Viscera Flashcards

1
Q

Why is learning about viscera relevant to CS Therapy?

A

Case history - may present with pathology of organ.
Need to know about location of organ to inform treatment.
Need to have awareness of organ pathologies.
For each organ need to know the sympathetic and parasympathetic nerve supply, sympathetic plexi.
Need to understand emotional connection.

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2
Q

Why would you treat viscera?

A

Disorders (gyne; digestive; immune; respiratory; cardiac); Adhesions; scars;
Allergies; reactions to medication;
Pain (referred or related to vertebral segment)
Emotion or trauma
Improve function of the organ
Stress causes disease

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3
Q

What is the CS Integrated approach to treating viscera?

A

Whole body/mind complex;
Aim to improve underlying health and vitality of person to optimise health and combat disease
May address viscera separately
Viscera plays a part in primary, secondary or causative conditions.

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4
Q

What is an AP contact?

A

Anterior / Posterior

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5
Q

Why would you use an AP contact for treating viscera and what might you feel?

A

To envelope the viscera between hands
Engage, allow, follow, stillpoint, release, reorganise.
Might feel tissues melting, softening, dissolving - change in quality
Hands may be drawn in or be pushed out
Feel focal points either locally or in relation to elsewhere
Choose to work with CS rhythms
Energy drives between 2 hands or focal points or congestion.

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6
Q

Why would you unwind viscera?

A

Accessible to direct palpation
Can feel tension and tightness held in tissues which will soften and release
Allows for deeper contact
Tissues and organs are massaged with a deeper contact which brings oxygen and nutrients

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7
Q

What 2 structures may be palpable once whole abdominal area has been released and softened?

A

Pulsation of abdominal aorta
Psoas muscle - bilaterally along vertebral column

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8
Q

Where does the psoas muscle have its attachments?

A

Bi-laterally passing out sides of T12; L123

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9
Q

What is the psoas muscle known for?

A

Holding deep emotional tension

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10
Q

Where does the psoas muscle tend to cause restrictions?

A

L4,5 S1 - and tends to compress the Sciatic Nerve roots

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11
Q

Name common sites of tension in abdominal viscera?

A

Ileo-caecal valve
Distal descending colon
Sigmoid colon
Pelvic area - ovaries; uterus; bladder

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12
Q

What are the main principles of visceral unwinding?

A

1) Prepare soft tissues - knees up/ abdo bare; loosen area by massaging tissues, identify restrictions
2) Visceral unwinding - work deeply into viscera on outbreath, engage-allow-follow-stillpoint - release- reorganise
3) Integration - AP contact - sacrum and 2nd contact and then sacrum and crown contact.

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13
Q

Of what system would you associate the thoracic viscera?

A

Respiratory system

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14
Q

Name the viscera of the respiratory system (thoracic viscera) - clue PLTL

A

Pharynx - back of nose; back of mouth (naso & ora pharynx)
Larynx - voice box - find thyroid cartilage in throat
Trachea - connects pharynx and larynx to lungs
Lungs, bronchi and bronchioles

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15
Q

Describe location of trachea?

A

4 inches long from cricoid cartilage to posterior of sternum where it divides into 2 bronchi. It is strengthened by 16-20 cartilaginous rings!! Top 2-6 are palpable. Between the larynx (voice box) and bronchi.

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16
Q

What would you consider when thinking about upper thoracic viscera?

A

Cervical spine - C1 to C4
Cranial Nerves - Glossopharyngeal & Vagus
Sympathetic Supply - T1 - T2
Parasympathetic supply - Vagus
Throat Chakra
Thymus Gland
Thyroid and parathyroids - may affect local tissues and structures if there is dysfunction eg goitre

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17
Q

Name some pathologies associated with upper thoracic viscera>

A

Infections and inflammations - pharyngitis; laryngitis; tracheitis;
Throat - suppressed emotions - leading to restrictions and constrictions - sore throat
Underlying emotional tensions - anger; grief; birth; strangulations; speaking the truth
Fascial connections down to pericardium from throat

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18
Q

How you approach treating upper thoracic viscera and why?

