Somatic Dysfunction

Question 1

Classifications of somatic dysfunction

Answer 1

. M99.00: cranial
. M99.01: cervical
. M99.02: thoracic
. m99.03: lumbar
. M99.04: sacral
. M99.05: pelvic
. M99.06: lower extremity
. M99.07: upper extremity
. M99.08: rib cage
. M99.09: abdomen and other somatic dysfunction

Question 2

Neurophysiological phenomenon w/ somatic dysfunction

Answer 2

. Neuronal afferents input into CNS, effects go from CNS
. Spinal segments that are chronically irritable/hyperactive cause structural impairment
. Muscles innervated by these segments may become hypertonic manifesting in somatic dysfunction

Question 3

Effects of dysfunction at thoracolumbar junction

Answer 3

. Effect sympathetic output to intenstine

. Hypersympathetic drive, bowel less active, causes constipation, bowel obstruction, or a dynamic ileus

Question 4

Effects of somatic dysfunction in sacrum

Answer 4

. Inc. parasympathetic drive to gut, causes inc. poops/diarrhea

Question 5

Acute tension vs. chronic tension

Answer 5

. Acute: Increased rigidity

. Chronic: slightly increases, ropiness, stringiness

Question 6

Does acute or chronic tissue texture changes have edema?

Answer 6

Acute

Question 7

Erythema test in acute vs. chronic tissue texture changes

Answer 7

. Acute: redness lasts

. Chronic: redness fades quickly to skin blanches

Question 8

T/F Asymmetry can confirm presence of somatic dysfunction alone

Answer 8

F, need tissue texture change or motion change as well

Question 9

Quantity and quality of motion

Answer 9

. Quantity: range of motion

. Quality: compliance or resistance of motion

Question 10

Viscerosomatic reflex

Answer 10

. Involuntary nervous system response to sensory input
. Sum total of any involuntary activity
. Localized visceral stimuli producing patterns of reflex response in segmentally related somatic structures

Question 11

how do viscerosomatic reflexes clinical manifest?

Answer 11

. Palpable musculoskeletal findings assoc. w/ segmentally (spinal) related dysfunction or disease of viscera

Question 12

Paraspinal viscerosomatic reflex descriptions

Answer 12

. Assoc. w/ tissue texture changes that differentiate it from normal tissue texture change
. Findings greatest at rib angles and costotransverse area
. Skin/subQ puffiness
. Reluctance to applied motion
. Barrier feels rubbery not firm and distinct (minimal motion loss lesions)

Question 13

Vertebral segment

Answer 13

Single vertebrae

Question 14

Vertebral unit

Answer 14

2 adjacent vertebrae and assoc. arthrodial, ligamentous, muscular, neural, and lymphatic elements

Question 15

Concavity

Answer 15

. Inside curve: side to which sidebending occurs

Question 16

Convexity

Answer 16

Outside curve, side opposite where sidebending occurs

Question 17

Posterior component

Answer 17

. Positional descriptor referring to prominent transverse process

Question 18

Anterior component

Answer 18

. Positional descriptor referring to less prominent transverse process during vertebral rotation

Question 19

Reference point for segmental motion

Answer 19

. Most anterior, superior point on body of vertebrae relative to segment below it
. Motion assessed in all 3 planes of motion

Question 20

Fryette Principle 1 of motion

Answer 20

. When spine is in neutral and articular facets aren’t engaged, if sidebending is introduced a group of vertebrae (3+) rotate into produced convexity
. Max rotation at apex
. Rotation and sidebending occur to opposite side

Question 21

Neutral mechanics

Answer 21

. Also called type 1 mechanics

. When group of segments moves in style of principle 1

Question 22

Type 1 somatic dysfunction

Answer 22

. When group curve demonstrates restriction of motion and tissue texture changes

Question 23

T/F cervical spine has atypical type 1 motion

Answer 23

T, sidebending and rotation occur on same side

Question 24

Fryette Principle II of spinal motion

Answer 24

. When flexion and tension occurs and is sufficient to localize force to single segment, sidebending and rotation occur on same side
. Vertebral segment rotates into concavity
. Also called type II/non-neutral mechanics

Question 25

Type II somatic dysfunction

Answer 25

. Single segment demonstrates type II mechanics w/ tissue change and restriction of motion

Question 26

Fryette Principle III of spinal motion

Answer 26

. When motion has been introduced in 1 plane, the motion in the other planes. In altered

Question 27

Parts of axial skeleton that do not follow Fryette’s principles

Answer 27

. Occiput: tortes and sidebends in opp. Directions but is still weird and doesn’t follow type I . Atlas: only demonstrates rotation (little to no fl/extension and sidebending) . Sacrum: between iliac rotates and sidebends in opp. Direction but still doesn’t count as type I

Question 28

Barrier

Answer 28

Limit of motion

Question 29

Physiologic barrier

Answer 29

. Endpoint of active motion | . Altered through warm up activity to inc. range of motion

Question 30

Anatomical barrier

Answer 30

. Limit of passive motion . End of motion due to resistance of bony structures or ligaments . Tissue destruction occurs if motion pushes past this barrier

Question 31

Restrictive/pathological barrier

Answer 31

. Endpoint of motion when somatic dysfunction is present . Dec. in motion from tissue tension . Occurs w/in normal range of motion of joint or tissue

Question 32

Point of balance/neutral point

Answer 32

. Point where no tension is noted in range of motion

Question 33

Pathologic neutral

Answer 33

Normal range of motion is changed with shift in point of balance to new neutral point

Question 34

End feel

Answer 34

. Perceived quality of motion as anatomic or physiologic barrier is approached . Acute conditions don’t have this (feel rubbery not distinct) . Chronic conditions are very firm and discrete

Question 35

Direction of ease

Answer 35

Direction that does not have restriction

Question 36

3 ways of naming somatic dysfunction

Answer 36

. Where is it? . What will it do? . What won’t it do?

Question 37

What is somatic dysfunction usually named for?

Answer 37

Direction of freer motion . List dysfunction segment, the fl/extension component, then rotation, then sidebending, then subscript that indicates freer side of motion

Question 38

Does flexion increase of decrease the angle between sup. Vertebral segment on the segment below?

Answer 38

Decreases

Question 39

Does extension increase or decrease the angle of sup. Vertebral segment on the other segment?

Answer 39

Increases angle

Question 40

Tenderness objective report

Answer 40

Involuntary reaction

Question 41

Rule of 3’s

Answer 41

T1-T3: transverse processes are located at same level as tip of spinous processes . T4-T6: transverse process located half a level above tip of spinous processes . T7-T9: transverse process located full level above tip of spinous process . T10: transverse process full level above spinous process . T11: transverse process located half level above tip of spinous process . T12: transverse processes located at the same level as the tip of spinous process