Motion And Palpation Flashcards
(43 cards)
Standing structural exam
Observes the overall configuration of the body and determines location of most significant anatomic asymmetries/areas of concern (Screening exam)
What landmarks do you assess posteriorly on a standing structural exam?
.Mastoid process, occipital, vertebral prominent, acromion processes, scapulae, spine of scapulae, inferior angle of scapula, iliac crests, PSIS, greater trochanter, lat. and med. malleoli
What position is normally used to palpate back region?
Prone position
How do you find L1?
. Palpate ribs 11-12 w/ fingertips and stretch thumbs medically like you’re touching them together
. Palpate iliac crests to identify L4 and then count up
In lumbar region are transverse processes even with spinous process?
YES
How do you find erector spinae muscles?
Find spinous process of L1 and move thumbs 2 inches laterally
Where are lumbar transverse processes?
Deep to erector spinae muscles
How hard do you press on palpation of lumbar vertebra?
Apply amount of pressure required to blanch the nail of your thumb
As you press anteriorly on the back what force are you applying?
Left rotation for ace to vertebral segment
As you press over left transverse process what force are you giving?
Right rotational force of vertebral segment
How do you find the PSIS?
Place fingertips over iliac crests and drop thumbs medically and inferiorly
How do you find trochanter?
Put thumb over PSIS and rotation your hand down onto their side with thumb still on PSIS
How to assess flexion/extension of thoracic spine?
. Stand behind seated patient where patient’s feet reach floor
. Patient drops chin to chest and slump forwards (flexion)
.Patient sit up straight and look at ceiling (extension)
How to assess side bending of thoracic spine?
. Stand behind seated patient
. Have patient bend at waist right and left (right and left side bending)
how to assess rotation of thoracic spine?
. Stand behind seated patient
. Patient twists to right and look over right shoulder (right rotation)
. Twists left and looks over left shoulder (left rotation)
How to assess flexion/extension of lumbar spine?
. Stand behind standing patient w/ no shoes
. patient stand shoulder-width apart and bend forward at waist to touch toes without bending knees (flexion)
. Patient bends backward at waist to pain-free limitation (extension)
Normal angles for lumbar flexion and exension
. Flexion: 70-90 degrees
. Extension: 30-45 degrees
How to assess sidebending of lumbar spine
. Patient standing bends at waist to right and left by sliding hand down leg in direction of knee
How to assess rotation of lumbar spine
. patient standing twists at waist to right and left
. Not all this rotation is coming from back (hips, thoracic spine, and ribcage also involved)
When to perform soft tissue treatment in general
. When tissue has restricted motion or are mildly tender
. To get diagnostic information
What types of tissue are amendable in soft tissue treatment and which types are not?
. Chronic tissue texture changes (cooler, stringy, ropy) can be amendable
. Acute tissue changes (heat, erythema, spasm, tenderness, swelling) is not as much
What do you want to contact in soft tissue treatment for vertebral regions and how do you do it?
Contact paraspinal muscles in groove between spinous process and the muscle
. Apply firm pressure to muscle mass and pull in lat. direction w/o overstretching skin
How do you avoid overstretching skin?
Move fingers medically a short distance w/o losing contact w/ skin to gather excess skin and then apply deeper pressure and lat. traction on muscle
Guidelines for soft tissue treatment
. Apply and release force slowly
. Never allow muscle to snap back
. Don’t slide fingers over / overstretch skin
. Spread forces out and avoid direct force on bony prominences
. Sensing approach (see how patient and muscles respond and adjust accordingly)
. Stop when muscle relaxes
. Obtain feedback from patient
. Use finger pads and not fingernails
