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OPP Block 4 > VSR And Chapman Reflex > Flashcards

VSR And Chapman Reflex Flashcards

1
Q

Chapman reflex definition

A

A group of palpable points occurring in predictable locations on the anterior and posterior surfaces on the body that are reflections of visceral dysfunctions or disease.

also area sometimes called gangliform contracted lymphoid tissue nodules

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2
Q

Neurolymphatic postings

A

Commonly congested lymphatic areas that help viscerosomatic relief when treated

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3
Q

Proposed physiologic mechanisms of Chapman reflex

A

Sympathetic nerve fibers and lymph vessels travel together Through the same muscle/fascia
- therefore restriction causes pain and lymph congestion and ultimately a Chapman point

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4
Q

Reflex point characteristics

A

Edematous

Ropey

Fibrospongy

Shorty

Sharp

Very tender

DOES NOT RADIATE

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5
Q

Anterior Chapman reflex points details

A

Typically found in the intercoastal spaces UNDER the respective superior rib

  • typically bilaterally
  • tend to be more tender than posterior
  • typically help diagnose organ/system dysfunctions
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6
Q

Posterior Chapman reflex points details

A

Typically located on the corresponding transverse processes

  • normally found bilaterally
  • tender to be less tender than anterior, but still tender
  • typically used to treat the organ/system dysfunction
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7
Q

How to identify Chapman reflex points

A

Requires a thorough and relevant history
- physcial examination via history can point to possible Chapman point locations

If a Chapman point is present, it aids w/ diagnosis of the medical problem and helps narrow down the differential diagnoses

Using palpation w/ relaxed fingers and assess the anterior point locations first always. If none are found, then move to the posterior points for assessment

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8
Q

Treatment of Chapman reflex points

A

Begin by identifying the corresponding posterior reflex points associated w/ either the medical continues and/or the anterior reflex points
- identify anterior -> posterior, but always treat posterior -> anterior

1) use finger pad and apply firm pressure to the point being treated
2) slowly move the finger in a circular motion as to flatten the mass
3) continues for 10-30 seconds or until either the point is no longer palpable or the patient cant tolerate.

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9
Q

How to find intercostal site Chapman points

A

Finger pads directed postero-superiorly along the undersurface of the rib W/ deep firm rotation movement

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10
Q

Value of Chapman points

A

Essential part of a through OMM physical exam

Aids w/ diagnosis of disease

Treated autonomic system balance

May improve immune system efficiency

Improves lymphatic flow

Can improve medical conditions relating to the following:

  • Asthma
  • HTN
  • cardiac dysrhythmia
  • renal and bladder dysfunctions
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11
Q

Parasympathetic vs sympathetic routes to effector organs from brain

A

Parasympathetic
- brainstem and lateral horn of the sacral spine -> organ ganglia -> effector organs

Sympathetic
- lateral horn of the thoracic-lumbar spine -> prevertebral ganglia -> effector organs

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12
Q

Fiber differences in sympathetic vs parasympathetic ANS

A

Sympathetic

  • short preganglionic
  • long postganglionic

Parasympathetic

  • long preganglionic
  • short postganglionic
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13
Q

Sympathetic ganglia #s

A

All are lateral except the coccygeal ganglion and the stellate ganglion

Stellate ganglion
- fusion of the inferior cervical (4-7) and T1 ganglion

3 cervical

10-11 thoracic

3-5 sacral

Coccygeal ganglion
- site of sympathetic and parasympathetic fusion

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14
Q

Visceral parasympathetic nerves

A

CN10

S2-4
- pelvic splanchnic

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15
Q

Parasympathetic nerves in the head and the cranial nerve they ride on to get to their target

A

Ciliary -> CN3

Pterygopalatine and submandibular -> CN7

Otic -> CN9

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16
Q

Sympathetic trunk

A

The main carrier and site of sympathetic ganglion
- carries the thoracic, lumbar and sacral splanchnic sympathetics to the paravertebral ganglia in respective plexuses

From there the postganglionic fibers leave and enter the specific intrinsic organ ganglion

17
Q

What are the main parasympathetic nerve carriers

A

Vagus nerve for anything superiorly

Pelvic splanchnic for anything inferiorly

18
Q

Difference between General Somatic Efferent neurons (GSE) and General Visceral Efferent neurons (GVE)

A

GSE:
- motor components that directly innervate the skeletal muscle

GVE:
- motor components that indirectly innervate visceral structures via post ganglion is fibers

19
Q

Physiology of reflex arches

A

1) Begins with nociceptive from viscera initiates impulses due to a stimulus
2) impulse synapses w/ interneurons and becomes a visceral stimulus
3) visceral stimulus travels to both the motor and sympathetic efferent nerves to generate an effect
4) visceral reflex imputes elicits both a sympathetic and motor response of the segmental area of the origination of the stimulus

20
Q

Sites of efferent and Afferent spinal reflexes

A

Efferent

  • blood and lymph vessels
  • muscles
  • viscera

Afferent

  • blood and lymph vessels
  • skin
  • joints
  • muscles
  • viscera

*only the skin and joints have only afferent reflexes (cant generate a reflex, but can react)

21
Q

Types of reflexes

A

Viscerosomatic
- localized visceral stimuli producing a pattern of reflex responses in segmentally somatic structures

Somatovisceral
- localized somatic stimulation producing a pattern of reflex responses in segmentally related visceral structures

Viscerovisceral
- localized visceral stimuli that produces a pattern of reflex responses in segmentally visceral structures

