AOBNMM NMM/OMM flashcards

32 cards. Read the term and the definition here. The deck at the top of this page is optional.

Somatic dysfunction definition

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

TART mnemonic

Tissue texture abnormality, Asymmetry, Restriction of motion, Tenderness. At least one must be present to diagnose somatic dysfunction.

Facilitated segment

A spinal segment with lowered threshold for afferent input due to sustained noxious stimulation, often from visceral disease or trauma, leading to somatic dysfunction.

Viscerosomatic reflex

Autonomic and somatic reflex arc where visceral dysfunction produces somatic dysfunction in the corresponding spinal segment; sympathetic levels T1-L2, parasympathetic S2-S4.

Chapman's points

Anterior and posterior tender points associated with visceral dysfunction; anterior points on ribs or pelvis, posterior on spinous or transverse processes; treated with inhibitory pressure.

Muscle energy technique

An osteopathic technique where the patient voluntarily contracts muscles against a counterforce from a controlled position to improve motion and reduce restriction.

Counterstrain technique

An indirect technique using a position of ease to reduce tender points by 70% for 90 seconds, resetting muscle spindle reflex and reducing somatic dysfunction.

HVLA technique

High-velocity low-amplitude thrust applied at the restrictive barrier to restore motion; contraindicated in fracture, osteoporosis, or inflammatory arthritis.

Myofascial release

A manual technique applying sustained pressure to fascial restrictions; direct engages barrier, indirect follows tissue into ease; used to restore fascial mobility.

Cranial rhythmic impulse

Palpable rhythm of the primary respiratory mechanism at 10-14 cycles per minute, reflecting CSF fluctuation and cranial bone mobility.

Lymphatic pump technique

Rhythmic compression of thorax (thoracic pump) or lower extremities (pedal pump) to enhance lymphatic flow and immune function; avoid in acute infection or fracture.

Oral exam format

Case-based oral examination where candidates present differential diagnosis, treatment plan, and OMT technique selection, demonstrating clinical reasoning and osteopathic principles.

Osteopathic philosophy principles

Four tenets: body is a unit, body possesses self-regulatory mechanisms, structure and function are interrelated, and rational treatment based on these principles.

Contraindications to OMT

Absolute: fracture, dislocation, malignancy at site, infection, hemorrhage. Relative: osteoporosis, anticoagulation, pregnancy, recent surgery. Must be articulated in oral exam.

SOAP note format

Subjective, Objective, Assessment, Plan. In OMM, include TART findings, somatic dysfunction diagnosis, and specific OMT techniques with frequency.

Pediatric OMT modifications

Use gentle techniques (cranial, lymphatic, myofascial) and avoid HVLA; obtain parental consent; consider developmental stage and smaller anatomy.

Geriatric OMT modifications

Use gentle techniques (myofascial, cranial, MET) due to decreased bone density and tissue elasticity; screen for osteoporosis and polypharmacy effects.

Visceral-somatic integration

Explaining how visceral dysfunction creates somatic dysfunction via reflex arcs, and vice versa, using Chapman's points and viscerosomatic reflexes in clinical reasoning.

Treatment plan justification

In oral exam, justify OMT technique based on patient age, diagnosis, contraindications, and preference; include expected outcomes and follow-up plan.

Documentation of somatic dysfunction

Record segmental level, laterality, and TART findings; relate to presenting complaint; include in objective section of SOAP note.

Practical exam set-up

Position patient comfortably, explain procedure, obtain consent, wash hands, ensure privacy, and use proper body mechanics before palpation.

Palpation layers

Light touch assesses skin and superficial fascia; deep touch assesses muscle, deep fascia, and bone; note texture, temperature, moisture, tenderness.

Segmental motion testing

Assess flexion, extension, rotation, sidebending at each spinal level; note restriction and end-feel to identify somatic dysfunction.

HVLA practical application

Engage restrictive barrier, apply quick low-amplitude thrust; avoid in osteoporosis, fracture, inflammatory arthritis; reassess after.

Muscle energy practical steps

Position patient at restrictive barrier; patient contracts muscle against operator force for 3-5 seconds; relax; repeat 3-5 times; reassess motion.

Counterstrain practical steps

Locate tender point; position patient to reduce tenderness by 70%; hold 90 seconds; slowly return to neutral; reassess tenderness.

Myofascial release practical

Apply gentle sustained pressure to fascial restriction; direct or indirect; monitor tissue response; release when tissue softens.

Cranial technique practical

Assess CRI at 10-14 cycles/min; use gentle traction or molding; contraindicated in acute intracranial hemorrhage; document findings.

Lymphatic pump practical

Thoracic pump: rhythmic compression of thorax; pedal pump: rhythmic compression of lower extremities; enhance lymphatic flow; avoid in acute infection or fracture.

Informed consent in OMT

Explain procedure, benefits, risks, and alternatives; obtain verbal or written consent; document in chart; especially important for sensitive areas.

Body mechanics in OMT

Use proper posture, leverage, and table height to avoid injury; keep back straight, use legs, and maintain balance during techniques.

Reassessment after OMT

After technique, reassess TART findings and motion; document changes; determine need for further treatment or referral.