Osteopathic Principles and Tenets

A neurological exam is a systematic assessment of cognitive, sensory, and motor responses to identify pathologies of the nervous system. A neurological exam allows for the localization of neurologic lesions to narrow the differential diagnosis and focus on subsequent laboratory and imaging examinations. The exam should include assessments of the subject's mental status, speech, cranial nerves, motor system, deep tendon reflexes, sensation, balance, and coordination.

Pain has accompanied humans since they first existed, first lamented as the curse of existence and later understood as an adaptive mechanism that ensures survival. Pain is the most common symptomatic complaint and the main reason why people seek medical care. Pain symptoms are seen every day, by every physician, in every clinic and hospital in the world. Understanding pain physiology is the cornerstone to understanding how to treat it and to providing the individual with their first sigh of relief as definitive management is undertaken.

Bone is a compact type of hardened connective tissue composed of bone cells, membranes, an extracellular mineralized matrix, and central bone marrow. The 2 primary types of bone are compact and spongy. Because the matrix is mineralized (rather than aqueous), nutrients and waste cannot diffuse through the matrix. Bone has developed a unique structure to allow the functions to occur. The structure of bone allows the bone to be hard, but not too brittle, and gives bone the strength to resist compressive and bending forces. As a result, bone is ideally suited for the functions of support, protection of vital organs, and movement. In addition, bone produces blood cells in the marrow and is the body's primary storage site for calcium.

The process of bone formation is called ossification. The 2 types of ossification are intramembranous ossification, in which bone is developed directly from mesenchyme cells, and endochondral ossification, in which a hyaline cartilage model is created 1st and then later replaced with bone. Bone continues to grow into early adulthood at the epiphyseal plates, where chondrocytes continue to divide, die, and be replaced with mineralized bone. Bone mineralization occurs because the osteoblasts allow high levels of calcium and phosphate to accumulate above critical threshold levels within bone.