[Fundamentals] Chpt 8 Lecture

Body Mechanics - Use of the body in a efficient and bio-mechanically correct way. (Careful, efficient  Dilerberate. Involves Leverage, Good Posture, Good Body Mechanics, Using the strongest and largest muscles.

Compressive Force - For us, it is forward, and down. For others it's Lifting and Upward. The difference between us and other professions is the direction of the force.

[Test]Best stance - Asymmetrical, front leg is relaxed, back leg is carrying the weight with knee-lock(Screw-Home) in the last 15 degrees of extension.
Men & Women Center of Gravity - Men is Above waistline, with their nose not passed their toes, Women is below the waistline, with their nose not passed their heels.

Balance Point - Pressure/Compressing forces are equal but in the opposite direction. (i.e. weight on back foot, and opposite hand on the persons body. The force on the hand will be equal to the force on the persons body.

Contact point - Where you initially contact your client however unlike the Balance point the forces don't need to be equal.

Petrissage - Lifting, Leaning back, and letting go.

Pressure - Force down in a 90 degree angle.
Counter-Pressure -Allows you to use more pressure without using more force.


4 Basic concepts for body mechanics:

• Weight Transfer - Shifting your center of gravity.
• Perpendicularity - Syncing straight into the tissue, perpendicular to the body. Straight in at 90 degree.
• Stacking the Joints - Everything is in line. Lining up the joints to apply pressure not bending or wearing your joints.
• Keeping the Back Straight - Core stability, keeping the core strong.

Improper Body Mechanics(Dysfunction and why they may be caused):

• Neck and Shoulders - Why would a MT have neck and shoulder problems? Not using body weight, muscling through the massage.
• Wrist and Hand - Using thumbs to much, not staying behind the stroke. (Make sure to always keep relaxed wrists and hands during the massage, tense hands can lead to shoulder problems.)
• Knees - Twisting/Hyper-extension.
• Ankles & Feet - Not in the Asymmetric stance staying locked, and not moving positions frequently.

Pressure: 

• Pressure in a large area is more intense, and pressure in a smaller area is less intense. (i.e. Palm on the surface of the leg is good, if you were to use your fingers it might be to much.

[Test]Drag:

Resistance to Glide. (use lotion to reduce drag.)

Duration and Speed.

• Specific application

• Short duration = 10 seconds
• Moderate duration = 30 seconds
• Long duration = 60 seconds

• Massage session

• Short duration = 5–15 minutes
• Moderate duration = 15–30 minutes
• Long duration = 45–60 minutes

• Speed

• Slow: beginning to end of application 10 seconds
• Moderate: beginning to end of application 5 seconds
• Fast: beginning to end of application 2 seconds

Skin:

• 7 layers: L1 - Skin Surface, L2 - Skin, L3 - Superficial Fascia, L4 - First Muscle Layer, F5 - Second Muscle Layer, L6 - Third Muscle Layer, L7 - Bone.

Equipment:

• Table height usually 1/2 of your height.

[A&P] Chpt 3 Lecture

Because he gave us a decent review of the test, I'm just going over his review at the end. Keep in mind that the questions may not add up to 25, but some of them may just be repeat.

1.) If you have a base pair that's sequence is A, T, C, C, G, A, T, what would it's pair look like?

• From what I understood there are certain types of nucleotides that are always seen together, Adenine always binds to Thymine(A, T) and Cytosine always binds to Guanine. (C,G).  Now with that in mind remember that these are pairs, not with each other, but what they are binded with. With that in mind the answer is: 

A, T, C, C, G, A, T.

v   v  v   v  v   v  v

T, A, G, G, C, T, A. 

Look at the above, A is to T, T is to A, so on and so forth, just remember the "A and T" and "C and G".

2.)Next 3 questions are similar to each other all you need to do is remember 3 different words; Hypo(Under) Hyper(Over) Iso(Same)

• If you have a Hypotonic solution(NaCl) and you put a bloodcell in this solution, what will happen to the blood cell? Hypo = Under, a Hypo Solution is a solution of low NaCl, meaning if you drop a blood cell in Hypotonic solution it will swell as water enters the cell from the surrounding dilute solution.
• Now, in the exact opposite case you have Hypertonic(High NaCl) what happens to the blood cell then? They lose water from their cytoplasm into the surrounding Hypertonic solution causing them to shrink
• Lastly, Iso(Same) what would happen? Not a damn thing. Isotonic means Same, Same NaCl inside, and out.

