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Flashcards in PI Flashcards Deck (133)
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1

Two Purposes of Motion Palpation?

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

2

Three Uses for Motion Palpation?

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

3

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)

4

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

5

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

6

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

7

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

8

5 Components of the Gonstead system?

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

9

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

10

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

11

Antalgic Position:

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

12

Dishing:

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

13

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

14

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

15

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

16

AS Occiput:

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

17

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

PI ilium, an anatomically short leg, or fallen arch

18

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

AS ilium

19

Buttocks/Gluteals:

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

20

Rib Humping:

Ribs more prominent posteriorly on one side

21

High Shoulder:

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

22

Shoulder Drop:

Paralysis of trapezius

23

Skin Changes (7):

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

24

Skin Color--Redness:

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

25

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

26

Varicosities:

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

27

Petechiae:

Broken blood vessels (possible problem area)

28

Brown or White Patches:

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

29

Hair Changes:

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

30

Blemishes:

Possible problem area