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Year 1: OS Exam 1 > 2.3 Chapmans Reflexes > Flashcards

2.3 Chapmans Reflexes Flashcards

1
Q

describe a monosynaptic reflex

A

primary afferent neuron
one synapse
central motor efferent neuron

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2
Q

where is the cell body in the afferent sensory neuron located

A

in the dorsal root ganlion

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3
Q

2 types of primary afferents?

A

small cell body: lightley myelinated or unmyelniated, beta afferent, crude, touch, nociceptor

Large cell body

  • myelinated alpha-afferent
  • proprioception, discrimination mechanoreceptors
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4
Q

where is the cell body of the motor efferent neuron located

A

the ventral horn of the spinal cord

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5
Q

what is a polysynaptic reflex circuit

A

utilize interneurons between afferent and motor efferents

-many modulations possible

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6
Q

nerves involved in autonomic reflex arc

A

cranial nerves
spinal nerves
splanchnic nerves

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7
Q

autonomic reflex arc: afferent nerve of relex

A

neuron to viscera/blood vessel—>cell body in dorsal root ganglia—>central process terminates in dorsal horn on:
motor efferent or interneuron

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8
Q

efferent nerve of reflex cell body location

A

in lateral horn of cord or brain stem nuclei

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9
Q

efferent nerve reflex (preganglionic) axons can be ____ or ____

A

myelinated or unmyelinated

Myelinated: terminate on ganglion neurons outside CNS
on fascia of body wall or organs

unmyelinated preganglionic axons: travel from ganglia to cell targets of visceral organs

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10
Q

ANS has _____ efferent neurons in the pathway and somatic PNS has ___

A

2,1

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11
Q

ganglionic neurons of the ANS are in 3 locations

A

1) paravertebral ganglia (symp trunk)
2) collateral ganglia (clusters along large vessels of abdominal cavity)
3) hypogastric ganglia (fasica of visceral organs of pelvis)

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12
Q

somato-somatic reflex is what?

example?

A

afferent axon from somatic structure
efferent motor to somatic structure
-may have at least 1 interneuron
-example: touch hot object

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13
Q

visceral-visceral reflex

A

sensory from viscera to cord
efferent motor to viscera via ANS

-example: distended bowel reflexing back to cause spasm in muscular layer of bowel

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14
Q

viscero-somatic/somato-visceral reflex

  • interneurons yes or no?
  • what type of pain?
A

afferent sensory axon from viscera or somatic structure
efferent motor terminates on somatic or visceral structure
-interneurons involved
-referred pain
-visceral pain referred to somatic structures (appendicitis)

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15
Q

myocardial infarction is what type of reflex with referred pain

A

viscero-somatic

  • artery clots = sensory to cord
  • output to shoulder/neck/arm/symp system = motor output
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16
Q

treatment of the spinal level will do what to the visceral problem

A

will not cure it but will decrease visceral efferents thus calming of abnormal reflexes

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17
Q

frank chapman biography

A

graduated from ASO in 1899
practiced in chattagnooga, TN
expreience in palpation led to development of reflexes

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18
Q

clinical application of chapmans points

A

palpation revealed nodules (ganglioform contractions)

-points of palpation on anterior and posterior = viscerosomatc reflexes

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19
Q

process of chapmans points

A

locate point by anatomy, anterior points first

  • diagnosis = anterior
  • treatment = poserior

verify by palpation
gently rotate tip of finger over point
recheck anterior points after treating posterior

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20
Q

when is the treatment complete of chapman points

A

when reflex is gone

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21
Q

how long to treat each point

A

10-30 seconds, less is better

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22
Q

finding the anterior points sinus issue

A

approximately 3.5 inches lateral to the sternum on upper border of second rib in first intercostal space