3.)What is the process that occurs when a white blood cell engulfs a microbe? Phagocytosis.

4.)The movement of water and solutes through a membrane as a result of hydro-static pressure, this is a form of? Filtration.

5.)Process in which cell membranes take in fluids? Pinocytosis.

6.)What is it when diffusion happens through a selectively permeable membrane? Osmosis.

7.)Know the forms of Active/Passive.

• Active movement(require energy) - Phagocytosis, Pinocytosis, Ion Pump.
• Passive movement - Diffusion, Osmosis/Dialysis, Filtration.

8.)What is the purpose of the flagella in the sperm cell? To Propel.

9.)What programs the Ribosome? Nucleolus.

10.)What is the hairlike part of the cell? Cilia.

11.)What control's most of the cells activity? Nucleus.

12.)What is in a cell, that's rod-shaped and is important in cell division? Centrioles

13.)What is the organelle that chemically processes molecules? Golgi Apparatus.

14.)What organelle has a digestive/suicide feature? Lysosome

15.)What is the organelle we refer to as "protein factory"? Ribosome.

16.)What is an important part of the cell membrane (about 100 years ago this was stated)? Act as a cell id tag.

17.)What stabilizes the cell membrane? Cholesterol molecules.

18.)What are the Plasma membranes receptors known as? Protein.

19.)What is the Plasma Membrane composed of? Phospholipids, Cholesterol, Protein, 

Please keep in mind this may not be everything on the test, and you will probably be a bit more familiar with tissues, and muscles, just in case.

[Fundamentals] Chpt 4 - Lecture [Partial]

Massage and Medical Terminology for Professional Record Keeping:

• How we communicate: [Box 4-1]

• Language - is made up of socially shared rules that include the following:

• Sounds and symbols that convey meaning.
• Word definitions - vocabulary.
• Ability to make new words.
• Agreed upon sequences of words used to communicate - grammar.

• Terminology - languages specific to a specialized knowledge [medical terminology]
• Taxonomy - The science of classification according to a pre-determined system.
• Nomenclature - A system of names; a vocabulary, is a system of names with explanations of their meaning; a classification is a systematic organization of things.

• Terminology Defined by MTBOK [Box 4-2]

• Big box i'm going to try and simplify for you guys.
• Assessment - The collection and interpretation of information provided by the client, the client's family and friends the massage practitioner and referring medical professionals 
• Body, Mind, and Spirit - The three primary, interrelated, interacting, and integrated layers that comprise a health, balanced and unified human being.
• Body work - A term the encompasses all the various forms of massage, movement, and other touch techniques 
• Client - A recipient of service, be it from a wellness or a health care professional, regardless of his or her health status. All patients are clients, but not all clients are patients.
• Clinical Massage - Massage therapy practice involving more extensive use of assessment and specific focused techniques and applications with the intention of achieving clinical treatment or functional outcomes and remediation of symptoms.
• Deep tissue - Tissues beneath the superficial structure being treated.
• Deep tissue work/massage - A generic term commonly used to describe a variety of techniques to address specific deep tissues and structures, regardless of the force or pressure exerted or the level of discomfort or pain experienced during of after the application
• Discipline - An area of study involving particular concepts, a specific vocabulary, and so on.
• Massage therapy equivalent or related terms - Terms htat mean the same thing as massage; they also include therapeutic, body massage, myotherapy, massotherapy, body rub, massage technology, body work, bodywork therapy, somatic therapy, or any deviation of these terms.
• Massage therapist equivalent or related terms - Terms that mean the same thing as massage practitioner, they also include massage technician, somatic massage therapist, or any of a bunch of different terms. 
• Mobilization - The process of making a fixed part movable for releasing stored substances as in restoring motion to a joint, freeing a organ, or making available substances held in reserve in the body, such as glycogen or fat.
• Modality - A method of application or the employment of any physical agents and devices.
• Physical agent - Tools or materials used in the application of therapeutic modalities. the consist of energy and materials applied to the client/patient to assist in the achievement of a persons therapeutic goals.
• Soft tissues - The skin, fascia, adipose tissue, muscles, ect. ect.
• Special tests - methods use to assess for the presence of and to determine the degree of a condition in a client/patient.
• Standards of care - Treatment guidelines developed by the profession for a given condition which identify appropriate treatment based on scientific evidence and clinical experience.
• Standards of practice - Standards for the practice of a profession that members of that profession or organization are expected to adopt.
• Supportive Environment - A environment in which the therapist provides support and loving kindness within clear and appropriate boundaries.
• Technique - A procedure or skill used in massage therapy including; Compression, Friction, Gliding/stroking, Holding, Kneading, Lifting, Movement and mobilization, Percussion, Vibration.
• Therapeutic process - The capacity of the musculoskeletal system to self correct, come into balance and achieve equilibrium through the skillful normalization of tissue tone by a massage therapist.
• Treatment planning - The documented process of determining a treatment plan to address the therapeutic goals of the client/patient.
• Wellness -  The condition of optimum physical, emotional, intellectual, spiritual, social, and vocational well-being.

