omm review

7/26/2019 Omm Review

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Muscle contraction

Isotonic: no change in tensiono Concentric: shortening (internal force > external force; raising a weight)

o Eccentric: lengthening of muscle during contraction due to an external force (lowering a weight)

Isometric: no change in length (no approximation of origin and insertion)

Treatment Direct/Indi

rect

Active/Pas

siveCS Indirect Passie!P" Indirect PassieChapman#s

re$exes

%irect Passie

&he cerical spine:

Muscles:

o 'nterior and middle scalene (eleates stri)

o Posterior scalene (eleates *ndri)

o SCM: S+ towards, " awa-, inoled in torticollis

.oints:

o .oints of /usch0a: articulation of uncinated process and aoe ertera

%egeneration and arthritis of intererteral facet 1oints 2 MCC of cerical nere root

compression

%ull nec0 pain

Shooting pain3paresthesias

4steoph-te formation3degeneratie 1oint changes3narrowing of intererteral foramina

4': occiput and C (atlas)

'': C and C* (axis)

C*56: rotation emphasis

C758: S+ emphasis

&he thoracic spine:

/andmar0s:o Sternal notch: &*o Sternal angle: attaches to the *ndri and leel with &6

Rotationis the main moement

Muscles:o %iaphragm

9-phoid process

"is 5*

/5

o Intercostals: eleate the ris on inspiration

"icage:o &uercle: articulates with corresponding&P

o


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Similar s-mptoms as herniated disc

orse with extension (s herniated disc)

o Spond-lolisthesis: anterior displacement of a ertera oer the one elow

/63/7

%ue to fractures of the pars interarticularis of the erterae

'ching pain

Sti@ leg, short stride, waddling gait

&ight hamstrings ilaterall-

Most managed conseratiel-


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Positie spring

Positie ac0ward ending

o +ilateral sacral $exion is a common d-sfunction in the post5partum pt (due to irth mecahnics)

o Sacral shear 2 unilateral sacral !3E

o &reat /7 Lrstma- resole sacral d-sfunction

Gpper extremities:

Shoulder

Primar- muscles of the

shoulder!lexion 'nterior deltoid

'duction Middle deltoidExtension /at, teres ma1or, posterior deltoid'dduction Pec ma1or, latExternal rotation Infraspinatus, teres minorInternal rotation Suscap

o Suclaian a axillar- arachial aradial and ulnar aa

"adial a deep palmar arch

Glnar a superLcial palmar arch

o MC S% of the shoulder: internal and external rotation restrictionso Common shoulder prolems:

&4S:

Compression:

o

'nterior and middle scalenes

'dson#s testo Claicle and stri militar- posture test

o Pec minor and upper ris h-perextension test

Supraspinatus tendinitis: compression of the greater tuerosit- against the acromion

+icipital tenos-noitis: in$ammation of the tendon and sheath of the long head of the iceps

"otator cu@ tear

'dhesie capsulitis: t-picall- due to prolonged immoilit- of the shoulder after in1ur-

Shoulder dislocation

inging of scapula

+rachial plexus in1uries: Er %uchenne#s is MC (C73)

"adial n in1ur-

Elow, wrist, hand

Elow 1oint: ulnar and humerus

!lexors (of the wrist and hand) originate near the medial epicond-le of the humerus

Extensors originate near the lateral epicond-le Pronators (median n): pronator teres and pronator Auadratus

!%P attaches to the %IP

!%S attaches to the PIP

Somatic d-sfunction:

Swan nec0: extension contracture of the PIP ("')

+outonniere: $exion contracture of the PIP ("')

'pe hand: claw hand K thenar eminence wasting (due to median n damage)

%upu-tren#s contracture: of the palmar fascia ($exion of MCP and PIP usuall- of last two digits)

/ower extremities


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o angle: at 0nee

> *: genu valgum

N F: genu varum

o Patellar5femoral s-ndrome:

ea0ness of ?M lateral deiation of patella

o Compartment s-ndrome:

MC: anterior compartment

%ue to oeruse increased intracompartmental pressure

Compromises circulation within that compartment

'n0le and foot:

o .oints: &alocrural 1oint (tiiotalar 1oint): 3t the talus and the medial malleolus of the tiia and lateral

malleolus of the Lula

Plantar$exion and dorsi$exion

'n0le is more stale in dorsi$exion (HFJ of sprains occur in plantar$exion)

Sutalar 1oint (talocalcaneal 1oint):

Shoc0 asorer

'llows internal and external rotation of the leg while the foot is Lxed

o 'rches:

/ongitudinal:

Medial:o &alus

o =aicularo

Cuneiformso 5 M&s

/ateral:

o Calcaneus

o Cuoid

o 657 M&s

&ranserse: cuoid, naicular, cuneiforms

MC S% of the arches

Plantar glide of one of the oneso /igaments:

/ateral stailiOers: preents excessie supination

'nterior taloLular#C sprainedo Supination sprains:

I: ant &! ligament

II: ant &! and C! III: ant &!, C!, post &!

