Lab 5: ANS/Lymphatics Lab Flashcards
What are 3 sympathetic ANS treatments to normalize/reduce sympathetic tone?
1) Paraspinal Inhibition
2) Collateral Ganglia Dx/Inhibition
3) Rib Raising
What is the correct setup and technique for Paraspinal Inhibition?
- Pt supine; Doc seated beside table
- Hands placed under pt thoracolumbar spine w/ fingertips on contralateral paraspinal tissues, thenar and HT eminences over ipsilateral paraspinal tissues
- Gently squeeze fingers and palms together; Hold 60-90 secs or until muscles relax
- Repeat until tissue tension reduced/eliminated
What is the correct setup and technique for Rib Raising (seated)?
- Pt seated, Doc standing facing Pt
- Pt crosses arms and leans towards Doc. Grasp bilateral posterior/inferior rib angle (lateral to TP)
- Start w/ T12, applying anterolateral traction while pulling cephalad and toward you –> Continue up ribs
- May use respiration to assist you - apply pressure w/ inhale, release w/ exhale
What is the correct setup and technique for Rib Raising (supine)?
- Pt supine w/ Doc sitting on side to treat
- Contact rib angles by flexing fingers and starting w/ T12, apply anterolateral traction by rocking backward –> Continue up ribs
- May use respirations to assist - apply pressure w/ inhale, release w/ exhale
Manipulation of which 3 joints will influence parasympathetic tone via vargus nerve?
1) OA
2) AA
3) C2
What are the parasympathetic ANS treatments to normalize/reduce parasympathetic tone?
1) Suboccipital release
2) OA muscle energy
3) AA muscle energy
4) SI gapping
5) Sacral Inhibition
What is the correct setup and technique for OA muscle energy?
- Pt supine w/ Doc seated at table head
- Support posterior arch and lateral masses w/ “V” hold using thumb and index finger
- Grasp head and F/E head, Rotate, and Sidebend to the barrier THROUGH the occiput
- Have pt activate against resistance and repeat process until no new barriers —> Reassess
When performing AA ME what must always be done?
FULLY FLEX the C-spine!
*Locks out the rotation of the typical cervical vertebra
What is the correct setup and positioning for SI gapping?
- Pt supine w/ Doc at side of table
- Monitor at pt’s SI joint w/ cephalad hand
- Use caudad hand to flex and IR rotate pt’s ipsilateral hip w/ knee flexed
- Hold 20-60 secs or until relaxation felt at tissues –> Reassess
When evaluating Cervical-Thoracic Junction lymphatics what is the correct hand position?
Palms on the scapula and fingers rest w/ pads INFRAclavicularly to introduce rotation to the right and compare it to the left
What is the correct setup and technique for the Cervicothoracic (Necklace) Technique?
- Pt seated w/ Doc standing behind pt
- Docs thumbs rest on superior trapezium b/l, finger pads are anterior and inferior to clavicles
- Engage the RB in all 3 planes = R/L translation (rotation); Clockwise/Counterclockwise (sidebending); Anterior/Posterior (F/E)
- Force applied gently and held for 20-60 sec or until release felt
- Reasses components of dysf. for TART
What is the correct setup and technique for Lumbar/Pelvic INR (standing)?
- Pt standing w/ Doc behind pt contacting PSIS w/ thenar eminence and iliac crest w/ fingers
- Engage fascia directly/indirectly using: Ant/Post Innominate rotation, Right/Left Translation, Inflare/Outflare
- Pt adds REM by putting hands overhead w/ or w/o sidebending, and/or rotating arms R to L
- Perform until no further release and Reassess
Which 7 organs/parts correlate with the Celiac Ganglion?
- Distal esophagus
- Stomach
- Prox. duodenum
- Liver
- GB
- Spleen
- Portions of Pancreas
Which 6 organs/parts correlate with the Superior Mesenteric Ganglion?
- Distal duodenum
- Portions of pancreas
- Jejunum
- Ileum
- Ascending colon
- Prox. 2/3 of transverse colon
Which 4 organs/parts correlate with the Inferior Mesenteric Ganglion?
- Distal 1/3 of transverse colon
- Descending colon
- Sigmoid colon
- Rectum
How to correctly performe Collateral Ganglia Dx/Inhibition?
- Pt is supine with Doc standing beside table
- Use pads of fingers to feel an area of fullness, bogginess, or texture abnormality at the Celiac, Superior Mesenteric, or Inferior Mesenteric ganglia
Which sacral technique increases parasympathetic tone and which decreases?
- Sacral rocking increases tone
- Sacral inhibition decreases tone
What is the correct setup and technique for the lymphatic Innominate MFR?
- Pt supine; Doc at side of table facing cephalad
- Contact ASIS w/ palms and iliac crest w/ fingers
- Position innominates thru the fascia in an indirect or direct manner = A/P innominate rotation; Sup./Inf. Innominate shear; Inflare/Outflare
- Force is held for 20-60 secs or until release is palpated.
- Reassess
