Hospitalized pt. tx Flashcards
why perform OA release?
relieves pressure on vagus n.
compression of juglar vein can cause pressure on vagus nerve
venous back pressure can go to lower brainstem - where GI, heart and resp. centers are located - can result in decreased circulation in the brainstem
improve cardiac and GI function
compression of vagus can trigger vomit center - as well as distension
USES: h/a, resp. depression, asthma, COPD, pneumonia, nausea, vomiting, ileus
why perform rib raising in thorax?
enhances expectorant fn. of lungs
facilitates venous and lymph drainage through thorax and abdomen
encourages mucous draining from lungs
decreases inflammation/congestion
decrease atelectasis and pneumonia chance
encourage diaphragm motion
return of GI peristaltic motion
encourage SANS tone to the lungs
USEs: penumonia, asthma, COPD, congestion, post-op patients, ileus, ARF
why perform thoracic diaphragm MFR?
increase diaphragm tone
encourage venous and lymphatic drainage along with ventilatory effectiveness
improved arterial and lymphatic drainage
Use: extubation from ventilator, improve resp. effort, pneumonia, asthma, COPD, post op
CI’s to visceral manipuations?
Nausea and vomiting* Sweating Tachycardia Syncope Dizziness Guarding and pain on rebound
- Acute infection: appendicitis, peritonitis, diverticulitis, cholecystitis, gastroenteritis, etc.
- Ruptured viscera
- Acute blunt-force trauma
- Aortic aneurysm
- Ischemic bowel
Gallstones (relative) Cancer (relative) Bowel obstruction (relative) Pregnancy (relative) IUD (relative) Lack of consent
sequence of tx of colon?
Start by correcting any structural pelvic somatic dysfunctions
Then release the plexi (celiac ganglion just below xiphoid, inferior mesenteric just above umbilicus - superior mesenteric in between)
Then release the cecum (right)
The ileocecal valve (right)
Ascending colon
Hepatic flexure
Transverse colon
Splenic flexure
Descending colon
Sigmoid colon (end on the left!)
tx of pre-aortic plexi
Stand next to the supine patient.
Place fingers of both hands (one re-inforcing the other) along linea alba above the umbilicus.
Gently let your fingers sink into the tissues until you reach the plexi.
Maintain pressure and await a fascial release. There may be a few that occur on your way toward the plexi.
To stimulate the plexi, one can perform gentle, repeated rebounds.
hepatic flexure?
flexure attaches to the diaphragm by the right phrenicocolic ligament, lies between the right kidney (posterior) and the liver (anterior)
splenic flexure?
contacts the greater curvature of the stomach, attaches to the diaphragm by the left phrenicocolic ligament ; spleen is superior
treatment of cecum?
With gentle fingers (don’t lock the PIP and DIP joints), or both thumbs or the lateral curve of your fingers, slid along the iliac fossa until you palpate the cecum.
Push the lateral aspect of the cecum anteromedially.
Push the medial aspect of the cecum inferolaterally.
Push the inferior aspect of the cecum superolaterally.
Once this has been released, treat the iliocecal valve by placing the thenar eminence over the valve and applying pressure medially and then laterally until there is freer motion.
tx of sigmoid colon?
Patient is supine on the table with knees flexed.
With gentle fingers (don’t lock the PIP and DIP joints), or both thumbs or the lateral curve of your fingers, slid along the iliac fossa until you palpate the sigmoid colon.
Push the lateral aspect of the sigmoid superomedially toward the umbilicus.
Then place your fingers just above the pubic symphysis and push the sigmoid and small intestine superiorly toward the umbilicus.
There should be the perception of a fascial release.
sigmoid colon?
The root runs from the left side of L2 to the right sacroiliac joint.
The sigmoid mesocolonic attachment arises on the medial aspect of the left psoas muscle, curves over the iliac vessels and ends lying over the 3rd sacral segment.
treatment of mesentery (lift)
This technique can relieve venous congestion and edema in the intestines, improve immune function and absorption of nutrition
Technique also addresses part of the “central chain” or “central tendon” which refer to the fascial connection from the base of the sphenobasilar symphysis to the perineal body via the pre-tracheal fascia, mediastinum, the central tendon of the diaphragm, the midline of the abdominal cavity from which all of the organs arose via invagination of the gut cavity during embryology to the pre-sacral fascia.
This direct technique is best performed after mobilizing the cecum, ileocecal valve and sigmoid.
Do not perform this technique if there is a recent abdominal incision, acute ischemic bowel disease, bowel obstruction, etc.
Patient is supine or in the left lateral recumbent position.
Physician stands on the patient’s right side or behind them.
Place your finger tips at the left border of the mesenteric region and curl the fingertips. Then push them gently toward the patient’s spine and toward their right side until a restrictive barrier is engaged.
Maintain this position, taking up slack as releases occur, and hold until no further improvement is detected.
what do diaphragms do in respiration?
rib cage rises
resp. diaphram, thoracic inlet, pelvic floor, awnd viscera all distend
where does small bowel mesentary originate?
ligament of treitz - left side of lumbar vertebra, and crosses the SI joint
where does cecum attach?
attaches in the pelvir brim in right lower quadrant and var
