GI cases techniques, LAB Flashcards
What tissue to you address osteopathically to affect the viscera
ligaments, peritoneum, pleura and mediastinum
With inhalation how does the abdomen move
the viscera, diaphragm, thoracic inlet, pelvic floor descend while the rib cage raises
with inhalation describe blood flow in superior vena cava and portal vein
blood inf superior vena cava increases
flow in portal vein decreases
During respiration which way do the abdomoinal organs move
cephalocaudal (more so laterally and near midline than ant/post)
An anterior pull of fascia can be from what
visceral restriction, anterior rib or sternal problem
a posterior pull of fascia could be what
spinal or dural problem
lateral fascial pull could be what
extremities or paired bilateral viscera
when palpating the viscera which axis should your hand be on and how does it move with respiration
the longitudinal
moves away from midline in inspiration and toward midline in exhalation
what is difference somatoviscleral reflex than viscerosomatic
visceral problem from somatic structure is somatovisceral
visceral or somatic problem from viscera is viscerosomatic
goal of Tx of viscera
Balanced ligamentous tension, normal movement with respiration, balanced inherent motion and normalization of the nervous system, fluid, nurtrion and pressure exchange
in cases of intestinal ptosis, stress urinary incontinence, abnormal stoold production, diverticulosis, UC, crohn disease, asthma and allergies what area of small intestine should be evaluated
jejunoileum
describe Tx for root of mesentery small intestine
patient supine, knees bent
doctor to the R with fingers below root, thumbs above and palpating deep to the root
take tissue to tension then relax and see speed tissue comes back, use speed to rhythmically engage and disengage tension
when to evaluate the colon osteopathically
constipaion, diarrhea, intestinal prolpase, ptosis, diverticulosis, Hx appendectomy, IBS, UC, CD, hemorrhoids, anorectal pain
movement of colon with respiration
inspiration: counterclockwise inferior
expiration:
clockwise superior
Tx colon OMT
take to direct barrier, relax and let tissues come back, assume that rhythm and repeat steps while encouraging the motion that is better
motion of fascial pull over sigmoid colon
superior-medially
inferior-laterally
Tx sigmoid colon
take tissues in direcition of ease then exaggerate direction until feel release
take tissues into barrier and maintain with respiratory assistance
how to set up collateral ganglia inhibition
patient supine, operator faces abdomen, fingerpads along midline above umbilicus
assess for tenderness and tension in the subcut tissues
when feel tension patient breathes deeply and you maintain firm pressure toward spine
during exhale increase P on tissues
what is the cecal release (how do you do it)
supine patient with knees flexed and feet flat on the table(or laying on L side with hips and knees flexed)
operator has tumbs inside R ilium below ASIS
gentle progressive painless P to treat organ
describe placement of P for cecal release technique
lateral side of cecum superiomedially
medial side inferolaterally
inferior side superolaterally
how does the sigmoid release work
patient supine with knees flexed and feet flat on table, lying on R side with hips and knees flexed
fingerpads inside L ilium below ASIS and press along interior aspect
gentle pressure as you draw sigmoid and mesocolon superiomedially in direction of umbilicus
contraindications for mesenteric release of SI
abdominal incision, acute ischemic bowel disease, obstruction or similar condition
patient position for mesenteric release SI
supine or on L lateral recumbent position
Tx method for mesenteric release SI
hands on L border mesenteric region of SI with fingers curled, gently push toward patients back and then to R side until meet restriction
hold position until release then follow the fascial creep to the new barrier
repeat until no further barriers