Several Test questions in this section!!

[Terms]

[M - Myo - Muscles - Fibromyalgia]

[U - Nephr - Kidney - Polynephritis]

[R - Pulm - Lungs - Pulmonary]

[D - Gastro/colo - Stomach - Gastritis/ Colonospy]

[E - Adreno - Gland - Endocrine]

[R - Gyn - Female - Gynecologist]

[S - Osteo - Bone - Osteoporosis]

[I - Perma - Skin - Dermis]

[N - Necro - Nerve - Neuropathy]

[C - Cardio - Heart - Cardiovascular]

[H - Hemo - Blood - Hemotoma]

[Abbreviations]

[Epi = Over: Epidermis]

[Dis = Separation: Dislocation]

[Dys = Bad, Abnormal, Difficult: Dysphagia(Difficulty swallowing)]

[Hypo = Under: Hypoglycemia]

[Ante = Before, Forward: Antecubital]

[Hemi = Half: Hemiplegia]

[Ology = Study of: Pathology]

[Itis = Inflammation: Tendonitious]

[Rrhage = Excessive flow: hemorrhage]

[Positional Terms]:

Erect, Prone, Anatomical, Supine, Laterally Recumbent.

[Directional Terms]:

Dorsal/Posterior, Ventral/Anterior, Superior, Inferior, Superficial, Deep, Proximal, Distal, Intermediate, Medial, Lateral.

[Planes]:

Transverse, Frontal/Coronal, Sagittal

[Levels of structure]:

Chemical, Cellular, Tissues, Organs, Organ Systems, Organism.

[Tissues]:
Tissues are a collection of specialized cells that perform a special function.

• Epithelial Tissue - Made with cells that intertwine with each other, forms the coverings that align various parts of the body including the surface of the skin.

Types of Muscle Tissue.

• Connective Tissue - Tissue that connects, supports, binds, or separates other tissues or organs, typically having relatively few cells embedded in an amorphous matrix, often with collagen or other fibers, and including cartilaginous, fatty, and elastic tissues
• Muscle Tissue - Made of bundles of elongated cells it is the main component of the muscles attached to the skeleton.
• Nerve Tissue - Composed of tangles of neurons, forms the brain the spinal cord and the nerves. 

[Cavities]:

Cranial, Spinal, Thoracic(Super-Mediastinum, Pericardial, and Pleural) Diaphragm, Abdominal, Abdominopelvic, Pelvic. [Primary: Dorsal, Ventral]

[Spine]:

7 cervical vertebrae (upper neck)

12 thoracis vertebrae (middle back)

5 lumbar vertebrae (lower back)

5 sternum(fused) vertebrae (lower-er back)

2-3 coccyx(fused) vertebrae (butt)

[Skeletal System]:

206 bones, the bones of the skull, thorax and the spine form the "Axial skeletal". Protect the vital organs, Everything attached is considered the "Appendicular skeleton".

[Bone]:

Bone is a dense connective tissue composed primarily of calcium and phosphate.

[Joints]:

Joints are places where bones come together, where limbs are attached and where the motion if the skeletal system occurs

• Synarthrodial - Not movable.(joints in your head)
• Amphiarthrodial - Slightly movable (chest, pelvic area)
• Diathrodial - Most movable/freely movable (fingers hips and shoulders.)

Types of movements:

• Flexion - Movement that reduces the angle of a joint.
• Extension - Movement that increases the angle of a joint.
• Abduction - Movement away from the midline.
• Adduction - Movement toward the midline.
• Pronation - Turning of palm downward.
• Supination - Turning of palm upward.
• Eversion - Turning of the sole of the foot away from the midline.
• Inversion - Turning of the sole of the foot inward.
• Planter flexion - Movement of the planter surface of the sole of the foot downward.
• Dorsiflexion - Movement of the top or dorsal surface of the foot toward the shin
• Rotation - Rolling to the side.
• Circumduction - Moving in a cone; the ability to move the limb in a circular manner.
• Protraction - Thrusting a part of the body forward.
• Retraction - Pulling a part of the body backward.
• Elevation - Raising a part of the body.
• Depression - Lowering a part of the body.
• Opposition - Place one part of the body opposite another, as in placing the tip of the thumb opposite the tips of the fingers.

