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OPP final practical > Counterstrain > Flashcards

Counterstrain Flashcards

1
Q

Categorize counterstrain (i.e. is it passive or active? direct or indirect?)

A

Indirect and passive

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2
Q

Anterior thoracic tender point for T1

A

Sternal notch

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3
Q

Anterior thoracic tender point for T2

A

Junction of sternum and manubrium

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4
Q

Anterior thoracic tender point for T3-5

A

Next to each rib on the sternum

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5
Q

Anterior thoracic tender point for T6

A

Xiphoid-sternal junction

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6
Q

Anterior thoracic tender point for T7

A

Midline or inferior/lateral to the xiphoid process

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7
Q

Anterior thoracic tender point for T8

A

About 3 cm below the xiphoid; at the T12 level

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8
Q

Anterior thoracic tender point for T9

A

1-2 cm above the umbilicus midline or 2-3 cm below the umbilicus lateral

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9
Q

Anterior thoracic tender point for T10

A

1/4 the distance from the umbilicus to the pubic symphysis

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10
Q

Anterior thoracic tender point for T11

A

1/2 the distance from the umbilicus to the pubic symphysis

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11
Q

Anterior thoracic tender point for T12

A

Midaxillary line, inner surface of iliac crest

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12
Q

Position of treatment for T1-6 anterior points

A

Patient supine with arms off side of table

Physician with thigh behind the patients head/neck/back

Flex their neck and upper back. If the point is lateral, add sidending and rotation to the ipsilateral side

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13
Q

Position of treatment for midline anterior T7-9 tender points

A

Patient seated with pure flexion

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14
Q

Position for treatment of LATERAL anterior T7-9 tender points

A
  1. Patient seated
  2. Physician behind with foot on table (opposite tender point)
  3. Patients arm is draped over physician’s thigh (for sidebending) and can have them clasp arm (bring ipsilateral arm across chest-Adducted) to induce rotation
  4. Patient is leaning back against physician
    Page 102 of 116
  5. Side bend and flex them
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15
Q

Position for treatment of anterior T9-12 tender points

A
  1. Patient supine
  2. Physician with foot on the table and drapes the patients legs over thigh
  3. Flex the patients hips and knees to the level of dysfunction
  4. Rotate knees toward the side of the tender point
  5. If you need more sidebending, pull the ankles toward the tenderpoint
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16
Q

Position of posterior thoracic tenderpoints T1-12

A

Inferior/lateral tip of the spinous processes or the lateral aspects of the transverse process

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17
Q

Treatment position for posterior thoracic tenderpoints T1-6 MIDLINE

A

Prone:

  1. Patient Prone with arms off side of table
  2. Physician at head of table cupping patients chin
  3. Extend the neck (until release of tender point).

Supine:

  1. Patient supine with head off table (this does the extension)
  2. Physician supports head
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18
Q

Treatment position for midline posterior thoracic points T7-9 midline

A

Patient is prone with arms hanging overhead parallel to the table

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19
Q

Treatment position for LATERAL posterior thoracic points T4-9

A
  1. Patient in the prone position
  2. Physician at the head of the table with the forearm OR knee under the patients axilla on the ipsilateral side of the tender point
  3. Add a little sidebending if you desire
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20
Q

Anterior lumbar tender point for L1

A

Medial to ASIS

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21
Q

Anterior lumbar tender point for L2

A

Medial to AIIS

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22
Q

Anterior lumbar tender point for L3

A

Lateral to AIIS; press medial

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23
Q

Anterior lumbar tender point for L4

A

Inferior to AIIS; press cephalad

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24
Q

Anterior lumbar tender point for L5

A

1 cm lateral to the pubic symphysis

25
Q

Posterior lumbar tenderpoints L1-5

A

Inferolateral aspect of the spinous process or laterally on the transverse process

26
Q

Treatment position for anterior lumbar tenderpoint L1

A
  1. Patient is supine and the physician is standing on the SAME SIDE as the tenderpoint
  2. Flex the patients hips and knees
  3. Bring the patients hips TOWARD YOU
  4. Pull patients ankles TOWARD YOU
27
Q

Treatment position for anterior lumbar points L2-4

A
  1. Patient is supine with the physician standing on the OPPOSITE SIDE of the tenderpoint
  2. Flex the patients hips and kness
  3. Rotate the patients hips and knees TOWARD YOU
  4. Move the patients ankles TOWARD YOU
28
Q

Treatment position for anterior lumbar point L5

A
  1. Patient is supine and the physician is standing on the SAME SIDE as the tenderpoint with your leg on the table
  2. Flex the patients hips and knees over your thigh
  3. Rotate the patients hips and knees TOWARD YOU
  4. Move the patients ankles AWAY FROM YOU
29
Q

Treatment position for midline posterior lumbar tenderpoints L1-5

A
  1. Patient is prone and the physician is on the OPPOSITE SIDE from the tenderpoint
  2. Grab the thigh on the same side as the tenderpoint and EXTEND until the dysfunctional segment is engaged. Can use a pillow to help support the extension of the thigh
  3. ADDUCT and EXTERNALLY ROTATE the thigh
30
Q

