autonomics and somatic reflexes Flashcards
PS DUMBBELS
Diarrhea/Defecation urination meiosis - pupils contract bradycardia bronchospasma emesis lacrimation salivation
PS nerves
CN III, VII, IX, X; S2-4
which joint needs to be treated with autonomics?
OA - occipito-atlantal
mvmt of occiput on atlas/C1
symp innervation: UE and LE
UE: T2-5(6)
LE: T10(11) - L2(3)
visceral afferents is a sign of?
visceral irritation
how does visceral afferents message travel?
message of irritation travels back on bifurcating neuron
- synapses on somatic motor neurons and causes mm contraction
release proinflamm polypeptides at that level
prolonged stimulation of visceral afferents lead to?
facilitation
facilitation indicates?
lower threshold for irritation and dysfx
facilitated segments are?
hyper-irritable and hyper-responsive
mm maintained in hypertonic state
nociceptive fibers travel with
sympathetics
non-nociceptive fibers travel with
parasympathetics
somato-somatic reflex
localized somatic stimuli producing patterns of reflex response in segmentally related somatic structures
- DTRs
- withdrawal reflex
- T5 dysfx caused by tight linea alba
somato-visceral reflex
localized somatic stimulation producing patterns of reflex response in segmentally related visceral structures
- spinal manipulation –> changes in HR, BP, and symp activity to kidney and adrenal medulla
viscero-visceral reflex
localized visceral stimuli producing patterns of reflex response in segmentally related visceral structures
- gut distention –> gut contraction
- baroreceptor reflex –> BV stretch to change cause change in HR
viscero-somatic reflex
localized visceral stimuli producing patterns of reflex response in segmentally related somatic structures
- cardiac disease –> SD T1-5 RSL
- Type II dysfx
type II dysfx
- maintained by intertransverse mm
- rubbery end feel
- can’t be fixed by HVLA cus dysfx maintained by muscular rather than articular restriction
referred pain
- convergence-projection theory
- visceral and somatic afferents converge on the same or associated neurons or interneurons in the SC
- can follow viscero-somatic pattern or somato-somatic pattern
trigger points defintion
- hyperirritable spot in SkM that is associated with hypersensitive palpable nodule in a taut band
- painful on compression with radiating or referred pain, tenderness, motor dysfx, and autonomic phenomena
2 classifications of trigger points
- active: refer pain at rest, with muscular activity, or with palpation
- latent - produce pain only when probed with more steady pressure
trigger points tx
- inhibitory soft tissue
- deep massage
- dry needling
- injection with steroids
- MET
- vapocoolant spray with myofascial stretch
jump sign
patient response to pain: wince or voluntary withdrawal
local twitch
- transient contraction of the taun band of fibers with the trigger point
- presence differentiated b/w trigger point and fibromyalgia syndrome
tender points definition
- small, hypersensitive points in the myofascial tissues of the body
- finger tip size, discrete, small, tense, and edematous
how tender points are created
initial injury causes sudden unanticipated lengthening of the antagonistic mm to the originally strained painful agonist mm
where are tender points located?
- within myofascial structures: tendons, ligaments, mm bellies
- location consistent b/w patients suggest anatomic basis
tender points sensitive to palpation suggest?
related to nociceptive activity
do tender points radiate?
- no, they are localized
chapman’s points definition
- gangliform contraction that my block lymphatic drainage, causing inflamm in distal tissues
- believed to be part of symp dysfx (found in regions which overlap with visceral symp efferent innervation)
which type of reflex is it part of?
viscero-somatic reflex
what are gangliform?
not a nerve nor a cyst, but it is a rounded contraction
chapman clinical uses
- for dx
- for influencing the motion of fluids, mostly lymph
- for influencing visceral fx through the PNS
chapman’s points location
- small, smooth, firm, discrete nodules in fixed anatomic locations
- deep to skin and subcut areolar tissue on deep fascia or periosteum
- usually paired ant and post
anterior chapman’s points
often painful with light compression
do chapman’s points radiate?
no, but often tender with lymphatic congestion and altered myofascial texture
chapman’s points tx?
- firm, circular pressure
- attempt to flatten
- hold for 10-30s
