Somatic Dysfunction And Barriers Flashcards
4 tenets of Osteopathic Medicine
- The mind, body, and spirit are a unit
- The body is capable of self-regulation, self healing, and self maintenance
- Structure and function are reciprocally related
- Rational treatment is based upon understanding and implementing the other 3 tenets
AROM
Patient motivated; patient must give maximum effort
Patient initiated ROM; examiner visually observes
PROM
Patient must fully relax; you must “block linkage” of associated structure; examiner initiated ROM with passive patient
Greater then AROM because the patient muscles are relaxed
“Block the linkage”
Stabilization of associated and adjacent structures to focus movement to only the joint/s being assessed
Anatomic barrier
Limit of motion imposed by anatomic structure; limit of passive motion beyond which you have tissue disruption
Physiologic barrier
Limit of active motion
Elastic barrier
Range between physiologic and anatomic barrier of motion in which passive stretching occurs before tissue disruption; area that “warms up” with stretching
Restrictive barrier
Functional limit that abnormally diminishes the normal physiologic range
Diagnostic criteria for somatic dysfunction
T.A.R.T
Tissue texture abnormalities
Asymmetry of structure or motion
Restriction of motion
Tenderness
Characteristics of acute somatic dysfunction
Vasodilation, edema, tenderness, pain, tissue contraction
Characteristics of chronic somatic dysfunction
Tenderness, itching, fibrosis, paresthesias, tissue contractions
Acute somatic dysfunction
Immediate or short-term impairment or altered function of related components of the somatic system (body framework)
Chronic somatic dysfunction
Impairment or altered function of related components of the somatic system
Tissue texture abnormality
Palpable changes in tissues from skin to periarticular structures
Types include bogginess, thickening, springiness, rosiness, firmness or hardening, temperature or moisture change
Bogginess
Tissue texture abnormality characterized by a palpable sense of sponginess in the tissue resulting from congestion due to increased fluid content
Sign
Physical thing that you can reproduce and feel with your hands (objective)
Symptom
Thing that the patient experiences (reported in a history) that the physician cannot perceive (subjective)
Tone
Normal feel of muscle in the relaxed state
Hypertonicity
Extreme tone, i.e. spastic paralysis
Hypotonicity
Lack of tone, i.e. flaccid paralysis
Contraction
Normal tone of a muscle when it shortens or is activated against resistance
Contracture
Abnormal shortening of muscle due to fibrosis
Most often in tissue itself and often results from chronic condition
Muscle is no longer able to reach its full normal length
Spasm
Abnormal contraction maintained beyond physiologic need
Often sudden and involuntary contraction resulting in abnormal motion; generally accompanied by pain and restriction of normal function
Ropiness
Hard, firm, rope- or cord-like muscle tone
Generally indicative of chronic condition
Asymmetry
Absence of symmetry of position or motion
Dissimilarity in corresponding parts/organs on opposite sides of the body that should be alike
Determined by vision OR palpating
Restriction of motion
Resistance or impediment to movement
Barrier “end feel” characteristics
Palpatory experience or perceived quality of motion when joint is moved to its limit
Three examples: bone to bone (elbow extension), soft tissue approximation (knee flexion), tissue stretch (ankle dorsiflexion, shoulder lateral rotation, finger extension)
Look for amount AND quality of motion
Early muscle spasm
Protective spasm after injury (“guarding”)
Late muscle spasm
Chronic spasm potentially due to chronic tissue changes
Hard capsular
Frozen shoulder; reduced ROM in injured shoulder
Soft capsular
Synovitis such as swelling in the knee after injury
Tenderness
Discomfort or pain elicited via palpation
A state of unusual sensitivity to touch or pressure
Pain
Unpleasant sensation induced by noxious stimuli and generally received by specialized nerve endings
Tenderpoints
Small, discrete, hypersensitive areas within myofascial structures that result in localized pain
Trigger point
Small, discrete, hypersensitive areas within myofascial structures that when palpated cause referred pain
Goal of OMT
Remove somatic dysfunction and restore homeostasis
Role of OMT in the biomechanical model
Myofascial and joint functional optimization
Role of OMT in neurological model
Remove neurological imbalances and address nociception
Role of OMT in the respiratory/circulatory model
Maximize respiratory/circulatory function
Role of OMT in the metabolic model
Structure and function are reciprocally related
Direct OMT techniques
Method of action engages the restrictive barrier directly
Ex: MFR, INR, ST, MET, HVLA, Visceral
Combination OMT Techniques
Ex: MFR, Still, Percussor, PINS
Indirect OMT Techniques
Method of action involves positioning away from the restrictive barrier
Ex: MFR, INR, BLT/LAS, FPR, Functional, Visceral
