Title: Bone Wizardry / OMM Mastery / 1.The Basics
Tags: #BW_OMM::Content::Foundational #BW_OMM::Type::Cloze BoneWizardry bonewizardry-free omm omt #active #passive #Direct #EvaluatingSD #FacetMotion #Indirect #MuscleContraction
On every note of this deck, unless a note says otherwise:
Topic: The Basics
Review Links: - Bone Wizardry OMM fundamentals
- Practice: OMM Fundamentals QBank
Show outside sources
- NBOME OPP/OMT blueprint
- AACOM osteopathic glossary
- PCOM OMT overview

Q: A somatic dysfunction can present as:
[...]
Asymmetry
Restriction
Tenderness
A: Tissue texture changes
Q: A somatic dysfunction can present as:
Tissue texture changes
[...]
Restriction
Tenderness
A: Asymmetry
Q: A somatic dysfunction can present as:
Tissue texture changes
Asymmetry
[...]
Tenderness
A: Restriction
Q: A somatic dysfunction can present as:
Tissue texture changes
Asymmetry
Restriction
[...]
A: Tenderness
Bone Wizardry Lock: Each TART finding except tenderness is objective. You measure it on exam. Tenderness requires the patient to confirm it. Know all four to diagnose somatic dysfunction.

Q: [...]: the farthest point a patient can reach through active motion in any given joint.
A: Physiologic barrier
Q: A person may actively rotate their head 80° to either side; this is an example of a [...] barrier
A: physiologic
Q: [...]: the farthest a physician can passively move any given joint.
A: Anatomic barrier
Q: A physician may passively rotate the same patient's head 90° to either side; this is an example of [...] barrier
A: anatomic
Q: Anatomic barrier: the farthest a physician can [...] move any given joint.
A: passively
Q: Any movement beyond the [...] barrier will cause ligament, tendon or skeletal injury.
A: anatomical
Comment 3: Take it any further and pop goes the structures.
Comment 5: For example, a physician may passively rotate the same patient's head 90° to either side. Any movement beyond the anatomical barrier will cause ligament, tendon or skeletal injury
Bone Wizardry Lock: Physiologic is where the patient stops under their own power. Anatomic is where the joint stops when you move it for them. Cross the anatomic line and you break something.

Q: A [...] barrier prevents active motion into the physiologic barrier.
A: restrictive
Q: A restrictive barrier prevents active motion into the [...] barrier.
A: physiologic
Bone Wizardry Lock: A restrictive barrier is a pathological limit that shows up before the physiologic range is reached. It is what somatic dysfunction looks like in motion terms.

Q: [...] is the only subjective component of TART
A: Tenderness
Q: Tenderness is the only [...] component of TART
A: subjective
Bone Wizardry Lock: T, A, and R in TART are all objective. You find them on exam. Tenderness is the only one that depends on what the patient tells you.

Q: Acute SD tissue texture changes:
-Edematous
-[...]
-Boggy
-Muscles hypertonic
A: Erythematous
Q: Acute SD tissue texture changes:
-Edematous
-Erythematous
-Boggy
-Muscles [...]
A: hypertonic
Q: Chronic SD tissue texture changes:
-No edema
-No erythema
-[...] dry skin
-Muscles hypotonic
A: Cool
Q: Chronic SD tissue texture changes:
-No edema
-No erythema
-Cool dry skin
-Muscles [...]
A: hypotonic
Q: [...] SD tissue texture changes:
-No edema
-No erythema
-Cool dry skin
-Muscles hypotonic
A: Chronic
Bone Wizardry Lock: Acute SD tissue is hot, puffy, and tight, an active inflammatory picture. Chronic SD tissue has gone quiet: cool, dry, and slack. Match the tissue texture to the timeline before you pick a treatment.

