Indications for large intestine visceral OMT
Constipation
IBS
Other functional disorders
Viscerosomatic reflex findings
Relative contraindications for large intestine visceral OMT
Peritonitis
Colon obstruction
Recent abdominal surgery
What parts of the colon are retroperitoneal?
Ascending, descending, and sigmoid
Note that in healthy ppl colon tapers from proximal to distal
Note sympathetic (cord level, splanchnic nerves, collateral-prevertebral ganglia) and parasympathetic innervation associated with stomach, duodenum, liver, GB, pancreas, and spleen
Sympathetics: T5-9, greater splanchnic n., celiac collateral-prevertebral ganglion
Parasympathetic: vagus (CN X)
Note sympathetic (cord level, splanchnic nerves, collateral-prevertebral ganglia) and parasympathetic innervation associated with small bowel, proximal 2/3 of colon, kidneys, adrenals
Sympathetic: T10-11, lesser splanchnic nn, superior mesenteric ganglion
Parasympathetic: vagus (CN X)
Note sympathetic (cord level, splanchnic nerves, collateral-prevertebral ganglia) and parasympathetic innervation associated with distal 1/3 colon, lower ureters, bladder, pelvic organs
Symp: T12-L2, least splanchnic, inferior mesenteric
Parasympathetic: sacral (pelvic), splanchnic (S2-4)
Posterior colon chapmans reflex
A triangular area reaching from the transverse processes of L2-4 reaching to the crest of the ilium
[direct fascial relationship between the descending or ascending colon, depending on the side, and quadratus lumborum m]
Indications for small intestine visceral OMT
Indigestion Delayed gastric emptying Cholestasis Other functional disorders Viscerosomatic reflex findings
Relative contraindications for small intestine visceral OMT
Peritonitis
Splenomegaly
Recent abdominal surgery
Indications for liver visceral OMT
Passive congestion of liver and spleen
CHF (esp. right sided failure)
May increase immune competence in pts with infectious processes
Consider in pts with parenchymal dz of liver or spleen as it may affect the disease process by modulating blood and lymph fluid dynamics
Liver visceral dysfunction
Contraindications for liver visceral OMT
Fractures, dislocations in the thorax
Lymphatic system malignancy
Traumatic disruption of liver, spleen, or adjacent organs
Acute hepatitis
Friable hepatomegaly or splenomegaly as in mononucleosis or sickle cell anemia
Cord level of liver sympathetic innervation
T7-9
HIGH YIELD: goals of mesenteric/colonic release
- Enhance lymphatic and venous drainage
2. Alleviate congestion secondary to visceral ptosis/dysfunction