[Cartilage]:

The skeletal system includes two types of cartilage. Hyaline cartilage, which is very elastic, cushiony, and slippery, makes up the articular surfaces at the joints; the cartilage between the ribs and at the nose, larynx and trachea; and the fetal skeleton. Hyaline means "glass" the other type is "White fibrocartilage", which is elastic, flexible, and tough, is interarticular fibrocartilage found in joints such as the knee.

[Ligaments]

Attach bone to bone. Ligaments are pliable, flexible and tough.

[Skeletal Muscle]

Each skeletal muscle has sections, a origin where it begins, a insertion, where it attaches to (usually a mobile structure). and a muscle belly. Muscles create the potential for motion by creating a pulling force. Joints allow motion to occur. 

Smooth muscle involuntary wave-like contraction in the digestive tract = Remember peristalsis. 

Cardiac Muscle is also involuntary.

and Skeletal muscle is voluntary.

[3 types of actions]:

concentric, eccentric, isometric

• Concentric, Eccentric -  a form of isotonic actions. Isotonic contraction happens when movement meaning the proximal end is brought to the distal end, or the insertion is move to the origin. (Muscle contracting) Concentric - Muscle Contracts. Eccentric - Muscle Lengthens.
• Isometric - Tension put on the muscle but no contraction or movement occur. (pushing against a wall.)

Nervous System on wednesday [rest of the lecture]

[Fundamentals] Chpt 6 - Full

Indications and Contraindications

• Indication - A condition for which an approach would be beneficial.
• Contraindication - A condition for which an approach would be harmful. there are 3 types of contraindications.

• General - No massage techniques may be performed.
• Regional - Particular areas must be avoided.
• Application with Caution - A condition that requires the massage therapist to adapt the massage techniques so the client's safety is maintained.

• [Example of Indication and Contraindications] A diabetic patient has blood sugar over 200, it would be an indication to give them insulin to lower their blood sugar, However if their blood sugar is 70, it would be a contraindication to give them insulin to lower it.   

Indications for Massage

• Objective - Results that can be seen.
• Subjective - Results that are assumed from effective based on experience.

• The Effects of massage are both physical(Objective) and mental(Subjective).
• [Example of Objective and Subjective] If a patient says they think they have a fever and you can see they are sweating and flushed, that is Objective. If a patient says they have a headache, you can not see any signs, therefor it is Subjective.

• Anatomic benefits can be measured Objectively.
• Biochemic benefits can be measured Objectively and Subjectively.
• Physiologic benefits can be measured Subjectively.

Approaches to care

When considering approaches to care there are several ways of going about it, how do you decide which and why? Firstly, lets address the 3 approaches you can take, these are; Therapeutic change, Condition management, and Palliative care. 

• Therapeutic change

• This change process requires client energy and resource expenditure. Resources required; Support systems, Motivation, Information, Finances.
• Practitioner needs include knowledge and skills, careful assessment protocol, and professional support.
• Therapeutic change might be unrealistic at a particular time or under set of circumstances, Condition management or Palliative care can be offered instead. 

• Example of Therapeutic change - because athletes are looking to improve their physical qualities to compete massage could improve their flexibility allowing them to push off more efficiently and run faster.

• Condition management

• Support for clients unable to undergo therapeutic change process for various reasons; Chronic health condition. Life circumstances that create chronic stress, A situation for which change is not viable, Need to postpone time frame for change.
• Accounts for the largest client base for therapeutic massage.
• Benefits: Manages existing physical compensation patterns, Can slow the progression of chronic conditions, Can prevent a situation from becoming worse, Offers emotional support for stress symptoms.

• Example of Condition management - Construction worker with repetitive pain in hands, show the client how to manage the symptoms.

• Palliative care

• Uses of palliative care include; Meeting pleasure needs, coping with chronic pain, making the transition from life to death.
• Can reduce pain, but not necessarily suffering. (suffering can be mental and spiritual.)

• Examples of Palliative care - Day spa customers: Massage services are not part of a cohesive treatment plan, usually do it as a one-time experience, not possible to provide any true therapeutic change or condition management benefits because there is no time for proper assessment.

