hips don't move, try to reach floor with hands, mark distance from floor. keep knees extended & feet together this exercise combines hip flexion 4 inches off ground is norm

1. Sternal notch 2. Acromion process 3. C7 4. tip of chin 5. Base of nares 6. Mastoid Process 7. Auditory meatus

Skills Check off #1 Flashcards by August Sivak

Thoracolumbar flexion (ROM)

hold hips and stop when hips rotate backward. The focus here is flexion of your thoracolumbar spine.

*This measurement is from S2 to C7

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trunk flexors ROM

supine, regular sit up

start at 3, arms to the side

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MMT 1-5

0- paralyzed
1-  feel internal flex
2-  movement w/o gravity
3-  movement against gravity
4-  2 fingers
5-  most resistance

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Just Lumbar flexion/extension ROM

hold hips. measure from s2 go 15cm up. mark spot at 15cm. have flex and measure difference from 15cm.

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body land marks on spine

c7 is above t1

s2 is just below dimples or PSIS

L4 is top of iliac crest

t12 is last floating

T7 is inferior angle of scapula

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trunk extensors

lay prone

chest and head up, looking for xiphoid process off the table

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ROM thoraco-lumbar rotation

arms relaxed, rotate chest cavity

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MMT for low ab

patient lays supine, help lift up legs, put hand under back, have slowly lower legs and determine when lumbar spin flexes

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Angles for low ab MMT

75- is 2
70 is 3-
60 3+
45 4-
30 4

1 is unable to maintain position

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quadratus lumborum

(side hip raises

*line leg with hips (point leg more lateral then medial)

have them elevate hip and hold it and you put resistance on

5 full resistance
4 some
no three with no gravity (could do standing up)
2- no resistance

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lumbar rotators

lying supine do crossovers

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forward flexion

hips don’t move, try to reach floor with hands, mark distance from floor. keep knees extended & feet together

this exercise combines hip flexion

4 inches off ground is norm

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modified schobers test

this is the 15cm

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Cervical landmarks

Sternal notch
Acromion process
C7
tip of chin
Base of nares
Mastoid Process
Auditory meatus

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Normal values for cervical joint motion

for Cx flex

CROM 50 (40-60)
G-meter (40)
Tape 1-4cm
I-meter 50 °

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Normal values for cervical joint motion

Cx Ext

Crom- 70 (49-86)
G-meter 50
tape - 18-22 cm
Imeter 60

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Normal values for cervical joint motion

cx Lat Flex

Crom- 45 (26-45)
G-meter- 25
Tape 10-12 cm
Imeter- 45

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Normal values for cervical joint motion

Cx Rotat

Crom- 70 (46-75)
G-meter- 75
Tape 11-13 cm
Imeter- 80

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CX Flexion

CROM 50 (40-60)
G-meter (40)
Tape 1-4cm
I-meter 50 °

having patient sit with supported T & L.

Flexion-gently push chin to chest, firm end feel

Ext- gently push upward on chin and pull back on occipital

Goniometer- patient with hands on knees
Fulcrum: Auditiory meatus
Prox: perpendicular to ground
Distal: base of nares

Flexion & extension starts at 90°

Tape measure: one end on chin other in sternal notch.

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using goniometer for cervical side/lateral flexion

Crom- 45 (26-45)
G-meter- 25
Tape 10-12 cm
Imeter- 45

C7 is fulcrum

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using goniometer for cervical rotation

Crom- 70 (46-75)
G-meter- 75
Tape 11-13 cm
Imeter- 80

fulcrum is over patients head

proximal: parallel to imaginary line between acromial processes

Distal: in line with tip of nose/tongue depressor

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tape measure for cervical side flexion

mark patients mastoid and acromion process with pen.

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tape measure for Cx Rt

Crom- 70 (46-75)
G-meter- 75
Tape 11-13 cm
Imeter- 80

mark patients acromion and measure from chin.

