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last time Flashcards

1
Q

Muscle used for Muscle Energy: 1st Rib exhalation dysfunction

A

Anterior and middle scalenes

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2
Q

Muscle used for Muscle Energy: 2nd Rib

A

Posterior Scalene

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3
Q

Muscle used for Muscle Energy: Ribs 3?5

A

Pectoralis Minor

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4
Q

Muscle used for Muscle Energy: Ribs 6?8 (9)

A

Serratus anterior

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5
Q

Muscle used for Muscle Energy: Ribs 9?11

A

Latissimus Dorsi

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6
Q

Muscle used for Muscle Energy: Rib 12

A

Quadratus Lumborum

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7
Q

what lymphatic ducts drain the lungs?

A

Right lymphatic duct (The same as the heart)

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8
Q

What are the autonomic levels for the lungs?

A

Sympathetics? T1?T6; Parasympathetics? CN X, OA, C1, C2

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9
Q

Effect of parasympathetic stimulation on the lungs

A

contracts bronchiolar smooth muscle, decreases goblet cells, thins mucus secretions/ broncoconstriction vasodilation

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10
Q

Sympathetic Levels Lungs?

A

T1?T6

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11
Q

Sympathetic Levels Trachea & Bronchi?

A

T1?T6

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12
Q

Sympathetic Levels Visceral Pleura?

A

T1?T6

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13
Q

Sympathetic Levels Parietal Pleura?

A

T1?T11

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14
Q

Sympathetic effects on lungs

A

relaxation of bronchiolar smooth muscle, increases goblet cells, thickens mucus secretions

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15
Q

When treating a patient with bronchospasm (asthma) which side of the autonomic system should be treated first? Why?”

A

Treat the parasympathetic side of the autonomic system first to decrease any neurally mediated bronchoconstriction. If the sympathetic side of the system is treated first, the patient may go into acute refractory bronchspasm
Stretch receptors transmit signals via the___. When the lungs are inflated, how does this affect respiration? Vagus Nerve: when the lungs are inflated this signal turns off respiration

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16
Q

T/F: The vagus reflex is sensitive to stretch caused by air or fluid ? causing cessation or slowing of the respiratory signal.

A

True: it does not differentiate.

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17
Q

The ___ reflex mechanism cannot distinguish between air sacs filled with air and those filled with fluid

A

Hering?Breuer Reflex

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18
Q

What baroreceptor is sensitive to oxygen?

A

Carotid Body ? sends its signals to the respiratory center (medulla)

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19
Q

With lung tissue congestion, the respiratory center receives information from the vagus nerve: what happens next?

A

This limits the excursion of the diaphragm

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20
Q

Diaphragm’s greatest excursion is in what position?

A

The supine position

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21
Q

Thoracic Diaphragm motion increases the volume of the thorax in __ planes of motion.

A

3 Planes of Motion

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22
Q

what are Tender Points, Anterior vs Posterior?

A

Small tense edematous areas of tenderness 2?3mm diameter which do not radiate pain. Anterior Tender Points: Diagnostic Purposes; Posterior Tender Points: Are treated with counterstrain techniques

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23
Q

Chapman points at the 2nd intercostal space suggest problems with?

A

2nd intercostal space= Thyroid, Myocardium, Esophagus, Bronchus

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24
Q

What are Chapman Reflex Points?

A

Small nodules of tissue texture change that are 2?3 mm in diameter, that are thought to be reflections of visceral dysfunction (visceral?somatic reflex). Treated by rubbing in a firm rotating motion for 10?30 seconds

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25
Q

The “Asthma Reflex”

A

T2 left

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26
Q

Anterior bronchial Chapman’s reflex

A

Intercostal space between the 2nd and 3rd ribs close to the sternum

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27
Q

Posterior bronchial Chapman’s reflex

A

Midway between the spinous process and the tips of the transverse processes at T2

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28
Q

Anterior upper lung Chapman’s reflex

A

Intercostal space between the 3rd and 4th ribs close to the sternum

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29
Q

Posterio upper lung Chapman’s reflex

A

Midway between the spinous processes and the tips of the transverse processes of T3 and T4

