soft tissue and mfr

Question 1

what techniques are directly applied to the muscular and fascial structures of the body and affect the associated neural and vascular elements. improves articular motion. uses force

Answer 1

soft tissue techniques

*directed toward tissues other than skeletal or arthropodal (only muscular or facial and facial parts)

Question 2

what is in “soft tissue”

Answer 2

fascia 
muscles
organs
nerves
vasculature 
lymphatic

Question 3

fascial anatomy

“diety for the body”

Answer 3

connective tissue with collage and elastin in an amporhous metric of hydrated proteoglycans which mechanically links the collage fiber networks in these structures

Question 4

T/F fascia is a complete sytem with blood supply, fluid drainage, and innervations

Answer 4

true

Question 5

what comprises fascia ? what is its function?

Answer 5

irregular dense CT, fibrous elements of varying density

• involved in tissue protection and healing of surrounding systems (macrophages and mast cells)
• provides for mobility and stability of the MSK system
• elastic and contractile (myofibroblasts)
• stabilizes and maintains balance

NOT TENDONS LIGAMENTS OR APONEUROSES

Question 6

what is pannicular fascia (aka panniculus)

Answer 6

outermost layer of fascia

• derived from somatic mesenchyme
• surrounds the entire body (except orifices}
• outer part is adipise
• inner part is membranous and adherent

Question 7

what is axial and appendicular fascia (aka investing layer)

Answer 7

internal to the pannicular layer (fused to it)

-surrounds all of the muscles, periosteum of bone, and peritendon of tendons

Question 8

what is meningeal fascia

Answer 8

surrounds the nervous systeml including the dura

Question 9

what is visceral fascia

Answer 9

surrounds the body cavities (pleural, pericardial, and peritoneum)

Question 10

___ of mechanoreceptors in the skin also have fields in loose fascia
___ % of stretch receptors for muscles and balance are in fascia

Answer 10

20%

75% (on 25% in muscle)

Question 11

T/F fascia has liquid crystal like properties such as piezoelectricity

Answer 11

true

Question 12

what is viscoelastic material

Answer 12

any material that deforms according to rate of loading and deformity

Question 13

stress vs strain

Answer 13

stress- force that deforms CT

strain- percentage of deformation of CT

Question 14

what is hysteresis

Answer 14

energy loss from loading and unloading in CT

*strecting CT to its plastic deformational range will bring about lengthening of the tissue

Question 15

what is tissue creep

Answer 15

CT that has elongated (deformed) in response to constant load (below failure threshold)

Question 16

ease vs bind

Answer 16

ease- direction CT moves the most in

bind- restriction of CT mobility

Question 17

what is the concept pf the fascial sweater

Answer 17

fascial restrictions in one area of the body will create CT restrictions at a distance away from the original site of restriction = abnormal myofascial and joint mobility

Question 18

what is hookes law

Answer 18

the strain (deformation) placed on an elastic body is in proportion to the stress (force) placed upon it

• strain is proportional to the stress
• deformation is proportional to force

Question 19

what is wolff’s law

Answer 19

bone and fascia will develop according to the under stress placed upon it

Question 20

direct vs indirect techniques

Answer 20

direct- goes toward the restrictive barrier

indirect- goes away from the barrier

Question 21

what is sherrington’s law

Answer 21

when a muscle received a nerve impulse to contract, its antagonists receive an impulse to relax

*muscle contacts and antagonist relaxes

Question 22

compensatory pattern vs uncompensated pattern

Answer 22

compensatory

• healthy
• common (L/R/L/R) or uncommon (R/L/R/L)

uncompensated

• usually symptomatic
• usually trauma involved

Question 23

contraindication in severe osteoporosis

Answer 23

prone press may be contraindicated in thoracocostal region, but lateral recumbent techniques could be easily applied

Question 24

contraindication of acute injuries

Answer 24

direct tenhcniques to injured muscles or joints may do additional damage and should not be performed with Soft tissue tecnhique

Question 25

absolute ST contraindications

Answer 25

``` fracture/dislocatoin neurologic entrapment syndrome serious vascular compromise local malignancy local infection bleeding disorder ```

Question 26

ST Technique

Answer 26

forces are very gentle and of low amplitude and are applied rhythmically (1-2 seconds of stretch followed by 1-2 sec of release) - as the tissues respond the amplitude may increase but the rate of application remains the same - NO FRICTION - continued until desired affect is achieved

Question 27

increase distance between origin and insertion of muscles always parallel with muscle fibers

Answer 27

stretch (ST technique) - both hands move in opposite directions - or anchor one end and pull muscle in direction on other end

Question 28

repetitive pushing of tissue perpendicular to muscles fibers

Answer 28

kneading (ST technique)

Question 29

pushing and holding perpinduclar to the fibers at the musculotendinous part of hypertonic muscle -hold until relaxation of tissue

Answer 29

inhibition (ST technique) *hypertonic = muscle contracted when not actively contracting it

Question 30

what technique engages continual palpatory feedback to achieve release of myofascaial tissues

Answer 30

MFR use in SD, cant use HVLA or MET, and counterstrain may be difficult secondary to a patients inability to relax

Question 31

which technique is a treatment system in which combined procedures are designed to stretch and reflexively release patterned soft tissue and joint related restrictions

Answer 31

integrated neuromusculoskeletal release (INR) - uses breath holding - REMs (release enhancing maneuvers) speed the treatment process

Question 32

what are 3 activating forces of MFR | REMS

Answer 32

1. inherent forces (using bodies primary respiratory mechanism) 2. respiratory cooperation (patient directed inhalation exhalation or hoping of breath) 3. patient cooperation : patient asked to move to a position to aid in mobilizing specific areas of restriction

Question 33

MFR treatment endpoint

Answer 33

1. warmth, softening, or increase ROM of tissue 2. no change presented after activating forces used 3. tissue shows symmetry