Review Flashcards
What 3 things to focus on for FPR?
- Flatten curve
- Freedom of motion (indirect postion)
- Force (activating)
What 3 things to focus on for Stills?
- Put in ease of motion (indirect)
- Compress
- Take into RB (direct)
Dx ribs
Rib Dx: go through entire and see what patient likes to do
· Claw hands for rib 1
· Line hands on along ribs and sternum
· For ribs 11-12, bring hands around to back
Dx abdominal diaphragm
Abdominal Diaphragm Dx: name for what the pt likes to do in 3 planes of motion
· F/E
· Rotation/SB
Dx Pelvis and Upper Leg TP
- Do a seated flexion test
- a. Put my hands on PSIS and have pt lean forward
- b. Whatever hand goes superior, + forward-bending test on that side
2. Lay on back, faced up; look at heights of
- a. Iliac crest
- b. ASIS
- c. Mallei
- d. Feel leg and ask for TP throughout the leg
- Lay on stomach: look at heights of
- a. PSIS
- b. Feel butt and leg muscles and ask for TP throughout the le
***Asymmetric and hypertonicity should be on the dysfunctioned leg
Anterior innominate rotation
- + standing flexion test
- Iliac crest: even
- ASIS: inferior on side of dysx
- Malleoli: long on side of dsyfx
- PSIS: superior on side of dysfx
Posterior innominate rotation
- + standing flexion test
- Iliac crest: even
- ASIS: inferior on side of dysx
- Malleoli: long on side of dsyfx
- PSIS: superior on side of dysfx
Superior innominate shear
o + standing flexion test on side of dsyfx
o ASIS: superior on side of dysfx
o PSIS: superior on side of dysfx
o Malleoli: short on side of dsyfx
o Iliac crest: superior on side of dysfx
o Pubic tubercle height: superior on side of dyfx
Inferior innominate shear
o + standing flexion test on side of dsyfx
o ASIS: inferior on side of dysfx
o PSIS: inferior on side of dysfx
o Malleoli: long on side of dsyfx
o Iliac crest: inferior on side of dysfx
o Pubic tubercle height: inferior on side of dyfx
Dx Sacrum Dx with FPR Sacral Eval (restricted only)
Treat
- Put pillow under pts abdomen
- Put hands on ILA => push forward to head => feel which is restricted
* + test if restriction occurs- Doesn’t like to go forward on R side
- Thus, pt does not like to SB L, does like to SB R
- Doesn’t like to go forward on L side
- Thus, pt does not like to SB R, does like to SB L
- When tx when Prone FPR sacal: need to be on OPPOSITE side
- add a 2nd pillow under mid thigh
- While monitoring with thenar eminence ILA:
- Abduct entire leg off table
- Flex it down
- ER/IR where pt likes to go
- AF: push thenar eminence toward head for 3-5 seconds
- Neutral and reassess
- Doesn’t like to go forward on R side
- Put hands on ILA => push forward to head => feel which is restricted
When TX ribs:
BITE mnemonic -> Treat the:
- ________ rib for inhalation SDs
- _______ rib for exhalation SDs
- Bottom rib => inhalation SD
- Top rib => exhalation SD
Seated FPR can be used to treated what rib SDs?
- 1. Costochondral SD => tenderpoint on front of chest
- 2. Posterior ribs
- 3. Inhalation/exhalation sD
CHF Tx:
- 1. Suboccipital release
- 2. Thoracic inflet MFR
- 3. Dome the diaphragm
- 4. Pedal pumb
- 5. Rib raising
- 6. Efflaurage and petrissage
· Suboccipital Release
o Cup patients head
o Let weight of patients head rest on fingers tips
o Wait for tissue to relax
o Neutral and reassess
· Thoracic Inlet MFR
- o Place hands
- o Assess motion for: F/E, rotation and SB
- Hold until motion is restored
· Doming the Diaphragm
- o Patient lay down with knees flexed
- o Dome diaphragm
- § Tell pt to take a deep breath
- § Exhalation: push thumbs down and up
- § Inhalation: resist
- § Repeat 3-5 times
· Pedal Pump
o Dorsiflex pts foot
o Do a rhythmic force; 120 times per minute/ do for 1-2 minutes
· Rib Raising
o
§ Contact rib angles
§ Work from T12- up
· Effleurage Petrissage:
o Raise patients leg or arm to treat
§ Effleurage: stroke distal è proximal
§ Petrissage: “ring” knead and twist distal è proximal
· Close to you => further
Post Surgical PT:
- · Abdominal Ganglia Inhibition (do not do on pt if they have a midline incision)
- · Suboccipital Decompression
- · Cervical Ganglia Inhibition
- · Posterior Abdominal Diaphragmatic Release
- · Rib Raising
- · Abdominal Lift
- · Thoracic Inlet Release MFR (SC joint => angle of 1st rib posterior)- MFR
- · Abdominal Diaphragm Release
· Abdominal Ganglia Inhibition (do not do on pt if they have a midline incision)
- Place fingerpads along the patients mid-abdominal line and contact skin over ganglia
- Celiac ganglia: below the xiphoid
- Superior mesenteric ganglia: halfway between xiphoid and umbilicus
- Inferior mesenteric ganglia: just above the umbilicus
- Apply a gentle, downward pressure until I feel it soften
· Suboccipital Decompression
o Tx: superior cervical ganglion and vagus nerve
o Pt hand in suboccipital groove
o Essentially, the same thing as suboccipital release, except you add lateral traction and hold until tissue is released
· Cervical Ganglia Inhibition
o Contact articular pillars on cervical spine
o Lift anterior and superior, until tissue releases
Abdominal lift
o 1. Have pt lay down with feet flat on table
o 2. Pull bowel on 4 quadrants and push toward BB.
o 3. Load and hold for tissue to relax
· Thoracic Inlet Release MFR (SC joint => angle of 1st rib posterior)- MFR
o Apply a force down
§ Anterior/posterior motion
§ Side to side motion
§ Rotation clockwise and counterclockwise
o Follow where tissue wants to go and hold until I feel change
o Have pt take a few deep breaths until tissue releases
o Neutral and reassess
· Abdominal Diaphragm Release
o Contact lower rib cage and engage diaphragm that is deep
o Motion test: w rotation, translation, flex and extend
o Follow where tissue wants to go and hold until I feel change
o Have pt take a few deep breaths until tissue releases
o Neutral and reassess
FPR techniques:
Flatten curve, FOM (indirect), Activating force
- 1. Sacral (prone)
- 2. Piriformis (prone)
- 3. Glut max (prone)
- 4. Hamstrings (prone)
- 5. Quads (supine)
- 6. Costochondral SD (seated)
- 7. Posteiror rib (seated)
- 8. Inhale/Exhale Rib SD (seated)
Still Technique
Put in ease of motion, compress and take into RB
- 1. Superior inominate shear
- 2. Posteiror inominate rotation
- 3. Anterior inominate rotation
- 4. Posterior rib (like throwing a baseball)
- 5. INH/EXHALE Rib SD (patient is supine)
