Methods 4 Comp Eval #2 Flashcards

1
Q

Side Posture Hypothenar Sacral Base Push, Dysfunctional Side Up

A

-Used w/ Extended Ilium (Flexion Restriction) and/or counternutated (Nutation Restriction)
-PSIS (Higher)/Sacral Base (Superior/Posterior)
-Doctors Position: Modified Fencer Stance (Side of Dys.)
-Contact Hand: Caudal hand, hypothenar on the higher sacral base (P-A, slight I-S)
-Indifferent Hand: Cephalic hand upward traction up

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2
Q

Side Posture Hypothenar Sacral Base Push, Dysfunctional Side Down

A

-Used w/: Extended Ilium (FR) and/or Counternutated (NR)
-PSIS (ASL)/Sacral Base (Posterior/Superior)
-CH: Caudal Hand on the sacral base (lower side-P-A)

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3
Q

Side Posture Hypothenar Sacral Apex Push, Dysfunctional Side Down

A

-Used w/ Flexed Ilum (Extension Restriction) and/or nutated (counternutation restriction)
-CH: Causal hand, hypothenar on the up side of the sacral apex (P-A)

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4
Q

Side Posture Forearm Sacral Apex Push, Dysfunctional Side Down

A

-Used when patient present with flexed ilium (ER) and/or nutation (CN restriction)
-Contact hand: Hypothenar on the up-side of the sacral apex (P-A)

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5
Q

Prone UL Hypothenar Transverse Push (Rotation)

A

-DP: Square or modified fencer stance (facing cephlad)
-CH: Caudal hand on the transverse process (P-A)
-IH: Reinforcing anatomical snuffbox

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6
Q

Prone UL HypothenarTransverse Push (Lateral Flexion)

A

-DP: Fencer or Square Stance (facing caudal)
-CH: Hypothenar of cephalic hand on the TP (P-A/S-I)
-IH: Pisiform in the anatomical snuffbox

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7
Q

Prone BL Thenar Transverse Push (Extension Restriction)

A

-DP: Modified Fencer Stance facing parallel to the spine
-CH: Thenar contact over the superior TP (P-A/I-S)

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8
Q

Prone Unilateral Hypothenar Spinous Push (Thoracic)

A

-DP: Square or fencer stance at the cephlad side of table
-CH: Hypothenar of cephlad hand on lateral surface of superior spinous process on side of rotation/torque hand
-Left: counterclockwise/Right: Clockwise
-Vector: P-A/L-M w/ Torque

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9
Q

Prone Knife Edge Spinous Push (Extension)

A

-PP: Headrest in flexion
-DP: Fencer stance, facing cephlad
-CH: Mid knife-edge contact on the inferior edge of the superior spinous process (I-S with enough P-A on SP)
-IH: Calcaneal reinforcement

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10
Q

Prone Knife Edge/Spinous Push (Flexion)

A

PP: Prone/Head piece lowered
DP: Fencer stance/Facing Caudal on superior edge of superior spinous process (P-A/S-I)
IH: Calcaneal reinforcement

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11
Q

Supine Opposite-Side Thenar/Transverse Drop (Rotation)

A

-DP: Modified fencer, opposite side of contact, tissue slack from below
-CH: Unilateral thenar contact (A-P to induce rotation)

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12
Q

Supine Opposite-Side Thenar/Transverse Drop (Flexion)

A

-PP: Arms crossed w/ No Flexion
-DP: Modified fencer/opposite side of contact
-CH: BL thenar contact on inferior segment (A-P)

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13
Q

Supine Opposite-Side Thenar/Transverse Drop (Extension)

A

-DP: Modified fencer/opposite side of contact
-CH: BL thenar or spinous contact on sup. segment (A-P/I-S)

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14
Q

Prone UL Hypothenar/Transverse Push (Lateral Flexion)

A

DP: Fencer or square stance facing caudal
CH: Cephalic hand on the TP (P-A/S-I)

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15
Q

Supine Index/Pillar Push (Rotation)

A

DP: Towards head of table on side of contact, angled 45-90* to the patient
-CH: Proximal MCP index of hand on the side of segmental contact on posterolateral pillar
LOD: P-A w/ rotation

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16
Q

Supine Index/Pillar Push (Lateral Flexion)

A

DP: Lateral flex on side of contact/Tissue slack S-I
CH: Proximal MCP Index on posterolateral pillar (L-M/S-I)

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17
Q

Supine Thumb/Pillar Push (Rotation)

A

-DP: Approximately 90 degrees to patient
-Vec: P-A, slight I-S with rotation

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18
Q

Supine Thumb/Pillar Pull (Rotation)

A

DP: Opposite side of contact/45* to patient
CH: Anterolateral articular pillar of superior vertebrae
(A-P and slight I-S inducing rotation)

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19
Q

Seated Index/Occiput Lift (Lateral Flexion)

A

-PP: Head turned away from the side of contact
-DP: Standing b/h patient/patient’s head against sternum
-CH: Palmar surface of the middle finger corresponding to the side of the head of rotation/Contact on inferior border of occiput & lateral border of mastoid process
-Vector: I-S/L-M