Somatosomatic
- localized somatic stimuli producing patterns of reflex responses in segmentally related somatic structures

22
Q

Who coined the discover of viscerosomatic reflexes

A

Louisa burns (1907)

23
Q

Kehrs sign

A

Palpable tissue texture changes from T1-5 (upper shoulder) that is caused by the presence of blood in the peritoneal cavity
- this an example of both referred pain and viscerosomatic reflexes

24
Q

Spinal facilitation

A

The maintenance of a pool of neurons in a state of partial excitation

  • this allows smaller stimuli to trigger an impulse
  • a possible theory for describing the underlying neuronal activity in somatic dysfunctions
25
Q

Features of viscerosomatic reflex as it relates to OMT

A

Deep muscle reaction usually occurring through 2 or more adjacent spinal segments that have Somatic dysfunction

Resistance to segmental joint motion w/ a rubbery end feel compared to a hard end feel.

Skin and subcutaneous TART varies between acute or chronic

Does not manifest an asymmetric position most of the time

Causes somatic dysfunctions to resist normal OMT
- keeps coming back after OMT

Only treated via treating the causative visceral pathology

26
Q

Where to find tissue texture abnormalities of Viscerosomatic reflexes?

A

Bilateral or symmetrically at the affected spinal segments

- except is asymmetrical organs, which will case asymmetrical ipsilateral reflexes

27
Q

Both divisions of the vagus nerve

A

Left division
- innervates the AV node And everything above the duodenum that receives vagal parasympathetics

Right division
- innervates the SA node and everything above the transverse colon that revives vagal parasympathetics

the jejunum, ilium and ascending and descending colons are innervates only by the right decision of the vagus nerve

28
Q

What do pelvis splanchnics innervate?

A

Parasympathetic to the descending and sigmoid colon

Parasympathetic to the pelvic region

29
Q

Viscerosomatic reflex locations w/ respect to the diaphragm

A

Organs ABOVE the diaphragm have reflex ganglia above T5

Organ BELOW the diaphragm have reflex ganglia below T5

30
Q

common TART criteria for viscerosomatic reflexes chronic vs acute

A

Acute:

  • warm and red
  • sweating
  • red reflex
  • increased skin drag
  • edema
  • skin thickening
  • hypertonicity
  • not overall sensative

Chronic:

  • vasospasms
  • cool
  • low seating and skin drag
  • sensation of fibrotic tissue (ropeyness)
  • hardness
  • hypersensitivity or hyposensativity
31
Q

Common sympathetic OMT techniques

A

Rib raising

ST paraspinal relaxation

Lymphatic techniques

Sacrum and pelvic releases

32
Q

Common parasympathetic OMT techniques

A

Cranial manipulation
- specifically OA,AA and C2

Sacral and pelvic releases

33
Q

Why does treating the pelvis/sacrum affect both parasympathetic and sympathetic responses?

A

The ganglion impair is near and located at the sacrocoxxygeal joint (the site where the sympathetic and parasympathetic nerves meet)

34
Q

Anterior Chapman points

A

1st intercostal space
- correlates w/ middle ear (superior clavicle)
- correlates with nasal sinus
(Inferior clavicle)

Border of the sternum above the sternal notch
- correlates w/ tongue, tonsils, pharynx

2nd intercostal space (2-3 rib)
- correlates w/ bronchus, esophagus, thyroid and heart

3rd intercostal space (3-4 rib)
- correlates w/ upper lung

4th intercostal space (4-5 rib)
- correlates w/ lower lung

5th intercostal space (5-6)
- correlates w/ stomach

6th intercostal space (6-7)
- correlates w/ liver and gall bladder

7th intercostal space (7-8)
- correlates w/ spleen and pancreas

8th-10th intercostal spaces (8-10)
- correlates w/ small intestines

Tip of the 12th right rib
- correlates w/ appendix

1cm superior and lateral to the umbilicus
- correlates w/ the kidneys

2cm superior and 1cm lateral to the umbillicus (just superior to kidney point)
- correlates w/ adrenal glands

Anterior-lateral thigh (at the distal femur)
- correlates w/ colon bilaterally

Right lateral knee
- correlates w/ hepatic flexure

Left lateral knee
- correlates w/ splenic flexure and sigmoid colon

Supero-lateral humerus
- associated w/ retina and conjunctive

Tip of the coracoid process
- associated w/ cerebellum

35
Q

Posterior chapman points

A

Mastoid process
- associated w/ retina and conjunctive

AC 1 occiput

  • associated w/ Middle ear (left)
  • associated w/ nasal sinuses (left)

Superior nuchal line
- associated w/ cerebellum

C2 lateral to the spinous process
- associated w/ larynx, sinuses and arms

C2-5 transverse processes
- associated w/ cerebrum

C3-7 lateral to the spinous process
- associated w/ neck

Medial border of the scapula ABOVE the scapula spine
- associated w/ arms and pectoralis minor

Medial border of the scapula BELOW the scapular spine
- associated w/ pectorals minor

T2 lateral to the spinous process
- associated w/ esophagus and thyroid

T3 lateral to the spinous process
- associated w/ upper lung and myocardium

T4 lateral to the spinous process
- associated w/ upper and lower lung

T5 lateral left and right to the spinous process
- assocaited w/ stomach (left) and liver (right)

T6 lateral left and right to the spinous process
- associated w/ stomach (left) and liver/gallbladder (right)

T7 lateral left and right to spinous process
- assocaited w/ spleen (left) and pancreas (right)

OPP Block 4 (10 decks)

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