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8 Cards in this Set
- Front
- Back
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for fibromyalgia, how long must a pt have had symptoms to be diagnosed? What 3 places must pain be seen?
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3 months
1. On both the right and left sides of the body 2. Both above and below the waist 3. Mid body (for example: in the neck, med chest, or mid back or in in the head) note: ii. Pain on pressing at least 11 of the 18 spots that are known as tender points |
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2. Discuss the theories, causes, and contributing factors regarding Fibromyalgia and Chronic fatigue syndrome
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b. Strong neuroendocrine connection emerging (one study found low gray matter volume in bilateral prefrontal cortex, less gray matter-->more fatigue)
i. Hypothalamic dysfunction is often a common denominator in both (controls sleep, hormones, ANS, and temp) |
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Discuss the theories, causes, and contributing factors regarding Chronic Fatigue Syndrome
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i. Evidence exists for immune, endocrine, CV, and ANS dysfunction
3. Down-regulation of hypothalamic-pituitary adrenal axis, mild hypercortisolism 5. Found to be in a state of chronic immune activation with increased CD8 T cells a. Depressed function of NK cells, hypothesis of reactivation of latent viruses or of chronic low grade viral infection |
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i. Evidence of sleep disturbances and neuroendocrine dysfunction are thought to contribute to what problem?
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Fibromyalgia
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What is allostasis?
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a. Allostasis is the process of achieving stability, or homeostasis, through physiological or behavioral change
b. Basically, you have some general arousal and the brainstem intiates a protective response, which gives an allostatic compensation |
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how does allostasis come in to play with respect to fibromyalgia?
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1. In essence ALLOSTASIS IS A DEFENSIVE STAGE and lengthened activation leads to extensive WEAR and TEAR on all the organ systems of the body
a. Consequences of long term activation of allostasis: memory loss, depression, immunosupression, and enhanced Th2 cytokine activity i. Basically it just fucks everything up when overactivated |
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Goals of osteopathic tx for fibromyalgia?
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alleviate allostatic load, support return to homeostasis, decrease fatigue and pain, and increase daily functional abilities by supporting dysfunctional systems while eliminating identifiable contributing factors
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according to Nelson, what is the best OMT tx for ppl with fibromyalgia?
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GENTLE INDIRECT OMT
i. May get some relief from direct HVLA, these approaches often result in a flare in symptoms later in the day that may last for a few days g. OMM, warm baths, and acetaminophen are good for pain |
