OOP midterm Flashcards
homeostasis
Tendency of the body to seek and
maintain a condition of balance or
equilibrium within its internal
environment, even when faced with
external changes
Allostasis
body’s attempt to compensate for a stressful
situation in a protective manner
When threatened, the neuroendocrine-immune network-
capable of altering normal homeostatic rhythms
– As threat diminishes, feedback control systems should suppress
levels of allostatic compounds, returning body to normal function
– Disease processes will activate allostatic response
- Frequent activation of stress response
damages body chronically through activation
of the hypothalamic-pituitary adrenal (HPA) axis
– Effects add up progressively (cumulative)
Allostatic load: price paid for chronic exposure
to stress-mediated neuroendocrine adaptations
– Long-term exposure to allostatic chemical
environment (catecholamines, cortisol, cytokines)
* Long-term activation of allostatic mechanism—
gradual destruction of organ systems
– Gradual loss of effectiveness of feedback pathways to
reestablish normal homeostasis
Allostatic load:
Allostatic load: price paid for chronic exposure
to stress-mediated neuroendocrine adaptations
– Long-term exposure to allostatic chemical
environment (catecholamines, cortisol, cytokines)
* Long-term activation of allostatic mechanism—
gradual destruction of organ systems
– Gradual loss of effectiveness of feedback pathways to
reestablish normal homeostasis
Biomechanical Model
patient has T4/T3 restriction, so they would have trouble walking
Uses structural/mechanical perspective to assess patient
* Structural impediment caused by a dysfunction of muscles, joints,
&/connective tissue
Can lead to disturbances in various body functions
- Assess patient for a structural impediment (somatic dysfunction)
– By using OMT to correct somatic dysfunction, patient regains associated structural,
vascular, neurologic, metabolic, & behavioral functions - Objective: Optimize patient’s adaptive potential through restoring
structural integrity & function
Respiratory-Circulatory Model
Evaluation & treatment:
– Maximize capacity & efficiency of respiratory-circulatory functions
maintenance of extra- & intra-cellular environments
– Delivery of oxygen & nutrients
– Removal of cellular waste products
OMT addresses dysfunction in:
– Respiratory mechanics
– Circulation
– Flow of body fluids
restoring fluid circulation
ex: compressed nerved—-> light headed
neurological model
- Sensory & protective
- Focuses on impairments of neural function caused by or cause pathophysiologic responses in
the other 4 domains
relationship between somatic and autonomic NS
- Considers influence on neuroendocrine immune network by:
– Spinal facilitation
– Proprioceptive function
– Autonomic nervous system
– Activity of nociceptors (pain fibers)
compression of vangus nerve, anxiety
IMPAIRMENT OF A NEURAL FUNCTION
neurological model
OMT focus and goal of treatment
- OMT focus
– Reduction of mechanical stresses
– Balance of neural inputs
– Elimination of nociceptive drive - Goal of treatment:
– Re-establish normal/optimal neural function
– Attain autonomic balance and flexibility
– Address neural reflex activity
– Remove facilitated segments
– Decrease afferent nerve signals
– Achieve pain relief
compression of vangus nerve —> anxiety
Metabolic-Energy (Nutritional) Model
Recognizes that the body seeks to maintain a balance between
– Energy production, Distribution, Expenditure
* The body’s ability to restore & maintain health requires energy-efficient response to
infectious agents & repair of injuries
* Proper nutrition enables normal biochemical processes, cellular functions, &
neuromusculoskeletal activity
injury to MSK burdens the energy
diabetic—> weight gain —-> strain on body
Behavioral (Biopsychosocial) Model
- Recognizes that patient’s health includes:
– Mental, emotional, & spiritual state of being
– Personal lifestyle choices - Health is often affected by:
– Environmental, socioeconomic, cultural, & hereditary factors
– Various emotional reactions & psychological stresses - Environmental toxicities, inactivity, lack of exercise, use of addictive substances, poor
dietary choices can diminish a patient’s adaptive capacity, make him/her vulnerable to
infections and/or organ/system failure - Provide patient EDUCATION on:
– Health
– Disease & lifestyle choices
– Mental outlook
– Preventative care
diabetic—> weight gain—>strain on body
Somatic Dysfunction:
“Impaired or altered function of related components of the
somatic (body framework) system: skeletal, arthrodial, and myofascial structures, and
related vascular, lymphatic, and neural elements.”
– Impaired joint mechanics
– Altered mechanics of the associated soft connective tissue (e.g., abnormal
resting length of muscle, alteration of the tension of ligament, aberrant tension
across fascia, strain in the dura, and congestion in the extracellular matrix)
– Dysfunctions of arterial supply, venous and lymphatic drainage, and nerve
conduction
– Changes in the tissues resulting from the foregoing to include tissue texture
change (ropiness,
SAM’S RV LANE
Skeletal,
Arthrodial
Myofascial Structures
Related Vascular
Lymphatic and Neural Elements
Primary Somatic Dysfunction
– The somatic dysfunction that maintains a total pattern of dysfunction including
other secondary (“key lesion”)
– Initial or first somatic dysfunction to appear temporally
– Sudden trauma (usually an external force)
– Postural imbalances, micro trauma and repetitive trauma
Secondary Somatic Dysfunction
– Compensation for a primary problem
– Compensation for musculoskeletal defects
– Reflex response to visceral disease
– Reflex response to emotional stress
– Compensation for a hereditary imbalance
what are the 4 tenets of osteopathic medicine
structure and function relationship example
1892
1874
1918
R.K. Smith, M.D., D.O. presented information collected by the AOA at the Annual
Convention of the American Association of Clinical Research in New York City on
October 18, 1919:
* 2,445 DOs reported on their patients
– Influenza
* 110,120 cases treated
* Only 257 deaths (approximately 0.25% mortality rate)
* Reported MD patient mortality rate was 5%
– Influenza-associated Pneumonia
* 6,258 cases treated
* Only 635 deaths (approximately 10% mortality rate)
* Reported MD patient mortality rate was >30% (3x higher than DO rate)
DO had less death rates overall!!!
INC patient volume for DOs
1961
- 1961 - California Osteopathic Association merged with California Medical Association
- 1961 - The College of Osteopathic Physicians and Surgeons in Los Angeles changed
to an allopathic institution, becoming the California College of Medicine (now the
University of California Irvine School of Medicine) - 1962 - Qualified and consenting D.O.s were conferred M.D. degrees
– About 2,000 D.O.s converted their degree to M.D.
– No additional training/education was required, only an administrative fee of $65
– New degrees only recognized within California & specialists unable to practice as such
– D.O.s would no longer be licensed in the state
HOMEOSTASIS VS ALLOSTASIS
Homeostasis- process how body keeps itself in threshold where body can survive
Allostasis—how the body adapts to stressors ….. When the body is under a lot of stress, the baseline will shift. “body’s attempt to compensate for a stressful situation in a protective manner”
The big goal of Osteopathy is to restore homeostasis
palpation
Application of variable manual pressure upon the surface of the body for the
purpose of determine the shape, size, consistency, position, inherent motility and
health of the tissues beneath.
Observation of Static Landmark
Observation of Static Landmark- in the Mid-Gravity
Line/Plumb Line
- Mid-heel point
- Pubic symphysis
- Umbilicus
- Xiphoid process
- Mid-sternum
- Episternal notch
- Symphysis menti
- Glabella
Anterior Static Landmarks in the Mid-Gravity
Line/Plumb Line
