Title Palpation and Assessment Skills.pdf ✅

Contents This CD-ROM includes video sequences of all the techniques indicated by the icon. Where you see the icon next to a section it means that there are one or more video sequences to be found in that section. This CD-ROM is designed to be used in conjunction with the text and not as a stand-alone product. About the Author Foreword Preface Dedication Glossary Special topic 1 Using appropriate pressure (and the MPI) Chapter 1 Objective – palpatory literacy Special topic 2 Structure and function: are they inseparable? Chapter 2 Palpatory accuracy – mirage or reality? Special topic 3 Visual assessment, the dominant eye, and other issues Chapter 3 Fundamentals of palpation Special topic 4 The morphology of reflex and acupuncture points Chapter 4 Palpating and assessing the skin Special topic 5 Is it a muscle or a joint problem? Chapter 5 Palpating for changes in muscle structure Special topic 6 Red, white and black reaction Chapter 6 Palpation of subtle movements (including circulation of CSF, energy and ‘has tissue a memory?’) Special topic 7 Assessing dural restriction Chapter 7 Assessment of ‘abnormal mechanical tension’ in the nervous system Special topic 8 Source of pain – is it reflex or local? Chapter 8 Introduction to functional palpation Special topic 9 Joint play/‘end-feel’/range of motion: what are they? Chapter 9 Palpation and assessment of joints (including spine and pelvis) Special topic 10 Percussion palpation Chapter 10 Visceral palpation and respiratory function assessment Special topic 11 Palpating the traditional Chinese pulses Chapter 11 Palpation without touch Special topic 12 About hyperventilation Chapter 12 Palpation and emotional states Appendix: Location of Chapman’s neurolymphatic reflexes | About the Author | | Contents |Videos |Copyright |Search | |Foreword |Preface | Dedication |Glossary | |Special Topic 1 |Chapter 1 |Special Topic 2 |Chapter 2 | |Special Topic 3 |Chapter 3 |Special Topic 4 |Chapter 4 | |Special Topic 5 |Chapter 5 |Special Topic 6 |Chapter 6 | |Special Topic 7 |Chapter 7 |Special Topic 8 |Chapter 8 | |Special Topic 9 |Chapter 9 |Special Topic 10 |Chapter 10 | |Special Topic 11 |Chapter 11 |Special Topic 12 |Chapter 12 | |Appendix |
Foreword The encroachment of technology into diagnosis and treatment threatens to erode the long-established field of touch. But every mother knows the comforting healing impulse of her hand on her troubled child and many proxy grandmothers are being recruited into the neonatal nurseries to hold, and tenderly touch, abandoned babies, comfort and reassure them and enhance their weight gain and development. Intuition is the teacher of these mothers and grandmothers. May the intuitive dimension never depart from the physician and therapists regardless of technology. Perish the day when a robot arm will be ‘less expensive’, ‘more available’ and ‘more enduring’ than the compassionate ministrations of a nurse‘s or physician’s hands. A. T. Still abandoned the practice of medicine after three members of his immediate family died of spinal meningitis despite the best care that his profession had to offer. Before that his distress began in finding himself helpless before the ravages of acute illness which decimated his soldiers during the Civil War. But he reasoned that if God had permitted such diseases, he had also provided answers to them. So his research began. A diligent detailed study of human anatomy led him to the recognition that structure governs function, and efficient healthy function is dependent upon precisely integrated structure. Furthermore, the patient is a total being, a dynamic unit of function. Thus life and matter can be united but that union cannot continue with any hindrance to free and absolute motion. Thus motion is the fundamental function of the living body. As a result the inevitable conclusion must be that diseases are only effects. These are the central conclusions of A. T. Still as osteopathy came into being. Structural integrity and its potential for physiologic motion inspired William Garner Sutherland in his studies of the cranial mechanism following the incredible thought given to him about the sphenosquamous articulation – ‘beveled like the gills of a fish for respiratory motion of an articular mechanism.’ As with his original teacher Dr Still, Sutherland embarked on an intensive study of cranial anatomy – bone, membrane, fluid and nervous system and their extensions through the spinal mechanism to the sacrum. Eventually, came the recognition of the continuity of intracranial and intraspinal membranes with the fascial system of the body, the recognition of the relationship between cerebrospinal fluid and the lymphatic system thus returning to the dynamic unity of the whole patient. Motion is the measure between health and dysfunction, between vitality and fatigue, between joy and despair, and ultimately between life and death. Motion may be external, visible, voluntarily initiated, limited by pathology or enhanced by diligent training. Its dimension provides a valuable record of the state of the musculoskeletal system today and the progress manifested in response to the therapeutic modality. The far greater field of motion of vital significance to the health and well-being of our patients, however, is inherent, invisible, subtle in its dimensions and continuous whether awake or asleep as long as life persists. Food that enters the mouth is digested, assimilated, selectively absorbed or eliminated as it passes