Handbook Of Omt Review Chapter 9

Front 1

Facilitation

Back 1

Common with chronic dysfunction and infrequent with acute dysfunction.

Front 2

Actual manipulation usually first addrese and treats...

Back 2

the cause for facilitation. Manipulation is also used to reduce ympathetic contribution, then the lymphatics are addressed, then treatment is geared towards attaining an improved parasympathetic balance is performed.

Front 3

Rib Raising

Back 3

Primary manipulative method to moderate hypersympathetic activity (sympathetic). Improves diaphragmatic action and aids the lymphatics. First stimulates, then inhibits, the sympathetic system.

Front 4

How to get the effects of rib raising in the lumbar area

Back 4

Ileus prevention treatment

Front 5

Further sympathetic actions

Back 5

Collateral ganglia may be treated, which includes the preaortic and cervical ganglia. The preaortic ganglia are celiac, superior mesenteric, and inferior mesenteric ganglia.
The celiac ganglion innervates the upper GI tract, superior mesenteric ganglion innervates the small bowel distal to the duodeum, the ascending colon, proximal transverse colon, kidneys and adrenal glands and gonads. The inferior mesenteric ganglion innervates the distal transverse colon, descending colon, sigmoid colon, and rectum, and pelvic organs.

Front 6

Ganglion inhibition test

Back 6

Hands and fingers position same as the ganglion assessment. The patient takes a deep breath and, with exhalation, the clinican follows the excursion, pressing deeply into the tissues until resistance is met. This position is maintained. The breathing cycle is repeated again with the further following of excursions even deeper by the clinician. Pressure is held until resistance is relaxed or 90 seconds.

Front 7

Chapman's reflexes

Back 7

May also be used to moderate sympathetic hyperstimulation. They are well defined points of pain that result from viscerosomatic reflexes. Chapman's assessment is performed before any manipulation has been done that would alter sympathetic pathways.

Front 8

Dx/tx of chapman points

Back 8

Anterior points are used to diagnose, posterior points are used for treatment. Treated after rib raising.

Front 9

Travell's myofascial trigger points

Back 9

focal areas of irritation on the body that are usually associated with hypertonic skeletal muscle or taut fascia, when compressed, pain or autonomic response elsewhere is generated - sometimes this referred pain or autonomic response is generated spontaneously by these points without the contribution of compression. Treatment of trigger points are vapocoolant spray with stretch, focal anesthetic injection, muscle energy, or myofascial release.

Front 10

Jones Tenderpoints

Back 10

Small areas of focal irritability in muscles and fascia that are painful on compression. Like trigger points, they are usually associated with hypertonic muscle and/or taut fascia. Treated with counterstrain.

Front 11

Cervicothoracic diaphragm

Back 11

Common area of lymph drainage from anywhere in the body. It is the fascial diaphragm at the thoracic inlet. Any fascial preference or somatic dysfunction in this area should be treated.

Front 12

Abdominal diaphragm

Back 12

Dysfunctional diaphragm is manifested clincally by the lack of movement of any of the abdominal tissues down the pubic symphysis during respiratory effort. Further evaluation of the abdominal diaphragm can be performed by pressing and palpating for preference of rotation around an AP axis and restriction assiciated with it. Must also treat any SD of the diaphragm.

Front 13

Pelvic diaphragm

Back 13

Diagnosed by pressing into the lateral sides of the ischiorectal fossa, or by evaluating the muscles of the pelvic diaphragm via a rectal or vaginal examination. The pelvic diaphragm can then be released through the perineum, rectum, or vaginia. All pelvic diaphragm manipulative treatment should be followed by at home kegal exercises by the patient.

Front 14

Lymphatic pumps

Back 14

After diaphragms are treated, lymphatic pumps should be employed to encourage lympathic flow and eventual lymphatic return to the circulation.

Front 15

Thoracic lymphatic pump treatment

Back 15

Engages a rapid, strong negative intrathoracic pressure that encourages rapid lymphatic return to the thorax from other parts of the body.

Front 16

Pedal pump

Back 16

Intermittent and rhythmic force applied to the feet

Front 17

splenic pump

Back 17

Used to move lymph in patients with systemic infections and/or anemia. With the patient supine, gentle alternative compression and release is applied to the area over the spleen. This must not be done during splenomegaly.

Front 18

Liver pump

Back 18

Decongets the lymphatic and venous systems of the liver, relieving visceral congestion, and, theoretically, aiding in the overall detoxifciation process.

Front 19

Ending...

Back 19

After the lympathic pumps have been performed, rib raising may be performed again to encourage abdominal diaphragmatic excursion and to, once again, decrease hypersympathetic tone. The hypersympathic tone constricts veins and larger lymphatic vessels, such constriction prevents proper lymphatic drainage and encourages tissue congestion.

Front 20

Fascial dysfunction

Back 20

Should also be assess and treated to encourage good lymphatic flow. Fascias should be examined for evidence of compromised homeostatic mechanisms. Compensated patterns alternate with each other, uncompensated patterns consist of fascia running in the same direction.

Front 21

Common Compensated patterns

Back 21

Most people have a fascial rotation to the left at the OA area, to the right at the cervicothoracic area, left at the thoracolumbar area, and right at the lumbrosacral area.

Front 22

Uncommon compensatory pattern

Back 22

Persons who have a compensatory pattern byt one that is just the opposite of the aforementioned pattern. Usually traumatic origin.

Front 23

Mesenteries

Back 23

treated to aid in lymphatic flow.

Front 24

Final step in treating systemic dysfunction

Back 24

Treat parasympathetic nervous system dysfunction

Front 25

How do the parasympathetics control viscera

Back 25

Cranial nerves III, VII, IX, and X and pelvic splanic nerves S2, 3, 4. They synapse in a variety of ganglia dn plexuses.

Front 26

Sphenopalatine ganglion

Back 26

Has a strong influence on modulating glandular secretions in the head. Influenced by manipulation of the pterygopalatine muscle fascias.

Front 27

Cagus nerve

Back 27

Very important in balancing parasympathetic stimulation of the thoracic and abdominal viscera. manipulation of the OA is particularly useful, success may also be had by manipulation of the AA and C2 joints.

Front 28

Pelvic splanchnic nerves

Back 28

Treated to modulate parasympathetic influence of the left colon, sigmoid, and rectum and pelvic organs. This is accomplished through indirect inhibition of the inferior mesenteric ganglion and balancing pelvic splanchnic output by way of hypogastric plexus modulation. The hypogastric plexus contains sympathetic fibers from T12-L2 and parasympathetic fibers fromt he pelvis splanchnic nerves, and lies anterior to the lumbosacral region. Sacral rocking is able to modulate fibers in this plexus.