Osteopathic Approach To GI Patient Flashcards
What PS structure supplies the lesser curvature of the stomach?
R vagus
What kind of pain refers to ipsilateral shoulder?
Phrenic pain
What nerve supplies the greater curvature of the stomach and ends at the duodenum?
Left vagus
How does lymph from the abdominal viscera drain?
Into the cisterna chyli (L1-L2) –> thoracic duct –> subclavian v.
Who thought of normalizing sympathetic processes to achieve homeostasis?
Irvin Korr
What are the treatment areas for lymphatics?
Thoracic inlet
Thoracolumbar diaphragm pump
Pelvic diaphragm
Clinical findings of sympathetic stimulation?
Ileus
Constipation/flatulence
Abdominal distention
What activates pacinian corpuscles?
Stretch, spasm, inflammation, ischemia
SS II
Upper GI symp innervation?
PS?
T5-T9, greater splanchnic n., CG
Vagus N
Occiput, C1, C2
Lower GI symp innervation (duodenum, jejunum)?
PS?
T10-T11, Lesser s. N., SMG
Vagus n.
Occiput, C1, C2
What provides innervation to the proximal 2/3 of the transverse colon?
SMG (T10-T11)
Where are chapman’s points located?
Free nerve endings
What does PS activation look like clinically?
Increases secretion to GI glands
Diarrhea
GERD
What can decrease lymphatic drainage?
Poor efficiency of diaphragm
Torsion of fascia around lymph channels
Irritation of diaphragm by inflammation or perforation
Appendicitis is what kind of reflex?
Percutaneous reflex of Morley
NOT Visceral afferent reflex
PS to lower gi tract?
pelvic splanchnic nerves
If pain increases on abdominal tension test what does it mean?
Pain decreases?
TrP etiology (MSK problem)
Visceral origin
What tx can be used to normalize sympathetic activity?
Ventral abdominal inhibition of midline abdominal ganglia
5 model approach to GI pt?
Biomechanical Respiratory-circulatory Metabolic-Energy Neurological Behavioral
Where do all sympathetics end?
L2
What tx of the sacrum decreases PS tone?
Increases?
Sacral inhibition
Sacral rocking
Chapman’s points develop secondary to what?
Irritation/inflammation relative to specific organs
Lower GI symp innervation?
PS?
T12-L2, least s. N., IMG
Pelvic splanchnic n.
S2-S4
Viscerosomatic pain involves what?
Facilitated segment
What kind of pain is well localized, asymmetric, aggravated by specific motions, has additive effect?
Somatic pain
Vague, cramping, deep burning ache, sweating, N/V, pallor are examples of what?
True visceral pain
How to treat chapman’s points?
When is change observed?
Direct circular pressure for 10-30 seconds
24 hours
