Lecture 5 Flashcards
(107 cards)
1
Q
What is soft tissue?
A
living tissue in the body other than bones
2
Q
is bones soft tissue
A
nooooo
3
Q
ex of soft tissue
A
fascia muscles organs nerves vasculature lymphatics
4
Q
where is soft tissue techniques applied to
A
muscular and fascial structures
5
Q
what do soft tissue techniques affect
A
assx neural and vasculature elements
6
Q
Soft tissue preparation helps improvement of ___________
A
articular motion
7
Q
Does soft tissue have a wide range of applications of force or narrow range?
A
wide
8
Q
what makes ST techniques one of the most versatile treatments forms?
A
it can span a wide range of applications of force
9
Q
fascia atatomy- soft tissue
A
collagen and elastin in a network of proteoglycans (PGs) that link the collagen in it,
10
Q
ECM makes up how much of soft tissue
A
95%
11
Q
what is fascia
A
a complete system with [blood supply], [fluid drainage] and [innervation]
12
Q
what is the largest organ in the body
A
fascia
13
Q
job of fascia
A
protect tissues
heal surrounding systems
14
Q
What is NOT fascia
A
tendons
ligaments
aponeuroses
15
Q
What are the layers of fascia
A
- Pannicular fascia (panniculus)
- Axial and appendicular fascia
- Meningeal fascia
- Visceral fascia
16
Q
What is the most outerlayer of fascia
A
pannicular fascia
17
Q
tell me about pannicular fascia
A
- outermost layer
- derived from somatic mesenchyme
- surrounds entire body except orifices
- outer layer is adipose tissue
- inner layer is membraneous and adherent to outer
18
Q
pannicular fascia is derived from
A
somatic mesenchyme
19
Q
outer layer of pannicular fascia is made up of
A
adipose tissue
20
Q
inner layer of pannicular fascia is
A
membraneous and adherent to outer
21
Q
What layer of fascia is called the investing layer
A
axial and appendicular fascia
22
Q
tell me about axial and appendicular fascia
A
below pannicular layer
surrounds all muscles, periosteium of bone and peritendon of tendons
23
Q
what does the axial and appendicular fascia surround
A
muscles
perosteum of bone
perosteium of tendon
24
Q
fascia is omnipresent
A
its EVERYWHERE. covers EVERYTHING
25
if we take off all of the fascia, what are we
bones
26
fascia is also called
perimysium
27
is fascia continuous?
yes. from head to toe it is continuous.
28
what does it imply that fascia is continuous
a problem with fascia at one place may affect ROM in another place
29
Meningeal fascia
surrounds the NS
| includes the dura
30
what part of fascia is the dura
meningeal
31
Visceral fascia
surrounds the cavities of the body
32
ex. of visceral fascia
pleural
pericardial
peritoneum
33
omnipotent fascia
its POWERFUL- stabilizes and mobilizes musculoskeletal system
34
is fascia elastic or contractile
both
35
what allows fascia to be contractile
myofibroblasts
36
what does it mean that fascia is a visoelastic material
deforms according to the [rate of loading] and [deformity].
37
stress
force that we use to deform CT
38
Strain
percentage of deformation of the tissue
39
stress produces a _____
strain
40
increase stress = ______ strain
increase
41
during cyclic loading of a tendon, what direction does the stress-strain curve move?
RIGHT
giving us better mobility
42
Hysteresis
difference between the loading and unloading characteristics repersents NRG that is lost in the CT system
43
What happens if we stretch CT into its plastic deformational range?
lengthens it
44
because our fascia is viceroelastic, what must we do
keep stretching it
45
what is tissue creep
used in direct methods, MFR
under a sustained constant load, CT will elongate (deform)
46
for tissue to creep, constant load must be
below failure threshold
47
what is ease
direction CT is moved most easily during deformational stretching
48
other words for ease
looseness
laxity
greater degree of mobility
49
what is bind
palpable restriction of CT mobility
50
the restriction of fascia at one area will do what?
create CT restrictions at OTHER areas away from the initial site
or may increase mobility at other places
51
What is the result of the "fascial sweater"
abnormal myofascial and joint mobility
52
newtons third law
when two bodies interact the forces exerted are equal in magnitude and oppisite in direction
53
hookes law
the strain (deformation) placed on an elastic body is proportionate to the stress (force) we use
54
one word for strain
deformation
55
one word for stress
force
56
Wolffs law
fascia will develop/reform based on the stress we put on it
57
energy in the fascia is ____ and _____ according to wolfs law
stored
releasesd (piezoelectricity)
58
AROM, PROM
what is changed when a restrrictive barrier is present
BOTH
59
direct techniques
restore motion by going INTO restrictive barrier
60
indirect techniques
restore motion by going AWAY from restrictive barrier
61
indirect techniques will have what effects?
