Competency 8 Flashcards
1
Q
Counterstrain–say this for every one
A
- Diagnose somatic dysfunction
- Find significant tender point
- Establish pain scale
- Wrap around TP while monitoring
- Reduce pain by at least 70%
- Maintain for 90 sec (120 for ribs)
- Return the patient slowly and passively back to neutral
- Reasses the TP
2
Q
a) Anterior cervicals TPs
A
AC1: posterior surface of ascending ramus of mandible
AC2-6: Anterolateral aspect of TP of affected vertebrae
AC 7: posterior superior surface of proximal clavice where SCM inserts
AC8: Anterior aspect of sternoclavicular joint where SCM inserts
3
Q
a) anterior cervicals treatment
A
Head and neck in relation to TP:
- AC1: RA
- AC2-6: FSARA
- AC 7: FSTRA
- AC8: FSARA
4
Q
b) Anterior thoracics TPs
A
- AT1: Midline, suprasternal notc
- AT2: Midline, manubrium
- AT3: Midline, costal cartilage at level of T3
- AT4: Midline, costal cartilage at level of T4
- AT5: Midline, 1 inch superior to xiphoid
- AT6: Midline, at sternal-xiphoid junction
- AT7: midline, at tip of xiphoid
- AT8: Midline, 1.5 inches inferior to xiphoid
- AT9: Midline, 1-2 cm superior to umbilicus
- AT10: Midline, 1-2 cm inferior to umbilicus
- AT11: Midline, 3-4 cm below umbilicus
- AT12: Midaxillary line, on superior medial surface of iliac crest
5
Q
b) Anterior thoracics treatment
A
- AT1-8: Place knee under patients’s head and neck or trunk to use as wedge to flex trunk into involved vertebrae. More flexion needed lower the points
- AT9-12: Use patients legs to cause flexion (at waist); hips and knees flexed to 90 and fine tune by adding rotation towards doctor.
- Can add flexion by putting pillow under thorax
6
Q
c)Anterior ribs TPs
A
- AR1: Inferior to clavicle on rib 1, lateral to manubrium (directly inferior to SC joint)
- AR2: 1.5 inch lateral to manubrium on rib 2 at mid-clavicular line
- AR3-6: Anterior axillary line on ribs 3-6
7
Q
c) Anterior ribs treatment
A
AR 1 and 2 Patient supine with doc at head of table; all for depressed rib, inhalation restriction (exhalation dysfnx)
- AR1: Head and neck: F STRT
- AR2: Head and neck: F STRT
- AR3-6: Patient seated, doc behind, put docs knee under arm on UNAFFECTED side. Flex head and neck then rotate and sidebend torso the tender point (F STRT)
8
Q
d) Anterior lumbar points
A
- AL1: medial to ASIS
- AL2: Medial to AIIS
- AL3: Lateral to AIIS
- AL4: Inferior aspect of AIIS
- AL5: Anterior aspect of pubic bone about 1 cm lateral to pubic symphysis (near pubic tubercle)
9
Q
d) Anterior lumbar treatment
A
- All supine
- AL1: stand on same side with foot on table; flex knees/hips >90 degrees and pull knees and ankes towards you—FSTRT
- AL2: stand on opposite side with foot on table; flex hips/knees to 90 and pull knees and ankles towards you–FSARA (requires lot of rotation of flexed femurs away from TP)
- AL3: stand on opposite side with foot on table; flex hips/knees to 90, ankles towards you with minimal knee rotation towards you (F SART)
- AL4: stand on opposite side with foot on table; flex hip and knees to 90; ankles towards you with minimal knee rotation towards you
- AL5: stand on SAME side with foot on table. Flex hip 90-135, push ankles away and rotate knees slightly towards (FSART)
10
Q
E) Anterior pelvis TPs
A
- Iliacus: Lower abdominal quadrant, 1-2 in medial to ASIS deep in iliac fossa
- Low ilium: Superior aspect of lateral ramus, where psoas crosses pelvic rim
- Inguinal ligament: Lateral surface of pubic bone near atachment of inguinal ligament
11
Q
E) anterior pelvis treatment
A
- Supine, stand on same side of TP
- Iliacus: stand foot on table; flex hips/knees to 90 with ankles crossed over docs knee with knees separated (frog-legged position, ER of both hips)
- Low ilium: Flex ipsilateral hip and knee to 90, slight ER hip, fine tune with adduction or abduction
- Inguinal ligament: stand with foot on table; flex both hip and knee to 90 and rest on students knee, cross opposite ankle over the leg on side of student, pull ankle towards you (IR of hip on side of TP)
