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MSS - OPP Exam 2 > Mechanisms of Activating Forces > Flashcards

Mechanisms of Activating Forces Flashcards

1
Q

somatic dysfunction

A

impaired or altered functions of related components of somatic system

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2
Q

what indicates somatic dysfunction?

A

TART changes

not all TART changes are equal

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3
Q

what predisposes someone to somatic dysfunction?

A 
posture**
gravity
anatomical anomalies
transitional areas** - change in vertebrate
muscle hyperirritability
physiologic locking of joint
adaptation to stressors
trauma
compensation for other structural deficit
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4
Q

viscerosomatic SD

A

rubbery tissue texture change

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5
Q

arthrodial SD

A

bony end feel at restrictive barrier

joint SD**

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6
Q

muscular SD

A

tight, tense end feel

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7
Q

strain/counterstrain SD?

A

tender points have more tenderness

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8
Q

arthrodial SD details?

A

not out of place (subluxed) but won’t complete full ROM

  • say it is restricted
  • tightening of fascia, myofascia, capsular components
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9
Q

two main theories of SD?

A

proprioceptive - proprioception
nociceptive - painful stimulus

**not sure, maybe a combination of the two

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10
Q

proprioceptive theory

A

muscles cause SD
alteration in intrinsic and extrinsic reflexes

inappropriate gamma activity creates imbalanced joint bc of inappropriate muscle length and tone

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11
Q

3 types of neural feedback providing proprioception?

A

1 - primary annulospiral
2 - secondary flower spray ending
3 - golgi tendon organs

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12
Q

primary annulospiral endings

A

transmit info on length/stretch/velocity of muscles

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13
Q

secondary flower spray endings

A

transmit info on length/stretch

**not velocity

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14
Q

golgi tendon organs

A

transmit info on muscle tension

  • contraction induces firing of golgi tendon organs
  • connected in series with extrafusal fibers
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15
Q

muscle spindle?

A

intrafusal fibers in a spindle attached to extrafusal fibers

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16
Q

intrinsic reflex system?

A

involves the muscle spindles

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17
Q

gamma motor neurons

A

intrafusal fibers

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18
Q

alpha motor neurons

A

extrafusal fibers

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19
Q

extrinsic reflex system

A

anterior horn cells of alpha and gamma efferents to muscle receive synaptic impulses from sensory nerves originating in other muscles or organs

important in antagonist/agonist muscle pairs

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20
Q

gamma gain?

A

one of determinants of physiologic motion barrier and barrier of SD

resetting gamma gain my occur via pre or post synaptic inhibition

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21
Q

spinal facilitation

A

asymptomatic areas have increased muscle activity as well as pain and tenderness

a facilitated segment bc it is hyperirritable and hyper responsive
-muscles in this region = hypertonic

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22
Q

somatosomatic reflex

A

defensive reflex

-step on nail, withdraw foot

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23
Q

viscerovisceral reflex

A

signal from organ that goes to another organ

-distension of gut causing increased contraction of gut muscle

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24
Q

somatovisceral reflex

A

stimulation of abdominal skin inhibits activity

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25
Q

viscerosomatic reflex

A

sense from organ affects muscles

ex/ upper back pain with an MI

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26
Q

nociceptive theory

A

noxious stimulus stimulates nociceptor
can either:
-activate sympathetic nerves
-activate skeletal muscle

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27
Q

what can happened with constant contraction of skeletal muscle?

A

lay down fibrous and scar tissue

-bc it is easier for body to maintain shortened muscle by increased connective tissue than simply contracting all the time

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28
Q

OMT techniques do what?

A

actively stretch connective tissue in joint capsules, tendons, muscles, and ligaments in segments of restricted motion

**stretching would typically increased proprioceptive and nociceptive drives

therefore, OMT must first decrease or override these drives prior to stretching the tissues

each technique does this differently

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29
Q

HVLA

A

high velocity low amplitude
aka thrust technique

a direct technique

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30
Q

HVLA best for what?

A

hard bony end feel

  • can feel where lock up joint
  • only forcing a short distance
31
Q

how does HVLA work?

A

abnormal muscle activity maintains joint restriction

treat joint, because it will reflexively reset muscles surrounding it

sudden stretch or change in position of joint alters the afferent output of mechanoreceptors in joint capsule, resulting in release of hypertonicity

32
Q

what is the HVLA pop?

A

release of gas in synovial fluid
snap/release of ligament
bone pulled out and snapped into neutral position

don’t need snap, crackle, pop for treatment**

33
Q

indications for HVLA?

A

firm bony end feel barrier
great for short time
sicker the patient, less the dose

treating same segment with HVLA more than once a week is discouraged (bc of joint hypermobility)

34
Q

absolute contraindications of HVLA?

A 
down syndrome
rheumatoid arthritis
dwarfism
chiari malformation
fracture/dislocation/spinal or joint instability
ankylosis/spondylosis
surgical fusion
klippel-feil syndrome
vertebrobasilar insufficiency
inflammatory joint disease
joint infection
bony malignancy
patient refusal
35
Q

muscle energy technique?

