Exam ) Flashcards
1
Q
Muscle used for Muscle Energy: 1st Rib exhalation dysfunction
A
Anterior and middle scalenes
2
Q
Muscle used for Muscle Energy: 2nd Rib
A
Posterior Scalene
3
Q
Muscle used for Muscle Energy: Ribs 3?5
A
Pectoralis Minor
4
Q
Muscle used for Muscle Energy: Ribs 6?8 (9)
A
Serratus anterior
5
Q
Muscle used for Muscle Energy: Ribs 9?11
A
Latissimus Dorsi
6
Q
Muscle used for Muscle Energy: Rib 12
A
Quadratus Lumborum
7
Q
what lymphatic ducts drain the lungs?
A
Right lymphatic duct (The same as the heart)
8
Q
What are the autonomic levels for the lungs?
A
Sympathetics? T1?T6; Parasympathetics? CN X, OA, C1, C2
9
Q
Effect of parasympathetic stimulation on the lungs
A
contracts bronchiolar smooth muscle, decreases goblet cells, thins mucus secretions/ broncoconstriction vasodilation
10
Q
Sympathetic Levels Lungs?
A
T1?T6
11
Q
Sympathetic Levels Trachea & Bronchi?
A
T1?T6
12
Q
Sympathetic Levels Visceral Pleura?
A
T1?T6
13
Q
Sympathetic Levels Parietal Pleura?
A
T1?T11
14
Q
Sympathetic effects on lungs
A
relaxation of bronchiolar smooth muscle, increases goblet cells, thickens mucus secretions
15
Q
When treating a patient with bronchospasm (asthma) which side of the autonomic system should be treated first? Why?”
A
Treat the parasympathetic side of the autonomic system first to decrease any neurally mediated bronchoconstriction. If the sympathetic side of the system is treated first, the patient may go into acute refractory bronchspasm
Stretch receptors transmit signals via the___. When the lungs are inflated, how does this affect respiration? Vagus Nerve: when the lungs are inflated this signal turns off respiration
16
Q
T/F: The vagus reflex is sensitive to stretch caused by air or fluid ? causing cessation or slowing of the respiratory signal.
A
True: it does not differentiate.
17
Q
The ___ reflex mechanism cannot distinguish between air sacs filled with air and those filled with fluid
A
Hering?Breuer Reflex
18
Q
What baroreceptor is sensitive to oxygen?
A
Carotid Body ? sends its signals to the respiratory center (medulla)
19
Q
With lung tissue congestion, the respiratory center receives information from the vagus nerve: what happens next?
A
This limits the excursion of the diaphragm
20
Q
Diaphragm’s greatest excursion is in what position?
A
The supine position
21
Q
Thoracic Diaphragm motion increases the volume of the thorax in __ planes of motion.
A
3 Planes of Motion
22
Q
what are Tender Points, Anterior vs Posterior?
A
Small tense edematous areas of tenderness 2?3mm diameter which do not radiate pain. Anterior Tender Points: Diagnostic Purposes; Posterior Tender Points: Are treated with counterstrain techniques
23
Q
Chapman points at the 2nd intercostal space suggest problems with?
A
2nd intercostal space= Thyroid, Myocardium, Esophagus, Bronchus
24
Q
What are Chapman Reflex Points?
A
Small nodules of tissue texture change that are 2?3 mm in diameter, that are thought to be reflections of visceral dysfunction (visceral?somatic reflex). Treated by rubbing in a firm rotating motion for 10?30 seconds
25
The "Asthma Reflex"
T2 left
26
Anterior bronchial Chapman's reflex
Intercostal space between the 2nd and 3rd ribs close to the sternum
27
Posterior bronchial Chapman's reflex
Midway between the spinous process and the tips of the transverse processes at T2
28
Anterior upper lung Chapman's reflex
Intercostal space between the 3rd and 4th ribs close to the sternum
29
Posterio upper lung Chapman's reflex
Midway between the spinous processes and the tips of the transverse processes of T3 and T4
30
Anterior lower lung Chapman's reflex
Intercostal space between the 4th and 5th ribs close to the sternum
31
Posterior lower lung Chapman's reflex
Midway between the spinous processes and the tips of the transverse processes of T4 and T5
32
Which way do the vertebrae rotate in a visceral dysfunction
Vertebrae rotate towards visceral dysfunction
33
sympathetic innervation of the heart has its origins ___
cord segments T 1?6
34
The parasympathetic innervation of the heart has its origins from ___
Vagus Nerve
35
When the Ventricles are involved in production of pain, it tends to refer to
C8 to T3 dermatomes
36
When the Atria are responsible for the pain, it tends to occur where?
lower in the chest wall in the T4 to T6 dermatomes
37
Where are the posterior Chapman reflex points?