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23
Q

treating posterior point sinus issue

A

midway between spinous process and TP on CV2

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24
Q

patient with pelvic pain where do you palpate and what does this check for

A

palpate IT band on lateral side of thigh

-checks prostate or broad ligament

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25
Q

checking the colon
top 1/5 =
mid 3/5 =
lowest 1/5 =

A

area from greater trochanter to just above the patella
on anterolateral part of thigh

top 1/5 = cecum
mid 3/5 = ascending colon
lowest 1/5 = transverse colon

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26
Q

examine points for ovaries

A

upper pubic symphysis

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27
Q

groin gland examine point

A

last 2/5 of sartorius muscle

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28
Q

kidney point and signs

A

inch lateral and above umbilicus

-polyuria, anuria

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29
Q

adrenal point and signs

A

inch lateral and 2 inches aboveumbilicus

-fatigue, malaise, insufficient sleep

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30
Q

thyroid points and signs

A

intercostal space between ribs 2-3 close to sternum

-nervousness, wt loss, tachycardia

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31
Q

hepatic congestion point

A

on right midmammilary line btwn ribs 6-7

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32
Q

pyloric reflexes

A

between ribs 5-6 and 6-7 on left

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33
Q

splenic reflex

A

on LEFT between ribs 7-8 at intercostal cartilage

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34
Q

small intestine

A

intercostal spaces
ribs 8-9 = upper
ribs 9-10 = middle
ribs 10-11 = lower

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35
Q

what are the small intestine points used for

A

differential between ulcer and enteritis

36
Q

acupuncture
kidney channel-K11
-fullness in lower abdomen, dysuria

Chapman?

A

urethra reflex

urethral cystitis

37
Q

acupuncture liver 14: abdominal distension, acid regurgitation

chapman?

A

gastric hypercongestion

  • midmammilary line 6th intercostal space
  • fermentation of stomach contents
38
Q

acupuncture stomach 18: pain in chest (heartburn)

-chapman?

A

hyperacidity
midmammilary line 5th ICS
hyperchlorydria
gastric ulcer

39
Q

acupuncture abdominal lament spleen 16: indigestion, dysentery

chapman?

A

Small intestine

  • ICS 8-9,9-10,10-11
  • indigestion, enteritis
40
Q

acupuncture kidney 25: cough, asthma

chapman?

A

bronchitis

  • 2nd ICS
  • congestion in chest, bronchitis
41
Q

appendix point anterior

A

tip of 12th rib on right

42
Q

appendix posterior point

A

between TP of T11-T12

-some tenderness, but no palpable nodule

43
Q

what layers in the spinal cord gray mater are mechanoreceptors located?

A

3 and 4

44
Q

what layers in the spinal cord gray mater are a-delta fast pain fibers located?

A

1 and 5

45
Q

what layers in the spinal cord gray mater are small C fibers of slow pain located?

A

2

46
Q

what could account for visceral pain being so diffuse?

A

overlap of visceral and somatic input in SC gray matter and many afferent branches go both caudal and cephalad

47
Q

what accounts for localized pain patterns?

A

interaction of afferents with somatic efferents

48
Q

decompensation of homeostasis

A

Altered or impaired function due to relationship b/t visceral and somatic dysfunctions

  • visceral disturbances reflexively activate somatic musculature which produces dysfunction
  • somatic disturbance can also reflexives alter visceral function
49
Q

somatic component of disease

A

msk palpatory findings may correlate with visceral disturbances, so normalizing the MS component may normalize autonomic outflow and restore homeostasis

50
Q

what is facilitation?

A

maintain pool of neurons in state of sub threshold excitation so less afferent stimulation is required to trigger discharge of impulses
*less stim to illicit reflex (ex: music in scary movie facilitates you)

51
Q

Where are nociception absent in the body?

A

brain and hyaline cartilage

52
Q

what is the current theory for the cause of facilitation?

A

nociception

-release of peptides in inflammatory cascade lower nociceptor thresholds thus increasing output to cord

53
Q

what disrupts the balance between habituation and sensitization?

A

inflammation

54
Q

short term excitability-sensitization

A

1-2 sec of afferent input with excitability lasting 90-120 secs

55
Q

What is long term sensitization?

A

input of several minutes is hours of excitability

56
Q

who was the first to show reflex changes using EMG?

A

Denslow- correlated long-lasting, low threshold areas of afferent input to areas of injury and disease

57
Q

who coined term facilitated segment and what does that mean?