CalcaneoLular

Posterior taloLular

Medial stailiOer: preents excessie pronation(an0le is more stale in pronation)

%eltoid:o Excessie pronation fracture of the medial malleolus (more li0el- than pure

ligament in1ur-) Plantar ligaments:

Spring (calcaneonaicular): strengthens and supports the medial longitudinal arch

Plantar aponeurosis: calcaneus phalangeso Chronic irritation: heel spur

Craniosacral motion:

Primar- respirator- mechanism:

o Inherent motilit- of the rain and SC

/engthens during exhalation

o !luctuation of CS!

"ate of C"I: F56 c-cles per min

Increase rate: exercise, feer, after 4M&

o Moement of the intracranial and intraspinal memranes

%ural attachments: C*, C, S*

"eciprocal tension memrane

o 'rticular moilit- of the cranial ones

o Inoluntar- moilit- of the sacrum 3t the ilia

!lexion at S+S: S+S rises

o !lexion of midline ones (sphenoid, occiput, ethmoid, omer)


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o External rotation of paired ones

o Extension of sacral ase

o idens head and decreases 'P diameter (ernie)

o Inhalation phase

Extension at S+S: S+S descends

o Extension of midline ones

o Internal rotation of paired oneso !lexion of sacral ase

o &hinning of head and increased 'P diameter (ert)o Exhalation phase

Cranial nn:o ?* d-sfunction tic douloureux (trigeminal neuralgia)

o Superior orital Lssure: , 6, ?, o , F, * d-sfunction poor suc0ling in the neworn

Cranial treatments:o ?enous sinus drainage 7H5

&o increase intracranial enous drainage - a@ecting the dural memranes

&: superior nuchal line

C: middle Lnger of one hand on the inion

4: *nd56th Lngers of oth hands erticall- from inion to suoccipital tissues

S: sagittal suture with crossed thums regma

*nd56th Lngers in opposition at metopic suture

o C?6: ul decompression:

&o enhance the amplitude of C"I

"esist $exion phase and encourage extension until a still point is reached

&hen allow restoration of normal !3E

o ?ault hold:

Index Lnger: greater wing of sphenoid

Middle: temporal one in front of ear

"ing: mastoid regions of temporal one

/ittle: sAuamous portion of the occiput

o 'solute CIs: leed, increased ICP, s0ull fracture

o "elatie CIs: seiOure histor-, d-stonia, traumatic rain in1ur-

!acilitation:

SensitiOed interneurons increased output

'utonomic innerationo Paras-mpathetics:

Sweating in palms and soles

%ecreased numer of golet cellsthin secretions (resp epith)

=o e@ect on s-stemic arterioles

Maintains normal ureter peristalsis

Ql-cogen s-nthesis in lier

"elaxes uterus3constricts cerix

9 (agus)


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(efore the

ligament of

treitO: 3t

duodenum

and 1e1unum)

splanchinic3celi

ac ganglion

Middle QI& &F5 /esser

splanchnic3sup

erior

mesenteric

ganglion

/ower QI&(after the

splenic

$exure)

&*5/* /eastsplanchnic3infer

ior mesenteric

ganglionRidne-s &F5Gpper

ureters3gona

ds

&F5

/ower ureters &*5/+ladder3genit

alia

&5/*

Prostate &*5/*/egs &5/*

&echniAues:o S-mpathetic

"i raising

Soft tissue paraspinal inhiition

Qanglion release

Chapmans

Cerical paraspinal ganglia

o Paras-mpathetic

Cranial

Sphenopalatine ganglion techniAue: encourages thin water- secretions through short

intermittentl- manual Lnger pressure intraorall- to the sphenopalatine ganglion Cond-lar decompression: frees passage through the 1ugular foramen

?agus nere in$uence: manipulation of 4', '', or C*

Sacral S% treatment

Points: Chapman#s: ganglioform contraction

o Presents icero5somatic d-sfunction

o %oes not radiate

&rigger point: h-persensitie focuso "eferred paino &aut and within a muscle

o Somatic manifestation of a ?S, S?, or SS re$exo &reatment: apocoolant spra-, local anesthetic

&ender point: h-persensitie points in the m-ofascial tissueso &aut m-ofascial ands

o =o referred pain

M-ofascial release:

Includes:o CS

o !P"o Gnwinding

o +/&o !unctional indirect release

o %irect fascial release

o Cranial

o ?isceral

%iaphragms:

o &entorium cereelli

o &horacic inlet

Common compensator- pattern: /"/"

/-mphatics:


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Ma1or thoracic duct:

o %rains into the 1unction of the / internal 1ugular and suclaian

Minor thoracic duct:

o %rains into the " rachiocephalic ein

o %rains right GE, right hemicarnium, heart, lungs (except / upper loe)

Production: *3 - lier and intestines

&horacic duct:o Cisterna chili (/*)aortic hiatus (&*) nec0 / ma1or duct

Inneration: s-mpathetics asoconstriction and increased peristalsiso Intercostal nn

o Cisternal ch-li: & Increases in interstitial $uid pressure (normall- 5Bmm

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