Midway between the spinous process and the tips of the transverse processes in the space between the transverse processes of T2 & T3 bilaterally
38
Where are the anterior Chapman Myocardial Reflexes?
2nd intercostal space at the Sternal Border
39
Where are the posterior Chapman Myocardial Reflexes?
The space between the transverse processes of T2 and T3 midway between the spinous process and the tip of the transverse process
40
Where are the anterior Chapman Adrenal Reflexes?
Lateral Aspect of rectus abdominus at the level of the inferior margin of the costal margin
41
Where are the posterior Chapman Adrenal Reflexes?
Intertransverse spaces on both sides of T11 and T12 midway between the spinous processes and transverse processes
42
Severe Scoliosis with thoracic curve greater than ____ seriously compromises cardiac function
60?75 degrees
43
Severe Kyphosis measuring greater than __ degrees compromises cardiac function
60 degrees
44
Patients with flattening of the thoracic kyphosis or with postural crossovers in the upper thoracics, tend to develop _____ when subjected to other stressors
tachyarrhythmias
45
anterior triggerpoint which serves an initiating or perpetuation role in tachyarrhythmias
5th intercostal space located in the right pectoralis major muscle
46
Abnormal gait patterns may increase cardiac work by up to ___%
300%
47
sympathetic Innervation of the heart emanates from
cord segments T1?T6
48
Right sided sympathetic fibers to the hart innervate ___
right heart and sinoatrial (SA) node.
49
Hypersympathecotonia in right sided nerve fibers to the heart predisposes to
supraventricular tachyarrhythmias
50
autonomic innervation to the Left side of the heart innervates ___
left heart and atrioventricular (AV) node
51
Hypersympathecotonia in LEFT heart sympathetic fibers predisposes to
ectopic foci and ventricular fibrillation
52
Increase in sympathetic tone in blood vessels produces
generally vasoconstriction
53
Vasculature of the arms receives its sympathetic supply from
T2 to T8 levels
54
Vasculature of the legs receives its sympathetic supply from
T11 to L2 levels
55
The Vagus nerves have fibers which join and course to them from
C?1 & C?2 nerve roots
56
Observation of patients has demonstrated that correction of high cervical somatic dysfunction resulted in ____ vagal tone
transient increase in vagal tone followed by a reduction in vagal effect
57
Right Vagus innervates what part of the heart?
Sino Atrial Node
58
Hyperactivity of the right vagus predisposes
sinus bradyarrythmias
59
Left Vagus innervates the ___
Atrio Ventricular Node
60
Hyperactivity of left vagus predisposes
AV Blocks
61
Deep pressure over the ______ suture on the skull will reflexly slow the heart
occipitomastoid suture
62
Heart lymphatics drain predominantly to the
right lymphatic duct
63
Lymphatic drainage from the heart and lungs is carried back to the heart primarily by the
right lymphatic duct
64
Head and neck Lymph drains to
right lymphatic trunk via Right Jugular Trunk
65
Heart, Lungs, Liver Lymph drain to
right lymphatic duct via Right Bronchomediastinal Trunk
66
Right arm lymph drains to
right lymphatic trunk via Right Subclavian Trunk
67
Pleural causes of chest pain
effusion, consolidation, bronchospasm, pulmonary embolism, pulmonary hypertension, pneumothorax, hemothorax, atelectasis, asthma, copd, pneumonia
68
Musculoskeletal disorders of chest pain
strain, sprain, contusion, fracture, costochondritis, fibrositis, myositis, thoracic outlet syndrome, diaphragmatic dysfunction, ankylosing spondylitis, disc disease
69
Cardiac causes of chest pain
coronary ischemia, myocardial infarction, arrhythmias
70
Infections that cause chest pain
viral, bacterial, parasitical, fungal, mediastinitis, pleurisy, interstitial pneumonitis, bronchitis, tracheitis
71
In CHF, lymphatic flow through the thoracic duct increases ___ times the resting level
3?40 times
72
In Acute MI autonomic Techniques are directed at dysfunctions located
OA, C1, C2, T1 to T4 and R1 to R4
73
in Acute MI paraspinal soft tissue techniques may be performed from
T1 to L2 to generally diminish sympathetic tone and decrease peripheral vascular resistance
74
Cranial Acute MI autonomics treatment is ___
Treat dysfunction of the skull base and occipitomastoid suture, if present
75
Acute MI tx of Lymphatics: apply indirect techniques to the_____; Apply _____ to assist inhalation and promote lymphatic flow; Redome diaphragm using_____ technique
Lymphatics: Apply indirect techniques to the thoracic inlet; Apply pectoral traction to assist inhalation and promote lymphatic flow; Redome diaphragm using indirect AP diaphragm technique
76
Autonomics treatment for hypertension is directed to
entire sympathetic bed (T1 to L2) to generally decrease peripheral vascular resistance. Study of 100 hypertensive patients: Drop of 33 mm Hg systolic, Drop of 9 mm Hg diastolic P
77
What are the chapman points for hypertension?
