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Boards: OPP > Savarese Ch 10: Facilitation > Flashcards

Savarese Ch 10: Facilitation Flashcards

1
Q

What is facilitation?

A

The maintenance of a pool of neurons in a state of partial or sub-threshold excitation.

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2
Q

What are the 3 parts of a spinal reflex?

A
  1. An afferent limb –> Sensory input
  2. A central limb –> Spinal pathway (interneurons)
  3. An Efferent limb –> motor pathway
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3
Q

In facilitation, what is actually sensitized?

A

The interneurons at a spinal cord level.

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4
Q

Through which pathway does visceral dysfunction transmit information to the spinal cord?

A

Autonomic afferents

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5
Q

Parasympathetic Effects on the Eye (pupil and lens)

A

Pupil: Constricts (miosis)
Lens: Contracts for NEAR vision

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6
Q

Sympathetic effects on the eye (pupil and lens)

A

Pupil: Dilates (mydriasis)
Lens: Slight relaxation for far vision

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7
Q

Parasympathetic Effects on Glands (ex. nasal, lacrimal, parotid, submandibular, gastric, and pancreatic)

A

Stimulates COPIOUS Secretion

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8
Q

Sympathetic Effects on Glands (ex. nasal, lacrimal, parotid, submandibular, gastric, and pancreatic)

A

Vasoconstriction for SLIGHT secretion.

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9
Q

Parasympathetic effect on Sweat glands

A

Sweating on palms of hands

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10
Q

Sympathetic effects on sweat glands

A

Copious sweating (cholinergic)

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11
Q

Parasympathetic effects on the heart

A

Decreases contraction and conduction velocity

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12
Q

Sympathetic effects on the heart

A

Increases contractility and conduction velocity

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13
Q

Parasympathetic Effects on the Lungs (bronchiolar smooth muscle; Respiratory Epithelium)

A

Bronchiolar smooth muscle: Contracts

Respiratory Epithelium: Decreases # of goblet cells to enhance THIN secretions

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14
Q

Sympathetic effects on the lungs (Bronchiolar smooth muscle, Respiratory epithelium)

A

Bronchiolar smooth muscle: Relax

Respiratory Epithelium: Increases # of goblet cells to produce thick secretions.

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15
Q

Parasympathetic Effects on the GI tract (Smooth muscle - lumen & sphincters; Secretion/Motility)

A

Lumen: Contracts
Sphincters: Relaxes
Secretion/Motility: Increases

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16
Q

Sympathetic Effects on the GI tract (Smooth muscle - lumen & sphincters; Secretion/Motility)

A

Lumen: Relaxes
Sphincters: Contracts
Secretion/Motility: Decreases

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17
Q

Parasympathetic Effects on Systemic arterioles: Skin/visceral vessels; Skeletal Muscles

A

NONE (for both)

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18
Q

Sympathetic Effects on Systemic arterioles: Skin/visceral vessels; Skeletal Muscles

A

Skin and visceral vessels: Contracts

Skeletal muscles: Relaxes

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19
Q 
Parasympathetic Effects on Genitourinary
Bladder wall (detrusor); Bladder sphincter (Trigone); Penis
A

Detrusor: Contracts
Trigone: Relaxes
Penis: Erection (Anatomical position!)

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20
Q 
Sympathetic Effects on Genitourinary
Bladder wall (detrusor); Bladder sphincter (Trigone); Penis
A

Detrusor: Relaxes
Trigone: Contracts
Penis: Ejaculation

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21
Q

Parasympathetic Effects on the Kidneys

A

Unknown

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22
Q

Sympathetic Effects on the Kidneys

A

Vasoconstriction of AFFERENT arterioloe (this is how it was spelled) –> DECREASED GFR –> Decreased Urine volume

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23
Q

Parasympathetic Effects on the ureters

A

Maintains normal peristalsis

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24
Q

Sympathetic Effects on the ureters

A

Ureterospasm

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25
Q

Parasympathetic Effect on the liver

A

Slight glycogen synthesis

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26
Q

Sympathetic effect on the liver

A

Glycogenolysis (release of glucose into bloodstream)

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27
Q

Parasympathetic Effect on the uterus (fundus; cervix)

A

Fundus: Relaxation
Cervix: Constricts

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28
Q

Sympathetic Effect on the uterus (fundus/boyd; cervix)

A

Fundus: constricts
Cervix: Relaxes

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29
Q

Where does Parasympathetic innervation of the Pupils originate?

