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OS II > Chapmans Reflex (Test 2) > Flashcards

Chapmans Reflex (Test 2) Flashcards

1
Q

Somatic Reflex Arch-Basic Circuit

A

Monosynaptic Reflex:

  •  Primary AFFERENT neuron
  •  One synapse
  •  Central Motor EFFERENT neuron
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2
Q

PRIMARY AFFERENT NERUON

A
  •  Cell body in DORSAL root ganglion
  •  Follows nerves to target tissue and then to receptor or it is a receptor
  •  Axon extends to dorsal horn of cord
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3
Q

2 Types of Primary Afferents

A

1)  SMALL CELL BODY
- Lightly myelinated or Unmyelinated

  • Beta-Afferent (small caliber fiber)
  • Crude touch, nociceptor

2) LARGE CELL BODY
- Myelinated Alpha-afferent (large caliber fiber)

  • Proprioception, Discrimination mechanoreceptors
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4
Q

MOTOR EFFERENT NEURON

A
  •  Cell body in VENTRAL Horn of cord

-  Innervates (via spinal nerves) effector organ & skeletal muscle ( via neuromuscular junction

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5
Q

Monosynaptic Reflexes

A

- Between 1° Afferent Fiber and VENTRAL horn motor neuron routing to a skeletal muscle

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6
Q

Polysynaptic Reflex Circuit

A

1) Utilize INTERNEURONS between afferent and motor efferents
a) Many modulations possible

b)Complicated responses to sensory information

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7
Q

Autonomic Reflex Arc

A

1) Afferent
2) Efferent
3) Peripheral ANS

  • Cranial Nerves
  • Spinal Nerves
  • Splanchnic Nerves (Visceral)
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8
Q

Afferent Nerve of Autonomic Reflex Arc

A

- Cell body in dorsal root ganglia

- Neuron to Viscera/Blood vessel

  • The central process terminates in DORSAL horn
    a)  Motor efferent
    b)  Interneuron
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9
Q

Efferent Nerve of Autonomic Reflex Arch (Preganglionic)

A

- In lateral horn of cord or brain stem nuclei

- Myelinated axons that terminate on ganglion neurons outside the CNS
a) GANGLIONIC Neurons:
 i. Encapsulated ganglia in fascia of the body wall or the fascia of organs

  • Unmyelinated preganglionic axons
    a)Travel from Ganglia to Cellular targets of Visceral Organs
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10
Q

Autonomic Reflex Arc

A

Distinguishing feature of ANS and Somatic PNS:
- ANS has 2 Efferent (Outgoing) Neurons in Pathway, Somatic PNS ONLY 1

  • Sensory Neurons very Similar

Ganglionic Neurons of ANS in 3 Locations:
- Paravertebral Ganglia (SYMPATHETIC TRUNK)

  • Collateral Ganglia (Clusters along Large Vessels of Abdominal Cavity)
  • Hypogastric Ganglia (In Fascia of Visceral Organs of Pelvis)
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11
Q

Function of Ganglia in Autonomic Reflex Arc

A
  • Produce numerous Neuro Regulators
    a) Allow for Complex Motor and/ or Secretomotor responses
  • Some Ganglia have Sensory Neurons that DO NOT Communicate with the CNA and thus act as Mini Peripheral Brains
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12
Q

Body Integration

A
  • These body Reflexive Circuit help to Integrate the functions of the Body Systems
  • Forms the Basis of the Whole Body (Body, Mind, Spirit) concepts of Osteopathic Philosophy and for Dr. Still’s definition of Health
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13
Q

Body Integration Somato-Somatic Reflex

A
  • Afferent Axon from Somatic Structure
  • Efferent Motor to Somatic Structure
  • May have at least 1 Interneuron
    Ex: a) Touch to a Hot Object
    b) Cat righting Reflex
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14
Q

Body Integration Viscero- Visceral Reflex

A
  • Sensory from Viscera to Cord
  • Efferent Motor to Viscera (Via ANS, Para and Symp)
  • Example:
    a) Distended Bowel Reflexing back to cause SPASM in Muscular Layer of Bowel
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15
Q

Body Integration

Viscero-Somatic/ Somato-Visceral Reflex

A
  • Afferent Sensory axon from viscera or Somatic structure
  • Efferent motor terminates on Somatic or Visceral structure
  • Interneurons are involved
  • May be the basis for referred pain
     a) Visceral pain referred to somatic structures
     Ex: Appendicitis
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16
Q

Body Integration
Viscero-Somatic/ Tomato-Visceral Reflex

Sensory Information

A
  • Sensory Information results in excitatory or inhibitory actions onto motoneurons
     a) Depends on pathway
    b) Interneurons overlap of Viscera and somatic sensory information
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17
Q

Body Integration
Viscero-Somatic/ Somato-Visceral Reflex

Osteopathic Medicine

A
  • Utilized in the practice of Osteopathic medicine, Palpatory diagnosis and Treatment

a) MYOCARDIAL INFARCTION
- Artery Clots-Sensory to cord-motor output to shoulder /neck /arm/ sympathetic system (sweat glands & adrenal glands)

