Lumbar

Question 1

HVLA type 1 dysfunction

Answer 1

• pt lies lateral recumbent with PTP up and doc facing patient
• monitor at apex with arm and pull anterior to rotate to the df and CEPHALAD to engage side bending
• swithc monitoring hands
• flex hips and knees to 90 degrees
• pt instructed to hook the foot
• cephalad arm against pts anterior shoulder
• caudad arm against posterior aspect of pt’s hip
• rotational thrust

Question 2

HVLA type 2 dysfunction

Answer 2

• pt lies lateral recumbent with ptp up
• monitor at segment
• grab lower arm and pull ant
• take that arm and pull CAUDAD to engage sidebending
• flex hips and knees to 90 degrees
• hook foot
• do the hvla thing

Question 3

AL1

Answer 3

• medial to ASIS
• Tx: F STRT
• stand on side of df, flex, pull hips towards you

Question 4

AL2

Answer 4

• Medial to AIIS

- tx: stand on opp side, FSARA, flex and pull towards you again

Question 5

AL3-4

Answer 5

• AL3 is lateral and AL4 is inferior to AIIS
• tx: pt supine, stand opp of df, flex, ankles towards you, knees away from you
• FSART

Question 6

AL5

Answer 6

• anterior superior aspect of pubic bone about 1 cm lateral to pubic symphysis
• tx: pt supine, doc on same side
• flex hip push ankles away from you and rotate knees toward you
• FSART

Question 7

PL1-5

Answer 7

• midline on the spinous processes
• tx: pt. prone, doc on same side of tp
• doc extends patient’s hip ipsilateral to tender point, fine tuning as necessary

Question 8

PL 1-3 transverse process

Answer 8

• on respective transverse process
• tx: pt. prone, doc on opp side of tenderpoint
• extend pts hip ipsilateral to tp and rotate the pts leg toward the tp, fine tuning as necessary

Question 9

UPL5/PL5

Answer 9

• superior medial edge of PSIS

- tx is same as for PL1-3, just extend and rotate toward tp

Question 10

LPL5

Answer 10

• inferior aspect of PSIS
• tx: pt prone with thigh on df side suspended over side of table
• flex hip and knee to 90, the adduct and IR of the hip (so point the knee inwards)

Question 11

PL3 lat (Gluteus Medius)

Answer 11

• 2/3 lateral between the PSIS and the tensor fascia latae (so just go straight out from the PSIS)
• tx: pt prone, doc on whichever side he wants
• extend pts hip, on same side of df and fine tune as necessary… easy

Question 12

PL4 Lat (Glut medius)

Answer 12

• Posterior margin of tensor fascia latae (look on the document, it shows it a little lower than PL3)
• tx: pt prone, doc on w/e side,
• extend pts hip on same side of dysfunction and fine tune as necessary (may be less extension than for PL3)