Treatment position for lateral posterior lumbar tenderpoints L1-5

A
  1. Patient is prone, physician is standing on the OPPOSITE SIDE from the tenderpoint
  2. Sidebend by pushing the legs TOWARD the direction of the tenderpoint
  3. Grasp the ASIS and rotate it towards you. Can use a pillow under the ASIS
31
Q

Quadratus lumborum tenderpoints

A

Lateral to the lateral posterior lumbar tenderpoints

32
Q

Treatment position for quadratus lumborum tender points

A
  1. Patient is prone, phsyician is on the SAME SIDE as the tender point
  2. Grab the lower leg, extend and abduct it
  3. Flex the knee
  4. Grab the ankle to internally or externally rotate the leg
33
Q

Anterior cervical tenderpoint C1 (AC1)

A

About halfway between angle of mandible and mastoid process

34
Q

Anterior cervical tenderpoints C2-6

A

Anterior aspect of the transverse process at that level

35
Q

Anterior cervical tenderpoint for C7 (type 1 dysfunction of C7)

A

On the clavicle about 2 cm lateral the the sternoclavicular joint

36
Q

Anterior tenderpoint for type II dysfunction of C7 (AC8)

A

Right around the sternal notch

37
Q

Treatment for AC1

A

Rotate away

38
Q

Treatment position for AC2-AC6

A

Flex, sidebend away rotate away (SARA)

39
Q

Treatment position for AC7

A

Flex, sidebend TOWARD rotate away (F STAR)

40
Q

Treatment position for AC8

A

F SARA

41
Q

Posterior cervical tenderpoint C1 lateral; position and treatment

A

On the occiput; extended with fine tuning

42
Q

Posterior cervical tenderpoint C1 midline; position and treatment

A

Inion; flexion with fine tuning

43
Q

Posterior cervical tenderpoint C2; position and treatment

A

Inferolateral to the spinous process; extension with fine tuning

44
Q

Posterior cervical tenderpoints C3-8; position and treatment

A

Inferolateral aspects of the spinous processes; they are all E SARA except for C3 which is FLEXED SARA

45
Q

Anterior tenderpoint for rib 1

A

Sternoclavicular joint

46
Q

Anterior tenderpoint for rib 2

A

Midclavicular line, 2nd rib

47
Q

Anterior tenderpoint for ribs 3-6

A

Anterior axillary line for the corresponding ribs

48
Q

Treatment position for anterior ribs 1-6

A

General; seated, flexed neck, sidebend toward, rotate toward.

More specific:

  1. Patient is in the “mermaid” position; seated with the legs up on the table on the side of the tenderpoint
  2. Physician puts knee up on table OPPOSITE the tenderpoint and puts the patients arm over the physician’s thigh
  3. Then sidebend and rotate the patient’s torso toward the tenderpoint and flex the patients neck
49
Q

Posterior tenderpoint for rib 1

A

Posterior surface of rib 1

50
Q

Posterior tenderpoint for ribs 2-6

A

Superior surface of rib angles

51
Q

Treatment position for posterior rib 1

A
  1. Physician is standing behind the patient one knee under the axilla of the patient opposite the tenderpoint
  2. EXTEND, sidebend away, rotate towards
52
Q

Treatment for posterior ribs 2-6

A
  1. Patient sits with legs up on table OPPOSITE of the diagnosis (mermaid-like position again)
  2. Phsyician places foot on the table on the IPSILATERAL side of the diagnosis under the patients axilla
  3. Then you flex the patients neck, sidebend the torso away and rotate the torso away
53
Q

Supraspinatus tenderpoint and treatment

A

Position: Middle of supraspinatus muscle

Treatment:
Grab the arm and Flex, ABDuct, and Externally Rotate
FABDER

54
Q

Infraspinatus tenderpoint and treatment

A

Position: Middle of infraspinatus muscle

Treatment: Flex, internally rotate and abduct the shoulder
FIRABD

55
Q

Levator scapulae tenderpoint and treatment

A

Position: Above the superior angle of the scapula on the levator scapula

Treatment:

  1. Patient is laying prone with their head rotated away from the tenderpoint
  2. Grab the wrist of the patient on the same side as the tenderpoint and internally rotate, abduct, and add traction
56
Q

Iliacus tenderpoint and treatment

A

Location: 1/3 of the distance between ASIS and midline

Treatment: Put the patients legs into the “frog leg” position where the ankles are crossed, hips and knees are flexed to 90 degrees, knees are dropped apart and the legs are resting on the physicians knee

57
Q

Piriformis tenderpoint

A

With the patient prone, find the halfway point between the PSIS and the ILA. Then find the halfway point between that point and the greater trochanter. This should be the location of the piriformis

58
Q

Piriformis treatment

A
  1. With the patient prone, patients ipsilateral leg is off the table, knee is flexed, hip as abducted and leg is externally rotated

OPP final practical (3 decks)

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