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OS Exam 1

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what axis do midline bones move in a sagittal plane vs paired bones?

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6 years ago

Date created

Mar 14, 2020

Cards (37)

Section 1

(37 cards)

what axis do midline bones move in a sagittal plane vs paired bones?

Front

-transverse axis (flexion/extension) in sagittal plane; paired moves in AP axis (abd/add) in coronal plane

Back

Head pain: -what innervates the anterior 2/3 and posterior 1/3? -whats most likely associated with tension headache? -what are proposed mechanisms for tension headaches? -describe the history of tension headaches? -whats the difference in episodic vs chronic tension headache?

Front

-anterior 2/3=Trigeminal nerve; posterior 1/3=lesser occipital (C1-3), recurrent branches of CN IX,X; sympathetics T1-T4 -anxiety/depression -myofascial trigger points in head, neck, shoulder-->spinal trigeminal nucleus-->head; peripheral pain=episodic; chronic= central pain mechanisms -banding/bilateral pain of mod intensity -episodic= ≤30 min for up to 7 days; chronic= ≥15 days/month for ≥3 months

Back

-who developed cranial technique -5 components of the PRM -what contributes to mobility of cranial bones? -what is the Traube Hering Wave? -how did aMRI research contribute to this finding?

Front

-William Sutherland -CSF: mobility of brain and SC, fluctuation of CSF, mobility of intracranial & intraspinal membrane, articulation of cranial bones, involuntary sacrum/ilia -motility from contractile glial cells -glial cels-->change blood flow velocity/neurovascular coupling (measurable by laser doppler) -Chiari malformation-->physiological variation of brain

Back

-what is the CRI -rate? -rhythm? -amplitude? -strength? -direction?

Front

-palpable motion independent of respiration (still feel when holding breath), but influenced by respiratory/circulatory -10-14 cycles/min -"like the tide of the ocean" -related to vitality -longitudinal and symmetric

Back

-describe the movement of the ethmoid in flexion? -what occurs at ethmoid during headache?

Front

-follows occiput-->posterior (Christa Galli goes superior posterior) -lymphatic backup at christi galli-->increased dural tension (migraine) or vascular effects

Back

what could be a cause of chronic TMD? -cause of chovestk sign? -carpopedal spasm

Front

-Mood disorders-anxiety, depression, PTSD, abuse -hypocalcemia-->hypereflexia; -hypocalcemia-->flexion of wrist/adduction of thumb-->palm

Back

-most common signs/sx with TM pain? -what is nocturnal bruxism? -reason for click of TM? -what could cause a posterior capsule injury?

Front

-pain, ear discomfort-->TM discomfort -teeth grinding while sleeping- those who grind have less pain -disc displacement s/p disc thinned/stretched -direct blow with closed mouth-->posterior capsule

Back

what levels associated with lungs? -heart? -parts of SI/colon -Kid/ureters/bladder?

Front

T2-4 T1-5 -SI= T9/10; ascending/transverse=T11-L1; Descending/sigmoid-L1-L2/S2-->S4 -kidney=T10/11; Ureters=T11-->L2; Bladder=T10/11/S2-->S4

Back

-what is the goal for opening the jaw? -what confers a poorer prognosis in TMJD?

Front

-fit index and middle finger between teeth -psychiatric dysfunction

Back

where is the SMG and what does it do? -where is the celiac and what does it do? -where is the IFG and what does it do?

Front

-smg= midway between xiphoid and umbilicus-distal duodenum, part of pancreas, SI, and --> proximal 2/3 colon -celiac= between SMG and xiphoid- esophagus-->part of pancreas -IFG- between SMG and umbilicus= distal 1/3 transverse colon-->rectum

Back

what type of injury affects the squamous portion of the temporal bone? petrous portion -whats unique about a newborn's temporal bone? -what causes a high pitch tinnitus? low pitch tinnitus? -what moves during flexion SD? -what clinical signs would be seen?

Front

-zygomatic (facial injury); otovestibular damage -lacks mastoid process -high pitch=internal rotation (Extension SD); low pitch=external rotation (flexion SD) -ext rotation--> squamous portion lateral and mastoid moves medial -TMJ pain, dizzinesss, ear infection, swallowing

Back

-what muscle for blowing? -what muscle for pouting? -draw tip of chin upwards? -protrude upper lip? -snarl? -smile? -grimace? -wrinkle forehead/raise eyebrows?

Front

-buccinator -depressor labii inferior -mentalis -zygomatic minor -levator anguli oris -zygomaticus major -risorius -frontal belly of occiptofrontalis

Back

what are the specific CN functions in PNS (cranio-sacral)? -where is vascular symp/psns at? whats different in visceral? -describe allostatic load?

Front

CN3=eye; CN7- lacrimal, palatine, and submandibular; CN9= parotid; CNX- CV/GI; Sacral=colon, rectum, GU -vascular= only SNS in extremities; PSNS visceral same as PSNS EXCEPT also viscera of head/neck -chronic stress-->atrophy of hippocampus

Back

-what is the typical general motion of midline vs paired bones?