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Cx flexion with dual inclinometer

C7 @ zero
posterior head

flex chin to chest and take difference

Cx ext with dual inclinometer

1. spine of scapula 2. posterior head extend head and record distance

Cx side flexion with dual inclinometer

1. over c7 and other over top of head, both set @ zero | - side flex and record the difference

Cx Rot with I-meter

just use one, lay supine, put on forehead and have patient rotate

Cervical muscle groups for forward flexion

``` longus capitis longus colli rectus capitus (maybe anterior?) anterior scalene sternocleidomastoid ```

Cervical muscle groups for Anterolateral flexion

sternocleidomastiod

Cervical muscle groups for Extension

obliques capités superior Rectus capitis posterior ( maj & minor) semispinalis capitis & cervicis splenius capitis and cervicis Upper trapezius

MMT neck flexion

patient in supine with shoulders abducted to 90° stabilize: abs and or thorax Palpation: longus capitis and longus colli anterior to sternocleidomastoid (SCM) apply resistance to forehead (for 4 or 5) give 1-5

MMT anterolateral neck flexion

patient supine with abducted 90° and head turned to contralateral side Stabilize: abs and/or thorax palpate: SCM Patient: laterally flex the neck to the side of resistance Grade 3 is no resistance, 2 is partial rom in lateral flexion

MMT in Neck extension

Patient: prone, shoulders abducted 90° & elbows flexed Stab: upper thorax palp: neck extensors lateral to spinous process examiner: stabilize thorax as needed and apply resistance on the occiput as the patient attempts extension Patient: extend the head and neck through complete ROM

Muscles of mastication

Medial Pterygoid: jaw protrusion & lateral deviation Lateral Ptyergoid: opening your mouth temporalis: Masseter:

muscles of facial expression

Occipitofrontalis: raising eyebrows Corrugator supercilli: frowning orbicularis Occuli: close the eyes tightly

Muscles of facial expression

Procerus: raising skin of nose Nasalis: widening nostrils Levator labii superioris- raising upper lip to show teeth Zygomaticus major- smiling orbicularis oris- whistling Buccinator: blowing flute or trumpet

We need _____% of Cx ROM to perform ADL

70%

Spine Anterior Aspects

ribs edge of rib cage umbilicus iliac crests- anterior superior iliac spine

Spine Posterior Aspects

twelfth rib posterior superior iliac spine (PSIS) dimples sacrum spinous processes of vertebrae

what is the significance of t2

superior angle of scapula

what is significance of t7

inferior angle of scapula

what is significant of t12

twelfth rib

what is significance of l4

iliac crest

finder transverse spin

have lie prone and about 1 inch from SP in thoracic and 2 inches in lumbar

what is the lamina groove

area north or south of two transverse vertebrae

AMA prefer which measurement tool

inclinometers

If you find PSIS you have

S2 in the middle

how do you use tape measure for T-L flexion

stabilize spine then look at C7 and s2. take difference of two

dual inclinometer forward flexion and extension for TL spine

inclinometers at midline of S2 and T1 ***T1 not C7

dual inclinometer for forward flexion and extension for lx spine

inclinometers at s2 & t12(last rib)

dual inclinometer for lateral flexion for TL spine

S2 & T1

goniometer for lateral flexion for T-L Spine

fulcrum is at s2 SP proximal is perpendicular to ground Distal follows C7

goniometer for rotation for T-L spine

fulcrum is top of head proximal is acrominal process distal is movement of head

modified schooners test for lumbar flexion

1st mark midpoint of sacrum at PSIS measure 15cm above that point

normal value for forward flexion and side flexion with tape measure

4 inches forward 21.6 cm side flexion

normal value with goniometer for side flexion and rotation

side flexion- 35° | rotation 45°

normal value of forward flexion, extension, and side flexion with inclinometer

60° (lumbar motion s1 & t12) ext 25° side flexion 25°

males vs females with ext & flexion of spine

women- better extent | men- better flex