Treat Posterior Adrenal Points (Intertransverse spaces of T11 and T12 midway between the spinous processes and transverse processes):Drop of 15 mm Hg Systolic, Drop of 8 mm Hg Diastolic,
CHF tx of Lymphatics: Treat any restriction at the ____, Treat dysfunctions of the ___, _____, and rib cage, _____ the diaphragm, Apply thoracic, abdominal and pedal lymphatic pumps if their heart can handle it (NOT ACUTELY) Treat any restriction at the thoracic inlet\nTreat dysfunctions of the thoracic spine, L1 to L3, and rib cage\nRedome the diaphragm\nApply thoracic, abdominal and pedal lymphatic pumps (NOT ACUTELY)
Where are the heart anterior Chapman reflex points? Close to the sternum in the second intercostal space bilaterally
What are the effects of increased sympathetic tone on the healthy heart In the healthy heart, increased sympathetic tone Increases the force of contraction, Shortens the time of systole, Increases ventricular output
78
Consequences of Increased Sympathetic Tone in cardiovascular disease?
Vasospasm; Increases morbidity following myocardial infarction, Predisposes to arrhythmias, Inhibits development of collateral circulation, Adversely affects degree of recovery post?MI
79
________ tone implicated in essential hypertension due to vascular changes with the kidneys"""
"Vasomotor nerves are unopposed
Consequences of Increased Sympathetic Tone: ______ lymphatic drainage,_______ bronchodilation, _______ gastrointestinal activit, Is involved in almost all disease processes Diminished lymphatic drainage, Increases bronchodilation, Decreases gastrointestinal activity, Is involved in almost all disease processes
What is the Oculocardiac Reflex? Pressure on the carotid body or the globe of the eye (Oculocardiac Reflex) will also slow the heart, Slows heart by 5?13 bpm, Will not slow at all in sympathecotonic patients
80
Parasympathetics cause peripheral arteriolar vasodilation in select regions (5)
Vessels of Submaxillary Gland, Vessels of Parotid Gland, Vessels in the Blush Region of the Face, Vessels in the tongue, Vessels of the penis & clitoris (erection & engorgement)
81
Parasympathetics:_____ heart rate and contractility, ______ bronchoconstriction, ______ gastrointestinal activity, Only rarely causes _____
Decrease heart rate and contractility, increase bronchoconstriction, Increase gastrointestinal activity, Only rarely causes vasodilation
82
OMM Treatment for Acute Myocardial Infarction
Use indirect methods or soft tissue techniques for at least first 72 hours post MI, Search for right Pectoralis Major trigger point Treat if present
Sympathetics to lung T1?6
Sympathetics to trachea, bronchi T1?6
Sympathetics to visceral pleura T1?6
Sympathetics to Parietal pleura T1?11
What are the main muscles of respiration? inhalation: external intercostals, and innerchondral part of the internal intercostals, diaphragm, (deep inhalation also includes scalene, SCM, levator costorum, serratus posterior superior); exhalation: passive recoil (quiet breathing), internal intercostals and abdominal muscles (active breathing)
what are the motor and sensory nerves to the diaphragm? phrenic nerve (C3?5)
inhalation dysfunction key rib in group: bottom rib? holds the rest up
exhalation dysfunction key rib in group: top rib? holds the rest down
what are the boundaries of the superior thoracic inlet? manubrium, proximal clavicles, first ribs, and body of T1
tx for prevention of post?op pneumonia Pre?op: Treat C3?5; Post?op: Treat C3?5 and ribraising
The right lymphatic duct drains what? heart, lungs, liver, head, neck, and right upper limb
MI treatment General: use indirect methods or soft tissue techniques for at least first 72 hours post MI. Somatic: Search for right Pectoralis Major trigger point, Treat if present
83
lymphatic ducts are under what nervous control?
sympathetic
84
An MI with involvement of the ventricles where will TART be detected?
