis
The level of well-being of an individual maintained by internal physiologic harmony that is the result of a relatively stable state or equilibrium among the interdependent body functions
OMT precautions
Cancer Frailty due to severity of disease Youth Elderly
DOs in the Military
- 1941 DOs can't serve, # of DOs increase in hospitals due to MDs getting deployed - 1957 DOs able to serve in civil service - 1963 DOs seen as equal as MDs Harry J Walter was first commissioned DO into armed forces
Acute Somatic Dysfunction
immediate or short term impairment or altered function of related components of the somatic system
Anatomic Barrier
the limit of motion imposed by anatomic structure
Role of OMT in 5 models
Biomechanical - myofascial & joint functional optimization Neurological - remove neurologic imbalances, address nociception Respiratory/circulatory - maximize function Metabolic - structure and function are reciprocally related Behavioral - More of a cause than an effect; how we spend our time effects the first 4
Tissue texture abnormality
A palpable change in tissues from skin to periarticular structures that represents any combination of the following signs: vasodilation, edema, flaccidity, hypertonicity, contracture, fibrosis, as well as the following symptoms: itching, pain, tenderness, paresthesias. Types of TTA's include: bogginess, thickening, stringiness, ropiness, firmness (hardening), increased/decreased temperature, and increased/decreased moisture.
OMT recommendations
Rest (1-4 days) Hydration (1-2 liters per day)
Restriction of motion
A resistance or impediment to movement
Direct OMT technique
Method of action engage the restrictive barrier directly
Physiologic Barrier
limit of active motion
Tenderness
Discomfort or pain elicited by an osteopath through palpation
What is acute Somatic Dysfunction characterized by?
Vasodilation Edema Tenderness Pain Tissue contraction
Jeanette Bolles
first woman to receive the DO degree
Abraham (Adam) Flexner
Traveled to all medical schools in the US in 1910 Authored a report on state medial education Wrote harsh criticism of both MD and DO schools 8 DO schools left after report State licensing boards began enforcing stricter requirements
Elastic Barrier
the range between the physiologic and anatomic barrier of motion in which passive ligamentous stretching occurs before tissue disruption; Limit of PROM Ex) the area that "warms up" with stretching
4 Tenets of Osteopathic Medicine
1. The mind, body, and spirit are a unit. 2. The body is capable of self-regulation, self-healing, and health maintenance 3. Structure and function are reciprocally interrelated 4. Rational treatment is based upon understand & implementing the other 3 tenets
acute TART changes
TTA - red, swollen, boggy, increased tone Asymmetry - present Restriction - present, painful with motion Tenderness - Sharp pain
Used epidemiology to prove cholera came from contaminated water in bristol
William Budd
Louisa Burns
Had spinal meningitis --> treated it with osteopathy
barrier end-feel characteristics
the palpatory experience or perceived quality of motion when a joint is moved to its limit
California Incident of 1961
• prohibited the granting of new licenses to DOs in the state. • DOs who agreed to the change were able to obtain an MD degree by attending 12 Saturday classes and paying $65 • 85% of practicing DO's traded in their DO degrees for MD degrees This was abolished after a year
Somatic Dysfunction
impaired or altered function of related components of the somatic system
OMT indications
Somatic dysfunction/visceral dysfunction
Asymmetry
Absence of symmetry of position or motion Determined by vision or palpation
chronic TART changes
TTA - dry, cool, ropy, pale, decreased tone Asymmetry - present, compensation occurs Restriction - present, maybe not. guarded or empty Tenderness - Dull, achy pain
AROM
Active range of motion Pt. motivated & patient's movements
PROM
Passive range of motion Pt. must relax fully & SD must block linkage Better than AROM because muscles are relaxed
Professors of the first American school of Osteopathy
AT Still & William Smith First class consisted of 5 of Still's children
When was KCU established?
1916
"Block the linkage"
Stabilization of associated and adjacent structures to focus movement to only the joint being assessed
When was AT Still born?
August 6, 1828
Used epidemiology to trace source of cholera outbreak in london
John Snow
OMT contraindications
Some are technique specific General = Cancer, RA, fractures, severe frailty
Indirect OMT technique
Method of action involving positioning away from the restrictive barrier
Decreased mortality through handwashing
Ingaz Semmelweiss
Restrictive Barrier
a functional limit that abnormally diminishes the normal physiologic range
Influenza Pandemic
1917-1918 killed a bunch of people osteopathic patients survived more often
What is chronic somatic dysfunction characterized by?
Tenderness Itching Fibrosis Paresthesias Tissue contraction
What year did AT Still die?
