Methods Flashcards
Name the 12 hand contacts and locations
pisiform (outer corner of heel of hand)
calcaneal (on the heel of hand)
thenar (body of thumb)
hypothenar (lateral side of palm)
metacarpal/ knife edge (outer edge of the hand)
digital (finger tip)
thumb (finger tip of thumb)
web (web between index and thumb)
index (medial side of first knuckle of index finger)
proximal interphalangeal (inner second knuckle of finger)
distal IP (inside of last knuckle of finger)
How do you locate the T3 spinous process?
Find the clavicle
Move laterally to the AC joint
Move posteriorly on the acromion process
Follow acromion medially along spine of the scapula
Follow medially until contact T3 SP
How do you locate the T7 spinous process?
Find the scapula
Palpate the inferior angle
(can use chicken wing to aid)
Follow medially until contact T7 SP
When will you locate T7 vs T6 using inferior angle of scapula?
T7 will be found when patient is standing or seated. T6 will be found if patient is prone.
How do you locate T12 spinous process?
Palpate the patients trunk until you feel soft tissue below the last rib
Palpate superiorly until last rib is located
Follow rib medially and superiorly to T12 SP
What SP will you find if you track medially from last rib?
L1-L2
How do you locate the transverse processes of the thoracic spine?
T1-4: palpate up 1 interspace and over 2 finger widths
T5-8: palpate up 2 interspaces and over 2 finger widths
T9-12: palpate up 1 spinous process and over 1 finger width
How do you locate the L4 spinous process?
in females: medial to iliac crest is L4-L5 interspace
in males: medial to iliac crest is L4 spinous process
How do you locate the L5 spinous process?
Find the PSIS
Medial to this is the S2 tubercle
Palpate superiorly from S2, feeling for impression and then L5 spinous process
How do you locate the lumbar mammillary processes?
L1-3: up 1 interspace and over 1 finger width
L4-5: up 1 interspace and over 2 finger widths
What are the lumbar active range of motions and corresponding degrees of RoM?
Flexion 90
Extension 30
Right/Left Rotation 30
Right/ Left Lateral Flexion 35
How do you set up and execute the ‘supported Adam’s test’?
Patient stands facing away from doctor and flexes forwards upon instruction.
The doctor uses the side of their hip against the back of the patients hips, holding the patients ASIS’s.
How do you interpret the results of the ‘supported Adam’s test’?
If pain subsides with pelvic bracing it is a pelvic problem.
If pain persists with support, it is a lower back problem
Locate the PSIS
Find Iliac Crests and palpate inferiorly and medially to the “bumps”
Find the S2 Tubercle
In the midline of the PSISs
Locate the Ischial Tuberosity
known as the ‘sit bones’ located slightly lateral and inferior to the tip of coccyx
Locate the piriformis
Triangulation using: PSIS, Greater Trochanter, Ischial Tuberosity
How do you execute the Gillet Knee Raising Test
Kneel behind patient towards one side
patient faces away from doc with hand support
doc has thumb on PSIS of moving leg and thumb on S2 tubercle
have patient flex knee and hip of side being assessed
have patients extend hip on assessment side
repeat on other side
How to interpret Gillet Knee Raise Test
as patient raises knee (flex knee and hip) PSIS should move PIM (posterior inferior medial)
as patient extends leg back (ext knee and hip) PSIS should move ASL (anterior superior lateral)
What is the External Occipital Protuberance (EOP) and how do you locate it?
Large bump in the midline of posterior skull
How do you locate the Mastoid Processes
Lateral, inferior and slightly anterior from EOP
How do you locate the C2 spinous process?
First large SP inferior from the EOP
How do you locate the C1 transverse processes
inferior and anterior of the tips of the mastoid processes
How do you locate the C3,4,5 spinous processes
Use the ‘Three Finger Rule’: place ring finger, middle and index finger just inferiorly to C2 SP and should be on C3,4,5
What is known as the vertebral prominence?
C7, it is large!
How do you locate C6 and C7 spinous processes?
place index finger on C7 prominence and place middle finger on C6.
Upon flexion C6 should move anteriorly, C7 should not move
How do you locate the C2,3 articular pillars?
Locate the C2,3 SP and move laterally 1 finger width
How do you locate the C4,5,6,7 articular processes?
From the SP move up 1 interspace and lateral 1 finger width
How do you locate the C1 transverse process?
inferior and anterior to the tips of the mastoid processes
What are the cervical ranges of motion?
Flexion: 60 degrees
Extension: 75 degrees
Right/Left Rotation: 80 degrees
Right/Left Lateral Flexion: 45 degrees
