Tissue texture changes

A second mnemonic has been proposed for the diagnostic criteria, S-T-A-R, by Dennis Dow-ling, DO. In this mnemonic, the S represents sensitivily. Tenderness is a response by the patient to palpation by the physiciam This occurs in tissue that should normally not be tender to palpatioa However, the sensitivity change may be experienced by the patient as numbness, paresthesia, or anesthesia, or other subjective sensatioa The T still represents tissue texture changes, the A, asymmetry, the R, restriction of motion, as in TART. This may be used if the student or physician finds it more helpfiil. 

Tissue texture changes are a significant diagnostic tool. They occur in response to a variety of factors, including the following ... 

In counterstrain, the diagnosis is made by finding reflex "tender points." Each involved ligament, joint, or muscle has its own specific tender points, anterior or posterior, depending on the joint somatic dysfunction. The point may he in the shortened muscle or in a more distant area to which it has been referred reflexively. It is a palpable tissue texture change and comprises a tense, fibrotic area approximalely the size of a dime. It is tender to an amount of pressure that would not normally cause pain. The tender points may very well be related to trigger points (Travell points) and acupuncture points there are marked similarities in distribution. 

Chapman s reflexes are also located along the extremities. This is because of the fact that the upper and lower extremities are innervated by T2-8 and T1 1-L2, respectively. The arm and leg share sympathetic fibers with the viscera. For example, the colon and thigh are innervated by the sympathetic cell bodies ofTl 1-L2. If the patient has colitis, the resulting Chapman s reflex will manifest as quarter-sized or half-dollar-sized "shotty plaque(s)" along the outer thigh. Likewise, disorders ofthe eye may exhibit tissue texture changes along the anterior superior aspect of the humerus. 

The physician cups the patient s head in the palm of his hand and slides his fingers along the occipital sulcus laterally until he palpates the tips of the mastoid processes. Tissue texture changes are noted. Then he moves his fingers just inferior and lateral to them and onto the... 

The physician then palpates deeper into the muscle tissue. The paraspinal muscles lie parallel to the spinal column. They are larger in the lumbar region than in other regions of the spine. The quadratus lumborum attaches to the twelfth rib, the spinal column, and the crest of the ilium. These muscles are frequently the source of low back pain and should be evaluated for hypertonicity, spasm, bogginess, and other tissue texture changes. 

The foot and ankle may be palpated with the patient seated or supine. Soft tissues are palpated for tenderness and swelling. Tissue texture changes should be noted. Bony landmarks are palpated for any asymmetry or arthritic changes. 

Irradiation has a serious effect on softening and texture changes of many fruits. The level required for disease control in grapes is too high to avoid extreme softening of the tissues. Therefore, irradiation does not appear possible for grapes. 

Now let us consider recent results from this laboratory concerning the effects of metal ions on the rates of texture changes in acidified cucumber tissue texture. To investigate the effect of NaCl on cucumber texture in the absence of enzymatic degradation, the firmness changes in blanched tissue under acid conditions, pH 3.2-3.8, were measured (43). The procedure was to blanch cucumber slices or mesocarp tissue pieces in boiling water for 3 min to inactivate pectinesterase (19). After cooling, the tissue samples were covered with a brine which contained acetic acid and S02, to equilibrate at 0.6% and 200 ppm, respectively, and the appropriate amount of NaCl. The tissue equilibrated with the brine in the cold and then samples were incubated at 44C so they would soften reasonably rapidly. Firmness of the tissue was evaluated at the... 

These studies demonstrate the diverse nature of the role of pectins in the texture changes of ripening tomato fruit. The inverse relationship between EDG activity and the extent of softening in gel and pericarp emphasize that EDG does not play a major role in the early, dramatic period of gel formation. The marked losses in pectin neutral sugars, including xylose, occurred simultaneously with initial gel formation although the mechanism and function of these losses in this tissue remain unknown. 

Like hydrogen ions, salt has a number of other important functions in cured meat which are outside the scope of this article. Callow (1947) has summarized earlier studies on swelling and texture changes of muscle tissue in salt. Ingram (1949a) and Hankins et al. (1950) discuss the salty flavor in bacon. Bulman and Ayres (1952) have contributed to the already extensive literature on the preservative effect of sodium chloride and other curing salts. 

Bazhal, M. I., Ngadi, M. O., Raghavan, G. S. V., Nguyen, D. H., 2003. Textural changes in apple tissue during pulsed electric field treatment. J. Food Sci. 68 249-253. 

The soft tissues of the thoracic area should be palpated for texture changes skin, fascia, subcutaneous tissues, and muscle. Large muscle hypertonicity or small localized areas of muscle tension should be noted. Areas of tenderness or specific Jones tender points or trigger points should be noted. 

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