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Definition
Body is a unit.
Body is capable of self-regulation, self-healing, and health maintenence.
Structure and function are directly interrelated.
Rational treatment is based upon the above principles. |
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| Restore homeostasis, improve venous return and lymphatic return, restore motion, balance autonomic nervous system |
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Definition
anatomical = farthest
Physiological = functional limit
Restrictive barrier and dysfunctional neutral |
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| Somatic dysfunction vs manipulative techniques classification |
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Definition
| somatic based on freer motion, manipulative based on the way forces applied relative to restrictive barrier |
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| Direct vs indirect...which uses more aggressive and which one for acute. |
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| Aggresive = direct, for acute = indirect |
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| What dictates the level of aggressiveness of the technique? |
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| HVLA, Muscle energy, soft tissue, Direct myofascial release, Visceral, counterstrain (aggressiveness order?) |
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| amount of force applied dependent on clinical circumstance and patient tolerance. |
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Direct vs indirect (results longevity?)
Which requires more dexterity with less palpatory skill? |
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Definition
Results of direct are faster but dont last as long
Direct technique |
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| How do you figure out which treatment to use? |
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Definition
how much force can your patient handle?
acute vs. chronic problems
pain tolerance |
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| Articulatory technique...D or Ind.? procedure? Contraindications? |
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Definition
Direct
Repeatedly engage the barrier; stretch it and back off
Fracture, severe DJD or osteoarthiritis, joint inflammation, severe osteoperosis |
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| Soft tissue technique..D or I? procedure? various ways of applying forces? |
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Definition
Direct...treats muscle and fascia while monittoring response and motion changes; never slide on skin and usually dont push tissues on bone...
Tractional technique-stretching
Kneading - RHYTHMIC lateral strecthing of a myofascial structure
inhibition - sustained deep pressure over a hypertonic muscle |
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Direct Myofascial release
Coupled with what? effective depends on what? Success specifically depends on? |
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Definition
works on tissues; effectiveness depends on neural reflexes and physical stresses on the system such as elasticity
success = lower inappropriate input to CNS |
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| Difference between direct and indirect MFR |
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Definition
Direct = load and unload
Indirect = unload and follow...follow a pattern of unwinding |
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Definition
| Dissectable mass of fibroelastic connective tissue |
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Term
Extrafusal muscle fibers (function and innervation)
What type of feedback mechanism? |
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Definition
Contraction of main muscle mass and innervated by alpha motor neurons...
Positive feedback |
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Definition
| Prevents excessive muscle tension by inhibiting alpha motor neurons |
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Intrafusal fibers
Innervation?
Length of the intrafusal muscle fiber reported how? |
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Definition
Propioceptive, judges how much muscle tone will be required for the upcoming action; protects muscle from tearing
Gamma motor neurons; length of intrafusal reported by spinal cord independently of extrafusal length; resting muscle = normal gamma gain; muscle spasm = increased gamma gain |
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| What kind of effects do direct and indirect techniques have on muscle spasms? |
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Definition
Indirect = generally inhibit or decrease of extrafusal muscle fibers = lowers gamma gain
Direct = stretchs the extrafusal fivers resulting on pulling of golgi tendon receptors which also inhibit that muscle's contraction; also gamma gain is often lowered |
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| Types of muscle contractions |
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Definition
Isometric= contraction while maintaining a constant length
Isotonic - contraction which a change in length
Isotonic Isolytic - fast contraction, length of muscle change quick
Isotonic Isokinetic - Length changes at a constant velocity |
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Term
Muscle energy...D or I? Isotonic or isometric?
how long to contract? how long to rest?
when do you stop?
note = another advantage is that patient discomfort is minimized because they control final activating force |
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Definition
Direct, isometric
3-5 seconds contraction; rest = 2 seconds; improving if the range of motion improves |
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| HVLA...D or I? procedure? Theory |
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Definition
Direct
joint is placed against barrier, then HVLAmoves joint past barrier
Theory - mechanoreceptors increases muscle tone which acts to protect joints from excessive motion under dysfunctional circumstances; HVLA decreases joint mechanoreceptor firing |
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| patient does not give consent, fracture, potential vascular compromise (relative risk) |
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| What is the pop? (two theories) |
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Definition
Cavitation- sudden distraction of joint results in nitrogen bubble
Volume - sudden increase in joint volume within an enclosed joint
- not necessary for successful treatment |
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| Do direct techniques promote lymphatic drainage? |
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Definition
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| after relaxation...continued treatment will cause muscle to be...? |
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Definition
| red, hot, boggy, and ultimately spasm |
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| Soft tissue...D or I? principles? |
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Definition
| Direct; the key is to contact the paraspinal muscle in the groove between the spinous process and the muscle mass; apply a lateral force with deep pressure while avoiding stretching |
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| Soft tissue different types of techniques |
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Definition
| Bowstringing; unilateral lateral stretch; suboccipital release aka killer fingers; thoracic prone pressure; lumbar prone pressure |
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| Myofascial release - direct...release time? types of motions involved? Where you place your hands? |
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Definition
| release time is a several second phenomenon, motions - vertical, horizontal, rotational; place hands in thoracocolumbar junction (inferior rib, trunk rotater, and diaphragmatic sites) |
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