Somatic Reflex Arch-Basic Circuit
Monosynaptic Reflex:
- Primary AFFERENT neuron
- One synapse
- Central Motor EFFERENT neuron
PRIMARY AFFERENT NERUON
- Cell body in DORSAL root ganglion
- Follows nerves to target tissue and then to receptor or it is a receptor
- Axon extends to dorsal horn of cord
2 Types of Primary Afferents
1) SMALL CELL BODY
- Lightly myelinated or Unmyelinated
- Beta-Afferent (small caliber fiber)
- Crude touch, nociceptor
2) LARGE CELL BODY
- Myelinated Alpha-afferent (large caliber fiber)
- Proprioception, Discrimination mechanoreceptors
MOTOR EFFERENT NEURON
- Cell body in VENTRAL Horn of cord
- Innervates (via spinal nerves) effector organ & skeletal muscle ( via neuromuscular junction
Monosynaptic Reflexes
- Between 1° Afferent Fiber and VENTRAL horn motor neuron routing to a skeletal muscle
Polysynaptic Reflex Circuit
1) Utilize INTERNEURONS between afferent and motor efferents
a) Many modulations possible
b)Complicated responses to sensory information
Autonomic Reflex Arc
1) Afferent
2) Efferent
3) Peripheral ANS
- Cranial Nerves
- Spinal Nerves
- Splanchnic Nerves (Visceral)
Afferent Nerve of Autonomic Reflex Arc
- Cell body in dorsal root ganglia
- Neuron to Viscera/Blood vessel
- The central process terminates in DORSAL horn
a) Motor efferent
b) Interneuron
Efferent Nerve of Autonomic Reflex Arch (Preganglionic)
- In lateral horn of cord or brain stem nuclei
- Myelinated axons that terminate on ganglion neurons outside the CNS
a) GANGLIONIC Neurons:
i. Encapsulated ganglia in fascia of the body wall or the fascia of organs
- Unmyelinated preganglionic axons
a)Travel from Ganglia to Cellular targets of Visceral Organs
Autonomic Reflex Arc
Distinguishing feature of ANS and Somatic PNS:
- ANS has 2 Efferent (Outgoing) Neurons in Pathway, Somatic PNS ONLY 1
- Sensory Neurons very Similar
Ganglionic Neurons of ANS in 3 Locations:
- Paravertebral Ganglia (SYMPATHETIC TRUNK)
- Collateral Ganglia (Clusters along Large Vessels of Abdominal Cavity)
- Hypogastric Ganglia (In Fascia of Visceral Organs of Pelvis)
Function of Ganglia in Autonomic Reflex Arc
- Produce numerous Neuro Regulators
a) Allow for Complex Motor and/ or Secretomotor responses - Some Ganglia have Sensory Neurons that DO NOT Communicate with the CNA and thus act as Mini Peripheral Brains
Body Integration
- These body Reflexive Circuit help to Integrate the functions of the Body Systems
- Forms the Basis of the Whole Body (Body, Mind, Spirit) concepts of Osteopathic Philosophy and for Dr. Still’s definition of Health
Body Integration Somato-Somatic Reflex
- Afferent Axon from Somatic Structure
- Efferent Motor to Somatic Structure
- May have at least 1 Interneuron
Ex: a) Touch to a Hot Object
b) Cat righting Reflex
Body Integration Viscero- Visceral Reflex
- Sensory from Viscera to Cord
- Efferent Motor to Viscera (Via ANS, Para and Symp)
- Example:
a) Distended Bowel Reflexing back to cause SPASM in Muscular Layer of Bowel
Body Integration
Viscero-Somatic/ Somato-Visceral Reflex
- Afferent Sensory axon from viscera or Somatic structure
- Efferent motor terminates on Somatic or Visceral structure
- Interneurons are involved
- May be the basis for referred pain
a) Visceral pain referred to somatic structures
Ex: Appendicitis
Body Integration
Viscero-Somatic/ Tomato-Visceral Reflex
Sensory Information
- Sensory Information results in excitatory or inhibitory actions onto motoneurons
a) Depends on pathway
b) Interneurons overlap of Viscera and somatic sensory information
Body Integration
Viscero-Somatic/ Somato-Visceral Reflex
Osteopathic Medicine
