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OS Yr II Exam 1 > Lumbar Counterstrain > Flashcards

Lumbar Counterstrain Flashcards

1
Q
A
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2
Q
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AL1: F STRT

Location: medial ASIS

Treatment position: Pt supine.

Doc on ipsilateral side.

Flex hips/knees to 90

supporting with doc’s leg on table.

Pull ankles (SB) & knees (Rot) towards doc.

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3
Q
A

AL 2: F SARAH

Location: medial AIIS

Treatment position: Pt supine.

Doc contralateral side.

Hips/knees flexed.

Ankles (SB)

knees (Rot) toward Doc, away from TP.

Rot >>> SB

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6
Q

Location: medial AIIS

A

AL2

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7
Q

Location: medial to ASIS

A

AL1

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8
Q

Location: lateral and inferior AIIS

A

A3(L), A4(Inf)

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9
Q
A

AL 5

Location: lateral to pubic symphysis

Treatment position: Pt supine.

Doc ipsilateral w/ ft on table.

Flex hip to 135

ankles (SB) away from doc & TP.

Knees (rot.) slightly toward doc & TP.

▫ F SART

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10
Q
A

PL 1-5 Spinous Process

Location: Midline on respective SP

Treatment position: Pt prone

Doc ipsilateral to TP.

Extend hip, fine tune with SB as necessary

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11
Q

AL3 and AL4 counterstrain

A

Treatment position: Pt supine.

Doc ipsilateral w/ ft on table.

Flex knees/hips to 90.

Ankles (SB) away from doc & TP

knees (Rot) toward doc & TP

▫ F SART

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12
Q
A

Upper Pole L5 (UPL5)

Location: superomedial PSIS

Treatment position: Pt prone.

Doc contralateral to TP.

Extend hip ipsilateral to TP, externally rotates hip towards TP

*Same motion as PL 1-3 TP. Monitoring at diff. location with different amounts of extension/rotation to address specific tenderpoint*

U-PLP-EE-5

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13
Q
A

Lower Pole L5 (LPL5)

Location: inferior PSIS

Treatment position: Pt prone with dysfunctional side over side of table.

Doc flexes hip & knee to 90.

Add IR/Adduction of hip to fine tune.

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14
Q
A
  1. PL3 Lateral/Gluteus
    1. Location: between PSIS/TFL
    2. Treatment position: Pt prone. Doc ipsilateral. Extend hip, fine tune with Abduction.
    3. Actions of glutes
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15
Q

(same picture, different spot)

A

PL4 Lateral/Gluteus

Location: posterior margin of TFL

Treatment position: Pt prone. Doc ipsilateral. Extend hip, fine tune with Abduction. (Less ext. than PL3)

▫ Actions of glutes

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16
Q
  1. F SART
  2. F SARAH
  3. F STRT
A
  1. F SART - A3/A4/A5
  2. F SARAH - A2
  3. F STRT - A 1
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19
Q

PL 1-3 Transverse Process

A

PL 1-3 Transverse Process

Location: on respective TP, can be b/l

Treatment position: Pt prone.

Doc contralateral side.

Extend ipsilateral hip to TP, externally rotate hip towards TP.

TPEE

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21
Q
A

Location: RLQ, medial to ASIS, deep in iliac fossa

Treatment position: Pt supine.

Doc ipsilateral w/ foot on table.

Flex hips/knees to 90, crossing ankles over doc’s knee, inducing marked ER

▫ “Frog leg”

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22
Q
A

Low Ilium

Location: superior pubic ramus, where psoas m. crosses pelvic rim

Treatment position: Pt supine.

Doc ipsilateral. Flex hip & knee to >90. Fine tune if nec.

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23
Q
A

Inguinal Ligament

Location: lateral pubic tubercle

Treatment position: Pt supine.

Doc ipsilateral w/ foot on table.

Flex hips/knees to 90, rest on doc’s knee. Cross c/l ankle over i/l leg, pull ankles towards doc (IR of dysfnl. hip)

▫Assoc.: inguinal lig. and/or pectineus m.

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24
Q
A

High Ilium Sacroiliac (HISI)

Location: lateral PSIS

Treatment position: Pt prone.

Doc ipsilateral.

Extend hip and fine tune with ab/adduction.

Assoc. with Glut. max., Q. lumborum, or iliolumbar lig.

25
Q
A

High Ilium Flairout (HIFO)

Location: 2” inferior, just medial to PSIS

Treatment position: Pt prone. Doc contralateral. Extend dysfnl leg enough to clear opp. leg. Induce marked adduction/ER pulling leg towards doc.

▫ Assoc. w/ coccygeus m.

26
Q
A

Piriformis

Location: half-way from ILA to greater trochanter in belly of m.

Treatment position: Pt prone, dysfnl side off table. Flex pt’s hip to 135. Abduct and externally rotate by lifting knee superolaterally

30
Q

Which PLs require the doctor to stand on the contralateral side?

A

PL1-3 and UPL5

31
Q

Which PLs require the doctor to be standing ipsilaterl to the TP?

A

PL 1-5 SP, LPPL5, PL 3 Lat Glut, PL 4 Lat Glut

32
Q

which PLs require external rotation?

A

UPL5

PL1-3 TPs

U-PEE-L5

PL1,2,ThrEE

33
Q

which PLs require flexion?

41
Q

FISI

A

Location: approx. 4” below PSIS, glut max attachment inferiorly

• Treatment position: Pt prone with dysfnl side at edge of table. Doc ipsilateral. Abduct hip, then flex just enough to clear table edge (in case finetuning with ER is nec.

