What will manipulation do for a hypermobile joint?
Give temporary relief.
What should the role of manpulation be for a hypermobile joint?
Leave this joint or vector alone and adjust joint restrictions.
How likely will neurologic problems be the cause of a joint dysfunction/ subluxation syndrome?
Unlikely in most circumstances.
What are the local clinical indications of a subluxation?
"P-pain (spontaneous) and tenderness (palpatory). A- asymmetry. R- Range of motion abnormaility (segmental range). T-tone
nondermatomal patterns of referred pain follow what distribution?
Sclerotomal.
What is sclerotome?
"Periosteum
"What is a dermatome
and what is a myotome?"
"What is more diffuse in arrangement a sclerotome
dermatome
Nociceptive referred pain follows what pattern of distribution?
Sclerotomal.
What is a more technically accurate way of saying sclerotomal pain?
Nociceptive referred pain.
With nociceptive referred pain how far will the pain travel down an extremity?
"Pain will not travel
What is hyperconvergence?
"The receptive field of such a projection neuron
What type of reflexes can cause a subluxation?
Reflex from a visceral disease.
What is a dual diagnosis?
At UWS we often assign a dual diagnosis to patients� like lumbar derangement associated with lumbar joint dysfunction.
What part of a subluxation causes local pain?
Myopathic component.
How can a hypo or hyper mobile joint cause local pain?
"This results in a shift of the axis of rotation in the motion unit resulting in abnormal loads and irritation of tissue. ""the broken door hinge analogy""."
What are the immediate effects of pain from hypomobility?
"A restricted joint itself probably wont hurt
What are the long term effects of pain from hypomobility?
Pain from degenerative tissue breaking down because of lack of local circulation of synovial fluid.
Hypomobile joints lead to what?
Degeneration.
How many weeks will it take to get joint degeneration with a hypomobile joint?
4 weeks- articular surface changes. 8 weeks- osteophytes forming from the facets.
Can joint degeneration like osteophytes be reversed after the fixation of a hypomobile joint is fixed?
No the changes do not appear to be reversible.
What is the proposed effects of adjusting to local and referred pain?
Suppresses both.
How can adjusting reduce muscle spasms?
"Not from stretch on muscles
What causes a temporary increase in motion due to adjusting?
Changes in synovial fluid.
What else can cause increased motion due to adjusting?
"Breaking adhesions
How will adjusting effect inhibited muscles?
Can activate them.
What can adjusting do to proprioceptive inputs?
Restore proper proprioceptive input.
What are 2 other ways to say deep referred pain?
"Somatic referred pain
"Patients with irritaated joints often feel pain or other symptoms spreading out over their shoulders
between their shoulders and even into their arms and this can happen when?"
Pain signals from injured tissue in the facet/subluxatin cause what to happen to the spinal cell in the track that communicates the pain?
Hypersensitizes.
Once the spinal cells are hypersensitized (are now sensitive) what type of signals from the non symptomatic area can cause destabilization of the pathway?
Non-painful.
Hypersensitivity and spontaneous pain projects into what?
Scleratomes.
When can radicular syndromes occur?
When the nerve root is compressed or irritated.
Name 2 things that can compress or irritate the nerve roots?
Disc hernitation and osteophyte formation.
What area must a lesion be located within to cause a radicular syndrome?
IVF.
What happens when nerve roots become compressed or irritated?
"Compressed/ torn- causes loss of function like loss of sensation
Very often what happens with radicular syndromes?
The nerve root is both compressed and irritated.
What would a patient history of a radicular syndrome be like?
"Dermatomal pain
What are signs of a radicular syndrome from a physcial?
"Positive tension tests
What would a positive tension test suggest? What will neurological tests suggest?