MS1 Myochains/spinal ligaments Flashcards
LFC1
TP: sup/lat aspect of condyloid process
Tx: c/s ext, SB towards and Rot away
LFC2
TP #1: sup/ant aspect of condyloid process (A to P)
TP#2: medial aspect of C2 paravertebral (M to L under paravertebral mass)
Tx: c/s ext, SB towards and Rot away
LFC3
TP #1: sup/post aspect of condyloid process (P to A)
TP#2: medial aspect of C3 paravertebral (M to L under paravertebral mass)
Tx: c/s ext, SB towards and Rot away
LFC4
radial head stuck in all planes
TP#1: medial aspect of laminae of C4 (M to L under paravertebral mass)
TP#2: on aconeus (b/w radial head and olecranon) (L to M)
Tx: c/s ext, rotate away and sb towards and lift in ant/med direction of mid cervical spine
LFC5
TP#1: medial aspect of laminae of C5 (45 deg angle, med to paravertebral mass)
TP#2 post/medial end of clavicle (P to A)
TP#3: post aspect of PSIS (P to A)
TX: c/s ext, c/s rot away, side bend toward and medial lift of mid cervical spine
LFC6
TP#1: medial aspect of C6 laminae (45 deg angle, medial to paraverterbral mass)
TP#2: distal/volar aspect of radioulnar ligament (A to P)
TX: c/s ext, c/s rot away, side bend toward and medial lift of lower cervical spine
LFC7
TP#1: medial aspect of C7 laminae (45 deg angle, medial to paraverterbral mass)
TP#2: bicipital aponeurosis (A to P)
TX: c/s rot away, t/s extension, side bend toward via scapular protraction with medial compression
LFT1
TP#1: medial aspect of T1 laminae (45 deg angle, medial to paraverterbral mass)
TP#2: ant most aspect of lateral surface of acromion (lat to med)
TX: c/s rot away, t/s extension, side bend toward and rotation away from TP side via scapular protraction with medial compression
LFT2
TP#1: medial aspect of T2 laminae (45 deg angle, medial to paraverterbral mass)
TP#2: post most aspect of lateral surface of acromion (lat to med)
TX: c/s rot away, t/s extension, side bend toward and rotation away from TP side via scapular protraction with medial compression
LFT3
TP#1: medial aspect of T3 laminae (45 deg angle, medial to paraverterbral mass)
TP#2: coracobrachialis muscle (located in the ant axilla slightly inferior to the pectoralis major insertion - sup to inf palpation in shoulder abduction and ER)
TX: c/s rot away, t/s extension, side bend toward and rotation away from TP side via scapular protraction with medial compression
LFT4
TP#1: medial aspect of T4 laminae (at 45 degree angle to med under paravertebral mass)
TP#2: dorsal/medial base of 1st metacarpal (med to lat on the inf/med corner of metacarpal)
Tx: t/s extension, side bend toward and rotation away with scapular anterior-medial “lift” and slight medial compression
LFT5
TP#1: medial aspect of T5 laminae (at 45 degree angle to med under paravertebral mass)
TP#2: located over palmar aponeuorsis of 2nd metacarpal (lat to med snapping)
Tx: t/s extension, side bend toward and rotation away with scapular anterior-medial “lift” and slight medial compression
LFT6
TP#1: medial aspect of T6 laminae (at 45 degree angle to med under paravertebral mass)
TP#2: located over palmar aponeuorsis of 3rd metacarpal (lat to med snapping)
Tx: t/s extension, side bend toward and rotation away with scapular anterior-medial “lift” and slight medial compression
LFT7
TP#1: medial aspect of T7 laminae (at 45 degree angle to med under paravertebral mass)
TP#2: inf/med aspect of dorsal scaphoid (med to extensor pollics longus tendon)
TP#3: lateral patella-femoral on post surface of mid patella (P to A onto post surface of patella)
TP#4: palmar aponeurosis of 5th metacarpal (lat to med)
