Somatic Dysfunction And Barriers Lecture Flashcards

1
Q

What are the 4 tenants of Osteopathic Medicine?

A
  1. Mind, body, and spirit are a unit
  2. Body is capable of self-regulation, self-healing, and health maintenance
  3. Structure and functions reciprocally interrelated
  4. Rational treatment is based upon understanding and implementing the other 3 tenets
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2
Q

What is the definition of somatic dysfunction?

A

Impaired or altered function of related components of the somatic (body framework) system: skeletal, arthrodial, Myofascial structures, and their related vascular, lymphatic, and neural elements.

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3
Q

What is the definition of Osteopathic Manipulative Treatment (OMT)?

A

The therapeutic application of manually guided forces by an osteopathic physician to improve physiologic function and/or support homeostasis that has been altered by somatic dysfunction

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4
Q

What is acute somatic dysfunction?

A

Immediate or short-term impairment or altered function of related components of the somatic system, characterized by: vasodilation, edema, tenderness, pain, or tissue contraction

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5
Q

What is chronic somatic dysfunction?

A

Impairment or altered function of related components of the somatic system, characterized by: tenderness, itching, fibrosis, paresthesias, and/or tissue contraction

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6
Q

What is the diagnostic criteria for somatic dysfunction?

A

TART exam

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7
Q

What does TART stand for?

A

Tissue texture abnormalities
Asymmetry of structure or motion
Restriction of Motion
Tenderness illicited

Any one of which must be present for the diagnosis of somatic dysfunction

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8
Q

What is tissue texture abnormality and what are different types?

A

A palpable change in tissues from skin to periarticular structures

Ex) bogginess (sponginess due to congestion from increased fluid content), thickening, stringiness, rosiness, firmness, temperature change, moisture change

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9
Q

What is tone, hypertonicity, and hypotonicity?

A

Tone: Normal feel of muscle in the relaxed state

Hypertonicity: At the extreme = spastic paralysis

Hypotonicity: Flaccid paralysis with no tone at all

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10
Q

What is contraction vs contracture?

A

Contraction: Normal tone of a muscle when it shortens or is activated against resistance

Contracture: Abnormal shortening of a muscle due to fibrosis, and often results from a chronic condition and the muscle is no longer able to reach its full normal length

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11
Q

What is spasm?

A

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

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12
Q

What does ropiness tend to indicate?

A

Typically indicates a chronic condition

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13
Q

What is an acute vs chronic vascular tissue texture change?

A

Acute: Inflamed vessel wall injury, endogenous peptide released

Chronic: Sympathetic tone increases vascular constriction

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14
Q

What is acute vs chronic sympathetic tissue texture change?

A

Acute: Local vasoconstriction overpowered by local chemical release, net effect is vasodilation

Chronic: Vasoconstriction, hypersympathetic tone, may be regional

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15
Q

What is acute vs chronic musculature tissue texture change?

A

Acute: Local increase in tone, muscle contraction, spasm - mediated by increase spindle activity

Chronic: decreased muscle tone, flaccid, mushy, limited ROM due to contracture

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16
Q

What is an Anatomic barrier? How about Physiologic Barrier?

A

Anatomic: limit of motion imposed by Anatomic structure; the limit of passive motion

Physiologic: the limit of active motion

17
Q

What is the elastic barrier?

A

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

18
Q

What is the restrictive barrier?

A

A functional limit that abnormally diminishes the normal physiologic range

19
Q

What is AROM and PROM?

A

AROM - patient initiated ROM, examiner visually observes

PROM - examiner initiated ROM with passive patient

PROM > AROM because pt’s muscles are relaxed

20
Q

What is “blocking the linkage”?

A

Stabilization of associated and adjacent structures to focus movement to only the joints being assessed

21
Q

What is Barrier “end-feel” and what are some characteristics/examples?

A

The Palpation experience or perceived quality of motion when a joint is moved to its limit

Early muscle spasm [protective] and known as guarding, late muscle spasm [chronic], hard capsular [frozen shoulder], and soft capsular [synovitis-swelling of the knee after injury]

22
Q

What are differences between acute and chronic pain?

A

Acute: sharp, severe, cutting

Chronic: dull, ache, paresthesias

23
Q

What are the differences between acute vs chronic visceral functions?

A

Acute: minimal somatovisceral effects

Chronic: Somatovisceral effects are common

24
Q

What are the differences between acute vs chronic visceral dysfunction?

A

Acute: May or may not be present; if trauma is severe, it is often present

Chronic: often involved in somatic dysfunction

25
Q

What are the differences noted in the TART exam between acute and chronic somatic dysfunction?

A

Acute:
Tissue texture - red, swollen, boggy, increased tone
Asymmetry - present
Restriction - present, painful with motion
Tenderness - sharp pain

Chronic:
Tissue texture - dry, cool, ropy, pale, decreased tone
Asymmetry - present, compensation occurs
Restriction - present but maybe not. Guarded or “empty”
Tenderness - dull, achy pain

26
Q

What is the difference between a tender point and a trigger point?

A

A tender point is a small discrete hypersensitive area within Myofascial structures that result in LOCALIZED pain

A trigger point is a small discrete hypersensitive area within Myofascial structures where Palpation causes REFERRED pain away from the site

27
Q

What are somatic dysfunctions named for?

A

Where the position of ease is (aka where it LIKES to go)

28
Q

What are some indications and adverse reactions of OMT?

A

Indications: somatic dysfunction and/or visceral dysfunction

Adverse reactions: soreness similar to workout or massage soreness

29
Q

What are some precautions, recommendations, and contraindications for OMT?

A

Precautions: cancer, fraility due to severity of disease, youth, and/or elderly

Recommendations: rest (1-4 days) and hydration

Contraindications: generally cancer, Rheumatoid arthritis, fractures, or severe frailty (but otherwise different techniques have different contraindications)

30
Q

What do direct techniques vs indirect techniques do?

A

Direct: method of action engage the restrictive barrier directly

Indirect: method of action involve positioning away from the restrictive barrier

31
Q

What is the role of OMT in the 5 Models (Biomechanical, neurological, respiratory/circulatory, metabolic, and behavioral)?

A

Biomechanical: Myofascial and joint function optimization

Neurological: remove neurologic imbalances; address nociception (pain)

Respiratory/Circulatory: maximize function

Metabolic: structure and function are reciprocally related

Behavioral: more of a cause than an effect; how we spend our time affects the above 4; the exercise Rx teaches patients to treat themselves