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Osteopathic Skills > CPA #3 > Flashcards

CPA #3 Flashcards

1
Q

ART, Upper Thoracics (T1-4), Type 2, seated

A
  1. Pt seated, phys stand behind/sit next to
  2. Phys place thenar em of posterior hand (or ipsilateral hand) on prox paraspinal thoracic tissue in dysfxn area.
  3. Other hand reach in front and cup patient head
  4. Induce side bend of head toward phys while apply springing force perpendicular to length of vert at thoracic SD.
  5. Continue throughout or at local segment.
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2
Q

ART, Lower thoracic (T5-12), Sidebending SD, Prone

A
  1. Phys: caudal hand on opposite side of spine, fingers point cephalad, thenar eminence over transverse process of dysfxn segment
  2. Cephalad hand on near side of spine. Hypothenar eminence over opposite TP, fingers point caudad
  3. Apply ant pressure
  4. Exert longitudinal force at same time with both hands. Slowly release pressure
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3
Q

ART, Low Thoracics, Type 1 SD, Seated

A
  1. Pt sit, place ipsilateral hand to PTP behind neck and hold elbow.
  2. Phys: monitor dysfxn seg with thumb and index, monitor one below with middle finger.
  3. Pass over one bicep. Position into sidbending RB, then rotation RB.
  4. Induce motion into one plane toward and through RB.
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4
Q

ART, Low Thoracic, Type 2, extension SD, seated

A
  1. Doc stand behind pt, who is seated with arms folded across chest
  2. Doc place hand on opp shoulder.
  3. Stabilize lower of the two vert being treated by grasping spinous process
  4. Flex thorax into restriction.
  5. Hold in RB for 1-2 sec, return to neural
  6. Repeat
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5
Q

ART, Low Thoracic, Type 2, Flexsion SD, seated

A
  1. Doc stand behind pt who has arms folded across chest
  2. Doc stabilize opposite shoulder.
  3. Stabilize lower of two vert being treated by grasping spinous process.
  4. Induce extensions by applying anterior force while bending the thorax back.
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6
Q

ART, Low Thoracic, Rotation SD, Seated

A
  1. Stand behind/sit beside pt who is seated with arms crossed.
  2. Put hand on opp shoulder
  3. Place thenar eminence at TP of dysfxn seg contralateral to doc
  4. Doc induce Rotation force by pulling shoulder anteriorly and press ant with thenar em
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7
Q

MET, Up thoracic, type 1, SD, seated

A
  1. Pt seated with doc behind on opp side of PTP
  2. Doc monitor TP of Apex of dysfxn group with thumb and index. Middle finger monitor one below.
  3. Place other hand on pt head, induce side bending into RB
  4. Induce rotation by rotating head
  5. Instruct pt to hold inhale and resist force/return to neutral.
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8
Q

Met, Up thoracic, type 2 SD, seated

A

Same as type one with added flexion/extension.

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9
Q

Met, lower thoracic, type 1, seated

A
  1. Pt seat doc at opp side of PTP
  2. Pt grasp neck with ipsilateral hand to PTP, grasp elbow
  3. Phys monitor TP at apex of group dysfxn with thumb and index, one below with middle finge.
  4. Pass over one bicep.
  5. Move pt into rotation and sidebend RB
  6. Pt hold inhal and resist/return to neutral
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10
Q

Met, Low Thoracic, type 2, seated

A

Same as type 1 but pass over 2 arm + flex/extend

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11
Q

ART Lumbar SIde bend SD, seated

A
  1. Doc behind and beside pt who seated with arm cross
  2. Doc place arm over pt should with hand on opp shoulder
  3. Place thenar eminence at TP of dysfxn vert on ipsilateral side
  4. Induce sidebend force by press down with Axilla while induce lateral translation away from dr with thenar eminence
  5. Hold 1-2 sec
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12
Q

ART lumbar rotation SD, seated

A
  1. Doc stand behind and beside pt who seated with arm folded
  2. Doc place arm over pt shoulder with hand on opp shoulder
  3. Thenar em at TP of dysfxn vert on contralateral side.
  4. Induce rotation wile pressing ant with thenar em
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13
Q

ART Lumbar sidebend SD, Lateral Recumbent

A
  1. Stand at side of table in front of pt
  2. Flex pt knees and hips to 90 degree
  3. Doc place left had so fingers palp spinous process lumbar spine
  4. Place right Han and forearm under pt ankles and lift upward until left hand palpated induced left side bending.
  5. Hold stretch 1-2 sec, return neutral
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14
Q