1917
Section 2
(50 cards)
Barbara Ross-Lee
First Female Dean of a medical college
Oculocephalogyric reflex
eye movements affect cervical and truncal musculature as body attempts to follow -- do very gentle force
Indirect Technique
Go to area of ease
Meningeal fascia
surrounds the nervous system and includes the dura
Evaluating motion
Direction, Range, and quality Direction -> extension, flexion, etc. Range--> degrees Quality --> smooth, catching, restricted
Crossed extensor reflex
When the flexor muscle in one extremity is contracted voluntarily, the flexor muscle in the contralateral extremity relaxes and the extensor contracts - for areas that are too damaged to be directly touched - contralateral
Newton's Third Law
When two bodies interact, the force exerted by one is equal in magnitude and opposite in direction to the forces exerted by the other
soft tissue technique
A system of diagnosis and treatment directed toward tissues other than skeletal or arthrodial elements - force is applied gently and in a Rhythmic fashion
Coupled motion
The association of one motion about an axis with another motion around a different axis
Respiratory assistance
The physician applies a fulcrum against which the patient's voluntary respiratory forces can work
MFR contraindications
Absolute: Lack of Pt consent, absence of somatic dysfunction Relative: infection, fracture, metastatic disease, soft tissue injury, post op pt, rheumatologic condition involving instability of cervical spine, blood thinners
Directive techniques
Go towards & eventually through restrictive barrier
Hysteresis
Difference between the loading and unloading characteristics represents energy that is lost in the connective tissue system - stretching brings length to the tissues
MET problems - PT
- Contract too hard - contract in the wrong direction - sustain the contraction for too short a time - do not relax appropriately following contraction
First and last states to license DOs
First --> Vermont Last --> Mississippi
Types of joints
fibrous, cartilaginous, synovial
Isokinetic strengthening
-Establish normal tone and str in a muscle weakened by hypertonicity of opposing muscle group -with asymmetry of ROM, might be asymmetry in muscle strength. -Treat shortening of antagonist muscle-->agonists spontaneously increase str if shortened muscles lengthened first
fascia
A complete system with blood supply, fluid drainage, and innervations - composed of irregularly arranged fibrous elements - NOT tendons, ligaments, aponeuroses - It is Omnipresent, omnipotent, omniscient
Endomorph
Round and heavy body type -> endoderm derived
Isolytic lengthening
-Lengthen muscle shortened by contracture -vibration used here has effect on myotatic units in addition to mechanical and circulatory
INR
Integrated Neuromusculoskeletal Release - combines procedures that are designed to stretch and reflexively release patterned soft tissue and joint related restrictions - Includes breath holding, engaging muscles, etc.
eccentric isotonic contraction
Contraction of a muscle with separation of the origin & insertion (muscle lengthens)
Hooke's Law
The law stating that the stress of a solid is directly proportional to the strain applied to it.
myofascial release
engages continual palpatory feedback to achieve release of myofascial tissue
Plumb Line
- External Auditory Canal - Acromion Process - Greater Trochanter - Anterior medial Malleolus
Axial & appendicular fascia
Internal to pannicular layer - fused to panniculus and surrounds all muscles
Pannicular Fascia
-Loose and dense irregular connective tissue. -Variable fat content - outermost fascia
Linkage
relationship of joint mechanics surrounding structures - Block linkage to get a direct look at certain joint
Isometric contraction
Contraction in muscle with no change in distance between origin and insertion
soft tissue contraindications
- Relative: Severe Osteoporosis & acute injuries - Absolute: fracture, dislocation, neurologic entrapment syndromes, vascular compromise, local malignancy, local infection, bleeding disorder
concentric isotonic contraction
Contraction of a muscle with approximation of origin & insertion (muscle shortens)
Wolff's Law
A bone grows or remodels in response to forces or demands placed upon it
Creep
Connective tissue under a sustained, constant load (below failure threshold), will elongate (deform) in response to load
Soft Tissue Indications
Stretch, improve tissue nutrition, gain symmetry, improve immune response, improve circulation
Marcelino Oliva
• Cuban born • Graduate of KCU!! • President of Florida Osteopathic Medical association 1971-1975 • First minority AOA president in 1988-1989
Isolytic contraction
attempted concentric contraction with external force causing separation of origin and insertion
Stress vs. Strain
Stress = force that attempts to deform a connective tissue structure Strain = % of deformation of connective tissue
Isometric v Isotonic
Isometric = light/moderate contraction, unyielding counterforce Isotonic = hard/maximal contraction, counterforce permits controlled motion
Types of soft tissue
Fascia, muscles, organs, nerves, vasculature, lymphatic
visceral fascia
Surrounds the body cavities (pleural, pericardial & peritoneum)
MET contraindications
- Local fracture - Local dislocation - moderate to severe segmental instability in the cervical spine - evocation of neurological symptoms or signs on rotation of the neck - low vitality - post surgery - unable/unwilling to follow verbal cues
ART contraindications
- avoid combination of rotation and extension in the cervical spine - local fracture/dislocation - neurologic entrapment syndromes - serious vascular compromise - local malignancy - local infection - bleeding disorders
Ectomorph
tall and skinny --> Ectoderm derived
Mesomorph
the "average" body build --> mesoderm derived
Mamie Johnston
First female graduate from KCU, retired in 1981 as professor here
MET problems - DR
- not controlling joint position in relation to the barrier movement - not providing the counterforce in the correct direction - not giving accurate instructions - Moving to a new joint position to soon after the patient stops contracting
Viscoelastic material
Any material that deforms according to rate of loading and deformity
William G. Anderson
• Associate dean KCOM (now AT Still University) • Big in the Civil Rights Movement • AOA president 1994-1995 • AOA board of trustees for 20 years
Sherrington's Law
When a muscle receives a nerve impulse to contract, its antagonists, receives, simultaneously, an impulse to relax
reciprocal inhibition
when a gentle contraction is initiated in the agonist muscle, there is a reflex relaxation of that muscle's antagonistic group - ipsilateral
Section 3
(16 cards)