Zinc/BLT Flashcards
1
Q
Define BLT/BMT according to Sutherland
A
Movement of a joint/articulation that does not cause asymmetry tensions in the ligaments
2
Q
Is the tension distributed through the ligaments in any given joint balanced?
A
Yes
3
Q
What is a consequence of Tensegrity
A
When one part changes, the entire part changes (body, region, joint…even cell)
4
Q
What should exist in a normal joint relationship? Used by who?
A
Balanced ligamentous tension (BLT)
Wales in her terminology for the technique as well as the goal of the treatment
5
Q
What happens when a force is applied to a joint? Used by who?
A
Ligamentous articular strain (LAS)
Beck in his terminology for the technique as well as the problem
6
Q
Order of names for the technique
A
- Balanced Membranous Tension (BMT)
- Balanced Ligamentous Tension (BLT)
- Ligamentous Articular Strain (LAS)
7
Q
What year did Sutherland implement techniques?
A
1940’s
8
Q
What 2 peoples helped promote LAS and BLT?
A
- Rollin Becker, DO
2. Anne Wales, DO
9
Q
Is BLT indirect or direct?
A
Indirect technique
10
Q
Explain Soft Tissue OMT
A
Direct method that is typically applied at and through either an elastic or restrictive barrier
Rhythmic and Repetitious
11
Q
What 2 direct methods do we use at the RESTRICTIVE barrier?
A
- MFR
2. LAS
12
Q
What 2 indirect methods do we use at the WOBBLE POINT?
A
- MFR
2. BLT/BMT
13
Q
Do the functional release OMT types require continuous adjustment of position/pressure in response to progressive change?
A
Yes
14
Q
BLT (viscoelastic model)
A
Some elongation is lost and some is retained after application of tension force
15
Q
How do we diagnose MFR?
A
Locate ease/bind “barriers”
16
Q
Where do we take myofascial (target) tissues to in MFR?
A
To a specific start point
17
Q
What do we wait for at the feather edge of the restrictive barrier in MFR?
A
Heat to cause collagen ‘state’ change from gel to sol and viscoelastic (“creep”) resposne
18
Q
How long might it take for the heat to cause collagen state?
A
20-30 seconds…while you adapt to TTC
19
Q
What do we follow in MFR?
A
‘Creep’ until a release takes place
20
Q
May we use release enhancing mechanisms (REMs) or other motions and/or joint positioning?
A
Yes
21
Q
Do we need to “finish”…creep stops and there is return to normal?
A
Yes
22
Q
Do we re-check TTC?
A
Yes
23
Q
Give the definitions explainingg MFR and BLT/LAS
A
- MFR - continuous adjustment of position/pressure in response to palpating progressive change of myofascial tissues
- Continuous adjustment of position/pressure in response to palpating progressive change of ligamentous/joint capsular tissues
24
Q
What is the major difference between MFR and BLT/LAS?
A
Which tissue you are listening to when you diagnose and treat!!!!
25
Does fine movement cause much change?
Yes (any motion at a mobile point can cause tissues to tighten)
26
Balance in not what?
Cramming beyond the tissue's elastic limits, and yet it is not touching light as a butterfly
27
Is a vital resilience still present in the tissue?
Yes
28
When is shifting point created?
When reached and applied to area that is not perfectly balanced
29
Should we sense that the tissue "animate"?
Yes
30
What is the key to successful treatment?
The delicate balance point to any part of the body or any tissue
31
Indirect BLT Balance Point
Point of balance of an articular surface from which all the motions physiologic to that articulation may take place
32
BMT Balance Point. Where is it used?
Applicable in interosseous or dural membranes
Used in OCMM and in interosseous membranes (radius, fibula)
33
Are balance feel and release similar in most function OMT?
Yes
34
1st-3rd observations of spinal joints by Fryette at al in BLT site mechanic returning physiological motion
1. T-L neutral
2. T-L non-neutral
3. 3 planes..all joints
35
3 points in BLT at spinal facets/joints
1. Importance of picturing facet/joint facings
2. Importance of translation/glide movements
3. Seek "balanced" tension around joint
36
BLT at regional transition zones
Not Fryette; balance entire region
37
What is the key for BLT site mechanics?
Usually minor motion SD
38
5 Models
1. Postural-Biomechanical
2. Biopsychosocial
3. Neuromuscular-Autonomic
4. Metabolic-Hormonal (Bioenergic)
5. Respiratory Circulatory
39
What model is used in BLT/BMT/LAS and Zink?
Respiratory-Circulatory Model
40
What is the Common Compensatory Pattern in the Respiratory-Circulatory Model?
Left/Right/Left/Right (from top to bottom)
Opposite from bottom to top
41
Where did Zink graduate from? Where did he move to teach?
PCOM; Des Moies (Fluid Freak)
42
3 facts about Zink
1. Espoused RC model
2. Linked primary to secondary respiration with "Craniosternosacral Mechanism"
3. Developed ALS - wrote approach
43
3 facts about the underlying conditions for a patient being considered for the RC Model
1. Congestive component (edema, swelling)
2. Compromisses respiratory and/or circulation function
3. Would benefit from enhance immune function
44
3 dysfunction compromises for a patient being considered for the RC model
1. Lymphaticovenous pathways
2. "Terminal lymphatic drainage sites"
3. Diaphragm functions
45
4 places in RC Model for terminal lymphatic congestion
1. Supraclavicular (HEENT)
2. Posterior Axillary Fold (UE)
3. Sub-Xiphoid Process (abdominal)
4. Inguinal (LE)
46
Step 0 Findings
1. History of sign of infection (fever)
| 2. History indicating underlying congestive pathophysiology
47
Step 1 findings
1. Uncompensated zink fascial pattern (or CP in bedridden)
2. Terminal lymphatic drain site congestion
3. Scale muscle spasm (esp with rib 1 SD)
48
Step 2 findings
1. Not breathing down to pubic symphysis
2. Paradoxical respiration
3. Tight pelvic floor
49
Step 3 findings
1. Generalized signs of congestion
2. Secondary respiratory-related SD
3. Poor primary respiration mechanism
50
Step 4 findings
1. Organs congested (hepatomegaly)
| 1. Specific somatic site swollen
51
What are 3 things the RC model is about?