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30
Q

Anterior lower lung Chapman’s reflex

A

Intercostal space between the 4th and 5th ribs close to the sternum

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31
Q

Posterior lower lung Chapman’s reflex

A

Midway between the spinous processes and the tips of the transverse processes of T4 and T5

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32
Q

Which way do the vertebrae rotate in a visceral dysfunction

A

Vertebrae rotate towards visceral dysfunction

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33
Q

sympathetic innervation of the heart has its origins ___

A

cord segments T 1?6

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34
Q

The parasympathetic innervation of the heart has its origins from ___

A

Vagus Nerve

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35
Q

When the Ventricles are involved in production of pain, it tends to refer to

A

C8 to T3 dermatomes

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36
Q

When the Atria are responsible for the pain, it tends to occur where?

A

lower in the chest wall in the T4 to T6 dermatomes

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37
Q

Where are the posterior Chapman reflex points?

A

Midway between the spinous process and the tips of the transverse processes in the space between the transverse processes of T2 & T3 bilaterally

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38
Q

Where are the anterior Chapman Myocardial Reflexes?

A

2nd intercostal space at the Sternal Border

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39
Q

Where are the posterior Chapman Myocardial Reflexes?

A

The space between the transverse processes of T2 and T3 midway between the spinous process and the tip of the transverse process

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40
Q

Where are the anterior Chapman Adrenal Reflexes?

A

Lateral Aspect of rectus abdominus at the level of the inferior margin of the costal margin

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41
Q

Where are the posterior Chapman Adrenal Reflexes?

A

Intertransverse spaces on both sides of T11 and T12 midway between the spinous processes and transverse processes

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42
Q

Severe Scoliosis with thoracic curve greater than ____ seriously compromises cardiac function

A

60?75 degrees

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43
Q

Severe Kyphosis measuring greater than __ degrees compromises cardiac function

A

60 degrees

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44
Q

Patients with flattening of the thoracic kyphosis or with postural crossovers in the upper thoracics, tend to develop _____ when subjected to other stressors

A

tachyarrhythmias

45
Q

anterior triggerpoint which serves an initiating or perpetuation role in tachyarrhythmias

A

5th intercostal space located in the right pectoralis major muscle

46
Q

Abnormal gait patterns may increase cardiac work by up to ___%

A

300%

47
Q

sympathetic Innervation of the heart emanates from

A

cord segments T1?T6

48
Q

Right sided sympathetic fibers to the hart innervate ___

A

right heart and sinoatrial (SA) node.

49
Q

Hypersympathecotonia in right sided nerve fibers to the heart predisposes to

A

supraventricular tachyarrhythmias

50
Q

autonomic innervation to the Left side of the heart innervates ___

A

left heart and atrioventricular (AV) node

51
Q

Hypersympathecotonia in LEFT heart sympathetic fibers predisposes to

A

ectopic foci and ventricular fibrillation

52
Q

Increase in sympathetic tone in blood vessels produces

A

generally vasoconstriction

53
Q

Vasculature of the arms receives its sympathetic supply from

A

T2 to T8 levels

54
Q

Vasculature of the legs receives its sympathetic supply from

A

T11 to L2 levels

55
Q

The Vagus nerves have fibers which join and course to them from

A

C?1 & C?2 nerve roots

56
Q

Observation of patients has demonstrated that correction of high cervical somatic dysfunction resulted in ____ vagal tone

A

transient increase in vagal tone followed by a reduction in vagal effect

57
Q

Right Vagus innervates what part of the heart?

A

Sino Atrial Node

58
Q

Hyperactivity of the right vagus predisposes

A

sinus bradyarrythmias

59
Q

Left Vagus innervates the ___

A

Atrio Ventricular Node

60
Q

Hyperactivity of left vagus predisposes

A

AV Blocks

61
Q

Deep pressure over the ______ suture on the skull will reflexly slow the heart

A

occipitomastoid suture

62
Q

Heart lymphatics drain predominantly to the

A

right lymphatic duct

63
Q

Lymphatic drainage from the heart and lungs is carried back to the heart primarily by the