Tx: preset with trunk side bend toward and adduction of arm across chest
L/s extension, side bend toward and rotation away via adduction of opposite leg
LFT8
TP#1: medial aspect of T8 laminae (at 45 degree angle to med under paravertebral mass)
TP#2: sup/lat aspect of calcaneus (1/2 way b/w achilles and inf aspect of tibia) approach sup to inf on lateral calcaneus TP is located slightly below the level of the medial malleolus in line with fibula
Tx: preset with trunk side bend toward and adduction of arm across chest
L/s extension, side bend toward and rotation away via adduction of opposite leg
LFT9
TP#1: medial aspect of T9 laminae (at 45 degree angle to med under paravertebral mass)
TP#2: sup/med aspect of calcaneus (1/2 way b/w achilles and inf aspect of tibia) approach sup to inf on medial calcaneus * TP is located slightly below the level of the medial malleolus* in the joint line
Tx: preset with trunk side bend toward and adduction of arm across chest
L/s extension, side bend toward and rotation away via adduction of opposite leg
LFT10
locks up pubic symphysis
TP#1: medial aspect of T10 laminae (at 45 degree angle to med under paravertebral mass)
TP#2: ant/prox adductor longus tendon (1cm distal to origin of pubic bone) (A to P)
Tx: preset with trunk side bend toward and adduction of arm across chest
L/s extension, side bend toward and rotation away via adduction of opposite leg
LFT11
TP#1: medial aspect of T11 laminae at (45 degree angle to med under paravertebral mass)
TP#2: distal iliacus (2fw above AIIS) ant to post
TP#3: lateral aspect of greater trochanter (approach lat to med)
Tx: preset with trunk side bend toward and adduction of arm across chest
L/s extension, side bend toward and rotation away via adduction of opposite leg
LFT12
TP#1: medial aspect of laminae of T12 (at 45 degree angle to med under paravertebral mass)
TP#2: medial patello-femoral joint line on the posterior surface of the mid patella (P->A on the posterior surface of the patella)
Tx: preset with trunk side bend toward and adduction of arm across chest
L/s extension, side bend toward and rotation away via adduction of opposite leg
LFL1
TP#1: medial aspect of laminae of L1 (at 45 degree angle to med under paravertebral mass)
TP#2: inferior most aspect of the distal tibia (inf to sup)
Tx: preset with trunk side bend toward and adduction of the shoulder across the chest
L/s extension, side bend toward and rotation away via adduction of opposite leg
LFL2
TP#1: medial aspect of laminae of L2 (at 45 degree angle to med under paravertebral mass)
TP#2: inferior most aspect of the distal fibula (inf to sup)
Tx: preset with trunk side bend toward and adduction of arm across chest
L/s extension, side bend toward and rotation away via adduction of opposite leg
LFL3
TP#1: medial aspect of laminae of L3 (at 45 degree angle to med under paravertebral mass)
TP#2: posterior aspect of lateral femoral condyle (Post to ant)
Tx: preset with trunk side bend toward and adduction of arm across chest
L/s extension, side bend toward and rotation away via adduction of opposite leg
LFL4
xTP#1: medial aspect of L4 laminae (at 45 degree angle to med under paravertebral mass)
TP#2: ant/med aspect of tibia slightly inf to tib/fib joint line
Tx: preset with trunk side bend toward and adduction of arm across chest
L/s extension, side bend toward and rotation away via adduction of opposite leg
LFL5
TP#1: medial aspect of L5 laminae (at 45 degree angle to med under paravertebral mass)
TP#2: lateral aspect of plantar aponeurosis (lat to med band snap)
