OPP Flashcards
posterior fibular head
talus internally rotated
foot inverted and plantarflexed
(recall: PEED, AIIP are ME setup only)
anterior fibular head
talus externally rotated
foot everted and dorsiflexed
(recall: PEED, AIIP are ME setup only)
Yergason’s test
asseses long head of the biceps tendon
have pt flex elbow to 90 with forearm pronated, then have them supinate against resistance
Adson’s test
to dx thoracic outlet syndrome
have patient turn head to ipsa side and extend neck with deep inspiration
(+): pt loses radial pulse on that side
Finkelstein test
for De Quervain tenosynovitis
(affects aBductor pollicus longus and extensor pollicus brevis)
presents with radial wrist/thumb pain
Primary Respiratory Mechanism
CNS, CSF, dura, cranial bones, and sacrum
dural attachments (4 sites)
foreamen magnum, C2, C3, and S2
Reciprocal Tension Membrane
meninges, dura
allows for cranium and sacrum to move in sync
normal cranial rhythmic impulse? (CRI)
10-14 cycles/minute
how does the sacral base move during SBS flexion?
posteriorly (opposite of anatomical flexion )
how does the sacral base move during SBS extension?
anteriorly (opposite of anatomical extension )
sacral nutation?
anatomical flexion
sacral counternutation?
anatomical extension
the sacrum rotates around this axis for cranial movements
superior transverse axis (S2)
the innominate rotates around the sacrum on this axis
inferior transverse axis
where do you feel on the skull for craniosacral mvmt?
at the SBS articulation: the occiput (basilar portion) and the sphenoid
Cobb angles? how do you measure?
mild? moderate? severe?
measurement: draw horizontal lines from the vertebral bodies of the ends of the curve. Draw perpendicular lines from these horizontal lines. The angle they form is the Cobb angle
mild: 5-15
moderate: 20-45
severe: 50+
What Cobb angle does respiratory function become affected?
CV function?
resp: 50+
cardio: 75+
The sacrum moves around this axis for respiratory motion
S2 superior transverse axis
The sacrum moves around this axis for postural motion
Middle transverse axis
3 Rules about sacral torsion relating to L5?
1) When L5 is sidebent, the sacral oblique axis is engaged on the same side as the sidebending
2) When L5 is rotated, the sacrum rotates the opposite way on an oblique axis
3) The seated flexion test is found on the opposite side of the oblique axis
What Cobb angles should you brace?
between 20-40
surgery at greater than 45
CCP is (L/R)
OA - L
CT - R
TL - L
LS - R
Midline bones (cranial)
sphenoid
occiput
ethmoid
vomer
paired bones (cranial)
Frontal (metopic suture)
temporal
parietal
Starting heel lifts: elderly vs young person?
Elderly: do 1/16” aka 1.5mm
young: do 1/8” aka 3.2mm
will want to increase thickness q2weeks until 1/2 to 3/4 of discrepancy is reached
max leg length discrepancy that can be treated with heel lifts?
must be less than 2cm
Things that happen during cranial flexion
midline bones flex
paired bones extend
Ernie head (AP diam shrinks, transverse diam grows)
things get pulled cephalad
Things that happen during cranial extension
midline bones extend
paired bones flex
Bert head (AP diam grows, transverse diam shrinks)
things get pulled caudad
Concentric m. contraction?
muscle shortens (origin and insertion approximate) during tension
Eccentric m. contraction?