A

MET
using muscles to correct SD
direct technique

36
Q

direct technique

A

towards barrier

37
Q

indirect technique

A

away from barrier

38
Q

good for treating edema/congestion?

A

MET

because muscle contraction for lymphatic and venous circulation

39
Q

steps in MET?

A 
find restriction, take to barrier
patient applies counterforce
have patient relax
wait a couple seconds (2-3 seconds)
-post-relaxation phase***
move to new barrier
repeat until no changes occur

reassess

40
Q

isometric

A

no length change in muscle

41
Q

isotonic

A

length chain and tone of muscles

42
Q

concentric

A

muscle shortening (patient wins)

43
Q

eccentric

A

lengthening of muscle (doc wins)

44
Q

isolytic eccentric

A

quick movement

for fibrotic or chronically shortened myofascial tisues

45
Q

isokinetic

A

length change at constant velocity

46
Q

post-isometric relaxation

A

after patient contracts
-neuromuscular apparatus in refractory state during which passive stretching may be performed without encountering strong myotatic reflex opposition

takes 2-3 seconds for this to occur, so WAIT

47
Q

joint mobilization using muscle force

A

muscular forces

we don’t really do that at RVU

48
Q

respiratory assistance

A

use patient breathing to assist

49
Q

oculocephalogyric reflex

A

using the eye muscles that affect cervical and truncal muscles

50
Q

reciprocal inhibition

A

gentle contraction is initiated in agonist, there is reflex relaxation of that muscles antagonistic group

51
Q

crossed extensor reflex

A

uses cross pattern locomotion in CNS
-left bicep dysfunction, treat right bicep

when flexor muscle contracted, flexor muscle contralaterally relaxes

52
Q

absolute contraindications for absolute?

A

absence of SD
lack of consent
oculocephalogyric reflex - patient had recent surgery or trauma to eye

53
Q

direct MFR

A

restrictive barrier engaged and tissue loaded until relaxes

54
Q

indirect MFR

A

dysfunctional tissue guided along path of least resistance

55
Q

MFR absolute contraindications?

A

absence of SD

lack of consent

56
Q

OCF

A

osteopathy in cranial field

system of diagnosis and treatment by DO using primary respiratory mechanism and balanced membranous tension

can be direct or indirect

57
Q

absolute contraindications for OCF?

A

increased intracranial pressures
acute intracranial bleeding
skull fracture
acute CVA

58
Q

strain/counterstrain technique?

A

take muscle and find tender point then take muscle to the shortened relaxed phase

super shorten muscle - so that the nervous system releases the stimulation allowing it to relax

indirect technique**

59
Q

steps for S/CS

A

10 on pain scale
super shorten muscle to level of 3
maintain for 90 seconds
passively return to original position** important

recheck

60
Q

what forms a tenderpoint?

A

inappropriate proprioceptive reflex caused by gamma system

rapid lengthening of myofascial tissue

  • body tries to prevent damage by rapidly contracting
  • causes antagonist muscle to rapidly lengthen and produces inappropriate reflex and tenderpoint
  • nociceptive feedback from antagonist muscle interpreted as muscle strain
  • hypertonic myofascial tissue and restricted motion (SD)

**guarding reflex by patient may also produce reflex

61
Q

tenderpoints in fascial or ligaments?

A

trauma causes damage to myofascial tissues
nociceptors alert CNS
muscle fatigue due to decreased cellular metabolism
tenderpoint formation

62
Q

absolute contraindications for S/CS

A

absence of SD

lack of consent

63
Q

lymphatic technique

A

designed to remove impediment to lymphatic circulation and promote flow of lymph

a direct technique

64
Q

lymphatic technique mechanisms

A

any treatment reducing fascial restriction can improve lymph flow

65
Q

steps in lymphatic technique

A

start centrally and move peripherally

66
Q

absolute contraindications for lymphatic technique

A

aneuresis if not on dialysis
necrotizing fasciitis (in area involved)
lack of consent

67
Q

soft tissue technique

A

direct technique

stretching, pressure, traction, separation of muscle while monitoring changes by palpation

68
Q

stretching

A

traction

forces along longitudinal axis

69
Q

kneading

A

forces along perpendicular axis (bowstring)

70
Q

inhibition

A

forces superficial to deep over specific area of tension (tender point)

71
Q

effleurage

A

lymphatic treatment superficially
distal > proximal
peripheral > central

72
Q

petrissage and skin rolling

A

deep kneading and skin rolling

-breaks adhesive bands from skin to deeper tissue

73
Q

tapotement

A

repetitively striking muscle belly with hypothenar edge of hand (karate chop!)

74
Q

absolute contraindications for soft tissue technique?

A

absence of SD

lack of consent

MSS - OPP Exam 2 (10 decks)

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