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OS III Exam 1

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Section 1

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Focused OMT for late stage (1-3 weeks) of post-op

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7 years ago

Date created

Mar 1, 2020

Cards (36)

Section 1

(36 cards)

Focused OMT for late stage (1-3 weeks) of post-op

Front

Treat fascia/tissues, SD, and viscero-somatic reflexes for residual pain - At this stage OMT enhances analgesia, reduces complications, aids recovery, and may decrease hospital length of stay

Back

Tx of renal failure

Front

Tx underlying cause (may include OMT) Tx complications that come until pt recovers - iv fluids - meds to control K+ - meds to restore blood Ca++ - dialysis

Back

Symptoms of Kidney stones

Front

Severe colicky flank pain with radiation into the groin

Back

Tx of interstitial cystitis painful bladder syndrome

Front

Nothing definitive NSAIDS, antidepressants, antihistamines, elmiron, OMT,

Back

Steps of lymphatic tx

Front

1. OMT to thoracic inlet and diaphragms to diminish lymphatic congestion 2. Localized, end-organ targeted lymphatic techniques 3. Lymphatic pump techniques Goals Improve O2/nutritions & reduce risk of infection, healing time, fibrosis and scarring

Back

Goals of OMT of a hospitalized pt

Front

- Promote homeostasis & pt's ability to cope with disease process - Sleep, ambulation, eating, defecation, pain relief - Treat dysfunction that impede homeostatic processes instead of long-standing and unrelated problems since it takes pt energy to incorporate changes

Back

Signs & Symptoms of interstitial cystitis painful bladder syndrome

Front

- Pain in pelvis or between vagina/anus in women - Pain between scrotum & anus in men - Chronic pelvic pain - Persistent and urgent need to urinate - Frequent urination in small amounts - Pain or discomfort while bladder fills that is relieved upon urination - Pain with sex More common in women

Back

Contraindications of OMT on surgical pts

Front

- Direct manipulation over surgical site - Ab. plexus inhibition if midline abdominal incision or aortic aneurysm - Sigmoid release if left hemicolectomy - Mesenteric release if anterior abdominal incisions - Rib raising if fracture or recent spine surgery - pedal pump if DVT, LE fractures, or recent abdominal surgery - Lymph tx if osseous fx, bacterial infectiosn with large fever, local infection, some cancers -

Back

How does the kidney change with age?

Front

- Decreased GFR - Number of nephrons is reduced - Creatinine Clearance declines - This inhibits the ability to clear drugs leading to more likelihood of drug toxicity

Back

Tx for cystitis

Front

Abx therapy Increased fluid intake OMT as tolerated can progress to pyelonephritis if not treated

Back

Tx approaches for hospitalized pts

Front

1. pt is evaluated and OSE findings interpreted in relation to principle and understanding of the pt's disease process 2. Tx plan is developed to address the dysfunction in such a way as to improve the function of the pt's underlying physiology 3. Choice of technique is based on the effect desired and the condition of the pt

Back

Types of incontinence

Front

- Stress incontinence - Urge (sudden urge then involuntary loss of urine) - Overflow (dribbling from bladder not emptying fully) - Functional (physical or mental impairment) - Mixed

Back

Dx of interstitial cystitis painful bladder syndrome

Front

- bladder diary, pelvic exam, UA w/ cytology, cytoscopy with biopsy, K+ sensitivity test

Back

symptoms of cystitis

Front

Dysuria, hematuria, frequency, urgency, fever, lower Ab pain

Back

Issues with OMT in hospitalized pts

Front

- Privacy - Modesty - Turn off TV - Objects in the way - Surgical incisions and dressings - Decubitus ulcers

Back

Order of tx for a hospitalized pt

Front

1. Tx facilitated areas first - Neurons in facilitated segments have decreased AP and fire of easily - Frequent tx is needed due to facilitated segments being messed up due to the acute visceral process

Back

What OMT aspects should you assess to give you clues toward a differential diagnosis?

Front

Viscero-somatic reflexes Somato-somatic reflexes Jones tender points Trigger points Chapman reflexes

Back

Causes of incontinence

Front

- Temporary from substances that stimulate bladder or increase urine volume like alcohol or heart meds - Persistent due to physical problem (prego, cancer, neuro issues)

Back

What is Nephrolithiasis

Front

Kidney stones one of the most common disorders of the GUT

Back

Focused OMT for diuresis stage (4-6 days) of post-op

Front

Focus on lymphatic, GI, renal, and ANS systems

Back

What are the components of a pre-op structural exam?

Front

-biomechanics --> cervical-thoracic-lumbar-sacrum spinal assessment - respiratory/circulatory --> lymphatic assessment, cranial assessment, rib motion - neurologic --> somato-visceral & viscero-somatic considerations, TP counterstain exam, chapman's reflexes

Back

Dx of kidney stones

Front

- UA looking for blood, crystals, or signs of infection - Use CT w/o contrast - Pee through strainer to collect and analyze stones stones are usually calcium oxalate or calcium phosphate

Back

Which nerve is responsible for referred pain to the groin in a pt with kidney stones?

Front

Genitofemoral

Back

Indication for OMT approach to Tx

Front

SD either primary or secondary to viscerosomatic reflex related to disease

Back

Tx of kidney stones

Front

Aggressive Hydration & dietary modification - Minimal 2 L water/day - Avoid strictly vegetarian diets - Avoid excessive animal protein, salt, vitamin C/D, or soft drink consumption - Consume phytate rich foods such as bran, legumes, beans, and wild rice

Back

Contraindications for OMT approach to Tx

Front

- Pt unable to tolerate OMT secondary to pain or positioning - If it delays more definitive care

Back

Why should post-op OMT be performed?

Front

- Shortens hospital stay - Decrease morbidity and mortality - Decrease pain - Facilitate lymph flow and improve diaphragmatic mobility - Increase pt satisfaction

Back

OMT considerations for pre-op evaluation

Front

- Concerns about airway with anesthesia (optimize C-spine) - OMT to reduce mid-cervical SD (c3-5) to help decrease post-op pulmonary complications (diaphragm) - Presence of SD before surgery may be a complication factor

Back

Focused OMT for inflammatory stage (1-3 days) of post-op

Front

Systemic approach. - facilitate lymph flow, improve mobility, and restore biodynamic vitality

Back

Causes of renal failure

Front

- Impaired blood flow ( blood loss, dehydration, obstruction, infection) - Damage to kidneys (clots, infection, toxins) - Urine blockage in the kidneys (cancer, nerve damage, stones)

Back

Dx of incontinence

Front

- UA - Bladder diary - Post-void residual (using cath to measure amount of urine left in bladder after voiding)

Back

Ex of renal failure

Front

Urine output measurements, UA, BUN/CR, Imaging, and biopsy

Back

Population at highest risk for cystitis

Front

-Sexually active women - Infants - Pregnant women - elderly - Catheter patients

Back

Tx of incontinence

Front

- Behavioral (bladder training) - Pelvic floor exercises - Electrical stimulation - Medications - Medical devices - Interventional therapies (botox) - Surgery -OMT

Back

S & S of renal failure

Front

- Decrease urine output - Fluid retention - SOB - Fatigue - Confusion - Nausea - Weakness - Irregular hearbeat - Chest pain - Seizures

Back

Tests to dx cystitis

Front

Midstream UA, Lloyd's punch, unexplained blood in urine is cancer until proven otherwise

Back