down the extensive digestive system. Blood is pumped from the heart to be oxygenated by the lungs and thence dynamically distributed to every cell in the body from the scalp to the toe. The reproductive system has its own inherent rhythmic motion from its preparatory monthly cycle until such time as the intense inherent motility of the sperm fertilises the ovum at the exact right time and a rapid motile developmental panorama of events is set in motion until such time as a fully developed newborn is propelled by a powerful rhythmic cycle of activity out into the external world. The water system is efficiently maintained by the inherent rhythmic activity of the renal system. Each of these internal, invisible, involuntary systems functions quietly and effectively so long as there is no disturbance, diversion or interruption in its remarkable involuntary rhythmic motion. But the respiratory system has some unique characteristics. It has an inherent, involuntary rhythm highly sensitive to the gaseous composition of the atmospheric air, and to fluctuating oxygen demands of the inner physiology. It may be interrupted voluntarily for a period of time, the duration of which is ultimately determined by another inherent rhythm, which will never be interrupted as long as life persists, and which is beyond the will to control for it is the primary respiratory mechanism (PRM). Becker provides vivid directions for palpating these inherent rhythms, the diagnostic touch whereby he searches for what the patient’s body wants to tell him. The potency within the patient and the fulcrum established by the operator need to be understood if Becker is to be fully appreciated. But what are we palpating? Inherent slow rhythmic motion of the central nervous system has been known for generations and was in fact first described by Magendie in 1845. However, Sutherland also recognised the motion of the cerebrospinal fluid, a slow rhythmic fluctuating motion. His initial inspired thought concerning respiratory motion of an articular mechanism prompted an intensive study of all the bones of the cranium and the dural membranes which bind them together and reciprocally integrate their motion. The palpation of cranial motion has been reported in patients of all ages. This rhythmic motion of the cranial bones was recorded in 1971 (VF). Skull bone motion may be considered as very small comparative changes of the position of bones at their sutures: the mobility of skull bones is in fact localised in sutures. Rhythmic periodicity of skull bone motion of 6–15 cycles/minutes has been clearly demonstrated (Chaitow 1999; Moskalenko 2000).
Understanding the PRM underlying these bone motions requires a recognition of the nature of the inherent forces, namely fluctuation of vascular tone and the replacement of cerebrospinal fluid inside the cranial cavity and between the cranial and spinal cavities. Still declared that ‘the rule of the artery is supreme but the cerebrospinal fluid is in command.’ Transcranial Dopplerography integrated with Bioelectrical Impedance have substantiated this, but have also demonstrated conclusively that skilfully applied therapeutic touch can enhance the CV and CSF motility. Following from this fundamental basis of the PRM its activity can be described by the complex of objective parameters as well as from the results of spectrum analysis which is the most adequate method for the analysis of slow fluctuations with changeable frequency and amplitude (Moskalenko 2001). It is the relation of these control links with different time constants that support brain metabolic supply and water balance of brain tissue. They are responsible for motion of the brain tissue and skull bone motion. As Still stated long ago, the brain is the dynamo. Functional palpation, the evaluation of this primary respiratory mechanism is the essential sequel to structural palpation. It provides a vital measure of the level of wellness of this person, the potential for positive change in the inherent physiology. It may reveal underlying etiologies and the appropriate strategy for addressing them. Structural palpation with the precise recognition described in this text will provide a picture of the traumatic forces and their consequences which have caused the problems presented by the patient. Functional palpation, through the inherent motility of the PRM, provides wisdom concerning the therapeutic potential, the inherent therapeutic potency of the physician within this patient. Develop those ‘thinking, feeling, seeing, knowing fingers’ and then ‘be up and touching’ (Sutherland). San Diego, CA, USA Viola M. Frymann REFERENCES Chaitow L 1999 Cranial manipulation: theory and practice. Churchill Livingstone, Edinburgh Moskalenko Y 2000 Physiologic of mechanism of slow fluctuations inside the cranium. Part 2. Osteo 51: 4-11 Moskalenko Y, Weinstein GB 2001 Development of current concepts of physiology of cerebral circulation: a comparative analysis. Journal of Evolution Biochemistry and Physiology 37: 492-605 | About the Author | | Contents | Videos | Copyright | Search | | Foreword | Preface | Dedication | Glossary | | Special Topic 1 | Chapter 1 | Special Topic 2 | Chapter 2 | | Special Topic 3 | Chapter 3 | Special Topic 4 | Chapter 4 | | Special Topic 5 | Chapter 5 | Special Topic 6 | Chapter 6 | | Special Topic 7 | Chapter 7 | Special Topic 8 | Chapter 8 | | Special Topic 9 | Chapter 9 | Special Topic 10 | Chapter 10 | | Special Topic 11 | Chapter 11 | Special Topic 12 | Chapter 12 | | Appendix |