A

CN III (midbrain) –> Ciliary ganglion

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30
Q

Where does Parasympathetic innervation of the Lacrimal and nasal glands originate?

A

CN VII (pons) –> Sphenopalatine ganglion

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31
Q

Where does Parasympathetic innervation of the Submandiubular and sublingal glands originate?

A

CN VII (pons) –> submandibular ganglion

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32
Q

Where does Parasympathetic innervation of the Parotid Gland originate?

A

CN IX (Medulla) –> otic ganglion

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33
Q

Where does Parasympathetic innervation of the Heart originate?

A

CN X (medulla)

34
Q

Where does Parasympathetic innervation of the Bronchial Tree originate?

A

CN X (Medulla)

35
Q

Where does Parasympathetic innervation of the Lower 2/3 of esophagus; stomach; Sm intestine; liver; gallbladder; pancreas originate?

A

CN X (Medulla)

36
Q

Where does Parasympathetic innervation of the Kidney and upper ureter originate?

A

CN X (Medulla)

37
Q

Where does Parasympathetic innervation of the Ovaries and Testes originate?

A

CN X (Medulla)

38
Q

Where does Parasympathetic innervation of the Ascending and Transverse Colon originate?

A

CN X (Medulla)

39
Q

Where does Parasympathetic innervation of the Lower ureter and bladder originate?

A

Pelvic splanchnic (S2-4)

40
Q

Where does Parasympathetic innervation of the Uterus, prostate, genitalia originate?

A

Pelvis splanchnic (s2-4)

41
Q

Where does Parasympathetic innervation of the Descending colon, Sigmoid, and rectum originate?

A

Pelvic Splanchnic (S2-4)

42
Q

What is the sympathetic innervation of the HEAD AND NECK

43
Q

What is the sympathetic innervation of the HEART

44
Q

What is the sympathetic innervation of the RESPIRATORY SYSTEM

45
Q

What is the sympathetic innervation of the ESOPHAGUS

46
Q

What is the sympathetic innervation of the UPPER GI SYSTEM? And corresponding nerve and ganglion
(Stomach; liver; Gallbladder; Spleen; Portions of the pancreas and deuodenum)

A

T5-T9

Greater Splanchinic Nerve –> Celiac Ganglion

47
Q

What is the sympathetic innervation of the MIDDLE GI TRACT? And corresponding nerve and ganglion
(Portions of the pancreas and duodenum; Jejunum; Ilium; Ascending colon; Proximal 2/3 of transverse colon [right colon])

A

T10-T11

Lesser splanchnic Nerve –> Superior Mesenteric Ganglion

48
Q

What is the sympathetic innervation of the LOWER GI TRACT? And corresponding nerve and ganglion
(Distal 1/3 of transverse colon; Descending colon, Sigmoid colon (left colon); Rectum)

A

T12-L2

Least Splanchnic Nerve –> Inferior Mesenteric Ganglion

49
Q

What is the sympathetic innervation of the APPENDIX

50
Q

What is the sympathetic innervation of the KIDNEYS? (and corresponding ganglion)

A

T10-T11

Superior Mesenteric Ganglion

51
Q

What is the sympathetic innervation of the ADRENAL MEDULLA

52
Q

What is the sympathetic innervation of the UPPER URETERS? And corresponding ganglion

A

T10-T11

Superior Mesenteric Ganglion

53
Q

What is the sympathetic innervation of the LOWER URETER? And corresponding ganglion

A

T12-L1

Inferior Mesenteric Ganglion

54
Q

What is the sympathetic innervation of the BLADDER

55
Q

What is the sympathetic innervation of the GONADS

56
Q

What is the sympathetic innervation of the UTERUS AND CERVIX

57
Q

What is the sympathetic innervation of the ERECTILE TISSUE OF PENIS AND CLITORIS

58
Q

What is the sympathetic innervation of the PROSTATE

59
Q

What is the sympathetic innervation of the EXTREMITIES (arms vs Legs)

A

Arms: T2-T8
Legs: T11-L2

60
Q

What is the significance of the LIGAMENT OF TREITZ w/ regards to sympathetic innervation

A

Anything before the ligament = T5-T9

Ligament divides the duodenum and jejunum

61
Q

What is the significance of the SPLENIC FLEXURE of the large intestine w/ regards to sympathetic innervation?