muscle lengthens (origin and insertion move apart) during tension
CP of middle ear (AOM)
first rib and clavicles, superior medial aspect of clavicle
Celiac ganglion release levels
T5-T9
inferior mesenteric release levels
distal 1/3 of T colon and down to rectum, include lower ureters (T12-L2)
Superior mesenteric release levels
duodenum to 2/3 T colon (T10-T11)
CP of vagina
posterior thigh
Posterior CP of bladder
Transverse process of L2
Posterior Kidney CP
between T12-L1
Posterior Appendix CP
T11 transverse process
Prostate CP
lateral and posterior margin of IT band
CP colon
anterior IT band
CP for rectum
over lesser trochanter
CP of heart
2nd intercostal space
2nd intercostal space
myocardium, thyroid gland, esophagus, bronchi
CP for pancreas
right 7th intercostal space
CP for spleen
left 7th intercostal
Cervical Main Motion and SB/R
OA - F/E - Opposite SB and Rot
AA - Rot - Opposite SB and Rot (Type I)
C2-C4 - Rot - Same SB and Rot
C5-C7 - SB - Same SB and Rot
Typical Ribs
Ribs 3-10
Atypical Ribs
Ribs 1,2,11,12
True Ribs
Ribs 1-7
False Ribs
Ribs 8-10
Floating Ribs
Ribs 11-12
Pump Handle Ribs
Ribs 1-5
Bucket Handle Ribs
Ribs 6-10
Caliper Motion Ribs
Ribs 11, 12
Rib 1 Muscle
Anterior Scalene
Ex ME: head moves anterior
Rib 2 Muscle
Posterior Scalene
Ex ME: turn head 30 degrees away and lift head
Rib 3-5 Muscle
Pectoralis minor
Ex ME: push elbow towards opposite ASIS
Ribs 6-8 Muscle
Serratius Anterior
Ex ME: push arm anterior
Ribs 9-10 Muscle
Lat Dorsi
Ex ME: adduct arm
Ribs 11-12 Muscle
Quadratus lumborum
Ex ME: adduct arm
Knock Knee and Q angle
Genu valgus and Inc Q angle
Primary Respiratory Motion
- CNS - inherent mobility of brain and spinal cord
- CSF - fluctation of CSF
- Dura - movement of intracranial and intraspinal membrane
- Cranial - articular mobility of cranial bones
- Sacrum - involuntary mobility of the sacrum between ilia
Torsion
named for superior greater wing of sphenoid
i.g. left index finger is more cephalad in L torsion
SB/Rotation
named for which was the SBS points
i.g. Left sidebending = “apex left”
Vertical
named for sphenoid motion
i.g. pinkys point opposite up/down
Lateral strain
named for sphenoid again
i.g. pinkys point toward the side
Cervical CS
Anterior - SARA
Maverick C7 - F STAR
Posterior - ESARA
Maverick Inion - F only
Thoracic CS
Anterior F SARA
Posterio E SARA
Ribs CS
Anterior Ribs 1,2 - F head + STRT
Anterior Ribs 3-6 - STRT only
Posterior Ribs - E SARA
Lumbar Tender Points
L1 - medial to ASIS
L2 - L4 on AIIS
L2 medial, L3 lateral, L4 inferior to L3
L5 - 1 cm lateral to pubic symph on superior ramus
Lumbar CS
Anterior - Hips F and rotated away
Posterior - Hips extened and SB away
Lumbar Maverik Posterior
L5 - Prone hip and knee flexed, leg IR and adducted
iliacus TP
~7cm medial to ASIS
Tx: supine hip flexed and ER
Piriformis TP
in pirimformis muscle 7cm medial and slightly cephald to greater troch
Tx: Prone hip and knee flexed, thigh abducted and ER
FPR
neutral, compression/distraction, ease
FPR is NiCE
Still
Ease into Restriction
Tx Sacrum ME
Axis side down
Forward Torsion Face Down - “fall forward face plant”
Backwards Torsion lies on their Back
constant muscle tension w/ change in length
isotonic
Isotonic sub types
Concentric - muscle shortens (curls)
Eccentric - muscle lengthens
Isolytic
doctor lengthens against contraction (force to lengthen ig muscle strength testing)
Isometric
no shortening or lengthening i.g. Muscle Energy
Isokinetic
no change in speed while lengthening/shortening - swimming
CP for Esophagus
2nd and 3rd ICS
Thyroid CP
2nd ICS
Bronchi CP
2nd ICS
Larynx CP
superior aspect 2nd rib
Upper Lung/Lower Lung CP
3rd and 4th ICS
Stomach CP
L 5th ICS (acid)
L 6th ICS (perstalisis)
Liver CP
5th and 6th R ICS
GB CP
6th R ICS
Urethra CP
superior ramus, 2cm lateral to symph
Ovaries CP
lateral to pubic symph
Prostate/Broad lig CP
outer femur
Pylorus CP
center of sternum
Retina/Conjunctiva CP
greater tubercle of humerus
Neck CP
Surgical neck of humerus
Cerebellum CP
tip of coracoid process
Nasal sinuses CP
top of 1st rib midclav line
Pharynx CP
top of 1st rib meeting manubrium
Tongue CP
2nd rib at costosternal joint
