Osteopathic Approach To GI Patient

Question 1

What PS structure supplies the lesser curvature of the stomach?

Answer 1

R vagus

Question 2

What kind of pain refers to ipsilateral shoulder?

Answer 2

Phrenic pain

Question 3

What nerve supplies the greater curvature of the stomach and ends at the duodenum?

Answer 3

Left vagus

Question 4

How does lymph from the abdominal viscera drain?

Answer 4

Into the cisterna chyli (L1-L2) –> thoracic duct –> subclavian v.

Question 5

Who thought of normalizing sympathetic processes to achieve homeostasis?

Answer 5

Irvin Korr

Question 6

What are the treatment areas for lymphatics?

Answer 6

Thoracic inlet
Thoracolumbar diaphragm pump
Pelvic diaphragm

Question 7

Clinical findings of sympathetic stimulation?

Answer 7

Ileus
Constipation/flatulence
Abdominal distention

Question 8

What activates pacinian corpuscles?

Answer 8

Stretch, spasm, inflammation, ischemia

SS II

Question 9

Upper GI symp innervation?

PS?

Answer 9

T5-T9, greater splanchnic n., CG

Vagus N
Occiput, C1, C2

Question 10

Lower GI symp innervation (duodenum, jejunum)?

PS?

Answer 10

T10-T11, Lesser s. N., SMG

Vagus n.
Occiput, C1, C2

Question 11

What provides innervation to the proximal 2/3 of the transverse colon?

Answer 11

SMG (T10-T11)

Question 12

Where are chapman’s points located?

Answer 12

Free nerve endings

Question 13

What does PS activation look like clinically?

Answer 13

Increases secretion to GI glands
Diarrhea
GERD

Question 14

What can decrease lymphatic drainage?

Answer 14

Poor efficiency of diaphragm
Torsion of fascia around lymph channels
Irritation of diaphragm by inflammation or perforation

Question 15

Appendicitis is what kind of reflex?

Answer 15

Percutaneous reflex of Morley

NOT Visceral afferent reflex

Question 16

PS to lower gi tract?

Answer 16

pelvic splanchnic nerves

Question 17

If pain increases on abdominal tension test what does it mean?

Pain decreases?

Answer 17

TrP etiology (MSK problem)

Visceral origin

Question 18

What tx can be used to normalize sympathetic activity?

Answer 18

Ventral abdominal inhibition of midline abdominal ganglia

Question 19

5 model approach to GI pt?

Answer 19

Biomechanical 
Respiratory-circulatory
Metabolic-Energy
Neurological 
Behavioral

Question 20

Where do all sympathetics end?

Answer 20

L2

Question 21

What tx of the sacrum decreases PS tone?

Increases?

Answer 21

Sacral inhibition

Sacral rocking

Question 22

Chapman’s points develop secondary to what?

Answer 22

Irritation/inflammation relative to specific organs

Question 23

Lower GI symp innervation?

PS?

Answer 23

T12-L2, least s. N., IMG

Pelvic splanchnic n.
S2-S4

Question 24

Viscerosomatic pain involves what?

Answer 24

Facilitated segment

Question 25

What kind of pain is well localized, asymmetric, aggravated by specific motions, has additive effect?

Answer 25

Somatic pain

Question 26

Vague, cramping, deep burning ache, sweating, N/V, pallor are examples of what?

Answer 26

True visceral pain

Question 27

How to treat chapman’s points?

When is change observed?

Answer 27

Direct circular pressure for 10-30 seconds

24 hours