Lab #1 Flashcards
Look
look for symmetry in the body, such as in the ear height, shoulder height, iliac crest, achilles arches, clavicles, nipple height, etc.
thoracic kyphosis
hunchback
Feel
performing a thermal scan, check for tissue texture changes, areas of tenderness, palpate bony landmarks
red reflex test
spread two fingers around spine and rub the skin with a firm stroke
blanching is whiteness, indicates chronicity of somatic dysfunction
erythema is redness, indicates acute somatic dysfunction
skin turgor test
pinch skin up and release
tented skin means poor turgor, could be due to dehydration, aging, certain metabolic diseases
gross thoracic motion testing interpretation
normal range of movements are flexion (bending forward) 80 degress, extension (bending backward) 30 degrees, lateral bend 35 degrees, and rotation 45 degrees (need to have patient seated for rotation testing)
10-step screening examination according to Greenman (only steps 1, 2, 3 and 9)
- postural analysis: static evaluation and palpate landmarks
- gait analysis and lower extremity screening: ask the patient to duck-walk
- standing trunk side-bending
- head and neck mobility - multiple planes
observation of the plumb line sagittal plane
string should hang slightly posterior to the coronal structure, through the external auditory meatus, through cervical vertebral bodies, through the shoulder joint, through the lumbar vertebra bodies, slightly posterior to the axis of the hip joint, slightly anterior to the axis of the knee joint, and slightly anterior to the lateral malleolus
observation of the plumb line coronal plane
should pass through the inion (ie, the projecting part of the occipital bone at the base of the skull), the midline of the vertebrae, midline of the sacrum and coccyx, a point midway between both medial malleoli (bump on inner side of ankle joint)
scoliosis identification
lateral curvature of the spine, can be observed in coronal plane
Cobb angles observation
for patients with scoliosis, you identify the upper end and lower end vertebrae (top and bottom ones of curved section), you draw lines extending their borders, and measure the Cobb Angle these lines make
Cobb angle interpretation
5-15 degrees: mild scoliosis
20-45 degrees: moderate scoliosis
> 50 degrees: severe scoliosis
vertebral prominence ID
at C7 spinous process
spine that sticks out at base of neck
spine of the scapula ID
at the T3 spinous process level
top of the scapula that sticks out
inferior angle of the scapula ID
at the level of the T7 spinous process
the tip of the scapula that sticks out on the bottom
level of the 12th rib ID
at the level of the T12 spinous process
bottommost rib that sticks out of back
horizontal line connecting top of the iliac crests ID
between spinous processes of L4 and L5
feel for the tips of the pelvic bones and imaginary line that connects them
structural vs functional sciolosis
structural is more common, involves spinal rotation and side to side curvature of spine. Affects spine structure and considered permanent without treatment.
functional is from temporary cause, involves only side to side curvature, no spinal rotation. Spine structure is still normal.
how do you do the thoracolumbar range of motion (ROM) testing (passive) - all three planes, seated only
- have the patient seated on table
- T1-T12 testing: put your hand on their right and left acromium (shoulders), bend them laterally to the right and left sides, approximate the number of degrees on each side
- T1-T8 testing: put hands between acromiums and nape of neck, repeat
- T1-T4 testing: put hands on sides of nape of neck, repeat
- ask the patient to straddle the table, put hands on the acromium, and gently rotate them side to side, see how many degrees
- flexion/extension testing
