OMM Exam (mnemonics/key info) – Flashcards
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Lecture 1 (Prev. Health of CNS)
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Primary prevention
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prevent it first.
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Second. prevention
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reduce repeat attacks.
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Primary stroke preve examples
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control HT (most impt modifiable risk factor for stroke) (<140/90) control high lipids/diabetes, stop smoking, not use hormone thpy, reduce weight, treat depression etc
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secondary prevention examples
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mostly dealing with medications to control the above listed stuff (ht, diabetes, high lipids (<70)) exercise, DASH diet,
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Dementia Screening ?
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Insufficient evidence. still you want to counsel the pt though
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Neural Tube Defect
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A grade screening done at 14-18 weeks of gestation take folic acid as supp, if women >35 and pregnant --> do testing (amnio/etc as well)
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Visual acuity
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insuff evidence Snellen Chart is a good screening test
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Glaucoma
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insuff evidence no gold standard exam available
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Risks are usually .....
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Blacks>Hispanics>white
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I statement info
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require relevant talk with pt to provide screening is up to provider/pt
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USPSTF guidelines
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A: offer this service/ highly recomm B: same as above/recomm C: recomm to certain at risk pts D: absolutely NOT I: insuff evidence
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Lecture 2/3
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L. Back Pain
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Most CAM therapy used for this problem (spinal manipulation being the most) *a prior hx of LBP is strongest predictor of future episode
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Red Flags for a HX
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*cauda equina symps *atherosclerotic disease *corticosteroids/osteoporosis * sev night time pain *infections, drug use * and lots more
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Deep tendon reflexes
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2/5 is normal if more -- hyperreflexive
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babinski sign
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sensory exam
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Single Legged HyperExt *Single Ladies love Pretty Faces*
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pain of side there SB toward indicative of Pars/Facet problems
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Seated Kemp test *Late night camping in the Forest*
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*like spurlings, *Late pain--> Facet problem *early pain--> disc pblm
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Bicycle Test
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*Diff b/w neural and circulatory claudication (pain while walkilng, relived with rest) make pt ride bike *if pain goes away--> neurogenic *if pain is there after --> vascular source of pain
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Pheasants Test *Peasants have LBPain bc they work on farms all the time*
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Test for LBP + if reproduce symps *flex knees/compress lumbars
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Homer Pheasant's Test *Homer Simpson is quite an Actor*
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*test for Achilles reflex *redo pheasants test, if + , recheck reflex *if diminished DTR--> indicate Lumbar Stenosis
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Discogenic (disco on legs/hips... thats what these exams test )
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Straight Leg Raise
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if + radicular symps on IPSILATERAL leg/back *passive flexion of hip
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Laseague Test
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*flex hip to 90, flex knee, then passively extend knee *radicular pain on IPSILATERAL back/leg
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Bowstring test *I have to Retie my bowstrings bc they are Loose"
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*repeat Laseagues test *press thumb in popliteal space if + IPSILATERAL back/leg
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Braggard Test *The Dog Straight up Barked and then Bit me"
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*do straight leg raise , if + then *Dorsiflex the foot *IPSILATERAL radicular symps
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Slump *My Dog Kneeds a Slurpee*
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*C/T/L spine *Extend knee, Dorsiflex foot (both passive) *+ radicular
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Nachlas Test *I love Feeding on Nachos*
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*tests for Femoral n. *passive flex knee
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Bonnet's Test *Bonny drives a Prius SLR*
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*for Piriformis syndrome *straight leg raise done if + then *forcefully IR Hip
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Lumbar vs Sacral
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Goldwaithes test *I want a LexuS b4 I go to Sacramento"
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*if pain occurs b4 LS movement--> SacroIliac pain *if pain occurs after LS movement--> L-S pain
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Yeoman Test *Yeoman drive a LexuS, Sivic, and a Honda"
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*reproduction of pain can be LS, SI, or HIp. *ext hip, and monitor L-S
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for Hip and Pelvis
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Thomas
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*test for Iliopsoas--> thigh off table *Rec Femoris--> knee flexion *TFL--> knee lateral to ASIS *IT band---> Foot ER
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FABERE * The FU****G bear Ate the Females b4 I could save them*
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*if pain reprod b4 the SI joint--> Acetabulum/femoral joint *if pain after SI joint engaged --> SI is source of pain *flex, abd, ext r
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Scrub Test *My anatomy Scrubs are mIA*
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*reprod of pain indicate (IA--> intraarticular pain) *compress femoral head into aceatb and move hip through cir motion
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Ely's Test *Ely has a tight rectum*
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*Rectus femoris tightness
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Hibb's Test *Hibbs comes b4---> Hip
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*IR/ER hip while monitoring pelvis pain early--> hip , later is SI
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Malingering Tests:
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Waddell's signs
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*signs of non-organic cause of disease *assoc with depression, anxiety, somatization OVERREACTION
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Flip Test *I kneed to Flip someone off*
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*passive ext knee *+ if no FLIP back
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Axial Compression *Compress my head, ill have pain in my Ass/Leg"
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*press downward on head and compress spine * + if symps in back/leg
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Hoover *Herbert, the pervert, loves to feel down people, NOT*
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*flex hip/knee ext *feel downward force through heel on opp leg *+ if Do NOT feel down force
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Other Impo stuff form 2-3 lecture
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*in no serious pathology--> no tests needed *get imaging for pts who don't improve in 6 wks and have red flags *CT Scan--> bone detail, Contrast CT/Myelography for those who can't get an MRI *MRI--> initial imaging of choice for LBP
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Lecture 4 (Cranial Nerve EXAM)
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CN I (olfactory)
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* test in pts w/ frontal lob disorder *make them smell stuff (not drugs or alcohol though) *if can't smell--> ANOSMIA
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CN II (optic)
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* can test w/ snellen chart, TEST EACH EYE SEPARATELY *look at the nerve with opthalmoscope * Use your RIGHT hand/RIght eye to look at pts RIGHT EYE
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Optic disc
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*blind spot, Optic nerve enters through here *not sensitive to light
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Optic LESIONS
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*if lesion at CHIASM--> bitemporal hemianopsia *if lesion b4 chiasm--> deficits in one eye *if lesion in opt tract or anywhere until it reaches vis cortex --> deficits tht are similar for both eyes
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If Transected Optic Nerve
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*ipsilateral blindness, it will not regenerate *if a tumor (increased intracranial pressure) --> papilledeam
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I CANT DO THIS ANYMORE, SCREW OMM...
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