Lecture 5 Flashcards

1
Q

What is soft tissue?

A

living tissue in the body other than bones

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2
Q

is bones soft tissue

A

nooooo

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3
Q

ex of soft tissue

A
fascia
muscles
organs
nerves 
vasculature
lymphatics
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4
Q

where is soft tissue techniques applied to

A

muscular and fascial structures

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5
Q

what do soft tissue techniques affect

A

assx neural and vasculature elements

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6
Q

Soft tissue preparation helps improvement of ___________

A

articular motion

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7
Q

Does soft tissue have a wide range of applications of force or narrow range?

A

wide

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8
Q

what makes ST techniques one of the most versatile treatments forms?

A

it can span a wide range of applications of force

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9
Q

fascia atatomy- soft tissue

A

collagen and elastin in a network of proteoglycans (PGs) that link the collagen in it,

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10
Q

ECM makes up how much of soft tissue

A

95%

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11
Q

what is fascia

A

a complete system with [blood supply], [fluid drainage] and [innervation]

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12
Q

what is the largest organ in the body

A

fascia

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13
Q

job of fascia

A

protect tissues

heal surrounding systems

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14
Q

What is NOT fascia

A

tendons
ligaments
aponeuroses

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15
Q

What are the layers of fascia

A
  1. Pannicular fascia (panniculus)
  2. Axial and appendicular fascia
  3. Meningeal fascia
  4. Visceral fascia
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16
Q

What is the most outerlayer of fascia

A

pannicular fascia

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17
Q

tell me about pannicular fascia

A
  • outermost layer
  • derived from somatic mesenchyme
  • surrounds entire body except orifices
  • outer layer is adipose tissue
  • inner layer is membraneous and adherent to outer
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18
Q

pannicular fascia is derived from

A

somatic mesenchyme

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19
Q

outer layer of pannicular fascia is made up of

A

adipose tissue

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20
Q

inner layer of pannicular fascia is

A

membraneous and adherent to outer

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21
Q

What layer of fascia is called the investing layer

A

axial and appendicular fascia

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22
Q

tell me about axial and appendicular fascia

A

below pannicular layer

surrounds all muscles, periosteium of bone and peritendon of tendons

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23
Q

what does the axial and appendicular fascia surround

A

muscles
perosteum of bone
perosteium of tendon

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24
Q

fascia is omnipresent

A

its EVERYWHERE. covers EVERYTHING

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25
Q

if we take off all of the fascia, what are we

A

bones

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26
Q

fascia is also called

A

perimysium

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27
Q

is fascia continuous?

A

yes. from head to toe it is continuous.

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28
Q

what does it imply that fascia is continuous

A

a problem with fascia at one place may affect ROM in another place

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29
Q

Meningeal fascia

A

surrounds the NS

includes the dura

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30
Q

what part of fascia is the dura

A

meningeal

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31
Q

Visceral fascia

A

surrounds the cavities of the body

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32
Q

ex. of visceral fascia

A

pleural
pericardial
peritoneum

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33
Q

omnipotent fascia

A

its POWERFUL- stabilizes and mobilizes musculoskeletal system

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34
Q

is fascia elastic or contractile

A

both

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35
Q

what allows fascia to be contractile

A

myofibroblasts

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36
Q

what does it mean that fascia is a visoelastic material

A

deforms according to the [rate of loading] and [deformity].

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37
Q

stress

A

force that we use to deform CT

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38
Q

Strain

A

percentage of deformation of the tissue

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39
Q

stress produces a _____

A

strain

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40
Q

increase stress = ______ strain

A

increase

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41
Q

during cyclic loading of a tendon, what direction does the stress-strain curve move?

A

RIGHT

giving us better mobility

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42
Q

Hysteresis

A

difference between the loading and unloading characteristics repersents NRG that is lost in the CT system

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43
Q

What happens if we stretch CT into its plastic deformational range?

A

lengthens it

44
Q

because our fascia is viceroelastic, what must we do

A

keep stretching it

45
Q

what is tissue creep

A

used in direct methods, MFR

under a sustained constant load, CT will elongate (deform)

46
Q

for tissue to creep, constant load must be

A

below failure threshold

47
Q

what is ease

A

direction CT is moved most easily during deformational stretching

48
Q

other words for ease

A

looseness

laxity

greater degree of mobility

49
Q

what is bind

A

palpable restriction of CT mobility

50
Q

the restriction of fascia at one area will do what?

A

create CT restrictions at OTHER areas away from the initial site

or may increase mobility at other places

51
Q

What is the result of the “fascial sweater”

A

abnormal myofascial and joint mobility

52
Q

newtons third law

A

when two bodies interact the forces exerted are equal in magnitude and oppisite in direction

53
Q

hookes law

A

the strain (deformation) placed on an elastic body is proportionate to the stress (force) we use

54
Q

one word for strain

A

deformation

55
Q

one word for stress

A

force

56
Q

Wolffs law

A

fascia will develop/reform based on the stress we put on it

57
Q

energy in the fascia is ____ and _____ according to wolfs law

A

stored

releasesd (piezoelectricity)

58
Q

AROM, PROM

what is changed when a restrrictive barrier is present

A

BOTH

59
Q

direct techniques

A

restore motion by going INTO restrictive barrier

60
Q

indirect techniques

A

restore motion by going AWAY from restrictive barrier

61
Q

indirect techniques will have what effects?

