Anterior Cervical, Thoracic, Rib COUNTERSTRAIN Flashcards
What is the anterior cervical AC1 (LC1) location and treatment?
-posterior surface of the ascending ramus or mandible
-pt supine doc at head of table RA head (rotate head away from TP)
What is the location and treatment for AC2-6?
-anterolateral aspect of TP of affected vertebrae
- pt supine doc at head of table
- F SARA
What is the location and treatment for AC7?
-posterosuperior surface of proximal clavicle (lateral to AC8)
- pt supine doc at head of table
- F STRA
What is the location and treatment for the AC8?
-MEDIAL end of clavicle at sternal attachment of SCM
- pt supine doc at head of table
- F SARA
Where are the Anterior thoracic AC 1-12 TPs?
AT1- midline Supra stern also notch AT2- midline manubrium AT3- midline at costal cartilage of named vertebrae AT4- midline at costal cartilage of named vertebrae AT5- midline superior to xyphoid AT6- midline at sternal-xiphoid junction AT7- midline tip of xiphoid AT8- midline inferior to xiphoid AT9- midline superior to umbilicus AT10- midline inferior to umbilicus AT11- midline 3-4cm below umbilicus AT12- BILATERAL mid-axillary line on ILIAC CREST
How will you treat At1-8 TPs?
- pt supine with feet flat on table doc at head of table
- place knee under pt head/neck or trunk to wedge into FLEXION at the involved vertebrae
- support head/neck and fine tune flexion
**more flexion for lower TP’s
How will you treat AT9-12 TPs?
- pt supine doc on same side as TP with foot on table
- doc uses pts legs to cause FLEXION at waist, and hips and knees bent to 90
- fine tune with rotation towards doc
Where are the anterior lateral thoracic TP and how do you treat them?
- AL 5-6T = at costosternal joint at affected level
- AL 7-8T = inferior medial surface of costal cartilage inferolateral from xiphoid
- pt SEATED doc behind with leg on table under pts arm on UNAFFECTED side
- F STRA
Where are anterior rib points AR1 and 2 and how do you treat them?
- AR1 = inferior to clavicle on rib 1 inf to SC joint lat manubrium
- AR2 = lateral to manubrium on rib 2 in MIDCLAVICULAR line
- pt supine doc at head of table
- F STRT (treat depressed rib, inhalation dysfunction)
Where at anterior rib points AR3-6 and how would you treat them?
-AR3-6 = anterior axillary line on ribs 3-6
- pt SEATED doc behind with pts arm over doc knee on UNAFFECTED side
- F STRT
- treat depressed rib, inhalation dysfunction
What is the location and treatment for PC1 inion TP?
-inferior to external occipital protuberance, lateral, on insertion of semispinalis capitis
- cradle head in monitoring hand and other hand on pts forehead
- FLEX pts neck into comfort position and fine tune
What is the location and treatment for PC1, PC2 TP?
- PC1 = 3 cm below inion and medial to OM suture, press anterior/medial
- PC2 = main muscle mass 2-3cm lateral to midline and below occiput
-E SARA (and fine tune)
What is the location and treatment for PC3 TP?
-inferolateral aspect of C2 SP
- F SARA (FLEX and not extend–> exception *MAVERICK)
- flex to 45 may also require you to STRA instead depends on pt
What is the location and treatment for PC4-7 TP?
-on the inferolateral aspect of SP for the spinal nerve
Ex) PC5 are on SP C4
-E SARA
What is the location and treatment for PC8 TP?
-located on SP C7
F SARA or E SARA depending on pt
What is the location and how would you treat PT 1-3 TP?
-on SP of respective vertebrae
- pt PRONE with arms draped over SIDES of table
- doc cups pts chin wiht one hand other on TP
- slowly and passively EXTEND pts neck (fine tune with SB/R away)
What is the location and treatment for PT 4-6?
-on SP of respective vertebrae
- pt PRONE with arms draped of TOP of table (aide T spine extension)
- doc cups pts chin and monitors TP
- slowly passively extend pts neck (fine tune with SB/R away)
What is the location and treatment for PT7-9 TP?
-on SP of respective vertebrae
- pt is PRONE with arms draped of TOP of table with PILLOW under chest to further extend T spine
- doc cups chin and slowly extends pts neck
- fine tuning with SB/R away
What is the location and treatment for PT10-12 TP?
-on SP of respective vertebrae
- pt PRONE with arms draped of TOP of table with PILLOW under chest to further extend T spine
- doc grasp pt ASIS on side OPPOSITE dysfunction raising pts hip and inducing extension of lower T spine
What is the location and treatment for posterior rib 1 TP?
-posterior margin of rib HEAD beneth margin of trapezius m
- pt seated doc behind with pts arm on side of dysfunction on knee
- doc SB and rotates HEAD toward dysfunction and slightly extends
- E STRT (HEAD)
What is the location and treatment for posterior rib 2 TP?
-superior surface of angles of ribs at medial border of scapula
- pt seated doc behind with pts arm on side of dysfunction on knee
- doc flexes head and SB/R TRUNK and NECK away from TP
- F SARA
What is the location and treatment for posterior ribs 3-6 TP?
-superior surface of angle of ribs at medial border of scapula
- pt seated, doc behind with pts arm on side of dysfunction on knee
- grasp pts shoulder on dysfunction side and SB/R TRUNK away
- SARA
