T Spine and Rib HVLA

Question 1

positioning for HVLA supine T-spine

Answer 1

stand opposite PTP
pt crosses arm, PTP-side arm on top
use cephalad hand to lift patients head into restrictive barrier - F/E, sidebending (type 1 away, type 2 towards) and rotation

Question 2

prone HVLA setup

Answer 2

stand opposite PTP 
type 1: caudad hand on PTP, cephalad hand on opposite TP 
Type 2 (flexed): caudad hand on opposite TP, cephalad hand on PTP

Question 3

supine knee fulcrum HVLA setup

Answer 3

pt clasps fingers behind neck
put ipsilateral knee into PTP
place hands through pt arms and encircle rib cage with fingers over rib angles
pull patients . chest downward into thigh while adding cephalad traction

Question 4

seated lower T spine setup

Answer 4

pt seated with ipsilateral PTP hand behind neck and other arm grasping PTP elbow
stand opposite PTP and place ipsilateral hand on PTP
grasp biceps (Type 1- under arm opposite SD, Type 2 - over arm opposite SD)
engage RB in all thre eplanes
thrust on vertebrae

Question 5

HVLA seated knee fulcrum setup

Answer 5

pt seated with hands clasped behind neck
put ipsilateral kene to PTP into spine
pass hands beneath pts arms and through flexed arms to grasp forearms
pull pt over knee

Question 6

seated 1st rib HVLA

Answer 6

stand behind pt
place foot on table opposite SD and drape pt arm
contact dysfunctional rib with 2nd MCP and hold top of pt head
induce SB by moving head toward dysfunctional rib
inferior and meidal j stroke

Question 7

upper ribs 1-4 chin pivot HVLA setup

Answer 7

pt prone, cups chin with hand ipsilateral SD
physician places cephalad hand on rib
move pt elbow cephalod until motion is palpated
rotate pt head into barrier
rapid anterolateral thrust on dysfucntional rib

Question 8

rib 3-10 inhalation SD, exhalation emphasis HVLA setup

Answer 8

kirksville crunch but doc places hand on the rib angle (superior)
posterior thrust

Question 9

rib 3-10 exhalation SD, inhalation emphasis

Answer 9

kirksville crunch but doc places hand on rib angle (inferior)
caudal thrust

Question 10

posterior rib head HVLA setup

Answer 10

kirksville crunch but arm on side of dsyfunction grasps opposite ASIS