Meganism Practical Cards Flashcards
Dx-C3-C7 supine FRS
They’re in prone, your fingers are on the articular pillar, elbows out. Check in neutral and go side to side. BIAS THEN INTO A LITTLE EXTENSION.
When you translate, you’re assessing opposite side SB and rotation.
Dx-C3-C7 supine ERS
They’re in prone, your fingers are on articular pillars, elbows out. Check in neutral. BIAS INTO FLEXION. Translate side to side.
If they can’t go left, they’re having a hard time going right and are stuck in left
Dx-AA supine rotation restriction
Flex to 45 degrees to lock out ligamentum flavum. Put your fingers on C1 and support the head on your stomach. Without SB, rotate head.
If they can’t go left, it’s a right sided problem.
Dx-OA supine extension restriction
For flexion lesions
Grab their head with fingers on posterior arch of C1. Extend them and translate left and right.
Dx-OA supine flexion restriction
For extension lesions
Grab their head with fingers on posterior arch of C1. Flex then and translate left and right.
Rx-FRS left C5,6
One finger extension one
Finger on RIGHT articular pillar of C6 and apply P-A force to extend. Place your hand on their head. Translate them LEFT and slightly rotate RIGHT. Tell them to try to look over their LEFT SHOULDER.
Rx-ERS left C2,3
The Pinch one
Pinch- index finger in joint line and thumb on LEFT articular pillar of C2. Put your LEFT hand on their head. Use fingers to translate LEFT and rotate RIGHT.
Ask them to extend, SB and rotate LEFT against you.
Rx-Restricted atlas rotation left
The hand on the face
Put your fingers on the arch of the atlas. Bring neck to 45 degrees. Rotate their head LEFT and expect to feel the arch at your LEFT finger. Place RIGHT hand on top side of their face.
Resist RIGHT rotation.
Rx-Restricted left OA extension
Put LEFT finger between occiput and C1 (cervicocranial junction). Put your RIGHT hand under their chin. Extend them and translate RIGHT (LEFT SB & RIGHT rotation).
Ask them to SB RIGHT.
Rx-Restricted right OA flexion
Put LEFT finger between occiput and C1 (cervicocranial junction). Put your RIGHT hand under their chin. Flex them and translate RIGHT (LEFT SB & RIGHT rotation).
Have then extend into your hand.
Dx-T1-5 type 1 and 2 dysfunctions
Get scapula out-of-the-way by having them cross their arms. Upper T spine can be examined entirely while seated. Assess transverse processes. Assessed symmetry by looking above and below it. When you find asymmetry in flexion or extension and not a neutral it is a minor motion loss. Assess flexion and extension.
Rx-ERS left T4,5
LEFT facet is stuck closed
The diagonal one
You stand RIGHT fingers LEFT on T4 TP and interspinous space. RIGHT hand on their head. Flex their neck and tell them to slouch. SB RIGHT and rotate RIGHT, you can use your torso.
Resist extension and LEFT SB and rotation by telling them to try to look over their LEFT shoulder.
Rx-FRS left T2,3
RIGHT facet stuck open
The push with your hand one
You stand LEFT, fingers RIGHT waiting to feel RIGHT TP and provide P-A force with the palm of your hand. Swanneck LEFT hand. They’re in extension, SB RIGHT and slightly rotated RIGHT.
Instruct them to look down at their left hip.
Rx-T1-5 neutral group dysfunction, NSrRl
The leg one
Find the apex/middle segment. Put up RIGHT knee (the side they side bend to) under their axilla. Swanneck RIGHT. Bring out your leg to SB them LEFT. Rotate their neck RIGHT.
Have them push into your leg and arm.
Dx-T6-12 type 1 and 2 dysfunctions
Look for transverse processes. Flexion and neutral in sitting but extension is done in prone. Get cranial and caudal views!
Rx-ERS right T8,9
The twist into you/ comforting one
In sitting, they put their hand on their RIGHT shoulder and so do you. Your RIGHT fingers are on interspinous space and TP. Put your axilla on their shoulder. Flexion to localize, SB LEFT, and rotate LEFT.
Tell them to extend, SB RIGHT and rotate RIGHT.
Rx-FRS right T8,9
The three stepper
Teach them to weight shift
Palpate RIGHT TP and interspinous space.
1) weight shift LEFT. Put your hand on their LEFT shoulder. Bring them into LEFT rotation and ask them to rotate RIGHT.
2) weight shift RIGHT. Provide P-A force with fingers and increase LEFT SB and LEFT rotation
3) neutral weight. Provide P-A force with fist at T9 and grab their RIGHT shoulder, wrapping your arm across their chest. Tell them to flex.
Rx-T6-12 neutral group dysfunction (NSlRr)
The one way weight shift
Thread the needle
They put their hand on their RIGHT shoulder and you weave. Your RIGHT thumb is localized on apex of the convexity. Weight shift LEFT. SB RIGHT rotate LEFT.
Tell them to SB LEFT and rotate RIGHT
Dx-L1-5 type 1 and 2 dysfunction
L1-4 TPs
L5 articular pillars
Sacral rock to find L5.