A

Case history to check for pathologies
Fascial unwinding of the throat
Throat work - engaging with soft tissues and muscles; tensions, restrictions
Throat work for birth trauma/ strangulation
Local restrictions or whole body - restrictions from elsewhere
Thymus gland - for immunity; also consider hypothalamus as it’s leader
Sub-occipital release - release jugular foramen for which the vagus, glossopharyngeal nerves travel through plus jugular vein - enhancing venous drainage if there is infection/ mucus
Cranial nerve pathways - individual and JF
Temporals - mastoid tip and ear hold to release JF
Fascial unwinding of neck - Spinal Accessory Nerve - spinal division with its pathway through C4 to C1
Fascial unwinding of neck - release neck = release throat tensions
Superior Cervical Sympathetic chain in neck - C4 to C1
Carotid Plexus; Pulmonary Plexus
Emotional centres
Integrated treatment

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19
Q

What would you consider when thinking about the lungs, bronchi and bronchioles?

A

Sympathetic T2 to T6
Phrenic Nerve - C345
Parasympathetic Vagus
Pulmonary Plexus
Emotional qualities - grief; anxiety
Breathing patterns
Quality of diaphragm
Lifestyle choices - smoking; drugs; work environment

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20
Q

Name pathologies of lungs?

A

Bronchitis and Bronchiolitis - infection, inflammation of bronchi and bronchioles
Asthma; COPD
Upper respiratory tract (URTI) - pneumonia (viral or bacterial?); pleurisy
Chemical causes - asbestos; drugs; smoking
Parasites
Allergens

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21
Q

How would you approach treating the lungs?

A

Case history for pathologies
Release emotional centres -
heart centre (grief, anxiety) or physical restrictions;
cardiac plexus
solar plexus - emotional and physical tension
major area for sympathetic outflow T2 to T6 -
pulmonary plexus
check breathing patterns - release diaphragm
shock being held in system or diaphragm? consider birth story
myo-fascial tension in back around T2 to T6 (asthma)
tension in intercostal nerves round ribs
Contacts -
Heart; SP; combined heart and SP
Neck unwinding - goes down to T4
Diaphragm release - phrenic nerve C345
Deepen the breath - check no holding
Vagus Nerve - check pathway; JF - may lead to cranial contact to release foramen if restricted
Bilateral scapula contact

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22
Q

What is the fascial layer covering the heart called?

A

Pericardium

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23
Q

Where is the heart located?

A

3rd to 5th left intercostal space

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24
Q

What would you consider when thinking about the heart?

A

Sympathetic nerve supply T1 to T5
Parasympathetic - Vagus
Cardiac Plexus
Case History and pathologies
Emotional factors - trauma - grief/loss
Thymus gland sits anterior to heart

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25
Q

Name some pathologies of the heart

A

Angina; Coronary Thrombosis; Myocardial Infarct; Congenital hole in heart; heart surgery; high or low blood pressure; palpitations.

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26
Q

What are the symptoms of a heart attack but what may it mimic?

A

Pain in chest, difficulty breathing and speaking; pale; sweating; clutching at the chest area. May mimic brachial plexus symptoms of left side - arm or rib lesions, intercostal muscle pain.

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27
Q

How would you approach treating the heart area?

A

Case history - emotional traumas
Heart centre - cardiac plexus at front and upper thoracic spine at posterior contact for sympathetic outflow from T1 to T5.
Scapula contact
Neck unwinding - connecting with fascia down to heart and pericardium
Fascial unwinding of the heart
Release diaphragm - central tendon attaches diaphragm to pericardium - every expansion of the diaphragm massages the heart = improved mobility = improved arterial blood supply and free fluids and venous drainage back at the heart.
Emotional tensions in heart can present as neuro sensations in left arm and little finger with tightness in upper left chest.
Vagus nerve and pathway
Heart Chakra

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28
Q

What do you know about the diaphragm?

