CSA 2 Exam

Question 1

General Tenderness

Answer 1

Caused by I’s & T’s

• inflammation
• infection
• tumor
• trauma

Question 2

Tenderpoints

Answer 2

a specific point which exhibits acute tenderness when probed

Looking for changes in

• fascia
• muscle tendrils
• CT
• nerve fibers
• changes in vascular elements

Question 3

Tender points are…

Answer 3

a sign of somatic dysfunction

we do not treat tender points

we treat somatic dysfunction

Question 4

Treatment of Somatic Dysfunction

diagnosed by tender points

Answer 4

Treat

• most tender one
• if more than one, treat most central one
• treat most significant first

Question 5

what initiates somatic dysfunction?

Answer 5

muscle spindle reflex

nociceptors

nocifensive reflexes

Question 6

why and how is somatic dysfunction maintained?

Answer 6

guarding mechanism to protect from further damage

at spinal cord level or at higher CNS levels

Question 7

Who described strain/counterstain?

Answer 7

Lawrence Jones DO

Question 8

What is counterstrain?

Answer 8

a passive positional OMT that places a segment in a position of comfort

an indirect treatment to restore/reset nociceptive and proprioceptive activity

Question 9

When was counterstrain described?

Answer 9

1955 by Lawrence Jones

published in 1964 in JAOA as “Spontaneous Release by Positioning”

Question 10

What is the main diagnostic criteria for counterstrain?

Answer 10

Tenderness

Question 11

What is the minimum resolution we want?

Answer 11

70%

Question 12

Why do we return the patient back to neutral slowly?

Answer 12

to prevent re-inciting the nociceptive reflex

Question 13

What happens during the 90 secs treat?

Answer 13

holding the muscle in a shortened position decreases the proprioceptive and mechanoreceptive input

allows CNS to reset normal resting length and tension parameters

Question 14

Advantages of Counterstrain

Answer 14

non-traumatic

easy, safe, effective

Question 15

Disadvantages

Answer 15

takes time

treatment reactions lasting up to 24-36 hours

Question 16

What is strain?

Answer 16

severe over-stretching of a muscle

stretched muscle has increased freq of impulse

Question 17

What are tensegrity systems stabilized by?

Answer 17

Tensegrity systems are stabilized by

continous tension (soft tissue) with discontinuous compression (bone)

Question 18

Mechanotransduction

Answer 18

the process of mechanical signals being converted into biochemical changes

Question 19

Prestressed tensegrity structures are…

Answer 19

a series of discontinuous compression-resistant elements held w.i. a web of continuous tension elements

Question 20

Geodesic tensegrity structures are…

How do they differ from prestressed tensegrity structures?

Answer 20

tensegrity structures stabilized through force triangulation

individual elements are capable of alternating btw generating tension or resisting compression

Question 21

Tenets of tensegrity structures

Answer 21

• intrinsically self-stabilizing
• flexible while minimizing damage
• return to original shape (elastic)
• efficient, lightweight, + strong

Question 22

Who researched biotensegrity at the cellular level?

Answer 22

Ingber

Question 23

Who researched tensegrity?

Answer 23

Fuller

Question 24

In vitro vs in vivo study

Answer 24

in vitro

• microfilaments = bent
• microtubules = straight

in vivo

• microfilaments = straight
• microtubules = bent

Question 25

Outcomes of mechanotransduction are…

Answer 25

• modifications in cell physiology
  
  • activate cAMP production
• modifications in gene expression
  
  • activation through deformation of microfilaments + microtubules
    
    • chromatin remodeling + nuclear pore open/closing
• modifications in intracellular bchm
  
  • activation of Ca ion channels (TRPV4)
    
    • alters focal adhesion