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OS > Osteopathic Reflexes Lecture > Flashcards

Osteopathic Reflexes Lecture Flashcards

1
Q

What is a reflex?

A

relationship between an input stimulus to the body & an output action to either a muscle or secretory organ

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2
Q

What are interneurons?

A

neurons that take in information from body or viscera & send out that info (stay w/ in brain)

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3
Q

What is found in lower layers of spinal cord gray matter?

A

interneurons

motorneuron cell bodies

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4
Q

Why do we see a localized pain pattern?

A

interaction of somatic efferents with visceral & somatic afferents

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5
Q

Basis for activation of somatic muscle activity

A

visceral afferents activate sympathetic outflows & skeletal muscle motor neurons

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6
Q

Descending influences on reflexes

A

effect long-lasting excitability of outflows by maintaining the reflex

will either increase, decrease, or sensitize neurons

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7
Q

What produces dysfunction?

A

visceral disturbances reflexively cause activation in somatic musculature

somatic disturbances can reflexively alter visceral function

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8
Q

What does dysfunction lead to?

A

loss of health & decompensation of homeostasis

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9
Q

Somatic component of disease

A

MSK palpatory findings may correlate w/ visceral disturbances

normalization of autonomic outflows results in restoration of homeostasis

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10
Q

Facilitated segment concept

A

afferent input comes into cord interacting w/ interneuron chains

interneurons can act as amplifiers or inhibitors

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11
Q

Habituation

A

process of decreasing response of neural pathway w/ continuous stimulation

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12
Q

Nociception Theory

A

Habituation & sensitization

2 processes exist together to help maintain a homeostasis btwn over-reaction & under-reaction to a stimulus

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13
Q

What happens in facilitation?

A

less afferent stimulation required to trigger discharge of impulses (go off no matter what)

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14
Q

Nociception steps

A

once stimulus is strong enough to depolarize nociceptive pathways, impulses travel to spinal cord & branch to multiple sites

release of peptides @ motorneuron level in peripheral tissues

peptides involved in inflammatory cascade & initiate release of prostaglandins

chemical soup spreads in tissues

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15
Q

What does NOT have nociceptors?

A

brain or hyaline cartilage

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16
Q

What is the result of the chemical soup of proteins?

A

lowers nociceptor threshold which increases input to spinal cord

inflammation results in larger than normal motor outputs to autonomics & somatic systems

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17
Q

Outline steps that increase sensitivity of neurons

A

Short term excitability
Long term sensitization (minutes to hours)
Fixation (longer output)
Permanent excitatbility (death of inhibitory interneurons)

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18
Q

Facilitated Segment Concept

A

excitable areas assoc w/ injury & disease

low threshold spinal reflexes represent pathways in hyper-excited state

relates to skeletal muscle & sympathetic nervous system

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19
Q

Allostasis

A

long term neural effect of segmental facilitation on what your body wants to maintain

stimulus to tissues
develop chemical soup of inflammation
causes primary afferent sensitization
results in hyperalgesia

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20
Q

Hyperalgesia

A

exaggerated response to noxious stimulus (so do not engage that stimulus again)

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21
Q

Allostasis in spinal cord

A

Dorsal horn: lose inhibitory neuron function (lots of Ca2+)

Ventral horn: outflows to soma & autonomics (muscle spasms & affects visceral fxn)

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22
Q

Allostasis in brainstem

A

arousal system leads to loss of control of protective mechanisms=allostasis overload

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23
Q

Somatosomatic reflex

A

localized somatic stimuli producing patterns of reflex response in segmentally related somatic structures

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24
Q

Somatovisceral reflex

A

localized somatic stimulation producing patterns of reflex response in segmentally related visceral structures

ex: somaticocardiac, somatogastic, somatoadrenal

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25
Q

Viscerosomatic reflex

A

localized visceral stimuli producing patterns of reflex response in segmentally related somatic structures