Pathology, Health, and Therapeutic Massage.

• Pathology - is the study of disease. To practice safely, massage practitioners need a basic understanding of pathologic processes:

• Referring appropriately, recognizing contraindicating symptoms, recognize general types of disorders, specific signs and symptoms, and the development of disease processes, and understanding possible interactions between massage and medications.

• Health - optimal functioning with freedom from disease or abnormal processes. Factors that can influence health are:

• Inherited(Genetics) and constitutional traits, Lifestyle(diet, exercise, rest, stress level.),Beliefs and attitudes, self-esteem, loving relationships. Authentic personality and freedom from self-hindering patterns.

• Dysfunction - the in-between state of "not-healthy" and "not-sick".

• Effective approaches to dysfunction include mind/body medicine, stress management, and prevention methods. Active pathologic processes often require more aggressive treatment.

• Peak performance - maximum conditioning or functioning to a particular action. (physical or mental, energy consuming or stressful)

• During Peak performance your body does not hold back energy expenditure. Injury, Depletion and Illness can result if you do not give the body enough time to recover. 

• Disease - occurs when homeostasis cannot be returned to normal easily.

• In "Acute" cases of disease homeostasis can be returned to normal quickly, however in "Chronic" cases the body's homeostasis may never be restored and compensation is developed because of it. (Compensation is the process of counterbalancing a defect in body structure or function. (You limp on your left leg because your right leg has been injured.)) Further details in "Development of Pathologic Conditions"

• Functioning limits - The body has anatomic and physiologic functioning limits, the heart can only beat so fast, the endocrine can only secrete a maximum amount of hormones. 

• The body can only perform at an extent, when this is reached the body signals this by pain, fatigue or strain. However when the extraordinary events can push the body's functioning limits. Normally the body will never allow us to push past our limits, showing you signs of fatigue or pain before we can reach those limits, but in rare circumstances events may happen that will make the body push far beyond those limits and allow us to be super human for a short duration. (Mother lifting a van to save her child.)
• On the other hand " Dysfunction" results when the reserve runs low because restorative mechanisms are unable to function effectively, or when the body begins to "limit" function in an attempt to maintain higher energy reserves.
• Many massage professionals will serve people at the beginning of dysfunctional patterns; ie when the client does not feel their best, but are not sick. After dysfunction has set in, an intervention should be applied at the point where ROM limits were first observed.

• Development of Pathologic conditions - 

• Illness occurs when a body process breaks down, it also tends to indicate cautions and general contraindications.
• Injury occurs when tissue is damaged.
• Types of massage for injury can help edema, pain, circulation, approximation, and scar tissue formation.
• Healing taxes the body's reserves, our goal as the practitioner is to help the body supply healing so that it may heal faster, we do this by relieving stress, a relaxing the body. If a body is high on stress and cannot relax your body will heal a lot more slowly than it would without stress.

• If we cannot help the client with injury massage or illness massage we need to refer them to a professional that can help them.

• Signs - objective abnormalities than can be seen or measured by someone other than the patient.
• Symptoms - Subjective abnormalities felt only by the patient.
• Syndromes - Groups of Signs and Symptoms usually from a common cause.
• Acute Diseases - developed signs and symptoms quickly but only last for a short duration.
• Chronic Diseases - Opposite of acute, signs and symptoms may developed slowly and last a long duration, possibly until death.
• Communicable Diseases - can be transmitted from one person to another.
• Homeostasis - relevant constancy of the body's internal environment. 
• Compensation - a process of counterbalancing a defect in structure or function.
• Risk Factors - predisposing conditions that make a disease or injury more likely to happen; Genetic or inherited traits, Age-related or biologic factors, Lifestyle, Environment, Preexisting or primary conditions, Stress.
• General Adaptation Syndrome(GAS) - three stage response to harmful stimuli; Alarm("Fight or Flight"), Resistance reaction, Exhaustion. (Prolonged or excessive "Fight or Flight" response can disrupt normal functioning throughout the body.
• Generalized Stress Conditions -  The hypothalamus acts on the interior pituitary gland to cause the release of adrenocorticotropic hormone (ACTH) this stimulates the adrenal cortex to secrete glucocorticoid. while this is happening the sympathetic division of the autonomic nervous system(ANS) i stimulated by the adrenal medulla, resulting in the release of epinephrines and norepinephrines to assist with the body in responding to the stressful stimulus.

 Pathologic Conditions and Indications for Massage.