Q: Asymmetry is present in [...] SD
A: acute
Q: Restriction is present in acute SD, and painful with [...]
A: movement
Q: Restriction is present in [...] SD, and painful with movement
A: acute
Q: Tenderness is [...] in acute SD
A: severe/sharp
Q: Tenderness is severe/sharp in [...] SD
A: acute
Q: Tenderness is [...] in chronic SD
A: dull/achy/burning
Q: Tenderness is dull/achy/burning in [...] SD
A: chronic
Bone Wizardry Lock: In acute SD, pain is sharp and restriction hurts with movement. In chronic SD, pain is dull, achy, or burning. Use tenderness quality and tissue texture together to place the dysfunction on a timeline.

Q: Fryette's Law 1: with the spine in the [...] position (neither flexed nor extended), introducing sidebending causes vertebral rotation to the opposite side.
A: neutral
Q: Fryette's Law 1: with the spine in the neutral position (neither flexed nor extended), introducing sidebending causes vertebral rotation to the [...] side.
A: opposite
Q: Fryette's Law [...]: with the spine in the neutral position (neither flexed nor extended), introducing sidebending causes vertebral rotation to the opposite side.
A: 1
Q: Fryette's Law 1 applies to a [...] of vertebrae
A: group
Q: Fryette's Law [...] applies to a group of vertebrae
A: 1
Comment: For example,if a person were to sidebend at T6-L2, the bodies of the vertebrae would rotate in the opposite direction.
Comment 2: For example,if a person were to sidebend at T6-L2,the bodies of the vertebrae would rotate in the opposite direction.
Bone Wizardry Lock: Law 1 is the neutral rule: sidebend one way, rotation goes the other. This happens in groups of vertebrae, not at a single level.

Q: Assess rotation by placing the thumbs over the [...] of each segment.
If the right thumb is more posterior than the left, then the segment is rotated right.
A: transverse processes
Q: Assess rotation by placing the thumbs over the transverse processes of each segment.
If the right thumb is more [...] than the left, then the segment is rotated right.
A: posterior
Q: Assess rotation by placing the thumbs over the transverse processes of each segment.
If the right thumb is more posterior than the left, then the segment is rotated [...].
A: right
Bone Wizardry Lock: Whichever thumb lands more posterior is the side of rotation. Name the dysfunction by that side.

Q: Flexion/extension rotate around the [...] axis and the [...] plane
A: transverse; sagittal
Q: Rotation rotates around the [...] axis and [...] plane
A: vertical; transverse
Q: Sidebending rotates around the [...] axis and the [...] plane
A: AP; coronal
Bone Wizardry Lock: Pair each motion with its axis and plane: flexion/extension lives in the sagittal plane around the transverse axis; rotation is in the transverse plane around the vertical axis; sidebending is in the coronal plane around the AP axis.

Q: [...] contraction: the muscle shortens as it contracts, pulling its origin and insertion toward each other.
A: Concentric
Q: [...] contraction: the muscle is contracting but lengthening because an external force is overpowering it.
A: Eccentric
Q: What type of contraction occurs when the operator's force is less than the patient's?
[...]
A: Isotonic
Q: What type of contraction occurs when the operator's force is more than the patient's?
[...]
A: Isolytic
Q: What type of contraction occurs when the operator's force is equal to the patient's?
[...]
A: Isometric
Bone Wizardry Lock: Concentric shortens, eccentric lengthens under load. For OMT force comparisons: operator less than patient means isotonic (patient's muscle moves); equal means isometric (no movement); operator more than patient means isolytic (you stretch the muscle out).

Q: In a [...] treatment, the practitioner "engages" the restrictive barrier.
A: direct
Q: In a direct treatment, the practitioner "[...]" the restrictive barrier.
A: engages
Q: In an [...] treatment the practitioner moves tissues and/or joints away from the restrictive barrier into the direction of freedom.
A: indirect
Q: In an indirect treatment the practitioner moves tissues and/or joints [...] from the restrictive barrier into the direction of freedom.
A: away
Comment: This means that the body tissues and/or joints are eventually moved through the restrictive barrier.
Bone Wizardry Lock: Direct technique works into the restriction. Indirect technique moves away from it, toward freedom, letting the tissue self-correct. The direction you move is everything.

