Pneumonia Flashcards
Still technique addresses primary what?
Primary articular (x, y, z-axis) type 1 and 2 dysfunctinos
Steps 1-3 for Still
- Make a diagnosis (type 1 or 2)
- Flatten (flex or extend) AP curve
- Add facilitating force (compression or torsion)
Steps 4-7 for Still
- Move dysfunctional segment toward position of ease of flexion or extension
- Move dysfunctional segment toward position of ease for side bending or rotation
- Hold 3-5 seconds (may have quick impulse) and slowly release pressure while returning to neutral
- Reassess with TART
For atlantoaxial C1-C2 dysfunction in PIR, why do we flex the patients head 45 degrees?
Segmentally restrict motions of the OA and C2-C7
For AA PIR, if we rotate the patient’s head to the R, which way do they push?
To the left
After the 3-5 second engagement and 2-second rest, where do we take the head in AA PIR?
Further, until we gently reach the restrictive barrier
How many times do we repeat the treatment in PIR for AA?
3-5 times or until motion is maximally achieved
What is the activating force for C2-C7 dysfunctions?
Gentle, 1 pound or less with working hand
What must we maintain during side-bending and rotation for C2-C7?
The compressive force
Where are our hands on rib raising?
Both hands under patient’s thoracolumbar region
Where do the pads of our fingers lay for rib raising?
On the paravertebral tissues over the costotransverse articulation on the side near the physician
Do we lean down on our elbows and simultaneously draw the fingers on for rib raising?
Yes
What kind of stretch does rib raising cause?
Lateral stretch
Rib raising may be performed as a what?
Intermittent kneading technique or with sustained deep inhibitory pressure
How do we place the shoulder in ribs 6-8 exhalation dysfunctions and serratus anterior contraction mobilizing the rib?
We flex is 90 degrees
Where do we place our hands on ribs 6-8 serratus? How do we exert our force?
Superior angle of dysfunctional rib; caudad and lateral traction
How does the patient push their elbow in ribs 6-8 serratus?
Toward the ceiling (scapular protraction)
For HVLA extended, which side do we stand on?
Opposite of the rotational component
What do we do with the arms in HVLA extended?
Place them across the chest forming a V with patient grasping opposite shoulders with hands
What is the effectiveness of the HVLA extended technique determined by?
Reassessing the intersegmental motion at the level of the dysfunctional segment
Is thoracic inlet/outlet “steering wheel” direct or indirect?
Direct
Where are the hands placed on “steering wheel”?
Thumbs over posterior first rib region and place index and 3rd digits immediately superior and inferior to clavicle at the sternoclavicular joints bilaterally
In “steering wheel” how much force do we use and for how long?
Just enough force to control the skin and underlying fascia so we don’t slide across the skin; 20-60 seconds
May the motion pattern for the hemi-diaphragm be similar or unique for each side? Related or unrelated to other dysfunction?
Yes
Where is our middle finger position on the back for hemi-diaphragm? Front?
On spinous process of T12; xiphoid process
How do our hands rotate on hemi-diaphragm?
Clockwise on inhalation; counter-clockwise on exhalation
Why do we use thoracic pump?
Atelectasis
7 contraindications for thoracic pump? (FOCIMSS)
- Fracture
- Osteoporosis
- COPD
- Incision
- Metastatic cancer
- Severe congestion
- Subclavian line
How do we have the hips and knees for thoracic pump?
Flext with feet flat
Where do we put our thenar eminences for thoracic pump?
Inferior to patient’s clavicles with fingers over rib cage (sternum for females)
How do we do thoracic pump during inhalation and exhalation?
Increase pressure on exhalation, maintain pressure during inhalation
Do we suddenly release pressure on last inhalation? Why?
Yes - patient takes rapid breath inflating any atelectatic segments
