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OS > Viscerosomatic & Chapman Take 2 > Flashcards

Viscerosomatic & Chapman Take 2 Flashcards

1
Q

Myotatic reflex

A

tonic contraction of muscle in response to stretching force, due to stimulation of muscle receptors

agonist is contracted while antagonist muscle is relaxed

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2
Q

What is a reflex?

A

relationship between an input stimulus to the body & output action to muscle or secretory organ

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3
Q

What is important about spinal cord gray matter?

A

processing area of cord

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4
Q

What is located in the lower layers of spinal cord gray matter?

A

interneurons

motorneuron cell bodies

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5
Q

Where do afferent fibers into spinal cord terminate?

A

end in layers 1 & 5

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6
Q

What input do interneurons receive?

A

70-80% of interneurons receive input from both visceral & somatic afferents

may account for visceral pain being so diffuse & poorly localized

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7
Q

What is responsible for localized pain pattern we see?

A

interaction of interneurons w/ somatic efferents

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8
Q

What is significant about the overlap of visceral & somatic afferent fibers?

A

basis for activation of somatic muscle activity seen w/ visceral disturbances

visceral afferents activate sympathetic outflows & skeletal muscle motor neurons

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9
Q

How do descending influences impact reflexes?

A

affect long-lasting excitability of outflows by maintaining reflex (sensitization of interneurons acts as amplifier of input so more output expected)

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10
Q

What is the basis for decompensation of homeostasis?

A

visceral disturbances reflexively cause activation in somatic musculature & produces dysfunction (facilitated segment)

somatic disturbances can reflexively alter visceral function

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11
Q

What is the somatic component of disease?

A

MSK palpatory findings may correlate w/ visceral disturbances

normalizing MS component may normalize autonomic outflows (leading to restoration of homeostasis)

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12
Q

What is habituation?

A

process of decreasing response of a neural pathway w/ a continuous stimulation

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13
Q

What is sensitization?

A

when a stimulus is repeated, response may grow for longer

a stable response level is reached that can continue @ increased level as long as stimulus is continued

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14
Q

How do habituation & sensitization contribute to homeostasis?

A

habituation & sensitization processes exist together to help maintain a homeostasis between over-reaction & under-reaction to a stimulus

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15
Q

What is the concept of facilitation?

A

maintenance of a pool of neurons in a state of subthreshold excitation

less afferent stimulation is needed to trigger discharge of impulses

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16
Q

Nociception theory

A

a stimulus activates nociceptive pathways that travel to spinal cord & branch to many sites

results in release of peptides @ motorneuron level in peripheral tissues

peptides lead to inflammatory cascade & initiate release of “chemical soup” that spreads in tissues

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17
Q

What is the main result of chemical soup in peripheral tissues?

A

lowers nociceptor threshold which INCREASES input to spinal cord

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18
Q

Where are nociceptors NOT found?

A

in brain or hyaline cartilage

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19
Q

What is the result of inflammation in tissues?

A

disrupts balance between habituation & sensitization

larger than normal motor outputs to autonomics & somatic systems

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20
Q

Steps for increasing sensitivity of neurons

A 
short term excitability (sensitization)
long term sensitization (lasting for hours)
fixation (lasts for days-weeks)
permanent excitability (w/ death of inhibitory interneurons)
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21
Q

Who was the main person behind the facilitated segment concept?

A

Denslow showed reflex changes (long lasting, low threshold areas to afferent inputs)

correlated excitable areas w/ injury & disease

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22
Q

Facilitated segment concept

A

includes skeletal muscle & sympathetic nervous system

23
Q

What is allostasis?

A

the long term neural effect of segmental facilitation

24
Q

What is the process that leads to allostasis?

A 
stimulus (insult) is applied to tissues
develop chemical soup of inflammation
causes primary afferent sensitization
results in hyperalgesia
secondary hyperalgesia develops
25
Q

What is hyperalgesia?

A

exaggerated response to noxious stimulus

26
Q

Effect of allostasis on dorsal horn neurons

A

Ca2+ channels open
phosphorylation cascades
lose inhibitory neuron function

all lead to maintaining facilitation

27
Q

Effect of allostasis on ventral horn neurons

A

facilitation outflows to autonomics (affects visceral function)

facilitation outflows to soma (muscle spasm=asymmetry & altered ROM)

28
Q

Effect of allostasis on brain stem

A

facilitation decreases endogenous descending pathways

over release of catecholamines & glucocorticoids which damages system

29
Q

Allostasis overload

A

ultimate result of loss of control & protective mechanisms from brainstem

30
Q

What are the main effects of allostasis on body systems?

