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OS 3, Exam 2 > Counterstrain: Anterior Trunk - Lab/OSCE > Flashcards

Counterstrain: Anterior Trunk - Lab/OSCE Flashcards

1
Q

What do you treat first if there is more than one point of similar tenderness, in the thoracics and ribs?

A

Treat the most tender, most central/proximal, and thoracic first.

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2
Q

AC1 location and treatment position

A
  • Tip of TP on C1, high on posterior edge of ascending ramus at earlobe.
  • Tx - Pt supine, doc at head of table, RA
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3
Q

AC2-6, AC8 location and treatment position

A
  • Anteriolateral aspect of transverse process of affected vertebra
  • Tx - Pt supine, doc at head of table, FSARA
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4
Q

AC7 location and treatment position

A
  • Posterosuperior surface of proximal clavicle where SCM inserts
  • Pt supine, doc at head of table, FSTRA
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5
Q

What tenderpoint is lateral to AC8 tenderpoint?

What muscle do these two tenderpoints seem to be related to?

A

AC7

SCM insertions

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6
Q

AC8 requires the same flexion as what other anterior cervical?

A

AC3

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7
Q

AT1-AT8 Treatment

A
  • Position - pt supine with feet flat on table, doc at head of table
  • Doc places nee under upper back to wedge/flex pt to involved vertebra. Fine tune flexion with other hand.
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8
Q

AT9-AT12 Locations

A

AT9 - Midline 1-2 cm above umbilicus
**AT10 - Midline about 1-2 cm below umbilicus
AT11 - Midline about 3-4cm below umbilicus
AT12 - mid-axillary line on superior-medial surface of iliac crest

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9
Q

AT9-AL1Treatment

A
  • Position - pt supine with doc on SAME SIDE as tenderpoint with FOOT ON TABLE
  • Doc flexes pt’s leg/hip to 90degrees with fine tuning rotation toward doc. FSTRT
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10
Q

AL 5-6T Location
AL 7-8T Location
Treatment

A
  • AL 5-6T: At costosternal joint at affected level
  • AL 7-8T: On inferior medial surface of costasl cartilages, 1 and 2 inches inferolateral from xiphoid
  • SAME TX - Pt SEATED, doc behind pt with leg on table under pt’s arm on unaffected side - FSTRA
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11
Q

What are anterior rib (1-6) tenderpoints usually indicative of?
What are posterior rib tenderpoints usually indicative of?

A

Anterior TP = Depressed rib = exhalation dysfunction

Posterior TP = Elevated rib = inhalation dysfunction

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12
Q

AR1 location
AR2 location
Treament

A
  • AR1: Inferior to clavicle on rib1, lateral to manubrium (inf to SC joint)
  • AR2: 1.5 in lateral to manubrium on rib 2 at mid-clavicular line
  • SAME Tx - Pt supine, doc at head of table. FLEX NECK to 45. F-STRT the neck
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13
Q

What does AR1-2, AR3-6 counterstrain treat?

A

Treats a depressed rib, inhalation restriction.

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14
Q

AR3-6 location and treament

A
  • Anterior axillary line on ribs 3-6

- Tx - Pt SEATED, doc behind with knee under arm of UNAFFECTED side. FSTRT to neck and torso.

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15
Q

AL1 location

A

Location - Medial to ASIS

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16
Q

AL2 location and treatment

A

Location - Medial and inferior to AIIS
Tx - pt supine, doc on OPPOSITE SIDE of the TP with foot on table. Flex pt’s knees/hips 90 degrees and rotate 60 toward doc. FSART

17
Q

What is special about AL2 treatment?

A
  • Requires significant rotation of flexed femurs away from tenderpoint side.
18
Q

AL3 location
AL4 location
Treatment

A
  • AL3 location - lateral to AIIS
  • AL4 location - inferior aspect of AIIS
  • Treatment - pt supine, ankles toward physician, minimal knee rotation toward doc. FSART.
19
Q

AL5 location and treatment

A
  • Location - anterior aspect of pubic bone, 1cm lateral to pubic symphysis
  • Tx - pt supine, doc on SAME SIDE of TP with foot on table. Flex hip to 135 degrees and push ankles away/knees toward doc. FSTART
20
Q

Iliacus (IL) location and treatment

A
  • Location - in lower quadrant, 1-2 in medial to ASIS deep in iliac fossa
  • Tx - pt supine, doc on SAME SIDE as TP with foot on table. Flex knees/hips to 90, ankles crossed on doc’s knees = ER of hips &raquo_space; FROG LEGGED
21
Q

Low ilium (LI) location and treatment

A
  • Location - superior aspect of lateral ramus, where psoas m crosses pelvic rim.
  • Tx - pt supine, doc on SAME SIDE of TP. Flex 1 knee/hip to 90, ER hip, fine tune with AD/AB.
22
Q

Inguinal ligament (inlig) locatoon and treatment

A
  • Location - lateral surface of pubic bone near attachment of inguinal ligament
  • Tx - pt supine, doc SAME SIDE of TP with foot on table, F knees/hips to 90, rest on doc’s knee. Cross opposite ankle over leg on side of doc with ankles toward doc. (IR hip on side of TP).
23
Q

If both thoracic TP and rib TP are present, which is treated first?

A

Thoracic.

24
Q

AT1 location

A

Midline in suprasternal notch

25
Q

AT2 location

A

Midline on the manubrium

26
Q

AT3-4 location

A

Midline at level of costal cartilage related to the named vertebra.

27
Q

AT5 location

A

Midline 1 inch above the xiphoid junction

28
Q

AT6 location

A

Midline at sternal-xiphoid junction

29
Q

AT7 location

A

Midline at tip of xiphoid

30
Q

AT8 location

A

Midline 1.5inches below the xiphoid

OS 3, Exam 2 (10 decks)

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