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OMM Lecture > Thoracic II Indirect I > Flashcards

Thoracic II Indirect I Flashcards

1
Q

Treating injury w/ counter strain

A

. Counters strain by reintroducing position of original strain which is position of shortened tissues and relative ease

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2
Q

Neurophysiology of normal and shortened muscles

A

. Muscle spindles report changes in overall muscle length and rate of change of stretch
. Stretching muscle inc. firing of spindles
. Hyper-shortened muscles produce little/no firing

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3
Q

Counterstrain application

A

. Acute or chronic somatic dysfunction
. Somatic dysfunctions w/ neural component (hypershortened muscle)
. Can be primary treatment of in conjunction w/ other approaches
. Any area of body can be treated but patient must relax
. Good for patient’s w/ painful musculoskeletal conditions

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4
Q

Facilitated position release

A

. Indirect myofascial releases developed by Stanley Schiowitz
. Positional, uses facilitating force to activate inherent forces
. Good for somatic dysfunction or abnormal muscle tension
. Activating force held for 3-5 sec.
. Used for articular or myofascial restrictions

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5
Q

Physiologic basis for FPR

A

. Similar to counterstrain
. Muscle spindles report stretch, inc. firing of gamma afferents in stretched muscle
. Restoration of hyper-shortened muscle dec. firing
. Compressive force causes neural feedback to rapidly normalize

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6
Q

FPR general procedure

A 
. Put joint in loose pack position
. Flatten spine
. Add facilitated force
. Position into freedom of motion or shortening of muscle 
. Hold 3-5 sec. then release
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7
Q

Indications to complete FPR

A

. Somatic dysfunction w/ neural component
. Any area of body
. Acute or chronic
. Need for gentle technique
. Primary treatment or combined w/ others
. Useful for pain from disc herniation

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8
Q

Cellular components of fascia

A
  1. Fibroblasts
  2. Fat cells
  3. Fixed macrophages
  4. Mast cells
  5. Plasma cells
  6. Leukocytes
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9
Q

Components of ECM

A
  1. Collagen (tensile strength)
  2. Proteoglycans/Mucopolysaccharides (glycosaminoglycans)
  3. Mucin
  4. Reticulin
  5. Elastin
  6. Fibers: Elastic and Reticular
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10
Q

Superficial fascia

A

. Loose fibrous envelope beneath skin containing fat, cutaneous vessels, and nerves
. Related to dermis

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11
Q

Subserous fascia

A

Covers, supports, and lubricates organs

. Comprises the loose CT underlying endothelial, vascular, and glandular surfaces

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12
Q

Deep fascia

A

. Strong fibrous CT that compartmentalizes body into cavities
. Inner and outer layers can envelop structure
. Specialized around joints to form/strengthen ligaments

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13
Q

Fascial functions

A

. Super fascial planes follow fiber direction of muscles they span and cover multiple joints
. Allows individual structures to communicate while not disturbing their individual functions
. Limits and directs planes of motion
. Provides anatomic support and stability while acting as location where metabolic/physiologic functions occur

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14
Q

T/F Fascia is not affected by internal forces

A

F, affected by both external and internal forces

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15
Q

Fascial sheet qualities

A

. Move w/ respiration and inherent movement assoc. w/ cranial rhythmic impulse (CRI), circulation, lymph flow, and muscular pumps
. Some sheets have multidirectional fibers (trap)
. SOme have complex, non-linear motion
. Some have no motion (scar tissue)
. Had 3D areas of tightness and looseness

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16
Q

Unique physiologic properties of fascia

A

. Plasticity: quality of being formed and retaining shape
. Elasticity: recoverable deformation
. Viscosity: rate of deformation under load

17
Q

Horizontal diaphragms of fascia

A

a. Abdominal diaphragm
b. Pelvic diaphragm
c. Thoracic inlet
d. Tentorium cerebelli
e. Lesser diaphragms
f. Palmar fascia
g. Plantar fascia

18
Q

Longitudinal cables of fascia

A

. Dural sleeve from occiput to S2
. Ant. Longitudinal ligament to S2
. Psoas major to lower extremity
. Rectus abdominus, quadratus lumborum, internal/external abdominal oblique
. Trachea, esophagus, pericardium inserting to central tendon of diaphragm

19
Q

Still technique

A

. Starts indirect then becomes direct
. Gentle, precise localization
. Utilized location of all planes of motion to balance point/position of ease
. Uses final activating force through affected tissue
. Vector force from part of body that can be used as lever for techniques
. As coupled vector force and tissue motion takes tissue past its restriction a palpable release occurs

20
Q

When to use Still technique

A 
. Any type of dysfunction
. Quick and efficient 
. Retreat w/o complications
. Gentle
. Treat in seated and supine positions
21
Q

Indirect balancing

A

. Indirect treatment where restrictive barrier is disengaged, tissue moves away from it until tension is equal in all planes
. Release via inherent forces
. Good for articular restrictions

22
Q

Balance point

A

. New neutral
. Floating sensation (loss of tension)
. Same amount of tension in all planes

23
Q

Mechanics of treating w/ indirect balancing

A
  1. Finding a point of neutral tension.
  2. The new neutral point.
  3. Stacking components.
  4. Include translatory movements.
  5. Include exhalation/inhalation.
  6. Include cranial motion.
24
Q

Clinical usefulness of indirect balancing

A

. Older patients
. When HVLA or DIrect techniques were contraindicated
. Acute injuries
. Achieving general relaxation

25
Q

Strain reflexes cause

A

. Impaired metabolism
. Impaired circulation
. Altered proprioception
. Maintenance of nociceptive sensitivity in involved tissues

26
Q

T/F Never remove monitoring finger i counterstrain and indirect balancing

A

T, wait until it is time to completely reassess after patient pain is less than 3/10

27
Q

How many treatment points can you treat per visit?

A

6

28
Q

How many days do you wait until patient can repeat counterstrain treatment?

A

3 days

29
Q

WHen to NOT use counterstrain

A

. Fracture directly affected by positioning
. Ligamentous tear directly affected by positioning
. Severely ill patient until they have been stabilized
. Patient refuses treatment

30
Q

Counterstrain relative contraindications

A

. Patient can’t voluntarily relax
. Patient develops neurologic symptoms during treatment
. Patients w/ vascular disease, spinal disease, rheumatologic or other condition where positioning leads to vascular compromise or joint instability

31
Q

Force effects in CT

A 
. Plastic or elastic deformation 
. Viscosity
. Creep
. Stress 
. Strain
32
Q

Physical properties of muscle

A 
. Irritability
. Contractility
. Relaxation
. Dispensability
. Elasticity
33
Q

Exercise caution w/ using MFR for

A 
. Open wounds
. Fractures
. DVT
. Abscess
. Soft tissue/ bony infection
. Aortic aneursym 
. Severely ill patient
34
Q

Facilitating forces

A

Compression (most common)
Torsion
Traction

OMM Lecture (16 decks)

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