5 ST & MFR Lecture Flashcards

1
Q

Soft Tissue Techniques directly applied where?

Soft tissue preparation facilitates what?

A

Applied to muscular and fascial structures of body

Facilitates improvement of articular motion

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2
Q

What is soft tissue?

What is included?

A

Living tissues of the body other than bone

Fascia, Muscles, Organs, Nerves, Vasculature, Lymphatic

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3
Q

Fascia

What is it?

Composed of?

Function?

What is it not?

A

Complete system with blood supply, fluid drainage, & innervations (largest organ system in body)

Composed of irregularly arranged fibrous elements of varying density

Involved in tissue protection and healing of surrounding systems

It is not Tendons, Ligaments, Aponeuroses

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4
Q

Fascia is Omnipresent

A

There is a myofascialarthroidal continuity throughout the body

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5
Q

Describe continuity of Fascia

A

Perimysium (Fascia) –> Peritendium –> Periosteum

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6
Q

Pannicular Fascia

A

Outermost layer derived from Somatic mesenchyme and surrounds entire body with exception of orifices

Outer layer is adipose & Inner layer is membranous and adherent to outer portion

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7
Q

Axial & Appendicular Fascia

A

Internal to Pannicular layer; fused to Panniculus and surrounds all muscles, periosteum of bone, and peritendon of tendons

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8
Q

Meningeal Fascia

A

Surrounds nervous system including the Dura

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9
Q

Visceral Fascia

A

Surrounds body cavities (pleural, pericardial, & peritoneum)

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10
Q

Fascia is Omnipotent

Contractile components

Healing components

A

Provides for mobility and stability of MSK system

Myofibroblasts

Macrophages, Mast Cells

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11
Q

Fascia is Omniscient

A

20% of cutaneous mechanoreceptors supplying skin have receptive fields in subcutaneous tissue (loose fascia)

75% of stretch receptor free endings for muscles and proprioception in fascia

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12
Q

Viscoelastic Material

A

Any material that deforms according to rate of loading and deformity

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13
Q

Stress-Strain Relationship

A

Stress is force that attempts to deform CT structure

Strain is percentage of deformation of CT

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14
Q

Hysteresis

A

Difference between loading and unloading characteristics represents energy that is lost in CT system; energy loss is Hysteresis

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15
Q

Creep

A

CT under sustained, constant load (below failure threshold), will elongate (deform) in response to load

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16
Q

Ease

A

Direction in which CT may be moved most easily during deformational stretching

Palpated as sense of tissue “looseness”, or laxity/greater degree of mobility

17
Q

Bind

A

Palpable restriction of CT mobility

18
Q

Hooke’s Law

A

Strain (deformation) placed on an elastic body is in proportion to the stress (force) placed upon it

19
Q

Wolff’s Law

A

Bone will develop according to stresses placed upon it

20
Q

Sherrington’s Law

A

When muscle receives nerve impulse to contract, its antagonists, receive, simultaneously, an impulse to relax

21
Q

Common Compensatory Patterns

Uncommon Compensatory Patterns

Uncompensated Pattern

A

80% of Healthy People (L/R/L/R)

20% of Healthy People (R/L/R/R)

Usually symptomatic and a trauma usually involved

22
Q

Transition Zones of Spine

A

OA, C1, C2

C7, T1

T12, L1

L5, Sacrum

23
Q

Transverse Restrictors

A

Tentorium Cerebelli

Thoracic Inlet

Thoracolumbar Diaphragm

Pelvic Diaphragm

24
Q

Soft Tissue (ST) Technique

A

System of Dx and Tx directed toward tissues other than skeletal or arthrodial elements

25
Tx Goals for TTA
Stretch and increase elasticity of myofascial structures to return symmetry Improve local tissue nutrition, oxygenation, and removal of metabolic wastes to normalize tissue texture
26
Tx Goals of Asymmetry of Myofascia
Restore symmetry Normalize tone
27
Tx Goal for Restriction of Motion
Set fascia free to normalize ROM
28
Tx Goal for Tenderness
Normalize neurologic activity Improve abnormal somato-somatic & somato-visceral reflexes
29
ST Indications
**Diagnostically**: identify restricted motion, sensitivity, TTA **Feedback** about tissue response to OMT Improve local & systemic **immune response** Provide general state of **relaxation** **Enhance circulation** to local myofascial structures Provide general state of **tonic stimulation**
30
ST Relative Contraindications
Severe Osteoporosis Acute injuries
31
ST Absolute Contraindications
Fracture/Dislocation Neurologic entrapment syndromes Serious vascular compromise Local malignancy Local infection Bleeding disorders
32
Stretch (Parallel Traction) Knead (Perpendicular Traction) Inhibition
Increase distance between origin and insertion (parallel with muscle fibers) Repetitive pushing of tissue perpendicular to muscle fibers Push and hold perpendicular to fibers at musculotendinous part of hypertonic muscle
33
MFR INR
System of diagnosis and Tx which engages continual palpatory feedback to achieve release of myofascial tissues Tx system in which combined procedures are designed to stretch and reflexively release patterned ST and joint related restrictions
34
What are REMs (Release Enhancing Maneuvers)
Breath holding Prone/Supine simulated swimming & pendulul arm swing R/L cervical traction Isometric limb and neck movements against table Patient evoked movement from cranial nerves
35
Indications for MFR
SD When HVLA or MET contraindicated When counterstrain may be difficult secondary to patient's inability to relax
36
**Contraindications of MFR** Absolute Relative
* Lack of consent or Absence of SD * Infection of ST or Bone * Fx, Avulsion, or Dislocation * Metastatic disease * ST injuries: Thermal, Hematoma, Open wounds * Post Op Patients with wound dehiscience * Rheumatologic condition involving instability of CS * DVT or Anticoagulation therapy
37
**Activating Forces** Inherent Forces Respiratory Cooperation Patient Cooperation
Using body's PRM (primary respiratory mechanism) Refers to physician directed, patient performed, inhalation/exhalation/holding breath to assist with manipulative intervention Patient asked to move in specific directions to aid in mobilizing specific areas of restriction
38
**MFR Treatment Endpoint** 3-D release often palpated as:
Warmth, Softening, Increased ROM