ART lumbar type 2 flex SD, seated

A
  1. Doc stand beside pt
  2. Place arm over pt shoulder with hand on opp shoulder
  3. Stabilize segment inferior to dysfxn by grasping spinous process with fingers and thumb with finer and thumb/ or use thenar em over S.P.
  4. Extend by anterior translation of stabilizing hand, bend Thoracolumbar region around fulcrum.
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15
Q

ART LUmbar type 2 extension SD seated

A
  1. Doc beside pt
  2. Arm over pt shoulder with hand on opp shoulder
  3. Stabilize seg inferior to dysfxn segment by grasping spinous process with fingers and thumb. Or use thenar eminence
  4. Direct flexion force towards stabilizing hand, tapping in intervertebral joint space.
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16
Q

MET lumbar type 1 SD seated

A
  1. Pt seated with doc standing behind pt opposite PTP
  2. Pt place hand on ipsilateral side ofPTP at neck. Grab elbow
  3. Monitor at apex of curve with caudad hand, cephelad goes over one bicep
  4. Flex pt torso until motion is felt under monitoring hand.
  5. Engage rotiang and SB until motion is felt.
  6. Pt return to neutral/resist force.
17
Q

MET lumbar type 2 SD seated

A
  1. Pt seated doc standing behind opposite the PTP
  2. Pt place hand at neck on same side as PTP, grab elbow
  3. Monitor at apex.
  4. Other hand pass over 2 bicep
  5. Flex/extend, then rotate and SB
  6. Return to neutral/resist force
18
Q

MET lumbar type 1 SD, lateral recumbent

Long lever technique

A

NUDR
Neutral dysfxn, PTP up, pt force down, recumbent

  1. Pt lat recumbent, PTP up, doc face pt.
  2. Monitor at apex of curve with cephalad hand
  3. Flex hop and knee until motion felt under monitoring hand
  4. Lift pt ankles, side bending the lumbar spine into barrier.
  5. Pt push ankle towards floor.
  6. Relax, repeat
19
Q

MET lumbar type 2, extended SD lat recumbent.

Long lever.

A

SUUE
Modified sims, PTP up, pt force up, extension dysfxn

  1. Pt in mod sim, (lat recumbent, pt hug table.) PTP up, doc face pt.
  2. Monitor dysfnc with cephelad hand
  3. With caudad, flex hip and knees through dysfunctional seg, engage flexion barrier.
    Pt legs dropped off table to engage side bending barrier.
  4. Pt asked to raise both ankles up against counterforce.
  5. Relax, repeat.
20
Q

Met lumbar type 2 flex sd lat recumb

Long lever

A

FDDR
Flexed dysfxn, PTP down, pt force down, lat recumb.

  1. Monitor at dysfxn with caudad hand.
  2. Grasp pt. Arm pull ant/sup engage rotation and SB barrier.
  3. Switch monitoring hand.
  4. Straighten bottom leg, engage extension barrier.
  5. Engage SB barrier, life ankles.
  6. Pt push down
21
Q

Met lumbar type 1 sd lat recumb

Long restrictor technique

A
  1. Pt lat recumb, PTP down, phys face pt.
  2. Caudad hand or thigh to flex pt knees and hips while cephelad hand monitors apex of curve.
  3. Fine tune flex extension of hip until dysfxn is neutral.
  4. Pt top leg lowered off edge of table, caus ant rotation of pelvis, until monitor hand detects motion
  5. Switch monitor hands, use cephelad hand to move pets top shoulder post until caudad detects motion.
  6. Pt push should against counterforce.
  7. Pt pull hip post and cephelad agains resistance
22
Q

Met lumbar type 2 sd lat recumb. Long restricor

A
  1. Pt lat recumb, PTP down. Doc face pt
  2. Caudad hand/ thigh flex pt knees and hips while celphelad hand monitor segment
  3. Fine tune flex extend until seg is neutral
  4. Place pt top foot behind bottom knee in popliteal fossa.
  5. Switch monitor hands, cephelad move to pt top shoulder posteriorly until caudad detect motion
  6. Pt push shoulder forward against counterforce.
  7. Pt pull hip post agains resistance

Osteopathic Skills (2 decks)

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