Competency 9 Flashcards Preview

OS3 competencies 8 and 9 > Competency 9 > Flashcards

Flashcards in Competency 9 Deck (12):
1

1a: Posterior cervical points

-PC 1 inion: 1-2 cm inferior to external occipital protuberance, slightly lateral, on insertion of semispinalis capitis
-PC1: 3 cm below inion, 1 cm medial to OM suture; press anterior and medial
-PC2: in main muscle mass about 2-3 cm lateral to midline and just below occiput
-PC3: Inferolateral aspect of C2 spinous process
-PC4-8: Inferolateral aspect of SP, named for spinal nerve that exits below (PC5 are on C4 SP)

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1a: Posterior cervical treatments

-PC1 inion: Cradle head in monitoring hand; non monitoring hand on forehead and flex neck with finetuning
-PC1: ESARA
-PC2: ESARA
-PC3: FSARA--flex 45 degrees (may need to STRA instead)
-PC4-7: ESARA
-PC8: FSARA or ESARA depending on patient

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b) Posterior thoracic points

-PT1-12: spinous process of respective vertebrae

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b) Posterior thoracic treatment

Patient prone; stand at head of table
-PT1-3: patients arms draped over side of table; cup chin with one hand and monitor TP with the other; slowly and passively extend neck finetuning with R and SB away
-PT4-6: Patients arms draped over the top of the table (adds extension); cup chin with one hand and monitor TP with the other; slowly and passively extend neck finetuning with R and SB away
-PT7-9: Patients arms draped over the top of table with pillow under chest (adds extension); cup chin with one hand and monitor TP with the other; slowly and passively extend neck, fine tuning with R and SB away from TP
-PT10-12: Patients arms draped over top of table with pillow under chest (adds extension); stand at side of table and grasp ASIS opposite the dysfunction and raise patients hip inducing further extension of lower T spine

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C) Posterior rib points

-PR1: Posterior margin of rib head beneath the margin of trapezius
-PR2-6: Superior surface of angle of ribs, at medial border of scapula, 2.5 inches lateral to midline

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c) Posterior rib treatment

Patient seated, doc standing behind; place patients arm on dysfunctional side on docs knee
-PR1: slightly extend head, sidebend and rotate head towards dysfunctional side
-PR2: Flex head, SB and R trunk away then R and SB neck away
-PR3-6: Grasp patients shoulder on dysfunctional side and SB and R trunk away at level of dysfunction

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d) Posterior lumbar points

-PL1-5 SP: midline, spinous processes
-PL1-3 TP: bilateral on respective TPs
-UPL5: superior, medial edge of PSIS
-LPL5: inferior aspect of PSIS
-PL3 lateral: 2/3 lateral from PSIS to TFL
-PL4 lateral: posterior margin of TFL

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d) Posterior lumbar treatments

Patient prone
-PL1-5 SP: stand on same side of TP; extend patients ipsilateral hip to TP, fine tuning as necessary
-PL1-3 TP and UPL5: stand opposite side of TP; extend patients ipsilateral hip to TP and rotate leg towards TP, finetuning as necessary
-LPL5: thigh on dysfunctional side suspended over table. Doc at same side of dysfunction. Flex hip and knee to 90. Add adduction and internal rotation
-PL3 lateral & PL4 lateral: stand on whichever side you want, Extend hip on same side of dysfunction and fine tune as necessary

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e) Pelvis counterstrain points

-High ilium: press on lateral aspect of PSIS
-High ilium Flair out: 1 and 3/4 inches below and 1/4 inch medial to lower edge of PSIS
-Piriformis: 1/2 to 2/3 distance between ILA to greater trochanter
-Flair in Sacroiliac: 4 in below PSIS, slightly lateral, related to attachment of gluteus maximus

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e) Pelvis counterstrain treatments

Patient prone
-High ilium: stand on same side of dysfunction, while monitoring TPm extend hip and fine tune with ab/adduction
-High ilium flair out: stand on whichever side is comfortable; extend patients leg ipsilateral to TP enough to clear opposite leg and induce adduction and external rotation
-Piriformis: SIT on same side of dysfunction and while monitoring TP, flex patients leg over side of table to 135 deg, abducting and externally rotating the hip
-Flair in Sacroiliac: Patient prone, stand on same side of dysfunction and flex hip only enough to allow knee to clear table. Fine tune with external rotation

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f) Posterior sacral points

-PS1 bilateral: 1/2 inch medial to inferior aspect of PSIS
-PS2-4: midline on sacrum below/between sacral spines
-PS5: bilateral- 1/4 inch medial and superior to ILA bilaterally

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f) Posterior sacral treatments

Patient prone, standing beside patient
-PS1 bilateral: apply posterior to anterior force diagonally opposite the TP (if left PS1 tender, apply force to right ILA)
-PS2-4: apply force posterior to anterior on midline apex or base of sacrum to provide transverse axis rotation
-PS5 bilateral: Apply posterior to anterior pressure diagonally opposite the TP (if PS5 on left is tender, apply pressure on right sacral sulcus)