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OPP IV EXAM 1 > Visceral Lectures > Flashcards

Visceral Lectures Flashcards

1
Q

List the anatomiccal layers from surface to organ through the abdominal wall.

A 
Skin 
Superficial fascia
Anterior rectus sheath/investing fascia
Rectus abdominus
Deep investing fascia
Transveralis fascia
Peritoneum
Empty space (hand drops)
Viscera
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2
Q

Describe indirect treatment of visceral organs.

A 
Layer palpation to level of organ.
Fascial (local) listening.
Motion testing in various planes.
BLT: stack in directio nof EASE and wait for release (~30 seconds)
Re-assess.
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3
Q

Describe direct treatment of visceral organs – release of colon for constipation.

A

Start at distal portion (sigmoid colon) and insert fingers gently on lateral wall of colon.
Pull gently/firmly toward umbilicus.
Wait for release.
Repeat moving proximally along colon (descending; ascending; cecum)

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4
Q

Viscerosomatic reflexes T6-9 Right

A

Liver (R)

Gallbladder (R)

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5
Q

Viscerosomatic reflexes T7 (2)

A

Spleen (L)

Pancreas (R)

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6
Q

Viscerosomatic reflexes T10-11

A 
Right colon
Adrenals
Kidneys
Ovaries
Testes
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7
Q

Viscerosomatic reflexes T12-L2

A

Left colon

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8
Q

Viscerosomatic reflexes T12

A

Appendix

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9
Q

Sympathetic preganglionics

  • spinal levels?
  • divisions?
A 
T5-L2
Greater (T5-9)
Lesser (T10-11)
Least Splanchnic (T12)
Lumbar splanchnic (L1-L2)
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10
Q

Celiac Ganglion Post-Ganglionic to: (7)

A 
FOREGUT:
Distal esophagus
Stomach
Liver
Gallbladder
Spleen
portions of pancreas
proximal duodenum
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11
Q

Superior Mesenteric Ganglion Post-Ganglionic to: (10)

A 
MIDGUT:
Portions of pancreas
Duodenum
Jejunum
Ileum
Asc colon
Prox 2/3 of transverse colon
ALSO:
Adrenals
Gonads
Kidneys
Upper 1/2 ureter
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12
Q

Inferior Mesenteric Ganglion Post-Ganglionic to: (7)

A 
HINDGUT:
Distal 1/3 of transverse 
Desc colon
Sigmoid
Rectum
ALSO: 
Lower 1/2 Ureter
Bladder
Genitals
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13
Q

Indications for visceral manipulation

A 
liver dysfunction
gallbladder dysfunction
stomach (GERD; hypomotility)
small intestinal mobility/motility
colon (constipation; IBS; iliocecal valve)
pain of non-surgical nature
lymphatic congestion
immune dysfunction (spleen)
vascular supply problems.
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14
Q

Absolute contraindications to visceral manipulation

A 
acute abdomen
appendicitis
pancreatitis
splenomegaly
GI obstruction
abdominal aortic aneurysm
post-abdominal/pelvic surgery (NO direct)
GI infection (colitis; duodenitis; ileitis)
tumor.
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15
Q

Relative contraindications to visceral manipulation

A

Abdom hernia/diastasis

Pain of unknown origin

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16
Q

Viscerosomatic reflex T5-6 (R)

A

Upper esophagus

17
Q

Viscerosomatic reflexes T5-9 (L)

A

Lower esophagus

Stomach

18
Q

Viscerosomatic reflexes T8-9

A

Small intestine

19
Q

Name 3 techniques to treat the sympathetics in the abdomen

A

Chapman reflexes
Rib raising
Ventral abdominal ganglion inhibition

20
Q

Name 3 techniques to treat the parasympathetics to the abdomen

A

Cervical (OA, AA)
Soft tissue (suboccipital)
Cranial (occipitomastoid suture)

21
Q

Describe true visceral pain

  • where are the receptors?
  • carried by what type of fibers?
  • where is the pain and what does it feel like?
A

pacinian corpuscles; free nerve endings
activated by spasm or stretch
carried by visceral afferents
midline, poorly localized, vague, deep, diffuse, burning ache.

22
Q

Describe viscerosomatic pain

-where are the receptors?

A

pain receptors in anterior and lateral parietal peritoneum, lesser omentum, mesentery, mesocolon
facilitated cord segments in somatic areas related to viscera sympathetic innervation.

23
Q

Describe the percutaneous reflex of Morley.

A

NO pain receptors in visceral peritoneum (greater omentum; spleen)
Awareness of pain only if affecting adjacent pain-sensitive structure.

24
Q

Where does cranial nerve X exit?

Describe its innervations (6).

A

Jugular foramen
Left: greater curvature of stomach; duodenum
Right: lesser curvature of stomach; small intestines; right colon; organs/glands up to mid-transverse colon.

25
Q

Discuss visceral manipulation and who it was defined by.

A

Jean-Pierre Barral
Organ/viscera in good health has physiologic motion
Restriction implies functional impairment
Motion repeated thousands of times daily

26
Q

Mobility vs. motility in terms of visceral manipulation and testing

A

Mobility: voluntary or diaphragmatic; skeletal muscle effects –direct movement of organ via PALPATION

Motility: inherent motion –listening

Paired organs test together!
Pressure on suspected organ while monitoring will inhibit the influence on the monitored organ.

27
Q

Visceral rhythm:

  • how many cycles/min?
  • motion is …?
A

7-8 cycles/min
Motion is toward and away from midline

Inspiration: cranial FLEXION; swelling of organ
EXpiration: cranial EXtension; organ gets smaller

28
Q

How many cycles before results should be expected in visceral treatment?
-how long should you wait between treatmnets?

A

15 cycles

Wait 3-4 weeks b/t treatments.

29
Q

Contraindications to visceral tx.

A

Acute infection (except bladder)
Foreign bodies
Calculi (relative)
Thrombosis

30
Q

Describe the liver flip technique.

-is it direct or indirect?

A

Physician standing behind seated patient.
Reach under ribcage with PADS of fingers (2-3)
Lift fingers enough to move liver
Move up and down ribcage.

31
Q

Fulford diaphragm (shock) release is used primarily to:

A

Re-establish diaphragm motion

Can be used for pts with hx of MVA.

32
Q

Sympathetics T10-11 innervate (2)

-which ganglion?

A

Right colon
1/2 transverse colon
Superior mesenteric ganglion

33
Q

Sympathetics T12-L2 innervate (2)

-which ganglion? (2)

A

1/2 transverse
Left colon
Inferior mesenteric ganglion
Lumbar

34
Q

Hyperactivity of the sympathetics in the lower GI tract can produce which symptoms:

A

Flatulence
Abdominal distension
Constipation
Ileus (inactivity)

35
Q

Vagus innervates (2)

A

Right colon

1/2 transverse

36
Q

Pelvic splanchnics innervae (4)

A

1/2 transverse (distal)
Left colon
Sigmoid
Rectum

OPP IV EXAM 1 (4 decks)

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