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Flashcards in CBL Cardiovascular Disease Techniques Deck (20)
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Intercostal respiratory muscles

External intercoastals
- elevate the ribs during inhalation

Internal intercoastals
- depress ribs w/ exhalation

Innermost intercoastals
- aid in exhalation


What joints in the spine are closest to the sympathetic chain ganglia?

Costovertebral joints


Upper thoracic paraspinal inhibition/traction steps

1) seated next to supine patient w/ hands under upper thoracic spine

2) find the posterior rib angles w/ finger pads

3) contact the soft tissues just superficial to these rib angles w/ fingers perpendicular to the persons body (parallel to the long axis of the ribs)

4) lean backwards w/ torso slightly transferring a minimal traction force through hands to soft tissues


Thoracic spine BLT steps

*note: this is an INDIRECT technique*

1) Stand/sit directly to the side of the supine patient where the affected vertebra is

2) contact the spinous process of the affected segments w/ finger pads and make firm contact

3) move vertebra into rotation (right and left)

4) move vertebra into flexion or extension (push the spinous process together or apart)
- if there is tightness in both, keep neutral

5) translate right -> left and left -> right to induce sidebending
- remember If it is type 1, to induce sidebending opposite, push veterbal body medially

6) DONT TAKE TO BARRIER, only to where disengagement is found

7) add desperation as well


Craniocervical MFR release

Note: this is an INDIRECT technique

1) patient supine w. Doctor at head of table seated

2) place hands so that the palms are on the occiput and the fingers surround the posterior and lateral cervical regions , with fingers interlaced.

3) perform layer palpation

4)assess motion in rotation, translation and flexion/extension

5) stack those 3 w/ compression or traction (which ever is relaxed)

6) add respiration


5 models of OMT




Metabolic energy



Why is metoprolol a special BB?

It is specific to B1 receptors and does NOT affect B2 receptors
- very good with patients w/ COPD and asthma


What is the most common sympathetic innervation point for an acute MI

T2 spinal segment on the left


Techniques used for balancing sympathetic vs parasympathetic tones

- Rib raising
- work on the thoracic vertebrae w/ ribs (T1-T5)

- suboccipital inhibition
- work on the upper cervical vertebrae (specifically OA/AA)


Travell Trigger points

Found on the right pectorals muscle and is almost always seen in patients w/ SVTs


What is the starting point for most treatments w/ increased sympathetic


*usually start proximal and work to ribs specifically to reduce input through facilitated segments*


Hyperactivity of the right vagus predisposes someone to what?

Brady arrhythmias
- this is because it effects the SA node and controls the Atria
- also includes sick sinus syndrome


Hyperactivity of the left side of the vagus nerve predisposes someone to what?

AV heart blocks
- because it innervates the AV node and controls ventricles
- examples are any heart blocks


Sympathetic affects on the heart

Increases heart contraction

Shorten diastole

Increases ventricular output

Increases rate of contraction

Increases BP


What rib joint is closest to the sympathetic chain ganglion

Costoverterbal joints


Do you use indirect or direct treatment for acute MIs?

Indirect treatments
- due to causing initial sympathetic stimulation which would make the condition worse

Initial treatment is usually aimed at the upper thoracic spine and rib cage to decrease chance of additional segmental imputes


NYHA class indications for CHF

1: no symptoms or limitations w/ ordinary activity

2: mild symptoms (mild dyspnea/ angina) w/ ordinary activity

3: symptoms are present except at rest

4: symptoms are always present

* note abnormal gait increases cardiac workload up to 300%*



Afferent mechanoreceptors and metabolic receptors that give input to control ventilation


Prolonged sympathetic stimulation to the kidney results in what?

Retention of sodium and water through B-1 receptors


Sympathetic and parasympathetic activity effects on lymphatic drainage

Sympathetics control the diameter of the thoracic duct and large lymph vessels
- increased sympathetics = reduce the diameter and overall flow