Rib, Anterior Cervical, Anterior Thoracic Counterstrain Flashcards

1
Q

counterstrain steps

A
  1. Structural exam to locate somatic dysfunction
  2. Find a significant tender point
  3. Establish pain/tenderness scale
  4. Wrap the patient around the tender point while monitoring
  5. Reduce pain by at least 70% (ptin position of comfort)
  6. Maintain position for 90 seconds
  7. Passively return to neutral
  8. Recheck/reassess
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2
Q

if you have similar tenderness points, which do you treat first?

A

treat most central/and or proximal

if thoracic and rib TP, treat thoracic 1st

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3
Q

What tender point is and where should you press down:

Posterior surface of ramus of mandible

A

AC1 mandible

push posterior to anterior

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4
Q

What tender point is and What tender point is and where should you press down:

Midway between ramus and mastoid process on the transverse process of C1

A

AC 1 TP

push lateral to medial (Rennie)

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5
Q

What tender point is:

Anterior surface of transverse processes

A

AC 2-6

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6
Q

What tender point is and where should you press down:

2cm lateral to the medial end of the clavicle

A

AC 7

clavicular head of SCM

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7
Q

What tender point is and where should you press down:

Medial end of clavicle

A

AC 8

sternal head of SCM at sternal notch

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8
Q

AC1 TP and mandible are put in to what tx positions?

A

cervical SaRa

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9
Q

AC 2-6 are put in to what tx positions?

A

Cervical FSaRa

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10
Q

AC7 is put in to what tx positions?

A

cervical FStRa

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11
Q

AC8 is put in to what tx positions?

A

cervical FSaRa

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12
Q

an anterior rib tenderpoint indicates what?

A

DEPRESSED ribs

ribs depress w exhalation

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13
Q

an posterior rib tenderpoint indicates what?

A

ELEVATED ribs

ribs elevate w inhalation

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14
Q

Anterior Ribs are put in to what tx positions?

A

FStRt

AR 1-2: supine

AR 3-10: use your knee opposite to the tender point, and prop his arm up on your knee

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15
Q

What tender point is:

below clavicle on rib 1, lateral to maubrium

A

AR 1

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16
Q

What tender point is:

superior aspect of the rib, midclavicular line

A

AR 2

17
Q

What tender point is:

anterior axillary line on 3-6th ribs

A

AR 3-6

18
Q

when are ribs more prominent? less prominent?

A

less when elevated

more when depressed

19
Q

What tender point is:

On PosteroSuperior aspect of Rib 1 just lateral to the costotransverse articulation

A

PR 1

20
Q

What tender point is:

On the PosteroSuperior angle of the corresponding rib at medial border of scapula, about 2 1/2 inches lateral to midline

A

PR 2-10

21
Q

tx for PR 1-10?

A

Rib 1 E SART*** Maverick
pt is supine

Ribs 2-10 F SARA
pt is sitting

22
Q

What tender point is:

suprasternal notch

A

AT1

23
Q

What tender point is:

angle of the manubrium (Louis)

A

AT2

24
Q

What tender point is:

on the sternum at the same numbered costal level.

A

AT3-6

25
Q

TX position for anterior T1-6

A

cervical and thoracic flexion to level of TP

AT1-2: supine
AT3-6: seated, with arms holding the edge of the table in the back

26
Q

TX position for anterior T7-12?

A

F StRa

AT7-9: seated, using opposite knee to St, flexion with head, rotate away

AT10-12: stand on ipsi side, bring knees toward which rotates away
to return to neutral, he takes a deep breath while he does that flex his knees and bring them back down

27
Q

What tender point is:

inferior tip of xiphoid and/or 1/4 distance from tip of xiphoid and umbilicus

A

AT7

28
Q

What tender point is:

halfway between tip of xiphoid and umbilicus

A

AT8

29
Q

What tender point is:

3/4 distance from tip of xiphoid and umbilicus

A

AT9

30
Q

What tender point is:

1/4 distance from the umbilicus to the pubic symphysis

A

AT10

31
Q

What tender point is:

halfway between the umbilicus and pubic symphysis

A

AT11

32
Q

What tender point is:

on the anterior superior surface of the iliac crest at the mid-axillary line

A

AT12

33
Q

What does rotation refer to?

A

movement of lumbar vertebrae in relation to tender point

ie moving LE towards tenderpoint, torso and lumbar vertebrae rotates away

34
Q

To diagnosis for posterior ribs what should you do first?

A

have the pt should cross arms so you can pull the scapula away

35
Q

for posterior, rib 3-10 how do you set up for the tx?

A

you use your opposite knee to SB, and pull his oppo shoulder to turn away

36
Q

how should you return to neutral?

A

have the pt take a deep breath and as they exhale, slowly move them to neutral