1. ANS

Question 1

Head and neck (including upper esophagus)

Answer 1

T1-5

Question 2

heart

Answer 2

T1-6

Question 3

Lungs

Answer 3

T1-7

Question 4

Upper GI (includes lower esophagus)

Answer 4

T5-10

Question 5

SI/ascending colon

Answer 5

T9-11

Question 6

Ascending and transverse colon

Answer 6

T10-L2

Question 7

Descending and sigmoid colon/rectum

Answer 7

T12-L2

Question 8

adrenal glands

Answer 8

T5-10

Question 9

GU tract (+ bladder)

Answer 9

T10-L2

Question 10

Ureter (upper/lower)

Answer 10

• Upper ureter: T10-11
• Lower ureter: T12-L2

Question 11

Upper extremeties

Answer 11

T2-7

Question 12

Lower extremeties

Answer 12

T11-L2

Question 13

Heart, lungs, esophagus, upper GI, SI, kidneys, ascending and transverse colon, upper ureter

Answer 13

Vagus N (OA,AA)

Question 14

Colon, rectum, reproductive organs, bladder, pelvis, lower ureter

Answer 14

Pelvic splanchnic N; S2-4 (sacrum)

Question 15

_____ involuntarily controls body functions and is regulated by what?

Answer 15

ANS

Hypothalamus, limbic system and brainstem

Question 16

Practically every interneuron that receives input from a visceral nociceptor also receives input from a __________

Answer 16

somatic source

Question 17

Almost 80% of interneurons that receive input from somatic structures also receive _________

Answer 17

visceral input

Question 18

There is no evidence for any ______ pathway that transmits ONLY visceral signals from the spinal cord to the brain

Answer 18

ascending

Question 19

What nerves transmit parasympathetic information?

Answer 19

• From brainstem nuclei
  
  • CN 3, 7, 9, 10
• Intermediate gray matter S2-S4

Question 20

What nerves transmit sympathetic information?

Answer 20

• Intermediolateralcell column, located in the lateral horn of T1-L2

Question 21

Sympathetic ganglia

Answer 21

1. Cervical
   
   1. superior
   2. Middle
   3. Stellate
2. Paravertebral (thoracolumbar)
3. Prevertebral
   
   1. celiac
   2. Superior mesenteric
   3. Inferior mesenteric

Question 22

What N transmits parasympathetic innervation to Cardiopulm/GI

Answer 22

CN10

Question 23

What N transmits parasympathetic innervation to colon, rectum, GU

Answer 23

S2-S4

Question 24

What can sustain local reflex activity independent of CNS

Answer 24

Enteric NS

Question 25

**Sympathetic fibers** controls ______ and \_\_\_\_\_\_.

Answer 25

**Vascular** (fascia, smooth m, sweat glands AND trunk and extremities) **Visceral** (smooth m, cardiac..)

Question 26

Parasympathetic fibers do **not** control what?

Answer 26

**Extremeties** and **vascularature** DO: visceral (same as symp + viscera in head/neck)

Question 27

**SENSITIZATION** Progressive amplification of a response follows *repeated* administrations of a stimulus. If the stimulus is terminated, what happens?

Answer 27

**neurons return to baseline**

Question 28

**Faciltation** allows us to to maintain neurons that are in a state of subthreshold excitation by...

Answer 28

sending **less afferent stimulation** to trigger impulse

Question 29

Once established, facilitation can be sustained by \_\_\_\_\_\_\_

Answer 29

## Footnote **normal central nervous system (CNS) activity**

Question 30

**VISCEROSOMATIC REFLEXES** tend to have _________ SD that usually affect \_\_\_\_\_\_\_\_. Features (3)

Answer 30

* Non-neutral type 2 SD * Small rotators * Increased moisture, temperature, rubbery (poorly defined) end point)

Question 31

**Chapmans reflexes** are an example of \_\_\_\_\_\_\_\_\_

Answer 31

**viscerosomatic reflexes**

Question 32

What is the process where the body responds to stressors, to maintain homeostasis?

Answer 32

**Allostasis**

Question 33

Frequent of feedback pathways meant to reestablish normal homeostasis. Chronic exposure to stress =\> atrophy of the hippocampus =\> affecting feedback, memory and autonomic function

Answer 33

## Footnote **ALLOSTATIC LOAD**

Question 34

**Lymphatic fluid pumps** include

Answer 34

1. **Thoracic inlet** 2. **Thoracic diaphragm** 3. **Pelvic diaphragm**

Question 35

**Transition zones (myofascial pathways)**

Answer 35

1. OA (occipitoatlantal) 2. Cervicothoracic 3. Thoracolumbar 4. Lumbosacral

Question 36

**Lymphatics** receive innervation from the _______ NS. SD may be \_\_\_\_\_\_\_\_\_.

Answer 36

* Sympathetic * Disabling a pump

Question 37

**MI** can sometimes present as \_\_\_\_\_\_\_\_.

Answer 37

**Upper back pain** -if upper back pain, ask about head, heart and lungs

Question 38

Do viscerosomatic reflexes respond to OMT?

Answer 38

**No**

Question 39

If thoracolumbar junction pain, ask questions about...

Answer 39

**GI/GU**

Question 40

Pt has SOB, cough, lower lobe pneumonia. What kind of OMT do you give?

Answer 40

1. Rib raising 1. make sure you get Rib 1 on the L to open the thoracic inlet 2. Subocciptal release 3. Dome diaphragm 4. Pedal pump 1. more walking = less pedal pump

Question 41

A 14 month old male is brought to the doctor’s office with complaints of fussiness, fever, and runny nose. Physical exam shows vital signs stable, with mildly elevated temp. TM’s bulging and red, posterior pharynx mildly erythematous with posterior nasal drainage noted. Heart regular without murmur, lungs clear in all fields. Biomechanical? Neurological?

Answer 41

- Treat SD - OA/AA T1-5 Chapmans Lymphatics

Question 42

URI OMT

Answer 42

1. Thoracic inlet 2. Rib raising 3. Ear pull (temporal bone) 4. Suboccipital release

Question 43

Pt has death in fam; increasing anxiety and palpittions. Sx worsen to CP. No SOB, diaphoresis, NV, back pain. HR is irregulat Behavior? Neuro? Respiratory circulatory?

Answer 43

Behavior? no tobacco/caffeine, get sleep Neuro? T10-L2/OA/AA Respiratory circulatory? T1-T6

Question 44

Rib raising affects what what nerve levels?

Answer 44

**T1-6** **T10-12**