Review: T Spine And Rib HVLA Flashcards
doc/pt positioning for HVLA supine T-spine
Doc stands opposite side of PTP
Type 1: side bend away from doc
Type 2: sidebend toward doc
Upon exhalation, doc exerts posterior to anterior HVLA thrust through their abdomen toward PTP
[this is Kirksville Crunch]
Doc/pt positioning for HVLA prone (note type 1 vs. type 2 hand placement)
Stand opposite side of PTP
Type 1: hand facing caudad, place hypothenar eminence on PTP. Hand facing cephalad, place thenar eminence on opposite TP
Type 2 (flexed): hand facing cephalad, place thenar eminence on PTP; hand facing caudad, place hypothenar eminence on opposite TP
At end of exhalation, a downward anterior HVLA thrust with a counterbalance (twist) in direction the fingers are pointing with greater force on PTP side
Doc/pt position for seated 1st rib inhalation dysfunction (J stroke)
Pt seated with doc standing behind
Doc places foot on table opposite the dysfunction and pt drapes arm over doc’s knee
Doc contacts dysfunctional rib with second MCP joint of one hand and top of pts head with the other, engaging barrier by SB head TOWARD the dysfunctional rib
Thrust is inferior/medially on superior rib
Upper ribs 1-4 inhalation HVLA (chin pivot)
Pt prone with doc standing at head of table opposite side of dysfunction
Pt cups their chin with hand ipsilateral to SD
Thrust = anterolateral
Rib 3-10 inhalation SD, exhalation emphasis HVLA
Pt supine with doc opposite dysfunctional rib
Pt crosses arms over body with arm on side of dysfunctional rib on top
Doc places thenar eminence of caudad hand posterior/SUPERIOR to angle of dysfunctional rib
At the end of exhalaation doc applies posterior thrust directed toward thenar eminence
Rib 3-10 exhalation SD, inhalation emphasis HVLA
Pt supine with doc opposite dysfunctional rib
Pt crosses arms over body with arm on side of dysfunctional rib on top
Doc places thenar eminence of caudad hand posterior/INFERIOR to angle of dysfunctional rib
At the end of exhalation, doc applies posterior thrust directed SLIGHTLY CAUDAL to doc’s thenar eminence
Pt position for posterior rib head modified kirksville crunch HVLA
Pt supine with doc opposite side of dysfunction
Pt crosses arms over body - arm on side of dysfunction grasps opposite ASIS while contralateral arm grasps opposite shoulder
Thrust is posterior toward thenar eminence
