(4) Osteopathic Reflexes

Question 1

What is a reflex?

Answer 1

A relationship b/w an input stimulus to the body and an output action to either a muscle or secretory organ

Question 2

Spinal cord gray matter

Layers 3,4 =?

Answer 2

Mechanoreceptors

Question 3

Spinal cord gray matter

Layers 1 and 5?

Answer 3

A (delta) fast pain fibers

Question 4

Spinal cord gray matter

Layer 2?

Answer 4

Small c fibers of slow pain

Question 5

What is the CLINICAL APPLICATION of using reflexes?

Answer 5

Visceral disturbances reflexly cause activation in the somatic musculature

Which produces dysfunction!!!

Somatic disturbances can reflexly alter visceral function

Question 6

Sensitivity of Neurons

What is:

Short term excitability?

Answer 6

Excitability lasts for 90-120 seconds

Question 7

Sensitivity of Neurons

What is:

Long term sensitization?

Answer 7

Inputs of several minutes

Excitability lasts for hours

Question 8

Sensitivity of Neurons

What is:

Fixation?

Answer 8

15-40 minutes of afferent input

Excitability lasts for days or weeks

Question 9

Sensitivity of Neurons

What is:

Permanent Excitability?

Answer 9

Lasts forever (?) - a long time

Death of inhibitory interneurons

Question 10

Who was the first to show reflex changes using EMG?

Answer 10

Denslow

Question 11

Who coined the term facilitated segment?

What is a facilitated segment?

Answer 11

Korr

Interneurons that are bombarded with excitement

Question 12

What is habituation?

Answer 12

Process of decreasing response of a neural pathway with continuous stimulation

Question 13

What is the opposite of habituation?

Answer 13

Sensitization

Question 14

What is allostasis?

Answer 14

Long term neural effect of segmental facilitation

Question 15

Allostasis has been associated with?

Answer 15

CV : HTN, increased risk of MI

Neuro: Depression, anxiety, memory loss, decreased cognition

Immune: immunosupression, autoimmune disease

Question 16

Define:

Somatosomatic

Answer 16

Localized somatic stimuli producing patterns of reflex response in segmentally related…

Somatic structures

Question 17

Define:

Somatovisceral

Answer 17

Localized somatic stimulation producing patterns of reflex response in segmentally related…

Visceral structures

Question 18

Define:

Viscerosomatic

Answer 18

Localized visceral stimuli producing patterns of reflex response in segmentally related…

Somatic structures

Question 19

Define:

Viscerovisceral

Answer 19

Localized visceral stimuli producing patterns of reflex response in segmentally related…

Visceral structures

Question 20

What are a couple of examples of somatosomatic reflex?

Answer 20

Withdrawal response

Myotatic response

Question 21

What is an example of a viscerovisceral reflex?

Answer 21

Distention of the gut results in increased contraction of the gut muscle

Question 22

What is a somatocardiac reflex?

Answer 22

Nociceptive somatic stimuli result in elevation of heart rate and blood pressure

Question 23

What is a somatogastric reflex?

Answer 23

Nociceptive somatic stimuli results in inhibition of peristalsis in the stomach

Question 24

What is the somatoadrenal reflex?

Answer 24

Nociceptive somatic stimuli results in the release of catecholamines from the adrenal medulla

Question 25

What is a **viscerosomatic reflex?** Name a MAJOR example of this

Answer 25

When somatic pain referral is due to visceral nociceptie stimuli Heart attack

Question 26

Where are a majority of interneurons living in the spinal cord?

Answer 26

DRG

Question 27

State the levels of viscerosomatic reflexes of: Head/neck

Answer 27

T1-T5

Question 28

State the levels of **sympathetic** viscerosomatic reflexes of: Upper GI (Including Upper Esophagus)

Answer 28

T5-T10

Question 29

State the levels of **sympathetic** viscerosomatic reflexes of: Small intestine/Ascending colon

Answer 29

T9-T11

Question 30

State the levels of **sympathetic** viscerosomatic reflexes of: Ascending and Transverse Colon

Answer 30

T10-L2

Question 31

State the levels of **sympathetic** viscerosomatic reflexes of: Descending and Sigmoid Colon/Rectum

