Methods 4 Comp Eval #2

Question 1

Side Posture Hypothenar Sacral Base Push, Dysfunctional Side Up

Answer 1

-Used w/ Extended Ilium (Flexion Restriction) and/or counternutated (Nutation Restriction)
-PSIS (Higher)/Sacral Base (Superior/Posterior)
-Doctors Position: Modified Fencer Stance (Side of Dys.)
-Contact Hand: Caudal hand, hypothenar on the higher sacral base (P-A, slight I-S)
-Indifferent Hand: Cephalic hand upward traction up

Question 2

Side Posture Hypothenar Sacral Base Push, Dysfunctional Side Down

Answer 2

-Used w/: Extended Ilium (FR) and/or Counternutated (NR)
-PSIS (ASL)/Sacral Base (Posterior/Superior)
-CH: Caudal Hand on the sacral base (lower side-P-A)

Question 3

Side Posture Hypothenar Sacral Apex Push, Dysfunctional Side Down

Answer 3

-Used w/ Flexed Ilum (Extension Restriction) and/or nutated (counternutation restriction)
-CH: Causal hand, hypothenar on the up side of the sacral apex (P-A)

Question 4

Side Posture Forearm Sacral Apex Push, Dysfunctional Side Down

Answer 4

-Used when patient present with flexed ilium (ER) and/or nutation (CN restriction)
-Contact hand: Hypothenar on the up-side of the sacral apex (P-A)

Question 5

Prone UL Hypothenar Transverse Push (Rotation)

Answer 5

-DP: Square or modified fencer stance (facing cephlad)
-CH: Caudal hand on the transverse process (P-A)
-IH: Reinforcing anatomical snuffbox

Question 6

Prone UL HypothenarTransverse Push (Lateral Flexion)

Answer 6

-DP: Fencer or Square Stance (facing caudal)
-CH: Hypothenar of cephalic hand on the TP (P-A/S-I)
-IH: Pisiform in the anatomical snuffbox

Question 7

Prone BL Thenar Transverse Push (Extension Restriction)

Answer 7

-DP: Modified Fencer Stance facing parallel to the spine
-CH: Thenar contact over the superior TP (P-A/I-S)

Question 8

Prone Unilateral Hypothenar Spinous Push (Thoracic)

Answer 8

-DP: Square or fencer stance at the cephlad side of table
-CH: Hypothenar of cephlad hand on lateral surface of superior spinous process on side of rotation/torque hand
-Left: counterclockwise/Right: Clockwise
-Vector: P-A/L-M w/ Torque

Question 9

Prone Knife Edge Spinous Push (Extension)

Answer 9

-PP: Headrest in flexion
-DP: Fencer stance, facing cephlad
-CH: Mid knife-edge contact on the inferior edge of the superior spinous process (I-S with enough P-A on SP)
-IH: Calcaneal reinforcement

Question 10

Prone Knife Edge/Spinous Push (Flexion)

Answer 10

PP: Prone/Head piece lowered
DP: Fencer stance/Facing Caudal on superior edge of superior spinous process (P-A/S-I)
IH: Calcaneal reinforcement

Question 11

Supine Opposite-Side Thenar/Transverse Drop (Rotation)

Answer 11

-DP: Modified fencer, opposite side of contact, tissue slack from below
-CH: Unilateral thenar contact (A-P to induce rotation)

Question 12

Supine Opposite-Side Thenar/Transverse Drop (Flexion)

Answer 12

-PP: Arms crossed w/ No Flexion
-DP: Modified fencer/opposite side of contact
-CH: BL thenar contact on inferior segment (A-P)

Question 13

Supine Opposite-Side Thenar/Transverse Drop (Extension)

Answer 13

-DP: Modified fencer/opposite side of contact
-CH: BL thenar or spinous contact on sup. segment (A-P/I-S)

Question 14

Prone UL Hypothenar/Transverse Push (Lateral Flexion)

Answer 14

DP: Fencer or square stance facing caudal
CH: Cephalic hand on the TP (P-A/S-I)

Question 15

Supine Index/Pillar Push (Rotation)