• Inflammatory Response - Processes that minimize tissue injury to promote healing

• Active, important part of the healing process, the primary signs are; Heat, Redness, Swelling, and Pain. Occurs in response to injury and may also accompany  specific immune system reactions. Sometimes the inflammatory response can be more intense or prolonged than desired, and can be suppressed by antihistamines or antiinflammatories.
•  Heat and Redness - Histamine, Prostaglandins, and kinens are associated with inflammation. Dilated blood vessels increase blood volume and bring WBCs.
• Swelling and Pain - Edema results in increased permeability of vessel walls. Increased pressure triggers pain receptors. Inflammatory exudate is the fluid that accumulates.
• Extent of Inflammation - Local(on your hand or arm.) Systemic(Allergic reaction-full body response) Chronic Inflammatory Disease(Hepatitis, RA).
• [How Massage can benefit prolonged Inflammation; it activates the body's natural antiinflammatory agents, triggers completion of process, involves lymphatic flow to dilute and remove irritant.]

• Indications for Inflammatory Response

• Tissue Repair - Combination of two processes; Regeneration with similar cells, and Replacement with fibous connective tissue(Scar Tissue).
• Healing Process Goals -  Promote regeneration, minimize replacement. Slow the formation of scar tissue. Keep scar tissue that does not form pliable.
•  Therapeutic Inflammation creates a controlled, localized area of inflammation to jump-start the healing processes. The types of therapeutic inflammation include: Deep friction, Connective tissue stretching, Moxibustion(burning the skin), and Acupuncture.
• Contraindications - Suppressed Healing mechanisms, Conditions of impaired repair and restorative functions (unless carefully monitored), Use of antiinflammatory medications.

Pain

• Pain is a very important mechanism to understand, it's a complex, private, and abstract experience. Managing pain can be a major challenge, it can affect us in many different ways; Physiologic, Psychologic and Social Aspects. The Practitioner needs to recognize that the clients pain is what they say it is, and exists when the client says it does.
•  There are four processes involved in pain sensations; 

• Pain transduction - Noxious stimuli lead to electrical activity in pain receptors.
• Pain transmission -  Pain impulses travel through PNS(Parasympathetic Nervous Systom) and CNS(Central Nervous System).
• Pain modulation - neural activity can influence pain transmission at the spinal cord, also involves activity in primary afferent pain receptors.
•  Pain perception - subjective experience.

• Fast Pain - Local and specific, Sensation on the surface, Prickling, Sharp, Electrical.
• Slow pain -  More Diffuse(spread out), Felt in deeper tissues, Burning, throbbing, aching, usually associated with tissue damage.
• Utility of pain sensations - Cue us to protect ourselves from further hurt, Initiate a search for medical assistance, Help pinpoint underlying cause.
•  Nociceptors(Ends of dendrites) - 

•  These are found in almost every body tissue, respond to any type of stimuli, and adapt slightly, or not at all.

•  Pain transmission to cerebral cortex

• Neospinothalamic tract - carries type A(fast pain) nociceptors to the thalamus.
•  Paleospinothalamic tract - carries type C(slow, chronic pain) nociceptors to the brainstem.

• Influences on perception of pain

• Emotional interpretation -  Hypothalamus and limbic structures.
• Rational interpretation - Frontal cortex 
• CNS Mechanisms
• Neurotransmitters and neuromodulators(substance P, acetylcholine, norepinephrine, epinephrine, dopamine, serotonin)
•  Endorphines

• The pain threshold is the point at which a stimulus is perceived as painful. This Varies somewhat among individuals. Perceptual dominance, some pain overshadows other pain; can be activated by massage that “hurts good”.
• Pain tolerance is the duration or intensity of pain endured before relief is sought. This varies widely among individuals  

• Origins of pain

• Somatic - from stimulation of skin, skeletal muscle, joints, tendons, and fascia.
• Visceral - from stimulation of internal organs  

• The Cortex accurately locates origin of most somatic and some visceral pain.

• Acute pain - A disease, symptom, or a temporary treatment aspect.

• Warning signal that arouses sympathetic nervous system. Temporary, sudden onset, localized. Client is often able to describe it. Arouses sympathetic ANS.

• Chronic pain - persists or recurs for indefinite periods, usually longer than 6 months.

• Major health problem for many, Obscure onset(Hidden, or concealed), Character and quality can change. Anxiety, sleep disturbances, depression common,  Multidisciplinary approach to treatment.

