Last CPA Flashcards
Overall
- TART
- Diagnosis
- Treat with either Direct or Indirect (they will tell you which)
- Reassess for 2/4 TTAs
- Be as expedient as possible
Cervical Spine
• OA: Type 1 like S and R opposite
• AA: rotation only (No flexion extension component)
• C2-7: Type 2 like S and R same (has flexion component)
Direct treatment
• OA: ME Go all 3 components into barrier, they try and bring back, repeat
• AA: ME fully flex cspine, rotate to barrier, they try and bring back, repeat
• C2-7: ME Go all 3 components into barrier, they go against
Indirect treatment
• Same as direct but do BLT instead
Thoracic Spine
• Prone pressing diagnosis, type 1 Tongo, type 2 F/E same side sidebent and rotated
Direct treatment: Seated Muscle energy type 1 over 1 bicep, type 2 over 2 biceps, they making hand elbow holding on side opposite the side you will rotate them towards
Indirect treatment: Seated BLT
Lumbar spine
• Prone pressing diagnosis, type 1 Tongo, type 2 F/E same side sidebent and rotated
Direct treatment: Seated Muscle energy type 1 over 1 bicep, type 2 over 2 biceps, they making hand elbow holding on side opposite the side you will rotate them towards
Indirect treatment: Seated BLT
Sacrum
- Diagnosis: Seated flexion test
- Fingers in sacral sulcus and ILAs, (gonna find that both sacral sulci are seem equally deep while the ILAs both seem posmkjterior. Bilaterally flexed sacrum.)
Direct treatment: Bilateral sacral flexion: ME they prone, put both hands on ilas, as they inhale press down further on sacral apex, resist flexion.
Indirect treatment: Bilateral sacral flexion: BLT. They supine, put hands under the sacral base, have them take deep breath in and out see which one it felt more relaxed in, then hold breath until air hunger, then breathe.
Innominate
- Diagnosis: Asis compression to lateralize, then check ASIS heights (higher one side), iliac crest heights (higher same side), PSIS heights (higher same side) medial malleoli heights (higher one side, inflare outflare will be normal.
- Direct: Superior innominate shear ME: IR, abduct, pull down, they try to pull up, repeat
- Indirect: Apply principles of BLT to treat superior innominate shear
Ribs 2-10
- Diagnosis: Check placement of ribs statically, then do so with their breathing. If one side goes higher with inhalation its an inhaled rib, if one side goes lower with exhalation its an exhaled rib
- Direct treatment: ME, fingers above the affected rib, sidebend them towards affected rib, resist inhalation, push down with exhalation
- Indirect treatment: Apply principles of BLT
Ribs 1, 11, 12
- Rib 1: Thumbs behind neck, index finger in supraclavicular fossa, have them inhale exhale
- 11/12: they prone, fingers on the ribs in back, caliper motion for inhalation exhalation
- Direct rib 1: ME Inhalation dysfunction: pressing down during inhalations, Flex sidebend towards rotate away
- Direct 11/12: ME Inhalation dysfunction: They prone, stand on opposite side, one hand on psis to stabilize other hand below the ribs, push up with exhalation resist inhalation
- Indirect: For 11/12 Apply principles of BLT to pull down.
Shoulder
- SC Joint: have them shrug (abduction), lower shoulders (adduction), reach to ceiling (flexion), lower arms to table (extension) (For this assume an abducted clavicle)
- AC Joint: Cross arm adduction while palpating at AC joint and do IR/ER
- Scapulothoracic: Grab their scapula, check rotation, elevation/depression, abduction/adduction, backwards and forwards tilts
- GH joint: Flexion, extension, abduction, adduction, IR/ER
Direct and indirect:
Scapulothoracic MFR stack tissues then hold until creep.
Glenohumeral MFR hold until creep
Ac Joint: MFR for IR ER While holding AC Joint, or for horizontal adduction/abduction
SC Joint: Assume elevated/abducted clavicle, then do springing downwards at sc joint with respirations.
Elbow
- Diagnosis: Flexion/extension, IR/ER, Abduction adduction. (Assume adducted elbow SD)Also check the proximal radial head for anterior/posterior and the interosseus membrane.
- Direct: do Elbow adduction ME.
- Indirect: do indirect MFR for elbow adduction.
Hand/Wrist
- Diagnosis: Flexion, extension, wrist adduction, wrist abduction, then check Metacarpals, and phalanges for position and rotation, and flexor retinaculum
- Direct and indirect: Assume it’s a wrist Flexion somatic dysfunction and do ME for direct, and MFR for indirect
Hip (leg)
- Flexion, extension, IR/ER (this one by flexing up), Abduction/adduction
- Direct/indirect: Assume hip extension SD, Do MFR
Knee
- Diagnosis: Flexion, extension, IR/ER, and anterior posterior fibular head
- Assume flexed SD on one side. Indirect/direct do MFR for that side
Foot and ankle
- Diagnosis: Plantar flexion, dorsiflexion, inversion, eversion. (Find problem is inversion SD), others are lateral malleolus anterior posterior, navicular/cuboid/cuneiform dorsal ventral glide, metatarsal dorsal ventral glide, MTP/interphalangeal circumduction
- Direct/indirect: Do MFR for the inversion SD
