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CPA 3 Flashcards

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1
Q

cervical SD FPR

A
  • pt supine, phys at head supporting head and monitoring segment
  • flex head to neutral
  • apply compression towards feet
  • while maintaining compression, move towards ease of motion (SD), hold 3-5 seconds, return to neutral, realease
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2
Q

hypertonic suboccipital FPR

A
  • pt supine w/ head off table, phys head supporting head and monitoring segment
  • slightly flex headf to neutral
  • gentle compression towards feet
  • extend head and SB/R to same side as hypertonic Ms
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3
Q

OA MET

A
  • pt supine, phys at head of table
  • one hand under occiput, other hand under chin
  • put head into RB and instruct to return to neutral and resist 3-5 seconds, relax, new RB
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4
Q

thoracic inlet MFR

A
  • pt supine, phys at head of table
  • index fingers above SC joint
  • press towards pts feet and twitst hands to feel for restriction of motion
  • perform MFR until tissue creep
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5
Q

fulcrum ART

A
  • arms crossed under pts head w/ palms on shoulders
  • repetitively flex patients neck for stretch
  • repeat 2-3 minutes
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6
Q

Eff and Pet

A
  • pt supine, phys on side
  • raise pts arm/leg to treat
  • eff - stroking force distal to proximal
  • pet - kneading/twisting force distal to proximal
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7
Q

lower thoracic type 1 ART

A
  • pt seated, physician behind to the side, pt ipsilateral hand to PTP is behind neck (Rr = right hand)
  • physician posterior hand monitors PTP w/ thumb/index fingers and middle finger on inferior TP
  • physician anterior hand goes under ipsilateral arm and grasps contralateral bicep
  • engage sidebending RB then rotation RB (if RrSl -> sidebend right (towards bicep) and rotate left) while stabilizing inferior vertebrae w/ palm
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8
Q

lower thoracic FPR

A
  • pt seated, phys behind
  • one hand monitors, other hand across posterior neck
  • instruct pt to ext spine
  • add compression down to monitoring segment
  • put pt into SD, hold 3-5 seconds, return to netural, release compression
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9
Q

OA ART?

A
  • pt supine, phys at head of table
  • one hand under head, other hand under chin
  • move head to RB, hold 1-2 seconds, relax, repeat
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10
Q

Cervical SD Stills

A
  • pt supine, phys head
  • finger on SD segment on side of rotation
  • induce F/E of ease, and then SB/R of ease
  • compress and move into RBs
  • release compression and return to neutral
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11
Q

lower thoracic type 2 MET

A
  • same position as type 1 but phys arm passes over 2 arms

- engage RBs (included F/E for type 2)

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12
Q

BLT thoracic/lumbar

A

-pt prone, phys at side of SB SD
-cephalad thumb over ipsliateral
TP of T12 and digits 2/3 of cephalad over opposite TP
-caudad thumb over ipsilateral TP of L1 and digits 2/3 of caudad over opposite TP
-pt instructed to hold inhalation or exhalation depending on which one is more relaxing
-phys adds compression pushing T12/L1 together then adds force into the table
-next, phys adds SB and rotation force from hands towards the SD, at total balanced position phys holds until air hunger

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13
Q

lumbar type 2 MET

A

-same as lumbar type 1 MET, but pass over both arms and engage flexion OR extension RB then SB/R

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14
Q

lumbar SB SD seated ART

A
  • pt seated, phys beside pt facing opposite way (sit on opposite side SB RB is)
  • phys places arm across and onto opposite shoulder and other thenar eminence on ipsilateral TP of SD
  • induce SB by pressing down w/ axilla and pushing medially with thenar eminence, hold 1-2 seconds then relax, repeat rhythmically
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15
Q

Upper thoracic FPR

A
  • pt seated, phys behind
  • one hand monitors segment, other hand on top of head
  • pt instructed to ext head to neutralize upper thoracics
  • add compression down to monitoring segment
  • put pt into SD, hold 3-5 seconds, return to neut, release compression
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16
Q

fulcrum ST/MFR

A
  • arms crossed under pts head w/ palms on shoulders
  • repetitively flex neck for stretch
  • repeat 2-3 minutes
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17
Q

mandibular drainage (galbreath)

A
  • pt supine w/ head rotate towards phys, phys standing at opposite side to treat
  • stabilize head w/ cephalad hand, fingers of caudad hand posterior to mandibular ramus
  • slow, repetitive, motion towards chin
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18
Q

AA ART?