Q: In an [...] treatment, the patient will assist in the treatment.
A: active
Q: In a [...] treatment, the patient will relax and allow the practitioner to move the body tissues.
A: passive
Comment: Active = Assist
Comment 2: Passive = Practitioner
Bone Wizardry Lock: Active means the patient participates in producing the corrective motion. Passive means the physician does all the moving while the patient stays relaxed.

Q: Name the treatments that are only indirect:
1. [...]
2. [...]
A: Counterstrain; Facilitated Positional Release (FPR)
Name the treatments that are only direct:
1. Muscle energy
2. HVLA
3. Lymphatic treatment
4. Chapman's reflexes
Q: Name the treatment types that can be either direct or indirect:
1. [...]
2. [...]
A: MFR; Cranial
Bone Wizardry Lock: Indirect techniques work toward ease, never against restriction. Direct techniques always engage the restrictive barrier. That division is what separates counterstrain and FPR from the rest of the list.

Q: Elderly patients and hospitalized patients typically respond better to [...] techniques or gentle [...] techniques such as articulatory techniques.
A: indirect; direct
Bone Wizardry Lock: Elderly and hospitalized patients tolerate indirect or gentle direct techniques better. Articulatory is the standard gentle direct choice for these populations.

Q: The use of [...] in a patient with advanced osteoporosis or metastatic cancer may lead to a pathologic fracture
A: HVLA
Q: The use of HVLA in a patient with advanced [...] or [...] may lead to a pathologic fracture
A: osteoporosis; metastatic cancer
Bone Wizardry Lock: HVLA is contraindicated when bone integrity is compromised. Advanced osteoporosis and metastatic bone disease both create pathologic fracture risk under high-velocity force.

Q: Pediatric patients can be treated more [...]; whereas geriatric patients may need a [...] time to respond to the treatment.
A: frequently; longer
Bone Wizardry Lock: Kids respond quickly and tolerate more frequent treatment sessions. Geriatric patients need more time between sessions and a longer overall treatment timeline.

Q: For psoas syndrome, treat the [...] spine or [...] spine first.
A: lumbar; thoraco-lumbar
Q: Treat the ribs and upper thoracic spine before treating the [...] spine
A: cervical
Q: Treat the [...] spine before treating rib dysfunctions
A: thoracic
Bone Wizardry Lock: Sequencing prevents aggravating a secondary dysfunction when the primary is untreated. Thoracic first, then ribs, then cervical. For psoas syndrome, treat the lumbar or thoracolumbar before the psoas itself.

Q: [...] barrier is the limit to where the patient can take it.
A: Physiologic
Bone Wizardry Lock: The physiologic barrier is the active end of a patient's range. Beyond it is the anatomic barrier. Most techniques work within or at the physiologic barrier.

Q: Fryette's Law [...] states motion in 1 plane decreases motion in other planes.
A: 3
Bone Wizardry Lock: Fryette 3 is the clinical constraint: loading motion in one plane reduces available range in the other two. Address planes sequentially rather than stacking all three at once.

Q: Somatic dysfunctions are named for the [...]
A: ease
Comment: i.e. direction it prefers
Bone Wizardry Lock: Named for ease, not restriction. A vertebra diagnosed as rotated right prefers right rotation and resists left rotation. Treat toward the restriction.

Q: Patient is diagnosed as T2ES_LR_L, how would you initially position them if you were doing a direct technique?
[...]
A: T2FS_RR_R
Bone Wizardry Lock: Direct technique starts at the restrictive barrier, opposite to the position of ease. T2 eased into extension, sidebend left, and rotation left, so the direct starting position is flexion, sidebend right, and rotation right.