20
Q

Seated Index Occiput Push (Rotation)

A

-DP: Stand behind patient, towards side of contact
-CH: Ventral lateral surface of the index, palm turned up, forearm approximately 45* to the patient, remaining fingers supping lower occiput, superior mastoid groove on the side of contact
-Vector: P-A w/ Rotation

21
Q

Seated Calcaneal/Zygomatic Pull (Extension)

A

PP: Roll towel behind the cervical spine
CH: Calcaneal contact of both hands on the superior aspect of the zygoma bilaterally
Vec: S-I, with enough A-P to stay on contact

22
Q

Seated Index/Occiput Push (Lateral Flexion)

A

-CH: Ventral lateral surface of index; palm turned up and wrist straight, forearm approximately 45* to the patient, remaining fingers cupping lower occiput, superior mastoid groove
-Vec: P-A, L-M, S-I

23
Q

Supine Hypothenar/Occiput Lift

A

PP: Doctor supports the patients head off the end of table
DP: Facing cephlad, lower fencer stance, weight shifted toward the superior leg, apply pre-adjustive long axis distraction by leaning bodyweight headward
CH: Hypothenar of caudal hand, contacting inferior edge of the occiput, medial to the mastoid
IH: Fingers wrap around the patient’s chin while forearm supports the patients head
Vector: I-S

24
Q

Supine Thumb/Occiput Push (Rotation)

A

PP: Doctor supporting the patients head off the end of the table
DP: Toward head of table, anlged 45-90* to the patient
CH: Thumb of the hand corresponding to the side of segmental contact, posterior aspect of the mastoid, fingers resting on the angle of the jaw, forearm down the sternum
Vec: P-A/I-S w/ corkscrew-like motion

