Practical 1

Question 1

Glabella

Answer 1

flat, hairless surface on the frontal bone of the skull, just superior between the two eyebrows

Question 2

supraorbital foramen (notch)

Answer 2

notch located on the upper ridge of the eyebrow on the medial, one-third of the frontal one.

Question 3

infraorbital foramen (notch)

Answer 3

notch located on the maxilla just lateral to the superior aspect of the nose and almost directly inferior to the supraobital foramen, on the inferior orbit of the eye; may feel like divot

Question 4

mental foramen

Answer 4

foramina located on the anterior surface of the mandible just inferior to the second premolar; bilateral structure

Question 5

zygomatic arch (of temporal bone)

Answer 5

posterior lateral portion of the cheekbone;

Question 6

symphysis menti

Answer 6

midline ridge on the anterior surface of the mandible; may have dimple or cleft

Question 7

external acoustic meatus

Answer 7

the hole of the ear; temporal bone

Question 8

TMJ

Answer 8

the junction of the condylar portion of the mandible with the indentation (articular tubercle) of the temporal bone. place one finger in the ear and another just in front of the ear to palpate

Question 9

angel of the mandible

Answer 9

find the TMJ, and palpate the mandible inferiorly until it makes an angle anteriorly

Question 10

mastoid process of temporal bone

Answer 10

bony prominence posterior to the ear lobule

Question 11

transverse process of atlas (C-1)

Answer 11

midway between the angle of the mandible and the tip of the mastoid process of the temporal bone; with the tip of the index finger, gently palpate this area, the small, firm structure is the transverse process of C1.

Question 12

inion (external occipital protuberance)

Answer 12

small bump/protuberance located in the midline on the posterior, inferior aspect of the occiput

Question 13

superior nuchal ridge

Answer 13

ridge of the bone on the occiput that runs laterally from the inion to the mastoid process of the temporal bone

Question 14

first rib

Answer 14

with the patient supine, place your hands on the lateral portion of the cervical spine palpating inferiorly towards the shoulders. as you near the base of the neck you will feel a firm structure that protrudes laterally; this will be the transverse process of T1. move just laterally to the transverse process and the bony plateau is the first rib. may also grasp the trapezius and push the angled muscle a the base to the neck and push the tissue posterior and add gentle pressure towards feet

Question 15

clavicle

Answer 15

stand in front of the patient and place your palms on the anterior, superior portion of the chest and place hands on top of patient’s shoulders, allowing fingers to drape anteriorly towards the chest

Question 16

jugular notch (episternal/suprasternal)

Answer 16

in the midline, lightly palpate the anterior aspect of the base of the neck. continue inferiorly until you feel a notch or groove intermediate to the 2 medial clavicular heads

Question 17

suboccipital tension release

Answer 17

utilization: to treat tension headaches, prepare for cervical correction, and to assess and stretch dural attachments to C2, C3, and the occiput; apply an anterior and superior force to the occipito-atlantal junction

Question 18

posterior cervical soft tissue

Answer 18

utilization: to treat the short restrictor muscles of the cervical spine; apply an anterior and lateral force to the short restrictor muscles in a rhythmic fashion; second hand acts as to stabilize the head

Question 19

cervical stretching for flexion

Answer 19

utilization: to address the long restrictor muscles of the cervical spine, to stretch the myofascial elements of the cervical and upper thoracic regions, to promote venous and lymphatic drainage of the tissues; done for 3 barriers where patient applies a gentle pressure for 3 seconds against the physicians flexion force; the physician waits for a 2 count before attempting to reach the next barrier; continue this technique into muscle energy techniques to address problem

Question 20

cervical stretching for sidebending

Answer 20

using arm for support instead of 1 arm as in the cervical stretching for flexion test; sidebend and rotate the patient TOWARDS your arm that is supporting the patient’s head; do this until release is felt OR to transition into muscle energy technique

Question 21

rib-raising, lateral recumbant

Answer 21

utilization: to aide in respiration (asthma), to aid in circulation in patient with congestion (pneumonia, chronic obstructive lung disease, cardiovascular, and structural injury, and in pre/post-op care; MAKE SURE TO ASK FOR SHOULDER PAIN FIRST; patient stands towards the front of patient who has their arm on their head; use this elbow as a counterforce as you apply an anterior and lateral motion on the posterior rib cage until tissues release

Question 22

rib-raising, supine

Answer 22

utilization: to aid in respiration (asthma), to aid in circulation in patients with congestion (pneumonia, chronic obstructive lung disease, cardiovascular, and structural injury), and in pre/post-op care; physician applies an anterior and lateral motion until the release of tissues occurs

Question 23

prone thoracic perpendicular stretch

Answer 23

utilization: to laterally stretch fascial restrictions within the paravertebral musculature of the thoracic spine an to free up any rib or thoracic restrictions; physician applies an anterior and lateral pressure to the patient with the TOP HAND, holding each stretch for 3 seconds without sliding across the tissues

Question 24

pectoral traction

Answer 24

utlization: to increase the A-P diameter of the thorax, to improve venous and lymphatic drainage of the thorax, to release tension in the clavi-pectoral fascia, to drain the anterior axillary fold edema from upper extremity, and to provide drainage from the head and neck; patient must be SUPINE WITH KNEES BENT; apply a superior traction on tissues, and increase the pressure as the patient inhales; continue applying pressure against the tissues when patient exhales; do this for 3 deep breath cycles

