Flashcards in Visceral Lectures Deck (36)
List the anatomiccal layers from surface to organ through the abdominal wall.
Anterior rectus sheath/investing fascia
Deep investing fascia
Empty space (hand drops)
Describe indirect treatment of visceral organs.
Layer palpation to level of organ.
Fascial (local) listening.
Motion testing in various planes.
BLT: stack in directio nof EASE and wait for release (~30 seconds)
Describe direct treatment of visceral organs -- release of colon for constipation.
Start at distal portion (sigmoid colon) and insert fingers gently on lateral wall of colon.
Pull gently/firmly toward umbilicus.
Wait for release.
Repeat moving proximally along colon (descending; ascending; cecum)
Viscerosomatic reflexes T6-9 Right
Viscerosomatic reflexes T7 (2)
Viscerosomatic reflexes T10-11
Viscerosomatic reflexes T12-L2
Viscerosomatic reflexes T12
Least Splanchnic (T12)
Lumbar splanchnic (L1-L2)
Celiac Ganglion Post-Ganglionic to: (7)
portions of pancreas
Superior Mesenteric Ganglion Post-Ganglionic to: (10)
Portions of pancreas
Prox 2/3 of transverse colon
Upper 1/2 ureter
Inferior Mesenteric Ganglion Post-Ganglionic to: (7)
Distal 1/3 of transverse
Lower 1/2 Ureter
Indications for visceral manipulation
stomach (GERD; hypomotility)
small intestinal mobility/motility
colon (constipation; IBS; iliocecal valve)
pain of non-surgical nature
immune dysfunction (spleen)
vascular supply problems.
Absolute contraindications to visceral manipulation
abdominal aortic aneurysm
post-abdominal/pelvic surgery (NO direct)
GI infection (colitis; duodenitis; ileitis)
Relative contraindications to visceral manipulation
Pain of unknown origin
Viscerosomatic reflex T5-6 (R)
Viscerosomatic reflexes T5-9 (L)
Viscerosomatic reflexes T8-9
Name 3 techniques to treat the sympathetics in the abdomen
Ventral abdominal ganglion inhibition
Name 3 techniques to treat the parasympathetics to the abdomen
Cervical (OA, AA)
Soft tissue (suboccipital)
Cranial (occipitomastoid suture)
Describe true visceral pain
-where are the receptors?
-carried by what type of fibers?
-where is the pain and what does it feel like?
pacinian corpuscles; free nerve endings
activated by spasm or stretch
carried by visceral afferents
midline, poorly localized, vague, deep, diffuse, burning ache.
Describe viscerosomatic pain
-where are the receptors?
pain receptors in anterior and lateral parietal peritoneum, lesser omentum, mesentery, mesocolon
facilitated cord segments in somatic areas related to viscera sympathetic innervation.
Describe the percutaneous reflex of Morley.
NO pain receptors in visceral peritoneum (greater omentum; spleen)
Awareness of pain only if affecting adjacent pain-sensitive structure.
Where does cranial nerve X exit?
Describe its innervations (6).
Left: greater curvature of stomach; duodenum
Right: lesser curvature of stomach; small intestines; right colon; organs/glands up to mid-transverse colon.
Discuss visceral manipulation and who it was defined by.
Organ/viscera in good health has physiologic motion
Restriction implies functional impairment
Motion repeated thousands of times daily
Mobility vs. motility in terms of visceral manipulation and testing
Mobility: voluntary or diaphragmatic; skeletal muscle effects --direct movement of organ via PALPATION
Motility: inherent motion --listening
Paired organs test together!
Pressure on suspected organ while monitoring will inhibit the influence on the monitored organ.
-how many cycles/min?
-motion is ...?
Motion is toward and away from midline
Inspiration: cranial FLEXION; swelling of organ
EXpiration: cranial EXtension; organ gets smaller
How many cycles before results should be expected in visceral treatment?
-how long should you wait between treatmnets?
Wait 3-4 weeks b/t treatments.
Contraindications to visceral tx.
Acute infection (except bladder)