Cervical Spine HVLA Flashcards Preview

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Flashcards in Cervical Spine HVLA Deck (11)
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1

Steps of HVLA

  1. Diagnosis - Correctly diagnose SD
  2. Position - Pt and physician relaxed and comfortable
  3. Isolation - Forces localized at facet joints b/w 2 vertebrae
  4. Forces - Accumulate, engage restrictive barrier
  5. Release - use pt's breathing to perform release enhancing maneuver
  6. Thrust - Barrier engaged => Short, rapid thrust w/ sudden acceleration and deceleration
  7. Reassess - Confirm treatment resolved

2

Restrictive barrier

Functional limit w/in anatomic ROM that abnormally diminishes normal physiologic range

3

In cervical HVLA, what motion should you absolutely do not do?

Hyperextend the neck

4

Contralateral Traction

Cervical ST or MFR

5

Cradling with Traction

Cervical ST or MFR

6

Suboccipital Release

Cervical ST or MFR

7

Bilateral Forearm Fulcrum Forward Bending

Cervical ST or MFR

8

OA SD Cervical HVLA

9

AA SD Cervical HVLA

10

C2-7 Rotational Emphasis Cervical HVLA

Doc uses index finger pads to form a “little bridge” contacting the articular pillars on either side spinous process of the affected vertebra (C4).

  • Flex the patient’s head until motion is identified at the level of dysfunction (not below).
  • Sidebend towards the freedom TO the interspace at level of dysfunction. (ex. Sidebend right to C4-5)
  • Rotate towards the RB to the restrictive barrier
  • Apply a thrust in the rotational plane of C4 with the contact on the posterior transverse process.

ALTERNATE HAND POSITION

  • Doc uses 2nd MCP to contact the lateral aspect of the articular pillar on the side of sidebending RB. The other hand and forearm cradles the patient’s head and chin
  • Be conscious of finger positioning on chin to neither pull on the jaw or compromise the patient’s airway.
  • Flex the patient’s head until motion is identified at the level of dysfunction, then allow the head to move into slight extension
  • This isolates motion from above and below the segment.
  • Sidebend towards the freedom (R in this case) TO the interspace of the dysfunction. (C3/4).
  • This locks out the vertebrae above the dysfunction
  • Rotate towards the RB (L in this case) THROUGH the interspace of dysfunction (C3/4)
  • Apply a thrust in the rotational plane of the dysfunctional vertebra (C3) with the hand contacting the posterior transverse process.

Rays of the sun approach to direction of thrust:

  • Upper cervicals thrust is towards the eye
  • Middle cervicals thrust is straight across the neck
  • Lower cervicals the thrust is directed down toward the chest

Example:
o DX: C4 E RrSr
o TX Localization: C4 F RL

11

C2-C7 Sidebending Emphasis Cervical HVLA