C8?T3
85
An MI with involvement of the atria where will TART be detected?
T4?6
86
An anterior MI infartct would reffer TART where?
T2?3 Left
87
An inferior wall MI would reffer TART where?
T3?5 Left and C2
88
Hyertension is associated with TART changes where?
C6, T2, T6
89
General treatment for all tenderpoints
COUNTERSTRAIN: Find position of comfort (70% improvement) via sidebending, flexion, extension, rotation as directed. Maintain the position for 90 seconds. Return to neutral and reasses.
90
Posterior tenderpoint for C1 is found where?
inion or muscle mass lateral to nuchal line
91
Posterior tenderpoints for C2?7 are found where?
on the articular pillars or "located on the interspinous ligaments between the spinous processes or slightly medial or lateral to them."
92
Treatment for posterior cervical tenderpoints
C1 (inion) flex, C1?7 (articular pillars) Extend and SARA, EXCEPT C3= Flex and STRAw
93
Location of ant. C1 tenderpoint
posterior edge of the ascending mandible
94
Location of ant. C2?C3 tenderpoint
on or deep to the SCM (or anterolateral tip of the articular pillars of the cervical vertebrae)
95
Location of ant. C4?C6 tenderpoints
anterior to the SCM (or anterolateral tip of the articular pillars of the cervical vertebrae)
96
Location of ant. C7 tenderpoint
lateral attachment of SCM to clavicle
97
Location of ant. C8 tenderpoint
medial tip of the clavicle
98
Treatment for anterior cervical tenderpoints
C1 rotate away, C2?C8 Flex and SARA, EXCEPT C7= Flex ans STRAw
99
Location of the Ant. Tenderpoint 1
mindline at episternal notch
100
Location of AT2
Midline, junction of manubrium and sternum (angle of Louis)
101
Muscle used for Muscle Energy: 1st Rib exhalation dysfunction
Anterior and middle scalenes
102
Muscle used for Muscle Energy: 2nd Rib
Posterior Scalene
103
Muscle used for Muscle Energy: Ribs 3?5
Pectoralis Minor
104
Muscle used for Muscle Energy: Ribs 6?8 (9)
Serratus anterior
105
Muscle used for Muscle Energy: Ribs 9?11
Latissimus Dorsi
106
Muscle used for Muscle Energy: Rib 12
Quadratus Lumborum
107
what lymphatic ducts drain the lungs?
Right lymphatic duct (The same as the heart)
108
What are the autonomic levels for the lungs?
Sympathetics? T1?T6; Parasympathetics? CN X, OA, C1, C2
109
Effect of parasympathetic stimulation on the lungs
contracts bronchiolar smooth muscle, decreases goblet cells, thins mucus secretions/ broncoconstriction vasodilation
110
Sympathetic Levels Lungs?
T1?T6
111
Sympathetic Levels Trachea & Bronchi?
T1?T6
112
Sympathetic Levels Visceral Pleura?
T1?T6
113
Sympathetic Levels Parietal Pleura?
T1?T11
114
Sympathetic effects on lungs
relaxation of bronchiolar smooth muscle, increases goblet cells, thickens mucus secretions
115
When treating a patient with bronchospasm (asthma) which side of the autonomic system should be treated first? Why?"
Treat the parasympathetic side of the autonomic system first to decrease any neurally mediated bronchoconstriction. If the sympathetic side of the system is treated first, the patient may go into acute refractory bronchspasm
Stretch receptors transmit signals via the___. When the lungs are inflated, how does this affect respiration? Vagus Nerve: when the lungs are inflated this signal turns off respiration
116
T/F: The vagus reflex is sensitive to stretch caused by air or fluid ? causing cessation or slowing of the respiratory signal.
True: it does not differentiate.