- Utilized in the practice of Osteopathic medicine, Palpatory diagnosis and Treatment
a) MYOCARDIAL INFARCTION
- Artery Clots-Sensory to cord-motor output to shoulder /neck /arm/ sympathetic system (sweat glands & adrenal glands)
Body Integration
Viscero-Somatic/ Tomato-Visceral Reflex
Viscera and Skeletal Muscle
- VISCERA
a)Means for the energy demands & maintenance of muscle - SKELETAL MUSCLE
a) Machine carrying out daily life - Constant integration of function and communication for all functions
Body Integration
Viscero-Somatic/ Tomato-Visceral Reflex
When Reflexes are OVERDRIVE
WHEN REFLEXES ARE ON OVERDRIVE:
- Tissue texture changes maintained thus more Asymmetry, Restriction of Motion and thus Tenderness
- Clues for Somatic dysfunction related to Viscera supplied by that Spinal level when findings are recurrent despite ongoing treatment
Body Integration
Viscero-Somatic/ Somato-Visceral Reflex
Treatment of the Spinal Level NOT CURE the Visceral Problem
TREATMENT OF THE SPINAL LEVEL NOT CURE THE VISCERAL PROBLEM:
- Will help DECREASE the Visceral EFFERENTS thus allowing calming of abnormal reflexes -HOMEOSTASIS
- Treating ribs with RIB RAISING lymphatic technique:
a) DECREASES vasoconstriction
b) INCREASES fluid flowing in lymph and viscera of chest cage
Frank Chapman
- Graduated from the American School of Osteopathy in 1897!!!!!!!!!!!!!!!!!!!!!
- Practiced in Chattanooga, Tennessee
- Experience in PALPATION led to his development of the reflexes which bear his name
Clinical Application by Dr. Chapman
- Dr. Chapman (and several of his peers and followers) believed there is a NEUROLYMPHATIC reflex basis.
- Lymphatic system drainage blocked
- He named his reflexes “Endocrine Reflexes” which was appropriate for his time, the early 1900’s
- His palpation revealed nodules “GANGLIOFORM CONTRACTIONS”
- Points of Palpation on the Anterior and Posterior aka VISCEROSOMATIC REFLEXES
- He used them to STIMULATE HEALING with difficult patients and “started the healing process sooner”
- He believed he was stimulating the LYMPHATIC SYSTEM in very specific areas of the body
- He also realized the ‘COMPLEMENTARY’ nature of joint manipulation and his reflexes.
a) “Do not fail to give them [bony lesions] due attention”
Clinical Application
The PROCESS
1) Locate a point by anatomy
a) ANTERIOR POINTS FIRST
i. DIAGNOSIS (& treatment) = ANTERIOR
ii. TREATMENT = posterior 2) Verify by palpation 3) GENTLY ROTATE the tip of your finger over the point 4) Treat POSTERIOR POINTS 5) Recheck ANTERIOR POINTS
Clinical Application
Treatment Complete
TREATMENT is COMPLETE:
- When the REFLEX is GONE
- NOT when the Patients reports LACK OF PAIN
HOW LONG TO TREAT EACH POINT:
- 10 to 30 Seconds in One Text, 20 Seconds to 2 MINS in another
- LESS IS BETTER!!!!!!!
- Dr. Chapman continued until the Tissue CHANGED UNDER his Fingertip
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Dr. Dougherty Innominates Lecture (Test 1)15
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Sacral Somatic Dysfunction Lecture (Test 1)18
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Dr. Dougherty Innominates PRE CLASS Lecture (Test 1)26
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Introduction to Sacrum Lecture (Test 1)30
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Introduction to Muscle Energy and HVLA Lecture (Test 1)47
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Sacral Treatment (Test 1)9
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Innominate Treatment (Test 1)12
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Chapmans Reflex (Test 2)41