42
Q

FISI, HIFO, HISI, maneuver X

A

Flair-in sarcal iliac

high iliac flair-our

high ileal sacral iliac

periformis

43
Q

Posterior Lumbar all together

A

PIL-P5L midline

P1L-P3L transverse process

UP5L

LP4L

PL3 Lat

PL4 Lat

45
Q
  1. superomedial border of PSIS
  2. inferior aspect of the PSIS
  3. lateral aspect of the PSIS
  4. 2” inferior and just medial to the PSIS
  5. 2/3 of the way between PSIS and TFL
  6. Posterior margin of TFL
  7. Lower quadrant, 1-2 inches medial to the ASIS + deep in iliac fossa
  8. lateral aspect of the superior ramus where psoas crosses pelvic rim
  9. lateral surface of the pubic bone near attachment of inguinal ligament
A
  1. upper pole 5
  2. lower pole 5
  3. HISI
  4. HIFO
  5. PL3 lat glut
  6. PL4 lat glut
  7. Iliacus, frog legs, Anterior aspect of the pubic bone, 1 cm lateral to pubic symphysis
  8. Low ilium, Lateral aspect of superior pubic ramus, where psoas muscle crosses pelvic rim
  9. Inguinal lig, Lateral surface of the pubic bone near attachment of inguinal ligament
46
Q
  1. FISI
  2. HISI
  3. HIFO
  4. Periformis
A
  1. Approx 4” below PSIS, related to glut. max attachment
    1. slightly superior and lateral to the ILA
  2. Lateral aspect of PSIS
  3. 2” inferior and just medial to the PSIS, related to coccygeus m.
  4. Half-way from sacral inferolateral angle (ILA) to greater trochanter
47
Q

TP is Medial to inferior border of PSIS b/l (sacral sulci)

Pt prone; Dr. standing on pt’s side. Apply posterior to anterior pressure at the location diagonally opposite the TP. (ie, if left side has tender point, doc applies pressure at R sacral sulcus)

A

PS1: Medial to inferior border of PSIS b/l (sacral sulci)

48
Q

PS 2

A

Midline on sacrum, between sacral spines

patient prone; Dr. standing on pt’s side. Apply posterior to anterior pressure on apex (if PS2) or base (if PS4) of sacrum, producing transverse axis rotation. PS3 may vary where the force is applied, for this point it is important to communicate with your patient, asking in which direction is the tenderness reduced

49
Q

PS2

A

Midline on sacrum, between sacral spines

Pt prone

Apply posterior to anterior pressure on apex (if PS2) sacrum, producing transverse axis rotation.

50
Q

PS4

A

Midline on sacrum, between sacral spines

Pt prone; Dr. standing on pt’s side. Apply posterior to anterior pressure on apex (if PS2) or base (if PS4) of sacrum, producing transverse axis rotation. PS3 may vary where the force is applied, for this point it is important to communicate with your patient, asking in which direction is the tenderness reduced

51
Q

PS4

A

midline on sacrum, between sacral spines

Pt prone; Dr. standing on pt’s side. Apply posterior to anterior pressure at the location diagonally opposite the TP. (ie, if Left PS5 is tender, doc applies pressure at R sacral sulcus)

52
Q

PS 5 (bilateral)

A

Superomedial ILA bilate

Pt prone; Dr. standing on pt’s side. Apply posterior to anterior pressure at the location diagonally opposite the TP. (ie, if Left PS5 is tender, doc applies pressure at R sacral sulcus)

53
Q
A

PS1 Medial to inferior border of PSIS b/l (sacral sulci)

54
Q
A

PS2

Pt prone; Dr. standing on pt’s side. Apply posterior to anterior pressure on apex (if PS2) or base (if PS4) of sacrum, producing transverse axis rotation. PS3 may vary where the force is applied, for this point it is important to communicate with your patient, asking in which direction is the tenderness reduced

55
Q
A

Midline on sacrum, between sacral spines

Pt prone; Dr. standing on pt’s side. Apply posterior to anterior pressure on apex (if PS2) or base (if PS4) of sacrum, producing transverse axis rotation. PS3 may vary where the force is applied, for this point it is important to communicate with your patient, asking in which direction is the tenderness reduced

56
Q
A

PS4

Midline on sacrum, between sacral spines

Pt prone; Dr. standing on pt’s side. Apply posterior to anterior pressure on apex (if PS2) or base (if PS4) of sacrum, producing transverse axis rotation. PS3 may vary where the force is applied, for this point it is important to communicate with your patient, asking in which direction is the tenderness reduced

57
Q

PS4

A

Midline on sacrum, between sacral spines

Pt prone; Dr. standing on pt’s side. Apply posterior to anterior pressure on apex (if PS2) or base (if PS4) of sacrum, producing transverse axis rotation. PS3 may vary where the force is applied, for this point it is important to communicate with your patient, asking in which direction is the tenderness reduced

58
Q

PS5

A

Superomedial ILA bilaterally

Pt prone; Dr. standing on pt’s side. Apply posterior to anterior pressure at the location diagonally opposite the TP. (ie, if Left PS5 is tender, doc applies pressure at R sacral sulcus)

59
Q

PS3

A

Pt prone; Dr. standing on pt’s side. Apply posterior to anterior pressure variably; PS3 may vary where the force is applied, for this point it is important to communicate with your patient, asking in which direction is the tenderness reduced

60
Q

PS4

A

Pt prone; Dr. standing on pt’s side. Apply posterior to anterior pressure on base producing transverse axis rotation.

OS Yr II Exam 1 (8 decks)

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