• Intractable pain - Is persistent with treatment or without demonstrable disease.

• Intractable pain poses the greatest challenge to health care providers. Massage provides temporary relief through distraction.

• Phantom pain - Can occur after an amputation.

• Pain or other sensations seem to originate from amputated extremity, Brain misinterprets stimuli from proximal portions of sensory nerves.

• Referred pain - felt far from its origin.

• Visceral pain and deep somatic pain can refer, A diagnosis must be obtained from a physician.

• Sources of information for assessment:

• Subjective information from the client, Direct observation of verbal and nonverbal information, Gender and, cultural differences in expression

• Sympathetic responses to acute pain:

• Decreased ROM, Muscle guarding, Trigger points, Areas of increased or decreased sensitivity

 Impingement Syndrome

• Two types of nerve impingement:

• Compression - pressure on a nerve by a bony structure.
• Entrapment - pressure on a nerve by soft tissue. 

• Impingement classified by the plexus affected.  

• The Cervical plexus - includes the phrenic nerve and the ventral branches of four upper cervical nerves.

• Symptoms - headaches, neck pain, breathing difficulties, and pain sensations in neck, ear, and shoulder (transmitted by cutaneous branches of nerves.)
• Origins of pressure - include suboccipital and the sternocleidomastoid muscles, and shortened connective tissues at cranial base.

• The Brachial plexus - situated in the neck and axilla.

• Symptoms - pain in the shoulder, chest, arm, wrist, and hand, and thoracic outlet syndrome.
• Origins of pressure - include scalenes, pectoralis minor, subclavius, and arm muscles.

• Lumbar plexus

• Symptoms - pain in lower back, belt area, lower abdomen, genitals, thigh, and medial lower leg.
• Origins of pressure - can include quadratus lumborum, psoas, and lumbar dorsal fascia.

•  The Sacral plexus - sciatic nerve and serves the pelvic structure, buttocks, and lower limb.

• Symptoms - gluteal, genital, leg, and foot pain
• Origin of sciatic pressure - include piriformis muscle and ligaments of the sacroiliac joint  

• Massage can reduce pressure on nerves:

• Soften and stretch connective tissue, normalize muscle tension patterns, restore normal resting length to shortened muscles.

Psychological Dysfunctions

• Science has validated the mind/body link in terms of health and disease. Many risk factors for the development physical(body) pathologic conditions are mentally(mind) influenced.
• Major types of mental health dysfunctions - Trauma, Posttraumatic stress disorder, Pain and fatigue syndromes, Anxiety and depressive disorders, Stress-related illness.

• Massage can physically influence mental state through compassionate touch. Soothing ANS Hyper and Hypo Activity, Managing pain, normalizing breathing patterns, providing support for returning the body to normal homeostasis.
• 
  

Tumors and Cancer

• Tumors - benign (usually localized and slow-growing) or malignant (can metastasize).

• Detection of Cancer - Point out abnormalities or changes, suggest medical evaluation.
• Cancer not always a contraindication - Massage can support immune function as part of comprehensive treatment program, it's important not to overtax the body's systems.

 Medications

• Massage and medications can interact synergistically or antagonistically to; 
  stimulate a body process, 
  inhibit a body process, or 
  replace a body function.

