MIS 1 Flashcards

1
Q

Central Nervous System (CNS)

A

Brain and spinal Cord. Integrative and controls other centers.

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2
Q

Peripheral Nervous System (PNS)

A

Cranial Nerves and spinal nerves. Communication lines between the CNS and the rest of the body.

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3
Q

Autonomic Nervous system

A

ANS monitors and controls visceral functions that are below the level of consciousness, including breathing, heart rate, salivation, perspiration, and pupillary dilation. This ANS is subdivided into 2 division: sympathetic and parasympathetic.

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4
Q

Sympathetic Nervous System

A
– “Fight or flight” response
– Adrenaline and Norepinephrine release
– Hypertonicity
– In a state of stress and anxiety
– Factors that Increase SNS: hyperinflation, stimulate auditory and visual inputs, stressful environment
– Sympathetic duct compression
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5
Q

Parasympathetic Nervous system

A

– “Rest and Digest” response
– Body returns to normal homeostasis
– Decrease muscle tone
– Factors that increases PNS activity = Breathing, Low frequency sounds, low level light, calm environment, warm colors

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6
Q

Sympathetic Nervous System Effects on the Body

A
Dilates pupil
Inhibits salivation
Relaxes bronchi
Accelerates Heart
Inhibits digestive activity
Stimulates glucose release by liver
secretion of epinephrine and norepinephrine from kidney
relaxes bladder
contracts rectum

Direct influence of the SNS: increase motor output such as increase in muscle tone, muscle length, muscle twitch force, myocardial relaxation rate.

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7
Q

Parasympathetic Nervous System Effects on the Body

A
Contracts pupil
Stimulates salivation
Inhibits heart
Contracts bronchi
Stimulates digestive activity
Stimulates gallbladder
Contracts bladder
Relaxes rectum
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8
Q

Cerebrospinal Fluid (CSF)

A

CSF has a number of other crucial roles to play:
• Flush out waste product from CNS
• Provides the protection of the brain
– acting as a shock absorber and helping to maintain the shape of the brain

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9
Q

Primary Respiratory System (PRS)

A
The deepest connection between structure and function.
PRS is comprised of
1. CSF
2. CNS
3. Dural membrane
4. Primary Respiratory Fulcrums (PRF)
5. Primary Respiratory Levers (PRL)
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10
Q

Two phases of Primary Respiration (Primary Inhalation & Primary Exhalation)

A

Primary Inhalation: a subtle motion occurs in fluid and tissues, which rise upwards and at the same time expands from side to side.
Flexion + ER + Abduction

Primary exhalation: motion that generally recedes down toward the lower part of the body and narrows from side to side.
Extension + IR + Adduction

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10
Q

Primary Respiratory Fulcrum

A

3 Major fulcrum

  1. Sphenoid
  2. sternum
  3. sacrum

The energy that provides the power for primary respiration is found at these fulcrum points, so they are significant places for the functioning of the body. Any kind of motion is organized around a fulcrum, and levers get their power to produce motion from their fulcrum points.

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11
Q

Primary Respiratory Levers (PRLs)

A

Maxilla
Respiratory Diaphragm
Pelvic floor diaphragm

These levers are also known as transverse diaphragm.

Restrictions at the PRLs commonly act as sites of restriction of the expression of primary respiration.

Psychotherapists notes that PRLs are places where the flow of feelings and sensations often become blocked.

Part 1 pg. 99

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12
Q

5 Mocean Principles

A
  1. we are dynamically designed creation
  2. everything begins at the AXIAL system through ‘core-link’
  3. Everything is connected to everything else and body functions as a totality
  4. Motion and respiration are executed in reciprocal alternating manner
  5. We are asymmetrically designed creation
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13
Q

Mocean Principle #1

A

We are created as dynamic creatures

breath about 21,000 - 22,000 times a day.
7-8 liters of air / min
~11,000 liters of air in a day

We move during our sleep (circulation, hormone production, cellular regeneration, etc)

Our body constantly needs to alternate

  1. static posture compromises respiratory dynamics
  2. switch out of a sympathetic-dominant state and into a more parasympathetic-dominant resting state
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14
Q

Mocean Principle #2

A

Everything begins at the AXIAL system

The axial structure acts as the natural fulcrum around which all aspects of PRM are expressed.

