COMLEX: techniques

Question 1

Chapman’s point: appendix

Answer 1

anterior = tip of right 12th rib. 
posterior = transverse process of T11.

Question 2

Chapman’s point: adrenals

Answer 2

anterior = 2" superior and 1" lateral to umbilicus.
posterior = b/t spinous and transverse processes of T11 and T12.

Question 3

Chapman’s point: kidneys

Answer 3

anterior = 1" superior and 1" lateral to the umbilicus.
posterior = b/t spinous and transverse processes of T12 and L1.

Question 4

Chapman’s point: bladder

Answer 4

periumbilical region

Question 5

Chapman’s point: colon

Answer 5

lateral thigh within the iliotibial band from the greater trochanter to just above the knee

Question 6

treatment for a trigger point

Answer 6

spray and stretch using vapocoolant spray. injection with local anesthetic.

Question 7

myofascial release procedure

Answer 7

1. ) palpate restriction.
2. ) apply compression (indirect) or traction (direct).
3. ) add twisting or transverse forces
4. ) use enhancers
5. ) await release

Question 8

direct vs. indirect MFR

Answer 8

direct engages myofascial tissues toward a restrictive barrier. indirect engages myofascial tissues away from a restrictive barrier (engaging anatomic barrier).

Question 9

basic sequence for lymphatic treatment

Answer 9

1. ) thoracic inlet
2. ) rib raising or paraspinal inhibition
3. ) redome the thoracoabdominal diaphragm
4. ) lymphatic pump

Question 10

passive indirect technique in which the tissue being treated is positioned at a point of balance, or ease, away from the restrictive barrier

Answer 10

counterstrain

Question 11

counterstrain (tenderpoint) treatment position: anterior cervical

Answer 11

sidebend away, rotate away

Question 12

counterstrain (tenderpoint) treatment position: anterior C7

Answer 12

flex, sidebend toward, rotate away

Question 13

counterstrain (tenderpoint) treatment position: posterior cervical

Answer 13

extend, sidebend, and rotate away

Question 14

counterstrain (tenderpoint) treatment position: posterior C1 (inion)

Answer 14

marked flexion

Question 15

counterstrain (tenderpoint) treatment position: anterior thoracic

Answer 15

flex thorax, sidebend and rotate away

Question 16

counterstrain (tenderpoint) treatment position: posterior thoracic

Answer 16

extend, rotate and sidebend away

Question 17

counterstrain (tenderpoint) treatment position: anterior ribs 1-2

Answer 17

flex head, sidebend and rotate towards

Question 18

counterstrain (tenderpoint) treatment position: anterior ribs 3-6

Answer 18

sidebend and rotat thorax toward, encourage slight flexion

Question 19

counterstrain (tenderpoint) treatment position: posterior ribs

Answer 19

minimal flexion, sidebend and rotate away

Question 20

counterstrain (tenderpoint) treatment position: anterior lumbar

Answer 20

patient supine, knees and hips flexed and rotated away

Question 21

anterior tenderpoint for L5

Answer 21

1cm lateral to the pubic symphysis on the superior ramus

Question 22

counterstrain (tenderpoint) treatment position: posterior lumbar

Answer 22

patient prone, extend and sidebend away

Question 23

counterstrain (tenderpoint) treatment position: lower pole 5th lumbar

Answer 23

patient prone. hip and knee flexed, leg internally rotated and adducted.

Question 24

counterstrain (tenderpoint) treatment position: iliacus

Answer 24

patient supine with hip flexed and externally rotated

Question 25

counterstrain (tenderpoint) treatment position: piriformis

Answer 25

patient prone. hip and knee flexed. thigh abducted and externally rotated.

Question 26

technique for FPR

Answer 26

1. ) patient in neutral position. straighten AP curve of the spine. 2. ) apply facilitating force (compression, torsion, or both). 3. ) shorten muscle to be treated. 4. ) hold position 3-4 seconds. 5. ) release and reevaluate.

Question 27

tenderpoint location: piriformis

Answer 27

7cm medial to and slightly cephalad to the greater trochanter

Question 28

tenderpoint location: iliacus

Answer 28

7cm medial to the ASIS

Question 29

tenderpoint location: lower pole 5th lumbar

Answer 29

caudad to PSIS

Question 30

tenderpoint location: posterior lumbar

Answer 30

on either side of the spinous process of on the transverse process. L3 and L4 may be on the iliac crest. L5 may be on the PSIS.

Question 31

tenderpoint location: anterior L1

Answer 31

medial to the ASIS

Question 32

tenderpoint location: anterior L2-L4

Answer 32

on the AIIS

Question 33

tenderpoint location: anterior L5

Answer 33

1cm lateral to the pubic symphysis on the superior ramus

Question 34

tenderpoint location: posterior rib

Answer 34

angle of the corresponding rib

Question 35

tenderpoint location: anterior rib 1

Answer 35

just below the medial end of the clavicle

Question 36

tenderpoint location: anterior rib 2

Answer 36

6-8cm lateral to the sternum on rib 2

Question 37

tenderpoint location: anterior ribs 3-6

Answer 37

along the mid-axillary line on the corresponding rib

Question 38

which muscle is used to correct exhalation dysfunction of rib 1?

Answer 38

anterior and middle scalenes

Question 39

which muscle is used to correct exhalation dysfunction of rib 2?

Answer 39

posterior scalene

Question 40

which muscle is used to correct exhalation dysfunction of ribs 3-5?

Answer 40

pec minor

Question 41

which muscle is used to correct exhalation dysfunction of ribs 6-9?

Answer 41

serratus anterior

Question 42

which muscle is used to correct exhalation dysfunction of ribs 10-11?

Answer 42

latissimus dorsi

Question 43

which muscle is used to correct exhalation dysfunction of rib 12?

Answer 43

quadratus lumborum

Question 44

absolute contraindications for HVLA

Answer 44

osteoporosis, osteomyelitis, fractures, bone metastasis, severe RA, Down Syndrome

Question 45

relative contraindications for HVLA

Answer 45

acute whiplash, pregnancy, post-surgical conditions, herniated nucleus pulposus, anticoagulation or hemophiliacs, vertebral artery ischemia (+ Wallenberg's test)

Question 46

McMurray test

Answer 46

knee passively extended from flexed position with varus stress (lateral meniscus) or valgus stress (medial meniscus). (+) = pop or crepitus, indicates meniscal tear

Question 47

balanced ligamentous tension

Answer 47

move the segment in the direction of the lesion. when the tension is properly balanced, the respiratory/muscular cooperation of the patient is employed to overcome resistance.