OMM 3 Thoracics and Ribs CS, FPR, Still

Question 1

Describe the location and treatment position for AT 1 Midline

Answer 1

Suprasternal Notch

Supine. Primarily Flexion with minor S and/or R

Question 2

Describe the location and treatment position for AT 2 Midline

Answer 2

Point is from midpoint of manubrium to Sternal angle

Supine. Primarily Flexion with minor S and/or R

Question 3

Describe the location and treatment position for AT 3-6 Midline

Answer 3

On sternum, at level of corresponding rib level.

Supine. Primarily Flexion with minor S and/or R

Question 4

Describe the location and treatment position for AT 7-9 Bilateral

Answer 4

Lateral to midline within rectus abdominus. Divide Xiphoid-to-Umbilius into quarters AT-7 is Upper, AT-8 Halfway, AT-9 3/4 below

Seated. Flexion, Sidebending toward. Rotate Torso away (Rotate Pelvis Toward)

Question 5

Describe the location and treatment position for AT 10-12

Answer 5

Divide Umbilicus-to-Pubic Symphasis into quarters. AT-10 is 1/4 below Umbilicus and slightly more lateral than AT-9. AT-11 is 1/2 below Umbilicus and lateral to 10. AT-12 is mid-axilllary line on the inner iliac crest.

Supine. Flexion, Sidebending toward. Rotate Torso away (Rotate Pelvis Toward)

Question 6

Describe the location and treatment position for PT 1-12 Spinous

Answer 6

Inferior midline or Inferolateral part of spinous process tip.

Prone. Primarily Extension, some S-R away.

Question 7

Describe the indication and procedure for FPR Thoracics, Seated

Answer 7

Thoracic Somatic Dysfunction

Patient seated. Stand behind patient and take segment to position of ease in all 3 planes. Introduce “V Shaped” vector through the shoulders and Hold 3-5 seconds.

Question 8

Describe the indication and procedure for Still Thoracics, Seated

Answer 8

Thoracic Somatic Dysfunction

Exact same as FPR for Thoracics; only once localized, take them passively back through neutral and into the barrier in all planes.

Question 9

Describe the location and treatment position for AR 1

Answer 9

Inferior to the clavicle on the 1st chondrosternal articulation.

Using Cervico-thoracic spine: Flex, S-R toward (Dr. foot up on table if patient seated, can also be done supine).

Question 10

Describe the location and treatment position for AR 2

Answer 10

Superior aspect of rib 2 in midclavicular line. (more lateral than AR-1)

Using Cervico-thoracic spine: Flex, S-R toward (Dr. foot up on table if patient seated, can also be done supine).

Question 11

Describe the location and treatment position for AR 3-10

Answer 11

Anterior axillary line at level of corresponding rib. (more lateral than AR-2)

Seated. Flex, S-R towards. (Dr. foot up on table).

Question 12

Describe the location and treatment position for PR 1

Answer 12

MAVERICK
Posterior-Superior aspect of rib, lateral to costo-transverse articulation.

Seated. Using Cervico-thoracic spine: Slight extension, S-away, R-toward (Dr. foot up on table).

Question 13

Describe the location and treatment position for PR 2-10

Answer 13

Superior aspect of rib near rib angle.

Seated. Flexion, S-R away. Dr.’s foot up on table.

Question 14

Describe the indication and procedure for FPR PR 1 Patient Supine

Answer 14

Elevated Posterior 1st Rib, Patient Supine, Stand on the Side of the dysfunction; facing the patient.

Inside hand on posterior aspect of 1st rib at T1 articulation. Cross the patient’s affected side arm across the chest. Localize motion the the tib articulation with Slight Abduction and Internal Rotation of the humerus (while grasping pt. at elbow). Then introduce compression from the elbow down through the rib attachment. Move the eblow in backward arc past their ear and then backwards and down (Maintain Vector!).

Question 15

Describe the indication and procedure for FPR Posterior Ribs, Patient Prone

Answer 15

Posterior Rib, Patient prone with pillow under chest cage to flatten thoracic AP curve. Physician on opposite side of rib dysfunction.

Caudad hand senses at the angle of the dysfunctional rib. Cephalad hand curls around opposite shouder, contacting clavicular area. Vector force intorduced through cephalad hand on the shoulder until localized to the rib. While maintaining vector; life the shoulder posteriorly until motion is localized at the rib (this introduces combined compresion, extension, sidebending, and rotation). Hold 3-5 seconds, return to neutral.

Question 16

Describe the indication and procedure for Still Posterior ribs, Patient Seated

Answer 16

Posterior Rib?

One hand on posterior rib angle. Cradle elbow and abduct and extend until motion localized at rib agle. Compression through elobw twoard rib angle. Maintain vector and rotate forwards and out in an arc, ending in adduction.