Visceral OMT Lab

Question 1

Indications for large intestine visceral OMT

Answer 1

Constipation
IBS
Other functional disorders
Viscerosomatic reflex findings

Question 2

Relative contraindications for large intestine visceral OMT

Answer 2

Peritonitis
Colon obstruction
Recent abdominal surgery

Question 3

What parts of the colon are retroperitoneal?

Answer 3

Ascending, descending, and sigmoid

Note that in healthy ppl colon tapers from proximal to distal

Question 4

Note sympathetic (cord level, splanchnic nerves, collateral-prevertebral ganglia) and parasympathetic innervation associated with stomach, duodenum, liver, GB, pancreas, and spleen

Answer 4

Sympathetics: T5-9, greater splanchnic n., celiac collateral-prevertebral ganglion

Parasympathetic: vagus (CN X)

Question 5

Note sympathetic (cord level, splanchnic nerves, collateral-prevertebral ganglia) and parasympathetic innervation associated with small bowel, proximal 2/3 of colon, kidneys, adrenals

Answer 5

Sympathetic: T10-11, lesser splanchnic nn, superior mesenteric ganglion

Parasympathetic: vagus (CN X)

Question 6

Note sympathetic (cord level, splanchnic nerves, collateral-prevertebral ganglia) and parasympathetic innervation associated with distal 1/3 colon, lower ureters, bladder, pelvic organs

Answer 6

Symp: T12-L2, least splanchnic, inferior mesenteric

Parasympathetic: sacral (pelvic), splanchnic (S2-4)

Question 7

Posterior colon chapmans reflex

Answer 7

A triangular area reaching from the transverse processes of L2-4 reaching to the crest of the ilium

[direct fascial relationship between the descending or ascending colon, depending on the side, and quadratus lumborum m]

Question 8

Indications for small intestine visceral OMT

Answer 8

Indigestion
Delayed gastric emptying
Cholestasis
Other functional disorders
Viscerosomatic reflex findings

Question 9

Relative contraindications for small intestine visceral OMT

Answer 9

Peritonitis
Splenomegaly
Recent abdominal surgery

Question 10

Indications for liver visceral OMT

Answer 10

Passive congestion of liver and spleen

CHF (esp. right sided failure)

May increase immune competence in pts with infectious processes

Consider in pts with parenchymal dz of liver or spleen as it may affect the disease process by modulating blood and lymph fluid dynamics

Liver visceral dysfunction

Question 11

Contraindications for liver visceral OMT

Answer 11

Fractures, dislocations in the thorax

Lymphatic system malignancy

Traumatic disruption of liver, spleen, or adjacent organs

Acute hepatitis

Friable hepatomegaly or splenomegaly as in mononucleosis or sickle cell anemia

Question 12

Cord level of liver sympathetic innervation

Answer 12

T7-9

Question 13

HIGH YIELD: goals of mesenteric/colonic release

Answer 13

1. Enhance lymphatic and venous drainage

2. Alleviate congestion secondary to visceral ptosis/dysfunction