9: Visceral Manipulation And Abd Exam

Question 1

Four reasons there would be increased dullness in the abd/chest on percussion

Answer 1

1. Perforated bowel -> free air in abdomen
2. COPD -> hyperinflation of lungs
3. Lung path like pleural effusion or consolidation
4. Ascites fluid in abdomen

Question 2

Visceral vs somatic pain

Answer 2

Visceral: due to stretching/contracting hollow organs -> vague and not localized
Somatic: localized, aggravated by specific movements

Question 3

Peritoneal pain

Answer 3

Due to inflammation of abdominal cavity lining, reproduced by movement of organs against peritoneum

Question 4

Two possible paths with a positive psoas sign

Answer 4

1. Appy

2. Psoas irritation

Question 5

Two paths associated with positive obturator test

Answer 5

1. Appy

2. Obturator irritation

Question 6

Primary driver of lymphatic fluid

Answer 6

Thoracic diaphragm

Question 7

Ribs and vertebrae associated with the diaphragm

Answer 7

1. Ribs: 5-12

2. Vertebrae: T5-L3

Question 8

OMM to relax abdominal wall and bowel adhesions

Answer 8

Colon release, mesenteric release

Question 9

Viscerosomatic vs somatovisceral

Answer 9

1. Viscerosomatic: localized visceral stimuli producing patterns of reflex response in segmentally related somatic structures
2. Somatovisceral: changes in soma produce alterations in segmentally related neuro system

Question 10

Symps for head/neck

Answer 10

T1-T5

Question 11

Symps for heart vs lungs

Answer 11

Heart: T1-6
Lungs: T1-7

Question 12

SI/ascending colon vs ascending and transverse colon symp levels

Answer 12

SI/ascending: T9-11

Ascending/transverse: T10-L2

Question 13

Descending/sigmoid colon/rectum symp levels

Answer 13

T12-L2

Question 14

Adrenal and upper GI symps

Answer 14

T5-10

Question 15

GU symps

Answer 15

T10-L2

Question 16

Three groups that have vagus nerve (OA,AA) as parasymp innervation

Answer 16

1. Heart and lungs
2. upper GI -> transverse colon
3. Kidneys and upper ureters

Question 17

Three groups that use S2-4 (sacrum) for parasymp innervation

Answer 17

1. Colon -> Rectum
2. Reproductive organs
3. Bladder, pelvis, lower ureter

Question 18

Three sympathetic ganglion and their levels

Answer 18

1. Celiac: T5-T9
2. Superior mesenteric: T10-11
3. Inferior mesenteric ganglion: T12-L2

Question 19

Where is the cisterna chyli’s dilation

Answer 19

L1-2