A

right lymphatic duct

64
Q

Head and neck Lymph drains to

A

right lymphatic trunk via Right Jugular Trunk

65
Q

Heart, Lungs, Liver Lymph drain to

A

right lymphatic duct via Right Bronchomediastinal Trunk

66
Q

Right arm lymph drains to

A

right lymphatic trunk via Right Subclavian Trunk

67
Q

Pleural causes of chest pain

A

effusion, consolidation, bronchospasm, pulmonary embolism, pulmonary hypertension, pneumothorax, hemothorax, atelectasis, asthma, copd, pneumonia

68
Q

Musculoskeletal disorders of chest pain

A

strain, sprain, contusion, fracture, costochondritis, fibrositis, myositis, thoracic outlet syndrome, diaphragmatic dysfunction, ankylosing spondylitis, disc disease

69
Q

Cardiac causes of chest pain

A

coronary ischemia, myocardial infarction, arrhythmias

70
Q

Infections that cause chest pain

A

viral, bacterial, parasitical, fungal, mediastinitis, pleurisy, interstitial pneumonitis, bronchitis, tracheitis

71
Q

In CHF, lymphatic flow through the thoracic duct increases ___ times the resting level

A

3?40 times

72
Q

In Acute MI autonomic Techniques are directed at dysfunctions located

A

OA, C1, C2, T1 to T4 and R1 to R4

73
Q

in Acute MI paraspinal soft tissue techniques may be performed from

A

T1 to L2 to generally diminish sympathetic tone and decrease peripheral vascular resistance

74
Q

Cranial Acute MI autonomics treatment is ___

A

Treat dysfunction of the skull base and occipitomastoid suture, if present

75
Q

Acute MI tx of Lymphatics: apply indirect techniques to the_____; Apply _____ to assist inhalation and promote lymphatic flow; Redome diaphragm using_____ technique

A

Lymphatics: Apply indirect techniques to the thoracic inlet; Apply pectoral traction to assist inhalation and promote lymphatic flow; Redome diaphragm using indirect AP diaphragm technique

76
Q

Autonomics treatment for hypertension is directed to

A

entire sympathetic bed (T1 to L2) to generally decrease peripheral vascular resistance. Study of 100 hypertensive patients: Drop of 33 mm Hg systolic, Drop of 9 mm Hg diastolic P

77
Q

What are the chapman points for hypertension?

A

Treat Posterior Adrenal Points (Intertransverse spaces of T11 and T12 midway between the spinous processes and transverse processes):Drop of 15 mm Hg Systolic, Drop of 8 mm Hg Diastolic,
CHF tx of Lymphatics: Treat any restriction at the ____, Treat dysfunctions of the ___, _____, and rib cage, _____ the diaphragm, Apply thoracic, abdominal and pedal lymphatic pumps if their heart can handle it (NOT ACUTELY) Treat any restriction at the thoracic inlet\nTreat dysfunctions of the thoracic spine, L1 to L3, and rib cage\nRedome the diaphragm\nApply thoracic, abdominal and pedal lymphatic pumps (NOT ACUTELY)
Where are the heart anterior Chapman reflex points? Close to the sternum in the second intercostal space bilaterally
What are the effects of increased sympathetic tone on the healthy heart In the healthy heart, increased sympathetic tone Increases the force of contraction, Shortens the time of systole, Increases ventricular output

78
Q

Consequences of Increased Sympathetic Tone in cardiovascular disease?

A

Vasospasm; Increases morbidity following myocardial infarction, Predisposes to arrhythmias, Inhibits development of collateral circulation, Adversely affects degree of recovery post?MI

79
Q

________ tone implicated in essential hypertension due to vascular changes with the kidneys”””

A

“Vasomotor nerves are unopposed
Consequences of Increased Sympathetic Tone: ______ lymphatic drainage,_______ bronchodilation, _______ gastrointestinal activit, Is involved in almost all disease processes Diminished lymphatic drainage, Increases bronchodilation, Decreases gastrointestinal activity, Is involved in almost all disease processes
What is the Oculocardiac Reflex? Pressure on the carotid body or the globe of the eye (Oculocardiac Reflex) will also slow the heart, Slows heart by 5?13 bpm, Will not slow at all in sympathecotonic patients

80
Q

Parasympathetics cause peripheral arteriolar vasodilation in select regions (5)

