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OS-II CPA 1 > Counterstrain > Flashcards

Counterstrain Flashcards

1
Q

What are the 7 steps?

A
  1. Find a significant Tender Point.
  2. Establish a tenderness scale: rank this pain on a scale from 1-10
  3. Monitor Tender Point throughout (as you are placing in position of ease)
  4. Place patient in “Position of Ease.” (where tissue softens)
  5. Hold 90 seconds.
  6. Slowly return to neutral.
  7. Recheck tenderness.
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2
Q

You want to examine ALL of the affected area to find the MOST significant tender point.

If multiple tender points, which one do you treat?

A
  1. treat the most tender first
  2. if more than 1 have the same tenderness, treat most central and/or proximal
  3. if thoracic and rib TP, treat thoracic 1st
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3
Q

Steps:

A
  1. TART screen: cerivical spine, thoracic spine, lumbar spine. If you find one, check segment above and below.
  2. Counterstrain tenderpoint examination of abnormal vertebral segmental level and examine level above and below.
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4
Q

Where is PC2-P8 located?

PC1 inion

PC1 occiput

PC2 occiput?

A

PC2- superior aspect of C2 spinous process

PC3- inferior aspect of C2 spinous process

PC4- inferior aspect of C3 SP

PC5-inferior aspect of C4 SP

PC6- inferior aspect of C5 SP

PC7- inferior aspect of C6 SP

PC8- inferior aspect of C7 SP

PC1 inion: inferior nuchal line; lateral to inion

PC1 occiput: On the inferior nuchal line midway between inion and mastoid

PC2 occiput: in between the PC1 inion and PC1 occiput

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5
Q

PC1 inion

A

PC1 inion- on the inferior nuchal line; lateral to inion

F St RA (FSTAR

  1. Find point
  2. Establish tenderness scale
  3. Monitor point as you put them in position of ease
  • Flex occiput
  • SB towards
  • Rotate away. Ask pain on a scale from 1-10 again
  • Hold 90 seconds
  1. Slowly and passively return to neutral
  2. Recheck tenderness.
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6
Q

PC1 occiput

PC2 occiput

A

E SaRa

  1. Find point
  2. Establish tenderness scale
  3. Monitor point as you put them in position of ease
  • Extend
  • SB away
  • Rotate away. Ask pain on a scale from 1-10
  • Hold 90 seconds
  1. Slowly and passively return to neutral
  2. Recheck tenderness.
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7
Q

PC2

&

PC4-8

A

e- E SaRa (as you go down, more, you need more extension)

  1. Find point
  2. Establish tenderness scale
  3. Monitor point as you put them in position of ease
  • Extend
  • SB away
  • Rotate away. Ask pain on a scale from 1-10
  • Hold 90 seconds
  1. Slowly and passively return to neutral
  2. Recheck tenderness.

PC1 occiput, PC2 occiput

PC2-8 are all e-R SaRa; except PC3, which is F SaRa

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8
Q

PC3

A

f-F Sa Ra

  1. Find point
  2. Establish tenderness scale
  3. Monitor point as you put them in position of ease
  • flex
  • SB away
  • Rotate away. Ask pain on a scale from 1-10
  • Hold 90 seconds
  1. Slowly and passively return to neutral
  2. Recheck tenderness.
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9
Q

Where are your posterior thoracic counterstrain points located?

A

PT1-12 are located

on the inferior aspect of SP and the TP

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10
Q

PT 1-12 SP (spinous process) Counterstrain

A

e-E

  1. Find point
  2. Establish tenderness scale
  3. Monitor point as you put them in position of ease
  • Have pt lay on stomach
  • SP 1-6, leave arms hanging off of the side of table
  • SP 7-12, stretch arms in front of you.
  • Extend patients head (use head of the bed and lift up to extend even more for lower segments)
  • Ask pain on a scale from 1-10
  • Hold 90 seconds
  1. Slowly and passively return to neutral
  2. Recheck tenderness.
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11
Q

PT 1-3 Transverse Process

A

E Sa Ra

  1. Find point
  2. Establish tenderness scale
  3. Monitor point as you put them in position of ease
  • Pt is on back with head hanging off table
  • SB away
  • R away
  • Ask pain on a scale from 1-10
  • Hold 90 seconds
  1. Slowly and passively return to neutral
  2. Recheck tenderness.
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12
Q

