Autonomics/Chapman's Points

Question 1

Afferents into the spinal cord gray matter synapse at what layers?

Answer 1

Upper layers

Question 2

Interneurons and motorneuron cell bodies are at what spinal cord gray matter layers?

Answer 2

Lower layers

Question 3

A majority of the interneurons receive input from?

Answer 3

BOTH visceral and somatic afferents

Question 4

Do visceral and somatic afferents overlap?

Answer 4

Yes

Question 5

Interactions with somatic _____ localize pain

Answer 5

Efferents

Question 6

Cortical inhibition

Answer 6

Descending influences on reflexes

• Excitation amplifies output
• Inhibition reduces output

Question 7

Facilitated segment concept

Answer 7

Constant afferent bombardment by injured somatic or visceral fibers leads to segmental excitation which produces excessive efferent response

Question 8

For facilitated segment concept, the low threshold spinal reflexes represent a _____ pathway state caused by continuous bombardment of inputs

Answer 8

Hyper-excited pathway

Question 9

What did the facilitated segment concept researchers use to show somatic reflex changes?

Answer 9

EMG

Question 10

Sensitization

Answer 10

Process of increasing a response of a neural pathway with repetitive stimulation

Question 11

Habituation

Answer 11

Process of decreasing a response of a neural pathway with continuous stimulation

Question 12

The nociceptive theory of facilitation says that _____ and ____ exist together to maintain homeostasis

Answer 12

Sensitization and Habituation

Question 13

Current theory as to cause for facilitation involves?

Answer 13

Alteration of nociceptive input

Question 14

Describe the order of events for the nociceptive theory of facilitation

Answer 14

Once a stimulus is strong enough it travels to cord and branches
- releases peptides
- chemical soup (inflammatory cascade) spreads in tissues and cord
- Lowers threshold for nociceptors and interneurons
= Results in a larger than normal motor and autonomic output in those spinal level associated areas

Question 15

Facilitation

Answer 15

Maintenance of a pool of neurons in a state of subthreshold excitation
- LESS afferent stimulation is needed to trigger discharge of impulses

Question 16

What may cause facilitation?

Answer 16

Aberrant patterns of afferent input

Sustained increase in afferent input

Question 17

Once facilitation is established, how is it maintained?

Answer 17

Normal CNS activity - self sustaining

Question 18

Allostasis

Answer 18

Response to stress in attempt to regain homeostasis

Question 19

What is the longterm neural effect of segmental facilitation?

Answer 19

Allostasis overload

Question 20

Describe the steps to allostasis overload

Answer 20

Stimulus
Chemical soup of inflammatory mediators
Primary afferent sensitization
Hyperalgesia and prolonged response
Central sensitization of spinal cord neurons
Brainstem decreases descending inhibition
= allostasis overload

Question 21

Allostasis overload can cause?

Answer 21

HTN, Depression, anxiety, memory loss, etc.

Question 22

What are the 4 reflex types?

Answer 22

1. Somatosomatic
2. Somatovisceral
3. Viscerosomatic
4. Viscerovisceral

Question 23

Somatosomatic reflex

Answer 23

Somatic stimuli produces reflex response in somatic structures
- ex. withdrawal response

Question 24

Somatovisceral reflex

Answer 24

Somatic stimuli produces reflex response in visceral structures

Question 25

Ex. of somatovisceral reflex

Answer 25

Somatocardiac Somatogastric Somatoadrenal -- somatic stimuli (pain) causes visceral response

Question 26

Somatocardiac reflex (somatovisceral)

Answer 26

Nociceptive pain somatic stimuli causes an increased HR and BP

Question 27

Somatoadrenal reflex (somatovisceral)

Answer 27

Nociceptive pain somatic stimuli causes the release of catecholamines (adrenalin)

Question 28

Viscerosomatic reflex

Answer 28

Visceral stimuli produces reflex response in somatic structures ex. Cardiac visceral pain experienced as somatic pain

Question 29

Viscerovisceral reflex

Answer 29

Visceral stimuli produce reflex response in visceral structures

Question 30

Ex. of a viscerovisceral reflex

Answer 30

Gastrocolic = Distention of gut --> contraction of gut muscle - when you eat you poop

Question 31

The vagus nerve is ____% sensory

Answer 31

80-90%

Question 32

What type of neurons connect visceral and somatic systems?

Answer 32

Interneurons

Question 33

What type of reflexes are chapman points?

Answer 33

Viscerosomatic reflexes

Question 34

What are chapman points?

Answer 34

Palpable points on body that are reflections of visceral dysfunction

Question 35

What type of contraction is seen with chapman points?

Answer 35

Gangliform contraction

Question 36

Gangliform contraction

Answer 36

Blocks lymphatic drainage and causes sympathetic dysfunction

Question 37

Where are chapman points located?

Answer 37

Deep to the skin in subcutaneous tissue, deep fascia

Question 38

What do chapman points feel like?

Answer 38

Small, smooth, firm nodules 2-3 cm in diameter

Question 39

What will the patient feel when you press on their chapman point?

Answer 39

Pain - sharp and NON-radiating

Question 40

For a chapman reflex point to be (+), what must be present?

Answer 40

Anterior and posterior points for that organ

Question 41

What does a non-tender chapman point indicate?

Answer 41

Nothing

Question 42

How do you treat chapman points?

Answer 42

Rotatory stimulation - massage it