117
The ___ reflex mechanism cannot distinguish between air sacs filled with air and those filled with fluid
Hering?Breuer Reflex
118
What baroreceptor is sensitive to oxygen?
Carotid Body ? sends its signals to the respiratory center (medulla)
119
With lung tissue congestion, the respiratory center receives information from the vagus nerve: what happens next?
This limits the excursion of the diaphragm
120
Diaphragm's greatest excursion is in what position?
The supine position
121
Thoracic Diaphragm motion increases the volume of the thorax in __ planes of motion.
3 Planes of Motion
122
what are Tender Points, Anterior vs Posterior?
Small tense edematous areas of tenderness *2?3mm* diameter which do not radiate pain. Anterior Tender Points: Diagnostic Purposes; Posterior Tender Points: Are treated with *counterstrain* techniques
123
Chapman points at the 2nd intercostal space suggest problems with?
2nd intercostal space= Thyroid, Myocardium, Esophagus, Bronchus
124
What are Chapman Reflex Points?
Small nodules of tissue texture change that are *2?3 mm* in diameter, that are thought to be reflections of visceral dysfunction (visceral?somatic reflex). Treated by rubbing in a firm rotating motion for 10?30 seconds
125
The "Asthma Reflex"
T2 left
126
Anterior bronchial Chapman's reflex
Intercostal space between the 2nd and 3rd ribs close to the sternum
127
Posterior bronchial Chapman's reflex
Midway between the spinous process and the tips of the transverse processes at T2
128
Anterior upper lung Chapman's reflex
Intercostal space between the 3rd and 4th ribs close to the sternum
129
Posterio upper lung Chapman's reflex
Midway between the spinous processes and the tips of the transverse processes of T3 and T4
130
Anterior lower lung Chapman's reflex
Intercostal space between the 4th and 5th ribs close to the sternum
131
Posterior lower lung Chapman's reflex
Midway between the spinous processes and the tips of the transverse processes of T4 and T5
132
Which way do the vertebrae rotate in a visceral dysfunction
Vertebrae rotate towards visceral dysfunction
133
sympathetic innervation of the heart has its origins ___
cord segments T 1?6
134
The parasympathetic innervation of the heart has its origins from ___
Vagus Nerve
135
When the Ventricles are involved in production of pain, it tends to refer to
C8 to T3 dermatomes
136
When the Atria are responsible for the pain, it tends to occur where?
lower in the chest wall in the T4 to T6 dermatomes
137
Where are the posterior Chapman reflex points?
Midway between the spinous process and the tips of the transverse processes in the space between the transverse processes of T2 & T3 bilaterally
138
Where are the anterior Chapman Myocardial Reflexes?
2nd intercostal space at the Sternal Border
139
Where are the posterior Chapman Myocardial Reflexes?
The space between the transverse processes of T2 and T3 midway between the spinous process and the tip of the transverse process
140
Where are the anterior Chapman Adrenal Reflexes?
Lateral Aspect of rectus abdominus at the level of the inferior margin of the costal margin
141
Where are the posterior Chapman Adrenal Reflexes?
Intertransverse spaces on both sides of T11 and T12 midway between the spinous processes and transverse processes
142
Severe Scoliosis with thoracic curve greater than ____ seriously compromises cardiac function
60?75 degrees
143
Severe Kyphosis measuring greater than __ degrees compromises cardiac function
60 degrees
144
Patients with flattening of the thoracic kyphosis or with postural crossovers in the upper thoracics, tend to develop _____ when subjected to other stressors
tachyarrhythmias
145
anterior triggerpoint which serves an initiating or perpetuation role in tachyarrhythmias
5th intercostal space located in the right pectoralis major muscle
146
Abnormal gait patterns may increase cardiac work by up to ___%
300%
147
sympathetic Innervation of the heart emanates from
cord segments T1?T6
148
Right sided sympathetic fibers to the hart innervate ___
right heart and sinoatrial (SA) node.
149
Hypersympathecotonia in right sided nerve fibers to the heart predisposes to
supraventricular tachyarrhythmias
150
autonomic innervation to the Left side of the heart innervates ___
left heart and atrioventricular (AV) node
151
Hypersympathecotonia in LEFT heart sympathetic fibers predisposes to
ectopic foci and ventricular fibrillation
152
Increase in sympathetic tone in blood vessels produces
generally vasoconstriction
153
Vasculature of the arms receives its sympathetic supply from
T2 to T8 levels
154
Vasculature of the legs receives its sympathetic supply from
T11 to L2 levels
155
The Vagus nerves have fibers which join and course to them from
C?1 & C?2 nerve roots
156
Observation of patients has demonstrated that correction of high cervical somatic dysfunction resulted in ____ vagal tone
transient increase in vagal tone followed by a reduction in vagal effect
157
Right Vagus innervates what part of the heart?
