Lecture 2: Viscerosomatic, Somatovisceral, Viscerovisceral and Somatosomatic reflexes

Question 1

Localized somatic stimuli producing patterns of reflex response in segmentally related somatic structures defines?

Answer 1

Somatosomatic reflex

Question 2

Locaized somatic stimulatio producing patterns of reflex in segmentally related visceral structures defines?

Answer 2

Somatovisceral reflex

Question 3

Localized visceral stimuli producing patterns of reflex response in segmentally related somatic structures defines?

Answer 3

Viscerosomatic reflex

Question 4

Localized visceral stimuli producing patterns of reflex in segmentally related visceral structures defines?

Answer 4

Viscerovisceral reflex

Question 5

A somatosomatic reflex response that occurs when a noxious stimulus is applied to a somatic structure?

Answer 5

Withdrawl response

Question 6

The somatosomatic reflex response that occurs when a stretch receptor is stimulated and the stretched muscle receives the impulse to fire, while its antagonist receives an inhibitory message

Answer 6

Myotatic reflex

Question 7

Nociceptive somatic stimuli results in elevation of heart rate and BP is example of?

Answer 7

Somatocardiac reflex

Question 8

The radiation of pain to the shoulder that occurs with an MI is an example of what kind of reflex?

Answer 8

• Viscerosomatic reflex
• Somatic pain referral due to visceral nociceptive stimuli

Question 9

A group of palpable points occurring in predictable locations on the anterior and posterior surfaces of the body that are considered to be reflections of visceral dysfunction or disease, defines what?

Answer 9

Chapman’s Reflexes

Question 10

Chapman located over 200 center on the body surface and established their association with the visceral and endocrine glands. When did he publish his observations and the first chart?

In what text?

Answer 10

1929

Lymphatic reflexes: a specific method of osteopathic diagnosis and treatment

Question 11

Chapman’s Reflexes are manifested by _________ contractions, which are believed to be congestions within ________?

Answer 11

• Gangliform contractions
• Congestions within fascia due to lymph stasis secondary to visceral dysfunction

Question 12

What are the 3 component characteristics of Chapmans Reflexes?

Answer 12

1) Viscerosomatic reflex of both diagnostic and treatment value
2) Gangliform contraction that blocks lymphatic drainage and causes SNS dysfunction (neurolymphatic)
3) A consistent reproducible series of points both anterior and posterior related to specific organs or conditions

Question 13

What are the palpatory features of Chapman’s points?

Size?

Consistency?

Answer 13

• Located deep to the skin in the subcutaneous areolar tissue on deep fascia or periosteum
• Paired anterior and posterior points in most cases
• Small, smooth and firm nodule (boba tea pearls)
• ~2-3 mm in diameter
• Dense, but not hard

Question 14

Owens desribed Chapman’s points using what 5 adjectives?

Answer 14

1) Gangliform
2) Edematous
3) Ridge-like or ropy
4) Fibrospongy
5) Shotty

Question 15

For a CR point to be positive, what is the criteria?

Generally recommended to initially use which CR for diagnostic purposes?

Answer 15

• Both anterior and the posterior CR should be
• Initially use the anterior CR for diagnostic purposes

Question 16

Once a CR is found and isolated what kind of pressure should be applied by examiner?

Answer 16

GENTLE and FIRM pressure

Question 17

The pain elicited by a CR is characteristically?

Answer 17

Pinpoint, sharp, and non-radiating

Question 18

What are the 2 principles when using CRs as a diagnostic tool?

Answer 18

1) Never make a diagnosis based solely on a nontender CR
2) Never ignore or trivialize a tender CR, unless you have a good explanation for the findings

Question 19

What are the contraindications for treating CRs?

Answer 19

1) Anytime a patient is emergent care the emphasis is always on Airway, Breathing, and Circulation, not OMT
2) Patient refusal
3) Relatively contraindicated with fracture and cancer, other patient instabilitiy

Question 20

How would you document a Chapmans reflex on right lower lung in SOAP note?

Answer 20

Objective: Musculoskeletal: Chapman’s reflex on right for lower lung

Assessment: Somatic dysfunction, other

Plan: OMT done using soft tissue, lymphatics

Question 21

What are the post-treatment recommendations after treatment of Chapman’s reflex?

Pain management meds?

Answer 21

• Drink plenty of water (1-3 liters) over the next 24 hours (adults)
• Patients may take what they ‘normally’ take for pain management, as long as there are no other contraindications

Question 22

In 1901, Chapman had a patient with severe _______ whose response to osteopathic treatment directed to the spine was slow.

Answer 22

Adenoiditis

Question 23

Indications for diagnosis and for treatment of Chapman’s Reflexes?

Answer 23

For diagnosis: as part of a screening exam when clinically indicated from patient history

For treatment: upon finding a CR that is possibly clinically relevant for the patient

Question 24

Where is the anterior Chapman’s Reflex for Stomach acidity?

Answer 24

L 5th ICS

Question 25

What are the Anterior and Posterior Chapman’s points for Tonsilitis?

Answer 25

Anterior: 1st ICS

Posterior: C1, midway along the articular process

Question 26

What are the Anterior and Posterior Chapman’s points for Pharyngitis?

Answer 26

Anterior: 1st rib, where the clavicle crosses it

Posterior: C2, midway between SP and TP