CPA2 Flashcards
supine t-spine hvla
doc opposite ptp; pt arms crossed over chest, w/ ptp side arm on top
doc caudal thenar eminence on ptp, doc abdomen placed on pts elbows, doc cephalad hand positions neck (type 1 SB away from doc, type 2 SB towards doc)
pt exhales x2, doc thrusts through abdomen
prone t-spine hvla
doc opposite ptp,hands placed facing opposite directions on each side of spine (type 1 - ptp side facing caudad, type 2 - ptp side facing cephalad)
pt exhales x2, doc thrusts and twists
supine knee fulcrum hvla - upper and middle thoracics
pt supine w/ fingers behind neck, doc at head w/ ipsilateral knee to ptp as the fulcrum
docs hands pass through pts arms and encircle ribs
pt exhales x2, doc pulls pts chest down into thigh and adds cephalad traction
seated lower t spine hvla
pt seated w/ ptp side hand behind neck and holding their elbow with other hand; doc opposite ptp
doc ipsilateral thenar eminence on SD vertebrae, other hand grasping bicpes (t1 vs t2)
doc engages RB in all 3 planes, pt exhales x2, doc pulls pt through RB w/ slight anterior force from monitoring hand
hvla seated knee fulcrum technique
pt seated w/ hands behind neck, doc behind pt
doc ptp side knee on vertebrae, doc hands beneath pt arms and grasps forearms
pt exhales x2, doc pulls pt superiorly and posteriorly
ribs 1-4 hvla
pt prone, doc opposite SD side
pt cubs chin w/ hand ipsilateral to SD, doc places thenar/hypothenar eminences at SD w/ cephalad hand while caudad hand goes on pts head rotating it towards the SD into the barrier
pt exhales x2, doc applies anterolateral thrust on SD rib (hand on head only stabilizes)
seated 1st rib inhlalation dysfunction hvla
pt seated, doc behind w/ foot on table opposite SD and pts arm draped over it
doc contacts SD rib w/ second MCP joint of one hand and top of pts head w/ other hand
doc engages barrier by SB head towards SD rib, pt exhales and thrusts inferior/medially on the superior rib (load 1st exhale, thrust second)
ribs 3-10 bucket handle inhalation SD hvla
pt supine, doc opposite SD rib
pt crosses arms over body w/ SD side arm on top, doc caudal thenar eminence posterior and superior to angle of SD rib while other hand elevates pt head
doc applies pressure through elbows localizing at SD rib, pt exhales x2 and doc applies posterior thrust towards thenar eminence
ribs 3-10 bucket handle exhalation SD hvla
pt supine, doc opposite SD rib
pt arms crossed over body w/ SD side arm on top, doc caudad thenar eminence of caudad hand on posterior/inferior border of SD rib and other hand elevates pts head
doc applies pressure through elbows localizing at SD rib, pt exhales x2 and doc applies posterior thrust slightly caudal to thenar eminence
modified kirksville crunch (same side SD hvla)
pt supine, doc same side ptp
pt arms over chest w/ ptp arm on top, doc thenar eminence of cephalad hand on ptp and other hand grasps pts elbows and raises them until vector is felt on ptp
posterior hand induces SB, pt exhales x2, doc exerts pressure through abdomen
superior innominate shear hvla
pt supine w/ feet off end of table, doc at foot of table grasping pts tibia and fibula superior to ankle
doc IR and abducts leg, leans back, and pt exhales x2-x3 and at the end an downward thrust is exerted
inferior innominate shear hvla hands
pt lateral recumbent w/ SD up, doc behind pt w/ cephalad hand on PSIS and caudad hand on ASIS
doc provides lateral distraction to gap the joint, then cephalad force, pt exhales x2-x3 and at the end a cephalad thrust is exerted
inferior innominate shear hvla forearms
pt LR w/ SD up, doc in front of pt w/ hands monitoring lumbosacral junction
pt straightens bottom leg and places foot of top leg just distal to popliteal fossa
doc cephalad hand motiors SI joint, caudad forearm is placed inferior to ischial tuberosity; pt exhales x2, cephalad force from forearm
anterior innominate rotation hvla
pt LR w/ SD up, doc in front of pt w/ cephalad hand b/w L5/S1 and caudal hand flexing pts hips until motion is felt at the joint
