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80 Cards in this Set
- Front
- Back
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frayette's 1st principle
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when SB from neutral position, rotation of vertebral bodies follows to opposite direction; SB precedes rotation. (NSxRy)
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Frayette's 2nd principle
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when SB is attempted from non-neutral position, rotation precedes SB to same side F/E (RxSx); applies to a single vertebrae, rotation of vertebrae towards the concavity of the curve; traumatic origin
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anatomic barrier
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bone and ligament serve as final limits, damage when go beyond, absolute limit imposed by the joint
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physiological barrier
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extent a pt can move a joint stopped by soft tissue tension that limits active motion- can be moved by passive
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elastic barrier
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the range between the physiological and anatomic barriers of motion where stretching occurs
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restrictive barrier
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loss of joint normal ROM that stops joint before physiological barrier, functional limit within anatomic ROM
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end feel
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gradual increase of resistance when approaching the anatomical barrier produced by soft tissues of the joint structure
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facet direction rule
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cervical- BUM
thoracic- BUL lumbar- BM; all inferior facets are opposite of respective superior ones |
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isometric contraction
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maintains muscle length
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isotonic contraction
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allows origin and insertion to approximate
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isolytic contraction
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forces the muscle to lengthen
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concentric contraction
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contraction that results in shortening of the muscle
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eccentric contraction
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lengthening of muscle during contraction due to external force
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viscero-somatic reflex
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increased bympathetic response in segmentally related muscle/tissue from sympathetically stimulated organ (from noxious stimuli)
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somato-visceral reflex
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increased sympathetic tone to corresponding organ; prolonged sympathetic drive to a visceral organ alters function- toward dysfunction
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golgi tendon organs
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- sense changes in tension in muscle tendons
- cause reflex relaxation of agonist muscle fibers - TENdon=TENsion - found in SERIES |
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muscle spindle fibers
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- sense stretch of the muscle- think Spindle=Stretch
- muscle length and rate of change of length - found in parallel |
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nociceptors characteristics
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- activated by prolonged injury, pressure, ischemia
- impulses to all axon branches and into spinal cord - releases substance P and other peptide transmitters - chemical attractant--> tissue macrophages and lymphocytes - injured muscle shortens, overlying muscles contract to protect, stretching will restress the nocicepetors |
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proprioception
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- subconscious mechanism involved in self-regulation of posture and movement through stimuli originating in receptors imbedded in every joint, tendon, muscle and combined info from vestibular system
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SD relation to proprioception
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- alters proprioception, inappropriate body positioning, firing sequence, load distribution, overuse of wrong muscles
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passive motion
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outside force with no pt assistance (within range of anatomical barriers)
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active motion
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produced voluntarily by patient (within range of physiologic barriers)
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forward bending
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anterior motion in a sagittal plane around a transverse axis
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backward bending
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posterior motion in a sagittal plane around a transverse axis
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rotation
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motion in a horizontal plane around a vertical axis
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sidebending
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right or left motion in a coronal plane around an A/P axis
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when to use indirect techniques
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- acute painful situations, hospitalized patients
- metastatic CA, arthritis - osteoporosis, autoimmune |
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what techniques are contraindicated in cardiac/respiratory patient
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- pedal pump or thoracic pump unless they are compensated
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lymphatic pump also contraindicated when
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MI- increases venous return and results in CHF, arrhythmias
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cisterna chyli
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L1-L2 between right crus and aorta- size of a cigarette
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alternative types of ME if a patient is severely injured
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- reciprocal inhibition (indirect)
- reciprocal inhibition (direct) - respiratory assitance - crossed extensor reflex |
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indirect reciprocal inhibition
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- biceps muscle is in spasm- fully extend elbow and have pt contract his triceps against resistance- isometric force allows biceps to relax
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direct reciprocal inhibition
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- biceps muscle is in spasm, fully extend elbow, have pt contract triceps against resistance- isometric force allows biceps to relax
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respiratory assistance
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use pts voluntary respiratory motion to restore normal motion- inhalation rib dysfunctions
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crossed extensor reflex
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- used in extremities so severely injured they're not accessible to direct manipulation; contract R biceps causes relaxation of L biceps and contraction of L triceps
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landmarks:
suprasternal/jugular notch sternal angle xiphoid process umbilicus superior angle of scapula spine of scapula inferior angle of scapula |
- T2
- T4/5 (rib 2) - T9 - L2-L4 - T2 - T3/4 - T7 |
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findings of chronic pain
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- somato-visceral effects
- dull ache or pain - dry, scaly, itchy, blemished skin, folliculitis - regional sympathetic - limited ROM - muscle contraction - doughy, stringy, fibrotic tissue |
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findings of acute pain