Sino Atrial Node
158
Hyperactivity of the right vagus predisposes
sinus bradyarrythmias
159
Left Vagus innervates the ___
Atrio Ventricular Node
160
Hyperactivity of left vagus predisposes
AV Blocks
161
Deep pressure over the ______ suture on the skull will reflexly slow the heart
occipitomastoid suture
162
Heart lymphatics drain predominantly to the
right lymphatic duct
163
Lymphatic drainage from the heart and lungs is carried back to the heart primarily by the
right lymphatic duct
164
Head and neck Lymph drains to
right lymphatic trunk via Right Jugular Trunk
165
Heart, Lungs, Liver Lymph drain to
right lymphatic duct via Right Bronchomediastinal Trunk
166
Right arm lymph drains to
right lymphatic trunk via Right Subclavian Trunk
167
Pleural causes of chest pain
effusion, consolidation, bronchospasm, pulmonary embolism, pulmonary hypertension, pneumothorax, hemothorax, atelectasis, asthma, copd, pneumonia
168
Musculoskeletal disorders of chest pain
strain, sprain, contusion, fracture, costochondritis, fibrositis, myositis, thoracic outlet syndrome, diaphragmatic dysfunction, ankylosing spondylitis, disc disease
169
Cardiac causes of chest pain
coronary ischemia, myocardial infarction, arrhythmias
170
Infections that cause chest pain
viral, bacterial, parasitical, fungal, mediastinitis, pleurisy, interstitial pneumonitis, bronchitis, tracheitis
171
In CHF, lymphatic flow through the thoracic duct increases ___ times the resting level
3?40 times
172
In Acute MI autonomic Techniques are directed at dysfunctions located
OA, C1, C2, T1 to T4 and R1 to R4
173
in Acute MI paraspinal soft tissue techniques may be performed from
T1 to L2 to generally diminish sympathetic tone and decrease peripheral vascular resistance
174
Cranial Acute MI autonomics treatment is ___
Treat dysfunction of the skull base and occipitomastoid suture, if present
175
Acute MI tx of Lymphatics: apply indirect techniques to the_____; Apply _____ to assist inhalation and promote lymphatic flow; Redome diaphragm using_____ technique
Lymphatics: Apply indirect techniques to the thoracic inlet; Apply pectoral traction to assist inhalation and promote lymphatic flow; Redome diaphragm using indirect AP diaphragm technique
176
Autonomics treatment for hypertension is directed to
entire sympathetic bed (T1 to L2) to generally decrease peripheral vascular resistance. Study of 100 hypertensive patients: Drop of 33 mm Hg systolic, Drop of 9 mm Hg diastolic P
177
What are the chapman points for hypertension?
Treat Posterior Adrenal Points (Intertransverse spaces of T11 and T12 midway between the spinous processes and transverse processes):Drop of 15 mm Hg Systolic, Drop of 8 mm Hg Diastolic,
CHF tx of Lymphatics: Treat any restriction at the ____, Treat dysfunctions of the ___, _____, and rib cage, _____ the diaphragm, Apply thoracic, abdominal and pedal lymphatic pumps if their heart can handle it (NOT ACUTELY) Treat any restriction at the thoracic inlet\nTreat dysfunctions of the thoracic spine, L1 to L3, and rib cage\nRedome the diaphragm\nApply thoracic, abdominal and pedal lymphatic pumps (NOT ACUTELY)
Where are the heart anterior Chapman reflex points? Close to the sternum in the second intercostal space bilaterally
What are the effects of increased sympathetic tone on the healthy heart In the healthy heart, increased sympathetic tone Increases the force of contraction, Shortens the time of systole, Increases ventricular output
178
Consequences of Increased Sympathetic Tone in cardiovascular disease?
