Palpation

Question 1

FB Positional Fault

Answer 1

Ex MOI: expect to pick up a empty cooler but it is full
Clinical Presentation: pt presents flexed over, ext ROM is limited
PFC: decreased gap b/w T8-T9
When patient FB, facets should bilaterally upside
With FB positional fault (ex: T8-T9), T9 is stuck in upside, T8 is directly over T9 causing an increased space b/w T9-T10 and a decreased space b/w T8-T9
Tx: P/A glide bilateral contact on T10 TP causing bilateral gapping of facet jt

Question 2

BB Positional Fault

Answer 2

MOI: hyperextension injury
T9-T10 gets jammed into downslide causing an increased space b/w T8-T9 and decreased space b/w T9-T10
Clinical Presentation: Pt is unable to bend forward, no neurological signs
Tx: P/A glide bilateral contact on T0 TP causing bilateral gapping of facet jt

Question 3

Rotational Positional Fault

Answer 3

Ex: T9 rotated RIGHT on vertebral body of T10
Clinical Presentation: pt reports rotational MOI, can rotate R but not L
PFC: spinous process deviated to the L
Refer for X-rays to determine positional fault
TX: L ROT with lower finger on L TP of T10; R finger on TP of T9

Question 4

PIVM Scale

Answer 4

0 - ankylosis
1 - considerable restriction, hypomobile (tx with non-thrust initially)
2 - slight restriction, hypomobile (tx with non-thrust OR thrust)
3 - normal
4 - slight hypermobile (tx with stabilization)
5 - considerable hypermobile (tx with stabilization)
6 - unstable (tx with stabilization or pt may need fusion)