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OPP Lect 20
| Question | Answer |
|---|---|
| Why was the term "somatic dysfunction" developed? | to create a billable diagnosis for insurance. **All somatic dysfunction is just tissue in distress. |
| Is all somatic dysfunction the same thing? | NO, constantly expanding. **Broad umbrella b/c we need a way to classify what we are treating. |
| What is represented by the Lederman Model? | That physical loading will affect local tissue and not only cause the Mechanical changes that we observe, but also: 1.Fluid dynamic changes. 2.Reparative changes. |
| Effects of tissue change | 1.Physical displacement. 2.Distortion or rearrangement of elements. 3.Mechanotransduction (intrinsic response to manual contact). |
| Neuroreflexive tissue changes | 1.Somato-somatic. 2.Viscerosomatic. 3.Somatovisceral. |
| When first looking at somatic dysfunction, what will lead to the best treatment? | Looking for the trauma that cuased the SD. the "how" and "where". **making anatomic correlation with history, observation, palpation. |
| What is the difference between trauma and treatment in terms of tissue change? | 1.Trauma: disorganized tissue adaptation. 2.Treatment: Guided/organized tissue adaptation. |
| Is muscle a responsive tissue? | YES **Motion is mostly coordinated by the the Nervous System. |
| Proprioception | Active feedback system that relates spatial relationships. Sensing of motion and position of the body in space. **Involves sight, hearing, vestibular sys, golgi tendon, and muscle spindles. |
| What is the primary hypothesis counterstrain? | issues/imbalance of proprioceptive coordination. |
| Korr's hypothesis | Tone of muscles is related to position of the joints and the state of the nervous system |
| Somatic dysfunction involves | 1.Impairment of at least one of the elements of motion. 2.Disrupted interrelationship of elements. 3.Loss of integrity of the whole system. |
| What is the reflex coordination of Posture | Proprioception |
| What is the purpose of nocioception behavior? | body's natural way to gaurd against damage. |
| How many pressure receptors are involved in touch? | 4 |
| What is the difference between extra and intrafusal fibers? | Extra: outside the muscle spindle, within the muscle belly (form motor units via neuromuscular junctions). 2.Intra: within the muscle spindle. |
| Afferent nerves involved in Nociception | Nerve endings of unmylenated C fibers that sense noxious stimulus. **Almost everywhere |
| What is responsible for the muscle reflex? | H or Huffman reflex with muscle spendles afferents. |
| Muscle spindles sense | 1.stretch. 2.rate of stretch. 3.relative & absolute position in space. **like a thermostat |
| Counterstrain hypothesis for tenderpoints | Trauma/strain will cause proprioceptive dysregulation cuasing spindle afferents to send inaccurate info and recieve incorrect gamma stimulation. |
| Nociceptive model for tenderpoints | Involves the system that reports or anticipates tissue damage, interpreted as pain. |
| Chain of events: Counterstrain model | 1.Postural imbalance. 2.Strain. 3.Neural imbalance. 4.muscle spasm. 5.tenderness. 6.PAIN |
| Chain of events: nociceptive model | 1.Postural imbalance. 2.Strain. 3.PAIN. 4.neural imbalace. 5.muscle spasm. 6.tenderness |
| What is the goal of treatment? | to address the CAUSE! |
| Problem with nociceptive model: silent myotonia | No pain unless provoked with a poke, no EMG trace |
| Evidence supporting counterstrain model | 1.strain often occurs when shortened muscle suddenly lengthens. 2.sustained contraction promotes inflammation (including pain & tenderpoint). |
| How is counterstrain treatment successful? | Shortening the muscle turns off the gamma afferent signal |