OEBC Written Exam flashcards

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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 criteria

Tissue texture abnormality, Asymmetry, Restriction of motion, and Tenderness are the four diagnostic criteria for somatic dysfunction on physical examination.

Five osteopathic models

Biomechanical, respiratory-circulatory, neurologic, metabolic-nutritional, and behavioral-biopsychosocial models guide osteopathic assessment and treatment planning across the whole patient.

Structure-function reciprocity

The principle that anatomy and physiology influence each other bidirectionally, so altered structure can impair function and functional change can alter structure.

Diaphragm openings

The diaphragm has openings for the inferior vena cava at T8, esophagus at T10, and aorta at T12, with crura attaching to upper lumbar vertebrae.

Sympathetic outflow levels

Preganglionic sympathetic fibers arise from T1 through L2 spinal segments, while parasympathetic outflow is cranial (CN III, VII, IX, X) and sacral (S2-S4).

Thoracic duct drainage

The thoracic duct drains most of the body's lymph into the junction of the left internal jugular and left subclavian veins.

Rotator cuff muscles

Supraspinatus, infraspinatus, teres minor, and subscapularis stabilize the shoulder; supraspinatus initiates abduction and subscapularis medially rotates.

Frank-Starling relationship

Increased ventricular preload increases stroke volume up to a physiologic limit, after which further stretch reduces contractile efficiency and cardiac output.

Gate control theory

Large-diameter afferent input can inhibit transmission of small-diameter nociceptive signals in the dorsal horn, reducing perceived pain.

Viscerosomatic reflex

Visceral afferents converge with somatic afferents at the same spinal segment, producing segmental muscle spasm, tenderness, and skin changes.

Mean arterial pressure

MAP approximates diastolic pressure plus one-third of pulse pressure; cerebral autoregulation maintains blood flow across a range of roughly 60-150 mmHg.

SOAP note structure

Subjective, Objective, Assessment, and Plan organize clinical documentation, capturing history, examination findings, diagnosis, and treatment strategy.

Red flag symptoms

Unexplained weight loss, night pain, fever, neurologic deficit, bowel or bladder dysfunction, cancer history, and trauma warrant urgent evaluation before routine care.

Chapman's points

Anterior and posterior tissue texture changes associated with visceral dysfunction, used as diagnostic and treatment landmarks in osteopathic practice.

End-feel assessment

The quality of resistance felt at the end of passive range of motion distinguishes normal capsular, bony, spasm, and empty end-feels.

Muscle energy technique

The patient performs voluntary contraction against operator counterforce from a controlled position, using post-isometric relaxation to improve motion.

HVLA technique

A rapid thrust through a restrictive barrier after positioning; contraindicated in fracture, severe osteoporosis, and unstable spinal conditions.

Counterstrain technique

The patient is held in a position of comfort for about 90 seconds to reduce tender point reflex activity and restore normal motion.

Direct versus indirect technique

Direct technique engages and moves toward the restrictive barrier; indirect technique moves away from the barrier into the direction of ease.

Carpal tunnel syndrome

Median nerve compression at the wrist causing numbness in the thumb, index, middle, and radial ring finger, often worse at night.

Straight-leg raise test

A sensitive test for lumbosacral nerve root irritation; the crossed straight-leg raise is highly specific for disc herniation.

Adhesive capsulitis

Frozen shoulder progresses through painful, frozen, and thawing phases, with capsular restriction limiting external rotation most prominently.

Migraine features

Migraine is typically unilateral, pulsating, and accompanied by nausea and photophobia, distinguishing it from bilateral tension-type headache.

Facilitated segment

A spinal segment with lowered threshold for afferent input, maintaining abnormal reflex activity and contributing to somatic dysfunction.

Somatovisceral reflex

Somatic dysfunction can alter autonomic outflow to a viscus, potentially contributing to visceral dysfunction and symptoms.

Heart viscerosomatic level

Cardiac visceral afferents converge at T1-T5, predominantly on the left, producing segmental tenderness and somatic dysfunction in that region.

Gallbladder viscerosomatic level

Gallbladder and liver afferents converge at T5-T9 on the right, producing right-sided thoracic and upper abdominal somatic findings.

Informed consent elements

Disclosure of diagnosis, proposed treatment, risks, benefits, alternatives, and the right to refuse is required before proceeding.

Mandatory reporting

Suspected child abuse, elder abuse, and certain communicable diseases must be reported to appropriate authorities per jurisdictional law.

OMT contraindications

Acute fracture, hemorrhage, malignancy at the site, untreated infection, unstable medical condition, and lack of consent contraindicate osteopathic manipulative treatment.

Shared decision-making

Clinicians and patients discuss risks, benefits, and alternatives together, and the patient's preferences and autonomy guide the final plan.