[A&P] Chpt 2 - Key Terms

Biochemistry - Devoted to studying the chemical aspects of life.
Matter - Anything that occupies space and has mass.
Molecules - Molecules are particles of matter that are composed of one or more smaller units called Atoms.
Atoms - Basic units of matter.
Proton - Subatomic particle with a positive charge.
Neutron - Subatomic particle with no charge.
Electron - Subatomic particle with a negative charge.
Nucleus - The core of an atom, composed of positively charged protons and uncharged neutrons.
Atomic Number - Number of protons in an atom.
Atomic Mass - Number of protons and neutrons in an atom.
Orbital - Certain limits away from the atom that electrons dart around in.
Energy Levels - Limited region surrounding the nucleus of an atom at a certain distance containing electrons; also know as "Shell"
Elements - Pure substances, composed of only one type of atom.
Compounds - Substance whose molecules have more than one element in them.
Ionic Bond - Chemical bond formed by the positive-negative attraction between 2 ions.
Dissociate - When a compound breaks apart in solution.
Electrolytes - Substance that ionizes(dissociates to form ions) in solution, rending the substance capable of conducting an electric current.
Covalent Bond - Bond formed when 2 atoms share their electron.
Hydrogen Bond - A weak "bond" formed by hydrogen elements. (like 2 molecules of a water, the hydrogen is attracted to the oxygen of another water molecule, much like magnets to the fridge, they are together but not hard to separate like a Covalent Bond is.)
Organic - Compounds that are composed of molecules that contain Carbon-Carbon C-C.(Helium, Carbon Dioxide.)
Inorganic - Compounds that lack carbon and hydrogen atoms.
Solvent - Substance in which other substances are dissolved.
Solute - Substance that dissolves into another substance.
Aqueous Solution - When water is the solvent for a mixture (blend of 2 or more kinds of molecules), the mixture is called an aqueous solution. (salt into water)
Dehydration Synthesis - Reactants combine only after two hydrogen (H) atoms and an oxygen (O) atom are removed.
Hydrolysis - disrupts the bonds in large molecules, causing them to be broken down into smaller molecules. (opposite of dehydration synthesis)
Adenosine Triphosphate - breaks apart in muscle cells (into ADP) to yield energy needed for muscle contraction.
Chemical Equation - Chemist use this to represent a chemical reaction.
Buffers - chemicals in blood that maintain pH.
Carbohydrate - (carbon and water) Organic compounds containing hydrogen, carbon, and oxygen, in certain specific proportions.
Monosaccharide - basic unit of carbohydrate molecules.
Disaccharide - Molecule made up of 2 saccharide units.
Glycogen - Polysaccharide made up of a chain of glucose.
Lipids - fats and oils, fats when are solid at room temperature, and  oils such as corn oil.
Triglycerides - lipid molecules formed by a glycerol unit joined to three fatty acids.
Phospholipids - Phosphate containing fats molecule found in cell membrane.
Cholesterol - a steroid lipid.
Peptide Bonds - covalent bonds linking amino acids within a protein molecule.
Enzymes - a functional protein acting as a biochemical catalyst, allowing chemical actions to take place in a suitable time-frame.
Lock-and-Key - Each Enzyme has a shape that fits the specific molecules it works on as a key fits a specific lock.
Nucleotides - basic building blocks of nucleic acids are called nucleotides.

[Fundamentals] Power Points [2,3,5,6]

Chapter 2 Power Points (Tassa)
Chapter 3 Power Points (Tassa)
Chapter 5 Power Points (Rick)
Chapter 6 Power Points (Rick)

[A&P] Chpt 2 - Lecture

These are just my notes from the lecture, by the time Tassa's 3 hour lecture ended my recorder was dead on batteries. So this is all the notes I was able to copy down as he was literally flip flopping them, lol. So what i'll do is incorporate from the book where my notes are spotty.

  Matter is anything that occupies space and has mass. In the body most chemicals are in the form of Molecules. Molecules are particles of matter that composed of one of more smaller units called Atoms. There are 109 types of Atoms. A substance made up from one kind of atom is an Element. A atom is the smallest part of an Element that still has the properties of that Element.

  There are 3 types of subatomic particles that make up an Atom:

• Protons - These particles have a positive charge (+).
• Neutron - These particles have no charge. (Think neutral.)
• Electron - These particles have a negative charge. (-)

  The Neutron's and the Proton's are located in the middle of an atom called the "Nucleus".

• Atomic mass: Number of Proton's & Neutron's in the Atom.
• Atomic number: Number of Proton's in the Atom.

  Negatively charged Electron's surround the nucleus at a distance. In a electrically neutral atom, there is one electron for ever proton. (1 - 1 = neutral) Electron's dart about in the atom's Orbitals. 

• Orbitals - Atom's 1st Orbital can hold 2 electron's, the 2nd Orbital can hold 4 electron's, and the 3rd orbital can hold 8 electrons.

Orbital's are arranged by Energy Level's(EL) depending on their distance from the nucleus.

• Elements - one type of atom.
• Molecule - Two or more atom's together.
• Compound - Made of molecules.\

  Now, what happens when a Atom has a uneven number of electrons in their orbital? Well they become unstable, when this happens it seeks another atom to bond with.

• Chemical bonds:
• Chemical bonds are formed  when atoms are "unstable" they seek other atoms to bond with because their orbital is not "full". All but a hand-full of atoms have room for more electrons in their outer most energy level. (Noble gases.)

• Ionic Bonds - Ions formed when an atom gains or loses electrons in its outer energy level to become stable.

• Positive-Ions - Lost it's electrons.
• Negative-Ions - Has gained electrons.

 This is all for the lecture now, I'll continue after work tomorrow.