OMM for the hospitalized patient

Question 1

external occipital protuberance TP location and treatment

Answer 1

• location: directly on / slightly below the external occipital protuberance (inion)
• treatment: slightly extend C spine, lift and translate head anteriorly around the point, tip chin down slightly to a point of comfort

Question 2

laternal nuchal ridge TP location and treatment

Answer 2

• location: lateral most area along superior nuchal line
• treatment: rotate away and sidebend away, apply pressure down on occipito-parietal area while hand on occipital area acts as fulcrum

Question 3

anterior mid-cervical curve TP location and treatment

Answer 3

• location: roughly the anterior transverse process of C4

- treatment: lift head slightly, rotate away, flex C spine and sidebend toward the TP

Question 4

what is the intent for the anterior mid-cervical curve TP treatment?

Answer 4

decompress phrenic nerve

Question 5

bilateral spinous process TP location and treatment

Answer 5

• location: spinous process of C4 just left or right of midline in mid-posterior cervical area
• treatment:
• lift head just enough to slightly flex neck
• rotate head away and slightly sidebend toward (point inion toward) the TP
• lower head toward table to point of comfort

Question 6

T2 interspace TP location and treatment

Answer 6

• location: on side opposide to which T1 is rotated in the interspace between ribs 1 and 2 roughly at mid-clavicular line
• treatment: flex neck until motion is felt with monitoring finger, then slightly sidebend away and rotate towards so that the chin / nose points toward TP

Question 7

t3 interspace TP location and treatment

Answer 7

• location: on side to which T1 is rotated (in convexity created by inlet rotation) and in interspace between ribs 2 and 3 roughly at mid-clavicular line
• treatment: flex neck until motion is felt with monitoring finger, and slightly sidebend away and rotate toward so that the chin / nose points to TP

Question 8

indirect treatment of fibular head to balance tension in interosseus membrane: diagnosis

Answer 8

1. place thumb and index finger of cephalad hand around proximal fibular head to monitor motion
2. flex knees slightly
3. with caudad hand, evert foot, externally rotate tibia, and dorsiflex ankle
4. then invert foot, internally rotate tibia, and plantar flex the ankle
5. determine direction the proximal fibular moves most freely (posterior-medial or anterior-lateral)

Question 9

treatment of a posterior medial fibular head

Answer 9

1. place thumb and index finger of cephalad hand around proximal fibular head to monitor motion
2. flex knees slightly
3. with caudad hand, evert foot, externally rotate tibia, and dorsiflex ankle
4. simultaneously guide fibular head in a posterior and medial direction to accentuate its movement
5. find a point of balance between your hands and hold until a release is felt

Question 10

treatment of an anterior lateral fibular head

Answer 10

1. place thumb and index finger of cephalad hand around proximal fibular head to monitor motion
2. flex knees slightly
3. then invert foot, internally rotate tibia, and plantar flex the ankle
4. simultaneously guide the fibular head in an anterior and lateral direction to accentuate its movement
5. find a point of balance between your hands and hold until a release is felt