Tx: preset with trunk side bend toward and adduction of arm across chest
L/s extension, side bend toward and rotation away via adduction of opposite leg
LFS1
TP#1: middle aspect of plantar aponeurosis (lat to med snap)
TP#2: adjacent to spinous process (post to ant)
Tx: shoulder adduction of involved arm across chest
t/l ext, side bend toward and rotation away (via adduction of the uninvolved LE)
LFS2
TP#1: medial aspect of aponeurosis (lat to med snap)
TP#2: adjacent to spinous process post to ant
Tx: shoulder adduction of involved arm across chest
t/l ext, side bend toward and rotation away (via adduction of the uninvolved LE)
LFS3
TP#1: calcaneocuboid joint line (inf aspect of lateral foot - ant to lateral malleolus - inf to sup)
TP#2: adjacent to spinous process (post to ant)
Tx: shoulder adduction of involved arm across chest
t/l ext, side bend toward and rotation away (via adduction of the uninvolved LE)
LFS4
TP#1: talonavicular joint line (inf aspect of medial foot - directly inferior to medial malleolus - inf to sup)
TP#2: adjacent to spinous process (post to ant)
Tx: shoulder adduction of involved arm across chest
t/l ext, side bend toward and rotation away (via adduction of the uninvolved LE)
LFCX1-5
locks up MTP joints at every level
TP#1: post/sup femur below the trochanter (post to ant)
Tx: patient side lying with hips and knees flexed - involved side up
coccygeal SB towards and rotation away from tender point side via digital pressure on associated coccygeal segment
UEC6
“Block the sun”
TP#1: side of C6 SP
TP#2: medial axilla b/w the pec major and neurovascular bundle of the arm (inf to sup)
TP#3: upper trapezius
TP#4: superior GH joint line b/w acromion and coracoid (med to lat)
Tx: shoulder flexion, internal rotation, wrist extension, finger extension of digits 2-5
UEC7
“Im the boss”
TP#1: side of C7 SP
TP#2: GH joint line lateral to coracoid process (med to lat)
TP#3: adductor pollicus
Tx: shoulder flexion, shoulder horizontal adduction, elbow flexion, radial deviation and thumb extension
UET1
“Youre under arrest”
TP#1: side of T1 SP
TP#2: inferior aspect of coracoid process
Tx: seated, shoulder internal rotation behind back, wrist flexion, thumb extension, marked
UET2
“Levator scapulae” “sitting at picnic”
TP#1: side of T2 SP
TP#2: trapezoid ligament
TP#3: sup/med insertion of levator scapula (at the angle of the superior angle)
TP#4: abductor digiti minimi
Tx: scapular elevation and adduction, shoulder extension, wrist extension, ulnar deviation, 5th digit abduction
UET3
“Block the sun” “statue of liberty”
TP#1: side of T3 SP
TP#2: conoid ligament
TP#3: dorsal interrous muscle
TP#4: high in the lateral axilla b/w the lattismus and the neurovascular bundle (inf to sup)
Tx: shoulder flexion, abduction, internal rotation, wrist extension, finger extension
* add in compression of shoulder girdle medially with TP#4
UET5
“Swear an oath”
TP#1: side of T5 SP
TP#2: post GH joint line (2fw inf to acromion) and approach med to lat
TP#3: teres minor mid belly(medial to the post aspect of the greater tuberosity)
Tx: shoulder external rotation, elbow flexion, finger extension digits 2-5
UET7
“Middle trapezius chain”
TP#1: side of T7 SP
TP#2: anterior ascpect of lateral epicondyle
TP#3: middle trapezius
Tx: shoulder abduction (~100*), elbow extension and finger extesion
UET9
“Lower trapezius chain”
TP#1: side of T9 SP
TP#2:lower trapezius
Tx: shoulder abduction, elbow extension and finger extension
UET6
“force push”
TP#1: side of T6 SP