A

Anything after the flexure = T12-L2

Flexure divides the transverse and descending colon

62
Q

What is the significance of the SPLENIC FLEXURE and the LIGAMENT OF TREITZ (combined) w/regards to sympathetic innervation?

A

Anything between these 2 landmarks is innervated by T10-T11

63
Q

Are you tired of this chapter yet?

A

Yeah, me too

64
Q

Why should you know who Irvin Korr PhD was?

A

He established that there is HYPERSYMPATHETIC ACTIVITY in disease processes.
Therefore; it is important to curb sympathetic activity, or enhance parasympathetic activity when treating disease states.

65
Q

What are the 5 OM techniques aimed at the sympathetic nervous system?

A
  1. Rib raising
  2. Soft tissue paraspinal inhibiton
  3. Celiac ganglion, Superior mesenteric, Inferrior mesenteric releases
  4. Tx of Chapman’s reflexes
  5. Tx of cervical paraspinal sympathetic ganglia
66
Q

What are the 3 purposes of Rib Raising?

A
  1. Normalize (decrease) sympathetic activity
  2. Improve lymphatic return
  3. Encourages maximum inhalation and provokes a more effective negative intrathoracic pressure.
67
Q

What are the indications of rib raising?

A 
Visceral dysfunction 
Decreased rib excursion
Lymphatic congestion
Fever
Paraspinal muscle spasm
68
Q

What is the purpose of soft tissue paraspinal inhibition?

A

Normalize (decrease) sympathetic activity

*Ileus prevention!)

69
Q

What is the purpose of celiac ganglion, Superior mesenteric, and inferior mesenteric releases?

A

To normalize (decrease) sympathetic activity

70
Q

What are the indications (2) for celiac ganglion, Superior mesenteric, and inferior mesenteric releases?

A

GI Dysfunction

Pelvic dysfunction

71
Q

What is the purpose of treating Chapman’s reflexes?

A

To DECREASE sympathetic tone to associated visceral tissues

72
Q

What are the spinal levels to the SUPERIOR, MIDDLE, and INFERIOR cervical ganglia?

A

Superior: C1-3
Middle: C6-C7
Inferior: C7-T1

73
Q

What are the 5 OM techniques aimed at the PARASYMPATHETIC nervous system?

A
  1. Cranial manipulation
  2. Sphenopalatine ganglion technique
  3. Condylar decompression
  4. Tx through vagus nerve influence
  5. Tx of sacral somatic dysfunctions
74
Q

What is the purpose of Cranial Manipulation?

resist the urge to insert joke

A

Aids in dural strains and improves parasympathetic function in head structures innervated by CN 3, 7, 9, 10.

75
Q

What is the purpose of Sphenopalatine ganglion technique?

A

Enhancing parasympathetic activity will encourage thin watery secretions through short intermittently manual finger pressure intraorally to the sphenopalatine ganglion.

76
Q

What is the indication (1) for sphenopalatine ganglion technique?

A

Thick nasal secretions

77
Q

What is the purpose of Condylar decompression?

A

Help free parasympathetic responses to structures innervated by cranial nerves IX and X by freeing passage through the jugular foramen (i.e. occipito-mastoid suture)
Our profs say CNXII is primary here, FYI

78
Q

Give a clinically significant scenario with condylar compression:

A

Can result from child birth - may cause suckling difficulties for the newborn and thus failure to thrive.

79
Q

To treat CN X (parasympathetic tone), what joints should be targeted? (3)

A

OA, AA, C2

80
Q

What is the purpose for treatment of sacral somatic dysfunctions? (2)

A
  1. Normalize hyperparasympathetic activity in the LEFT colon, and pelvic structures.
  2. Reduce labor pain caused by cervical dilation
81
Q

What are the indications for sacral somatic dysfunction treatment? (3)

A
  1. Dysmenorrhea
  2. Labor pain from cervical dilation
  3. Constipation

Boards: OPP (13 decks)

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