Lecture 1: Somatic Dysfunction And Barriers

Question 1

What is characteristic of skin texture in acute dysfunction?

Answer 1

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

Question 2

What is characteristic of the skin texture in chronic dysfunction?

Answer 2

Cool, pale

• chronic = increased sympathetic tone

Question 3

What is characteristic of skin quality in acute dysfunction?

Answer 3

No trophic changes

Question 4

What is characteristic of skin quality in chronic dysfunction?

Answer 4

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

Question 5

What is the term used to describe the abnormal shortening of a muscle due to fibrosis. Most often in the tissue itself, often result of chronic condition. Muscle is no longer able to reach its full normal length.

Answer 5

Contracture

Question 6

What is the term used to describe the normal tone of a muscle when it shortens or is activated against resistance?

Answer 6

Contraction

Question 7

What is the term given to describe the normal feel of muscle in the relaxed state?

Answer 7

Tone

Question 8

What does extreme hypertonicity cause?

Answer 8

Spastic paralysis

Question 9

What is hypotonicity?

Answer 9

Flaccid paralysis when there is no tone at all

Question 10

What is the term given to describe an abnormal contraction maintained beyond physiologic need. Most often sudden and involuntary muscular contraction that results in abnormal motion and is usually accompanied by pain and restriction of normal function.

Answer 10

Spasm

Question 11

What is the term used to describe increased fluid in a hypertonic muscle, similar to a wet sponge?

Answer 11

Bogginess

Question 12

What type of condition does ropiness muscle tone indicate>

Answer 12

A chronic condition

Question 13

What is characteristic of tissues in acute dysfunction?

Answer 13

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

Question 14

What is characteristic of tissues in chronic dysfunction?

Answer 14

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

Question 15

What is characteristic of vasculature in acute dysfunction?

Answer 15

Inflammation, vessel wall injury, endogenous peptide release

Question 16

What is characteristic of vasculature in chronic dysfunction?

Answer 16

Sympathetic tone increases vascular constriction

Question 17

What is characteristic of sympathetics in acute dysfunction?

Answer 17

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

Question 18

What is characteristic of sympathetics in chronic dysfunction?

Answer 18

Vasoconstriction, hypersympathetic tone, may be regional

Question 19

What is characteristic of musculature in acute dysfunction?

Answer 19

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

Question 20

What is characteristic of musculature in chronic dysfunction?

Answer 20

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

Question 21

What is characteristic of mobility in acute dysfunction?

Answer 21

ROM is usually sluggish, may be guarded to prevent further pain

Question 22

What is characteristic of mobility in chronic dysfunction?

Answer 22

Limited ROM but motion itself feels normal

Question 23

What are 4 primary examples of abnormal end feel?

Answer 23

• Early muscle spasm (protective after injury)
• Late muscle spasm (chronic)
• Hard capsular (frozen shoulder)
• Soft capsular (synovitis -> swelling of knee after injury)

Question 24

What are 3 main examples of normal end feel?

Answer 24

• Bone to bone (elbow extension)
• Soft tissue approximation (knee flexion)
• Tissue stretch (ankle dorsiflexion, shoulder lateral rotation, finger extension)

Question 25

What is the anatomical barrier?

Answer 25

The limit of motion imposed by anatomical structure -> just beyond limit of PROM

Question 26

What is the 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

What is the restrictive barrier?

Answer 27

A functional limit within the anatomic ROM, which abnormally diminishes the normal ROM

• Cant achieve full ROM, something is preventing normal ROM

Question 28

What is the elastic barrier?

Answer 28

The range between the physiologic and anatomic barrier of motion in which passive ligamentous stretching occurs before tissue disruption

• The stretch between AROM and PROM -> often the area that a warm up affects

Question 29

What is characteristic of pain in acute dysfunction?

Answer 29

Sharp, severe, cutting

Question 30

What is characteristic of pain in chronic dysfunction?

Answer 30

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

Question 31

WHat is characteristic of visceral function in acute dysfunction?

Answer 31

Minimal somatovisceral effects

Question 32

What is characteristic of visceral function in chronic dysfunction?

Answer 32

Somatovisceral effects common

Question 33

What is the osteopathic philosophy?

Answer 33

Treat the pt!

• Pt may have symptoms, illness, pain, or psychosocial cause of disease

Question 34

A 48 yo male presents to your clinic with a cc neck pain. You begin to palpating the pts posterior neck and notice a “full” and slightly mushy feeling. While writing your SOAP note, how would you best describe your pt’s skin?

Answer 34

Boggy -> “wet sponge” feeling skin