Lecture 1 LO

Question 1

Describe the elements of somatic dysfunction

-Tissue texture changes-Skin (texture)-acute?

Answer 1

Warm, moist, red, inflamed (vascular and chemical changes)

Question 2

Describe the elements of somatic dysfunction

-Tissue texture changes-Skin (texture)-chronic?

Answer 2

Cool, pale (chronic increases sympathetic tone)

Question 3

Describe the elements of somatic dysfunction

-Tissue texture changes-Skin (quality)-acute?

Answer 3

No trophic changes

Question 4

Describe the elements of somatic dysfunction

-Tissue texture changes-Skin (quality)-Chronic?

Answer 4

Trophic changes: dry, scaly, cold, pale, shiny, hairless, pimples, folliculitis

Question 5

Describe the elements of somatic dysfunction

-Tissue texture changes-Tissues-acute?

Answer 5

Boggy edema, acute congestion, fluids in area of damage drawn in by chemical rxns

Question 6

Describe the elements of somatic dysfunction

-Tissue texture changes-Tissues-Chronic?

Answer 6

Chronic congestion, doughy, stringy, fibrotic, ropy, thickened, contractures

Question 7

Describe the elements of somatic dysfunction

-Tissue texture changes-vascular-acute?

Answer 7

Inflammation, vessel wall injury, endogenous peptide release

Question 8

Describe the elements of somatic dysfunction

-Tissue texture changes-Vascular-Chronic?

Answer 8

Sympathetic tone increases vascular constriction

Question 9

Describe the elements of somatic dysfunction

-Tissue texture changes-Sympathetics-Acute?

Answer 9

Sympathetic activity but local vasoconstriction overpowered by local chemical release, net effect is vasodilation

Question 10

Describe the elements of somatic dysfunction

-Tissue texture changes-Sympathetics-Chronic?

Answer 10

Vasoconstriction, hypersympathetic tone, may be regional

Question 11

Describe the elements of somatic dysfunction

-Tissue texture changes-Musculature-Acute?

Answer 11

Local increase in muscle tone, muscle contraction, spasm, increased tone of muscle spindle

Question 12

Describe the elements of somatic dysfunction

-Tissue texture changes-Musculature-Chronic?

Answer 12

Decreased muscle tone, flaccid, mushy, limited range of motion due to contractures

Question 13

Describe the elements of somatic dysfunction

-Asymmetry?

Answer 13

Are the bilateral parts of the body level with each other

-Right shoulder on same level with left shoulder

Question 14

Describe the elements of somatic dysfunction

-Restriction of motion-Mobility-Acute?

Answer 14

Usually sluggish, may be guarding (to prevent further pain)

Question 15

Describe the elements of somatic dysfunction

-Restriction of motion-Mobility-Chronic?

Answer 15

Limited range of motion, but motion itself feels normal

Question 16

Describe the elements of somatic dysfunction

-Tenderness?

Answer 16

• Discomfort of pain elicited by the physician through palpation
• A state of unusual sensitivity to touch or pressure

Question 17

Describe the elements of somatic dysfunction

-Tenderness-pain-acute?

Answer 17

Sharp, severe, cutting

Question 18

Describe the elements of somatic dysfunction

-Tenderness-pain-Chronic?

Answer 18

Dull, ache, paresthesias (tingling, burning, gnawing, itching)

Question 19

Describe the elements of somatic dysfunction

-Tenderness-visceral function-acute?

Answer 19

Minimal somatovisceral effects

Question 20

Describe the elements of somatic dysfunction

-Tenderness-Visceral function-chronic?

Answer 20

Somatovisceral effects common

Question 21

Define the term passive range of motion

Answer 21

• The patient is NOT active, completely passive
• Does not require participation of patient
• The examiner takes the patient’s relaxed limb through its complete range
• Because there are no muscles in use (ideally), there are no muscular restrictions, only ligaments to stop motion
• Greater range of motion in passive than active ROM

Question 22

Define the term active ROM

Answer 22

• The patient demonstrates the activity
• Requires the patient to use their own muscles, agonists and antagonists, to achieve the desired motion
• Because both sides of muscles are in use, the ROM is LESS than passive ROM
• Must have the understanding and cooperation of patient

Question 23

Define the term anatomic barrier

Answer 23

• The limit of motion imposed by anatomic structure
• Just beyond the limit of PROM
• The point past which tissue disruption occurs

Question 24

Define the term elastic barrier

Answer 24

• The range between the physiologic and anatomic barriers of motion in which passing ligamentous stretching occurs before tissue disruption
• “The stretch between AROM and PROM”
• Often the area that a “warm up” affects

Question 25

Define the term pathologic barrier

Answer 25

Permanent restriction of joint motion associated with pathologic changes of tissues

Question 26

Define the term physiologic barrier

Answer 26

- The limit of active motion - Can increase ROM by warm up activities - "As far as you can go by yourself"

Question 27

Define the term restrictive barrier

Answer 27

- A functional limit within the anatomic ROM, which abnormally diminishes the normal ROM - Cannot achieve full ROM-something preventing it-muscle contraction, tight ligament, etc.

Question 28

Define and understand somatic dysfunction

Answer 28

The impaired or altered function of related skeletal components of the somatic system -Skeletal, arthrodial (joints), myofascial structures, and related vascular, lymphatic, and neural elements

Question 29

Describe the elements of somatic dysfunction - Acronym? - What do each of the letters stand for?

Answer 29

- TART - Tissue texture changes - Asymmetry - Restriction of motion - Tenderness

Question 30

Tone - Definition? - Contrasts with?

Answer 30

- Normal feel of muscle in the relaxed state - Contrasts with hypertonicity-at the extreme=spastic paralysis - Contrasts with hypotonicity-no tone at all=flaccid paralysis

Question 31

Contraction

Answer 31

Normal tone of a muscle when it shortens or is activated agaist resistance

Question 32

Contracture

Answer 32

- Abnormal shortening of a muscle due to fibrosis - Most often in the tissue itself, often the result of a chronic condition - Muscle is no longer able to reach its full normal length

Question 33

Spasm

Answer 33

- Abnormal contraction maintained beyond physiological need - Most often sudden and involuntary muscular contraction that results in abnormal motion - Usually accompanied by pain and restriction of motion

Question 34

Bogginess

Answer 34

- Increased fluid in a hypertonic muscle | - Similar to a wet sponge

Question 35

Ropiness

Answer 35

- Hard, firm, rope or cord-like muscle tone | - Usually indicates a chronic condition

Question 36

End feel

Answer 36

- The palpatory experience or perceived quality of motion when a joint is moved to its limit-a barrier is approached - Abnormal end feel-early or late muscle spasm

Question 37

How somatic dysfunctions are named

Answer 37

- Where they like to live - Position of ease-if a body segment freely rotates to the left, but is restricted to the right, the restriction is named "rotated left"