VS and Chapman reflexes

Question 1

pain from chapman pt?

Answer 1

pinpoint, sharp, non radiating

v precise, 1-2mm not tender

Question 2

Palpatory features

Answer 2

look for tissue texture abnormalities and tenderness

in subcutaneous superficial layers (could be deep fascia or periosteum)

anterior and posterior

small, firm and smooth nodule w/dense texture, 2-3mm, can be soft or hard

confluent

Question 3

chapman point tx

Answer 3

gentle-mod pressure worked in slow small circles for 10-30 seconds in CCW or CW

should disappear or if its too tender for pt to bear

Question 4

What shouldn’t you do?

Answer 4

never make dx based on nontender chapman point - indicates nothing

don’t ignore tender Chapman point

Question 5

contraindications

Answer 5

anything more emergent
pt refused
fracture, CA, pt or local instability

Question 6

where should you document chapmen point finding?

Answer 6

objective, musculoskeletal

document its location not organ relationship

Question 7

What should go under assessment for CP?

Answer 7

SD of the “abdomen or other” region

Question 8

what should go under plan

Answer 8

OMT using soft tissue to listed cp

Question 9

what should you advise your pt to do after tx?

Answer 9

drink lots of water in next 24hrs, go on normal pain management, relative rest post omt

Question 10

where are the chapman’s pt for the arms?

Answer 10

posterior side

superior medial border of scapula

c2 lateral to sp

Question 11

viscerosomatic psym/sym regions for the UE and LE

Answer 11

UE - T2-7
LE - T11-L2
psym = none

Question 12

HEENT chapmans pts - anterior

Answer 12

Middle ear - superior medial 1/3 clavicle

larynx - rib 1, chostochondral junction

sinuses - superior border rib 2, inferior medial clavicle

tonsils - bw rib 1-2, lateral to manibrum

tongue - junction of rib and sternum

Question 13

HEENT chapmans pts - posterior

Answer 13

middle ear - occiput 2 cm lateral from midline

sinuses - below occiput, lateral to sp of C2

pharynx/larnyx/tongue - lateral to sp of C2

Question 14

viscerosomatic psym/sym regions for the HEENT

Answer 14

head/neck

symp - T1-5

psym - vagus

Question 15

infectious disease: tonsils, liver, spleen chapmans pt

Answer 15

tonsils - bw rib 1-2, lateral to manibrum

liver -right rib 5 costochondrial junction

spleen - left rib 6-7 costochondrial junction

Question 16

upper gi CP anterior

Answer 16

esophagus - bw rib 2-3 parasternally

stomach - left, bw rib 5-6, 6-7 at costochondral junction

liver -right rib 5 costochondrial junction

pancreas - right, bw rib 6-7 costochondrial junction

SI - bw rib 8-11 costochondrial junction bilaterally

Question 17

upper gi CP posterior

Answer 17

esophagus - lateral to T2 sp

stomach - left, later to t5 and t6 sp

liver - right, later to t5-6 sp

gb - right, lateral to t6

pancreas - right, lateral to sp of t7

SI - later to sp of t8-10

intestine peristalsis - superior surface of rib 11, medial to rib angle

Question 18

lower GI anterior

Answer 18

appendix - tip of the 12th rib

intestine peristalsis - lateral to AIIS bilaterally

colon - anterior iliotibial band
folded the colon down
cecum at greater trochanter (R), hepatic flexure just about R knee

Question 19

lower GI posterior

Answer 19

appendix - right, lateral to T12

rectum - posterior lateral sacrum 1/2 way bw sacral sulcus and ILA

larger intestines - TP L2-4

Question 20

viscerosomatics sympathics for GI

Answer 20

upper gi T5-T10

SI/Ascending colon. T9-T11

Ascending and Transverse Colon T10-L2

descending and sigmoid colon/rectum T12-L2

Question 21

viscerosomatics parasympathics for GI

Answer 21

upper gi vagus (OA AA)

SI/Ascending colon. vagus (OA AA)

Ascending and Transverse Colon vagus (OA AA)

descending and sigmoid colon/rectum S2-4

Question 22

pulmonary CP anterior

Answer 22

bronchus - rib 2-3 intercoastal space at the sternal border

upper lung - rib 3-4 intercoastal space at sternal border

lower lung - rib 4-5 intercoastal space at sternal border

Question 23

pulmonary CP posterior

Answer 23

bronchus - lateral to sp of t2

upper lung - lateral to sp of t3

lower lung - lateral to sp of t4

Question 24

viscerosomatics of pulmonary sym and psym

Answer 24

symp - T1-7

psym - vagus

Question 25

cardiovascular cp anterior

Answer 25

myocardium - rib 2-3 intercoastal space parasternally adrenal - 2 cm lateral, 2 cm superior to the umblicicus

Question 26

cardiovascular cp posteiror

Answer 26

myocardium - superior border of T3 (lateral to sp) adrenal - lateral to sp of T11

Question 27

viscerosomatics of cardiovascular

Answer 27

``` symp - heart T1-6 adrenals T5-T10 psym heart and adrenals - vagus (OA AA) ```

Question 28

urology cp anterior

Answer 28

bladder - umbilicus kidneys - 1 lateral, 1 inch superior to umbilicus uretera - pubic bone, anterior side on both sides prostate - posterior side of the IT band

Question 29

urology cp posterior

Answer 29

kidneys - later to L1 sp bladder and uterers - tp of L3 prostate - SI (sacral sulci) seminal vesicles - lateral from ischia superior medial surface of the psis and posterior femoral head.

Question 30

viscerosomatics of urology

Answer 30

symp GU tract T10-L2 (not bladder) upper ureter T10-11 lower ureter T12-L2 psym upper ureter - vagus bladder, Lower ureter, reproductive organs - S2-4

Question 31

obstetrics/gyn CP posterior

Answer 31

uterus - posteriori TP of l5, sacral sulus ovariers - inferolateral portion of t10 broad ligament - sacral sulus vag - sacral sulcus fallopian tubes - posterior femoral head, superomedial to PSIS

Question 32

viscerosomatics of ob/gyn

Answer 32

symp GU - L10-12 psymp _ S2-4

Question 33

obgyn CP anterior

Answer 33

uterus - 2 cm lateral fro midline to inferior pubic bone ovaries - pubic tubercle broad ligament - it band posterior aspect

Question 34

endocrine cp anterior

Answer 34

anterior - thyroid - ribs 2-3 intercostal space of parasternal border posterior - thyroidsp T2 lateral on either side