A
  • pt supine, phys at head of table
  • cradle pts head
  • fully flex spine to lock out c2-c7
  • rotate to RB, hold 1-2 seconds, relax, repeat
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19
Q

lower thoracic type 1 MET

A
  • pt seated, doc at side opposite PTP
  • pt grasps behind neck w/ ipsilateral hand of PTP and pt’s opposite hand grasps their elbow
  • phys monitors TPs and inferior TP with one hand and passes other hand under ipsilateral arm and on pt’s bicep of arm on PTP side
  • type 1 dysfunction = pass over one arm
  • move pt into RBs and ask them to return to netural, resist 3-5 seconds, relax, engage new RB
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20
Q

OA SD BLT

A
  • pt supine, phys at head w/ elbows on table
  • pincher grasp laminae on either side of C1
  • other hand on head to induce greatest position of BLT
  • have pt hold breath in best respiratory phase
  • repeat until best motion obtained
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21
Q

BLT upper thoracic

A
  • pt supine, phys at head
  • hand ipsilateral to PTP on segment, contralateral hand supporting head
  • move pt into flexion w/ R/SB into SD until reaching the point of balance ligamentous tension
  • have pt hold inhalation or exhalation as long as they can
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22
Q

C spine MET? (C2-C7)

A
  • pt supine, phys at head of table
  • cradle head within hands while contacting spine with fingers
  • place neck in RB, ask to return to neutral for 3-5 seconds, relax, new RB
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23
Q

upper thoracic Stills

A
  • pt seated, phys behind
  • one hand monitors TP, other hand moves head
  • f/e head into SD until motion felt at segment, then move into SB/R SDs until motion felt
  • add gentle compression and move towards RB
  • return to neutral, release
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24
Q

cervical chain drainage

???

