Piriformis Syndrome and Respiratory Patient Flashcards
5 findings you might expect to find on physical exam of this patient with UR infection/acute sinusitis
Pearly Grey Tympanic Membrane, Frontal sinus tenderness to palpation/percussion, Maxillary sinus tenderness to palpation/percussion, nasal erythema and edema, edematous inflamed oropharynx, postnasal drip/cobblestoning, Tissue texture change at OA, AA, and/or T1T4
Name the spinal level(s) from which the sympathetic nervous supply for the sinuses originate(s).
T1-4, passing through cervical ganglia
Name the spinal level(s) from which the parasympathetic nervous supply for the sinuses originate(s).
CN7, passing through sphenopalantine ganglion
A lymphatic tx technique for Area 1 for a pt with acute sinusitis/UR infection.
Area 1=chest
Technique: Pectoral Traction
Purpose: increasing negative pressure in thorax
Position: Pt supine, doc @ head.
Technique: grasp inferior border of pec @ anterior axilla. Arms extended, apply cephalad traction b/l. Pull when pt inhales and resist on exhale
Demonstrate and explain one lymphatic treatment for the head & neck region.
Pre/Post Auricular
Purpose: move congested lymph in ear region, temporal scalp, and lateral eyelids
Position: pt seated, doc in front or behind pt
Technique: spread fingers around ear to contact. Apply cw and ccw motion to auricular LN
Demonstrate and explain one sinus drainage techniques.
Direct Pressure, Sinus Milking
● Frontal sinus apply direct pressure over frontal sinuses with thumbs, increase pressure gradually and release in gentle, rhythmic motion (repeat cycle).
● Supraorbital notch gentle pressure applied over the supraorbital notch. Slide thumbs laterally along eyebrow ridge b/l
● Maxillary sinus apply pressure over sinuses with thumb, milk nasal passages by applying downward pressure on either side of nose while sweeping laterally across the maxilla
Name 3 areas where you would expect to find palpable evidence of somatic dysfunction related to the lower respiratory infection/pneumonia disease process.
Spine immobility and dysfunction, Rib restriction, diaphragm restriction, Chapman’s reflex point for lungs
Where would you expect to find palpable evidence of parasympathetic nervous system involvement in lower respiratory infection/pneumonia disease process.
OA, AA, Vagus Nerve - Congestion in sinuses, Ethmoid bone restriction, Headaches, restriction in cervical spine
Where would you expect to find palpable evidence of sympathetic nervous system involvement in lower respiratory infection/pneumonia disease process.
T2-7, upper thoracic sympathetic chain ganglion
Demonstrate the technique you would utilize first in the treatment of this patient’s lymphatic system.
Drive that Bus. MFR Thoracic Inlet.
Purpose: Move lymph centrally. Pt supine with HOB raised.
Doc: index fingers on SC joint, Angle Rib 1, Thumb on T1 transverse process. Press toward pt’s feet and twist hands to feel ROM. Feel that creep.
Define Piriformis Syndrome
This syndrome is associated with the piriformis muscle compressing the sciatic nerve. The syndrome presents with pain, tingling, numbness in the buttocks. Pain can extend down the sciatic nerve. Pain can be caused due to sitting in a car for a long period of time or running, or climbing stairs, or applying pressure to the piriformis muscle.
Possible etiology of Piriformis pain Syndrome
Piriformis muscle anatomical variant, spasm, trauma, overuse. Also, inactive gluteal muscles can facilitate the development of the syndrome, since gluteal muscles are extensors of the hip and aid the piriformis in external rotation of the femur.
Function of piriformis muscle when extended v flexed.
Extended hip - ER hip
Flexed hip >60 - ER, abduct hip
FABER: central, apprehension
Step 1/3
Hip flexed, abducted, ER. Doc induces further ER with posterior force at knee.
(+) anterior labral pathology
FABER: anterior/iliopsoas compartment
Step 3/3
Hip flexed, abducted, ER. Doc braces contralateral ASIS and patient IR against resitisnce
(+) iliopsoas insufficiency
