2c Flashcards
(79 cards)
1
Q
What level is the first spine that sticks out dominantly in the neck?
A
C7
2
Q
What level is the PSIS?
A
S2
3
Q
What level is the Angle of Louis?
A
T4
4
Q
What level is the xiphoid process?
A
T9
5
Q
What is the Angle of Louis?
A
Where manubrium and sternum meet
6
Q
Umbilicals level
A
L3-L4 interspace
7
Q
Greater trochanter is same level as what?
A
Pubic Symphysis
8
Q
Define “Somatic Dysfunction”
A
Impaired or altered function of related components of the somatic (bodywork) system including the skeletal, arthrodial, and myofascial structures and their related vascular, lymphatic, and neural elements
9
Q
Is Somatic Dysfunction treatable with OMT?
A
Yes
10
Q
What is the Soma?
A
Skeletal
Arthrodial
Myofascial
11
Q
What are the neural, vascular, and lymphatic elements?
A
Related to Soma
12
Q
What is the most important part of TART?
A
None; depends on which model or treatment you intend to use but Restriction is key
13
Q
TTA
A
Tissue Texture Abnormality (TTC)
14
Q
Can we measure Sensitivity in TART?
A
Yes; STAR
15
Q
3 things to use for “Tenderness”
A
- Biomechanical
- Counterstrain TPs
- Travell trigger points
16
Q
3 things to use for “Asymmetry”
A
- Postural Model
- Axial somatic dysfunction
- Appendicular somatic dysfunction
17
Q
Restricted Motion 2 things
A
- Zink Fascia = regions
2. AGR = segments
18
Q
3 things for “Tissue Texture Change”
A
- Acute-Chronic
- Neurological
- Congestion (fluid changes)
19
Q
Can tenderness be specific?
A
Yes
20
Q
Restriction on Motion 4 benefits
A
- Helps identify tissue type of dysfunction
- Allows naming articular dysfunction
- Allows positioning for direct or indirect methods
- Patten aids in “Differential Diagnosis”
21
Q
What is a Somatic Dysfunction Barrier?
A
Freedom in one area and restriction in another
22
Q
Patter of barrier can show what?
A
Position that patient was in when injury/dysfunction occurred
23
Q
Paired elements bilaterally restricted shows what?
A
Probably inflammation/pathlogical as opposed to somatic dysfunction
24
Q
Passive Motion gives what feel?
A
“End” feel
25
T5 somatic dysfunction shows what?
T5 moving on T6
26
What is useful in defining barriers?
End feel
27
Anatomic barrier
Limit of PASSIVE motion
28
Physiological Barrier
Limit of ACTIVE motion
29
Elastic Barrier
Range between physiological and anatomical barrier of motion in which passive ligamentous stretching occurs before tissue disruption
30
What is a Restrictive Barrier
Functional limit that abnormally diminishes the normal physiological range
31
Name the 4 barriers for a single direction
1. Physiological
2. Elastic
3. Anatomical
4. Restrictive
32
What is a Capsular Pattern
Barriers abrupt in BOTH paired directions - can't reach normal physiological barriers
33
What is a pathologic barrier?
A restriction of joint motion associated with pathological change of tissues (osteophytes)
34
Difference between Somatic Dysfunction and Capsular Dysfunction
```
Somatic = 1 barrier
Capsular = both directions of pair are restricted
```
35
Which Fryette is for a Group Curve?
Type 1
36
What does a Type 2 single segment do?
Rotates into intended concavity
37
What is Physiological Motion of the Spine related to ?
Fryette
38
If it doesn't return to normal, what do we have?
Dysfunction, not physiological motion
39
3 things with Fryette Type 1
1. May not be symptomatic
2. May need to treat if wish to rehabilitate posture
3. Often treat the apex of curve
40
3 things with Fryette Type 2
1. Often symptomatic (sclerotomal innervation)
2. Biomechanical from extreme flexion or extension
3. May be involved in viscerosomatic of somatovisceral reflexes
41
Which type is more common? Does it still have TART?