18
Q

Body Integration
Viscero-Somatic/ Tomato-Visceral Reflex

Viscera and Skeletal Muscle

A
  • VISCERA
    a)Means for the energy demands & maintenance of muscle
  • SKELETAL MUSCLE
    a) Machine carrying out daily life
  • Constant integration of function and communication for all functions
19
Q

Body Integration
Viscero-Somatic/ Tomato-Visceral Reflex

When Reflexes are OVERDRIVE

A

WHEN REFLEXES ARE ON OVERDRIVE:
- Tissue texture changes maintained thus more Asymmetry, Restriction of Motion and thus Tenderness

- Clues for Somatic dysfunction related to Viscera supplied by that Spinal level when findings are recurrent despite ongoing treatment

20
Q

Body Integration
Viscero-Somatic/ Somato-Visceral Reflex

Treatment of the Spinal Level NOT CURE the Visceral Problem

A

TREATMENT OF THE SPINAL LEVEL NOT CURE THE VISCERAL PROBLEM:
- Will help DECREASE the Visceral EFFERENTS thus allowing calming of abnormal reflexes -HOMEOSTASIS

- Treating ribs with RIB RAISING lymphatic technique:
a) DECREASES vasoconstriction
 b) INCREASES fluid flowing in lymph and viscera of chest cage

21
Q

Frank Chapman

A
  • Graduated from the American School of Osteopathy in 1897!!!!!!!!!!!!!!!!!!!!!
  • Practiced in Chattanooga, Tennessee
  • Experience in PALPATION led to his development of the reflexes which bear his name
22
Q

Clinical Application by Dr. Chapman

A
  • Dr. Chapman (and several of his peers and followers) believed there is a NEUROLYMPHATIC reflex basis.
  • Lymphatic system drainage blocked
  • He named his reflexes “Endocrine Reflexes” which was appropriate for his time, the early 1900’s
  • His palpation revealed nodules  “GANGLIOFORM CONTRACTIONS”
  • Points of Palpation on the Anterior and Posterior aka VISCEROSOMATIC REFLEXES
  • He used them to STIMULATE HEALING with difficult patients and “started the healing process sooner”
  • He believed he was stimulating the LYMPHATIC SYSTEM in very specific areas of the body
  • He also realized the ‘COMPLEMENTARY’ nature of joint manipulation and his reflexes.
    a)  “Do not fail to give them [bony lesions] due attention”
23
Q

Clinical Application

The PROCESS

A

1) Locate a point by anatomy
 a) ANTERIOR POINTS FIRST
i. DIAGNOSIS (& treatment) = ANTERIOR 

ii. TREATMENT = posterior 2)  Verify by palpation 3)  GENTLY ROTATE the tip of your finger over the point  4)  Treat POSTERIOR POINTS 5)  Recheck ANTERIOR POINTS
24
Q

Clinical Application

Treatment Complete

A

TREATMENT is COMPLETE:

  • When the REFLEX is GONE
  • NOT when the Patients reports LACK OF PAIN

HOW LONG TO TREAT EACH POINT:

  • 10 to 30 Seconds in One Text, 20 Seconds to 2 MINS in another
  • LESS IS BETTER!!!!!!!
  • Dr. Chapman continued until the Tissue CHANGED UNDER his Fingertip
25
Q

An Example

A

Patient Complains of:

  • Headache
  • Fever of 103
  • Runny Noe
  • Tired all the time

WHAT IS THE DIAGNOSIS?

  • URI
  • Sinusitis
  • Pharyngitis (Viral or Bacterial)

You EXAMINE the Patient:

  • Post Nasal DISCHARGE
  • Tender over SINUSES
  • Cough WORSENS when LYING DOWN
  • May have SEVER HALITOSIS

You Prescribe:

  • TOPICAL NASAL DECONGESTATN
  • Antimicrobial Therapy

TREATMENT OPTIONS:

  • You as Sinus Drainage Techniques
  • Treat the Cervical Spine
    a) SYMPATHETICS (Superior Cervical Ganglion at C2-C3)
    b) PARASYMPATHETICS (Vagus at C0- C1 aka OA Joint)
  • Chapman’s Approach
26
Q

Chapman’s Appraoch

A

1) FIND the ANTERIOR POINTS:
- Approximately 3 1/2 inches LATERAL to the Sternum on the UPPER BORDER of the SECOND RIB, in the FIRST INTERCOSTAL SPACE

  • With the SECOND or THIRD Finger, gently ROTATE OVER the Spot
    a) DO NOT SLIDE you Finger over the Skin
  • 10 to 20 Seconds ins a GOOD STARTING POINT
    a) UNDER TREAT rather than over Treat

2) Treat the POSTERIOR POINT
- “Midway between the SPINOUS PROCESS and the TIP of the TRANSVERSE PROCESS of the SECOND CERVICAL VERTEBRAE”

  • Gently stimulate this area with a Rotatory Motion
  • Which side, Left or Right?
    a) Whichever is worse (More sensitive Reflex)
27
Q