A
  • pt supine, phys at head
  • place thumb on anterior margin of SCM, and digits on posterior margin of SCM
  • lift/milk anteriorly until relaxation
  • treat one side at a time b/c carotid sinuses
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25
pre/post auricular drainage
- pt seated, phys behind - index and middle finger in front of and behind ear - clockwise and counterclockwise motion applied
26
IT band eff
- pt lateral recumbent w/ affected side up and top foot in popliteal fossa, phys on side - cephalad hand on pt's greater troch - caudad hand makes "C" on IT band and strokes distal to proximal starting halfway to knee - after it loosens, start just superior to knee
27
pectoral traction
- pt supine, phys at head - grasp inferior pectoral Ms at anterior axilla - extend arms, lean back to apply cephalad traction - pull during inhale, resist during exhale
28
cervical SD BLT
- pt supine, phys at head - palms under pt head - establish point of BLT - test respiratory phases - repeat until best motion obtained
29
submandibular drainage
- pt supine, phys at head | - apply raking motion under the jaw towards chin
30
suprahyoid/infrahyoid release
- pt supine, phys at side - fingers lateral to hyoid - move fingers side to side, may flex or extend head to decrease friction if theres crepitus
31
lumbar type 2 E SD lateral recumbent MET - long lever technique
SUUE = Sims, ptp Up, force Up, Extension SD - cephalad hand monitors, caudad hand raises hips/knees into barrier and they are dangled off table - pt applies upward force, relax, engage new RB
32
lumbar, extended (type 2) FPR
- pt prone w/ pillow under abdomen, phys at side contralateral to PTP - one hand monitors TP, other maneuvers LE - compression from finger on contralateral monitored TP - abduct and internally rotate leg ipsilateral to PTP, then extend the leg - hold 3-5 seconds, return to neutral, release
33
lower thoracic type 2 ESD ART
- pt seated with arms folded across chest, phys sits beside pt - phys anterior arm placed across and onto opposite shoulder - lower 2 vertebrae being treated are stabilized w/ index finger and thumb - thorax is flexed (into RB), held for 1-2 seconds rhythmically
34
C spine ART (C2-C7)
- pt supine, phys at head of table - cradle pts head - place head in RB, hold 1-2 seconds, relax, repeat
35
ischiorectal fossa release ???
- pt prone, phys seated at side - thumbs medial to ischial tuberosities - apply cephalad and lateral force, increase force during exhalation and maintain force in inhalation
36
lower thoracic type 2 FSD ART
-same as lower thoracic ESD ART but thorax is extended
37
sacral rock
- pt prone, phys at side - heel of cephalad hand on sacral base w/ fingers towards coccyx, caudad hand on top facing opposite - exert gentle downward pressure alternating w/ respiration
38
thoracic pump
- pt supine, phys at head - place thenar eminence of each hand over pec Ms just inferior to clavicles on ribs 2-4 (offer women a pillow or place their hands under yours) - during exhalation, apply compressive force downward and resist during inhalation - repeat 4-5 breaths, and during final inhalation briskly remove hands to allow for rapid, deep inhalation
39
upper thoracic (t1-t4) type 2 SD ART
- pt seated, physician sits on dysfunctional side (if RSB SD, will sit on right and push into LSB) - one hand cups size of head, other hand thumb on SD - gentle SB of head towards physician and force on vertebrae the opposite direction (away from SD)
40
lumbar type 1 seated MET
- phys standing behind opposite of PTP - pt hand on PTP side placed behind neck, and other hand on that elbow - phys monitors w/ one hand and other hand passes under ipsilateral arm to grasp bicep on SD side - flex torso until motion felt at monitoring hand, then engage RBs - instruct to return to neutral, resist 3-5 seconds, then relax and engage new RBs
41
lumbar type 1 lateral recumbent MET - long restrictor technique
- pt PTP down, phys facing pt - caudad hand flexes knees/hips while cephalad hand monitors segment until it is neutral (not curved) - pt's top leg dangled off table until monitoring hand feels motion - switch monitoring hands - cephalad hand moves pt's top shoulder posteriorly until monitoring hand detects motion - pt pushes shoulder anteriorly 3-5 seconds, relax, engage new RB - pt pushes hip posteriorly towards neutral 3-5 seconds, relax, engage new RB
42
tapotement
- pt prone, phys at side - rhythmic forces to thoracic region applied - hack = karate chop - cupping - slapping
43
lower thoracic rotation SD ART
- pt seated, phys sits beside pt; opposite R SD - phys arm across and onto opposite shoulder - thenar eminence placed on TP of SD on contralateral side - shoulder is pulled anteriorly for rotational force into RB while applying anterior force w/ thenar eminence, hold for 1-2 seconds in rhythmic fashion
44
lumbar R SD ART
- pt seated, phys beside pt facing opposite way (sit on site where rotation RB is) - phys arm across and on opposite shoulder, other hand thenar eminence on opposite side TP of SD - induce rotation by pressing down w/ axilla while pressing anteriorly w/ thenar eminence, hold 1-2 seconds, relax, rhythmically
45
lumbar type 2 F SD lateral recumbent MET - long lever technique
FDDR = Flexed SD, ptp Down, force Down, Recumbent - monitor w/ caudad hand, grasp arm and pull anterior/superior engaging RB - switch monitoring hand to cephalad - straighten bottom leg engaging E RB, grab top leg and engage SB barrier by lifting ankle - pt pushes down 3-5 seconds, relax, engage new RB
46
seated rib raising
- pt seated, phys facing pt - pt crosses arms and leans towards phys, phys grasps bilateral posterior/inferior ribs lateral to TPs - starting w/ T12, apply anterolateral traction while pulling cephalad toward you, continue up ribs - apply pressure w/ inhale, release w/ exhale
47
BLT lower thoracic