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15
Q

Mocean Principle #3

A

Everything is connected to everything else and body functions as a totality through

  1. Core-link
  2. Kinetic & potential chain of connective tissues - lower kinetic chain, L potential chain - upper kinetic chains - cranio-cervical kinetic chain - appendage chain

The different parts of the body often get separated for the purposes of study or examination, but in reality they are part of an interdependent system.

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16
Q

Mocean Principle #4

A

Reciprocal alternating tension & movement pattern.

All of bones, membranes, fluids and organs of the body express primary respiration as reciprocal pattern of movement.

The cyclical rhythms of primary respiration have the characteristic of reciprocal tension, a kind of tensile pushing and pulling produced in the body.

17
Q

Mocean Principle #5

A

Asymmetrically designed creation

the neurological, respiratory, circulatory, muscular and vision system are not the same on the left side of the body as they are on the right.

Left side:
- heart, stomach, spleen, descending colon

Right side:
- Liver, Gallbladder, ascending colon

Vagus nerve: right vagus nerve is longer than the left with different innervation patterns.

There is asymmetry in lungs as well.

  • 3 lobes on the right side
  • 2 lobes on the left side

There is asymmetry in diaphragm as well!

  • right diaphragm has a larger diameter (it’s bigger)
  • right has a thicker & larger central tendon
  • right has a higher dome, and is better able to maintain this shape

*Considering the size differential between the right and left diaphragm, contraction force of the diaphragm will not be equal.

18
Q

Lateralization of Human body

A
  • stronger, bigger, better positioned right diaphragm and the second heaviest organ, which is liver positioned on the right side, will shift the center of mass over to the right.
  • problem rises when we get stuck in one pattern and not be able to reciprocate the movement
  • when we are not alternating side to side, there is restriction in the Primary Respiration System and therefore whole body gets affected by it.
19
Q

Effect of RDP on PRF and PRL

A
  • RDP has an influence on the PRF, PRL and other connective tissues as a whole
  • Any kind of motion is organized around a Primary Respiratory Fulcrum, the still point around which things move.
  • Primary Respiratory Levers (diaphragms) get their power to produce PRM from their fulcrum points
  • If PRF is not positioned right, PRL will not be able to produce proper PRM (primary respiratory movement/mechanism) and therefore, affect the whole body.
20
Q

Relationship of Pelvic girdle and movement

A
  • Pelvic girdle is the foundation of the spine and helps support the weight of the whole trunk
    - What is pelvic girdle?

In discussing the pelvis, a distinction can be made between the “pelvic spine” and the “pelvic girdle.” The pelvic girdle, also known as the os coxae, Latin for “bone of the hip,” consists of the fused bones identified individually as the ilium, ischium, and pubis. The ring of this girdle is closed in the anterior by the pubic symphysis between the left and right pubic bones, and in the posterior between the left and right ilia and the sacrum at the sacroiliac joints. The pelvic spine consists of the sacrum and coccyx. Together these two parts form the bony pelvis.

  • The movement of the lower extremity supports the head, arm, and trunk
  • Control of HAT balance is achieved by reciprocal rotation of the upper extremity and lower extremity.
  • Pelvis plays an important role that facilitate gait and respiration
21
Q

RDP - state of the right side and left side

A

Right side:

  • state of exhalation
  • state of stance phase (R PC)

Left side:

  • state of inhalation
  • state of swing phase (L KC)
22
Q

RDP and Pelvis position

A
  • In RDP, pelvis is rotated to the right (right pelvic torsion) and COM is shifted over to the right.
  • Right torsion of L4-5 and sacrum
    - Right sacroiliac distraction
    - Left sacroiliac compression
  • Left ilium is in a state of “flexion” and “external rotation”. Closure of left obturator foremen
  • right hip is in a state of “extension” and “internal rotation”
23
Q

