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Step 2 OMM 2 7-11-2016

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ruhland1's version from 2016-07-11 18:12

Section

Counterstrains/tenderpoints/triggerpoint
Question Answer
Dr. Jonescoined “tenderpoint”
ASISL1 tenderpoint
Travell-simons trigger pointR Pectoralis muscle, can cause SVTs
Trigger pointrelationship between damaged myofascial nexus and a region of referred px
Trigger point txdry needling, local injxn steoroid and anesthetic
Flatterned thoracic kyphoses in UPPER thoracic spineup tachyarrythmias
Jones tenderpointnot related to visceral disease, treated w strain and counterstrain
Counterstrainput body in position of maximum comforot, treats tenderpoints
L4 ant tenderpointinferior AIIS
L3 ant tender pointlateral AIIS
L2 ant tender poiintmedial AIIS
L5 ant tender pointsuperior pubic ramus 1 cm lateral to pubic symphsis
T7 8 and 9 ant¼ and ½ and 3/4 distance from tip of xiphoid and umbilicus
T7-9 anterior tenderpoint counterstrain on rightflexion, sidebend towards, rotate away
T1 anteriorepisternal nortch
T2-6 anton sterum at level of rib
Iliacus muscle tendepointbelly of m found ⅓ distance from ASIS to the midline
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Vertebrate
Question Answer
C2-C7rotate and sidebend to same side (do not follow Fryettes principles)
Fryettes principlesTHORACIC and LUMBAR spine only
Type one mechanicsrot and sidebend occur opposite to one another in the netutral plane
Type 2 mechanicsrot and SB occur in same direction in either flexion or extension plane of motion
HVLAput in RESTRICTION for roation, and EASE for sidebending (thrust is directed into rotation restrictive barrier)
Fryettes Iif lumbar vertebate are rotated and sidebent in opposiste directions * it must be in neutral
Still’s techindirect HVLA (put in posiition of EASE then take into barrier (direct))
Ant L1-5 counterstrainposition patient supine with knees and hips flexed and rotated away
Resistance to translation to rightsidebent right
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MISC
Question Answer
Percutaneous reflex of Morleyvisceral to somatic pain refereal from parietal peritoneum to abdm wall
Law of Laplacevascular structures the become aneurysmal, up risk rupt exponentialy is radius increases
Sherringtons 1st lawdorsal nerve roots supply dermatomes, overlap with other segments
Sherringtons 2nd law(reciprical inhibition), when agonist contracts, antagonisit must relax
C fibersunmylenated, neuropathic px
Isometric contractionused in MET, held for 5 sec, doc pushes pt into new restrictive barrier
Reciprocal inhibition muscle energyengage restrictive barrier against resistance while forcing the muscle to lengthen
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Cranium
Question Answer
Sidebending rotation1 AP and 2 parallel vertical axis, named for side of convexity
Lateral strainsphenoid and occiuput rorate in same direction on verttical axis, paralleogram head
Torsional strainon AP axis sphenoid and occipiut rotate on opposite directions, named for higher greater wing of sphenoid
Condylar compressionadjacent to jugular formaen and hypoglossal cananl (dn CN IX X XI)
Vertial straintransverse axis’ of occiput and sphenoid rotate in same direction (pathological flexion extension)
Hit in head with balldysf CRI “rockhard bowling ball feel” 2/2 SBS compression
Inferior vertical strainsphenoid travels inferior to occiput
TMJtemporal bone dysfunction
Lateral pterygoidonly muscle involved in opening the jaw
Masseter, medial pterygoid, temporalis mclosing the jaw
CRI extensionpaired bones internally rotates, occiput goes down (think sacral flexion)
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Leg
Question Answer
Proximal fibular head that resiists poterior springanterior fibular head
Anterior fibular headtalus ext rot * up for evert and dorsiflex
Posterior fibular headtalus int rot * up invert and plantarflex
L4 nerve root compressionmedial lower leg, ankle dorsiflexion, knee DTR
Pirifomis syndscitica posterior leg, external rotator of femur
S1posterior thigh and lateral calf, achilles reflex
Gastronemus“tip toes” s1
Straight leg raiseimplies radiulopathy
Droped naviular bonedecreased medial longitudinal arch
Psoas hypertonicitythink “stuck in hip flexion” hunched over, cannot lay flat
Anterior drawer ankleant talofibular ligament
Tenderness of medial longitudnal arach footcuboid dysf
Posterior drawer ankledn calcneotalar unit
Common peroneal nearfibular head and dn eversion (superficial peroneal n) and dn dorsiflexion (deep peroneal n)
Sciatic nervemade of tibial nerve and common peroneal nerve
Femoral nervequadriceps, saphenous medial leg
Tibial nervehamstrings, up injury in popliteal fossa or glueal region
Posterior tibia or anterior talusup in prolonged plantar flexion, up restricted dorsi
HVLAare direct
Hiss platar whiptx dropped cuboid dysf
Locke’s techto dx 1sr metatarsal dorsal glide
Talar tugat talo calcaneal joint
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Nerve Pathos
Question Answer
Ulnar at elbowmedial epicondyl, ulnar claw, dn finger adb and add, dn thunb adduction (adductor pollicis)
Abduction 90 degreesupraspinatus and deltoid
Abduction above 90 dgreetrapezisus, serratus anterior
Forearm pronationpronator teres and pronator quadratus, median nerve
Posterior interosseius nerveof radial nerve, supinator m
Wrist dropradial nerve dange from a midshiaft humeral fracture
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Lymph
Question Answer
Left thoracic ducteverything but right chest, head, neck and arm (to right thoracic duct)
Pedal pumpcontraindicated on recent abdominal srx, DVT, recent frx to L EXT
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