Somatic Dysfunction Flashcards
Classifications of somatic dysfunction
. M99.00: cranial . M99.01: cervical . M99.02: thoracic . m99.03: lumbar . M99.04: sacral . M99.05: pelvic . M99.06: lower extremity . M99.07: upper extremity . M99.08: rib cage . M99.09: abdomen and other somatic dysfunction
Neurophysiological phenomenon w/ somatic dysfunction
. Neuronal afferents input into CNS, effects go from CNS
. Spinal segments that are chronically irritable/hyperactive cause structural impairment
. Muscles innervated by these segments may become hypertonic manifesting in somatic dysfunction
Effects of dysfunction at thoracolumbar junction
. Effect sympathetic output to intenstine
. Hypersympathetic drive, bowel less active, causes constipation, bowel obstruction, or a dynamic ileus
Effects of somatic dysfunction in sacrum
. Inc. parasympathetic drive to gut, causes inc. poops/diarrhea
Acute tension vs. chronic tension
. Acute: Increased rigidity
. Chronic: slightly increases, ropiness, stringiness
Does acute or chronic tissue texture changes have edema?
Acute
Erythema test in acute vs. chronic tissue texture changes
. Acute: redness lasts
. Chronic: redness fades quickly to skin blanches
T/F Asymmetry can confirm presence of somatic dysfunction alone
F, need tissue texture change or motion change as well
Quantity and quality of motion
. Quantity: range of motion
. Quality: compliance or resistance of motion
Viscerosomatic reflex
. Involuntary nervous system response to sensory input
. Sum total of any involuntary activity
. Localized visceral stimuli producing patterns of reflex response in segmentally related somatic structures
how do viscerosomatic reflexes clinical manifest?
. Palpable musculoskeletal findings assoc. w/ segmentally (spinal) related dysfunction or disease of viscera
Paraspinal viscerosomatic reflex descriptions
. Assoc. w/ tissue texture changes that differentiate it from normal tissue texture change
. Findings greatest at rib angles and costotransverse area
. Skin/subQ puffiness
. Reluctance to applied motion
. Barrier feels rubbery not firm and distinct (minimal motion loss lesions)
Vertebral segment
Single vertebrae
Vertebral unit
2 adjacent vertebrae and assoc. arthrodial, ligamentous, muscular, neural, and lymphatic elements
Concavity
. Inside curve: side to which sidebending occurs
Convexity
Outside curve, side opposite where sidebending occurs
Posterior component
. Positional descriptor referring to prominent transverse process
Anterior component
. Positional descriptor referring to less prominent transverse process during vertebral rotation
Reference point for segmental motion
. Most anterior, superior point on body of vertebrae relative to segment below it
. Motion assessed in all 3 planes of motion
Fryette Principle 1 of motion
. When spine is in neutral and articular facets aren’t engaged, if sidebending is introduced a group of vertebrae (3+) rotate into produced convexity
. Max rotation at apex
. Rotation and sidebending occur to opposite side
Neutral mechanics
. Also called type 1 mechanics
. When group of segments moves in style of principle 1
Type 1 somatic dysfunction
. When group curve demonstrates restriction of motion and tissue texture changes
T/F cervical spine has atypical type 1 motion
T, sidebending and rotation occur on same side
Fryette Principle II of spinal motion
. When flexion and tension occurs and is sufficient to localize force to single segment, sidebending and rotation occur on same side
. Vertebral segment rotates into concavity
. Also called type II/non-neutral mechanics
Type II somatic dysfunction
. Single segment demonstrates type II mechanics w/ tissue change and restriction of motion
Fryette Principle III of spinal motion
. When motion has been introduced in 1 plane, the motion in the other planes. In altered
Parts of axial skeleton that do not follow Fryette’s principles
. Occiput: tortes and sidebends in opp. Directions but is still weird and doesn’t follow type I
. Atlas: only demonstrates rotation (little to no fl/extension and sidebending)
. Sacrum: between iliac rotates and sidebends in opp. Direction but still doesn’t count as type I
Barrier
Limit of motion
Physiologic barrier
. Endpoint of active motion
. Altered through warm up activity to inc. range of motion
Anatomical barrier
. Limit of passive motion
. End of motion due to resistance of bony structures or ligaments
. Tissue destruction occurs if motion pushes past this barrier
Restrictive/pathological barrier
. Endpoint of motion when somatic dysfunction is present
. Dec. in motion from tissue tension
. Occurs w/in normal range of motion of joint or tissue
Point of balance/neutral point
. Point where no tension is noted in range of motion
Pathologic neutral
Normal range of motion is changed with shift in point of balance to new neutral point
End feel
. Perceived quality of motion as anatomic or physiologic barrier is approached
. Acute conditions don’t have this (feel rubbery not distinct)
. Chronic conditions are very firm and discrete
Direction of ease
Direction that does not have restriction
3 ways of naming somatic dysfunction
. Where is it?
. What will it do?
. What won’t it do?
What is somatic dysfunction usually named for?
Direction of freer motion
. List dysfunction segment, the fl/extension component, then rotation, then sidebending, then subscript that indicates freer side of motion
Does flexion increase of decrease the angle between sup. Vertebral segment on the segment below?
Decreases
Does extension increase or decrease the angle of sup. Vertebral segment on the other segment?
Increases angle
Tenderness objective report
Involuntary reaction
Rule of 3’s
T1-T3: transverse processes are located at same level as tip of spinous processes
. T4-T6: transverse process located half a level above tip of spinous processes
. T7-T9: transverse process located full level above tip of spinous process
. T10: transverse process full level above spinous process
. T11: transverse process located half level above tip of spinous process
. T12: transverse processes located at the same level as the tip of spinous process
