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ECOS 1 > ST, MRF, INR Lecture and LAB > Flashcards

ST, MRF, INR Lecture and LAB Flashcards

1
Q

Difference between soft tissue and fascia?

A

Soft tissue has tendons, ligaments, aponeuroses included

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2
Q

Components of Fascia?

A 
Fascia
Muscles
Organs
Nerves
Vasculature
Lymphatic vessels
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3
Q

What is soft tissue?

A

Everything not hardened by ossification

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4
Q

Is soft tissue technique direct or indirect?

A

Direct

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5
Q

What are the 3 soft tissue techniques?

A

Lateral (perpendicular) , linear(parallel), and inhibitory

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6
Q

AP Still used which technique a ton?

A

Deep inhibitory

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7
Q

MOA of soft tissue?

A

Relaxes hypertonic muscles and reduces spasm by decreasing alpha motor neuron activity
Stretches and increases the elasticity of shortened fascial structures
Improves local tissue nutrition, oxygenation, and removal of metabolic wastes

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8
Q

Soft tissue Indications?

A

Hypertonic muscles
Excessive tension in fascial structures
Abnormal somato-somatic or somato-visceral reflexes

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9
Q

Soft tissue safety reactions?

A

Ecchymosis (bruising)
Acute muscle spasm
Post-procedure muscle soreness

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10
Q

Soft tissue absolute contraindications?

A

Lack of consent
Skin or soft tissue is not intact (traumatized, friable [easily torn])
Absence of somatic dysfunction

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11
Q

Soft Tissue: ContraindicationsRelative

A 
Skin
   Contagious skin diseases
   Acute burns
   Painful rashes
   Abscess or cellulitis
   Skin cancers
Fascia
   Acute fasciitis
   Acute fascial tears
Muscle
    Acute muscular strains
   Myositis
   Muscle neoplasms
Ligament
   Acute ligamentous strain
   Acute ligamentous inflammatory disorders
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12
Q

Soft tissue linear technique description

A

Traction/Stretching
Origin and insertion of the myofascial structures being treated are longitudinally separated
1-2 seconds stretching, 1-2 seconds rest
Physician hands should not slide over skin or create friction.
After response is evaluated, force and amplitude may be increased.

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13
Q

Soft tissue lateral technique description

A

Kneading
Rhythmic, lateral stretching of the myofascial structure
Origin and insertion are held stationary, the central portion is stretched like a bowstring
1-2 seconds stretching, 1-2 seconds rest
Physician hands should not slide over skin or create friction.
After response is evaluated, force and amplitude may be increased.

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14
Q

Soft tissue inhibition technique description

A

Sustained deep pressure over a hypertonic myofascial structure

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15
Q

Is MFR direct or indirect?

A

Either one

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16
Q

MFR proposed MOA?

A

Interacts with the fascia and the tissues it

surrounds to improve homeostasis and innate healing

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17
Q

MFR indications

A 
Normalizing motion
Relieving edema
Reestablishing symmetry
Relieving pain
Aiding circulatory and lymphatic function
Normalizing neuroreflexive activity
Supporting visceral function
Restoring bioenergetic balance
Supporting homeostatic function
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18
Q

MFR Absolute Contraindications

A

Lack of consent

Absence of somatic dysfunction

19
Q

MFR: Relative Contraindications

A

Extreme caution should be exercised in patients with:Fractures
Open wounds
Soft tissue or bony infections
Abscesses
Deep venous thrombosis (threat of embolism)
Anticoagulation
Disseminated or focal neoplasm
Recent postoperative conditions over the site of proposed treatment (wound dehiscence)
Aortic aneurysm

20
Q

MFR compications?

A

Patients commonly experience post treatment soreness similar to post-exercise soreness, especially in the first 1-2 treatments
Those with autoimmune, inflammatory, and rheumatologic disorders may experience flare-ups in association with MFR treatment

21
Q

MFR extension direction?

A

Hands moved inferiorly

22
Q

MFR flexion direction?

A

Hands moved superiorly

23
Q

MFR right rotation direction?

A

Hands moved to the left

24
Q

MFR left rotation direction?

A

Hands moved to the right

25
Q

MFR Sidebending right direction?

A

Right hand inferior, left superior

26
Q

MFR Sidebending left direction?

A

Left hand inferior, right superior

27
Q

MFR technique description?

A

Engage tissues by adding light compression
Continue to hold tissue until relaxation or creep of underlying tissues is sensed.
Consider using a release enhancing mechanism, such as breathing

28
Q

What is INR

A

Integrated neuromuscular release. Use movement of the limbs to help move the fascia.

29
Q

What is INR done in tandom with?

A

MFR, typically with a direct.

