Lab 3: OMT for Post-Surgical Patient

Question 1

What are the 4 junctions that are assessed for fascial restrictions (i.e., Zink pattern)?

Answer 1

1. Craniocervical
2. Cervicothoracic
3. Thoracolumbar
4. Lumbosacral

Question 2

How do you do perform indirect MFR - Thoracic/Lumbar SD’s in supine position?

Answer 2

• Pt supine w/ doc on side opposite the PTP
• Contact SP on side of PTP and induce force by pulling the SP toward you, causing rotation into the freedom of motion (indirect tx)
• Maintain force until sense of increasing rotation to freedom of motion felt/tissue creep

Question 3

Pedal pump is a good choice for patients who have had surgery where?

Answer 3

Thoracic surgery

Question 4

How to perform MFR of thoracic cage w/ pt in seated position?

Answer 4

• PT seated, leaning forward slightly w/ feet on floor or step stool
• Doc stands behind pt and places hands (fingers spread) on pt’s thoracic rib cage and applies anterior force to engage tssues
• Tissue is moved superior/inferior, right/left, and clockwise/counter-clockwise
• Hold tissue in positions of ease until tissue softens

Question 5

How to perform Quadratus Lumborum Release Tx?

Answer 5

• Pt seated or supine w/ doc on side to be treated
• Palpate the 12th ribs and note if one or the other is pulled more inferior (using tip of rib as reference point)
• Contact the body of the 12th rib and apply anterior and lateral pressure

Question 6

Where is the anterior/posterior chapman’s point for the esophagus?

Answer 6

Anterior = B/l 2nd ICS

Posterior = B/l T2

Question 7

Where is the anterior chapman’s point for the Stomach and Spleen?

Answer 7

- Stomach = L 6th ICS

- Spleen = L 7th ICS

Question 8

How to do Prone I-Sacral Release tx?

Answer 8

• Pt is prone w/ doc standing next to patient
• Place bottom hand over sacrum w/ heel over base and fingers over apex. Place other hand on top in opposite direction
• Evaluate pattern of restriction by rocking sacrum into multiplanar direction, noting laxity and restriction
• Tx indirect or direct barrier by stacking dysfunction and consider utilizing REMs

Question 9

How to do Upper Limb and Shoulder MFR tx?

Answer 9

• Pt is prone w/ arm dangling over table and doc seated on side of dysf.
• Grasp humeral head of pt w/ both hands and monitor the tissues for tissue texture response to: F/E, IR/ER, AD/ABduction, Protraction/Retraction of scapula, Superior/Inferior scapular motion, Traction/Compression
• Engage either for direct or indirect MFR.

Question 10

After stacking the RB’s while doing Still’s Wrist MFR, what do you instruct the pt to do?

Answer 10

• Make a fist and/or spread fingers widely for 5 seconds and then relax hand
• Doc then engages new RB and repeats until no new RB’s met