1. Pathways
2. Motion
3. Pressure change
52
4 steps in optimal lymphatic treatment
1. Remove obstruction to flow
2. Maximize thoraco-abdomino-pelvic respiratory/circulatory pump interally
3. Externally augment the pumps
4. Stimulate local lymph drainage
53
2 things with "Remove Obstruction to Flow"
1. Correct key myofascial SD
| 2. Open myofascial pathways for drainage back to central system
54
2 things with "Maximize thoraco-abdomino-pelvic respiratory/circulatory pump interally"
1. Remove other key SD, especially at chest cage
| 2. Redome diaphragms/maximize respiration
55
1 things with "Externally Augment the Pumps"
Stimulate lymphaticovenous return by changing pressures (raise ribs, add pumps) and stimulating eNOS (endothelial nitric oxide synthase)
56
1 thing with "Stimulate Local Lymph Drainage"
Move fluids toward heart (effleurage-visceral OMT)
57
What are 3 steps in step 1 for diagnosing and treating fascial patters and associated SD
1 .Diagnose zink fascial pattern
2. Assess thoracoabdominal diaphragm functions
3. Assess for terminal lympahtic drainage dysfunction
58
What is the fascial SD effect for lymphatics, veins, arterioles
Lymphatics > veins > arterioles
59
What 2 places are transition zones at?
1. Anatomical regions: where structure changes
| 2. Where regional block (less motion structure) and regional rod (more motion) join
60
4 things about what transition zones are
1. Where structure changes --> function first changes
2. Highest area of compensation (postural, myofascial, etc)
3. Myofascial dysfunction reflects underlying boney SD
4. Areas where diaphragms attach (opportunity for 2-fers)
61
4 regions for transition zones
1. Cr-Cerv: OA-AA-C2 (we check and name for OA rotation)
2. Cerv-Th: T1-T4; ribs 1-2; manubrium
3. Th-L: lower ribs down to Th-L junction
4. Pelvic-Lumbar: L-P junction (named for pelvic rotation)
62
Are compensated patterns alternating?
Yes
63
Where are fascial patten SD at?
Sites where structure-function change
64
If pattern is not ideal, what is next best state?
Compensated
65
What are the 4 patterns
1. Ideal
2. Common compensated pattern (CCP)
3. Uncommon compensated patten (UCP)
4. Uncommon pattern
66
Fascial pattern palpated superficially reflects what? Assessed where?
Underlying direction deeper structures moved; assessed at first barrier
67
Regiona diagnosis allows what?
Unified regional OMT treatment if we wish
68
What do we listen to for direct/indirect myofascial?
Myofascial
69
What do we listen to for BLT (indirect) or LAS (combined)?
Articular
70
Do we compare muscle energy (direct) of one region to another?
Yes
71
Often regions prefer what?
SB-rotation to the same side (note Fryette Trpe spinal nomenclature is NOT used to describe REGIONAL motion)
72
Regions may be treated how?
With OMT of individual parts
73
Spine (articular-ligamentous)
Compensatory regional patterns usually linked to type 1 thoracic and lumbar spinal curves (postural compensation)
74
Soft tissue structures cross what?
Regions that may have significant impant
75
Note that OMT may be what?
Warranted even for compensated SD
Example is bed-ridden or for reompensation strategies)
76
What is goal in respiratory-circulatory system?
Enhance physiological homeostais
77
HVLA of 4 transition zones advantage
Fast
78
4 regions BLT/FPR advantage
Fewest possible side effects; comfortable in acute situations; best hospital choice
79
Regional MFR advantage
Several diaphragm "two-fers" (especially superior throacic inlet and inferior thoracic outlet: and prepares tissues for tensegrity needed for optimal local drainage
80
Are transtition zones vertebral units? Example?
NO!!!!!!!!
Superior thoracic inlet is T1-T4 PLUS manubrium PLUS ribs 1-2 PLUS myofascial structures (including scalenes)
81
What is step 2?
Remove diaphragms
82
5 discussion points
1. Active vs passive (elastic)
2. Synchronous motion (active vs passive)
3. Pressure gradients and Bernoully's principle
4. Organ location
5. OMT and pumps
83
4 diaphragm techniques
1. Cranial diaphragm
2. Sibson fascia (soft tissue)
3. Pelvic diaphragm
4. Thoracoabdominal diraphagm redoming
84
What is the Formation Phase?
Getting fluid, edema proteins and waste products into the lymphatics requires MOTION
85
2 things with Formation Phase
1. Primary inspiration
| 2. Secondary inspiration
86
2 one=way valves
1. Muscle pumps
| 2. Effleurage
87
Pressure changes between compartments or on-off pressure sensitive structures (spleen/liver) moves what?
Fluid
88
4 steps of RC Model
1. Open pathways (we advocate zink)
2. Optimize respiration (primary and secondary; redome diraphragms)
3. Augment fluids (lymph pumps and add primary respiration)
4. Movilize fluids from concern sites (mesenteric lifts/local effleurage)
89
3 things with Zink's Fascial Patter Approach
1. Compensated or not?
2. Where structure changes, this is first place functino changes (posutral homeostasis as well as sites of transverse diaphragms)
3. Uncomepnsated patterns often traumatic rather tha npostural
