Facilitation levels and chapmans points Flashcards
Pupils
T1-4
Sinuses
T1-4
carotid body and sinus
T1-4
lacrimal and salivary glands
T1-T4
trachea and bronchi
T1-6
heart
T1-6
upper extremity
T2-6
Lungs, visceral pleura
T1-6
esophagus
T1-6
gall bladder
R T5
spleen
L T7
pancreas
R T7
adrenal glands
T10-11
Small intestine
T10-11
ascending, transverse colon
T10-11
urinary bladder
T12-L2
kidneys
T10-11
ureters-proximal
T10-11
testes/ovaries
T10-11
uterus
T10-L2
lower extremity
T10-L3
appendix
T12
ureters-distal
T12-L1
descending, sigmoid colon, rectum
T12-L2
prostate
T12-L2
What are the PANs dumbbells
diarrhea/defecation urination meiosis- pupillary contraction bradycardia bronchospasm emesis lacrimation salivation
What levels are the SANs thoracolumbar
T1-L2
Which branch of ANS has greater divergence
SANs
nociceptive fibers travel with what branch of ANS
sympathetics
the vagus n is mainly afferent or efferent
afferent even though carries all PANs to abdominal and thoracic viscera
describe the type of fibers that carry light touch vibration and proprioception
large caliber myelinated
A- beta
terminate in pacinian, meissner, merkel discs, ruffini endings
describe type of fibers that carry nociception
small caliber unmyelinated
C fibers
high energy stimuli with naked nerve endings
sensitization
What are some examples of somato-somatic reflexes
DTRs, withdrawl reflex, gallbladder referral to right shoulder
what are some viscero-visceral reflexes
gut distention- gut contraction baroreceptro reflex (dec HR and vasodilation)
what are some viscero-somatic reflexes
cardiac disease has the SD at T1-5 RSL
when do we see somatovisceral reflexes
with spinal manipulation there are changes in HR BP and sympathetic activity of the kidney and adrenal gland
what causes neutral type I SD
chronic process, postural compensation
what causes non-neutral type II SD
acute process, trauma, viscera-somatic reflexes
What causes spinal facilitations
increased dynorphin(excitability) destruction of inhibitory interneurons activation of glial cells that amplify inflammation neuropeptide and aa NT spinal memory
what is the definition of a tenderpoint by Jones
small hypersensitive point in myofascial tissues of body used as diagnostic cirteria and Tx monitors
What causes tenderpoint
initial injury causes sudden unanticipated lengthening of the antagonistic muscle to the originally strained and painful agonist m
if a locailized small area of pain radiates is it a tender point or trigger point
trigger- Travells
what is a travell point
hyperirritable spot in skel m that is assoc with hypersensitive palpable nodule in a taut band
how do we Tx trigger points
inhibitory soft tissue, deep massage, injection, isometric MET, vapocoolant spray with myofascial stretch
describe a trigger point difference than fibromyalgia
fibromyalgia exhibit local twitch
Where are tender points usually found
tendinous attachments or belly of mm
What is a galgliform contraction
may block lymph drainage. sympathetic dysfunction
found in areas that overlap visceral sympathetic efferent innervation
chapmans points are used for Dx, Tx and evaluation of what reflex type
viscero-somatic
Anterior chapmands points do or don’t radiate
do not
What is a chapmans point
small smooth firm discrete nodule in fixed anatomical location
deep to skin and subcutaneous
feel like a split pea
what is the Tx for a chapmans point
firm circular pressure attempting to flatten for 10-30 seconds
where roughly are the chapmans points for nose tonsils tongue, pharynx, sinuses
left and right of sternum near sternal angle
b/l on sides of spinous processes C2-5
where is the chapmand point for middle ear
under clavicle parasagittal of sternum
lateral to superior nuchal line
where is chapmans point for cerebellum
under ac joint
just lateral to inferior nuchal line
where is chapmans point for esophagus and thyroid
sternal angle and then inferior
lateral spinous process T2
where are chapmans points for myocardium, upper lung and lower lung
sternocosto joints b/l
myocardium and upper lung T3 spinous process
lower lung is T4
where are chapmands points for the liver and stomach
liver is R rib 7 and posterior T5-6
stomach is L rib 7-8
posterior (acidity LT5, peristalsis LT6)
where are chapmand points for pyloric stenosis
directly R of the sternum
posterior T9
where are chapmans points for the gallbladder
R rib 8
posterior T6 R
Where are chapmands points for pancreas, small intestine
pancreas R rib 9 posterior RT7
small intestine rib 10 b/l posterior LT8-10
Where are chapmans points for spleen
L rib 9
posterior LT7
where are chapmands points for sppendix
R iliac crest
R T11 posterior
where are chapmans points for adrenals kidney and bladder
adrenals around L3 ant vertebral body posterior T11
kidney L4 posteiror L1
bladder R side of vertebral body L4/5 posterior L2 b/l
where are chapmans points for ovaries, testes, urethra
inferior to pubic symphysis
ovaries T10
testes T11
urethra L3
where are chapmans points for abdomen
inferior pubic ramus
posterior L3
Where are chapmands points for rectum
medial superior R femur
posterior S2 b/l
where are chapmans points for colon
lateral length of femur
posterior L2-4
where are chapmands poins for prostate and broad ligament
lateral length femur
SI joint posteriorly
where are chapmands points for inguinal lymph
L medial condyle of femur and beneath L tibial tuberosity
inferior SI joint posteriorly
where are chapmands points for vagina and clitoris
sacral coccyx joint
and under ischium
vagina also has medial inferior femur
where are chapmans points for sciatic n
at superior SI joint, acetabulum joint, lesser tubercle of femur and lateral condyle of femur
