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Flashcards in Zinc/BLT Deck (89):
1

Define BLT/BMT according to Sutherland

Movement of a joint/articulation that does not cause asymmetry tensions in the ligaments

2

Is the tension distributed through the ligaments in any given joint balanced?

Yes

3

What is a consequence of Tensegrity

When one part changes, the entire part changes (body, region, joint...even cell)

4

What should exist in a normal joint relationship? Used by who?

Balanced ligamentous tension (BLT)

Wales in her terminology for the technique as well as the goal of the treatment

5

What happens when a force is applied to a joint? Used by who?

Ligamentous articular strain (LAS)

Beck in his terminology for the technique as well as the problem

6

Order of names for the technique

1. Balanced Membranous Tension (BMT)
2. Balanced Ligamentous Tension (BLT)
3. Ligamentous Articular Strain (LAS)

7

What year did Sutherland implement techniques?

1940's

8

What 2 peoples helped promote LAS and BLT?

1. Rollin Becker, DO
2. Anne Wales, DO

9

Is BLT indirect or direct?

Indirect technique

10

Explain Soft Tissue OMT

Direct method that is typically applied at and through either an elastic or restrictive barrier

Rhythmic and Repetitious

11

What 2 direct methods do we use at the RESTRICTIVE barrier?

1. MFR
2. LAS

12

What 2 indirect methods do we use at the WOBBLE POINT?

1. MFR
2. BLT/BMT

13

Do the functional release OMT types require continuous adjustment of position/pressure in response to progressive change?

Yes

14

BLT (viscoelastic model)

Some elongation is lost and some is retained after application of tension force

15

How do we diagnose MFR?

Locate ease/bind "barriers"

16

Where do we take myofascial (target) tissues to in MFR?

To a specific start point

17

What do we wait for at the feather edge of the restrictive barrier in MFR?

Heat to cause collagen 'state' change from gel to sol and viscoelastic ("creep") resposne

18

How long might it take for the heat to cause collagen state?

20-30 seconds...while you adapt to TTC

19

What do we follow in MFR?

'Creep' until a release takes place

20

May we use release enhancing mechanisms (REMs) or other motions and/or joint positioning?

Yes

21

Do we need to "finish"...creep stops and there is return to normal?

Yes

22

Do we re-check TTC?

Yes

23

Give the definitions explainingg MFR and BLT/LAS

1. MFR - continuous adjustment of position/pressure in response to palpating progressive change of myofascial tissues

2. Continuous adjustment of position/pressure in response to palpating progressive change of ligamentous/joint capsular tissues

24

What is the major difference between MFR and BLT/LAS?

Which tissue you are listening to when you diagnose and treat!!!!

25

Does fine movement cause much change?

Yes (any motion at a mobile point can cause tissues to tighten)

26

Balance in not what?

Cramming beyond the tissue's elastic limits, and yet it is not touching light as a butterfly

27

Is a vital resilience still present in the tissue?

Yes

28

When is shifting point created?

When reached and applied to area that is not perfectly balanced

29

Should we sense that the tissue "animate"?

Yes

30

What is the key to successful treatment?

The delicate balance point to any part of the body or any tissue

31

Indirect BLT Balance Point

Point of balance of an articular surface from which all the motions physiologic to that articulation may take place

32

BMT Balance Point. Where is it used?

Applicable in interosseous or dural membranes

Used in OCMM and in interosseous membranes (radius, fibula)

33

Are balance feel and release similar in most function OMT?

Yes

34

1st-3rd observations of spinal joints by Fryette at al in BLT site mechanic returning physiological motion

1. T-L neutral
2. T-L non-neutral
3. 3 planes..all joints

35

3 points in BLT at spinal facets/joints

1. Importance of picturing facet/joint facings
2. Importance of translation/glide movements
3. Seek "balanced" tension around joint

36

BLT at regional transition zones

Not Fryette; balance entire region

37

What is the key for BLT site mechanics?

Usually minor motion SD

38

5 Models

1. Postural-Biomechanical
2. Biopsychosocial
3. Neuromuscular-Autonomic
4. Metabolic-Hormonal (Bioenergic)
5. Respiratory Circulatory

39

What model is used in BLT/BMT/LAS and Zink?

Respiratory-Circulatory Model

40

What is the Common Compensatory Pattern in the Respiratory-Circulatory Model?

Left/Right/Left/Right (from top to bottom)

Opposite from bottom to top

41

Where did Zink graduate from? Where did he move to teach?

PCOM; Des Moies (Fluid Freak)

42

3 facts about Zink

1. Espoused RC model

2. Linked primary to secondary respiration with "Craniosternosacral Mechanism"

3. Developed ALS - wrote approach

43

3 facts about the underlying conditions for a patient being considered for the RC Model

1. Congestive component (edema, swelling)

2. Compromisses respiratory and/or circulation function

3. Would benefit from enhance immune function

44

3 dysfunction compromises for a patient being considered for the RC model

1. Lymphaticovenous pathways

2. "Terminal lymphatic drainage sites"

3. Diaphragm functions

45

4 places in RC Model for terminal lymphatic congestion

1. Supraclavicular (HEENT)

2. Posterior Axillary Fold (UE)

3. Sub-Xiphoid Process (abdominal)

4. Inguinal (LE)

46

Step 0 Findings

1. History of sign of infection (fever)
2. History indicating underlying congestive pathophysiology

47

Step 1 findings

1. Uncompensated zink fascial pattern (or CP in bedridden)
2. Terminal lymphatic drain site congestion
3. Scale muscle spasm (esp with rib 1 SD)

48

Step 2 findings

1. Not breathing down to pubic symphysis
2. Paradoxical respiration
3. Tight pelvic floor

49

Step 3 findings

1. Generalized signs of congestion
2. Secondary respiratory-related SD
3. Poor primary respiration mechanism

50

Step 4 findings

1. Organs congested (hepatomegaly)
1. Specific somatic site swollen

51

What are 3 things the RC model is about?

