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OPP I Exam 2 > Mechanisms of Activating Forces- Luke > Flashcards

Mechanisms of Activating Forces- Luke Flashcards

1
Q

What are some key diagnostic findings that indicate a SD?

A

short story- TART
long story- Viscerosomatic SD typically has a rubbery tissue texture change
Arthrodial SD usually a bony end feel at the restrictive barrier
Muscular SD has a tight, tense end feel
SD associated with strain/counterstrain tender points have more tenderness

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2
Q

What are some predisposing factors to SD? Discuss because there is a lot.

A 
Posture
Habitual
Occupational
Active (sports related)
Gravity
Body habitus (obesity, pregnancy)
Weight-bearing 
Anatomical anomalies
Vertebra or facets
Transitional areas
OA, thoracic inlet, TL junction, LS junction
Muscle hyperirritability
Emotional stress
Infection
Somatic or visceral reflex
Muscle stress (overuse, overstretch, underpreparation, accumulation of waste products)
Physiologic locking of a joint
Adaptation to stressors
Trauma
Compensation for other structural deficits 
short leg
muscle imbalance
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3
Q

What are the two main theories of the etiology of SD?

A

Proprioceptive and Nociceptive or combo.

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4
Q

What is the proprioceptive theory?

A

Alteration in both the intrinsic and extrinsic reflexes. Inappropriate gamma activity creates inappropriate muscle length and tone, resulting in a functionally imbalanced joint

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5
Q

Spinal facilitation

A

facilitated segment”- plays a part in the etiology of SD because that area is hyperirritable and hyper-responsive – muscles in that region will be hypertonic

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6
Q 
Give examples of these reflexes
Somatosomatic
Viscerovisceral 
Somatovisceral
Viscerosomatic
A

Somatosomatic ex. Defensive reflex
Viscerovisceral ex. Distension of the gut causing increased contraction of the gut muscle
Somatovisceral ex. Stimulation of abdominal skin inhibits gut activity
Viscerosomatic ex. Upper back pain with an MI

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7
Q

What is the nociceptive theory?

A

Pain, lots of pictures in lecture.

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8
Q

Is HVLA a direct or indirect tech.

What is it best suited for?

A

Direct.

HVLA best suited to SD with restricted motion with a hard end feel

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9
Q

Discuss HVLA steps. DONT need to hear a pop.

What is the mechanism?

A

Edge of barrier, no backing of with a HVLA force
Sudden stretch or change of position of the joint alters the afferent output of the mechanoreceptors in the joint capsule, resulting in release of muscle hypertonicity

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10
Q

What are some HVLA indications.

A

SD with distinct, firm barrier mechanics, useful when there is limited time

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11
Q

HVLA contraindications. Absolute. Discuss

A 
Rheumatoid arthritis 
Down syndrome 
Achondroplastic dwarfism 
Chiari malformation 
Fracture / dislocation / spinal or joint instability 
Ankylosis / Spondylosis with fusion 
Surgical fusion 
Klippel-Feil syndrome 
Vertebrobasilar insufficiency 
Inflammatory joint disease 
Joint infection 
Bony malignancy 
Patient refusal
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12
Q

Relative contraindications.

A 
Acute herniated nucleus pulposus 
Acute radiculopathy 
Acute whiplash / severe muscle spasm / strain/sprain 
Osteopenia / Osteoporosis 
Spondylolisthesis 
Metabolic bone disease 
Hypermobility syndromes
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13
Q

Describe MET.

A

Direct, patient pushes upon request.

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14
Q

What is an important step to MET

A

Must pause 2-3 secoonds after contraction before going into the barrier again.

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15
Q

Isometric/Isotonic

Concentric/eccentric

A

No length change/ length change

shortening/lengthening

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16
Q

What is post isometric relaxation?

A

Immediately after an isometric contraction, the neuromuscular apparatus is in a refractory state during which passive stretching may be performed without encountering strong myotatic reflex opposition. All the physician needs to do is resist the contraction, and then take up the soft tissue slack during the refractory period.

17
Q

What is respiratory assistance?

A

Force of respiration that the physician can use.

18
Q

Oculocephalogyric Reflex

A

Functional muscle groups are contracted in response to voluntary eye motion on the part of the patient. These eye movements reflexively affect the cervical and truncal musculature as the body attempts to follow the lead provided by eye motion. It can be used to produce very gentle post-isometric relaxation or reciprocal inhibition.

19
Q

What is reciprocal inhibition?

A

When a gentle contraction is initiated in the agonist muscle, there is a reflex relaxation of that muscle’s antagonistic group.

20
Q

Crossed Extensor Reflex, discuss.

A

This form of muscle energy technique uses the learned cross pattern locomotion reflexes engrammed into the central nervous system.
Important- When the flexor muscle in one extremity is contracted voluntarily, the flexor muscle in the contralateral extremity relaxes and the extensor contracts.

21
Q

MET indications?

