Osteopathic Manual Therapy pt. 1

Which structure shields vertebral bodies from the transmission of habitual weight?

Vertebral disc

How is pressure from the nucleus pulposus transmitted from one vertebra to the next?

Via the cartilaginous end-plates

What structure serves as the attachment area for the fibers of the annulus fibrosus?

The cartilaginous end-plate

The end-plate permits _____ between the disc and the vertebral body.

Fluid exchange

Fryette’s First Law: If vertebral segments are in neutral without facet locking, how are rotation and sidebending coupled?

They are coupled in opposite directions

Fryette's First Law is also known as _____ motion.

Type I

Fryette’s Second Law: If vertebral segments are engaged (flexed or extended), how are sidebending and rotation coupled?

They are coupled in the same direction

Fryette's Second Law is also known as _____ motion.

Type II

Fryette’s Third Law: If motion is introduced into a segment in any plane, what happens to motion in other planes?

Motion in all other planes is reduced

In Type I (Neutral) mechanics, if a vertebra sidebends left, it must rotate _____.

Right

In Type II (Non-neutral) mechanics, if a vertebra sidebends right, it must rotate _____.

Right

What three fused bones make up the Innominate of the pelvis?

The ilium, ischium, and pubis

The sacrum is composed of _____ fused vertebrae.

5

The coccyx is composed of how many rudimentary vertebrae?

3 to 5

At what age range do Male SI ligaments typically increase in strength?

12-14 years old

How does the male sacrum typically compare to the Female sacrum in terms of dimensions?

The male sacrum is taller and narrow, while the Female sacrum is shorter and wider

A broader pelvis and laterally oblique ilia in females leads to increased _____ at the lower extremity.

Valgus

Which gender generally has more mobile pelvic joints?

Females

What concept describes stability in the pelvic girdle through the structural fit of the bones?

Form Closure

What concept describes stability in the pelvic girdle achieved through ligaments and muscular compression?

Force Closure

Which point is considered the most stable within the pelvic girdle during gait?

The pubis (symphysis pubis)

What are the three types of motion that occur at the symphysis pubis during gait?

Cephalic-to-Caudad translation
Anterior/Posterior rotation
Combined motion

What are the primary physiologic motions described for the sacroiliac joint?

Nutation and Counter-nutation

What motions make up sacroiliac anterior torsion

ROR and LOL

What motions make up sacroiliac posterior torsion

ROL and LOR

How do L5 and the sacrum generally move in relation to each other?

They move in opposite directions

As L5 forward bends, what motion occurs at the sacrum?

The sacrum counternutates

As L5 backward bends, what motion occurs at the sacrum?

The sacrum nutates

Nutation

Anterior-inferior movement of the sacral base relative to the ilium.

Counter-nutation

Posterior-superior movement of the sacral base relative to the ilium.

What motion does LOL sacral torsion do

Rotates left and Sidebends right

What motion does ROL sacral torsion do

Rotates right and Sidebends left

In lumbopelvic rhythm, what happens to the lumbar spine as the pelvis begins to rotate anteriorly around the hips during forward bending?

The lumbar spine flattens.

What are the two sacroiliac motions

Anterior/Posterior rotation
Superior (upslip)/Inferior (downslip)

What is somatic dysfunction

Impaired or altered function of related components of the somatic system; skeletal, arthrodial, and myofascial structures; and the related vascular lymphatic, and neural elements

Type 1: neutral lumbar spine dysfunction

Multiple segments
Minimal FB/BB
Lateral curvature
Prominence on side of convexity
“Fullness” over multiple TPs
Found in all 3 test positions
Neutral mechanics

Type 2: non-neutral lumbar spine dysfunction

Single vertebral motion segment involved
Includes FB/BB restrictions
Hypertonicity of 4th layer muscles
Prominence of one TP
Not found in all 3 test positions

What are the benefits of muscle energy techniques

Lengthen muscle
Neuromuscular re-education
Increase circulation
Mobilization

What positions do you palpate in to determine the positional diagnosis

FB
Neutral
BB

What structures do you need to assess for prominences to determine the positional diagnosis

TPs
Sacral bases
ILA’s