TP#2: lateral scaphoid bone
TP#3: pec minor
Tx: shoulder flexion (60 deg), adduction, wrist extension, radial deviation and thumb abduction
UET8
“Crossed latissimus chain”
TP#1: side of T8 SP
Tx: shoulder horizontal extension, wrist extension and radial deviation (arm behind back to opp butt)
may need a little hip abduction - so may beed to lay prone
UET11
“Latissimus Chain”
TP#1: side of spinous process of T11
TP#2: inferior aspect of lesser tuberosity
Tx: hip abduction, shoulder abduction to 45*, internal rotation, ulnar deviation and traction through long axis
UET10
“Serrato-Costal Fascia”
TP#1: side of T10 SP
TP#2: ant/lat border of scapula from mid scap to inf angle of scapula
TP#3: origin of serratus anterior on lateral aspect of 6th rib
Tx: glide the scapula in an anterior/lateral and inferior direction (fine tune with 45-70* of abduction)
LET12
“Medial ankle chain”/“runner, twist athletes”
TP#1: side of T12 SP
TP#2: ipsilateral talar dome joint (medial)
TP#3: upper aspect of post tib (upper 1/3 of post tib)
Tx: hip flexion, abduction, external rotation, knee flexion, ankle plantar flexion and inversion
LEL1 (AR5)
“Lateral ankle chain”/“runner/twist athletes”
TP#1: side of L1 SP
TP#2: sinus tarsi
TP#3: peroneus brevis (1/3 distal/lateral calf)
TP#4: anterior axillary line of rib 5
Treat: hip flexion, abduction, ext rotation, knee flexion, ankle DF and eversion
LEL2 (AR6)
“PCL”/“Medial Popliteal/First ray chain”
TP#1: side of L2 SP
TP#2: medial aspect of popliteal fossa at level of infrapatellar pole (Post to ant)
TP#3: distal flexor hallicus longus (med to distal fibula)
TP#4: anterior axillary line of rib 6
TX: shoulder across chest, hip slight flexion, abduction, knee flexion, ankle eversion and plantar flexion through the 1st metatarsal
LEL3 (AR2)
“Pelvic floor”
TP#1: side of L3 SP
TP#2: ant aspect of pubic ramus
TP#3: inf aspect of 2nd rib at mid-clavicular line
TP#4: puborectalis mm.
TX: hook lying, feet midline, rotate knees toward, shoulder across chest, compression of upper lung/rib cage inferio-medial
LEL4
“Lateral hamstring/lumbar chain”
TP#1: side of spinous process of L4
TP#2: distal 1/4 of lateral hamstring
Tx: hip abduction, external rotation, knee flexion, ankle plantar flexion and eversion, foot flexion of medial metatarsals
LEL5
“Medial hamstring/lumbar chain”
TP#1: side of spinous process of L5
TP#2: distal 1/4 of medial hamstring
Tx: hip abduction, external rotation, knee flexion, ankle plantar flexion and inversion, foot flexion of lateral metatarsals
AR1
“Soleus chain”/“dont touch me”
TP#1: inf aspect of lateral arch of 1st rib as it passes inf to the clavicle
TP#2: obturator internus muscle (post aspect of ischial ramus)
TP#3: mid belly of gracilis
TP#4: medial aspect of lower soleus muscle (1/2 way b/w inf/med gastroc belly and sup aspect of achilles tnedon)
TX: involved arm across chest, hip adduction, external rotation, ankle plantar flexion and inv and marked calcaneal inversion
AR2
“Pelvic floor”/“LEL3”
TP#1: inf aspect of second rib at mid clavicular line (inf to sup)
TP#2: ant aspect of pubic bone (2cm lat to pubic symphysis)
TP#3: puborectalis muscle
TP#4: clavicular head of the pec major (pinch mm.)
TX: in hooklying, knees rotated toward mildly, involved arm across chest and compression of upper lung/rib cage in an inferior/medial direction
AR3
“Pelvic floor”
TP#1: inf aspect of 3rd rib in the anterior axillary line (inf to sup)
TP#2: inf aspect of pubic ramus (adjacent to pubic ramus) (inf to sup)
TP#3: sternal head of pec major (above nipple line/pinch mm.)
