HVLA Flashcards

1
Q

Who was the first African-American to be elected President of the AOA and when?

A

William G. Anderson, DO; 1994

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2
Q

Did the AOA beat the AMA to having the first black president?

A

Yes by 1 year

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3
Q

What was William Anderson best know for?

A

Coalition of Desegregation for the Albany Movement in Albany, Georgia 1961

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4
Q

What do we have in normal barrier mechanics?

A
  1. Physiologic Barrier
  2. Anatomic Barrier
  3. Neutral Point
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5
Q

What SD occurs, what happens to motion?

A

It is restricted in one direction forming the restrictive barrier with a new neutral point

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6
Q

What 2 things do we do for this new SD?

A

Engage barrier and thrust or move the joint to the new neutral point to normalize the motion

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7
Q

What does direct mean?

A

Engaging the barrier

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8
Q

Who proposed the 3rd motion law?

A

CR Nelson, DO

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9
Q

What does Principle 3 say?

A

When one motion is introduced, it modifies the others; i.e. when flexion or extension is introduced, the amount of sidebending and/or rotation is changed

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10
Q

What do we apply Fryette and Nelson to ONLY?

A

T1-L5

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11
Q

What do C2-C7 classify as?

A

Type 2 like (some type 3)

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12
Q

What 3 bones do not follow Fryette?

A
  1. C1 (atlas)
  2. C2 (axis)
  3. Sacrum
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13
Q

What MUST we do for HVLA?

A

Thrust along the plane of the facets

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14
Q

Describe the Cervicals and their direction

A

“Shingle like” - superiorly anteriorly, inferiorly posteriorly

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15
Q

Describe the Thoracics and their direction

A

Facet plane - coronal posteriorly

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16
Q

Describe the Lumbars

A

Sagittal

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17
Q

Describe the Sacroiliac

A

L-shaped with a coronal component

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18
Q

Describe the OA

A

Occiput on atlas - “bowl-like” introduces sidebending and rotation to opposite sides

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19
Q

What is AA and how is its movements?

A

Atlas on axis - movement about the dens, rotational

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20
Q

Describe SI

A

Sacroiliac - coronal component, sidebending/rotation to opposite sides

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21
Q

What must we do for the barrier concept?

A

Define your problem before you can hope to fix it

22
Q

What must we be able to do for a diagnosis?

A

Understand and describe what the tissues are doing based on what your hands feel

23
Q

What does Qualitative mean?

A

“End Feel”

24
Q

How do we diagnose SD?

A

TART

25
Q

What part of TART is most important for HVLA?

A

Restriction of motion

26
Q

What do we considered for the R in TART for HVLA?

A

Quantity and Quality; are they localized?

27
Q

What is the necessary skill needed to define Barrier Mechanics?

A

Palpation of restriction of motion

28
Q

What 4 questions do we ask for Q&Q?

A
  1. Is segmental motion symmetrical/normal?
  2. Which directions are freer?
  3. How firm is the end feel at the restriction?
  4. Is the restriction segmental?
29
Q

Give the Quantity, Quality, and End Feel for motion loss by Barrier Mechanics?

A
  1. Notably decreased ROM
  2. No motion lost until barrier is engaged
  3. A palpably distinct endpoint to ROM
30
Q

Give the Quantity, Quality, and End Feel for motion loss with only soft tissue findings

A
  1. Minor QUANTITATIVE motion loss
  2. Rubbery, sluggish throughout that segment’s ROM
  3. Nebulous at best - rubbery feel
31
Q

Define HVLA

A

A rapid impulse of force (HV) traveling a VERY short distance (low amplitude), directed at a firmly held barrier/restriction which has been engaged in all 3 dimensions

32
Q

What is another way to say, “It will go this way, it won’t go that way”?

A

A local restriction of the myofascial components around a specific arthrodial joint, hindering movement of that joint in a specifically definable summed directional vector

33
Q

4 steps to the Basic Concept of HVLA?

A
  1. Identify the arthrodial joint with somatic dysfunction (vertebral unit)
  2. Immobilize one of the bones and hold it there. This may be the segment itself or segment below
  3. Accumulate your forces into the barrier at the dysfunctional joint by moving the second bone
  4. Rapid impulse of force through the second bone into the barrier
34
Q

Describe Lumbar Side Lumbar or Lumbar Roll Technique

A

Hold the segment above (dysfunctional segment) then move the segment below

35
Q

Describe the Thoracic Knee-Back Technique

A

Hold the segment below, then move the segment above (dysfunctional segment)

36
Q

Describe Lumbar or Thoracic Walk-Around Technique?

A

Localize to segment and move segment

37
Q

What do we do for HVLA setup?

A
  1. Engage the barriers (sidebending/rotation, flexion/extension)
  2. Accumulate forces (maintain each barrier as you engage next one)
38
Q

What MUST the end feel be for HVLA?

A

Solid with a distinct barrier to LOCALIZE the forces

39
Q

What do we thrust along?

A

Vector that sums the accumulated (stacked) vectors

40
Q

Do we apply least amount of force to be effective?

A

Yes

41
Q

Do we back off ever before the thrust?

A

No

42
Q

Does the auditory feedback (pop) matter?

A

No

43
Q

What is the famous saying for HVLA?

A

FORCE IS NOT A SUBSTITUTE FOR LOCALIZATION

44
Q

What MUST we do for HVLA?

A

Localize the forces!!!!!

45
Q

What can excessive dosage cause?

A

Hypermobility

46
Q

Why do we do HVLA?

A

To restore normal motion

47
Q

Can we use another technique to relax the patient first?

A

Yes

48
Q

What should we focus on? Avoid?

A

“Key” SD’s; repetitive thrusting on same segment

49
Q

What is the indication for HVLA? IMPORTANT!!!!

A

ARTICULAR SOMATIC DYSFUNCTION WITH IDENTIFIABLE BARRIER MECHANICS

50
Q

What are 3 contraindications for HVLA?

A
  1. Tissue fragility
  2. Severe overlying spasm
  3. Your own intuition (red flag!)
51
Q

What are the treatment choices for HVLA?

A
  1. Quick effective treatment
  2. Easily integrates with other modalities
  3. Patient preference