A

Not a true organ
Dome shaped - transverse structure
Divides the thorax above from abdomen below
Top is level with xipi -sternum
Attachments to ribs 7 to 12
Attaches to L123 via the crura (tendinous legs)
There are 3 openings
Attaches to the heart (pericardium) via fascia via central tendons which attach to the lung pleura.
Part of the reciprocal tension membrane system - tensions in any of the transverse membranes will be reflected
Tendency to hold shock in diaphragm

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29
Q

Name the 3 openings in the diaphragm

A

Aortic opening
Oesophageal opening
Vena Cava opening

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30
Q

Which opening in the diaphragm does the vagus nerve pass through?

A

Oesophageal opening

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31
Q

What is the nerve supply to the diaphragm?

A

Phrenic Nerve C345 - tension in the neck may affect or be affected by the diaphragm

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32
Q

How would you approach treating the diaphragm?

A

Fascial unwinding of neck - for release of phrenic nerve
Tensions held in neck will affect diaphragm so releasing neck will release diaphragm
Myofascial release - inferior borders of ribcage - sink deep
Check breathing - stuck/ held/ upper thoracic
Releasing other transverse structures eg tentorium - mastoid tip = reciprocal tension membrane system.
Emotional centres

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33
Q

What is the oesophagus?

A

10 inch long tube.
Originates from epiglottis
Food passes from pharynx to stomach
Passes through aortic opening and then oesophageal opening
Level with T11

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34
Q

What are some oesophageal pathologies?

A

Heartburn - inflammation from acid reflux from stomach through cardiac opening in diaphragm.
Hiatus hernia - upper part of stomach protrudes through cardiac opening in diaphragm.

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35
Q

Where is the stomach? - Abdominal viscera

A

Below diaphragm on left side

36
Q

What is the name of the sphincter that empties into the stomach?

A

Lower oesophageal sphincter

37
Q

What is the name of the sphincter that empties from the stomach into the duodenum (1st part of small intestine)

A

Pyloric Sphincter

38
Q

What is the function of the stomach?

A

To digest food, secrete gastric juices and mucus to break down food

39
Q

What nerve supply and other associations would you think about with the stomach?

A

Parasympathetic - Vagus
Sympathetic - T6 to T10 to
Coeliac Plexus via Greater Splanchnic nerves

40
Q

What happens to the pyloric sphincter during sympathetic stimulation?

A

It is regulated by sympathetic nerve supply T6 to T10. During sympathetic stimulation, the pyloric sphincter closes to stop food being digested because digestion is not required. Peristalsis stops.
During times of less stress and optimal health, parasympathetic supply via the vagus nerve supports digestion, increases peristalsis and the pyloric sphincter opens.

41
Q

What is the stomach pylorus?

A

Pylorus: a small circular opening between the stomach and the duodenum.
Marked by the thickening of circular muscle layers forming the pyloric sphincter to control the opening and closure.

42
Q

What is pyloric stenosis?

A

Narrowing of the opening from the last part of stomach - the pylorus to the first part of the small intestine (the duodenum).
Symptoms - projectile vomiting without bile usually after baby is fed.
Typically occurs 2 to 12 weeks old.
Unclear cause - Risk factors in babies include C-section; preterm birth, bottle feeding, stress; overstimulated ANS.
The diagnosis may be made by feeling an olive-shaped mass in the baby’s abdomen.

43
Q

What is a gastric ulcer?

A

Ulcerated lining of stomach caused by too much gastric juices - pain, vomiting blood, dark sticky stools.
Causes - infection of bacteria; stress; anti-inflammatory drugs. ANS dysfunction.

44
Q

What is a hiatus hernia?