A

shift our abnormal neutral barrier

62
Q

for someone more sick or with more severe injuries, what do you use,

direct or indirect

A

indirect

63
Q

how are tightness and looseness related

A

for every tightness, there is 3-D looseness that is usually in the exactly opposite direction from tightness

64
Q

sherringtons law

A

whena muscle receives nerve impoulse to contract

the antagonist m will receive an impulse at the same time to relax

65
Q

if our right clavicle area is tight, what will the left clavicle be

A

probably loose

exactly opposite

66
Q

what is the common compensatory pattern

A
LRLR
head tilted left
cerivcal-thoracic junction R
thoraco-lumbar- L
lumbo-sacral- R

80% of people

67
Q

What is the uncommon compensatory pattern

A

RLRL

20% of people

68
Q

when do uncompensated patterns occur

A

these are usually accompanied with symptoms and trauma

69
Q

what is the ideal pattern?

A

depends on the pt

70
Q

transition zones of spnie

A
  1. OA, C1, C2
  2. C7-T1
  3. T12-L1
  4. L5-sacrum
71
Q

Transverse restrictors

A
  1. tentorium cerebelli
  2. thoracic inlet
  3. thoracolumbar diaphragm
  4. pelvic diapragm
72
Q

how can we test compensatory patterns

A

motion test at transition zones

73
Q

what are soft tissue techniques

A

diagnose and tx tissues OTHER than skeletal or arthoidal

74
Q

ST

Tissue texture abnormality and assymetty goals

A
  1. Stretch and increase elasticity

2. Improve nutrition, oxygenation and remove wastes

75
Q

ST

Asymmetry of muscles bc hypertonic or spastic goals

A

return symmetry and normalize tone

76
Q

ST

Restriction motion due to myofascial restrictions goals

A

set fascia free

77
Q

ST

tenderness due to abnormal neurologic activity goals

A

normals neurologic activity (pain, guarding and propioception)

improve abnormal somato-somatic

and somato-visceral reflexes

78
Q

ST indication

A
  1. diagnostically identify areas of ROM, tissue texture changes, sensitivity
  2. feedback about tissue response to OMT
  3. imporve immune response
  4. relax
  5. enhance circulation
  6. tonic stimulation
79
Q

ST RELATIVE contraindications

A
  1. Severe osteoporosis

2. Acute injuries

80
Q

what techniqies are contraindicated in the thoracoacostal region

what can we use instead

A

prone pressure techniques

we can use lateral recumbant

81
Q

absolute contraindications

A

we cannot use in the local region for any of the following conditions

  1. fracture/dislocation
  2. neurological entrapment syndrome
  3. serious vascular compromise
  4. local malignancy
  5. local infection

6 bleeding disorders

82
Q

Principle of ST techniuq

A
  1. patient should be comfortable
  2. doc should be comfy
  3. at first, apply gentile forces rhymically for about 1 to 2 seconds

increase amplitude but keep rate same

83
Q

should ST techniques be uncomfortable?

A

no. they should be comfortable or a GOOD discomfort

84
Q

should we create friction on skin in ST?

A

no. hands should carry skin and tissue

85
Q

When do we stop ST technique?

A

when amp has reached max and has plateued

then reassess

86
Q

what is stretch

A

aka parallel traction

increase distance between origin and insertion

87
Q

in stretches, what way do we stretch

A

parallel with muscle fibers

88
Q

how can we stretch parallel with fibers?

A

stabilize one side and pull other

or pulling in opposite directions of each hand

89
Q

taffy pull=

A

stretch

90
Q

kneading is also called

A

perpendicular traction

91
Q

how do we knead

A

push PERPENDICULAR to the fibers

92
Q

bowstring=

A

kneading

93
Q

inhibition

A

push and hold perpendicular to fibers at the musculotendinous part

94
Q

ST strategies

A

stretch

knead

inhibition

95
Q

MFR uses what kind of feedback

A

continual palpatory feedback to achieve the release of myofascial tissues

96
Q

is MFR direct or indirect?

A

both.

Tissue creeps at direct

97
Q

when can we say that tissue creeps

A

direct MFR

98
Q

what does INR stand for

A

integrative neuromusculoskeletal release

99
Q

What is INR

A

a treatment where combined procedures are made to stretch and reflexively release ST

uses all three planes

100
Q

INR use what/

A

release enchancing maneuvers (REMS)

101
Q

REMS

A

release enhacing maneurvers.

used by INR

102
Q

what are example of REMS

A

breath holding

prone and supine simulated swimming nad pedulum arm swim

R/L cervical rotation

isometric limb and neck movements against table, chair

patient evoked movements from cranial nerves (eye, tongue, jaw)

103
Q

what are the indications for MFR?

A
  1. Somatic dysfunction
  2. when HVLA or muscle NRG is contraindicated (consider indirect MFR)
  3. when counterstrain is difficult due to pts inability to relax
104
Q

absolute contraindications ofr MFR

A

no consent

no SD

105
Q

relative contraindication

A
  • infection
  • fracture, avulsion, disolaction
  • metastatic dz
  • soft tissue injuries: thermal, hematoma, open wounds
  • wounds
  • rheumatalogic condition that involves instability of cervical spnine
  • DVT (deep vein thrombosis) or anticoagulation therapy
106
Q

When do we stop MFR

A

when we feel

  1. warmth
  2. softening
  3. increased compliance/ ROM
  4. activating forces no longer make a change
107
Q

what do we do when we are done with MFR

A

check and see if tissue is symetrical