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OS1 > 3 Intro to Somatic Dysfunction > Flashcards

3 Intro to Somatic Dysfunction Flashcards

1
Q

Four Tenets of Osteopathic Medicine

A
  1. The Mind, Body and Spirit are a Unit
  2. The Body is Capable of Self-Regulation, Self-Healing, and Health Maintenance
  3. Structure and Function are Reciprocally Interrelated
  4. Rational Treatment is Based Upon Understanding & Implementing the other 3 Tenets
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2
Q

Somatic Dysfunction

Definition?

What anatomical components are included in SD?

It is treatable using what?

A
  • Impaired or altered function of somatic (body framework) system:
    • Skeletal, Arthrodial, Myofascial Structures (SAM) and related:
      • Vascular, Lymphatic, Neural Elements (VLAN)
  • Osteopathic Manipulative Treatment
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3
Q

Osteopathic Manipulative Treatment (OMT)

Definition

A

Therapeutic application of manually guided forces to improve physiologic function and/or support homeostasis altered by SD

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4
Q

Acute Somatic Dysfunction

Definition

Characterized by?

A
  • Immediate/Short-Term impairment/altered function
  • Characterized by:
    • Vasodilation
    • Edema
    • Tenderness/Pain
    • Tissue contraction
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5
Q

Chronic Somatic Dysfunction

Definition

Characterized by?

A
  • Impairment/Altered Function
  • Characterized by:
    • Tenderness
    • Itching
    • Fibrosis
    • Paresthesias
    • Tissue contraction
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6
Q

Diagnostic Criteria for Somatic Dysfunction

T.A.R.T.

Which are Palpated and which are Elicited?

A

Tissue texture abnormalities (Palpated)

Asymmetry of structure or motion (Palpated)

Restriction of motion (Palpated)

Tenderness (Elicited)

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7
Q

Tissue Texture Abnormality

Definition

Types

Signs (Physical)

Symptoms (Patient Experiences)

A

Palpable change in tissues from skin to periarticular structures

Bogginess, Thickening, Stringiness, Ropiness, Firmness, Temperature change, Moisture change

Vasodilation, Edema, Flaccidity, Hypertonicity, Contracture, Fibrosis

Itching, Pain, Tenderness, Paresthesias

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8
Q

Bogginess

A

Palpable sponginess in tissue resulting from congestion due to increased fluid content

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9
Q

TTA Terms

Tone and different types

Contraction

Contracture

Spasm

Ropiness

A
  • Normal feel of muscle in relaxed state
    • Hypertonicity (at the extreme = spastic paralysis)
    • Hypotonicity (flaccid paralysis when no tone at all)
  • Normal tone of muscle when it shortens or is activated against resistance
  • Abnormal shortening of muscle due to fibrosis
  • Abnormal contraction maintained beyond physiologic need
  • Hard, firm, rope-like or cord-like muscle tone
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10
Q

Tissue Texture Changes

Vascular (Acute and Chronic)

Sympathetic (Acute and Chronic)

Musculature (Acute and Chronic)

A
  • Vascular
    • A: Inflamed vessel wall injury
    • C: Sympathetic tone increases vascular constriction
  • Sympathetic
    • A: Local vasoconstriction overpowered by local chemical release –> Vasodilation
    • C: Vasoconstriction, hypersympathetic tone, may be regional
  • Musculature
    • A: Local increase in tone, muscle contraction, spasm - mediated by increase spindle activity
    • C: Decreased muscle tone, flaccid, limited ROM due to contracture
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11
Q

Asymmetry

Defintion

How is it determined?

A

Absence of symmetry of position or motion

Determined by vision or palpation

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12
Q

Restriction of Motion

Anatomic Barrier

Physiologic Barrier

Elastic Barrier/Range

Restrictive Barrier

A

Resistance or impediment to movement

Motion limit due to anatomic structure; Limit of passive motion

Limit of active motion

Range between PB and AB in which passive stretching occurs before tissue disruption

Functional limit abnormally diminishing normal physiologic range

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13
Q

ROM Assessment

AROM vs PROM

Blocking Linkage

A

AROM (Patient initiated) < PROM (Examiner initiated)

Stabilization of associated/adjacent structures to focus movement to only joint/s being assessed

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14
Q

Barrier “End Feel”

Examples of Restricted ROM & Abnormal End-Feel

A

Palpatory experience or perceived quality of motion when joint is moved to its limit

  • Early muscle spasm (protective spasm after injury) - Empty end-feel or guarding
  • Late muscle spasm (chronic spasm)
  • Hard capsular (frozen shoulder)
  • Soft capsular (synovitis)
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15
Q

Tenderness Definition

Pain definition

A

Discomfort/pain elicited through palpation

Unpleasant sensation induced by noxious stimuli and generally received by specialized nerve endings

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16
Q

Pain (Acute and Chronic)

Visceral Function (Acute and Chronic)

Visceral Dysfunction (Acute and Chronic)

A
  • Pain
    • A: Sharp, severe, cutting
    • C: Dull, ache, paresthesias
  • Visceral Function
    • A: Minimal somatovisceral effects
    • C: Somatovisceral effects common
  • Visceral Dysfunction
    • A: May or may not be present (present w/ severe trauma)
    • C: Often involved in somatic dysfunction
17
Q

TART (Acute vs Chronic)

TTA

Asymmetry

Restriction

Tenderness

A
  • TTA
    • A: Red, Swollen, Boggy, Increased Tone
    • C: Dry, Cool, Ropy, Pale, Decreased Tone
  • Asymmetry
    • A: Present
    • C: Present, Compensation Occurs
  • Restriction
    • A: Present, Painful with Motion
    • C: Present, maybe not. Guarded or “Empty”
  • Tenderness
    • A: Sharp pain
    • C: Dull, Achy pain
18
Q

Tenderpoints

Trigger Points

A

Hypersensitive areas within myofascial structures that results in localized pain

Hypersensitive areas within myofascial structures - palpation causes referred pain away from site

19
Q

Naming Somatic Dysfunction

A

SDs named for position of ease

20
Q

What is the goal of OMT?

A

Remove SD and restore homeostasis

21
Q

OMT

Indications

Adverse Reactions

Precautions

Recommendations

Contraindications

A
  • SD and/or Visceral Dysfunction
  • Soreness similar to workout or massage soreness; other Sx similar to acute illness; exacerbation of current physical complaints
  • Cancer; Frailty due to severity of disease, youth, and/or elderly
  • Rest (1-4 days); Hydration (1-2 L/day)
  • Different techniques have different contraindications
    • General: Cancer; RA; Fractures; Severe Frailty
    • Direct Techniques contraindicated in ligamentous laxity states (including RA)
22
Q

Role of OMT in the 5 Models

Biomechanical

Neurological

Respiratory/Circulatory

Metabolic

Behavorial

A

Myofascial & Joint functional optimization

Remove neurologic imbalances; address nociception

Maximize function

Structure & function are reciprocally related

More of cause than effect; how time is spent affects other 4; Exercise Rx teaches patients to treat themselves

23
Q

Direct Techniques

Indirect Techniques

A

Engage restrictive barrier directly

Positioning away from restrictive barrier

OS1 (13 decks)

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