Positional influence of RDP on Pelvic diaphragm (PRL) outlets

A

L anterior pelvic outlet becomes weak and stretched

  • iliococcygeus
  • obturator internus
  • pubococcygeus

L posterior pelvic outlet becomes strong and tight

  • Gluteus Maximus
  • Piriformis
  • Coccygeus
24
Q

Origin of RDP and how it affects the spine

A
  1. The diaphragm pulls the dorsal (thoracic) spine up & forward
    • diaphragm has a poor supply of proprioceptors and it more then likely is guided by intercostal-to-phrenic reflexes (I-P reflex) and form of thorax. I-P reflex can be facilitated when sitting with proper lower thoracic support at the T10-T12 level.
      - So maybe that’s why diaphragm pulls the thoracic spine up and forward?
  2. Left psoas & iliacus pull the lumbar spine & pelvis down & forward
  3. These 2 forces pull the dorsolumbar spine forward increasing lumbar lordosis, anterior pelvic tilt & active lumbar extension.
  4. As a result, left thoracic & pelvic diaphragm decrease diaphragmatic respiratory effectiveness since it becomes more tonic as a postural muscle.
25
Q

Potential Chain of Muscles (PC) in RDP

A

Potential chain of muscles include
Muscles that turn on during the stance phase of gait (when the potential energy is the greatest)

  1. Diaphragm
  2. Psoas
  3. Iliacus
  4. TFL
  5. Internal & External Oblique
  6. G. Max & Medius
  7. Hamstring
  8. Adductor Magnus

In RDP - R PC becomes overactive

26
Q

Lower Kinetic chain of muscles (LKC)

A

Group of muscles that turn on during the swing phase of the gait

  1. Diaphragm
  2. Psoas
  3. Iliacus
  4. TFL
  5. Rectus Femorus
  6. Vastus Lataris

In RDP - L KC becomes overactive

27
Q

RDP -> Left side stance and right side stance

A

Left side: L KC is always “on” even when the weight is on the L foot.

Ride side: R PC is always “on” even when the right foot is not on the ground

Problems arises when L KC & R PC muscles don’t properly turn off during the stance phase of the left foot

This results in a lack of true tri-planner movement through the pelvis will lead to the thorax and neck to move with compensatory pattern

one of the most problematic possible compensatory activity is that a stronger faulty movement pattern and reflexive adaptation and improperly sense the ground during the gait.

28
Q

General Treatment Approach to RDP

A
  1. We first should start with achieving neutrality of the body - akin to a lack of commitment to one side or another
  2. Just because you are standing on your L foot, does not mean you are shifting weight to the L (or lateralized to the left)
  3. We can dampen this rightward bias so that it no longer interrupts our ability to shift to the left side for reciprocal alternating movement
  4. Neutrality does not guarantee alternating activity to happen
  5. After achieving systemic neutrality, retraining leftward biased movement patterns (LDP) is essential to get our body to fully alternate
  6. To accomplish this, we have to inhibit the overactive chain of muscles and facilitate weakened muscles that reflect RDP
29
Q

Ligaments: sensory organ

A
  1. Ligaments are generally viewed as passive structural elements. But it’s a primary sensory organ.
  2. There is considerable evidence to suggest that ligaments function as neural sensors to facilitate supportive reflex contractions of muscles.
  3. Ligaments are designed for check motion as well as structural stability
  4. Ligaments are associated with neural apparatus as well as the structural support.
30
Q

Patients with RDP and their Lower extremity dominance

A

Patient with RDP, L LKC over activty often demonstrate R LE dominance by “increasing their right stance phase time”

31
Q

Lumbo-Pelvic Ligamentous Muscles

A

Ligament - Agonistic Muscles

Iliolumbar - Quadratus Lumborum, Iliacus

Sacrospinous - Lower Gluteus Maximus, Piriformis

Posterior sacroiliac - Hamstring, Upper Gluteus Maximus

Sacrotuberous - Biceps Femoris (Hamstring)

Pubic ligaments - Rectus Abdominis, External Oblique, Pyramidalis, Adductor Magnus

32
Q

Ligament Description

A

Interosseous Ligament: strongest of the posterior ligament. Restrict sacral nutation and posterior pelvic rotation

Posterior Sacroiliac: restricts Counternutation and anterior pelvic rotation

Sacrotuberous: Restrict the amount of the upward movement of the inferior sacrum.