Vasospasm; Increases morbidity following myocardial infarction, Predisposes to arrhythmias, Inhibits development of collateral circulation, Adversely affects degree of recovery post?MI
179
________ tone implicated in essential hypertension due to vascular changes with the kidneys"""
"Vasomotor nerves are unopposed
Consequences of Increased Sympathetic Tone: ______ lymphatic drainage,_______ bronchodilation, _______ gastrointestinal activit, Is involved in almost all disease processes Diminished lymphatic drainage, Increases bronchodilation, Decreases gastrointestinal activity, Is involved in almost all disease processes
What is the Oculocardiac Reflex? Pressure on the carotid body or the globe of the eye (Oculocardiac Reflex) will also slow the heart, Slows heart by 5?13 bpm, Will not slow at all in sympathecotonic patients
180
Parasympathetics cause peripheral arteriolar vasodilation in select regions (5)
Vessels of Submaxillary Gland, Vessels of Parotid Gland, Vessels in the Blush Region of the Face, Vessels in the tongue, Vessels of the penis & clitoris (erection & engorgement)
181
Parasympathetics:_____ heart rate and contractility, ______ bronchoconstriction, ______ gastrointestinal activity, Only rarely causes _____
Decrease heart rate and contractility, increase bronchoconstriction, Increase gastrointestinal activity, Only rarely causes vasodilation
182
OMM Treatment for Acute Myocardial Infarction
Use indirect methods or soft tissue techniques for at least first 72 hours post MI, Search for right Pectoralis Major trigger point Treat if present
Sympathetics to lung T1?6
Sympathetics to trachea, bronchi T1?6
Sympathetics to visceral pleura T1?6
Sympathetics to Parietal pleura T1?11
What are the main muscles of respiration? inhalation: external intercostals, and innerchondral part of the internal intercostals, diaphragm, (deep inhalation also includes scalene, SCM, levator costorum, serratus posterior superior); exhalation: passive recoil (quiet breathing), internal intercostals and abdominal muscles (active breathing)
what are the motor and sensory nerves to the diaphragm? phrenic nerve (C3?5)
inhalation dysfunction key rib in group: bottom rib? holds the rest up
exhalation dysfunction key rib in group: top rib? holds the rest down
what are the boundaries of the superior thoracic inlet? manubrium, proximal clavicles, first ribs, and body of T1
tx for prevention of post?op pneumonia Pre?op: Treat C3?5; Post?op: Treat C3?5 and ribraising
The right lymphatic duct drains what? heart, lungs, liver, head, neck, and right upper limb
MI treatment General: use indirect methods or soft tissue techniques for at least first 72 hours post MI. Somatic: Search for right Pectoralis Major trigger point, Treat if present
183
lymphatic ducts are under what nervous control?
sympathetic
184
An MI with involvement of the ventricles where will TART be detected?
C8?T3
185
An MI with involvement of the atria where will TART be detected?
T4?6
186
An anterior MI infartct would reffer TART where?
T2?3 Left
187
An inferior wall MI would reffer TART where?
T3?5 Left and C2
188
Hyertension is associated with TART changes where?
C6, T2, T6
189
General treatment for all tenderpoints
COUNTERSTRAIN: Find position of comfort (70% improvement) via sidebending, flexion, extension, rotation as directed. Maintain the position for 90 seconds. Return to neutral and reasses.
190
Posterior tenderpoint for C1 is found where?
inion or muscle mass lateral to nuchal line
191
Posterior tenderpoints for C2?7 are found where?
on the articular pillars or "located on the interspinous ligaments between the spinous processes or slightly medial or lateral to them."
192
Treatment for posterior cervical tenderpoints
C1 (inion) flex, C1?7 (articular pillars) Extend and SARA, EXCEPT C3= Flex and STRAw
193
Location of ant. C1 tenderpoint
posterior edge of the ascending mandible
194
Location of ant. C2?C3 tenderpoint
on or deep to the SCM (or anterolateral tip of the articular pillars of the cervical vertebrae)
195
Location of ant. C4?C6 tenderpoints
anterior to the SCM (or anterolateral tip of the articular pillars of the cervical vertebrae)
196
Location of ant. C7 tenderpoint
lateral attachment of SCM to clavicle
197
Location of ant. C8 tenderpoint
medial tip of the clavicle
198
Treatment for anterior cervical tenderpoints
C1 rotate away, C2?C8 Flex and SARA, EXCEPT C7= Flex ans STRAw
199
Location of the Ant. Tenderpoint 1
mindline at episternal notch
200
Location of AT2
Midline, junction of manubrium and sternum (angle of Louis)
