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osteopathic diagnost
OPP
Question | Answer |
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The osteopathic diagnostic exam consists of these three components: | orthopedic exam osteopathic structural exam basic medical exam |
In the osteopathic diagnostic exam, you get structural observation clues through what? | TART |
when do we use an ostoepathic diagnostic exam? | acute musculoskeletal complaints, chronic musculoskeletal complaints, visceral or organic complaints, all the time! your fingers are the best tool |
This part of OMT gives you a therepeutic indicator whether the problem is strictuly musculoskeletal in nature or might be of viscerosomatic orgin | The patient's response to OMT |
the palpatory findings of TART are correlated to what? | viscerosomatic reflexes in organic ocomplaints, and these help to confirm your diagnosis |
In taking a subjective history for the ostoepathic diagnostic exam, what history findings are pertinent to the chief complaint? | trauma (fractures, dislocations, and injuries), repetitive use injurieds and occupation, congenital structural problems (flat feet, childhood scoliosis, short leg), history of surgery (scars causing adhesion), chronic painfuil regions, emotional trauma |
The subject part of the osteopathic diagnostic exam includes: | OLDCAARTS, osteopathic structural history |
the objective part of the osteopathic idagnostic exam includes: | posture/gait (initial observation), basic medical exam /ortho/neuro, TART, static postural exam, regional/segmental or global diagnosis |
in an ostoepathic structural exam, you need to assess the following: | posture/gait, TART, static postural exam (standing, seated, supine), regional/segmental or global diagnosis is often referred to as the osteopathic structural exam |
observing the patient's gait gives you clue about: | joint pain, stiffness, fluidity of motion and muscle weakness |
looking at a patient's posture gives you clues about: | how they sit, position, discomfort, handedness, sensory impairment, tremor or obvious neurologic/cognitive problem, emotional patterns: depressive, manic, aggressive? |
in a basic medical exam, with inspection you look for: | general symmetry, edema, deformities, color, nodules/masses (check skin and back for rash/shingles |
in a basic medical exam, with palpation you look for: | landmarks, heat, deformities, edema, effusion, tenderness, crepitance |
in a basic medical exam, with ROM, you look for: | all plaines, bilatterally, angles (geniometer) |
in a basic medical exam, with muscle strength, you look at: | all muscles, bilateral grade |
in a basic medical exam, with integrated function and special tests you look for: | DTRs, neuro exam, radicular symptoms when appropriate |
for the orthopedic/neurologic exam, what do you look for? | passive and active ROM to spine or joints, muscle strength/reflexes, special tests for impingement, nerve entrapment, radiculopathy, metabolic disorders. |
with the orthopedic/neurological exam you have to make sure you examine: | the joints above and below the area of complaint |
what are some examples of how you can integrate palpation and TART? | examination of head and neck: check for tissue tightness/texture and asymmetry when checking for cervical adenopathy and thyromegaly, when listening to heart and lungs, scan the thoracolumbar paravertegral regions (T1-T3) for TART |
what does TART stand for? | tissue texture abnormality, asymmetry, restriciton of motion, tenderness |
for the static postural exam, what are some things you look for? | mainly look for body symmetry: ankle posistion, popliteal crease, iliac crest height, scoliosis, lateral body creases (obese have asymmetry with scoliosis), standing flexion test,head tilt,normal AP curves, kyphosis/lordotic curves, abnormal head carriage |
what is the significance of the seated postural exam? | it evaluates the spine without the influence of the lower extremeties, and it includes the seated flexion test, segmentla diagnosis/motion testing with Fryettes, extremity biomechanics/ROM?tender points |
examples of the supine postural exam include: | ASIS compression test/pelvic findings, leg length, anterior tender points, transverse diaphragm rotations, inherent motion/CRI patterns |
examples of the prone postural exa minclude: | sacral diagnosis, posterior tender points, sacral inherent motion |
functional curves follow which of Fryette's mechanics? | type 1 |
the ergonomic adaptation of the spine is overwhelmed due to: | trauma, overuse, disease, structural gait abnormalities, aging, being overweight, postural habits, inactivity |
what are two approaches to examing a patient during an osteopathic diagnostic exam? | regional (evaluate joint/region above and below the region of complaint), whole body (fascial/structural patterning, long curves, biomechanical patterns) |
in this approach, you focus on a specific body region to diagnose and treat. This is analogous to doing a problem focused history and physical | regional approach |
the body regions identified for diagnostic purposes include: | head, cervical, thoracic, ribs, lumbar, sacrum, pelvis, upper extremity, lower extremity, and abdominal/visceral |
in this approach, you analyze the whole body's MSK system before determining the area of greatest resistance. several of the great manipulators in our profession do this intuitively and assume other clinicians and students are observing the same phenomena | whole body approach |
which approach, the regional or whole body approach, is more common among OMT specialists? | whole body approach |
the osteopathic structural exam can be from any of these five models: | biomechanical, respiratory/circulatory, neurologic, behavioral, metabolic energy |
this model looks at segmentla diagnosis including key lesion type 2 within type 1 mechanics: | biomechanical |
this model looks at fascial rotation diagnosis of all transverse diaphragms (tentorium cerebelli, OA, cervicothoracic, thoracolumbar, pelvic and arches of feet) | respiratory/circulatory |
this model looks at TART correlation with viscerosomatic reflexes and medical organ diagnoses | neurologic |
this model looks at craniosacral diagnosis (also in respiratory/circulatory model) with evaluation of inherent motion throughout the body | behavioral |
this model looks at TART diagnosis in thyroid/DM, and looks at how efficient/fluid is a patient's gait and normal movement | metaboic-energy |
there is ____ right way to do the Osteopathic diagnostic exam, but it's best to be _________ sot hat you gather your information completely with each exam | no, methodical |
what three things do you make sure to mention within documentation? | describe postural pattenrs, describe regions of TART, describe segmental diagnoses within a region or extremity |
what must you do in documenting somatic dysfunction? | you must document your structural findings to suppor teach region in which you have found a somatic dysfunction, either using the whole body approach or a regional approach |