A

Vessels of Submaxillary Gland, Vessels of Parotid Gland, Vessels in the Blush Region of the Face, Vessels in the tongue, Vessels of the penis & clitoris (erection & engorgement)

81
Q

Parasympathetics:_____ heart rate and contractility, ______ bronchoconstriction, ______ gastrointestinal activity, Only rarely causes _____

A

Decrease heart rate and contractility, increase bronchoconstriction, Increase gastrointestinal activity, Only rarely causes vasodilation

82
Q

OMM Treatment for Acute Myocardial Infarction

A

Use indirect methods or soft tissue techniques for at least first 72 hours post MI, Search for right Pectoralis Major trigger point Treat if present
Sympathetics to lung T1?6
Sympathetics to trachea, bronchi T1?6
Sympathetics to visceral pleura T1?6
Sympathetics to Parietal pleura T1?11
What are the main muscles of respiration? inhalation: external intercostals, and innerchondral part of the internal intercostals, diaphragm, (deep inhalation also includes scalene, SCM, levator costorum, serratus posterior superior); exhalation: passive recoil (quiet breathing), internal intercostals and abdominal muscles (active breathing)
what are the motor and sensory nerves to the diaphragm? phrenic nerve (C3?5)
inhalation dysfunction key rib in group: bottom rib? holds the rest up
exhalation dysfunction key rib in group: top rib? holds the rest down
what are the boundaries of the superior thoracic inlet? manubrium, proximal clavicles, first ribs, and body of T1
tx for prevention of post?op pneumonia Pre?op: Treat C3?5; Post?op: Treat C3?5 and ribraising
The right lymphatic duct drains what? heart, lungs, liver, head, neck, and right upper limb
MI treatment General: use indirect methods or soft tissue techniques for at least first 72 hours post MI. Somatic: Search for right Pectoralis Major trigger point, Treat if present

83
Q

lymphatic ducts are under what nervous control?

A

sympathetic

84
Q

An MI with involvement of the ventricles where will TART be detected?

A

C8?T3

85
Q

An MI with involvement of the atria where will TART be detected?

A

T4?6

86
Q

An anterior MI infartct would reffer TART where?

A

T2?3 Left

87
Q

An inferior wall MI would reffer TART where?

A

T3?5 Left and C2

88
Q

Hyertension is associated with TART changes where?

A

C6, T2, T6

89
Q

General treatment for all tenderpoints

A

COUNTERSTRAIN: Find position of comfort (70% improvement) via sidebending, flexion, extension, rotation as directed. Maintain the position for 90 seconds. Return to neutral and reasses.

90
Q

Posterior tenderpoint for C1 is found where?

A

inion or muscle mass lateral to nuchal line

91
Q

Posterior tenderpoints for C2?7 are found where?

A

on the articular pillars or “located on the interspinous ligaments between the spinous processes or slightly medial or lateral to them.”

92
Q

Treatment for posterior cervical tenderpoints

A

C1 (inion) flex, C1?7 (articular pillars) Extend and SARA, EXCEPT C3= Flex and STRAw

93
Q

Location of ant. C1 tenderpoint

A

posterior edge of the ascending mandible

94
Q

Location of ant. C2?C3 tenderpoint

A

on or deep to the SCM (or anterolateral tip of the articular pillars of the cervical vertebrae)

95
Q

Location of ant. C4?C6 tenderpoints

A

anterior to the SCM (or anterolateral tip of the articular pillars of the cervical vertebrae)

96
Q

Location of ant. C7 tenderpoint

A

lateral attachment of SCM to clavicle

97
Q

Location of ant. C8 tenderpoint

A

medial tip of the clavicle

98
Q

Treatment for anterior cervical tenderpoints

A

C1 rotate away, C2?C8 Flex and SARA, EXCEPT C7= Flex ans STRAw

99
Q

Location of the Ant. Tenderpoint 1

A

mindline at episternal notch

100
Q

Location of AT2

A

Midline, junction of manubrium and sternum (angle of Louis)

101
Q

Location of AT3?5

A

Midline at level of corresponding rib;

