chapter 14: CS and FPR Flashcards
maverick point
approx 5% of Tender points wil not improve with expected treatment even with careful fine tuning
these maverick points are treated by positioning the pt in a position opposite of what would be used typically
AC1 tender point and treatement
posterior surface of ascending ramus of mandible
treatment RA, pt supine
AC2-6 tender pt and treatment
anterolateral aspect of TP of affected vertebra
pt supine treatment F SARA
AC 7 TP and treatment
posterosuperior surface of prox clavicle where SCM inserts (lateral to AC8)
pt supine F STRA
AC 8 TP and treatment
medial end of clavicle at sternal attachment of SCM
pt supine F SARA
AT 1-8 treatment
pt supine, dr at head of table
dr places knee under pts head and kneck and flex them up and fine tune by flex and sidebending away a tad bit
AT 1-8 locations
1- suprasternal notch 2- midline on manubrium 3- midline at level of costal carilage 4- midline at level of costal carilage 5- 1 inch superior to xyphoid 6 at sternal xiphioid junction 7- tip of xiphoid 8 midline 1.5 inches inferior to xiphoid
AT9-12 location
9- midline 1-2 cm supedrior to umbilicus
10- midline 1-2 cm inferior to umbilicus
11- midline 3-4 cm below umbilicus
12- mid ax line on superomedial surface of iliac crest
AT 9-12 treatment
pt supine, dr same side of TP
flex pts legs, hips and knees bent 90 degrees with fine tuing by adding rotation toards dr
posterior cedrvical TPs location and treatment
usually at tip of spinous process or on lateral sides of spinous process
pt supine E SARA
PC1 inion location and treatment
1-2 cm inferior to external occipital protuberance, slighlty lateral, on insertion of semispinalis capitis
treat: pt supine, flexion while monitoring
posterior thoracic tenderpiont location and treatment
location: on either side of spinous process or on the transverse process
treat: pt prone, E SARA
1-3 pts arms off side of table
4-6 pts arms over top of table
7-9 arms over top of table with pillow under chest
10-12 arms over top of table with pillow under chest (grab ASIS side oppp of dyfunction and raise pts hip)
AR 1 location and treatement
directly inferior to SC joint
treat: supine, dr head of table, F STRT
AR 2 location and treatement
6-8 cm lateral to sternum on rib 2
pt supine F STRT
AR 3-6 location and treatment
location: mid axillary line on corresponding rib
treat: F STRT of thorax (pt seated, unaffected side arm draped over physician knee)
posterior rib locations TP
angle of the corresponding rib
treatment PR 1
pt seated, doc behind, pts arm side dysfunction on docs knee, sidebend and rotate pts head TOWARD dysfunction and extend
E STRT
treatment PR 2
pt seated, doc behind/to side, doc places pts arm on side of dysfunction on docs knee, doc flexes pts head and sidebends and rotates trunk away from dysfunction and neck too
F SARA
tretment PR 3-6
pt seated doc pt arm affected side draped over docs knee, doc grabs pts shoulder on side of dysfucntion and SARA pt
Anterior lumbar tenderpoints
AL1
AL2-4
AL5
AL1: medial to ASIS AL2: medial to AIIS AL3: lateral to AIIS AL4: inferior aspect of AIIS AL5: 1 cm lateral to pubic syphysis
treatment of AL1 and AL5
F STRA
AL 2-4 treatment
pt supine, dr. opp side of TP
flex hips and knees 90
F SART
iliacus TP location and treatment
location: 1-2 in (7 cm) medial to ASIS deep in iliac fossa
frog leg (supine, hip flexed and externally rotated)
psoas TP location
halfway btwn ASIS and umbilicus
piriformis TP
PSIS-ILA midpoint and greater trochanter
btwn these 2
low ilium location and treatment
location: superior ascpect of lateral ramus where psoas crosses pelvic rim
pt supine, flex hip and knee
slight ER hip and fine tune one leg
inguinal ligament TP location and treatment
location: lateral surface of pubic bone near attach of inguinal ligament
treatment position: supine, dr same side, flex hip and knee 90, cross opp ankle over leg
PL location and treatment
location: PL1-5: either side of the spinous process or on the TP
PL3 and 4 may be on iliac crest
PL5 at PSIS
treat: pt prone doc on same side of TP, doc extends pts hip ipsilataral to tp, E Sidebend away, fine tune rotation
LPL5
caudad to psis
treat: pt prone, hip and knee flexed, leg internally rotated and adducted
UPL5 TP
superior medial edge of PSIS
extend and sidebend away
sacrum
PS1
1/2 inch medial to inferior of PSIS
treat: pt prone, if PS1 tender on left, doc apply pressure on right ILA
posterior sacrum 2-4
midline on sacrum btwn or below sacral spines
pt prone, doct next to them, pressure posterior to anterior on midline
PS 5
1/4 inch medial and superiror to ILA
pt prone doc posterior to anterior pressure
PS5 tender on left, apply pressure at right sacral sulcus
high ilium location and treatment
lateral PSIS
pt prone, extend pts hip and fine tune
high ilium flare out HIFO
location: inch below and medial to lower edge PSIS
pt prone, extend ipsilateral leg then add adduction and slight external rotation
pirifomis treatment
pt prone, doc seated on same side of dysfunction,
doc flexes pts leg over side of table to 135 and abduct and externally rotate pts hip
flare in sacroiliac FISI
4 inches below psis
pt prone
doc seated on same side dysfunction
abduct pts hip, flex hip too
when utilizing faciliated positional release to a superficial muscle, which is performed first?
straightening of the AP spinal curves
