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Viscerosomatic Reflexes
Inflammation is a powerful stimulator of local nociceptors. The convergence of visceral nociceptors with the nociceptors from all somatic tissues produces several clinical effects:
Referred pain Segmental facilitation at the spinal cord level
Neurosecretoy Function of: Primary Afferent Nociceptors(PANs) They release these (dilatory) peptides: Substance P Calcitonin Gene-Related Polypeptide Somatostatin Normally, a basal release of these peptides; they are targeting the resistance arterioles, to act as a counterbalance to the SNS (since NO PNS to the extremities) However, can have a Neurogenic Inflammatory Response, if a lot of these are released vs. the basal release.
Neurosecretoy Function of: Primary Afferent Nociceptors(PANs) They release these (dilatory) peptides: Substance P Calcitonin Gene-Related Polypeptide Somatostatin Normally, a basal release of these peptides; they are targeting the resistance arterioles, to act as a counterbalance to the SNS (since NO PNS to the extremities) However, can have a Neurogenic Inflammatory Response, if a lot of these are released vs. the basal release.
Neurosecretoy Function of: Primary Afferent Nociceptors(PANs) They release these (dilatory) peptides: Substance P Calcitonin Gene-Related Polypeptide Somatostatin Normally, a basal release of these peptides; they are targeting the resistance arterioles, to act as a counterbalance to the SNS (since NO PNS to the extremities) However, can have a Neurogenic Inflammatory Response, if a lot of these are released vs. the basal release.
To spinal cord: increased afferent drive, due to this sensitization of the primary afferent fibers
Then - a change occurs at the level of the genes of those interneurons/internuncial neurons. Exaggerated segmental autonomic and alpha-motor response occurs; produces boggy spasm, increased temperature, increased sweat. Exaggerated ascending tract input to higher centers, produces hyperasthesia, and referred pain Alters autonomic outflow to viscera
From Frank Willard, PhD discussion of: Research by and Mary F. Anderson and Barbara J. Winterson of UNECOM Brain Research 678:140-150, 1995. After making a cut at the area of the green pointer, 85% of the facilitation remained. Therefore, the muscle spindle alone isnt sustaining the somatic dysfunction. The smallcaliber system is necessary for the initiation of this spinal facilitation, but then once initiated, this afferent drive is not needed to sustain the spinal /segmental facilitation.
Visceral Sympathetics
Thyroid T1-4 Mammary T1-6 Esophagus T1-6 Lung T1-6 Heart T1-6 Stomach T5-9 Left Liver T5-9 Gallbladder T5 Right Pancreas T7 Right Spleen T7 Left Small intestine to right colon T10-11 Left colon to rectum to pelvic organs T12-L2 Appendix T10 (T9T12) Ovary/Testes T1011 Kidney T10-11 Uterus T12-L2 Bladder T12-L2
Rib Raising
initially stimulates regional sympathetic efferent activity to organs related to that level of sympathetic innervation, but in the long run, rib raising results in a prolonged reduction in sympathetic nervous system outflow from the area treated.
p. 53 Nelson
Chapmans Reflexes
Chapmans reflexes are a system of reflex points originally used by Frank Chapman, D.O. These reflexes present as predictable anterior and posterior fascial tissue texture abnormalities. Gangliform contraction that blocks lymphatic drainage. Sympathetic nervous system dysfunction and lymphatic pathology following viscerosomatic reflexes.
Chapmans Reflexes
On palpation, Chapman reflexes are located deep to the skin, most often lying on the deep fascia or periosteum. Usually found paired on both the dorsal and ventral parts of the body. Small, smooth, firm nodules approximately 23mm in diameter and exquisitely tender to palpation but non-radiating.
Application of OMM
Diagnostic
Therapeutic
Adjunctive
Treatment
Hospital based any disease state will have an effect on the sympathetic tone and respiratory excursion of the patient. Gentle manipulation can help facilitate the body towards recovery. Ambulatory care osteopathic physicians have a unique qualification to utilize osteopathic manipulation as a therapeutic or adjunctive treatment for many disease states.
Questions???
"To find health should be the object of the doctor. Anyone can find disease." - Dr. A.T. Still