25
Hibbs Test
-Hand on medial PSIS/internally rotate the hip -Pain at the SI Joint (+) -No pain = Hip Pathology
26
Yeoman’s Test
-Thenar contact of the ipsilateral PSIS/Grab anterior aspect of the knee and lift the thigh -Pain at the SI joint = SI Dysfunction -Dull ache = tight hip flexors
27
Erichsen Sign
-Contact on BL ilium/thrust toward the midline -Pain = Sacroiliac -No pain = Ilifemoral
28
Belt Test
-Hips support at the midline/brace the ASIS -Pain produced = Lower back -No Pain = Pelvis
29
Nachlas Test
-Lift heel to ipsilateral buttock -Radicular Pain = L2-L4 compression or irritation by intradural lesion -Pain in buttock = SI Lesion -Pain at lumbosacral joint = lumbosacral lesion
30
Bechterew’s Test
-Radicular pain or if patient must lean back = compression of the sciatic nerve or lumbar nerve roots often due to lumbar disc protrusion
31
Seated Digit/Pillar Pull
• PP: Seated in chair • DP: Stand facing patient, oppositeside of contact, reaching across to contact superior segment of posterior articular pillar • CH: Middle digit on the posterior AP, with palm resting on patient’s cheek, remaining fingers supporting head. • IH: Stabilize head/occ, supporting temporal region, on opposite side contact • Vec: P-A slight I-S w/clockwise or counterclockwise rotation
32
Seated Digit/Spinous Push (Rotation)
• PP: Seated in chair • DP: Stand behind patient, side of contact, TISSUE SLACK AP to SP, laterally flex over contact • CH: 2nd digit on lateral spinous process of contact, palm up, THUMB resting on patient’s cheek • IH: Indifferent hand #1, elbow up and forearm pointing down, fingers pointing down, stabilize opposite occiput andcheek • Vec: P-A and L-M (in line with the patient’s eyes)
33
Seated Index/Spinous Push (Rotation)
-P-A and L-M
34
Prone Thumb/Spinous Push (Rotation/IL Lateral Flexion)
• PP: Prone, headpiece below horizontal to produce slight flexion in the thoracocervical spine • DP: Standing in low fencer stance on side of contact, facing cephalad, forward leg level at patient’s head, body weight centered over midline of the patient • CH: Distal palmer surface of caudal thumb partially abducted and locked, fingers resting on trapezius, contacting lateral surface of spinous process • IH: #3 thumb behind the occiput with fingers alongside the face opposite side of contact, inducing slight lateral flexion toward contact, with distraction **Opposite side contact • Vector: L-M, slight P-A
35
Prone Hypothenar/Transverse Push (Resisted)
• PP: Prone, headpiece below horizontal to produce slight flexion in the thoracocervical spine • DP: Standing in fencer stance on side of contact, facing cephalad, forward leg level at patient’s head, body weight centered over midline of the patient • CH: Hypothenar (pisiform) of caudal hand, contacting transverse process • IH: #3 thumb behind the occiput with fingers alongside the face on side of contact, inducing slight lateral flexion away from contact, with distraction • Vector: P-A *C7-T4
36
Prone Unilateral Hypothenar/Transverse Push
• PP: Prone, headpiece below horizontal to produce slight flexion in the thoracocervical spine, patient is instructed to turn head AWAY from contact • DP: Standing in fencer stance on side of contact, facing cephalad, forward leg level at patient’s head, body weight centered over midline of the patient • CH: Hypothenar (pisiform) of caudal hand, contacting transverse process • IH: Reinforce over hypothenar contact • Vector: P-A
37
Prone Bilateral Thenar/Transverse Push (Flexion)
-headpiece in NEUTRAL to induce extension in the thoracocervical spine • DP: Standing at the head end of the table facing caudal, transferring additional body weight into contact • CH: Bilateral thenar contacts running parallel to the spine , contacting bilateral transverse process of superior vertebrae • IH: Same as above • Vector: P-A and S-I
38
Supine Index Atlas Push (Rotation)
• PP: Supine, permission to contact the neck, identify how you found the segment • DP: Towards head of table, on side of contact, angled 45°-90° to the patient, tissue slack M-L • CH: Proximal ventral surface of index of the hand corresponding to the side of segmental contact, on posterior aspect of ATLAS TP, thumb rests on cheek • IH: #1-cradles patients head, supports contralateral occiput and upper cervical spine • VEC: P-A with counterclockwise rotation (or clockwise depending on the listing)
39
Supine Index Atlas Push (LF)
• PP: Supine, permission to contact the neck, identify how you found the segment • DP: Towards head of table, on side of contact, angled 45°-90° to the patient, laterally flexing head over contact, minimizing rotation, tissue slack S-I • CH: Proximal ventral surface of index of the hand corresponding to the side of segmental contact, on lateral aspect of ATLAS TP, thumb rests on cheek • IH: #1-cradles patients head, supports contralateral occiput and upper cervical spine • VEC: L-M • **“TRANSLATION” of C1 due to 5° of lateral flexion
40
Seated Index Atlas Push (Rotation)
• PP: Seated in a chair with a back, permission to contact the neck, identify how you found the segment • DP: Stand behind patient, side of contact, doctor has leg OPPOSITE of contact hand forward, tissue slack M-L • CH: Proximal ventral surface of index of the hand corresponding to the side of segmental contact, on posterior aspect of ATLAS TP, palm up, wrist straight, remaining fingers cup lower occiput • IH: Indifferent hand #1, elbow up and forearm pointing down, fingers pointing down, stabilize opposite occiput and cheek • Vec: P-A w/clockwise rotation (or counterclockwise depending on the listing)
41
Seated Index Atlas Push (LF)
• PP: Seated in a chair with a back, permission to contact the neck, identify how you found the segment • DP: Stand behind patient, side of contact, doctor has leg OPPOSITE of contact hand forward, tissue slack S-I • CH: Proximal ventral surface of index of the hand corresponding to the side of segmental contact, on posterior aspect of ATLAS TP, palm up, wrist straight, remaining fingers cup lower occiput • IH: Indifferent hand #1, elbow up and forearm pointing down, fingers pointing down, stabilize opposite occiput and cheek • Vec: L-M
42
Seated Digital Atlas Pull (Rotation)
• PP: Seated in a chair with a back, permission to contact the neck, identify how you found the segment • DP: Stand facing patient, opposite side of contact, reaching across to contact atlas transverse, tissue slack M-L • CH: Middle digit on the ATLAS TP, palm resting on patient’s cheek, remaining fingers supporting head. • IH: Stabilize head/occ, supporting temporal region, on opposite side contact • Vec: P-A w/clockwise rotation (or counterclockwise depending on the listing)
43
Supine Thumb Pillar Index Spinous Counterthrust
44
Prone Index Pillar Push (Rotation/LF)
• PP: Prone, asks permission to open gown/contact patient, verbalize finding the segment • DP: fencer stance, facing cephalad EITHER side of contact, tissue slack M-L • CH: Index on posterolateral aspect of superior articular pillar, fingers pointing down and thumb on posterior neck • IH: #3, thumb under occiput, fingers along face/head opposite side of contact (distract and rotate head to side of contact) • Vec: P-A and I-S
45
Seated Digital (Index) Pillar Push (Lateral Flexion)
• PP: Seated in a chair with back, asks permission to open gown/contact patient, verbalize finding the segment • DP: Stands behind patient, same side as contact, doctor has leg OPPOSITE of contact hand forward, tissue slack S-I • CH: 2nd digit on articular pillar of superior segment of contact, palm up, THUMB resting on patient’s cheek • IH: Indifferent hand #1, Elbow up and forearm pointing down, fingers pointing down, stabilize opposite occiput & cheek • VEC: L-M for lateral flexion malposition (close the wedge)
46
Seated Hypothenar Pillar Push (Rotation)
• PP: Seated in a chair with back, asks permission to open gown/contact patient, verbalize finding the segment • DP: Doctor stands in front of patient, same side as contact, fencer stance, tissue slack M-L • CH: anterolateral aspect of AP, pisiform hypothenar, with finger of hand obliquely vertical to provide support to head • IH: Reaches around cups occiput • LOD: A-P and slight I-S
47
Seated Index Spinous Push
P-A/L-M