Answer 31

T12-L2

Question 32

State the levels of **parasympathetic** viscerosomatic reflexes of: Upper GI (including upper esophagus)

Answer 32

Vagus n. (OA, AA)

Question 33

State the levels of **parasympathetic** viscerosomatic reflexes of: Small intestine/Ascending colon

Answer 33

Vagus n. (OA, AA)

Question 34

State the levels of **parasympathetic** viscerosomatic reflexes of: Ascending and Transverse Colon

Answer 34

Vagus n. (OA, AA)

Question 35

State the levels of **parasympathetic** viscerosomatic reflexes of: Descending and Sigmoid Colon/Rectum

Answer 35

S2-S4 (Sacrum)

Question 36

State the levels of **sympathetic** viscerosomatic reflexes of: Upper extremities

Answer 36

T2-T7

Question 37

State the levels of **sympathetic** viscerosomatic reflexes of: Lower extremities

Answer 37

T11-L2

Question 38

State the levels of **sympathetic** viscerosomatic reflexes of: Heart

Answer 38

T1-T6

Question 39

State the levels of **sympathetic** viscerosomatic reflexes of: Adrenals

Answer 39

T5-T10

Question 40

State the levels of **parasympathetic** viscerosomatic reflexes of: Heart

Answer 40

Vagus n. (OA, AA)

Question 41

State the levels of **parasympathetic** viscerosomatic reflexes of: Adrenals

Answer 41

Vagus n. (OA, AA)

Question 42

State the levels of **sympathetic** viscerosomatic reflexes of: Lungs

Answer 42

T1-T7

Question 43

State the levels of **parasympathetic** viscerosomatic reflexes of: Lungs

Answer 43

Vagus n. (OA, AA)

Question 44

State the levels of **sympathetic** viscerosomatic reflexes of: Genitourinary Tract

Answer 44

T10-L2

Question 45

State the levels of **parasympathetic** viscerosomatic reflexes of: Reproductive organs, pelvis

Answer 45

S2-S4

Question 46

State the levels of **sympathetic** viscerosomatic reflexes of: Genitourinary tract (includes bladder)

Answer 46

T10-L2

Question 47

State the levels of **sympathetic** viscerosomatic reflexes of: Ureter - Upper

Answer 47

T10-T11

Question 48

State the levels of **sympathetic** viscerosomatic reflexes of: Ureter - Lower

Answer 48

T12-L2

Question 49

State the levels of **parasympathetic** viscerosomatic reflexes of: Upper ureter

Answer 49

Vagus n. (OA, AA)

Question 50

State the levels of **parasympathetic** viscerosomatic reflexes of: Bladder

Answer 50

S2-S4 (Sacrum)

Question 51

State the levels of **parasympathetic** viscerosomatic reflexes of: Lower ureter

Answer 51

S2-S4 Sacrum

Question 52

State the levels of **parasympathetic** viscerosomatic reflexes of: Reproductive organs

Answer 52

S2-S4 Sacrum

Question 53

What are **chapman's points?**

Answer 53

A group of **palpable points** occuring in the predictable locations on the anterior and posterior surfaces of the body that are considered to be r_eflections of visceral dysfunction or disease_

Question 54

What are the **3 component characteristics** of chapman's reflexes?

Answer 54

1. Viscerosomatic reflex 2. Gangliform contraction 3. A consistent reproducible series of points both anterior and posterior related to specific organs or conditions

Question 55

The PAIN associated with a chapman's point is characteristically...

Answer 55

Pinpoint, sharp and non-radiating Located under the physicians finger tip Pain is greater than expected Pt. is usually previously unaware of the sore spot

Question 56

How do you treat a chapman's point?

Answer 56

1. Firm pressure 2. Heavy uncomfortable pressure to gangliform mass 3. Slowly move finger in circular fashion 4. Continue for 10-30 seconds 5. Can alternate CC/CCW 6. Cease stop treatment when mass dissapears or no one can tolerate

Question 57

Contraindications for chapman's?

Answer 57

Pt. needs emergent care Pt. refusal Fracture, cancer or otherwise instable