Answer 15

DP: Towards head of table on side of contact, angled 45-90* to the patient
-CH: Proximal MCP index of hand on the side of segmental contact on posterolateral pillar (P-A w/ rotation)

Question 16

Supine Index/Pillar Push (Lateral Flexion)

Answer 16

DP: Lateral flex on side of contact/Tissue slack S-I
CH: Proximal MCP Index on posterolateral pillar (L-M/S-I)

Question 17

Supine Thumb/Pillar Push (Rotation)

Answer 17

-DP: Approximately 90 degrees to patient
-Vec: P-A, slight I-S with rotation

Question 18

Supine Thumb/Pillar Pull (Rotation)

Answer 18

DP: Opposite side of contact/45* to patient
CH: Anterolateral articular pillar of superior vertebrae
(A-P and slight I-S inducing rotation)

Question 19

Seated Index/Occiput Lift (Lateral Flexion)

Answer 19

-PP: Head turned away from the side of contact
-DP: Standing b/h patient/patient’s head against sternum
-CH: Palmar surface of the middle finger corresponding to the side of the head of rotation/Contact on inferior border of occiput & lateral border of mastoid process
-Vector: I-S/L-M

Question 20

Seated Index Occiput Push (Rotation)

Answer 20

-DP: Stand behind patient, towards side of contact
-CH: Ventral lateral surface of the index, palm turned up, forearm approximately 45* to the patient, remaining fingers supping lower occiput, superior mastoid groove on the side of contact
-Vector: P-A w/ Rotation

Question 21

Seated Calcaneal/Zygomatic Pull (Extension)

Answer 21

PP: Roll towel behind the cervical spine
CH: Calcaneal contact of both hands on the superior aspect of the zygoma bilaterally
Vec: S-I, with enough A-P to stay on contact

Question 22

Seated Index/Occiput Push (Lateral Flexion)

Answer 22

-CH: Ventral lateral surface of index; palm turned up and wrist straight, forearm approximately 45* to the patient, remaining fingers cupping lower occiput, superior mastoid groove
-Vec: P-A, L-M, S-I

Question 23

Supine Hypothenar/Occiput Lift

Answer 23

PP: Doctor supports the patients head off the end of table
DP: Facing cephlad, lower fencer stance, weight shifted toward the superior leg, apply pre-adjustive long axis distraction by leaning bodyweight headward
CH: Hypothenar of caudal hand, contacting inferior edge of the occiput, medial to the mastoid
IH: Fingers wrap around the patient’s chin while forearm supports the patients head
Vector: I-S

Question 24

Supine Thumb/Occiput Push (Rotation)

Answer 24

PP: Doctor supporting the patients head off the end of the table
DP: Toward head of table, anlged 45-90* to the patient
CH: Thumb of the hand corresponding to the side of segmental contact, posterior aspect of the mastoid, fingers resting on the angle of the jaw, forearm down the sternum
Vec: P-A/I-S w/ corkscrew-like motion

Question 25

Hibbs Test

Answer 25

-Hand on medial PSIS/internally rotate the hip
-Pain at the SI Joint (+)
-No pain = Hip Pathology

Question 26

Yeoman’s Test

Answer 26

-Thenar contact of the ipsilateral PSIS/Grab anterior aspect of the knee and lift the thigh
-Pain at the SI joint = SI Dysfunction
-Dull ache = tight hip flexors

Question 27

Erichsen Sign

Answer 27

-Contact on BL ilium/thrust toward the midline
-Pain = Sacroiliac
-No pain = Ilifemoral

Question 28

Belt Test

Answer 28

-Hips support at the midline/brace the ASIS
-Pain produced = Lower back
-No Pain = Pelvis

Question 29

Nachlas Test

Answer 29

-Lift heel to ipsilateral buttock
-Radicular Pain = L2-L4 compression or irritation by intradural lesion
-Pain in buttock = SI Lesion
-Pain at lumbosacral joint = lumbosacral lesion

Question 30

Bechterew’s Test

Answer 30

-Radicular pain or if patient must lean back = compression of the sciatic nerve or lumbar nerve roots often due to lumbar disc protrusion