TP#4: iliococcygeus muscle
TX: in hooklying, feet toward, knees rotated to the involved side mildly, involved arm across chest and compression of upper lung/rub cage in an inferior/medial direction
AR4
“Pec and carpal tunnel chain”
TP#1: inf aspect of 4th rib in the anterior axillary line (inf to sup)
TP#2: anterior GH joint line below the coracoid process (below UET11) (med to lat)
TP#3: small depression over the anterior, distal radius (4cm prox to radial styloid)
Tx: arm adducted across chest, wrist flexion and ulnar deviation and compress distal carpal row, traction long axis humerus
AR5/LEL1
“Thoracic portion of lateral line”
TP#1: inf aspect of 5th rib in the anterior axillary line (inf to sup)
TP#2: lateral aspect of L1 spinous process
TP#3: superficially in the mid peroneus brevis
TP#4: inf/lat aspect of the talus in the sinus tarsi
TX: arm across chest, hip moderate flexion, abduction and external rotation, ankle dorsiflexion and eversion
AR6/LEL2
“PCL”/“Medial popliteal/first ray chain”
TP#1: inf aspect of 6th rib in the anterior axillary line (inf to sup)
TP#2: medial aspect of popliteal fossa (at the level of the inf patellar pole) (post to ant)
TP#3: distal flexor hallicus longus muscle
TP#4: side of spinous process L2
Tx: shoulder across the chest (of involved side), hip abduction, knee flexion, ankle eversion and plantar flexion through the 1st metatarsal
AR7
“Adducted/frozen shoulder chain”
TP#1: inf aspect of 7th rib in the anterior axillary line (inf to sup)
TP#2: inf surface of the neck of the humerus, in the lateral axilla (in line with AR4) (inf to sup)
TP#3: distal aspect of the short head of the biceps
TP#4: proximal coracobrachialis
Tx: c/s (mod side bend toward with rotation away), shoulder adduction (with arm against chest), elevation of shoulder girdle through the humerus
AR8
“Psoas/diaphragm crossed chain”
TP#1: inf aspect of 8th rib in the anterior axillary line (inf to sup)
TP#2: medial aspect of opposite AIIS
TP#3: proximal psoas major (lateral to the inferior aspect of the umbilicus and deep to the lateral fibers of the rectus abdominis)
Tx: hooklying, slide feet and rotate knees to the involved side, ipsilateral shoulder adduction of the shoulder across rib cage
deep release through the endopelvic fasica
AR9
“Crossed oblique line”
TP#1: inf aspect of 9th rib in the anterior axillary line (inf to sup)
TP#2: anterior inferior border of the ipsilateral scapula (serratus anterior) (inf to UET10)
TP#3: mid-belly TFL (on the OPPOSITE side)
Tx: hip (TFL side) flexion, abduction and internal rotation, shoulder adduction across rib cage (elbow straight)
superficial twist of the body
AR10
“Medial ankle/sartorius line”
TP#1: inf aspect of 10th rib 3cm post to medial margin of rib (inf to sup)
TP#2: mid belly sartorius
TP#3: anterio/medial aspect of the talus (2cm directly inferior to the ant aspect of the distal tibia)
Tx: t/s side bend toward, hip flexion, external rotation, knee flexion, ankle inversion and plantar flexion
AR11
“Rectus/toe extensor line”
TP#1: inf aspect of 11th rib 3cm from the rib tip (Inf to sup)
TP#2: inferior aspect of AIIS
TP#3: ant/sup aspect of the fibular head
TP#4: upper 1/4 of the extensor digitorium (A->P)
Tx: hip abduction, and external rotation, ankle eversion and dorsiflexion, toe extension (all digits)
pair with LFL3
AR12
“ACL”/“Popliteal/obturator externus chain”
TP#1: inf aspect of 12th rib 3cm from the rib tip
TP#2: lateral aspect of the popliteal fasica (at the level of the patella)
TP#3: mid belly fibularis tertius)
TP#4: superior-medial aspect of the obturator foramen (inf to sup on the posterior aspect of the medial pubic ramus)
Tx: hip adduction, and external rotation, knee flexion (mild), ankle plantar flexion (with a dorsiflexion force), forefoot valgus (external rotation)
Alar ligament
TP#1: b/w post arch of C1 and occiput (slightly medial to OM suture) (post-sup to ant-inf)
TP#2: inf aspect of C1 (inf to sup)
Tx: c/s extension, side bend toward, rotate away
affects pineal gland and sleep disturbance
what ligaments scan PLL?