doc drops pts top leg off of the table
cephalad hand moves to antecubital fossa w/ forearm on shoulder, caudad forearm placed along pelvis b/w PSIS and troachanter
pt exhales x2, force directed down femur shaft
posterior innominate rotation hvla
pt LR w/ SD up, doc in front of p w/ cephalad hand b/w L5/S1 and caudad hand flexing pts hips until motion felt
pt straightens bottom leg and top foot placed distal to popliteal fossa
doc cephalad hand moves to antecubital fossa w/ forearm on shoulder and caudad forearm on PSIS and iliac crest
pt exhales x2, force directred towards umbilicus
pubic restriction hvla
pt supine, knees flexed w/ feet flat on table; doc standing on either side of pt
MET alternation w/ hips
w/ final cycle, exert abduction force while pt is adducting
bilateral sacral flexion hvla
pt prone, doc at side monitoring SI joint and abducting the legs until motion is felt then IR
doc heel of hand on APEX of sacrum
pt inhales x2, final inhale apply anterior/superior thrust on sacrum
bilateral sacral extension hvla
pt prone in sphinx, doc beside pt monitoring SI and abducting legs until motion felt then ER
heel of doc hand is at base of sacrum
pt exhales x2, last exhale anterior/inferior thrust into sacrum
sacral torsion hvla
pt supine w/ hands behind neck, doc on axis side
SB pt LE AND torso away, creating a C-shape; caudal hand thenar eminence on contralateral ASIS and cephalad hand grasping pts contralateral distal bicep
cephalad hand induces rotation of torso into barrier pulling the opposite elbow towards self while stabilizing and preventing motion w/ other hand
pt exhales x2, thrust down through ASIS
L1-5 extension/neutral SDs - long lever, walk around
pt supine w/ hands behind neck, doc opposite PTP monitoring segment and SB pt towards RB by making C-shape away from doc
doc cephalad hand on pts contralateral distal bicep, caudad hand on contralateral ASIS
rotate pt trunk w/ cephalad hand into RB, pt exhales x2, rotational thrust down on arm
type 1 lumbar lateral recumbent hvla
pt LR w/ PTP up, doc in front of pt
grasp pts bottom arm and pull anterior/CEPHALAD while monitoring vertebrae to engage SB; then switch monitoring hands and flex hips until motion felt, then pt extends bottom leg and top leg goes in pop fossa
cephalad forearm on pts anterior shoulder, caudal forearm contacts line b/w PSIS and greater trochanter ; push shoulder posterior and hip anterior to engage RB
pt exhales x2, rotational thrust same direction
type 2 lumbar lateral recumbent hvla
pt LR w/ PTP up, doc facing pt
grab pts bottom arm and pull anterior/CAUDAD while monitoring PTP; switch and flex hips while monitoring
for T2E - leave bottom leg slightly bent w/ superior leg crossed over the bottom
For T2F - pt straightens bottom leg and places top foot into bottom legs popliteal fossa
caudal forearm contacts posterior pelvis from SI to greater trochanter, cephalad arm contacts pts anterior shoulder; caudal forearm rolls pelvis anterior into RB
pt exhales x2, rotational thrust through RB
cervical ST/MFR techniques
SO release, contralateral traction
OA SD hvla
pt supine, doc at head
doc contacts right occiput posterior to mastoid process and other hand grasps head
move head into RB and adds cephalad traction, thrust into RB w/ exhalation
AA SD hvla
pt supine, doc at head
cradle head w/ thumbs anterior to ears and rotate into RB while flexing C-spine
apply rotation through RB w/ exhalation
C2-C7 rotational emphasis hvla
pt supine, doc at head
docs index fingers from bridge on affected vertebrae spinous processes, and flexes head until motion felt
SB head towards freedom, rotate into RB and apply thrust in rotational plane w/ exhalation
C2-C7 SB emphasis hvla
pt supine, doc at head
docs index fingers form bridge and flexes head until motion felt
rotate into freedom, SB into RB; SB side hand applies thrust and other hand stabilizes head
upper cervicals = thrust towards eye
middle cervicals = thrust straight across neck
lower cervicals = thrust down towards chest
