Lab 1: Visceral OMT Flashcards
Palpation postioning and force direction for Sigmoid colon release?
Anteromedial of the left pelvic brim w/ force directed toward RUQ
Palpation postioning and force direction for Descending colon release?
Left posterolateral flank w/ medially directed force
Palpation postioning and force direction for Transverse colon release?
INFERIOR to costal margin w/ an INFERIOR force
Palpation postioning and force direction for Ascending colon release?
Right posterolateral flank w/ a medially directed force
3 relative contraindications for Large Intestinal Visceral OMT?
- Peritonitis
- Colon obstruction
- Recent abdominal surgery
Which areas do we do a TART screen for the PNS related to visceral dysfs.?
- Suboccipital region = Vagus N. (prox. 2/3 of colon)
- Sacral region = Pelvic splanchnics (S2-S4) –> (distal 1/3 colon)
3 relative contraindications for small intestine visceral OMT?
- Peritonitis
- Splenomegaly
- Recent abdominal surgery
For mesenteric/colonic release where is the palpation point for the SI Mesenteric Root?
1 inch INFERIOR and 1 inch LATERAL to the umbilicus
How would you treat T6 E RL SL with Still’s Technique?
- Extend to localize to T6, then add rotation L and SB L (indirect)
- Add compression thru shoulders to the segment
- Move T6 thru RB via shoulder contact (F Rr Sr) while maintaining compression
What are some indications for Liveral Viscral OMT?
- Passive congestion of liver and spleen
- CHF (especially right-sided HF)
- Liver visceral dysfunction
Contraindications for Liver Visceral OMT?
- Fractures, dislocations thorax
- Lymph system malignancy
- Traumatic disruption of liver, spleen, or adjacent organs
- Acute hepatitis
- Friable hepatomeglay or splenomegaly as in mononucleosis or sickle cell anemia
Palpation position for Liver pump treatment?
Activating force and direction?
- Caudad hand is placed on anteroinferior, right inferior ribs and costal margin
- Cephalad hand placed on posteroinferior, right inferior ribs and costal margin
- Use gentle alternating compressive, pumping force thru the rib cage to pump liver tissues for 30- 60 secs.
In the Liver Pump w/ Recoil Activation what is the force/direction and how are barriers stacked?
What is the activating force with this method?
- Compressive force, evaluate F/E, SB/R –> STACK in INDIRECT manner
- Have pt take few deep breaths and follow tissue release, then during early inhalation RELEASE compression and other forces
How is FPR performed for a Dx of T7 E Rr Sr?
- Neutralize sagittal curve, while monitoring segment, have pt extend spine to straighten kyphotic curve
- Add compression ≤1 lb localized to segment
- Indirect positioning: triplanar indirect positioning (T7 E Rr Sr) and hold 3-5 seconds
*FPR is essentially BLT w/ some compression!
Which ganglia is associated with the ascending colon and prox. 2/3 of transverse?
Found where?
- Superior Mesenteric
- Midway between xiphoid and umbilicus
Which ganglia is associated with the distal 1/3 of transverse colon, descending colon, sigmoid colon, and rectum?
Found where?
- Inferior Mesenteric ganglia
- Just superior to umbilicus (1/3 the way up from umbilicus to xiphoid)
Where is the posterior chapman’s points for the colon?
Triangular area from TP’s of L2-L4 reaching to iliac crest
*Direct fascial relationship w/ QL muscle
How to TART screen for SNS of proximal 2/3 and distal 1/3 of colon?
Which areas are you screening?
- Evaluate T10-T11 for proximal 2/3rd
- Evaluate T12-L2 for distal 1/3
- Pt is seated or standing; palpate the areas for TTA and asymmetry
- Test gross ROM
How to TART screen for PNS of proximal 2/3 and distal 1/3 of colon?
Which areas are you screening?
- Evaluate suboccipitals for proximal 2/3; upper, middle (C3-C5), and lower (C6-C7)
- Evaluate sacrum for distal 1/3; lumbosacral (lumbar) spring test or sacroiliac rocking oblique axis test
What is the correct technique for treating a Chapman’s point and for how long?
- Slowly massage w/ firm pressure of finger pads in circular fashion to mobilize accumulated fluid
- Perform for 10-30 seconds
Where are the anterior chapman’s points for the small intestines?
ICS of 8th-10th ribs
How do you perform FPR for the thoracics, seated?
- Upper have pt extend head; Lower have pt extend spine to neutralize kyphosis
- Add <1 lb. of compression down to segment you are monitoring
- Put patient into triplanar position of ease (INDIRECT)
- Hold 3-5 secs.; return to neutral and reassess
How do you perform Still Technique for Lower Thoracics?
- Pt is seated w/ doc behind pt and monitoring TP of affected seg.
- Extend spine until motion palpated at segment and then induce SB and R into the ease until motion felt at monitoring hand
- Add gentle compression
- Move thru triplanar RB’s while maintaining compression
- Return to neutral and reassess
What are the anterior and posterior chapman’s points for the Liver and GB?
- Liver = R 5th ICS (anterior) and R b/w T5 and T6 (posterior)
- GB = R 6th ICS (anterior) and R b/w T6 and T7 (posterior)
Which area of the spine should be evaluated for SNS dysfunction associated with the liver?
Evaluate T7-T9 TART –> SB, R, F/E
If wanting to treat the SNS component associated with the liver in the region of T7-T9 which treatment can be done that is indirect and which that is direct?
- Indirect = FPR for thoracics, seated
- Direct = Still’s for thoracics, seated
When doing seated ME or ART for the thoracics, which hand will the pt place behind their neck before grasping their elbow with the opposite hand?
Place hand on side of PTP behind neck