Type 1; yes
42
How is pain characterized in Type 2?
Deep, dull, achy
43
What is the Nociceptive Model?
Noxious stimulus of somatic dysfunction
44
What does noxious stimulus of somatic dysfunction lead to?
1. Local biochemical "sensitizing soup"
2. Activation of spinal reflexes
3. Activation of sympathetics
45
What is the process of a Spinal Cord Nocifensive Reflex?
1. Skeletal muscle activity (shortened)
2. Maintained shortening
3. Connective tissue reorganized in shortened form
46
4 Muscle Fascia Responses
1. Acute = contraction
2. Chronic = contracture
3. Segmentl facilitation
4. Pain-spasm-pain response
47
Do changes occur both in spinal cord and periphery? What does it affect?
Yes; local somatic dysfunction found and response to treatment
48
What 3 effects occur from Sympathetic Activation?
1. Visceral effects
| 2. Immune effects
49
What 6 things do we see in sympathetic activation?
1. Vasoconstriction of vessles to skin and segmental viscera
2. Activation of sweat glands in skin (acute and early chronic)
3. Activation of sympathetic responses to end-organs
4. Central sensitization: higher pain perception and response
5. Release of (nor)epinephrine and cortisol
6. Reduced immune function (direct and secondary)
50
2 examples of Noxious stimulus
1. Repetitive strain
| 2. Injury
51
What does a noxious stimulus initiate?
Production of "biochemical sensitizing soup"
52
6 examples of sensitizing soup
1. Cytokines
2. Histamine
3. Interleukins
4. Prostaglandins
5. Substance-P
6. Bradykinin
53
What does sensitizing soup lead to?
1. Hyperalgesia
2. Inflammation
3. Edema
54
What horn is the soup associated with?
Dorsal
55
Tissue Texture Change can help in what?
Choosing direct vs indirect OMT
56
What does Hysterisus mean?
After compression, how quickly do tissues return to non-compressed state
57
What blend do we see in tissue texture?
Blend of physiological processes: biochemical-autonomic-trophic
58
What does TTA permit?
Physiological diagnosis
59
Do acute and chronic associate just time?
No; different palpatory diagnostic criteria
60
What is acute associated with?
Biochemical - autonomic (sympathetic)
61
What is chronic associated with?
Autonomic (sympathetic) functional changes
62
What is very chronic associated with?
Sympathetic + trophic changes
63
What are bradykinins?
Histamine
64
Does acute vs chronic have a physiological meaning?
Yes
65
Acute needs what kind of OMT? (IMPORTANT)
Indirect OMT = acute
66
Chronic needs what kind of OMT? (IMPORTANT)
Direct OMT = chronic
67
3 things with acute
1. Pain
2. Edema
3. Muscle contraction
68
2 things with Chronic
1. Fibrosis
| 2. Muscle contracture
69
Difference between contraction and contracture
Contraction wound healing where wound edges are pulled together, contracture is abnormal contraction of a muscle
70
What is mechanotransruction?
Change of biochemical kinetics
71
What can speed healing in mechanotransduction?
Titrated mechanical force to integrins or venous stasis pumps)
72
Biomechanics can reduce and modulate what?
1. Musculoskeletal function
2. Nociception/pain
3. Homeostasis/physiologiy modulation in all systems
73
What does touching do?
Pain reduction impacting biopsychosocial mechanisms
74
Somatic Dysfunction can do what for the models?
Give somatic clues that can be linked to each model
75
Asymmetry used in what?
1. Postural model
| 2. Zink fascial pattern for either postural or respiratory-circulatory
76
Restriction in motion related to what?
1. Biomechanical model with AGR
| 2. Biomechanical model with flexion tests or pelvic sideshift test
77
Tenderness interprets what?
TTC of physiology for key lesion in any of the models
78
T>R in what?
Neurological-autonomic model
79
Tenderness often used in what?
Counterstrain