Front

midline= Anterior/posterior (transverse axis/sagittal plane); paired=AP (vertical) axis/lateral motion/coronal plane

Back

describe the SBS?

Front

-joint of basisphenoid and basiocciput- synchondrosis

Back

what are the 5 models in tension headache?

Front

-behavioral=Exercise rx neurological= counterstain points in cervicals/upper thoracics/ribs/UE CV=lymphatics first to reduce irritants from inflammation biomechanical=cranial, MET, HVLA, FPR

Back

whats OMT to decrease sympathetic tone? -OMT to normalize PSNS tone?

Front

rib raising, paraspinal inhibition, cervical ganglion inhibition, abdominal collateral ganglion technique, Type 2 SD tx -sub occipital inhibition, sphenopalatine ganglion release, sacral rock, SI gapping, BLT, gentle ME

Back

-why is there higher frequency in otitis media in infants? -where does the Eustachian tube lie? -where is a blockage most likely to occur -what cranial technique could promote drainage? -what bones is various parts of CNV carried in? trigeminal ganglion? -how would pressure be applied on the trigeminal ganglion?

Front

-shorter tube -groove of petrous temporal bone and greater wing of sphenoid between the foramen spinous and carotid canal -the narrowest portion-cranial base where sphenoid and temporal bones meet -temporal rocking -sphenoidal foramen: V1, C3,4,6-->Superior orbital fissure; V2- Foramen rotundum; V3=Foramen ovale; trigeminal ganglion lies in the temporal bone -because tentorium cerebra is attached to petrosal ridge; external rotation SD of temporal bone (4th/5th fingers superomedial)-->medial pressure on dura and strx deep; this also causes bells palsy due to ganglion pressure

Back

when to use radiographs in TMJD? -best radiograph?

Front

-not useful; if dental problems (periapical radiographs), pain with severe sx that don't improve with minor tx; concern for alternative cause -MRI

Back

whats significant about the sagittal sulcus and transverse sinus of the internal parietal bone? -where does the parietal bone move in flexion? -what clinical features might show this SD? -what headache is implicated?

Front

-sagittal=groove of MMA; transverse=marginal insertion of tentorium cerebelli -external rotation-->"DeLorean wings"- inferiorly (temporal articulation) moves laterally; superiorly (Sagittal articulation) moves inferiorly); pterion/asterion-laterally; -cranial syntosis- premature closure of suture; sagittal syntosis-->most common-->increase transverse (long head); lambdoid syntosis-->wide head -tension headache-->OM and asterion; pterion in temporal headaches

Back

what is a likely risk factor for migraines? -what history is associated with migraines? -what is the mechanism of migraine with aura and without aura? -what are intracranial pain-sensitive structures?

Front

-analgesic overuse (daily for ≥1 month) and MS -POUND= pulsating, 4-72 hours, unilateral, N/V, disabling -with aura=spreading oligemia= reduced blood volume in brain without aura= uncertain= -meninges at base of brain and intracranial blood vessels

Back

describe the ST, MT, and IT axes of motion on sacrum -what is the interaction between intracranial hemodynamics and CSF circulation?

Front

ST-->respiratory motion; posterior attachment of dura at S2; flexion/inhalation-->base tips post; extension/exhalation-->base anteriorly MT-->postural axis; nutation/counternuation at anterior of S2 IT-->ilial axis; at S3 -intracranial motion related to blood supply and O2 consumption of cerebral tissue-->influence but not dependent

Back

whats the pathophys of viscerosomatic reflex? -what is percutaneous reflex of Morely? -describe the sympathetic pathway in GI: -Describe the PSNS pathway in GI:

Front

increased stretch/irritation of GI nerves-->increased afferent signals to CNS-->afferent fibers synapse in dorsal horn of spinal cord; prolonged afferent activity leads to FACILITATION of neurons and corresponding spinal segments -not visceral afferent reflex; direct transfer of inflammation from viscera-->peritoneum -thoracic splanchnic nerve-->celiac (T5-9) & SMG (T10/11); lumbar splanchnic nerve-->IMG (T12-L2) -Vagus= upper and lower 1/2 GI- right vagus=lesser curvature of stomach, liver/gb, SI, right colon-->mid transverse; L vagus=greater curvature of stomach, and ends at duodenum lower 1/2 GI= pelvic splanchnic

Back

what exits the superior orbital fissure? -foramen rotundum? -foramen ovale? -foreman spinosum? -jugular foramen?

Front

-3, 4, 6, V1 -maxillary n, V2 -mandibular nerve, lesser petrosal n, v3 -mma -IX, X, XI

Back

what classes are the overbites and underbite?