1. Pathways
2. Motion
3. Pressure change

52

4 steps in optimal lymphatic treatment

1. Remove obstruction to flow
2. Maximize thoraco-abdomino-pelvic respiratory/circulatory pump interally
3. Externally augment the pumps
4. Stimulate local lymph drainage

53

2 things with "Remove Obstruction to Flow"

1. Correct key myofascial SD
2. Open myofascial pathways for drainage back to central system

54

2 things with "Maximize thoraco-abdomino-pelvic respiratory/circulatory pump interally"

1. Remove other key SD, especially at chest cage
2. Redome diaphragms/maximize respiration

55

1 things with "Externally Augment the Pumps"

Stimulate lymphaticovenous return by changing pressures (raise ribs, add pumps) and stimulating eNOS (endothelial nitric oxide synthase)

56

1 thing with "Stimulate Local Lymph Drainage"

Move fluids toward heart (effleurage-visceral OMT)

57

What are 3 steps in step 1 for diagnosing and treating fascial patters and associated SD

1 .Diagnose zink fascial pattern
2. Assess thoracoabdominal diaphragm functions
3. Assess for terminal lympahtic drainage dysfunction

58

What is the fascial SD effect for lymphatics, veins, arterioles

Lymphatics > veins > arterioles

59

What 2 places are transition zones at?

1. Anatomical regions: where structure changes
2. Where regional block (less motion structure) and regional rod (more motion) join

60

4 things about what transition zones are

1. Where structure changes --> function first changes

2. Highest area of compensation (postural, myofascial, etc)

3. Myofascial dysfunction reflects underlying boney SD

4. Areas where diaphragms attach (opportunity for 2-fers)

61

4 regions for transition zones

1. Cr-Cerv: OA-AA-C2 (we check and name for OA rotation)

2. Cerv-Th: T1-T4; ribs 1-2; manubrium

3. Th-L: lower ribs down to Th-L junction

4. Pelvic-Lumbar: L-P junction (named for pelvic rotation)

62

Are compensated patterns alternating?

Yes

63

Where are fascial patten SD at?

Sites where structure-function change

64

If pattern is not ideal, what is next best state?

Compensated

65

What are the 4 patterns

1. Ideal
2. Common compensated pattern (CCP)
3. Uncommon compensated patten (UCP)
4. Uncommon pattern

66

Fascial pattern palpated superficially reflects what? Assessed where?

Underlying direction deeper structures moved; assessed at first barrier

67

Regiona diagnosis allows what?

Unified regional OMT treatment if we wish

68

What do we listen to for direct/indirect myofascial?

Myofascial

69

What do we listen to for BLT (indirect) or LAS (combined)?

Articular

70

Do we compare muscle energy (direct) of one region to another?

Yes

71

Often regions prefer what?

SB-rotation to the same side (note Fryette Trpe spinal nomenclature is NOT used to describe REGIONAL motion)

72

Regions may be treated how?

With OMT of individual parts

73

Spine (articular-ligamentous)

Compensatory regional patterns usually linked to type 1 thoracic and lumbar spinal curves (postural compensation)

74

Soft tissue structures cross what?

Regions that may have significant impant

75

Note that OMT may be what?

Warranted even for compensated SD

Example is bed-ridden or for reompensation strategies)

76

What is goal in respiratory-circulatory system?

Enhance physiological homeostais

77

HVLA of 4 transition zones advantage

Fast

78

4 regions BLT/FPR advantage

Fewest possible side effects; comfortable in acute situations; best hospital choice

79

Regional MFR advantage

Several diaphragm "two-fers" (especially superior throacic inlet and inferior thoracic outlet: and prepares tissues for tensegrity needed for optimal local drainage

80

Are transtition zones vertebral units? Example?

NO!!!!!!!!

Superior thoracic inlet is T1-T4 PLUS manubrium PLUS ribs 1-2 PLUS myofascial structures (including scalenes)

81

What is step 2?

Remove diaphragms

82

5 discussion points

1. Active vs passive (elastic)
2. Synchronous motion (active vs passive)
3. Pressure gradients and Bernoully's principle
4. Organ location
5. OMT and pumps

83

4 diaphragm techniques

1. Cranial diaphragm
2. Sibson fascia (soft tissue)
3. Pelvic diaphragm
4. Thoracoabdominal diraphagm redoming

84

What is the Formation Phase?

Getting fluid, edema proteins and waste products into the lymphatics requires MOTION

85

2 things with Formation Phase

1. Primary inspiration
2. Secondary inspiration

86

2 one=way valves

1. Muscle pumps
2. Effleurage

87

Pressure changes between compartments or on-off pressure sensitive structures (spleen/liver) moves what?

Fluid

88

4 steps of RC Model

1. Open pathways (we advocate zink)

2. Optimize respiration (primary and secondary; redome diraphragms)

3. Augment fluids (lymph pumps and add primary respiration)

4. Movilize fluids from concern sites (mesenteric lifts/local effleurage)

89

3 things with Zink's Fascial Patter Approach

1. Compensated or not?

2. Where structure changes, this is first place functino changes (posutral homeostasis as well as sites of transverse diaphragms)

3. Uncomepnsated patterns often traumatic rather tha npostural