A

Stomach protruding through cardiac opening in diaphragm.

45
Q

What are the 3 parts to the small intestine? Clue: DJI

A

1st part - Duodenum
2nd part - Jejunum
3rd part - Ileum

46
Q

What is the nerve supply and other associations of the small intestine?

A

Sympathetic supply T6 to T10 via Coeliac Plexus,
Superior Mesenteric Plexus
Parasympathetic - Vagus

47
Q

Where and what is the function of the Ileocecal valve? (THINK ILEUM and CAECUM - SMALL-LARGE INTESTINE)

A

The ileocecal valve is a sphincter muscle
Located at the intersection of the small intestines and large intestines, between the ileum and cecum.
Positioned near the appendix
Functions to open and close the passageway between the small and large intestine to facilitate the movement of food through the digestive tract.
The ileocecal valve acts as a one-way valve. Hence it would also prevent waste from flowing back into the small intestine.

48
Q

Where is McBurneys point?

A

A spot on the abdomen relative to the pelvic bone and
The point is one-third of the way from the pelvic bone point to the bellybutton on the right side.

49
Q

How would you find the ileocecal valve?

A

Find McBurneys point - A spot on the abdomen relative to the pelvic bone and
The point is one-third of the way from the pelvic bone point to the bellybutton on the right side.

50
Q

What is the nerve supply to the Ileocecal valve?

A

Sympathetic - T10 to T12 via Coeliac Plexus
Superior Mesenteric Plexus, Inferior Mesenteric Plexus
Parasympathetic - Vagus

51
Q

How would you treat the Ileocecal valve?

A

During sympathetic nerve supply stimulation, the sphincter narrows or closes.
CS treatment to induce relaxation will support system to relax. Sympathetic supply from T10 to T12 via sympathetic Solar Plexus and Coeliac Plexus
Vagus nerve pathway
Unwinding of the valve?

52
Q

How is the appendix linked to the ileocecal valve?

A

Appendix is below ileocecal valve, under McBurneys point and attached to the caecum, the first part of the large intestine. Its lymphatic tissue supports immunity and infection. If the ileocecal valve isn’t functioning properly and it is narrow or closed due to excess sympathetic stimulation, stagnation and infection can occur which can lead to appendicitis.

53
Q

What are the symptoms of appendicitis?

A

Very tender McBurneys point.
Acute pain in appendicitis area.
High temperature & vomiting.

54
Q

Name the 5 parts of the large intestine (colon)? CATDS

A

1st part - caecum
2nd part - ascending colon
3rd part - transverse colon
4th part - descending colon
5th part - sigmoid colon

55
Q

What is the pathway of the: caecum

A

To connect the small intestine (Ileum) to the caecum (1st part of large intestine) via the ileocaecal valve

56
Q

What is the pathway of the: ascending colon

A

Digested food travels up from the caecum on the right abdo side towards the liver and turns into transverse colon

57
Q

What is the pathway of the: transverse colon

A

Transverse colon continues from hepatic flexure to splenic flexure and hangs down towards umbilicus level, leading to descending colon.

58
Q

What is the pathway of the: descending colon

A

Descending colon passes down left side of abdo into left iliac fossa where it continues into the sigmoid colon

59
Q

What is the pathway of the sigmoid colon?

A

Sigmoid colon leads into the rectum

60
Q

What is Diverticulitis?

A

Inflammation or infection of small pouches called Diverticula that develop along the walls of the intestines.
Pockets get filled with stagnant food, may cause infection, may strangulate.

61
Q

What is IBS?

A

Colon goes into spasm - common cause is stress.
If RIGHT SIDE of abdomen has IBS think VAGUS and follow pathway from medulla down to colon.
If LEFT SIDE of abdomen has IBS think Splanchnic Nerves - S234

62
Q

What is the nerve supply of the colon (large intestine?)

