(4) Osteopathic Reflexes Flashcards
What is a reflex?
A relationship b/w an input stimulus to the body and an output action to either a muscle or secretory organ
Spinal cord gray matter
Layers 3,4 =?
Mechanoreceptors
Spinal cord gray matter
Layers 1 and 5?
A (delta) fast pain fibers
Spinal cord gray matter
Layer 2?
Small c fibers of slow pain
What is the CLINICAL APPLICATION of using reflexes?
Visceral disturbances reflexly cause activation in the somatic musculature
Which produces dysfunction!!!
Somatic disturbances can reflexly alter visceral function
Sensitivity of Neurons
What is:
Short term excitability?
Excitability lasts for 90-120 seconds
Sensitivity of Neurons
What is:
Long term sensitization?
Inputs of several minutes
Excitability lasts for hours
Sensitivity of Neurons
What is:
Fixation?
15-40 minutes of afferent input
Excitability lasts for days or weeks
Sensitivity of Neurons
What is:
Permanent Excitability?
Lasts forever (?) - a long time
Death of inhibitory interneurons
Who was the first to show reflex changes using EMG?
Denslow
Who coined the term facilitated segment?
What is a facilitated segment?
Korr
Interneurons that are bombarded with excitement
What is habituation?
Process of decreasing response of a neural pathway with continuous stimulation
What is the opposite of habituation?
Sensitization
What is allostasis?
Long term neural effect of segmental facilitation
Allostasis has been associated with?
CV : HTN, increased risk of MI
Neuro: Depression, anxiety, memory loss, decreased cognition
Immune: immunosupression, autoimmune disease
Define:
Somatosomatic
Localized somatic stimuli producing patterns of reflex response in segmentally related…
Somatic structures
Define:
Somatovisceral
Localized somatic stimulation producing patterns of reflex response in segmentally related…
Visceral structures
Define:
Viscerosomatic
Localized visceral stimuli producing patterns of reflex response in segmentally related…
Somatic structures
Define:
Viscerovisceral
Localized visceral stimuli producing patterns of reflex response in segmentally related…
Visceral structures
What are a couple of examples of somatosomatic reflex?
Withdrawal response
Myotatic response
What is an example of a viscerovisceral reflex?
Distention of the gut results in increased contraction of the gut muscle
What is a somatocardiac reflex?
Nociceptive somatic stimuli result in elevation of heart rate and blood pressure
What is a somatogastric reflex?
Nociceptive somatic stimuli results in inhibition of peristalsis in the stomach
What is the somatoadrenal reflex?
Nociceptive somatic stimuli results in the release of catecholamines from the adrenal medulla
What is a viscerosomatic reflex?
Name a MAJOR example of this
When somatic pain referral is due to visceral nociceptie stimuli
Heart attack
Where are a majority of interneurons living in the spinal cord?
DRG
State the levels of viscerosomatic reflexes of:
Head/neck
T1-T5
State the levels of sympathetic viscerosomatic reflexes of:
Upper GI (Including Upper Esophagus)
T5-T10
State the levels of sympathetic viscerosomatic reflexes of:
Small intestine/Ascending colon
T9-T11
State the levels of sympathetic viscerosomatic reflexes of:
Ascending and Transverse Colon
T10-L2
State the levels of sympathetic viscerosomatic reflexes of:
Descending and Sigmoid Colon/Rectum
T12-L2
State the levels of parasympathetic viscerosomatic reflexes of:
Upper GI (including upper esophagus)
Vagus n.
(OA, AA)
State the levels of parasympathetic viscerosomatic reflexes of:
Small intestine/Ascending colon
Vagus n.
(OA, AA)
State the levels of parasympathetic viscerosomatic reflexes of:
Ascending and Transverse Colon
Vagus n.
(OA, AA)
State the levels of parasympathetic viscerosomatic reflexes of:
Descending and Sigmoid Colon/Rectum
S2-S4
(Sacrum)
State the levels of sympathetic viscerosomatic reflexes of:
Upper extremities
T2-T7
State the levels of sympathetic viscerosomatic reflexes of:
Lower extremities
T11-L2
State the levels of sympathetic viscerosomatic reflexes of:
Heart
T1-T6
State the levels of sympathetic viscerosomatic reflexes of:
Adrenals
T5-T10
State the levels of parasympathetic viscerosomatic reflexes of:
Heart
Vagus n.
(OA, AA)
State the levels of parasympathetic viscerosomatic reflexes of:
Adrenals
Vagus n.
(OA, AA)
State the levels of sympathetic viscerosomatic reflexes of:
Lungs
T1-T7
State the levels of parasympathetic viscerosomatic reflexes of:
Lungs
Vagus n.
(OA, AA)
State the levels of sympathetic viscerosomatic reflexes of:
Genitourinary Tract
T10-L2
State the levels of parasympathetic viscerosomatic reflexes of:
Reproductive organs, pelvis
S2-S4
State the levels of sympathetic viscerosomatic reflexes of:
Genitourinary tract (includes bladder)
T10-L2
State the levels of sympathetic viscerosomatic reflexes of:
Ureter - Upper
T10-T11
State the levels of sympathetic viscerosomatic reflexes of:
Ureter - Lower
T12-L2
State the levels of parasympathetic viscerosomatic reflexes of:
Upper ureter
Vagus n.
(OA, AA)
State the levels of parasympathetic viscerosomatic reflexes of:
Bladder
S2-S4
(Sacrum)
State the levels of parasympathetic viscerosomatic reflexes of:
Lower ureter
S2-S4
Sacrum
State the levels of parasympathetic viscerosomatic reflexes of:
Reproductive organs
S2-S4
Sacrum
What are chapman’s points?
A group of palpable points occuring in the predictable locations on the anterior and posterior surfaces of the body that are considered to be r_eflections of visceral dysfunction or disease_
What are the 3 component characteristics of chapman’s reflexes?
- Viscerosomatic reflex
- Gangliform contraction
- A consistent reproducible series of points both anterior and posterior related to specific organs or conditions
The PAIN associated with a chapman’s point is characteristically…
Pinpoint, sharp and non-radiating
Located under the physicians finger tip
Pain is greater than expected
Pt. is usually previously unaware of the sore spot
How do you treat a chapman’s point?
- Firm pressure
- Heavy uncomfortable pressure to gangliform mass
- Slowly move finger in circular fashion
- Continue for 10-30 seconds
- Can alternate CC/CCW
- Cease stop treatment when mass dissapears or no one can tolerate
Contraindications for chapman’s?
Pt. needs emergent care
Pt. refusal
Fracture, cancer or otherwise instable