A

CV (increased risk of MI)
neuro (depression, anxiety, decreased cognition)
immune (immunosuppression)

31
Q

Somatosomatic reflex

A

withdrawal response (when noxious stimulus is applied to somatic structure)

myotatic response (stretch receptor stimulated & agonist muscle receives impulse to fire)

32
Q

Viscerovisceral reflex

A

distention of gut results in increased contraction of gut muscle

reflexes involve afferent activity flowing from receptors into spinal cord thru interneurons to produce efferent or outflow activity w/ in sympathetic or parasympathetic motorneurons

33
Q

Somatovisceral reflex examples

A

somatiocardiac
somatogastric
somatoadrenal

34
Q

Somatiocardiac reflex

A

nociceptive somatic stimuli result in elevation of HR & blood pressure

35
Q

Somatogastric reflex

A

nociceptive somatic stimuli result in inhibition of peristalsis in stomach

36
Q

Somatoadrenal reflex

A

nociceptive somatic stimuli result in release of catecholamines from adrenal medulla (movement of inflamed knee)

37
Q

Viscerosomatic reflexes

A

somatic pain referral due to visceral nociceptive stimuli

38
Q

How are the visceral & somatic sensory systems related?

A

there are numerous interneuron connections in DRG creating complex communication network connecting visceral & somatic systems

39
Q

Chapman reflexes definition

A

used by Frank Chapman & described by Charles Owens

group of palpable points occurring in predictable locations on anterior & posterior surfaces of body that are considered to be reflections of visceral dysfunction or disease

40
Q

What prompted Chapman to study more about the lymphatic system?

A

noticed groin glands on pt that were painful & tried to gently manipulate them which lead to major relief for the pt

41
Q

How did Chapman study the lymphatic system?

A

mapped congested lymphatic areas that he found in consistent locations close to body surface & referred to them as neurolymphatic points w/ physiological relation to lymphatic & neuro systems

42
Q

When did Chapman first publish his observations?

A

in 1929 text titled “Lymphatic reflexes”

43
Q

What are Chapman’s reflexes?

A

CRs are manifested by gangliform contractions which are believed to be congestions w/ in fascia due to lymph stasis secondary to visceral dysfunctions

3 components:
viscerosomatic reflex (of diagnostic & treatment value)

gangliform contraction that blocks lymph drainage

consistent reproducible series of points both anterior & posterior related to SPECIFIC ORGANS or conditions

44
Q

Describe the palpatory findings assoc w/ Chapman’s reflexes

A

located deep to skin in subcutaneous areolar tissue

PAIRED anterior & posterior points

small, smooth & firm nodule that are 2-3 mm in diameter

may be confluent, dense but not hard

45
Q

How did Owens describe these points?

A

in 1943 as gangliform, edematous, ropy, fibrospongy, shotty

46
Q

How can you treat a Chapman point?

A

apply gentle but firm pressure w/ 1 finger pad

slowly move tip of finger in circular fashion for 10-30 seconds (can alternate directions)

47
Q

How can you DX a Chapman point?

A

pain that is pinpoint, sharp & non-radiating

located under physician’s finger tips

pain is greater than expected & pt usually unaware of sore spot

48
Q

When do you stop treating a Chapman point?

A

the mass disappears to pt/phys can no longer tolerate the procedure

49
Q

Indications for treat of CP

A

to DX: is part of screening exam when clinically indicated from pt history

to treat: upon finding that CR is possibly clinically relevant for that pt

50
Q

Contraindications of CP treatment

A

pt needs emergent care

pt refusal

relatively contraindicated w/ fracture, cancer & other pt instability

51
Q

Where does osteopathic medicine come in for pt care?

A

at the host by looking @ environmental factors leading to illness

52
Q

What does illness cause in the host?

A

decompensation

53
Q

What can help improve decompensation of homeostasis?

A

OMT!

54
Q

Why is OMT important?

A

reasonable to conclude that using OMT to break cycle of facilitation, homeostasis & health can be restored to the pt

OS (18 decks)

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