Common Compensatory Pattern (CCP)

Question 1

C2 is

Answer 1

rotated and side-bent left

Question 2

The head

Answer 2

side-bends right

Question 3

T1

Answer 3

rotates and side-bends right (flexed or extended)

Question 4

Right infraclavicular area is

Answer 4

concave and easily compressible

Question 5

T2-6 are

Answer 5

neutral side-bent left and rotated right

Question 6

The lower thoracic area

Answer 6

shifts left better than right

Question 7

The pelvis

Answer 7

rolls right better than left

Question 8

The left iliac crest is

Answer 8

superior and anterior

Question 9

The pelvis

Answer 9

torsions left (posterior left/anterior right)

Question 10

The sacrum

Answer 10

torsions left (left-on-left)

Question 11

The left arm

Answer 11

is short

Question 12

The left leg

Answer 12

is long/right is externally rotated

Question 13

Assess lower extremities

Answer 13

• observe feet: right more flared
• leg length: left leg longer
• rotate legs externally: right more externally rotated
• rotate legs internally: right leg resists internal rotation

Question 14

assess respiration

Answer 14

respiratory motion: motion of abdominal wall only down to umbilicus

Question 15

assess pelvic girdle

Answer 15

• observe: rotated clockwise
• vertical plane: left iliac crest more cephalad
• horizontal plane: right ASIS closer to table
• pelvic roll: rolls more easily to right and resists to left

Question 16

assess inguinal areas

Answer 16

• tissue tauter on left side

- tissues have more slack on right side

Question 17

assess innominates

Answer 17

• ASIS: right is inferior and medial, left is superior and lateral
• symphysis: more cephalad on left side
• ASIS pressure: right side yields and left offers resistance
• Facial drag: gives freely caudad on right and cephalad on left

Question 18

assess lumbar sine

Answer 18

• observe: lumbar spine arched off the table (height, extent of curve)
• motion of vertebra: lumbosacral junction limited

Question 19

assess thorax

Answer 19

-observe: upper thorax rotated clockwise, lower thorax rotated counterclockwise, lower ribs anterior on left
-costal margins: lower portion of thorax flares to left, left side more resistant to motion
Lower lateral aspect: contour neither tapered nor symmetrical
lower thoracic shift: more easily to left, resists to right

Question 20

assess first thoracic vertebra and first rib

Answer 20

• first rib is anterior on left, posterior on right

- first rib is elevated on left

Question 21

assess infraclavicular areas

Answer 21

• concave on right, convex on left

- press on synchondrosis: springs on right, rigid on left

Question 22

assess sternum

Answer 22

• palpation: long axis of sternum deviated right, sternal angle flattened
• fascial drag: tissue moves easily to left, resists to right

Question 23

assess cartilages of ribs 2-6

Answer 23

• palpation (use side of hand): cartilages of ribs 2-6 are prominent on left
• motion: left side resists compression and tender

Question 24

assess upper extremities

Answer 24

• observe: left arm appears higher than right off table, angle on left appears larger than right
• palpation: left arm shorter
• motion: tension on left greater than right

Question 25

assess cervical spine

Answer 25

• observe: head appears to be turned to left, side bent right
• second vertebra rotated to left

Question 26

assess sacrum

Answer 26

observation:

• right sulcus deep
• left ILA posterior and inferior
• left sacrotubeous ligament is tense and left is relaxed
  motion: left-on-left forward sacral torsion
• fascial drag is cephalad
• no sacral tender points
• sphinx test is negative (PSIS or ILA)

Question 27

assess rib cage (patient seated)

Answer 27

• 3rd rib angle prominent and tender on right
• ribs 2-6 are posterior and prominent on right
• 10th rib is inferior and posterior (locked in inhalation) on left