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ACOFP OMT Practical Review

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Emily Soni

on 24 January 2018

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Transcript of ACOFP OMT Practical Review

ACOFP OMT Practical Review
Emily Soni, DO
AOBFP


Objectives
By the end of today, you should be ready to rock this exam
Sample Case 1
Sample Case 2
81yo male c/o right shoulder pain. He had a tennis injury with a rotator cuff tear 3 months ago and has been using his sling since then. Shoulder is now only painful with movement.
PE: R shoulder: Normal inspection. Tenderness at acromion. Negative impingement signs. ROM is limited in all directions. Pain with ROM.
Sample Case 3
42yo obese male c/o left buttock pain that radiates to the left calf. He works at a desk all day long and pain is worse with sitting. PE: No neurologic deficits in the LEs. Tenderpt in middle of left buttock. The lumbar spine is symmetric with appropriate lordosis and full ROM. Negative FABRE and SLR.
What to Expect on Exam Day
This exam is taken at one of the national conventions sites
-Spring ACOFP
-Fall AOA OMED
Tips + Common things tested
Use your 15 min to jot down tx ideas
Talk out loud: Note landmarks and explain technique
Appear confident and do techniques you feel comfortable with
Do not complete thrust on HVLA - you will fail
Review the following commonly tested cases:
Sample Case 4
A 78yo male underwent AAA repair with graft and is in the ICU doing well.
PE: NAD, normotensive, HR 72, RR 18 with shallow breathing. Satting 92%
Heart: RRR. Ext: No edema
Lungs: Bi-basilar crackles.
Abdomen: Hypoactive BS. Incision c/d/i
Conclusion
You are going to ROCK this exam!
Additional resources to help
-http://didacticsonline.com/videos/
-OMT Review by Savarese
-OMM Guide (iphone app that's free)
-Your favorite OMT books
-The videos made by ACOFP
Any Questions?
No? - Then it's time for the practical...
Understand Make-up of Exam
-Know what to expect on exam day
-Understand how test is scored
Review Sample Cases
Cases fall into 3 categories
-Spine
-Extremities
-Systemic Diseases
Feel comfortable with practical
-Be able to identify landmarks
-Talk intelligently about the techniques you are performing
-Feel confident that you will pass this exam
The Written Cases
You will be given 15 minutes
3 multiple choice questions
4 possible answers
The Practical Portion
-You will pick a partner that you probably won't know
-You will rotate through 3 stations
-Your examiner will tell you if you have the correct answer
-4 minutes per partner at each station (8 min total)
The Grade
Each case will be scored on:
-Diagnosis (0 or 2 points)
-Identification of landmarks (0, 1, or 2 points )
-Implementation and demonstration of appropriate techniques (0, 1, or 2pts)
-Ability to discuss techniques (0, 1, or 2pts)
You need to pass 2 of 3 cases
You need 5 of 8 possible points to pass
Spine
Tension HA
Thoracic Outlet Syndrome
Lumbar Sprain
Whiplash
Compression fracture
Psoas Syndrome
Herniated disc
Extremities
Upper Extremity:
-Adhesive Capsulitis
-Rotator cuff tear
-Biceps tendonitis
-Lat/med Epicondylitis
-Carpal Tunnel Syndrome

Systemic Diseases
Sinusitis
Asthma/COPD
Pneumonia
Constipation/ileus
GERD
Hypertension
Cardiac arrythmias
OMT
Muscle energy to lumbar spine
-Post transverse process up
Counterstrain to Anterior iliacus tenderpoint
Myofascial release to lumbar spine
HVLA

Landmarks
L4 - level of the iliac crest
L3/4 is at the umbilicus (in non-obese)
Spinous and transverse processes
PSIS
Sacral base
ILA
ASIS
OMT
Mobilization of scapulothoracic joint
Counterstrain
Spencer techniques
-Stretching the tissues in extension
-Glenohumeral ext/flex w/ elbow flex
-Glenohumeral flex/ext w/ elbow ext
-Circumduction w/ traction and compression
-Adduction and ext rotation
-Abduction with int rotation
-Stretching the tissues again in ext

Landmarks
Acromion
Coracoid Process
Know the muscles of the rotator cuff
OMT
Muscle energy to Piriformis
-External rotator of the hip
-Extends and abducts thigh when hip is flexed
Counterstrain:
-TP usually 7 cm medial and slightly cephalad to greater trochanter
Landmarks
Greater trochanter of femur
Sacral ILA
OMT
Thoracic pump
Diaphragm release
Treat rib dysfunctions
Rib raising
Landmarks
Based on Jim Harvey's speech structures
A 52yo male c/o LBP with radiation to the groin for 3 days. It started after shoveling snow . He was then unable to straighten up. The patient is otherwise healthy and has no hx of LBP.
PE: Pt is uncomfortable. He is forward flexed and leaning left. No neurological deficits. Neg SLR
L1FRSl, L5FRSl. Right unilateral sacral extension. Left Psoas hypertonicity
A. Piriformis Syndrome
B. Herniated disc
C. Lumbar Stenosis
D. Psoas Syndrome
A. Herniated disc
B. Cuada Equina Syndrome
C. Sacroiliitis
D. Piriformis Syndrome
A. Adhesive capsulitis
B. Shoulder
impingement
C. Rotator cuff tear
D. Biceps tendonitis
A. Pulonary
emobolism
B. Post-op
atelectasis
C. PNA
D. CHF
Muscle Energy
Counterstrain
Articulatory
HVLA - DO NOT USE
Myofascial release
Lymphatic techniques
Common OMT Techniques
Lower extremity:
-Piriformis Syndrome
-Ankle sprain
-Knee sprain
-Plantar fasciitis
Full transcript