33
Q

Femoral Acetabular Joint Dynamic

A
Iliofemoral ligament (ant lig) - prevent hyperextension of the FA joint by twisting the femoral head into the acetabulum
   -Agonistic Muscle: gluteus medius, TFL, pectineus, Vastus Lateralis
Pubofemoral Ligament (ant lig) - prevent over-abduction of the hip, by tightening during extension & abduction of the FA joint
   -Ischiocondylar Adductor, Pectineus, Adductor Brevis
Ischiofemoral ligament (post lig) - prevent hyperextension of the FA joint, and internal rotation of the FA joint.
   -Gluteus Maximus, Quadratus Femoris, Obturator
34
Q

Positional Influence of muscle chains on Femoral Stabilizers & Gait

A
  1. Over activity of L KC drives the body into the right side, which leads right leg to position in the internally rotated state
  2. The left side needs to externally rotate to avoid tripping when you walk, and this is compensatory part of the left leg. Part in the right side is positional, and part in the left side is compensatory
  3. Overactive L KC lead to compensatory L Acetabular Femoral ER pattern, which have potential to over stretch the anterior ligaments and cause ligamentous laxity.
  4. Overactive R PC lead to excessive right Acetabular Femoral IR, which can cause posterior ligament laxity.

AF is the most important part in the treatment / performance perspective

35
Q

RDP influence on Muscle Length and Strength - Flexors

A

Iliacus / Psoas (ER) - Left side - Short and strong (compensatory). Overactive as a flexor and ER.

Iliacus / Psoas (ER) - Right side - Long and weak (positional)

Rectus Femoris (ER) - Left side - Short and Strong (compensatory)

Rectus Femoris (ER) - Right side - Long and Weak

TFL (IR) - Left side - short and strong (positional)
TFL (IR) - Right side - short or normal

Pectineus (IR > 90 hip flexion) - Left side - Long and weak (compensatory)

Pectineus (IR > 90 hip flexion) - Right side - Short and strong

36
Q

RDP influence on Muscle Length and Strength - Extensors

A

Biceps Femoris (ER) - Left side - Long and weak

Biceps Femoris (ER) - Right side - Long secondary to IR. Strong secondary to extension (positional)

Semi-tendinosis & semi-membranosus (IR) - Left side - Longer and weaker (compensatory)

Semi-tendinosis &semi-membranosus (IR) - Right side - Short and Strong (positional)

Glut Max (ER) - Left side - External rotators fibers: short and strong (compensatory) // Extension fibers: Long and weak (positional)

Glut Max (ER) - Right side - External rotators fibers: long and weak (positional) // extension fibers: Short and Strong (positional)

37
Q

RDP influence on Muscle Length and Strength - Abductors

A

Posterior Glut Med (ER) - Left side - Short and Strong (compensatory)

Posterior Glut Med (ER) - Right side - Long and weak (positional)

Anterior Glut Med (IR) - Left side - Long and weak (compensatory)

Anterior Glut Med (IR) - Right side - Long but strong (positional)

38
Q

RDP influence on Muscle Length and Strength - Adductor

A

Adductor Magnus and Longus (ER) - Left side - long and weak (compensatory)

Adductor Magnus and Longus (ER) - Right side - Short and Strong (positional)

Ischiocondylar Adductor (IR) - Left side - Longer and weaker (compensatory)

Ischiocondylar Adductor (IR) - Right side - Shorter and stronger (positional)

39
Q

RDP influence on Muscle Length and Strength - Rotators

A

Piriformis (ER) - Left side - Short and Strong (compensatory)

Piriformis (ER) - Right side - Long and weak (positional)

Obturator Internus (ER) - Left side - Short, straight and weak

Obturator Internus (ER) - Right side - Long, angled and weak (positional)

Vastus Lateralis (IR) - Left side - Long and weak (compensatory), but it can also be Short and strong

Vastus Lateralis (IR) - Right side - Short and strong