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OS-II Final > 1. HVLA > Flashcards

1. HVLA Flashcards

1
Q 
High Velocity Low Amplitude (HVLA) is an osteopathic technique employing a
\_\_\_\_\_\_, \_\_\_\_\_\_\_ force of \_\_\_\_\_
duration that travels a \_\_\_\_\_\_
distance within the anatomic range
of a joint and that engages the
restrictive barrier to elicit release of
restriction
A

rapid, therapeutic force of RAPID duration that travels a SHORT

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2
Q 
HVLA is an osteopathic technique employing a rapid, therapeutic force of brief
duration that travels a short
distance within the \_\_\_\_\_\_\_ range
of a joint and that engages the
\_\_\_\_\_\_ barrier to elicit release of
restriction
A

anatomic range

restrictive

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3
Q

Without SD, the end ROM that you will achieve during active motion is the ________ barrier.

A

physiologic barrier

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4
Q

Without SD, the end ROM that you will acheive during PASSIVE motion is the ______ barrier

A

anatomic barrier

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5
Q

_________ is the functional limit that abnormally

diminishes the normal physiologic range

A

restrictive barrier

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6
Q

Before HVLA, if a patient complains in their history of symptoms of problems that are related to the ______ artery, what should the doc do?

A

VERTEBRAL ARTERY

Vertebral artery tests should be done

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7
Q

If there is clinical suspicion of vertebral artery compromise by the history and physical findings, should HVLA be performed?

A

NO.

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8
Q

HVLA stands for

A 
HIGH VELOCITY
LOW AMPLITUDE (short distance)
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9
Q

What technique what the MAIN OS technique in medical schools before 1970s?

A

HVLA; after, it expanded to other modalities

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10
Q

What did was AT Still referred to as ?

A

Lightening bone setter

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11
Q

HVLA is done within what barrier?

A

anatomic

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12
Q

HVLA is also referred to as the _______ technique?

A

thrust

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13
Q

Before doing HVLA, we should always feel what kind of end-feel?

A

Hard end-feel (firm and distinct barrier)

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14
Q

What determines quantity of ROM?
What about the quality?

In a non-dysfunctional joint it is usually _______.

A

Quantity: the amount of movement FROM neutral.
Quality: palpatory sense of how smoothly a joint can move through its ROM.

symmetric

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15
Q

ROM is tested when?

A

physical

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16
Q

What is an end-feel?

A

quality of motion of a joint when it is brought passively to

its final barrier of motion

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17
Q

HVLA is a ____ technique

A

DIRECT

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18
Q

What are 2 indications for HVLA?

A
  1. Good from SD with ROM that has a distinct firm barrier.

2. Articular SD.

19
Q

When conducting HVLA, we thrust through the RB.

What findings should we see after we complete HVLA?

A

Restore motion at articulation, restore normal proprioceptive input which will cause a reflex relaxation of muscles and improve our TART findings

20
Q

What causes the sound in HVLA.

A

We dont know:

  1. Could be the release of gase
21
Q

What causes the sound in HVLA.

A

We dont know:

  1. Could be the release of gas into the synovial fluid when we break surface tension
  2. Snap/release of ligament adhesions in the joint
  3. Ballooning of joint capsule
  4. Bone itself snapping back into neutral
22
Q

Which of the following is considered a dysfunctional joint?

A. Subluxed
B. “Out of place”
C. “Out of joint”
D. Dislocated

A

NONEEEEE

23
Q

Do DOs “adjust” or “put back into place”

A

no

24
Q

What is an OMT’s goal in HVLA?

A

OMT’s goal is to restore motion loss and restore neutral point back to normal

25
Q

What are the 6 steps of HVLA?

A
  1. Diagnose SD
  2. Localize SEGMENT
  3. Stack: Engage the RB in all 3 planes of motion
  4. REM: Release enhancing maneuver (patient breathing)
  5. Mobilizing force- Corrective Thrust
  6. Reassess
26
Q

What is important to note about the initial position of HVLA?

A

its imp for the pt and doc to be in a comfortable position!

to do so, consider applying techniques to relax overlying myofascial structures

27
Q

What is a vertebral unit?

A

Two adjacent vertebrae with their associated disc,
arthrodial, ligamentous, muscular,
vascular , lymphatic, and neural
components

28
Q

What part of the vertebral unit are we treating in HVLA?

A

forces are located at the facet joint between 2 vertebra

29
Q

What are 2 ways to engage the RB of the vertebral unit in HVLA?

A
  1. “Through the dysfunction” to the segment below: – Forces are applied from the top down through the superior vertebra
  2. “To the dysfunction”-– Forces are applied from the bottom up through the inferior vertebra

Other Vertebrae of the unit is used as an opposing counterforce

30
Q 
Typical Vertebrae (C2-L5)- Assessed
and treated in 3 Planes of motion. What about if you do not have a segment that has 3 planes?
A

Assess for appendicular restriction: Typically restricted in one Major and an associated minor motion. HVLA typically treats restriction of minor motion.

31
Q

Once Barriers are engaged, use a short,
rapid thrust with sudden __________
and __________

A

acceleration

deceleration

32
Q

should force be released before or after thrust?

A

AFTER

33
Q

the amount of HVLA to give a patient depends on the patient.

– The sicker the patient, the \_\_\_\_\_ the dose
– Older patients respond more \_\_\_\_\_\_
– Most cases discourage thrusting the
same segment more than \_\_\_\_\_\_\_\_\_\_\_\_
– If the same SD keeps recurring,
evaluate and address for underlying
inciting factor
A

less
slowly
once a week

34
Q

What are the 3 benefits of HVLA?

A
  1. GREAT for a SD with a distinct firm RB.
  2. Well-tolerated and time efficient
  3. Patients will experience immediate relief, increase ROM and decreased pain.
35
Q

Should we perform HVLA?

  1. When a somatic dysfunction is judged to be an actual joint motion restriction (such as facet locking), not an exclusive soft tissue restriction.
    In the face of joint fixation
  2. To disrupt connective tissue adhesions
  3. To treat chronic dysfunction resistant to other treatment modalities
A

YES
YES
YES

36
Q

T/F

HVLA possibly remains as the safest procedure in medicine.

A

yes

37
Q

When performing HVLA, when treating the cervical spine, what should we avoid?

A
  1. Hyperextension

2. Excessive rotation

38
Q

What is ESSENTIAL for uncovering any contraindications of HVLA?

A

Before treating, do a thorough history and physical exam.

39
Q

If the risk outweighs the benefit, should HVLA be performed?

A

NO

40
Q

What is the most important safety consideration to consider when performing HVLA?

A

ACCURATE DIAGNOSIS IS IMPORTANT

41
Q

What are 4 other safety considerations to consider when performing HVLA?

A
  1. Patient’s consent and comfort is important
  2. Listen with your hands- Don’t thrust if the barrier DOES NOT FEEL RIGHT
  3. Too much force can damage tissue
  4. Hypermobility can be made worse by HVLA
42
Q

What are the 2 most important ABSOLUTE contraindications for HVLA and why?

A
  1. Rheumatoid Arthritis
  2. Down syndrome
  3. Spondylysis
  4. Local metastais
  5. SEVERE osteomyletisis or osteporosis

these patients can have alar ligament instability

43
Q

Relative contraindications?

A
  1. Acute problems
  2. Mild osteopenia, mild osteoporosis
  3. SpondoloTHESIS
  4. Hypermobility syndromes (marfans or ED)

OS-II Final (7 decks)

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