COMP 13

Question 1

What are the 12 steps of the osteopathetic screening evaluation for evidence of somatic dysfunction?

Answer 1

1. Pt walk a series of steps to evaluate for abnormalities of gait
2. Perform postural assessment for the transverse plane, anterior/posterior and lateral views
3. Palpate for tenderness over the iliolumbar ligament which is the first tender point associated with a postural decompensation pattern
4. Patient performs the active and passive ROM of shoulders
5. Patient bend forward at the waist looking for asymmetry of the thoracic cage and spinal curvature (aka scoliosis)
6. Perform the standing and seated flexion tests
7. Perform active gross spinal motion testing for flexion, extension, rotation, and side bending
8. Perform the acromion drop test by dividing the area between neck and acromion into thirds then inducing an inferior force in the following manner: A) lateral 1/3 induce inferior force to evaluate SB restriction of lower thoracics; B) middle 1/3 induce inferior force to evaluate SB resstriction of middle thoracic; C) medial 1/3 induce inferior force to evaluate side bending restriction of upper thoracic.
9. Perform hip drop test which screens for lumbar side bending restrictions
10. Perform pelvic side-shift test and which assesses fascial connection between lumbo-pelvic-hip complex. Translate the pelvis to the right or left of the central axis as translation along the horizontal axis, usually observed in standing position
11. Perform the evaluation for superior/elevated 1st rib, rib angle tenderness, and rib respiratory motion
12. Perform straight leg raise test and note that it will screen for lumbar radiculopathies, hip flexion restriction, IT band tension, and tightness of hamstrings.