- pt seated, phys behind - thumb ipsilateral to PTP contacts TP of inferior vertebrae in the unit - thumb contralateral contacts TP of superior vertebrae in the unit (still bordering vertebrae though) - pt instructed to lean back, then sit straighter or slouch - pt instructed to lean and rotate towards SD in small increments until balance ligamentous tension - have pt hold inhalation or exhalation as long as they can
48
cervical stroking
- pt supine, phys at head - place hands along paravertebral Ms - stroke region caudad to cephalad
49
AA SD Stills
- pt supine, phys at head - finger on TP of C1 on the side of rotation - rotate into SD - compress, and move through RB - release compression and return to neutral
50
supine rib raising
- pt supine, phys sitting on treatment side - contact rib angles by flexing fingers - start w/ T12, apply anterolateral traction by rocking backward, continue up ribs - pressure w/ inhale, release w/ exhale
51
lower thoracic Stills
- pt seated, phys behind - one hand monitors TP, other across posterior neck - f/e into SD until motion felt, the move into SB/R SDs until motion felt - add gentle compression towards segment and move into RBs - return to neutral, release
52
OA SD Stills
- pt supine, phys at head - place finger on SB component in occiput using palm to support head, and other hand on top of head - put head into SD - compress top of head and take head to RB - release compression and return to neutral
53
lumbar SB SD lateral recumbent
- phys at side of table pt is facing, pt lays on the side where SB SD is (RB to side facing up) - flex pt's knees/hips to approx 90 degrees - monitor SD w/ cephalad hand, with caudad hand grab ankles and lift towards the ceiling until left hand feels SB, hold 1-2 seconds, relax, rhythmic
54
lumbar type 2 F SD seated ART
- phys seated beside pt facing other way - one hand across and onto opposite shoulder, other hand on lumbar spine - induce extension w/ anterior force on lumbar hand and posterior force w/ shoulder hand, hold 1-2 seconds, relax, rhythmic
55
upper thoracic type 1 MET
- Pt seated, phys behind on opposite side of PTP - Phys monitors TPs of apex of SD group with curve of thumb and index finger while middle finger monitors SP of the segment below, other hand is on patients head - induce SB into RB by draping their arm over phys thigh (on table) and moving the head - induce rotation to RB by rotating head towards phys - instruct Pt to return to neutral and resist for 3-5 seconds, relax, engage next RB
56
lumbar type 2 lateral recumbent MET - long restrictor technique
- pt PTP down, phys facing pt - caudad hand flexes pts knees/hips while cephalad hand monitors segment until its neutral - pt's top foot placed behind bottom knee into popliteal fossa - switch monitoring hands - cephalad hand moves pt's top shoulder posteriorly until monitoring hand detects motion - pt pushes shoulder against resistance, relax, new RB engaged - pt pushes hip posteriorly against resistance, relax, new RB engaged
57
anterior tracheal/deep cervical ST
- pt supine, phys at side; or pt seated facing phys - place fingers lateral to trachea - move trachea from side to side working cephalad to caudad
58
abdominal pump
- pt supine, phys at pt's side - palms on abdomen w/ fingers towards head, thumbs side by side - pump posteriorly in a rhythmic manner, 20-30x/min
59
lumbar, flexed (type 2) FPR
- pt prone w/ pillow under abdomen, phys at side of table ipsilateral to PTP - one hand monitors TP, other hand maneuvers LE - flex ipsilateral leg off the table - apply compression to femur - adduct and internally rotate leg - hold 3-5 seconds, return to neutral, release
60
lumbar type 1 lateral recumbent MET - long lever technique
NUDR = Neutral, ptp Up, force Down, Recumbent - raise hips/knees until motion felt - flex ankles into RB and pt pushes down into floor for 3-5 seconds, relax, engage new RB
61
AA MET?
- pt supine, phys at head of table - one hand behind head, other hand on jaw (for R) - fully flex spine to lock out 2-7 - rotate head to RB, ask to return to neutral for 3-5 seconds, relax, new RB
62
lower thoracic (t5-t12) SB ART
- pt prone - physician caudad hand on opposite side of spine w/ fingers pointing cephalad over SD, and cephalad hand on the near side facing caudad over SD - anterior force is applied, then push hands in directions they're pointing for less then a second then slowly release, repeat until motion restored
63
doming the diaphragm ???
- pt supine, phys at pt's side - place hands in infracostal region below xiphoid process w/ fingertips/thumbs pointing cephalad - have pt take a deep breath, press posterior/superior, and push further on exhalation, 3-4x - on last time, move thumbs cephalad slightly under ribcage during exhalation
64
lumbar type 2 E SD seated ART
-same as F SD seated MET, but induce flexion by pulling anteirorly w/ shoulder hand and just monitor w/ lumbar hand
65
upper thoracic type 2 MET
- Pt seated, phys at side - phys monitors TPs of SD group using pads of thumb/index finger and middle finger on TP inferior while other hand is on pt's head - induce F/E down to SD segment (shouldn't feel movement at middle finger) (if ESD, move to F) - once F/E is localized, induce SB then rotation to RB - instruct pt to return to neutral for 3-5 seconds, relax, then engage new RB
66
fulcrum MET
- arms crossed under pts head w/ palms on shoulders - flex pts neck to RB - instruct pt to extend against phys, resist 3-5 seconds, relax, new RB
67
lower thoracic sidebending SD ART
- pt seated, phys sits beside pt; sits opposite SB SD - phys arm across and onto opposite shoulder - thenar eminence placed on TP of SD on ipsilateral side - phys induces SB by pressing down w/ axilla on ipsilateral shoulder while applying medial pressure to SD vertebrae, hold 1-2 seconds rhythmically

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