Question 25

clavi-pectoral stretch

Answer 25

utilization: to provide drainage from the head or neck, to treat edema caused by tonsillitis, pharyngitis, to treat anterior/rounded shoulders. should be completed AFTER the inlet has been addressed; patient is supine and physician applies a 10 pound pressure posterior and inferior into the patient; thenar eminences are placed on the anterior/superior part of the shoudler near the AC joint; pressure is held for 20 seconds

Question 26

posterior axillary tension

Answer 26

utlization: to increase the A-P diameter of the thorax, to improve venous and lymphatic drainage of the thora, to release tension in the clavi-pectoral fascia, and to drain congestion from the posterior axillary fold, upper extremities, head, and neck; patient is supine with knees flexed; physician applies a superior traction on tissues, patient takes deep breath in, and physician resists tissues as patient exhales; do this for 3 deep breath cycles

Question 27

thoracolumbar soft tissue - prone

Answer 27

utilization: to relax the paravertebral and quadratus lumborum musculature, to free up the motion of ribs 11 and 12, therapeutic and diagnostic for somatic and visceral dysfunctions, special attention may be given to those areas overlying the sympathetic nerve supply to the organs the physician wishes to affect through reflex mechanisms; physician applies a superior pressure on the ASIS and an anterior pressure on the paraspinal muscles adjacent to the lumbar spine; the hand on the ASIS moves first; this is a kneading motion done until the tissue softens or there is an increased ROM

Question 28

upper, mid, and thoracolumbar soft tissue - lateral recumbant

Answer 28

utilization: to relax the paravertebral and quadratus lumborum musculature; to free up the motion of ribs 4-12; therapeutic as well as diagnostic for somatic and visceral dysfunctions; special attention may be given to the areas overlying the sympathetic nerve supply to the organs the physician wishes to affect through reflex mechanisms; patient must use upper arm to stabilize themselves; physician applies a lateral and anterior force via top hand until the tissue softens or there is an increased ROM

Question 29

thoracolumbar soft tissue - supine

Answer 29

utilization: to relax the paravertebral and quadratus lumborum musculature; to free up the motion of ribs 11-12, therapeutic as well as diagnostic for somatic and visceral dysfunction, and special attention may be paid to the areas overlying the sympathetic nerves that supply organs that the physician wishes to affect using reflex mechanisms; patient lies supine with knees flexed; the physicians hand on the knees provides an opposing force as their other hand provides a lateral and anterior force to the muscles of the back; this is done in a kneading and alternating fashion until the tissue relaxes or there is an increased ROM

Question 30

ischial tuberosity spread

Answer 30

utilization: to release the fascia of the pelvis, to treat the sacrum, to separate the sacroiliac joints and allow for better motion of the sacrum between the innominates, to help the sacrum seat itself between the innominates, to improve the function of the urogenital-pelvic diaphragm, to decongest the pelvis and improve lower extremity drainage, to manage cystitis, proctitis, hemorrhoids, prostatitis, constipation, and sacroiliac dysfunction; patient lays on stomach and spreads legs while keeping the knees touching. physician applies a lateral pressure on the medial side of the ischial tuberosities; the physician applies a greater pressure as the patient coughs while also applying pressure to knees using elbows; done 3 times

Question 31

sacral rocking

Answer 31

utlization: to improve sacral respiratory motion, to relieve strains of the sacral fascia and related surrounding structures, to enhance the primary respiratory mechanism, to improve the function of the urogenital pelvic diaphragm, to treat constipation; physcian applies a rocking force that goes with the motion as the patient breaths for 1-2 minutes

Question 32

sacral inhibition

Answer 32

utilization: to treat diarrhea, to treat dysmenorrhea; be cautious with patients with spondylisthesis or stenosis of lumbar spine; an anterior force is applied for 1-2 minutes that resists the movement as the patient breathes

Question 33

myofascial shoulder release via scapular lift

Answer 33

utlization: to release myofascial restrictions of the shoulder girdle, to address rib dysfunctions; care should be taken if the patient has any shoulder issues; the patient lies lateral recumbant facing the physcian with their upper arm placed in winged position; the physician applies an inferior pressure on the upper shoulder while also lifting the scapula in a lateral fashion as the patient breathes; do this for 3 breaths and resist the movement of the shoulder towards the midline

Question 34

trap pinch

Answer 34

utilization: to decrease the congestion within the thoracic inlet, to ease tension of the trap, to assist in the treatment of headaches; patient is supine and physician uses the lobster claw to treat restrictions in the trap

Question 35

lymphatic pumping - dorsiflexion

Answer 35

utilization: to combat stasis, congestion, and pooling of body fluids which are the precursors to inflammation, symptoms of disease, and frank disease, to encourage natural venous return and circulation in pregnant patients, treating any infection; take care with recent matatstatic disease diagnosis and achilles tendinitis; patient is supine with feet on the table as the physcian places hands on the plantar surface of the feet and applies a rhythmic motion towards the abdomen; flexion occurs 40-60 times a minute for 2 minutes, twice a day