OT Mod 4 Questions

Question 1

Describe the three levels of somatic lesioning

Answer 1

Quality of the muscular and fascial lesioning from superficial to deep

Quality of the articular surfaces of joints and their ligamentous attachments

Osseous lesion - penetrates the bones themselves

Partially Lesioned = Muscular
Mostly Lesioned = Muscular and ligamentous level
Fully somatic lesion = muscular, ligamentous and osseous

Question 2

Describe the three levels of organic lesioning

Answer 2

Quality of the functional glandular substance

Vasomotor control (nutritional quality of the lesion)

Regulators (especially the neuro-regulators) see these reflected in the soma, signs and symptoms of the patient

Question 3

What system mediates between the two categories of lesioning?

Answer 3

The nervous system

Question 4

What are the determining factors for somatic and/or organic lesions?

Answer 4

Somatic

We use palpation and motion testing to determine the muscular and fascial lesioning from superficial to deep

Then we work our way to the osseous lesion which penetrates the bone itself

Depending on what is palpated, we can say that the patient is either partially, mostly or fully lesioned

Question 5

What are some potential dangers of aggressive treatment methods?

Answer 5

It could lead to too much at one time and aggravate the condition and/or an inability to stabilize and take on the treatment

Question 6

In your own words, describe what is meant by the term “nutritional & congestive quality” when applied to a lesion.

Answer 6

Quality of blood flow, the texture of the tissue and its fluidity in movement

Question 7

What are the difference between being partially, mostly or fully lesioned on the somatic side?

Answer 7

Partially - lesioned on the muscular level
Mostly - contain both muscular and ligamentous levels
Fully - muscular, ligamentous and osseous

Question 8

Why do we, as osteopathic practitioners/students, avoid treating conditions?

Answer 8

This line of thinking is for one, could injure the patient and the profession. Secondly, this line of reasoning ignores the acknowledged principle that each individual is different. The conditions for why and how any one person develops an illness in relation to another is so particular that it is a fool’s game to attempt to quantify every variation in existence.

Question 9

What technique principles allow us to work effectively on all parts of the body; not just on the neurology?

Answer 9

Modus operandi of the principled approach is to deliver force to make changes based on the functional anatomy, which then liberates the structures responsible for self-healing and self-regulating. We then utilize short and long levers, direct/indirect/balance approaches, amplitude, rate, rhythm, axes and planes.

Question 10

What principle is very important when it comes to controlling the outcome of a correction?

Answer 10

Quadripartite principle helps operators get to and stay on the proper plane of correction dictated by the functional anatomy under scrutiny

Question 11

What four important factors relate to positioning of both the operator and patient?

Answer 11

Footwork
Holds
Fixed Points
Lever

Question 12

How would proper footwork influence control and rhythm during a treatment?

Answer 12

When we move from our feet, the upper body, limbs and hands stay soft. This creates soft contact with with the patient that not only increase palpatory senses, but also helps patients accept the touch, relax their postures and allow operators to work with great ease.

Question 13

Explain the term ‘functional palpation’ in your own words.

Answer 13

Palpating with a soft touch for the areas of the body with the greatest restriction patterns, while simultaneously painting a palpatory picture of the anatomy behind what we are feeling and how it is affecting the physiology of the patient. Then we can proceed to testing other areas that we believe to be correlated with the area of concern

Question 14

What are the three stages/expressions of a lesion?

Answer 14

The longer the lesion has been around, the more fibrosity is found in the muscles and soft tissues, altering their function

A lesion that has not been there as long will produce more localized pain and contain more fluid

A more focal lesion will be more acute and affect the neurophysiological reflex

Question 15

Describe the first stage of treatment

Answer 15

The assessment of the fascia in relation to lines of force and how they affect the functionality of the body. We are looking and working for compensation.

Question 16

Why is an osteopathic diagnosis not established at this stage?

Answer 16

Because we are looking for compensation - which means we do not have a true osteopathic diagnosis at this point
Therefore we clear the fields that are influencing and supporting the distortion of health and allow the body to begin to fix itself with renewed vigor

Question 17

Describe the second stage of treatment

Answer 17

Look at the four quadrants and within those quadrants, at either an organ or group of spinal segments that could be impeding the health of the patient (start to see the key lesion).

Question 18

Describe the third stage of treatment

Answer 18

Turn to the localized treatment that is specific to one or two segments

Question 19

What is the supplemental treatment which may occur after the third stage?

Answer 19

The final stage that manifests after the localized treatments, this supplemental treatment verifies that the changes made to the body have an integrative and stabilizing effect.

Question 20

In prone position, how is the synchronically between the upper and lower polygons tested?

Answer 20

By performing motion testing with one hand is on the sacrum, which is the bottom primary pivot at D11/D12, the meeting point of each polygon, to the CT junction

Question 21

What do diaphragms have a significant influence on and how does this affect the nervous system?

Answer 21

Diaphragms have a significant impact on the distribution of fluid which in turn affects the chemical acid balance in the body. This acid-base balance has a direct impact on the sensory side of the nervous system

Question 22

As we palpate, what should we keep in mind about the lesioning between the somatic and visceral?

Answer 22

The somatic encompasses the superficial tissue, musculature, ligaments and bones - these are all external frame influences on the internal frame

Question 23

What decision must be made based on the patient’s constitution and vitality?

Answer 23

Whether or not the patient can endure a mechanical-oriented osteopathic treatment or if they need something specialized to help with their neurological pain

Question 24

What necessary compromise might this decision entail? (based on previous question)

Answer 24

This puts the patient in the best position to receive that type of corrective treatment at this particular time.

Question 25

How do we influence the autonomics without irritating the spine during spasm?

Answer 25

Gently applying inhibition with our thumbs over the eyes and again, ask the patient to breathe while the spasms are occurring. Once a change in breath pattern has occured, we return to the upper cervicals and note if there has been any chance to the muscle spinning and the overall tissue texture