PT 4-9 Transverse Process

A

E Sa RT

  1. Find point
  2. Establish tenderness scale
  3. Monitor point as you put them in position of ease
  • Pt is prone; doctor is on opposite side the tender point.
  • SB away
  • Lift up opposite shoulder and rock on heels
  • Ask pain on a scale from 1-10
  • Hold 90 seconds
  1. Slowly and passively return to neutral
  2. Recheck tenderness.
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13
Q

PT 10-12 TP

A

e-E Sa Ra (pelvis)

Rt (torso)

  1. Find point
  2. Establish tenderness scale
  3. Monitor point as you put them in position of ease
  • Pt is prone; doctor is on side of TP
  • Touch TP on the side youre on; SB away
  • Lift up ASIS on opposite side of doc
  • Ask pain on a scale from 1-10
  • Hold 90 seconds
  1. Slowly and passively return to neutral
  2. Recheck tenderness.
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14
Q

Where are PL1-PL5 SP at?

A

On the inferolateral aspect of THAT SP.

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15
Q

Where are PL1-3 TP at?

A

On the respective TP of THAT segment

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16
Q

PL1-5 SP counterstrain

A
  1. Find point
  2. Establish tenderness scale
  3. Monitor point as you put them in position of ease
  • Pt is prone; doctor is on opp side of tender point
  • Touch TP
  • Extend and adduct leg on the side the tender point is located

Ask pain on a scale from 1-10

Hold 90 seconds

  1. Slowly and passively return to neutral
  2. Recheck tenderness.
17
Q

PL1-3 TP Counterstrain

A
  1. Find point
  2. Establish tenderness scale
  3. Monitor point as you put them in position of ease (JUST LIKE PT10-12 TP, except touch opp TP)
  • Pt is prone; doctor is opp side of TP
  • Touch TP
  • Rotate away
  • Lift up ASIS on opposite side of doc
  • Ask pain on a scale from 1-10
  • Hold 90 seconds
  1. Slowly and passively return to neutral
  2. Recheck tenderness. (LO)
18
Q

Where is

  • UPL5
  • LPL5
  • HISI (high ilium sacroiliac)
  • PL3 gluteus
  • PL4 gluteus
A
  • UPL5- superior medial border of the PSIS
  • LPL5- inferior to PSIS, pressing anteriorly
  • HISI (high ilium sacroiliac)- about 2-3 cm lateral to PSIS
  • PL3 gluteus -2/3 of the way from the PSIS -> TFL
  • PL4- Posterior border of TFL
19
Q

UPL5

A
  1. Find point
  2. Establish tenderness scale
  3. Monitor point as you put them in position of ease
  • Pt is prone; doctor is opp side of TP
  • Touch TP on opp side
  • Extend, adduct knee on opposite side of doc and then add IR/ER.
  • Ask pain on a scale from 1-10
  • Hold 90 seconds
  1. Slowly and passively return to neutral
  2. Recheck tenderness.
20
Q

LPL5 (lower pole L5) Counterstrain

A
  1. Find point
  2. Establish tenderness scale
  3. Monitor point as you put them in position of ease
  • Pt is prone; doctor is same side of TP
  • Touch TP on same side
  • Let pts same leg hang off table and flex hip and knee.
  • Internally rotate the leg
  • Ask pain on a scale from 1-10
  • Hold 90 seconds
  1. Slowly and passively return to neutral
  2. Recheck tenderness.
21
Q

HISI Counterstrain

A
  1. Find point
  2. Establish tenderness scale
  3. Monitor point as you put them in position of ease
  • Pt is prone; doctor is same side of TP
  • Touch TP on same side
  • Extend the leg on same side, abduct and externally rotate. (e-E Abduct ER)
  • Ask pain on a scale from 1-10
  • Hold 90 seconds
  1. Slowly and passively return to neutral
  2. Recheck tenderness.
22
Q

PL3 and PL4 Gluteus Counterstrain

A

Same technique as HISI, just touching a different spot.

PL3- 2/3 of the way from the PSIS -> TFL

PL4- Posterior border of TFL

OS-II CPA 1 (7 decks)

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