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OMM M1T2E3 > Principles of HVLA Thrust Technique > Flashcards

Principles of HVLA Thrust Technique Flashcards

1
Q

Define HVLA

A

osteopathic technique employing a rapid therapeutic force of brief duration that travels a short distance within the anatomic range of motion of a joint; engages restrictive barrier in one or more planes that releases restriction Does not go beyond anatomic barrier

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2
Q

What type of manipulative treatment is HVLA?

A

direct

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3
Q

What type of motion should be restored to the dysfunctional joint after HVLA?

A

appropriate physiologic motion

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4
Q

Which barrier is engaged and which barrier is moved through?

A

restrictive barrier is engaged and dysfunctional barrier is moved through

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5
Q

How many planes are positioned before a final force is delivered?

A

all three planes

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6
Q

What theories explain the popping noise?

A

Hutton (bone popping into place); Wharton Hood (snapping of adhesions); Hargrove-Wilson (breaking of joint seal and release of nitrogen bubble); Nicholas-Ehrenfeuchter (thin layer adherence

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7
Q

Process where two congruent surfaces are “glued” together by a typically lubricating substance is thinly spread

A

This layer adherence theory

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8
Q

Joint surfaces in complete contact with each other in the anatomic position.

A

Congruent surgaces (ex. spinal facet joints)

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9
Q

List an example of a non congruent surface

A

Femoral condyles on tibial plateau

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10
Q

Synovial fluid is __X slippier than ice on ice

A

10X

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11
Q

Synovial fluid possesses (high/low) surface tension.

A

very high

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12
Q

An articular release must always be audible. (T/F)

A

False

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13
Q

An articular release can be present in a healthy state. (T/F)

A

True

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14
Q

How fast is an articular release?

A

0.04 to 0.06 seconds

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15
Q

What is phonoarthrography?

A

method for recording release; commonly studied in metacarpal phalangeal and cervical spine facet joints

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16
Q

List the steps of articular release?

A

Step 1: preliminary tension mobilization
Step 2: articular release
Step 3: overshoot in release
Step 4: Refractory tension; release in tension

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17
Q

What regions make an articular clunk?

A

sacroiliac joint, hip joint, any osteoarthritic joint

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18
Q

An articular crack sounds like what?

A

a breaking noise; bimodal or multimodal peak

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19
Q

An articular pop expresses what modality on a sound frequency scale?

A

single modal curve

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20
Q

When is crepitus most frequently emitted?

A

wrist in lateral extension

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21
Q

A ligamentous strum is a result of what?

A

a tense ligament or fascial structure rolling over a bone or solid prominence

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22
Q

A torn adhesion sound is heard during a ?

A

frozen shoulder; high-pitched non-repreatable tearing

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23
Q

What is the pressure in a facet joint just prior to release?

A

3.5 atmospheres

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24
Q

In what state must muscles be for producing articular release?

A

relaxed muscles

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25
Q

Too frequent articular mobilization may lead to what?

A

hypermobility and ligamentous & capsular hypertrophy

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26
Q

What is the refractory period in the finger? spinal articulations?

A

finger - 20 minutes

spinal articulations - 1- several hours

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27
Q

When external barometric pressure is lower it makes joints (easier or more difficult) to crack.

A

easier

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28
Q

What are some contraindications for HVLA?

A 
1 - unstable or hypermobile joints
2 - Rheumatoid arthritis
3 - Down Syndrome
4 - Advanced carotid disease
5 - local metastases
6 - osseous or ligamentous disruption and infection
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29
Q

Do you need to do a physical exam before manipulation?

A

yes

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30
Q

List 9 screening exams

A 
1 - Spurling's test
2- compression test
3- distraction test
4- vertebral artery test
5 - menigeal irritation tests
6- DTR: UE & LE
7 - Muscle strength
8 - sensation
9 - specific somatic dysfunction
31
Q

How do you set up the Spurling’s test?

A

extend neck and rotate & sidebend head toward side of testing. Then add axial force by physician

32
Q

Why would you use a Spurling test?

A

evaluate cervical nerve root impingement

33
Q

What is a positive compression test?

A

reproduction of radicular symptoms distant from the neck

34
Q

When would you do a distraction test?

A

only with a positive compression or spurling’s test

35
Q

What symptoms would display with C4/C5 disc herniation?

A

weakness in deltoid muscle; some shoulder pain

36
Q

What symptoms would display with C5/C6 disc herniation?

A

weakness in the biceps and wrist extensor muscles; numbness, tingling ** most common level**

37
Q

What symptoms would display with C6/C7 disc herniation?

A

weakness in triceps and finger extensor muscles; numbness, tingling also common level

38
Q

What symptoms would display with C7/T1 disc herniation?

A

weakness in handgrip, numbness, tingling

39
Q

How do you place the patient’s head during the vertebral artery test?

A

passive extension and cervical spine rotation

40
Q

In the vertebral artery test, which vertebral artery will be tested (ipsilateral/contralateral)

A

contralateral

41
Q

What does a positive vertebral artery test result in?

A

dizziness, nausea, syncope, dysarthria, dysphagia

42
Q

List 2 meningeal irritation tests

A

Kernig’s sign; Brudzinski’s sign

43
Q

What factors can influence deep tendon reflexes?

A

age, metabolic factors (thyroid dysfunction, electrolyte abnormalities) and anxiety level

44
Q

Key sensory level C2

A

occipital protuberance

45
Q

Key sensory level C3

A

supraclavicular fossa

46
Q

Key sensory level C4

A

superior AC joint

47
Q

Key sensory level C5

A

lateral side of antecubital fossa

48
Q

Key sensory level C6

A

thumb, dorsal

49
Q

Key sensory level C7

A

middle finger, dorsal

50
Q

Key sensory level C8

A

little finger, dorsal

51
Q

Key sensory level T1

A

medial side of antecubital epicondyle

52
Q

Key sensory level T2

A

apex of axilla

53
Q

Key sensory level T3

A

3rd intercostal space

54
Q

Key sensory level T4

A

nipple line

55
Q

Key sensory level T5

A

5th intercostal space

56
Q

Key sensory level T6

A

xiphoid process

57
Q

Key sensory level T7

A

7th intercostal space

58
Q

Key sensory level T8

A

8th intercostal space

59
Q

Key sensory level T9

A

9th intercostal space

60
Q

Key sensory level T10

A

10 intercostal space

61
Q

Key sensory level T11

A

11th intercostal space

62
Q

Key sensory level T12

A

inguinal ligament

63
Q

Key sensory level L1

A

top of thigh

64
Q

Key sensory level L2

A

mid-anterior thigh

65
Q

Key sensory level L3

A

medial femoral condyle

66
Q

Key sensory level L4

A

medial malleolus

67
Q

Key sensory level L5

A

dorsum of foot at 3rd MTP; lateral leg

68
Q

Key sensory level S1

A

lateral heel

69
Q

Key sensory level S2

A

popliteal fossa

70
Q

Key sensory level S3

A

ischial tuberosity; groin

71
Q

Key sensory level S4-S5

A

perianal area

72
Q

Cervical manipulation is much safer than the use of NSAIDs (T/F)?

A

True

73
Q

Does the physician emphasize force or localization?

A

localization

74
Q

What is the indication for HVLA?

A

somatic dysfunction with articular restriction

OMM M1T2E3 (9 decks)

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