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Questions and Answers
What is the somatic nervous system responsible for?
What is the somatic nervous system responsible for?
What is somatic dysfunction?
What is somatic dysfunction?
What is the myotatic reflex?
What is the myotatic reflex?
What is proprioceptive neuromuscular facilitation (PNF) stretching?
What is proprioceptive neuromuscular facilitation (PNF) stretching?
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What is the gamma motor neuron system responsible for?
What is the gamma motor neuron system responsible for?
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What is the integrated hypothesis theory?
What is the integrated hypothesis theory?
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What is the role of ATP in regulating muscle contraction?
What is the role of ATP in regulating muscle contraction?
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What is the precipitating event that may cause somatic dysfunction?
What is the precipitating event that may cause somatic dysfunction?
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What happens when a trigger point forms?
What happens when a trigger point forms?
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What is the effect of excessive release of acetylcholine on muscle contraction?
What is the effect of excessive release of acetylcholine on muscle contraction?
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What is the stretch, or myotatic, reflex responsible for?
What is the stretch, or myotatic, reflex responsible for?
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What is the role of alpha-gamma coactivation?
What is the role of alpha-gamma coactivation?
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What is the somatic nervous system responsible for?
What is the somatic nervous system responsible for?
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What is somatic dysfunction?
What is somatic dysfunction?
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What is the myotatic reflex?
What is the myotatic reflex?
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What is proprioceptive neuromuscular facilitation (PNF) stretching?
What is proprioceptive neuromuscular facilitation (PNF) stretching?
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What is the gamma motor neuron system responsible for?
What is the gamma motor neuron system responsible for?
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What is the integrated hypothesis theory?
What is the integrated hypothesis theory?
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What is the role of ATP in regulating muscle contraction?
What is the role of ATP in regulating muscle contraction?
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What is the precipitating event that may cause somatic dysfunction?
What is the precipitating event that may cause somatic dysfunction?
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What happens when a trigger point forms?
What happens when a trigger point forms?
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What is the effect of excessive release of acetylcholine on muscle contraction?
What is the effect of excessive release of acetylcholine on muscle contraction?
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What is the stretch, or myotatic, reflex responsible for?
What is the stretch, or myotatic, reflex responsible for?
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What is the role of alpha-gamma coactivation?
What is the role of alpha-gamma coactivation?
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What is the somatic nervous system responsible for?
What is the somatic nervous system responsible for?
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What is somatic dysfunction?
What is somatic dysfunction?
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What is the stretch reflex?
What is the stretch reflex?
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What is proprioceptive neuromuscular facilitation (PNF) stretching?
What is proprioceptive neuromuscular facilitation (PNF) stretching?
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What are the muscle spindle and Golgi tendon organ?
What are the muscle spindle and Golgi tendon organ?
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What is the gamma motor neuron system responsible for?
What is the gamma motor neuron system responsible for?
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What is the integrated hypothesis theory?
What is the integrated hypothesis theory?
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What is trigger point activation modulated at?
What is trigger point activation modulated at?
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What is the role of ATP in muscle contraction?
What is the role of ATP in muscle contraction?
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What happens when a trigger point forms?
What happens when a trigger point forms?
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What is a precipitating event that may cause somatic dysfunction?
What is a precipitating event that may cause somatic dysfunction?
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What happens when repeated eccentric contractions occur?
What happens when repeated eccentric contractions occur?
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Study Notes
Clinical Guide to Positional Release Therapy: Understanding the Neurophysiological Foundations and Theories of Somatic Dysfunction
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Positional Release Therapy (PRT) promotes tissue healing through manipulation of the somatic nervous system.
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The somatic nervous system is responsible for touch, temperature, pain, and proprioception.
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Somatic dysfunction may lead to the development and persistence of osteopathic lesions.
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Sensory information travels from first order neurons to second order neurons in the spinal cord and then to third order neurons in the cortex.
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The stretch, or myotatic, reflex is a reflex arc that controls the facilitation and inhibition of tissues.
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Proprioceptive neuromuscular facilitation (PNF) stretching manipulates proprioceptors to gain tissue relaxation.
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Pain can activate the myotatic reflex, and it may also activate contralateral alpha motor neurons.
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The muscle spindle and Golgi tendon organ are proprioceptors that work together to control muscle contraction.
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The gamma motor neuron system regulates the sensitivity of the muscle spindle to changes in dynamic stretch and static length.
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Pain modulates the activity of gamma motor neurons, which may lead to increased fusimotor activity.
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Alpha-gamma coactivation maintains muscle tone and spindle readiness.
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PRT interrupts the myotatic reflex and silences the spindle afferent discharge, which may hypersensitize the monosynaptic stretch reflex.Theories of Somatic Dysfunction and Trigger Point Formation
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Somatic dysfunction is the lack of homeostasis in the somatic system due to joint derangement, also known as an osteopathic lesion.
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The osteopathic lesion is associated with hyperirritable spinal segments and has five attributes: hyperesthesia, hyperirritability, changes in tissue texture, changes in local circulation, and altered autonomic functions.
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The length-tension relationship between muscle and connective tissue directly affects proprioceptors, resulting in altered gamma-fusimotor activity and reflex arc activity.
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The integrated hypothesis theory proposes that proprioceptors, the central nervous system, and biomechanical factors work together to produce and maintain somatic dysfunction, particularly the formation of trigger points.
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Trigger point activation and maintenance is modulated at the alpha motor neurons within the dorsal horn, causing a decrease in alpha motor neuron plateau depolarization levels and propagating the spontaneous release of acetylcholine at the motor terminal.
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Excessive release of acetylcholine may produce sustained muscle contraction, compressing local sensory nerves and vessels, resulting in reduced tissue oxygenation and ATP levels.
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ATP serves a critical role in regulating muscle contraction and inhibits the release of acetylcholine.
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The increased demand for muscular contraction in the absence of fuel produces an energy demand that cannot be met, causing a release of proinflammatory metabolites and further sensitizing nociceptors.
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Once a trigger point forms, it generates nociceptive input to the CNS, producing central sensitization of the spinal segment.
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An unaccustomed or unexpected maximal muscle exertion of either an eccentric or concentric nature is a precipitating event that may cause somatic dysfunction.
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Repeated eccentric contractions have been shown to damage sarcomeres and the vascular network within the muscular tissue environment, producing capillary restriction and impairing cellular and tissue perfusion.
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Capillary restriction and damage may impair cellular and tissue perfusion, resulting in greater acidity, activating nociceptors, and sparking the release of calcitonin gene–related peptide from the motor terminal.
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Description
Test your knowledge of the neurophysiological foundations and theories of somatic dysfunction with our Clinical Guide to Positional Release Therapy quiz. Learn about the somatic nervous system, proprioceptive neuromuscular facilitation, and the myotatic reflex. Explore the attributes of osteopathic lesions and the formation of trigger points. Discover how ATP, acetylcholine, and proinflammatory metabolites play a role in muscle contraction and tissue oxygenation. See if you can identify the precipitating events that