Osteopathic Principles

Question 1

Name the five principal domains

Answer 1

Physical
Cognitive
Affective
Social
Spiritual

Question 2

What are the eight osteopathic principles?

Answer 2

• the body is a unit
• structure and function are reciprocally related
• the body possesses self-regulatory mechanisms
• the body has the inherent capacity to defend and repair itself.
• disease ensures when normal adaptability is disrupted, or when environmental factors overcome the body’s capacity for self-maintainance.
• movement of body fluids is essential for health
• nerves play a crucial role in movement of body fluids
• somatic components of a disease may be a manifestation and also maintenance of the diseased state (eg. appendix - abdominal wall tenderness)

Question 3

Give two examples of ‘the body is a unit’

Answer 3

mechanical;
injured knee - abnormal gait - strain on spine

visceral;
lung disease - reduced O2 in blood - reduced tissue perfusion

Question 4

Finish this sentence; when normal adaptability is disrupted….

Answer 4

or when environmental changes overcome the body’s capacity for self-maintenance, then disease may ensue.

Question 5

How do the nerves control the movement of body fluids?

Answer 5

the sympathetic n.s. influences movement through vessels via neurological tone in smooth muscle of vessel walls.
Tendonitis may be slower to heal if dysfunction in upper thoracic spine.

Question 6

What does TART stand for?

Answer 6

Tenderness
Asymmetry
Range of movement altered
Tissue textile abnormalities

Question 7

Four common causes of somatic dysfunction

Answer 7

microtrauma - daily strain
macrotrauma - injury
inflammation - various sources
poor postural mechanics

Question 8

SD - skin changes - ACUTE phase (4)

• caused by enhanced sympathetic activity from the hypersensitive spinal cord segments.

Answer 8

hyperaemic
boggy/ increase oedema
warm
moist
\+ pain!

Question 9

SD - skin changes - CHRONIC phase (4)

Answer 9

ischaemic
firm/ flat
cool
dry

Question 10

What is allodynia?

Answer 10

abnormal sensation of pain to non-noxious stimulus

Question 11

What is sensitization?

Answer 11

increased response to neurones following repetitive stimulation.
TNF (tumour necrosis factor) seems to be responsible for the sensitization of neurons in the dorsal horns of the spinal cord.

Question 12

What is hyperalgesia?

Answer 12

– enhanced pain sensation to noxious stimulus

Question 13

Definition of somatic dysfunction

Answer 13

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

Question 14

What regulates muscle length?

Answer 14

Spinal nerves innervating the muscle spindles

Question 15

Examples of pro-inflammatory chemicals due to peripheral injury

Answer 15

• Bradykinin
• Histamine
• Cytokines
• Prostaglandins

Question 16

What happens when there is Enhanced sympathetic outflow from the hypersensitive spinal cord segments cause?

Answer 16

• Local temperature changes
• Hydration
In addition to the effects of vasoactive peptides:
• Increased blood flow
• Heat
• increased PAIN from the sensitisation peripherally and centrally

Question 17

SD – skin changes – ACUTE phase

Answer 17

Hyperaemic
Boggy/oedematous
Warm
Moist

Question 18

SD – skin changes – CHRONIC phase

Answer 18

Ischemic
Firm/flat
Cool
Dry

Question 19

How can osteopathy help with visceral imbalances?

Answer 19

some inflammatory visceral conditions can cause somatic dysfunction. Osteopathy helps with this.

Question 20

What somatic imbalances can be helped with osteopathy?

Answer 20

• Circulatory dysfunction
• Metabolic processes/diseases
• Neurological diseases
• Structural deformities
• Behavioural/psychological issues

Question 21

How can osteopathy reverses pathophysiological changes?

Answer 21

• Alleviates SD
• Restores normal NMS structural & functional relationships
• Decreases nociceptive input
• Improves joint mobility
• Reduces fluid congestion

Question 22

How is somatic dysfunction diagnosed?

Answer 22

requires at least one of the four cardinal signs (TART)

Question 23

What does somatic mean in allopathic medicine?

Answer 23

refers to the body structure to differentiate it from the psyche and so include the viscera

Question 24

What does somatic mean to osteopaths?

Answer 24

refers to neuro-musculo-skeletal structures only

Question 25

What is vertebral somatic dysfunction?

Answer 25

• hypersensitivity of a spinal segment that can cause altered range and quality of movement,
• altered tissue texture in the surrounding tissues,
• tenderness

Question 26

How can rotator cuff tendonitis create secondary dysfunction?

Answer 26

Reflex changes can occur in the related spinal segments (for the shoulder, the sensory information enters mainly at C5-C6).
Reflex behaviour will be affected in other tissues with motor control coming from this spinal segment.

Question 27

How can a hip problem create secondary somatic dysfunction?

Answer 27

The muscle tone will be affected in the affected area.
Altered gait can place more strain on the spine elsewhere.
Dysfunction at other spinal segments can cause altered reflex behaviour in other parts of the spine.