Test 2 Lecture Flashcards
Describe central sensitization in response to a chronic peripheral nociceptor site.
When an afferent stimulus bombards the spinal cord over an extended period of time, then the spinal cord becomes hyper excitable or sensitized.
In this sensitized state, a weaker afferent stimulus can excite both somatic and visceral efferents. Once established normal CNS activity can maintain it.
Describe how facilitation can lead to somatic dysfunction in a patient that strains a muscle
Strained muscle leads to a continuous sensory input and interneuron sensitization. Muscle becomes tense and restricts range of motion and it becomes tender to palpation. Prolonged tension continues the sensitization process. nociceptor activation releases chemicals and molecules in neighboring areas causing local vasodilation and tissue texture change. Finally muscle spasm, tension, exaggerated motor outputs can cause asymmetry (vertebrae for example can rotate and side bend).
How are champions points related to the discussion of somatic dysfunction as it relates to facilitation of the spine?
Chapmans points are associated with visceral dysfunction and are used for diagnosis. They represent the somatic manifestation of a visceral dysfunction. These are the gangliform contractions or tapioca pearls; smooth, firm, discretely palpable nodules located in the deep fascia or periosteum of bone. Pressure on these points will elicit sharp, non radiating, exquisitely distressing pain.
When you press into someones muscle, usually a taut band of muscle or fascia, and they feel radiating pain; what do you call it.
These are trigger points.
Tenderpoints do NOT radiate pain, trigger points DO.
what’s another name for viscero-viscero reflexes?
cross-organ sensitization
What are the 3 characteristics of a facilitated viscera-somatic reflex?
1 Persist beyond the time course of the originating stimulus
2 Produces effects disproportionate to stimulus intensity
3 Results in chronic changes in normal physiology of somatic structures induced by a subclinical visceral lesion
How does OMT disrupt the cycle of somatic dysfunction and neural reflexes?
Reduce peripheral tenderness
Reduce the hyper sympathetic drive
Augment lymphatic removal
Speed recovery
What are the attachments to ribs 1,2,3-5,6-9,10-11, 12
1 anterior and middle scaling 2 posterior scaling 3-5 pec minor 6-9 serratus anterior 10-11 latissimus dorsi 12 quadradus lumborum
What are some of the symptoms of costochondritis?
Multiple tender areas at articulations costosternal and costochondral junctions- No signs of acute injury: i.e. warm swollen
What are the 5 osteopathic models for patient treatment ?
Biomechanical Respiratory-Circulator Neurologic Metabolic energy Behavioral
How can you know if the pain a patient is feeling post mastectomy isn’t a cancer reoccurrence?
Pain is not typical of post mastectomy
concern with progressive pain
PE and ask details about the pain
As a baby was passing through the birth canal it twisted its thoracic diaphragm which would most likely lead to the following somatic dysfunction?
- torticollis
- plagiocephaly
- respiratiory irregularities
- lymphatic obstruction
- respiratory irregularities, irritability, and hiccups
You see a newborn with its head rotated away and side bent toward a hypertonic SCM. This disfunction is characterized by possible impingement of a nerve best treated by which procedure?
- OA decompression
- ME SCM
- Pedal pump
- Thoracic inlet release
OA decompression as CN XI is affected from possible compression at the occiput. This is torticollis
Which cranial bone is most susceptible to somatic dysfunction from the birthing process?
occiput
you notice a newborn with loss of naso-labial fold and facial paralysis. Cranial exam reveals nystagmus. The nerve affected attaches to which eye muscle?
lateral rectus CN VI
At birth the temporal and sphenoidal bones are arranged in what named segments?
Temporal- PMS petrosal, mastoid, squamous
Sphenoidal- Body with lesser wings, 2 greater wings, and pterygoid process
How are the occiput, parietal bone and frontal bone divided at birth
occiput- base, squama and two lateral parts
parietal- normal
frontal-two parts divided by metopic suture
The parallelograming of the temporal bone can cause external and internal rotation of the bone leading to what corresponding mastoid positions?
Internal rotation of temporal bone- more prominent mastoid moved anterolateral
External rotation of temporal bone-less prominent mastoid moved posteriomedialy
72.8% if newborns with cranial deformity, long labor, and birthing trauma have what problems in latter life?
learning difficulties
How do strain pattern correlate to learning difficulties?
There is a wide range of strain pattern in children both with and without learning difficulties. It seems that before 2 yrs old these have a larger impact of development.
