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Flashcards in PI Flashcards Deck (133)
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Two Purposes of Motion Palpation?

1- Confirm instrumentation findings
2- Verify an x-ray listing


Three Uses for Motion Palpation?

1- Which segment is subluxated
2- Listing of the subluxated segment
3- Effectiveness of the adjustment


Listing Body Rotation

1- Look at spinous rotation
2- Look at size of pedicles (wider= posterior rotation; narrower= anterior rotation)
3- Look at width of articular process (width is less on side of spinous rotation)


IN Characteristics (8)

1- Wider innominate
2- Narrower horizontal obturator foramen
3- HYPOlordosis of the lumbar spine
4- Raises femur head
5- Anterior SI joint opened
6- External foot rotation
7- Gluteal fold will be wide and flat
8- Wear on lateral heel and medial sole


EX Characteristics (8)

1- Narrower innominate
2- Wider horizontal obturator foramen
3- HYPERlordosis of the lumbar spine
4- Lowers femur head
5- Posterior SI joint opened
6- Internal foot rotation
7- Gluteal fold is narrow and peaked
8- Wear on medial heel and lateral sole


AS Characteristics (8)

1- Shorter innominate
2- Smaller vertical obturator foramen
3- HYPOlordosis of the lumbar spine
4- Raises femur head
5- Spongy edema at the posterior inferior SI joint
6- Sacrum posterior on the involved side
7- Leg will be longer
8- Gluteal fold will be higher


PI Characteristics (8)

1- Longer innominate
2- Longer vertical obturator foramen
3- HYPERlordosis of the lumbar spine
4- Lower femur head
5- Spongy edema at the posterior superior SI joint
6- Sacrum anterior on the involved side
7- Leg will be shorter
8- Gluteal fold will be lower


5 Components of the Gonstead system?

1- Symptomatology
2- Visualization
3- Static/motion palpation
4- Instrumentation
5- X-ray


Toe Out Foot Flare:

Unilateral- IN ilium or a PEX tibia (posterior rotation on side of external wedge)
Bilateral- Base posterior sacrum, knee problem, heavier kids (may outgrow it)
*wear on outside of heel


Toe In Foot Flare:

Unilateral- EX ilium, anterior talus (from inversion sprain), paralysis of extensor muscles
Bilateral- Posterior S2 tubercle, accompanied by hyperlordosis, pigeon toed, seen in children who walk too early


Antalgic Position:

(Cannot stand up straight)
- Check lumbars
- May have BP sacrum



Flatness in the thoracics is an anterior compensation for a posterior vertebra below


Components of Visualization (11)?

1- Head tilt/rotation
2- High shoulder
3- Low shoulder
4- Rib humping
5- Dishing
6- Loss of smooth lateral thoracic arc (stacking)
7- Scoliosis
8- Pelvic tilt
9- Buttocks/gluteals (wide/flat, narrow/peaked)
10- Foot flare
11- Antalgic position


Loss of Smooth Lateral Thoracic Curve:

Check spine by laterally flexing patient, look for loss of smooth arc
Bilateral loss- posteriority is the major component, stacking apparent
Unilateral loss- wedge part of listing on affected side is a major contributor; scoliosis will make lateral wedging harder to observe


Head Tilt/Rotation:

Head tilt is more common than rotation
Tilt- posteriorly rotated atlas will cause the head to be RAISED on that side due to shape of the superior articular facets (higher mastoid on that side)
Rotation- may be caused by overall spinal rotation or upper cervical rotation


AS Occiput:

In children, head tipped anteriorly and walks on toes
Bang heads to decrease pressure, resulting in a flattened forehead


Pelvic tilt: lower PSIS/gluteal fold, higher iliac crest

PI ilium, an anatomically short leg, or fallen arch


Pelvic tilt: higher PSIS/gluteal fold, lower iliac crest

AS ilium



Flat: IN ilium or posterior rotated sacrum
Narrow/peaked: EX ilium or sacrum rotated posterior on opposite side


Rib Humping:

Ribs more prominent posteriorly on one side


High Shoulder:

1- Open wedge in mid thoracics on side of high shoulder
2- PS shoulder
3- Superior scapula
4- SC or AC subluxation


Shoulder Drop:

Paralysis of trapezius


Skin Changes (7):

1- Skin color (2)
2- Varicosities
3- Petechiae
4- Brown or white patches
5- Blemishes
6- Scarring
7- Hair changes


Skin Color--Redness:

In acute situations:
1- Rubbing
2- Increased vascularization
3- Swollen irritated tissue
4- Cutaneous radiation


Skin Color--Parasympathetic/red spot discoloration:

Small red spot usually seen in a parasympathetic dermatomal area (Occiput-C5 and below L5)
Caused by a chronic condition in which there is a change in the integrity of the neurological component of the tissue
Found in the upper cervical or sacral regions



Chronic vascular changes in the sympathetic region, especially at VP and L5
When located at VP, may be accompanied by Dowager's Hump (edema)
These follow a vasotome, focus on center of involved area



Broken blood vessels (possible problem area)


Brown or White Patches:

Chronic neurological changes in the sympathetic area,
occur either left or right of spine because they are neurologically specific


Hair Changes:

Increased hair over sacrum and in abnormalities such as spina bifida
Decreased amount of hair over subluxation



Possible problem area