Articulatory Technique And Principles

Question 1

History

Answer 1

At least as old as osteopathic profession

1. A.T. Still used it

Question 2

Theories of joint dysfxn

Answer 2

1. Alteration in relationship of opposing joint surfaced
   A. Disrupt jt. Surface tracking
2. Articular capsule problems
   A. Change viscosity of synovial fluid
   B. Fringe of synovium trapped
3. Neural control mechanism
   A. Change afferent input -> can’t tell jt. Position in space

Question 3

Theory why dysfxn always segment stuck

Answer 3

1. Inhibited from FROM
  A. External/internal forces -> segment irritation -> edema and swelling
  B. Fascial tightening
  C. Reflex hypertonicity
  D. Dec ROM

Question 4

Joint play

Answer 4

1. Jt. Play
  A. Small movement at synovial jt.
  B. Term described by John Mennell, MD
2. Synovial juts. ~1/8” movement
3. Involuntary
4. Need oil order for pain-free non-restricted movement

Question 5

These gritty and articulatory technique

Answer 5

1. Use OMT to restore normal kinetics ->
  A. Appropriate motion
  B. Maximum adaptability 
2. Tx affects
  A. Jt. Surfaces
  B. Tensile elements
  C. Everything that passes thru tensile elements

Question 6

Secondary effects

Answer 6

1. Alter length/tone of CT
2. Alleviate vessel and lymphatic compression
3. Remove nerve compression
   A. Dec pain
   B. Inc peripheral n. Fxn
   C. Inc neurotrophic flow of proteins
   D. Normalize autonomic balance

Question 7

Articulatory

Answer 7

Direct, joint-focused group of techniques

1. Low-velocity, high amplitude (LVHA)
2. Repetitive = springing barrier
3. Use long lever forces

Question 8

Indications

Answer 8

1. Jt. Restriction due to somatic dysfxn of jt
2. Jt. Restriction due to periarticular tissue somatic dysfxn
3. Can affect:
   A. Single jt.
   B. Body region

Question 9

Absolute contraindications

Answer 9

1. Fracture/dislocation
2. Neurologic entrapment syndromes
3. Serious vascular compromise
4. Malignancy
5. Infection
6. Bleeding disorders

Question 10

Relative contraindications

Answer 10

1. Acute herniated nucleus pulposous

2. Upper cervical: repetitive extension and rotation (arteries)

Question 11

Principles

Answer 11

1. Set-up specific
2. Pt. Comfortable and relaxed
3. Dr. Comfortable - use leverage
4. Engage restrictive barrier
5. Gentle, firm force applied rhythmically
   A. Jt. Returns just short of restrictive barrier
6. Continued until progress plateaus

Question 12

Long lever

Answer 12

Fulcrum placed and force introduced

1. Part of body used as long lever
2. Force thru body part far away from dysfxn all jt.

Question 13

Short lever

Answer 13

Force thru badly part close to dysfxn all jt

Question 14

Planes

Answer 14

1. Sagittal
2. Transverse
3. Coronal

Question 15

Techniques in sagittal plane

Answer 15

1. Seated flexion
   A. Short lever = downward pressure
2. Seated extension
   A. Short lever = ant. Pressure

**around transverse axis

Question 16

Techniques in transverse plane

Answer 16

1. Seated rotation
   A. Short = contralateral transverse process (lateral pressure)

**around vertical axis

Question 17

Techniques in coronal plane

Answer 17

1. Seated sidebending

A. Short = ipsilateral (lateral translation)