Flexion- bend forward sitting with hands behind neck
Extension- prone in the cute position
Rx- ERS right L4,5
Pt on table with RIGHT hand on LEFT shoulder. Your hand is on LEFT shoulder with axilla on them. Fingers are RIGHT on interspinous space and T4’s TP. Flex them at their torso and ask them to slouch. SB LEFT rotate LEFT.
Pt tries to lift LEFT shoulder into you.
Rx-FRS left L3,4
The three stepper
Teach weight shifts.
You’re behind and RIGHT of seated pt. Palpate LEFT L3 TP and interspinous space. Place RIGHT hand on RIGHT shoulder.
1) weight shift RIGHT (SB LEFT)and rotate RIGHT. Tell them to rotate LEFT.
2) weight shift LEFT. Give them P-A force, SB LEFT and rotate RIGHT, and tell them to rotate LEFT.
3) neutral weight. Provide P-A with fist at L4 with your LEFT arm across their RIGHT shoulder and tell them to flex.
Rx-FRS left L4,5
The extension one
Pt lays with bad side up (RIGHT). Find L4,5, reach under them to extend. Extend shoulders. Extend legs. RIGHT rotate shoulders. RIGHT hand palpates L4,5.
LEFT hand abducts legs/ swanneck hips.
Ask them to push to the ceiling or try to sit.
Rx-L1-5 neutral group dysfunction (NSrRl)
Pt puts LEFT hand on RIGHT shoulder. Your LEFT hand on RIGHT shoulder. RIGHT thumb palpates apex. LEFT SB and RIGHT rotation.
Keep pt neutral
Ask them to SB RIGHT.
Dx-Sitting flexion test/ ILA exam in flexion
1) Patient is seated. Get to level of PSIS. Have patient put their hands behind their neck with elbows in front and curl down. Look for symmetry. Pathological side will go first and further.
2) move on to ILAs and do it again.
Dx-Prone ILA exam
Find ILAs and assess symmetry in neutral and spring. Drop onto inferior aspect and assess symmetry.
If ILAs are asymmetrical and inferior is level, it could be a forward or backward torsion
if both are asymmetrical it could be a unilateral dysfunction because it is sheared off the axis
Dx-Prone sacral base exam
Get on sacral base and palpate. Palpate articular pillars of L5 and spring. If sacral base is tender it could be the long dorsal sacral ligament.
Dx-Prone prop ILA and base exam
Patient in prone. Put your fingers on bases and thumbs on ILA’s. Have them take a deep breath and assess movement. Have them go into prone prop and reassess.
Dx-Lumbar spring test
Performed to assess lumbosacral relationship. Spring on lumbar spine.
+ unilateral extension dysfunction and counter nutation/ BST
Rx-Left unilateral sacral flexion
INternal rotation INspiration
Facing their head abduct RIGHT left 15 degrees and internally rotate. Palpate LEFT ILA with pisiform at 45 degrees and twist hand toward head. Push with hand. Use other hand to push down on LEFT sacral base. Instruct them to breathe. Push them more with extension.
Rx-Right unilateral sacral extension
EXtension EXternal rotation EXhalation
Face their feet, abduct RIGHT leg 15 degrees and externally rotate. Palpate RIGHT sacral base at 45 degrees and twist toward their feet. GET THEM INTO PRONE PROP. Put your hand under RIGHT ASIS. Breathe, exhale, push ASIS into your hand and push onto RIGHT sacral base.
Rx-L/L FST
Start them in prone. Have them flexed knees and you palpate RIGHT sacral base. Contact their ASIS And twist them to Sims position with dysfunctional side up. Rest their knees on your thigh. Palpate there RIGHT sacral base and facilitate counter nutation.
Grab their feet and ask them to try to bring them up. Increased hip flexion and drop the each time.
Rx- R/L BST
RIGHT Side up towards healing. Extend lumbar spine to localize with LEFT hand on base, use right hand to extend upper spine.
Use lawnmower pull to rotate.
Palpate base with RIGHT hand and bend their knees and let the top leg rest in the lower’s popliteal fossa.
Tell them to try to lift it toward the ceiling with you pushing down.
Dx-Standing forward flexion
Tests for SI dysfunction
- pt stands with PT standing behind pt
- PT contacts PSISs with thumbs
- pt asked to segmentally flex forward and bring hands to the floor
- PT monitors each PSIS for symmetry
POSITIVE if one goes first or further
could be tight QL bringing one side up first, tight HS holding other side down, etc
PT must be eye level with the PSISs
Dx-One legged stork test
Upper pole
Tests for SI dysfunction
- pt standing with PT standing behind pt
- PT contacts the median sacral crest of S2 with 1 thumb and the PSIS with the other
- pt asked to flex the hip past 90deg
- PT monitors PSIS for lateral/caudal migration
POSITIVE if PSIS moves cranially or no movement
Lower pole
Tests for SI dysfunction
- pt standing with PT standing behind pt
- PT contacts the sacral apex at the hiatus with one thumb and the post/inf aspect of the ilium with the other
- pt asked to flex the hip past 90deg
- PT monitors the Iliad movement for ant/inf/lat migration
POSITIVE if there is a lack of movement