A

SD

22
Q

MET absolute contraindications

A

Absence of somatic dysfunction
Lack of patient consent and/or cooperation
Oculocephalogyric reflex technique in someone with recent eye surgery or trauma

23
Q

Relative?

A

Infection, hematoma, or tear in involved muscle
Fracture or dislocation of involved joint
Rheumatologic conditions causing instability of the cervical spine
Undiagnosed joint swelling of involved joint
Positioning that compromises vasculature
Patient with low vitality who could be further compromised (acute post myocardial infarction for example)

24
Q

What is MFR,

what are the types?

A

continual palpatory feedback to achieve release of myofascial tissues
Direct MFR-a myofascial tissue restrictive barrier is engaged for the myofascial tissues and the tissue is loaded with a constant force until tissue release occurs.
Indirect MFR-the dysfunctional tissues are guided along the path of least resistance until free movement is achieved

25
Q

MFR indications

A

Somatic dysfunctions involving myofascial or other connective tissues

26
Q

Absolute contraindications?

A

Absolute*
Absence of somatic dysfunction
Lack of patient consent and/or cooperation

27
Q

Relative Contraindications

A 
Fractures
 open wounds, 
acute thermal injury
soft tissue or bony infections
deep venous thrombosis (threat of embolism) 
disseminated or focal neoplasm 
recent post-operative states over the site of proposed treatment (wound dehiscence)
 aortic aneurysm
28
Q 
Osteopathy in the Cranial Field
Steps: Balanced membranous tension 
Exaggeration 
Directing the tide 
Direct 
Disengagement (articular/suture release)
A

Can be direct or indirect, involves the use of the force of respiration.

29
Q

OCF indications

A 
Cranial Neuropathy-nerve entrapment 
Bell’s palsy 
Trigeminal neuralgia 
Atypical facial pain 
Headache 
Sinusitis 
Orofacial pain 
Vertigo 
Visual disturbances 
Tinnitus 
Temporomandibular Joint Dysfunction 
Malocclusions 
Strabismus 
Strain patterns of the sacrum 
Strain patterns of the axial and appendicular skeleton
30
Q

What is strain/counterstrain technique?

What type of tech is it?

A

An osteopathic system of diagnosis and indirect treatment in which the patient’s somatic dysfunction, diagnosed by an associated myofascial tender point, is treated by using a position of spontaneous tissue release while simultaneously monitoring the tender point.
Indirect

31
Q

What are the important S/CS steps?

Mechanism?

A

Holding it for 90 sec, 120 for ribs.

Reduction of chronic sympathetiic stimulation.

32
Q

S/CS indications

A

Acute or chronic somatic dysfunctions
Somatic dysfunctions with a neural component like a hypershortened muscle
As primary treatment or in conjunction with other approaches
Somatic dysfunctions in any area of the body

33
Q

Absolute contraindications

A

Absence of somatic dysfunction

Lack of patient consent and/or cooperation.

34
Q

Relative

A

Patient who cannot voluntarily relax
Severely ill patient
Vertebral artery disease
Severe osteoporosis

35
Q

What is the soft tissue tech.

A

A direct technique that usually involves lateral stretching, linear stretching, deep pressure, traction and/or separation of muscle origin and insertion while monitoring tissue response and muscle changes by palpation.

36
Q

Styles of soft tissue tech.

A

Stretching, kneading, inhibition, effleurage, petrissage, tapotement.

37
Q

ST indications

A

Somatic dysfunction including:
hypertonic muscles
excessive tension in fascial structures
abnormal somato-somatic and somato-visceral reflexes
Clinical conditions that would benefit from:
enhanced circulation to local myofascial structures
improved local tissue nutrition, oxygenation, and removal of metabolic wastes
improved local and systemic immune responsiveness
As an adjunct to additional manipulative treatment in order to:
identify other areas of somatic dysfunction
observe tissue response to the application of manipulative technique
provide a general state of relaxation
provide a general state of tonic stimulation
prepare tissues for other types of manipulation

38
Q

ST absolute contraindications

A

Absence of somatic dysfunction

Lack of patient consent and/or cooperation

39
Q

Relative

A

Skin: Disorders which would preclude skin contact, e.g., contagious skin diseases, acute burns, painful rashes, abscesses, skin cancers, etc.
Fascia: Acute fasciitis (infectious or autoimmune), acute fascial tears
Muscle: Acute muscular strains, acute myositis, muscle neoplasms.
Ligament: Acute ligamentous sprain, acute ligamentous inflammatory disorders, septic arthritis, primary or secondary joint neoplasms.
Bone: Acute fracture, osteomyelitis, primary or secondary bone tumors, osteoporosis
Viscera: Infectious or neoplastic enlargement of organs such as the liver and spleen. Gastric or bowel obstruction or distention. Acute organ pain, e.g., pyelonephritis. Undiagnosed abdominal or pelvic pain.
Vascular: Hematoma, deep venous thrombosis, uncontrolled bleeding disorders

OPP I Exam 2 (6 decks)

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