102
Q

Location of AT 6

A

Midline xiphoid?sternal junction
Location of AT 7 Midline on the xiphoid or inferolateral to tip of xiphoid;
Location of AT 8 3 cm below xiphoid at level of T12, midline or lateral
Location of AT 9 1?2 cm above umbilicus at level of L2, midline or 2?3 cm lateral
Location of AT 10 1?2 cm below umbilicus at level of L4, midline or 2?3 cm lateral
Location of AT 11 5?6 cm below umbilicus below level of iliac crests at superior L5 level, midline or 2?3 cm lateral
Location of AT 12 Superior, inner surface of liac crest at mid?axillary line
Treatment for AT 1?6 Flexion to dysfunctional level
Treatment for AT 7?9 F STRAw
Treatment for AT 10?12 Hip flexion 90?135 degrees, slight side bending, rotation toward (type I) or side bending toward, rotation away (type II)= F STRT or F STRAw
describe the Still technique take it the way it likes to go, add compression, maintain compression while reversing all components
Sympathetic innervation to the head and neck T1?4
Sympathetic innervation to the heart T1?6
Sympathetic innervation to the respiratory system T1?6/T2?7
sympathetic innervation to the esophagus T2?8
sympathetic innervation to upper GI (stomach, liver, gallbladder, pancreas, doudenum) T5?9 (greater splanchnic n./ celiac ganglion)
sympathetic innervation to middle GI (pancreas, doudenum, jejunum, illium, ascending colon, proximal 2/3 of transverse colon) T10?11 (lesser splanchnic n./ supperior mesenteric ganglion)
sympathetic innervation to lower GI T12?L2 (least splanchnic n./ inferior msenteric ganglion)
sympathetic innervation to appendix T12
sympathetic innervation to kidneys T10?11 (lesser splanchnic n./ supperior mesenteric ganglion)
sympathetic innervation to the adrenal medulla T10
sympathetic innervation to upper ureters T10?11 (lesser splanchnic n./ supperior mesenteric ganglion)
sympathetic innervation to lower ureters T12?L1 (least splanchnic n./ inferior msenteric ganglion)
sympathetic innervation to bladder T11?L2
sympathetic innervation to gonads T10?L2
sympathetic innervation to uterus and cervix T10?L2
sympathetic innervation to erectile tissue of the penis/clitorus T11?L2
sympathetic inervation to prostate T12?L2
sympathetic innervation to arms T2?8
sympathetic innervation to legs T11?L2
parasympathetic innervation to lower ureter and bladder pelvic splanchnic S2?4
parasympathetic innervation to uterus, prostate, genitalia pelvic splanchnic S2?4
parasympathetic innervation to kidney and upper ureter vagus (CN 10)
parasympathetic innervation to gonads vagus (CN 10)
parasympathetic innervation to ascending and transverse colon vagus (CN 10)
parasympathetic innervation to decending colon and rectum pelvic splanchnic S2?4
anterior chapman’s points for adrenal glands 1 inch lateral and 2inches superior to the umbilicus ipsilaterally (lateral aspect of the rectus abdominus at the level of the inferior costal margin
anterior chapman’s points for the kidneys 1inch lateral and 1inch superior to the umbilicus ipsilaterally
ant. Bladder chapman’s points umbilical area
posterior chapamn’s points for the small intestine B/L (R>L) T8?T10
ant. And posterior chapaman’s points for the appendix ant: tip of the 12rib; post: T12 right
post. Chapman’s points for cecum and ascending colon T12?L1 right
post. Chapman’s points for decending colon L2?3 left
anterior chapman’s points for the pancreas leteral to the costal cartilage 7th intercostal space on the right
posterior chapman’s points for the pancreas bwtween transverse processes of T7?8 right
upper GI reflex”

103
Q

posterior chapmans reflex for esophagus

A

T3 right

104
Q

post. Chapmans reflex for stomach

A

T5?8 left

105
Q

post. Chapman’s reflex for doudenum

A

T7?8 right

106
Q

ant. Chapman’s point for the urethra

A

myofacial tisues along the superior margin othe the pubic ramus about 2inches lateral to the pubic symphysis

107
Q

ant. Chapman’s point for the prostate

A

myofacial tissues along the posterior margin of the illiotibial band

108
Q

ant. Chapman’s point for the colon

A

iliotibial band (flipped)

OPP (4 decks)

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