Autonomics/Chapman's Points Flashcards
Afferents into the spinal cord gray matter synapse at what layers?
Upper layers
Interneurons and motorneuron cell bodies are at what spinal cord gray matter layers?
Lower layers
A majority of the interneurons receive input from?
BOTH visceral and somatic afferents
Do visceral and somatic afferents overlap?
Yes
Interactions with somatic _____ localize pain
Efferents
Cortical inhibition
Descending influences on reflexes
- Excitation amplifies output
- Inhibition reduces output
Facilitated segment concept
Constant afferent bombardment by injured somatic or visceral fibers leads to segmental excitation which produces excessive efferent response
For facilitated segment concept, the low threshold spinal reflexes represent a _____ pathway state caused by continuous bombardment of inputs
Hyper-excited pathway
What did the facilitated segment concept researchers use to show somatic reflex changes?
EMG
Sensitization
Process of increasing a response of a neural pathway with repetitive stimulation
Habituation
Process of decreasing a response of a neural pathway with continuous stimulation
The nociceptive theory of facilitation says that _____ and ____ exist together to maintain homeostasis
Sensitization and Habituation
Current theory as to cause for facilitation involves?
Alteration of nociceptive input
Describe the order of events for the nociceptive theory of facilitation
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
Facilitation
Maintenance of a pool of neurons in a state of subthreshold excitation
- LESS afferent stimulation is needed to trigger discharge of impulses
What may cause facilitation?
Aberrant patterns of afferent input
Sustained increase in afferent input
Once facilitation is established, how is it maintained?
Normal CNS activity - self sustaining
Allostasis
Response to stress in attempt to regain homeostasis
What is the longterm neural effect of segmental facilitation?
Allostasis overload
Describe the steps to allostasis overload
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
Allostasis overload can cause?
HTN, Depression, anxiety, memory loss, etc.
What are the 4 reflex types?
- Somatosomatic
- Somatovisceral
- Viscerosomatic
- Viscerovisceral
Somatosomatic reflex
Somatic stimuli produces reflex response in somatic structures
- ex. withdrawal response
Somatovisceral reflex
Somatic stimuli produces reflex response in visceral structures
Ex. of somatovisceral reflex
Somatocardiac
Somatogastric
Somatoadrenal
– somatic stimuli (pain) causes visceral response
Somatocardiac reflex (somatovisceral)
Nociceptive pain somatic stimuli causes an increased HR and BP
Somatoadrenal reflex (somatovisceral)
Nociceptive pain somatic stimuli causes the release of catecholamines (adrenalin)
Viscerosomatic reflex
Visceral stimuli produces reflex response in somatic structures
ex. Cardiac visceral pain experienced as somatic pain
Viscerovisceral reflex
Visceral stimuli produce reflex response in visceral structures
Ex. of a viscerovisceral reflex
Gastrocolic = Distention of gut –> contraction of gut muscle
- when you eat you poop
The vagus nerve is ____% sensory
80-90%
What type of neurons connect visceral and somatic systems?
Interneurons
What type of reflexes are chapman points?
Viscerosomatic reflexes
What are chapman points?
Palpable points on body that are reflections of visceral dysfunction
What type of contraction is seen with chapman points?
Gangliform contraction
Gangliform contraction
Blocks lymphatic drainage and causes sympathetic dysfunction
Where are chapman points located?
Deep to the skin in subcutaneous tissue, deep fascia
What do chapman points feel like?
Small, smooth, firm nodules 2-3 cm in diameter
What will the patient feel when you press on their chapman point?
Pain - sharp and NON-radiating
For a chapman reflex point to be (+), what must be present?
Anterior and posterior points for that organ
What does a non-tender chapman point indicate?
Nothing
How do you treat chapman points?
Rotatory stimulation - massage it
