Lecture 1 LO Flashcards
Describe the elements of somatic dysfunction
-Tissue texture changes-Skin (texture)-acute?
Warm, moist, red, inflamed (vascular and chemical changes)
Describe the elements of somatic dysfunction
-Tissue texture changes-Skin (texture)-chronic?
Cool, pale (chronic increases sympathetic tone)
Describe the elements of somatic dysfunction
-Tissue texture changes-Skin (quality)-acute?
No trophic changes
Describe the elements of somatic dysfunction
-Tissue texture changes-Skin (quality)-Chronic?
Trophic changes: dry, scaly, cold, pale, shiny, hairless, pimples, folliculitis
Describe the elements of somatic dysfunction
-Tissue texture changes-Tissues-acute?
Boggy edema, acute congestion, fluids in area of damage drawn in by chemical rxns
Describe the elements of somatic dysfunction
-Tissue texture changes-Tissues-Chronic?
Chronic congestion, doughy, stringy, fibrotic, ropy, thickened, contractures
Describe the elements of somatic dysfunction
-Tissue texture changes-vascular-acute?
Inflammation, vessel wall injury, endogenous peptide release
Describe the elements of somatic dysfunction
-Tissue texture changes-Vascular-Chronic?
Sympathetic tone increases vascular constriction
Describe the elements of somatic dysfunction
-Tissue texture changes-Sympathetics-Acute?
Sympathetic activity but local vasoconstriction overpowered by local chemical release, net effect is vasodilation
Describe the elements of somatic dysfunction
-Tissue texture changes-Sympathetics-Chronic?
Vasoconstriction, hypersympathetic tone, may be regional
Describe the elements of somatic dysfunction
-Tissue texture changes-Musculature-Acute?
Local increase in muscle tone, muscle contraction, spasm, increased tone of muscle spindle
Describe the elements of somatic dysfunction
-Tissue texture changes-Musculature-Chronic?
Decreased muscle tone, flaccid, mushy, limited range of motion due to contractures
Describe the elements of somatic dysfunction
-Asymmetry?
Are the bilateral parts of the body level with each other
-Right shoulder on same level with left shoulder
Describe the elements of somatic dysfunction
-Restriction of motion-Mobility-Acute?
Usually sluggish, may be guarding (to prevent further pain)
Describe the elements of somatic dysfunction
-Restriction of motion-Mobility-Chronic?
Limited range of motion, but motion itself feels normal
Describe the elements of somatic dysfunction
-Tenderness?
- Discomfort of pain elicited by the physician through palpation
- A state of unusual sensitivity to touch or pressure
Describe the elements of somatic dysfunction
-Tenderness-pain-acute?
Sharp, severe, cutting
Describe the elements of somatic dysfunction
-Tenderness-pain-Chronic?
Dull, ache, paresthesias (tingling, burning, gnawing, itching)
Describe the elements of somatic dysfunction
-Tenderness-visceral function-acute?
Minimal somatovisceral effects
Describe the elements of somatic dysfunction
-Tenderness-Visceral function-chronic?
Somatovisceral effects common
Define the term passive range of motion
- The patient is NOT active, completely passive
- Does not require participation of patient
- The examiner takes the patient’s relaxed limb through its complete range
- Because there are no muscles in use (ideally), there are no muscular restrictions, only ligaments to stop motion
- Greater range of motion in passive than active ROM
Define the term active ROM
- The patient demonstrates the activity
- Requires the patient to use their own muscles, agonists and antagonists, to achieve the desired motion
- Because both sides of muscles are in use, the ROM is LESS than passive ROM
- Must have the understanding and cooperation of patient
Define the term anatomic barrier
- The limit of motion imposed by anatomic structure
- Just beyond the limit of PROM
- The point past which tissue disruption occurs
Define the term elastic barrier
- The range between the physiologic and anatomic barriers of motion in which passing ligamentous stretching occurs before tissue disruption
- “The stretch between AROM and PROM”
- Often the area that a “warm up” affects
Define the term pathologic barrier
Permanent restriction of joint motion associated with pathologic changes of tissues
Define the term physiologic barrier
- The limit of active motion
- Can increase ROM by warm up activities
- “As far as you can go by yourself”
Define the term restrictive barrier
- A functional limit within the anatomic ROM, which abnormally diminishes the normal ROM
- Cannot achieve full ROM-something preventing it-muscle contraction, tight ligament, etc.
Define and understand somatic dysfunction
The impaired or altered function of related skeletal components of the somatic system
-Skeletal, arthrodial (joints), myofascial structures, and related vascular, lymphatic, and neural elements
Describe the elements of somatic dysfunction
- Acronym?
- What do each of the letters stand for?
- TART
- Tissue texture changes
- Asymmetry
- Restriction of motion
- Tenderness
Tone
- Definition?
- Contrasts with?
- Normal feel of muscle in the relaxed state
- Contrasts with hypertonicity-at the extreme=spastic paralysis
- Contrasts with hypotonicity-no tone at all=flaccid paralysis
Contraction
Normal tone of a muscle when it shortens or is activated agaist resistance
Contracture
- Abnormal shortening of a muscle due to fibrosis
- Most often in the tissue itself, often the result of a chronic condition
- Muscle is no longer able to reach its full normal length
Spasm
- Abnormal contraction maintained beyond physiological need
- Most often sudden and involuntary muscular contraction that results in abnormal motion
- Usually accompanied by pain and restriction of motion
Bogginess
- Increased fluid in a hypertonic muscle
- Similar to a wet sponge
Ropiness
- Hard, firm, rope or cord-like muscle tone
- Usually indicates a chronic condition
End feel
- The palpatory experience or perceived quality of motion when a joint is moved to its limit-a barrier is approached
- Abnormal end feel-early or late muscle spasm
How somatic dysfunctions are named
- Where they like to live
- Position of ease-if a body segment freely rotates to the left, but is restricted to the right, the restriction is named “rotated left”