Front

-Class 2a- overbite (lower first molar to upper mandible retrusion); Class 2b severe overbite; class 3= underbite (lower first molar to upper mandible protrusion)

Back

-risk factors for TMJD? -what are you looking for in palpation? -when to suspect TMJD based on PE (8)

Front

-neck trauma, female hormones, bruxism and clenching, psychological abnormalities; NOT genetics or orthodontics more likely with RA -crepitans/clicks -abnormal mandibular movements, decreased ROM of TMJ (<25 mm + pain), muscle tenderness, pain upon dynamic loading, bruxism, postural asymmetry, neck/shoulder tenderness, normal CN evaluation

Back

describe the anatomy of the TM joint? -describe motions of digastric/suprahyoid? -motions of left lateral and medial pterygoids? -motions of temporals, masseter, and medial pterygoid?

Front

-gliding joint separated by meniscus and 3 bands (thick anterior, thin intermediate, and thick posterior) -depress mandible; pterygoids depress jaw -move mandible lateral and forward on the RIGHT -close jaw

Back

-what is the Sutherland fulcrum? -what is reciprocal tension membrane? -what are the RTM poles of attachment? -describe the motion of the Sutherland fulcrum

Front

-location of straight sinus- at the junction of falx cerebri and tentorium cerebelli -meninges between cranium and sacrum "core link"; under constant tension but vault allows/limits motion -anterior (Christa gali), anterior inferior (clinoid of sphenoid), lateral (mastoid angles and petrous temporal), posterior (internal occipital protuberance and transverse ridges) -moves with CRI (but attached), and shifts straight sinus up and down

Back

describe the palatine bone in flexion/extension? -what is the clinical correlation?

Front

-flexion-->palate flattens (lateral/inferior); extension=palate rises (medial/superior) -difficulty swallowing vomer depresses palatine bones in flexion

Back

whats the difference between anterior/posterior Chapmans points? -wheres the esophagus? -pylorus (GERD)? -liver? -stomach acidity? -stomach? -GB? -pancreas? -spleen? -SI? -cecum? -sigmoid colon?

Front

anterior= diagnostic; posterior= treat -2nd ICS/ b/l -sternum -L 5 ICS -L 5TH ICS -L 6th ICS -R 6th ICS -R 7th ICS -L 7th ICS -B/L 8-10 ICS -right outer IT -L outer IT

Back

whats the difference between a C shape and S shape TMJD? -what does diminished lateral deviation on the right tell you?

Front

C shape= jaw moves away from hypertonic pterygoids and towards hypertonic masseter/temporalis; S shape= bilateral imbalance -right pterygoid is hypertonic

Back

describe level 1, 2, 3 TMJD tx?

Front

1= CBT- for psychosocial causes for pain/depression at 1 year -2- oral habit reversal, botox, Benzes, exercise -3= OMT, surgery, occlusive splints (mouthguard), steroid injection

Back

describe the motion of internal/external rotation of the frontal bone? -when does the sphenoid move the frontal bone? -what is the clinical significance (mechanical/clinical) -describe bicoronal syntosis? -unicoronal syntosis?

Front

-internal rotation: lateral process posterior; labella anterior; external rotation: lateral moves anterior/glabella posterior -during external rotation -coronal-tension HA; pterion- temporal HA; sinusitis, visual problems -premature fusion of both coronal sutures (L/R of sagittal)-->square front head (short and wide); compensatory vertical growth=turricephaly -premature fusion of one coronal suture-->anterior plagiocephaly ("c shaped appearance"- tip of nose points away from affected side)

Back

where does GI lymphatics drain?

Front

-cisterna chyli (right of abdominal aorta)-->thoracic duct-->subclavia

Back

where is the colon Chapmans points posteriorly -where does doc stand when treating colon Chapmans points and colon release? -what thoracic level is the duodenum? -what level is the liver? -describe liver pump WITH recoil activation?

Front

L2-L4 in a triangle reaching to crest of ilium -contralateral -T9-->greater splanchnic-->celiac ganglion -T7-9-->greater splanchnic-->celiac ganglion -evaluate in flex/ext/sidebending-->stack in DIRECT manner-->have patient take a few deep breaths-->release compression during one of the early inhalation

Back

what is a cervicogenic headache? -what is C2 neuralgia? -what is neck/tongue syndrome?

Front

-disorder of cervical spine and its component (bone, joint, soft tissue elements); involvement of C2/3 is most frequent source of headache; AA is second most -paroxysmal or sharp pain in occipital pain, ipsilateral eye lacrimation, and conjunctival injection -rapid head turning-->subluxation of AA joint and C2 spinal root compression-->ipsilateral tongue sensory sx

Back

what are the 5 models of osteopathic manipulation? -4 ways OS applies to systemic disease?

Front

postural/structural, neurological, resp/circ, bioenergy, psychosocial neurological- indirect: trigger points, visceral disease, emotional distress -fluid congestion- drainage pathways, choke points -nervous system -biochemical concerns: -visceral concerns

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