shift our abnormal neutral barrier
62
for someone more sick or with more severe injuries, what do you use,
direct or indirect
indirect
63
how are tightness and looseness related
for every tightness, there is 3-D looseness that is usually in the exactly opposite direction from tightness
64
sherringtons law
whena muscle receives nerve impoulse to contract
the antagonist m will receive an impulse at the same time to relax
65
if our right clavicle area is tight, what will the left clavicle be
probably loose
exactly opposite
66
what is the common compensatory pattern
```
LRLR
head tilted left
cerivcal-thoracic junction R
thoraco-lumbar- L
lumbo-sacral- R
```
80% of people
67
What is the uncommon compensatory pattern
RLRL
20% of people
68
when do uncompensated patterns occur
these are usually accompanied with symptoms and trauma
69
what is the ideal pattern?
depends on the pt
70
transition zones of spnie
1. OA, C1, C2
2. C7-T1
3. T12-L1
4. L5-sacrum
71
Transverse restrictors
1. tentorium cerebelli
2. thoracic inlet
3. thoracolumbar diaphragm
4. pelvic diapragm
72
how can we test compensatory patterns
motion test at transition zones
73
what are soft tissue techniques
diagnose and tx tissues OTHER than skeletal or arthoidal
74
ST
| Tissue texture abnormality and assymetty goals
1. Stretch and increase elasticity
| 2. Improve nutrition, oxygenation and remove wastes
75
ST
Asymmetry of muscles bc hypertonic or spastic goals
return symmetry and normalize tone
76
ST
Restriction motion due to myofascial restrictions goals
set fascia free
77
ST
tenderness due to abnormal neurologic activity goals
normals neurologic activity (pain, guarding and propioception)
improve abnormal somato-somatic
and somato-visceral reflexes
78
ST indication
1. diagnostically identify areas of ROM, tissue texture changes, sensitivity
2. feedback about tissue response to OMT
3. imporve immune response
4. relax
5. enhance circulation
4. tonic stimulation
79
ST RELATIVE contraindications
1. Severe osteoporosis
| 2. Acute injuries
80
what techniqies are contraindicated in the thoracoacostal region
what can we use instead
prone pressure techniques
we can use lateral recumbant
81
absolute contraindications
we cannot use in the local region for any of the following conditions
1. fracture/dislocation
2. neurological entrapment syndrome
3. serious vascular compromise
4. local malignancy
5. local infection
6 bleeding disorders
82
Principle of ST techniuq
1. patient should be comfortable
2. doc should be comfy
3. at first, apply gentile forces rhymically for about 1 to 2 seconds
increase amplitude but keep rate same
83
should ST techniques be uncomfortable?
no. they should be comfortable or a GOOD discomfort
84
should we create friction on skin in ST?
no. hands should carry skin and tissue
85
When do we stop ST technique?
when amp has reached max and has plateued
then reassess
86
what is stretch
aka parallel traction
increase distance between origin and insertion
87
in stretches, what way do we stretch
parallel with muscle fibers
88
how can we stretch parallel with fibers?
stabilize one side and pull other
or pulling in opposite directions of each hand
89
taffy pull=
stretch
90
kneading is also called
perpendicular traction
91
how do we knead
push PERPENDICULAR to the fibers
92
bowstring=
kneading
93
inhibition
push and hold perpendicular to fibers at the musculotendinous part
94
ST strategies
stretch
knead
inhibition
95
MFR uses what kind of feedback
continual palpatory feedback to achieve the release of myofascial tissues
96
is MFR direct or indirect?
both.
Tissue creeps at direct
97
when can we say that tissue creeps
direct MFR
98
what does INR stand for
integrative neuromusculoskeletal release
99
What is INR
a treatment where combined procedures are made to stretch and reflexively release ST
uses all three planes
100
INR use what/
release enchancing maneuvers (REMS)
101
REMS
release enhacing maneurvers.
used by INR
102
what are example of REMS
breath holding
prone and supine simulated swimming nad pedulum arm swim
R/L cervical rotation
isometric limb and neck movements against table, chair
patient evoked movements from cranial nerves (eye, tongue, jaw)
103
what are the indications for MFR?
1. Somatic dysfunction
2. when HVLA or muscle NRG is contraindicated (consider indirect MFR)
3. when counterstrain is difficult due to pts inability to relax
104
absolute contraindications ofr MFR
no consent
| no SD
105
relative contraindication
- infection
- fracture, avulsion, disolaction
- metastatic dz
- soft tissue injuries: thermal, hematoma, open wounds
- wounds
- rheumatalogic condition that involves instability of cervical spnine
- DVT (deep vein thrombosis) or anticoagulation therapy
106
When do we stop MFR
when we feel
1. warmth
2. softening
3. increased compliance/ ROM
4. activating forces no longer make a change
107
what do we do when we are done with MFR
check and see if tissue is symetrical