30
Q

ST Thoracic prone pressure

A 
Place thenar and hypothenar eminence
on paravertebral muscles opposite the
side you are standing
Keeping your elbows straight and using
own body weight, engage soft tissues
with a ventral force and move out
laterally creating a perpendicular
stretch
31
Q

ST Thoracic: Prone Pressure with Counterpressure

A 
Place thenar eminence and thumb of
caudal hand over the thoracic
paravertebral muscles opposite the
side you are standing
•
Place hypothenar eminence of
cephalad hand on paravertebral
muscles on the same side you are
standing
32
Q

ST Thoracic: Subscapular Stretch

A 
Take patient’s arm, on the side
being treated, and place it behind
the back
•
Place fingers around medial
border of scapula
•
Engage the tissue ventrally then
give gentle and upward traction,
pulling scapula away from rib
cage, on for 1 2 seconds, off for 1 2
seconds until muscle relaxation is
perceived
33
Q

ST Upper Thoracic with Shoulder

Block, Lateral Recumbent

A 
Standing at side of table facing patient
•
Inferior hand passes under patient’s arm
and contacts paravertebral muscles
•
Superior hand contacts anterior portion
of shoulder to give counterforce. Drape
patient’s arm over your arm.
•
With both hands, engage soft tissues
ventrally and move out laterally to create
a stretch for 1 2 seconds, off 1 2 seconds,
repeat until relaxation perceived
34
Q

ST Lower Thoracic Under the

Shoulder, Lateral Recumbent ST

A

F orearms contacting the axilla and iliac
crest, fingers contact medial aspect of the
erector spinae
•
Elbows spread apart, elongating distance
between the shoulder and the hip;
•
Traction the paraspinal muscles laterally.
•
Lean back to provide lateral force, on for 1
2 seconds, off for 1 2 seconds until muscle
relaxation is perceived

35
Q

ST Paraspinal Inhibitory Technique

A 
Place finger pads over
the paraspinal tissues.
•
Apply gentle, firm
pressure to engage
the tissues.
•
Continue pressure
until release occurs.
36
Q

Lumbar: Prone Pressure

A 
Place thenar and hypothenar
eminence on paravertebral muscles
opposite the side you are standing
•
Place other hand on top of hand
contacting the muscles
•
Keeping your elbows straight and
using own body weight, engage soft
tissues with a ventral force and
move out laterally creating a
perpendicular stretch for 1 2
seconds, off for 1 2 seconds until
tissue relaxation is perceived.
37
Q

Lumbar: Prone Pressure with

Counterleverage

A 
Using inferior hand, grasp ASIS on
other side of patient
•
Place thenar & hypothenar eminence of
superior hand on the paraspinal muscles
•
Pull posteriorly on the ASIS and apply
anterolateral pressure on lumbar
paraspinal muscles in a repetitive
rhythmic fashion holding the stretch for
1 2 seconds, then off for 1 2 seconds,
repeating until muscle relaxation is
perceived
38
Q

Lumbar: Paraspinal
Perpendicular Stretch,
Lateral Recumbent

A 
At side of table facing patient
Reach over patient’s back and
place finger pads on the
paravertebral muscles
•
Engage tissues with a ventral
force and move out laterally to
create a perpendicular stretch for
1 2 seconds, off for 1 2 seconds
until muscle relaxation is
perceived.
39
Q

C
Spine: Bilateral Forearm
Fulcrum Forward Bending

A 
Arms are crossed under patient’s head
and hands placed palm down on patient’s
shoulders
•
Repetitively flex patient neck, giving a
longitudinal stretch of the paravertebral
muscles 1 2 seconds on, 1 2 seconds off
40
Q

C
Spine: Cradling with
Traction, Supine

A 
Fingers placed under patient’s neck
bilaterally on paraspinal muscles, just
lateral to the spinous process
•
Engage soft tissue with anterior and
lateral force
•
Longitudinal traction exerted by
moving cephalad along the soft tissues,
not sliding on skin, holding for 1 2
seconds, off for 1 2 seconds, repeating
until muscle relaxation is perceived.
41
Q

Head & C
Spine: Suboccipital
Release

A 
Finger pads are placed in the
suboccipital region
•
Apply anterosuperior pressure
–
Kneading : pressure may be slowly
and rhythmically applied until tissue
texture changes occur.
–
Inhibition: Apply a constant
inhibitory pressure until tissue
texture changes occur.
42
Q

Prone Lumbosacral MFR/INR

A

Physician place one hand with pinky
just superior to the LS junction, thenar &
hypothenar eminence lateral to one of the SI
joints and the contralateral finger pads on the
lateral aspect of the other SI joint
Activating forces:
•
MFR: Inherent and respiratory
•
INR: REMs leg flex/extend, IR/ER

43
Q

Scapulothoracic

SD MFR

A 
1.
Pt: lateral recumbent, involved
shoulder up.
2.
Physician: faces the patient’s front
contacting the scapula posteriorly with
both hands (superior hand stabilizes
anterior and posterior aspect of scapula).
3.
Assess the ease and restrictions of the
6 scapular motions.
Flexion/Extension
Abduction/Adduction
Protraction/retraction
4.
Apply direct or indirect myofascial
release technique
44
Q

Cervical MFR/INR

A 
Setup:
pt. supine; cup the region of greatest
TART with finger pads (no pressure with
thumbs)
•
Gently add traction to engage the hypertonic
tissues
•
Assess flexion/extension, rotation, &
sidebending.
Activating forces:
•
MFR: Inherent and respiratory
•
INR: REMs eye, tongue & UE movement

ECOS 1 (22 decks)

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