A

Sympathetic supply from T10 to T12 via Sympathetic Plexus - Coeliac; Superior and Inferior Mesenteric and Hypergastric to colon
Parasympathetic -
1st half of colon = Vagus;
2nd half of colon = Pelvic Splanchnic nerves - S234

63
Q

Where is the rectum?

A

6 inches long - runs down inner curve of sacrum from level S3 to coccyx along midline.
Posterior to uterus; bladder; prostate.
Leads to anal canal - final 1.5inches of GIT.

64
Q

What is the nerve supply to the rectum?

A

Sympathetic - T10 to L2 via Hypogastric plexus
Parasympathetic - Pelvic Splanchnic Nerves S234

65
Q

Is it time for a cup of tea

A

Yes and biscuits

66
Q

Name 2 functions of the liver?

A

1) processes waste and toxins which it receives in the venous blood from all intestines via portal vein
2) produces bile to breakdown fats and which is stored in gall bladder.

67
Q

What is the nerve supply of the liver and gall-bladder?

A

Sympathetic T6 to T10 via coeliac and superior mesenteric plexus
Liver innervated by Hepatic plexus
Vagus - parasympathetic

68
Q

How would you treat the liver

A

AP - posterior hand T6 to T10 - anterior hand on liver or solar plexus (as sym. supply passes via plexus).
Direct contact with liver - above and below.

69
Q

What emotion do you relate to liver and gall-bladder?

A

Liver - Supressed anger
Gall-bladder - control

70
Q

Where is the liver and gall bladder?

A

Liver - upper right portion of the abdominal cavity, under the diaphragm and beside the stomach.
Gall-bladder - lower surface of liver, under ribcage on right and 1 inch right of xipi-sternum

71
Q

What is the function of the gall-bladder

A

Stores bile and secretes into duodenum to break down fats.

72
Q

What is cholestasis

A

Inflammation of gall bladder

73
Q

Where is the spleen?

A

Under diaphragm on left of stomach - level with T10 - size of a fist!

74
Q

What is the function of the spleen?

A

Filter blood
Stores red blood cells & platelets
Produces white blood cells - immune response
Dysfunction - malaria; leukaemia; infection

75
Q

What is the nerve supply to the spleen?

A

Sympathetic T6 to T10 via coeliac and superior mesenteric plexus
Vagus - parasympathetic

76
Q

Where are the kidneys?

A

behind peritoneum on back wall of abdomen
Left kidney - level with T12 to L2
Right kidney - Level with L123 (#below liver so lower)

77
Q

What is the nerve supply to the kidneys?

A

Sympathetic T10 to L2 via Coeliac; Superior and Inferior Mesenteric, Superior Hypogastric
Parasympathetic: Pelvic Splanchnic Nerves S234

78
Q

What are the symptoms of a kidney infection?

A

High temp, blood in urine, pain in lumbar area, nausea

79
Q

Pelvic viscera - bladder - Where is it?

A

Behind pubic bone, in front of vagina and uterus in women and higher than prostate in men.

80
Q

What is the function of the bladder?

A

To excrete waste products

81
Q

What is the nerve supply for the bladder?

A

Sympathetic T10 to L2 - via hypogastric plexus
Parasympathetic - pelvic splanchnic nerves S234

82
Q

What emotions would you associate with uterus?

A

Tension; fear; control

83
Q

What is the nerve supply to the uterus and ovaries and prostate?

A

Sympathetic T10 to L2 - via hypogastric plexus, superior and inferior mesenteric plexus
Parasympathetic - pelvic splanchnic nerves S234

84
Q

How might you approach treating the ovaries?

A

Case history - physical; emotional
Sacrum and pelvic centre
Sacrum and ovaries
Myofascial release - unwinding the ovaries - release tension

85
Q

Why would you use fascial unwinding of the trunk and vertebral column?

A

For someone who has whole body trauma eg multiple injuries from an accident - releases the spine at many different levels and the organs benefit too.