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Flashcards in VSR And Chapman Reflex Deck (35)
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Chapman reflex definition

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*


Neurolymphatic postings

Commonly congested lymphatic areas that help viscerosomatic relief when treated


Proposed physiologic mechanisms of Chapman reflex

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


Reflex point characteristics






Very tender



Anterior Chapman reflex points details

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


Posterior Chapman reflex points details

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


How to identify Chapman reflex points

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


Treatment of Chapman reflex points

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.


How to find intercostal site Chapman points

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


Value of Chapman points

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
- cardiac dysrhythmia
- renal and bladder dysfunctions


Parasympathetic vs sympathetic routes to effector organs from brain

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

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


Fiber differences in sympathetic vs parasympathetic ANS

- short preganglionic
- long postganglionic

- long preganglionic
- short postganglionic


Sympathetic ganglia #s

*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


Visceral parasympathetic nerves


- pelvic splanchnic


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

Ciliary -> CN3

Pterygopalatine and submandibular -> CN7

Otic -> CN9


Sympathetic trunk

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


What are the main parasympathetic nerve carriers

Vagus nerve for anything superiorly

Pelvic splanchnic for anything inferiorly


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

- motor components that directly innervate the skeletal muscle

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


Physiology of reflex arches

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


Sites of efferent and Afferent spinal reflexes

- blood and lymph vessels
- muscles
- viscera

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

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


Types of reflexes

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

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

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

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


Who coined the discover of viscerosomatic reflexes

Louisa burns (1907)


Kehrs sign

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


Spinal facilitation

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


Features of viscerosomatic reflex as it relates to OMT

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


Where to find tissue texture abnormalities of Viscerosomatic reflexes?

Bilateral or symmetrically at the affected spinal segments
- except is asymmetrical organs, which will case asymmetrical ipsilateral reflexes


Both divisions of the vagus nerve

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*


What do pelvis splanchnics innervate?

Parasympathetic to the descending and sigmoid colon

Parasympathetic to the pelvic region


Viscerosomatic reflex locations w/ respect to the diaphragm

Organs ABOVE the diaphragm have reflex ganglia above T5

Organ BELOW the diaphragm have reflex ganglia below T5


common TART criteria for viscerosomatic reflexes chronic vs acute

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

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