Alar, PLL, transverse ligament of atlas (AA), lateral atlanto-occipital (LAO), MM, LM
AA (transverse ligament of the atlas)
TP: over the side of the C2 spinous process (lat to med)
Tx: c/s extension, rotation away, side bend toward
LAO (lateral atlanto-occipital)
TP: post/inf aspect of the mastoid process in the deep groove (post to ant)
Tx: c/s side bend toward with slight c/s extension and rotation away from the TP side
PLL C2-C7
TP#1: inf aspect of the cervical transverse processes
TP#2: posterior humerus b/w the greater tuberosity and the deltoid insertion (P to A through the post deltoid muscle)
Tx: c/s extension, side bend and rotate toward
PLL T1-T8
TP#1: inf/lat tip of the t/s transverse processes (inf to sup) (lateral edge of the paravertebral)
TP#2: T1-6 have TP posterior aspect of humerus b/w deltoid insertion and supracondylar ridge
TP#3: T7-8 have TP over medial 1/3 of dorsal, medial radius
Tx: shoulder extension and adduction and shoulder ext rotation
PLL T9-T12
TP#1: inf/lat tip of the t/s transverse processes (inf to sup) (lateral edge of the paravertebral)
TP#2: T9-10 have TP ant/med aspect of the middle 1/3 of the fibula
Tx: supine, ipsilateral knee flexed, trunk side bend toward, uninvolved leg toward TP side, rotation away (via iliac crest lifting)
PLL L1-CX4
TP#1: dorsal coccyx CX3-CX4 post to ant
TP#2: lateral posterior femur/hamstring mass (post to ant)
Tx: side bend toward (slide feet toward TP side)
trunk rotation toward via involved iliac crest in a sup/ant/med position
involved segment will be extended with a “sunken” SP
DCFA
TP#1: anterior aspect of superior axillary (brachial plexus), A to P drag across the roof of the brachial plexus
TP#2: lateral aspect of the sternal notch (sup to inf)
Tx: c/s flexion, side bend toward, rotate away
DCFP
TP: posterior aspect of superior axillary (brachial plexus), A to P drag across the roof of the brachial plexus
TP#2: medial aspect of the sternal notch (sup to inf)
Tx: c/s extension, side bend toward, rotate away
ALL C1-C7
TP#1: superior aspect of the c/s transverse process (sup to inf)
TP#2: C2-C7, anterior humerus (b/s greater tubersoity and deltoid insertion)
(A to P - lateral to the bicipital tendon)
Tx: c/s flexion, side bend and rotate toward the TP side moderately
ALL T1-T12
TP#1: lateral aspect of the rib tubercles (L to M)
TP#2: T1-6 anterior humerus (from deltoid insertion to above the supracondylar ridge)
Tx: cervicothoracic flexion, side bend toward and mild rotation toward the tender point with post translatation of the involved segment
ALL L1-S2
TP: medial/posterior femur/hamstring mass
Tx: supine, hook lying, slide feet toward, hip flexion, adduction, internal rotation of the involved side
(Involved seg will be flexed with prominent SP)
DT11-L5
(sinuvertbral nerves)
TP: anterior/medial surface of the medial 1/2 of the femur
Tx: hooklying, LTR toward TP side (may be necessary to lift involved leg towards ceiling with lower ones)
MM- MS
(medial coronary ligaments)
TP: medial aspect of the tibia (1-2cm below the tibial plateau)
Tx: knee flexion, internal rotation of the tibia (scans PLL)
LM-MS
(lateral coronary ligaments)
TP: ant-lat aspect of the tibia (2-3 cm below the tibial plateau)
Tx: knee flexion, external rotation of the tibia (scans PLL)