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- minimal somato-visceral effects
- acute sharp, severe pain - warm, moist, inflamed skin - muscle spasm - ROM sluggish but normal - boggy edematous tissue |
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counterstrain technique
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to treat tender points, normalize muscle hypertonicity and reduce gamma gain; Tx most severe first, proximal before distal, medial before lateral, thoracic before ribs
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tenderpoints
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- for every posterior tenderpoint (treatment) there is an anterior point (diagnostic)
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tender point
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- small tense edematous areas of tenderness about a fingertip in diameter
- DO NOT radiate pain |
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trigger point
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discrete, focal, hyperirritable spots located in a taut band of skeletal muscle
- type of somatic dysfunction - radiate to a specific area when compressed - may require injection - muscle may be weak with limited ROM |
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chapman's reflex points
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- small, smooth, firm, discreet
- appx 2-3 mm in diameter* - predictable anterior and posterior fascial tissue texture abnormalities assumed to be reflections of visceral disease |
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treatment of chapmans point
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rub in a firm rotating motion for about 10-30 seconds
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chapman point adrenals
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anterior: 1 inch lateral and 2 inches superior to the umbilicus ipsilaterally
posterior: midway bw spines and TP of T11 and T12 |
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chapman point kidneys
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anterior: 1 inch lateral and 1 inch superior to the umbilicus ipsilaterally
posterior: intertransverse space (midway b/w spines and T12-L1 respectively) |
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chapman point bladder
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anterior: umbilical area
posterior: intertransverse space (midway b/w spines and TP tips of L1-L2) |
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chapman point or urethra
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anterior: myofascial tissues along superior margin of the pubic ramus about 2 cm lateral to the symphysis
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chapman point small intenstine
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bilateral (R>L) T8-T10
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chapmans point appendix
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T12 R with tenderness over tip of 12th rib R anterior
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champans point cecum and ascending colon
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IT band of the proximal R leg
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champan's point descending colon
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IT band of middle L leg
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chapman's point colon
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IT band
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upper GI reflex
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C2 L, T3 R, T5 L, T7 R
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HTN reflex
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C6, T2, T6
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champans point myocardium/thyroid/esophagus/bronchus
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2nd ICS b/l close to sternum and b/w T2 and T3 posteriorly
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champans point esophagus
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anterior: 2-3 ICS on R
posterior: T2-T3 on R |
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chapmans point stomach
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anterior: acid 5th ICS, peristalsis 6th ICS
posterior: T5-8 on L |
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champans point duodenum
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T7-T8 R
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champans point pancreas
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anterior: lateral to costal cartilage 7th ICS R
posterior: b/w TP of T7-T8 R |
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chapman's point spleen
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7th ICS on R
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chapman's point prostate
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anterior: myofascial tissues along posterior margin of IT band
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chapman's point inguinal
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anterior inguinal tenderpoint- lateral border of pubic bone near the attachment of the inguinal ligament
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meralgia paresthetica
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latera femoral cutaneous nerve compression b/w inguinal ligament and sartorius- from wearing tight belt
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chapman's point respiratory (bronchial)
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anterior: ICS b/w 2nd and 3rd ribs close to sternum
posterior: midway b/w SP and the tips of the TP at T2 and T3 |
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chapman's point respiratory (upper lung)
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anterior: ICS b/w 3rd and 4th ribs close to the sternum
posterior: midway b/w the spine and tips of TP of T3 and T4 |
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chapman's point respiratory (lower lung)
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anterior: ICS b/w 4th and 5th ribs close to the sternum
posterior: midway b/w the SP and the tips of T4 and T5 |
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asthma reflex
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T2 L
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bronchial mucosa
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T2-3 usually R
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lungs
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T3-4 on side of pathology
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how to prevent acute refractory bronchospasm
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treat parasympathetics first
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how to prevent post-op pneumonia
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treat phrenic (C3-C5)
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Hering-Breuer reflex
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parasympathetic
- protect mechanism to prevent over inflation of the lung (stretch receptors in bronchi/bronchioles) - unable to differentiate alveoli filled with air or fluid |
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cervical counterstrain- posterior
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- C1 inion flex
- C1-C7 extend and SARA, except C3, flex and STRAW |
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cervical counter- anterior
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- C1 rotate away
- C2-C8 flex and SARA, except C7- flex and STRAW |
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rib- anterior tenderpoint- exhalation dysfunction- rib 1
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just below medial end of clavicle
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rib- anterior tenderpoint- exhalation dysfunction- rib 2
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6-8 cm lateral to sternum of rib 2
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rib- anterior tenderpoint- exhalation dysfunction- ribs 3-6
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mid-axillary line on the corresponding rib
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anterior rib tenderpoints- treatment ribs 1 and 2
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flex head, sidebend and rotate towards
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anterior rib tenderpoints- treatment ribes 3-6
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sidebend and rotate the thorax toward, encourage slight flecion *hold 120 second to allow pt to relax*
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