STEP 2 OMM 1 7-11-2016

ruhland1's version from 2016-07-11 18:04


Question Answer
R+ SFT L Sulc Post L ILA post, negative springL on L Sacral torsion
Positive springdoesnt move, indicates backwards sacral torsion
R sided + SFTLeft sided oblique axis (axis points from L PSIS to R isch tuber)
Directinto the restriction
Indirectinto where it likes to go
L on L sacral torsionindiect technique into R sacral base (where it is stuck in), and is most anterior point so preferred spot over right LIA
L on L sacral torsion directL ILA since most posterior
L5 related to sacrumRotate in opposite directions, Side bend on same sacral oblique axis
L SFTest= right oblique axis * right sidebent L5
L+ SFT R base R ILAright on right sacral torsion
Right post inominate+ SFTest R and inferior PSIS R
Right on right sacral torsiontx place in right lateral Sims position for MET
Right lateral sims positionlying on right side with toso turned so facing down, hips flexed until motion palpated at the lumbosacral junction, legs held off table to induce right SB
Negative springsacral flexion
Positive springsacral exterion (sacrum dont move in spring test)
R on L sacral torsionplace on left lateral recumbent
Put in supine or proneto use balanced liagmentous or respiratory assist
Opposite letter torsionsposterior (backward) torsions
Same letter torsionsanterior torsion
Postpartumbilateral sacral flexion
Sacral oblqiue axisL5 sidedent on same ( so R axis with R SB)
Sacrumrotates opposite of L5
Forward (L on L or R on R….) sacral torsion METpt prone, arms off the table and ipsi oblique axis same as hip down


Question Answer
Ptosis miosis anhidrosisHorner (dn cerviccal chain ganglion)
Chain ganglion coursehypothalamus to upper thoracic vertb back up along cervical chain
Horner syndrome OMM1st rib elevated ipsi, trx, carotid disec
BITEBottom Inhalation Restriction Top Exhalation Restriction
Crus of diaphragmattached to L1-L3
Exhalation RestrictionInhalation dysffunction
Right anterior rib trx and t7-9 tenderpoints counterstrain
Rib inhalation restriction 1-2scalenes flex head and neck
Rib inhalation restriction 3-5pec minor, push ipsi elbow to contra ASIS
Rib inhalation restriction 2-8serratus ant (uniquely 6-8), push the arm anteriorly from an adducted and flexed poisition
Rib inhalation restriction 9-12lat dorsi, adducting the arm
Rib inhalation restriction 12quadratus lumborom


Question Answer
Unhappy triadACL MCL and medial meniscus
Medial meniscusleg is twisted as it remains planted on the ground, clicking and locking
AdductionLCL injury, rare, no cliick
Patellar tendonitisrepitive stress, ant knee effucion, focal tenderness, RICE, OMM pelvic inlet
Patella femoral syndweak vastus medialis, px over distal femur, RICE


Question Answer
Winging scapulaeserratus anterior, injury long thoracy nerve, need hx and px and EMG
Serratus ant conservative txbrace scapule to rub cage and avoid overstreetch
Latt dorsi attinferior angle of scapula, anchors scapule during shoulder motion
Lat dorsi nthoracodorso
Rhomboid makordorsal scapular n, wk * dn scapula adduction
TrapeziusCNXI, wk * up LATERAAL winging of scapula
Adeheive capulatiisdo Spencer


Nerve roots
Question Answer
Suprascapular, inf subscapular, sup subscapularc5-c6
Least splanchnic nervehindgut
Levator scapulaeC4, C3 and C5 (dorsal scapular nerve)
Thoracodorasoc6-c8 lat dorsi
Median ulnar and radial (posterior interossesus)c7-t1
Superior mesenteric gangliondistal duod to ⅔ of transverse colon


Question Answer
Pelvic inletOMM to up lymph flow, dn inflx, up recovery
Short leg syndromelook at sacral base unleveling difference, can cause scoliosis
Helig formulacalulates heel lift requirements (height of sacral base dysf, duration, any compensation present)
Sacral baselower on short leg night
Inominate short legrotated anteriorly on short leg
Lumbar spine short legsidebent away and rotated towards short leg
Short leg srxif >5cm
Heel liftmaxes at 10-12mm then use a shoe lift.
Heel lift txincrease 3 mm every 1-2weeks
Long standing short legfinal heel lift height should be 50% to 75% of discrepancy
Sudden short leg syndheel lift should correct 100% discrepancy
R posterior inominateMET is supine with right hip and knee passively flexed
R on L backward sacral torsionMET place on L side with torso turned right
Iliacus muscle counterstainpt supine, flexion of bilateral hips and knees and ext rot “frog leg”


Question Answer
McMurray’sup px and clicking with medial meniscus injusry
MurphysRUQ px that ceases inhalation during deep plalp
Sulcus signliagment laxity of glenohumeral joint, + indicates inferior subluxation dislocation
Hawkinsacromioclavicular joint impinge and supraspinatus tendon, flex arm and elbow at 90 and internallty rotate shoulder,
Jobes testaka empty beer can, suprasintutus
Speeds signflex arm 90 and supinate forearm, have patient resist your attempt at putting back in neutral, + is px at bicipital groove
Yergasonput in speeds poistion, now ext rot shoulder and supinate forearm against resist, px when biceps tendon slipping out of groove
Spencer techniqueMEMORIZE order, (extension flexion circumduction with compression, cirucumduction with traction, abduction, internal rot, pump
Every Faulty Capsule Tries Adhezing In PracticeSpencer Mnemonic


Question Answer
Chapmans and visceosomatic
Pancreast5-t-9 bil or rightsided, hx of binge drink
Stomacht5-t10 on left
Esophagust3-t6 on right
Gallbladdert5-10 on right
Appendixt9-12 on right (tip of R12)
Right lateral ITBprostate
Intestinal peristalsisASIS (think SBO or volvulus)
Kidney and proximal ureterpara symp from vagus and VS reflex at C1-2