Using the Reflexes

A
  • Todays Chapman’s Reflexes are more likely to be used an an Integral part of an Osteopathic Physical Examination than as a Specific Therapeutic Intervention
    a) Very popular to SHOW UP ON BOARDS in CASE PRESENTATIONS!!!!!!!!!!!!
  • There are limited studies into the use of the Reflexes in Treatment Outcomes
    a) HTN Study did show that when ADRENAL POINTS were treated an Average Drop of 15mm Hg SYSTOLIC and 8mm Hg DIASTOLIC along with a DECREASE in Serum ALDOSTERONE levels at 36 Hours POST TREATMENT
28
Q

Examine the Patient

A

1) Patient with PELVIC PAIN
- Determine if there is an INNOMINATE LESION
- Leg Length Discrepancy
- Tender INGUINAL LIGAMENT
- Sacral Dysfunction

29
Q

Palpate the Iliotibial Band on the Lateral Side of Thigh

A

a) Check the PROSTATE or Checks the BROAD LIGAMENT
- Fascia that suspends the Uterus and Ovaries
- Lymphatics travel through this Fascia

30
Q

Check the Colon

A

a) An Area about TWO INCHES WIDE that runs BETWEEN the Greater TROCHANTER to just ABOVE the PATELLA

b) ON the FRONT Outer Aspect of the Thigh, ANTEROLATERAL
- Top 1/5: CECUM
- Mid 3/5: ASCENDING COLON
- Lowest 1/5: TRANSVERSE COLON

31
Q

Ovaries and “Groin” Glands

A

OVARIES:
- Upper PUBIC SYMPHYSIS

“GROIN” Glands:
- Last 2/5 of the SARTORIAL MUSCLE

32
Q

Kidneys and Adrenal Points

A

KIDNEY POINTS:

  • An INCH LATERAL and an INCH ABOVE the UMBILICUS
  • Anuria, Polyuria

ADRENAL POINTS:

  • An INCH LATERAL and TWO INCHES ABOVE the UMBILICUS
  • Fatigue, Malaise, Insufficient Sleep
33
Q

Thyroid and Gastric Hyperacidity

A

THYROID Points:

  • INTERCOSTAL Space between ribs 2-3 CLOSE TO STERNUM
  • Extreme Nervousness, Weight Loss, Tachycardia

GASTRIC HYPERACIDITY:

  • On the LEFT MIDMAMMILARY LINE between Ribs 5 - 6 to the STERNUM
  • HYPERCHLORYHYDRIA or ULCER
34
Q

In Sequence:

1) Hepatic Congestion
2) Pyloric Reflexes
3) Splenic Reflex

A

HEPATIC CONGESTION:
- On the RIGHT MIDMAMMILARY LINE between Ribs 6 and 7

PYLORIC REFLEXES:
- Between Ribs 5 to 6 and 6 to 7 on the LEFT

SPLENIC REFLEX:
- On the LEFT between ribs 7 to 8 at the INTERCOSTAL CARTILAGE

35
Q

Small Intestine

A
  • Intercostal Spaces
  • Ribs 8 to 9 = UPPER
  • Ribs 9 to 10 = MIDDLE
  • Ribs 10 to 11 = LOWER
  • **Abdominal Distention
  • **Bowel Spasticity
  • Used in Differential between ULCER and ENTERITIS
36
Q

Some Comparisons

Acupuncture vs Chapman

A

ACUPUNCTURE:

  • Kidney Channel- K11
  • Fullness in Lower ABdomine, Dysuria

CHAPMAN:

  • Urethra Reflex
  • Urethral Cystitis
37
Q

Some Comparisons

Liver vs Gastric Hypercongestion

A

LIVER: 14

  • Abdominal Distention
  • Acid Regurgitation

GASTRIC HYPERCONGESTION

  • Midmammilary Line 6th Intercostal Space
  • Fermentation of Stomach Contents
38
Q

Some Comparisons

Stomach vs Hyperacidity

A

STOMACH 18:
- Pain in the Chest (Heartburn)

HYPERACIDITY:

  • Midmammilary line 5th Intercostal Space
  • Hyperchlorhydria
  • Gastric Ulcer
39
Q

Comparisons

“Abdominal Lament” Spleen vs Small Intestine

A

“ABDOMINAL LAMENT” SPLEEN 16:
- Indigestion, Dysentery

SMALL INTESTINE

  • Intercostal Spaces 8 to 9, 9 to 10, 10 to 11
  • Indigestion, Enteritis
40
Q

Comparisons

“Mind Storehouse” Kidney vs “Bronchitis”

A

“MIND STOREHOUSE” KIDNEY 25:
- Cough, Asthma

“BRONCHITIS”

  • Second Intercostal Space
  • Congestion in the Chest, Bronchitis
41
Q

Appendix Point

A

APPENDIX POINT

  • Tip of the 12th Rib on the RIGHT
  • Points VERY POSITIVE on Initial Exam

POSTERIOR POINT:

  • Between Transverse Processes of T11 - T12
  • Some tenderness, but no Palpable Nodule

OS II (8 decks)

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