A

Korr

low threshold spinal reflexes represented pathways in hyper-excited state by cont. bombardment of inputs

58
Q

allostasis

A

the process by which the body responds to stressors in order to regain homeostasis

59
Q

hyperalgesia

A

exaggerated response to noxious stimulus

-secondary hyperalgesia = central sensitization

60
Q

examples of somatovisceral reflexes? (3)

A
  1. somatio-cardiac
  2. ”“-gastric
  3. ”“-adrenal
61
Q

Somatocardiac reflex

A

nociceptive somatic stimuli results in increase HR and BP

62
Q

somatogastric reflex

A

nociceptive somatic stimuli resulting in inhibition of peristalsis in stomach

63
Q

somatic adrenal reflex

A

nociceptive somatic stimuli resulting in release of catecholamines from adrenal medulla
-ex: increased catecholamine in response to movement of knee

64
Q

head and neck (including upper esophagus) sympathetic viscerosomatic reflex level

A

T1-5

65
Q

Upper GI (including upper esophagus) sympathetic viscerosomatic reflex level

A

T5-10

66
Q

SI/ascending colon sympathetic viscerosomatic reflex level

A

T9-11

67
Q

Ascending and transverse colon sympathetic viscerosomatic reflex level

A

T10-12

68
Q

descending and sigmoid colon sympathetic viscerosomatic reflex level

A

T12-L2

69
Q

descending and sigmoid colon parasympathetic viscerosomatic reflex level

A

S2-4

70
Q

extremity sympathetic viscerosomatic reflex level

A

-no parasympathetic

T2-7/T11-L2

71
Q

Heart sympathetic viscerosomatic reflex level

A

T1-6

72
Q

heart parasympathetic viscerosomatic reflex nerve

A

Vagus n

73
Q

Lungs sympathetic viscerosomatic reflex level and parasympathetic n

A

T1-7

para: vagus n

74
Q

What are chapman reflexes?

A

A system of viscerosomatic reflex points that present as predictable anterior and posterior fascial tissue texture abnormalities due to lymph stasis secondary to visceral dysfunction

75
Q

What are the palpatory features of chapman’s points?

A

located deep to the skin in areolar tissue, paired posterior and anterior points, small, smooth, and firm nodule approximately 2-3 mm in diameter

76
Q

who originally used chapman’s reflexes and who described them?

A

used: Frank Chapman
described: Charles Owens

77
Q

when did chapman first publish his original chart and text for lymphatic reflexes?

A

1929

78
Q

3 characteristics of chapman’s reflexes?

A
  1. viscerosomatic: diagnostic and treatment value
  2. Gangliform contraction that blocks lymph drainage and causes SNS dysfunction (consistent reproducible points)
  3. anterior and posterior consistent reproducible points relating to specific organ or condition
79
Q

How did Owens first describe palpatory features in 1943?

A
  1. gangliform
  2. edematous
  3. ridge like or ropy
  4. fibrospongy
  5. shotty (few irregular LN, dense but not hard, found by finger over tissue with circular motion to find nodule under skin using clockwise and counter CW motion)
80
Q

What is done once you found and isolated a CR point?

A

apple GENTLE, FIRM pressure to cause a deep, disagreeable pain response
-first use anterior CR for diagnostic b/c of location consistency then posterior to confirm presence

81
Q

What is the pain associated with a chapman reflex like?

A
  • pinpoint, sharp, and non-radiating, right under physician’s fingertip
  • pain typically greater than expected
  • pt usually previously unaware of the sore spot
82
Q

when do you stop Chapmans treatment?

A

mass disappears OR pt/doctor can no longer tolerate procedure

83
Q

What are the two principles when using chapman reflexes as a diagnostic tool?

A
  • never make a diagnosis based solely on a nontender CR

- never ignore or trivialize a tender CR unless you have a good explanation for the findings

84
Q

contraindications for CR tx

A
  • pt needs emergent care ABC
  • refusal
  • fracture, cancer, other pt instability
85
Q

Where would you document CR?

A

objective: MSK- CR on location
Assessment: SD
Plan: OMT done using soft tissue, lymph

86
Q

what are post treatment precautions/side effects?

A
  • discomfort
  • drink plenty of water (2-3 L) over next 24 hours
  • Can take normal pain management meds as long as no other Contra-ind
  • rest
87
Q

Chapman and Pneumonia, sensitivity and specificity and odds ratio

A

sensitivity: 69
specificity: 64
odds ratio: 3.94

Year 1: OS Exam 1 (39 decks)

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