Intro to Functional P.E. Dicken Weatherby, N.D..
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1 4 Quadrants of Functional Diagnosis Functional & Nutritional P.E. Inspection The Basics of P.E. Palpation Percussion Auscultation Inspection Teaching your eyes to see. General appearance State of their nutrition Body habits y Symmetry Posture and gait Speech 1
2 A Simple Exercise How many fs are in this sentence? Finished files are the re- sult of years of scientific study combined with the experience of years. The answer is 6. Answer! Finished files are the result of years of scientif- ic study combined with the experience of years. Most people only count 3, missing the f in the 3 ofs Palpation Use of fingers to determine characteristics of an organ system Used in the neuro-lymphatic palpation The majority of the functional PE is palpation 2
3 Percussion Relationship between tactile sensation and sound produced. Provide information about the structure of the underlying organ or tissue A mass in the abdomen will change the percussive sound of the abdomen Auscultation Training our ears to hear Listening to the sounds produced by internal organs Absence of abnormal bowel sounds could indicate an acute abdominal emergency Equipment Needed Blood pressure cuff (automatic or blow up) Stethoscope Pen light Reflex hammer ph indicator paper Tracking forms 3
4 Medical Terminology Anatomical Directions Some Common Terms 1. Distal 2. Proximal 3. Lateral 4. Medial 5. Superior 6. Inferior 7. Anterior 8. Posterior Landmarks on Anterior Thorax 1. Clavicle 2. 1 st Rib 3. Intercostal spaces 4. Mid-clavicular line 5. Sternal border 6. Xyphoid 4
5 Vertebral indicators and Nutrition Autonomic Nervous System Traditional P.E. 5
6 Traditional Abdominal Exam Traditional Cardio Exam Trad. Peripheral Vascular Exam 6
7 Traditional Lung Exam Traditional Neuro Exam Functional P.E. 7
8 The Mirrors of the Body Reflexology Auricular Medicine Pulse Tongue Skin Applied Kinesiology Neurological Reflexes Neurological Reflexes History Lymphatic System 8
9 Why are these points present? Tenderness in a particular neuro-lymphatic or neuro-vascular point indicates dysfunction in a corresponding organ or system. Dysfunction occurs when there is an ongoing disruption in homeostasis. Homeostatic disruptors come in many different forms. Total Load Hormone Imbalances Medication Interactions Nutritional Deficiencies Repressed/Toxic Compromised Detoxification Environmental Toxins Emotions Heavy Metals Food Allergies Mold Exposure Structural Imbalances Intestinal Pathogens Leaky Gut TERRAIN DAMAGE FUNCTIONAL DISTURBANCES 9
10 The Functional P.E. Techniques 10
11 Exam Flow Chart Clinical Indicators Postural hypotension (adrenals) Paradoxical pupilary reflex Lowenbergs b tissue mineral assessment test Oral ph Assess hydration (check veins) Zinc Assessment Posterior/Vertebral Indicators Patient Prone Palpate paraspinally, on the transverse process, form occiput to sacrum and note pain or congestion as a possible indicator of stress to the corresponding organ. Palpate sacroiliac joint and pelvis for pain and alignment, as a possible indication of adrenal stress Palpate next to the spinous process of T6 and T7, assess for pain on the right side as a possible indicator of pancreatic stress/blood sugar imbalance. Anterior/Thoracic/ Abdominal Indicators Patient Supine HCL (stomach) 1 inch below xyphoid and on the left edge of rib cage on the costal margin. Enzyme (pancreas) 1 inch below xyphoid and on the right edge of rib cage on the costal margin. Liver on the 3 rd rib, 2 inches lateral to the sternum at the costochondral junction. 11
12 Anterior/Thoracic/ Abdominal Indicators Patient Supine Murphy s sign liver/gallbladder, press up under the right rib cage. Bennett reflex (small intestine) superficially palpate 4 quadrants 3 inches around umbilicus. Colon - palpate entire length and ileotibial band. Anterior/Thoracic/ Abdominal Indicators Patient Supine Colon palpate the colon ascending, transverse, descending and sigmoid. Head of pancreas - palpate 2/3rds of the way on a 45 degree angle between umbilicus and margin of ribs. Adrenal indicators Unilateral inguinal ligament pain Short leg, Medial knee pain. Extremity Indicators Patient Supine Arm Repeated (aerobic) muscle challenge (EFA sufficiency indicator). Muscle locking 20 times is normal Hand points Right web thumb (gallbladder) Right thenar pad (pancreas) Left thenar pad (heart) 12
13 Extremity Indicators Patient Supine Legs Tissue Mineral Assessment Pre-tibial edema Achilles Return Reflex Chapman reflexes colon Chapman reflexes prostate uterus Chapman reflexes testicles ovaries 13
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