Cervical & Lumbar

Question 1

11a. lateral translation (sidebending) evaluation of OA jt. for modified Type 1 SD

Answer 1

• modified type I mechanics: spine in F/E, Rt/S OPPOSITE
• pt supine
• seated at pt. head
• contact head in neutral w. finger 2-3 on mastoid process
• translate OA to L and R noting restrictions
• note if there is a restriction in translation to the R (L=>R) then OA lives in SB to the R … Rt. to the L.
• note if there is a restriction to translation to the L. (R=>L), then live in L SB … Rt. to the R.
• place OA segment in F performing same translation movement, noting if translation become more symmetrical => if Y, then FLEXION SD
• place OA in E perform translation, noting if movement more symmetrical -> if Y, EXTENSION SD
• documented in objective portion of SOAP

Question 2

11b. Rotational evaluation of OA jt for modified Type I SD

Answer 2

• note modified Type I: in F/E, Rt/SB opposite
• pt supine
• examiner at head of table
• head in neutral w/ fingers 2-3 on occipital ridge
• Lift anterior on R. ridge w/ R hand causing L Rt.; noting restrictions of motion
• Lift anteriorly on L. ridge, w/ L hand causing R Rt.; noting ROM
• note preferred Rt. to the R. … SB L
• note preferred Rt. to the L. … SB R
• place OA in F perform rt. movement noting more/less symmetry => if Y, Flexion SD w/ rt. and SB noted in opposite directions
• place OA in E perform rt. movement noting more/less symmetry => if Y, Extension SD w. rt. and SD noted in opposite directions
• documented in objective portion of SOAP

Question 3

11c. AA jt rotation SD

Answer 3

• atlas primary motion in relation to axis and can be restricted in Rt.
• pt supine, w/ examiner at head of table
• grasp pt head w. fingertips contacting laterally masses of atlas bilaterally
• flex C-spine fully locking C2-C7, isolating rt. of atlas
• rt. head/neck to R/L noting ROM
• greater motion to R implies restriction of L Rt. defined as AA Rt. R
• greater motion to L implies restriction of R Rt. defined as AA Rt. L.
• F/E and SB NOT TESTED
• documented in objective of SOAP

Question 4

11d. lateral translation evaluation of typical cervical spine Type 2 SD

Answer 4

• note Type II mechanics: motions in F/E and SB/Rt. SAME SIDE
• pts supine, dr. at pt. head
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