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

Counterstrain: Posterior Trunk - Lab/OSCE Flashcards

1
Q

8 steps of counterstrain

A
  1. Locate SD2. Find tender point3. Establish pain scale4. Wrap around tender point while monitoring5. Reduce pain by at least 70%6. Maintain position for 90 sec7. Passively return to neutral8. Reassess
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2
Q

Posterior cervical (all) - treatment position

A

Supine, physician seated at head

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3
Q

PC1 inion - location and treatment

A

Location - 1-2 cm inferior to external occipital protuberance, slightly lateral, on insertion of semispinalis capitusTreatment - Cradle head, place monitoring hand on forehead, flex neck to position of comfort

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4
Q

Special feature about PC1 inion

A

“Maverick point” - treat via lengthening tissues around the point rather than shortening/wrapping around

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5
Q

PC1 - locationPC2 - locationTreatment (both)

A

PC1 - 3cm below inion, 1cm medial to occipitomastoid suture, press anteromediallyPC2 - main muscle mass about 2-3 cm lateral to midline, just below occiputTreatment - ESARA

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6
Q

PC3 location and treatment

A

Location - Inferolateral C2 spinous processTreatment - FSARA (flex to 45º), may require FSTRA instead

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7
Q

PC4-7 - location and treatment

A

Location - Inferolateral spinous process of the spinal NERVE that runs through (ex. PC3 = C2 SP)Treatment - ESARA

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8
Q

PC8 - location and treatment

A

Location - same as PC 4-7Treatment - FSARA or ESARA, whichever works better

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9
Q

Posterior thoracic points - although the points are MIDLINE, rotating AWAY means _______

A

AWAY from the side of dysfunction (lateralized)

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10
Q

ALL posterior thoracic points (T1-12) - location

A

Spinous process of that vertebra

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11
Q

T1-9 posterior thoracic points - common positioning for treatmentWhat changes as you go down the spine?

A

Prone, doc cups pt’s chin (1 hand) and monitors TP (other hand). ESARA from there- Where pt’s arms are draped- If pillow is used under pt’s chest or not

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12
Q

T1-3 - treatment specifics

A

Arms draped to SIDES

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13
Q

T4-6 - treatment specifics

A

Arms draped over TOP of table (to extend T spine)

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14
Q

T7-9 - treatment specifics

A

Arms draped over TOP of table WITH PILLOW under chest

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15
Q

T10-12 - treatment (all)

A

Prone, arms draped over TOP of table WITH PILLOW under chest, doc grabs ASIS on side OPPOSITE the dysfunction and induces further lower spine extension

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16
Q

For RIB counterstrain, a posterior tender point means _____

A

ELEVATED (inhalation dysfunction)

17
Q

Posterior ribs counterstrain - length of treatment?

A

120 seconds

18
Q

PR1 - location and treatment

A

Location - Posterior rib head under trapezius margin
Treatment - Seated, doc standing behind/to side, pt’s arm on side of dysfunction is draped over doc’s knee, doc SB and R pt’s HEAD toward dysfunction and extends slightly

19
Q

PR2 - location and treatment

A

Location - Superior surface of rib angle at medial border of scapula (2-2.5 inches lateral to midline)
Treatment - Seated, doc standing behind/to side, pt’s arm on side of dysfunction is draped over doc’s knee, doc SB and R pt’s TRUNK away from dysfunction, then SB/R head away

20
Q

PR3-6 - location and treatment

A

Location - superior surface of rib angles at medial border of scapula, 2-2.5 inches lateral to midline
Treatment - Seated, doc standing behind/to side, pt’s arm on side of dysfunction is draped over doc’s knee, doc SB and R pt’s TRUNK away from dysfunction, then SB/R head away

21
Q

PL (posterior lumbar) 1-5 MIDLINE - location and treatment

A

Location - midline on spinous processes

Treatment - Prone, doc stands on side of tender point, extends pt’s same side hip to tender point and fine tune

22
Q

PL 1-3 Transverse Process - location and treatment

A

Location - on transverse process

Treatment - Prone, doc stands opposite of TP, extends hip (TP side) to TP and rotates leg towards, fine tuning

23
Q

UPL5 (upper) - location and treatment

A

Location - superior medial edge of PSIS

Treatment - Prone, doc stands opposite of TP, extends hip (TP side) to TP and rotates leg towards, fine tuning

24
Q

LPL5 (lower) - location and treatment

A

Location - Inferior aspect of PSISTreatment - Prone, leg of TP side hanging to side of table, flex hip and knee to 90º, add adduction and internal rotation to hip

25
Q

PL3 Lateral - location and treatment

A

Location - 2/3 lateral btwn PSIS and tensor fascia lata

Treatment - Prone, extend hip on side of TP and fine tune

26
Q

PL4 Lateral - location and treatment

A

Location - Posterior margin of tensor fascia lata

Treatment - Prone, extend hip of side of TP and fine tune

27
Q

PS1 (bilateral) - location and treatment

A

Location - sacral sulcus (1/2 inch medial to inferior PSIS) b/l
Treatment - Prone, apply anterior pressure diagonally opposite location of TP (ex. PS1 TP on L = doc applies pressure to R ILA)

28
Q

PS2-4 (Midline) - location and treatment

A

Location - Midline on sacrum btwn/below sacral spines

Treatment - Prone, apply anterior pressure on midline apex or base of sacrum to produce transverse axis rotation

29
Q

PS5 (bilateral) - location and treatment

A

Location - 1/4 inch medial and superior to ILA b/lTreatment - Prone, apply anterior pressure diagonally opposite the TP (ex. PS5 TP on L = doc applies pressure to R sacral sulcus)

30
Q

High Ilium (HI) - location and treatment

A

Location - Lateral aspect of PSIS

Treatment - Prone, monitor TP, extend hip and fine tune with abduction/adduction

31
Q

High Ilium flare-out (HIFO) - location and treatment

A

Location - 1.75 in below and 1/4 inch medial to lower PSIS

Treatment - Prone, extend leg and induce adduction over opposite leg and slight ER

32
Q

Piriformis - location and treatment

A

Location - 1/2 to 2/3 the distance from ILA to greater trochanter
Treatment - Prone, monitor TP, flex leg over side of table to 135º, abducting and externally rotating the hip

33
Q

Flare-in sacroiliac (FISI) - location and treatment

A

Location - 4 inches below PSIS, slightly lateral

Treatment - Prone, abduct hip and flex just until knee is below the top edge of table, fine tune with external rotation

OS 3, Exam 2 (10 decks)

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