Intro To Somatic Dysfunction Flashcards
Somatic dysfunction is defined as the
Impaired or altered function of related components of the somatic (bodywork) system including the skeletal, arthrodial (joints), and myofascial structures, and their related vascular, lymphatic and neural elements
What are the consequences of somatic dysfunction?
Poor posture may lead to tight trapezius muscles leading to HA or other pains
Can also be visceral - interactions b/w the vertebra and the nerves they protect may cause change in visceral fxn or vice versa
How do you diagnose somatic dysfunction?
Tissue texture abnormalities Asymmetry (static or active) Restriction of motion Tenderness The position of a body part as determined by palpitation and referenced to its defined adjacent structure
Tissue texture abnormalities
Temperature, drag, texture, edema, bogginess, elasticity, dryness, oiliness, scars, contraction, flaccidity, spasm, ropey or stringy
How do you name a somatic dysfunction?
Name it for what the structure WILL do
Ex: elbow can extend but is has restricted flexion then then it is elbow extended somatic dysfunction
Acute somatic dysfunction
Impairment or altered fxn of related components of the body framework system that is characterized by one or more of the following sx: pain, erythema, relative warmth, increased moisture/bogginess, vasodilation, edema, tenderness, and tissue contraction
Chronic somatic dysfunction
Impairment or altered fxn of long standing duration of related components fo the body framework system characterized by one or more of the following sx: itching, paresthesia, a palpable sense of tissue dryness, coolness, tissue contracture, fibrosis tenderness and pallor
Explain the difference between contraction and contracture
Contraction is the process of which a muscle becomes or is made shorter and tighter (acute)
Contracture is an abnormal, sometimes permanent, contraction of a muscle
What are some key words used for acute tissue texture abnormalities?
Erythematous, hot/increased warmth, bogginess, edema, spasm and tissue contraction
What are some key works for chronic tissue texture abnormalities?
Pale/blanching, cool, ropey, stringy, scar and doughy
How is somatic dysfunction treated?
By using OMT
Osteopathic manipulative treatment is the
Therapeutic application of manually guided forces by an osteopathic physician to improve physiologic function and/or support homeostasis that has been altered by somatic dysfunction
If a patient is doing the moving then they are
Active
If the doctor does the moving for the patient then they are
Passive
Which ROM (passive or active) has a greater range?
Passive ROM > active ROM
What is the physiologic barrier?
Limit of active motion
What is the anatomic barrier?
Limit imposed by anatomic structure
What is the elastic range?
The range between the physiologic and anatomic barrier (end of passive motion)
What is the restrictive barrier?
Functional limit that abnormally diminishes the normal physiologic range
What are the levels of evidence for OMT in order of highest level to lowest?
A: randomized clinical trials (RCTs), systematic reviews or meta-analyses of RCTs
B: case control or cohort studies, retrospective studies and certain uncontrolled studies
C: consensus statements, expert guidelines, usual practice and opinion
What are the contraindications for OMT?
If you find no somatic dysfunction
Pt does not give consent
In an inappropriate clinical situation (ex. Pt is unstable bc of a trauma)
What are some ways to avoid post OMT sx?
Take a good history and PE which allows operator to ascertain avoidable risks
Appropriate choice of technique by contemplating risk vs benefit ratio
Appropriate application of technique
Advise the pt to hydrate and rest & notify them that post OMT soreness is similar to post exercise soreness
What are the 10 body systems?
HEENT, cardiovascular, respiratory, GI, genitourinary, MSK, endocrine, integumentary, nervous, immune and psychiatric
What are the 5 osteopathic models?
Biomechanical, neurologic, respiratory/circulatory, metabolic/energetic/immune and behavioral (biopsychosocial)
Biomechanical model
MSK system including bones, muscles, tendons, ligaments and fascia
Integumentary
Body and its response to gravity
Neurologic model
Includes the nervous system, brain, spinal cord and its extension to the MSK system, autonomic system (including CN III, VII< IX and X & sacrum) as well as the sympathetic system
Respiratory/circulatory model
Cardiovascular including lymphatics system, respiratory, nose, throat and genitourinary
Metabolic/energetic/immune model
GI, lymph organs including spleen, liver, thymus, tonsils, appendix, lymph nodes, and the endocrine system including the hypothalamus-pituitary-adrenal axis
Behavioral (biopsychosocial) model
Psychological - behaviors that influence health and health decisions
What does health of the biomechanical model look like?
Efficient and effective posture and motion throughout the MSK system
What does disease of the biomechanical model look like?
Somatic dysfunction; inefficient posture; joint motion restrictions or hyper mobility; instability
How would you go about giving pt care in terms of the biomechanical model?
Alleviate somatic dysfunction utilizing osteopathic palpatory diagnosis and OMT to restore normal motion and function throughout the body
What does health of the neurologic model look like?
Efficient and effective sensory processing, neural integration and control, autonomic balance, central and peripheral nervous functions
What does disease of the neurologic model look like?
Abnormal sensation, imbalance of autonomic functions, central and peripheral sensitization/malfunction; pain syndromes
How can you give pt care for the neurological model?
Restore normal sensation, neurologic processes and control; alleviate pain
What does a healthy respiratory-circulatory model look like?
Efficient and effective arterial supply, venous and lymphatic drainage to and from all cells; effective respiration
What does a diseased respiratory-circulatory model look like?
Vascular compromise, edema, tissue congestion; poor gas exchange
How can you give pt care in the respiratory-circulatory model?
Remove mechanical impediments to respiration and circulation and relieve congestion and edema by improving venous and lymph drainage
What does a healthy metabolic-energetic-immune model look like?
Efferent and effective cellular metabolic processes, energy expenditure and exchange, endocrine and immune regulation and control
What does a diseased respiratory-circulatory model look like?
Energy loss, fatigue, ineffective metabolic processes, toxic waste buildup, inflammation, infection, poor wound healing, poor nutrition; adverse response to medication; loss of endocrine control of vital functions
How can you give pt care in the metabolic-energetic-immune model?
Restore efficient metabolic processes and bioenergetics, alleviate inflammation, infection, restore healing and repair functions and endocrine control
What does health look like in the behavioral model?
Efficient and effective mental, emotional, and spiritual functions, healthy lifestyle choices and actives, good social support system
What does disease look like in the behavior model?
Ineffective function due to drug abuse, environmental chemical exposure or trauma, poor lifestyle choices; inability to adapt to stress or environmental changes
How can you give pt care in the behavioral model?
Assess and treat the whole person-physical, psychological, social, cultural, behavioral, and spiritual aspects; collaborative partnership; individualized pt care ad self responsibility for healthy lifestyle choices
During the thought process of the 5 osteopathic models you should
Evaluate a pt’s problem and formulate a tx plan