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26
Q

Viscerovisceral reflex

A

localized visceral stimuli producing patterns of reflex response in segmentally related visceral structures

27
Q

Somatocardiac reflex

A

injury/pain is source of nociceptive somatic stimuli that elevate HR & BP

28
Q

Somatogastric reflex

A

nociceptive somatic stimuli results in increased inhibition of peristalsis in stomach

29
Q

Somatoadrenal reflex

A

nociceptive somatic stimuli results in release of catecholamines from adrenal medulla (movement of inflamed knee)

30
Q

Viscerosomatic reflexes

A

somatic pain referral due to visceral nociceptive stimuli

heart attack pain that radiates in different direction

31
Q

Visceral sensory systems

A

all visceral nerves contain sensory fibers & cells bodies located in DRG

numerous interneuron connections in DRG that creates complex network connecting visceral & somatic systems

32
Q

Head/neck

A

T1-T5

33
Q

Upper GI

A

T5-10

34
Q

Small intestine/ascending colon

A

T9-11

35
Q

ascending & transverse colon

A

T10-L2

36
Q

descending colon & sigmoid

A

T12-L2

37
Q

upper extremity

A

T2-T7

38
Q

lower extremity

A

T11-L2

39
Q

parasymp upper GI

A

vagus N

40
Q

parasymp small intestine/ascending colon

A

vagus N

41
Q

parasymp ascending & transverse colon

A

vagus N

42
Q

parasymp descending & sigmoid

A

S2-S4

43
Q

sympa & parasymp for heart

A

T1-T6

Vagus N

44
Q

sympa & parasymp for adrenals

A

T5-T10

Vagus N

45
Q

sympa & parasymp for lungs

A

T1-T7

Vagus N

46
Q

sympa & parasym for genitourinary tract

A

T10-L2

S2-S4 (repro organs)

47
Q

sympa for genitourinary tract

A

T10-L2

48
Q

sympa & parasympa for upper ureter

A

T10-T11

Vagus N

49
Q

sympa & parasymp for lower ureter

A

T10-L2

S2-S4

50
Q

parasymp for bladder & repro organs

A

S2-S4

51
Q

Chapman’s reflexes

A

group of palpable points occurring in predictable locations on anterior & posterior surfaces of body that are considered to be reflections of visceral dysfunction or disease

52
Q

3 component characteristics of Chapman’s reflexes

A

Viscerosomatic reflex

Gangliform contraction (blocks lymphatic drainage & causes SNS dysfunction)

consistent reproducible series of points both ant & post related to specific organs or conditions

53
Q

Palpatory features

A

deep to skin in subcut areolar tissue on deep fascia or periosteum

small, smooth & firm nodule

may be confluent

dense but not hard

54
Q

descriptions for palpatory features

A

gangliform, edematous, ridge like or ropey, fibrospongy, shotty

55
Q

what is the pain usually assoc w/ reflex?

A

pinpoint, sharp & non-radiating

located under physicians finger tip

pain is GREATER than expected (pt usually previously unaware of sore spot)

56
Q

Indications for treatment of chapman reflex

A

part of screening exam when clinically indicated from pt history & if clinically relevant to pt

57
Q

Contraindications for treat of chapman reflex

A

emergent care
pt refusal
relatively contraindicated w/ fracture, cancer & other instability

58
Q

What is some evidence for chapman reflex studies?

A

in pulmonary system (pts w/ pneumonia)

SD correlated to GI endoscopy findings

59
Q

What results from host + disease?

A

illness

60
Q

what does osteopathy look @ from host perspective?

A

enviro factors (structural, medical, surgical, psychosocial, alcohol & drugs & smoking)

61
Q

What happens when host affected by illness?

A

decompensation which disrupts homeostasis

62
Q

what is the goal of OMT?

A

re-obtain homeostasis

63
Q

use of OMT

A

break cycle of facilitation then homeostasis & health could be restored to pt

OS (18 decks)

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