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OS3 Exam II > Tender Points > Flashcards

Tender Points Flashcards

(127 cards)

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1
Q

AC1 location

A

-high on posterior edge of ascending ramus at earlobe

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2
Q

AC1 treatment

A

-rotate away with fine tuning

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3
Q

AC2-6 location

A

-anterolateral aspect of the TP of affected vertebra

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4
Q

AC2-6 treatment

A
  • flex, side bend away, rotate away

- F SARA

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5
Q

AC7 location

A

-posterosuperior surface of proximal clavicle where SCM muscle inserts (lateral to AC8 TP)

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6
Q

AC7 treatment

A

F STRA

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7
Q

AC8 location

A

-on the medial end of the clavicle at the sternal attachment of the SCM

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8
Q

AC8 treatment

A

-F SARA

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9
Q

AT1

A

-midline in suprasternal notch

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10
Q

AT2

A

midline on the manubrium

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11
Q

AT3-4

A

At the level of the costal cartilage related to the named vertebrae

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12
Q

AT5

A

about an inch above the xiphoid junction

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13
Q

AT6

A

at the sternal-xiphoid junction

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14
Q

AT7

A

at the tip of the xiphoid

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15
Q

AT8 location

A

midline 1.5 inches inferior to xiphoid

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16
Q

AT1-8 treatment

A
  • Dr places knee under patient’s head/neck or trunk to use as a wedge to flex patient to involved vertebrae.
  • Doc’s operating hand supports upper back and fine tunes flexion
  • more flexion needed the lower the TP’s
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17
Q

AT9 location

A

midline 1-2 cm superior to umbilicus

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18
Q

AT10 location

A

midline 1-2 cm inferior to umbilicus

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19
Q

AT11 location

A

midline 3-4 cm below umbilicus

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20
Q

AT12 location

A

mid-axillary line on the supermodel surface of iliac crest (bilateral)

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21
Q

AT9-12 treatment

A
  • Patient supine, doc on same side of TP with foot on table.
  • Doc uses patient’s legs to cause flexion. Patient’s hips and knees bent to 90 degrees with fine tuning by adding rotation towards Dr.
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22
Q

AL 5-6T location

A

-At the costosternal joint at the affected level

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23
Q

AL5-6T treatment

A
  • patient seated

- Doc behind patient with leg on table under patient’s arm on unaffected side; F STRA

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24
Q

AL7-8T location

A

-on inferior medial surface of costal cartilages, 1 and 2 inches inferolaterally from xiphoid

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25
AL7-8T treatment
-patient seated, doc behind patient with leg on table under patient's arm on unaffected side; F STRA
26
An anterior rib tender point usually indicates
a depressed rib | -ribs depress with exhalation
27
A posterior rib tender point usually indicates
an elevated rib | -ribs elevate with inhalation
28
AR1 location
-below clavicle on rib 1, lateral to manubrium
29
AR1 treatment
- patient supine - Flex neck up, F STRT - treats a depressed rib, inhalation restriction)
30
AR2 location
-1.5 inches lateral to manubrium on rib 2, at mid-clavicular line
31
AR2 treatment
- F STRT at the neck | - treats a depressed rib, inhalation restriction
32
AR3-6 location
-anterior axillary line on ribs 3-6 (slightly anterior to mid-axillary line)
33
AR3-6 treatment
- patient seated, Doc behind patient with foot on table and knee under arm on unaffected side - F STRT at the neck and torso - treats a depressed rib, inhalation restriction
34
AL1 location
-medial to ASIS
35
AL1 treatment
-patient supine, doc on same side as TP with foot on table; flex knees/hips to greater than 90 degrees, knees and ankles pulled toward the doc and the TP (equivalent to the upper body RA from the TP)
36
AL2 location
-medial to AIIS
37
AL2 treatment
- patient supine, doc opposite side of TP with foot on table; flex knees/hips 90 degrees, knees and ankles away from the TP and towards doc (F SARA) - treatment requires significant rotation of flexed hip away form tender point side
38
AL3-4 location
- AL3 lateral to AIIS | - AL4 inferior aspect of AIIS
39
AL3-4 treatment
-patient supine, doc opposite TP with foot on table; flex knees/hips to 90 degrees, ankles away from the TP and towards the doc, knees pushed toward the TP and away from the doc (F SART)
40
AL5 location
-anterior aspect of pubic bone about 1 cm lateral to pubic symphysis (near pubic tubercle)
41
AL5 treatment
-patient supine, doc same side of TP with foot on table; flex hip 90-135 degrees, push ankle away from TP and doc, and rotate knees slightly toward the TP and doc (F SART)
42
Iliacus TP
-in lower quadrant, 1-2 inches medial to ASIS deep in iliac fossa (iliacus muscle)
43
Iliacus TP Treatment
patient supine, doc same side as TP with foot on table; flex knees/hips 90 degrees, ankle crossed on doc's knee with knees separated, marked ER of both hips -frog legged
44
Low Ilium TP location
-superior aspect of lateral ramus, where psoas muscle crosses pelvic rim
45
Low Ilium TP treatment
patient supine; doc same side of TP | -flex knee/hip 90 degrees, slight ER hip, fine tune with AD/AB (only one leg)
46
Inguinal Ligament TP
-Lateral surface of pubic bone near attachment of inguinal ligament
47
Inguinal Ligament TP treatment
- patient supine; doc same side of TP with foot on table - flex knees/hips 90 degrees and rest on Doc's knee, cross opposite ankle over the leg on side of doc, ankles toward Doc (IR hip on side of TP)
48
Sartorius TP
- near the attachment of the sartorius muscle to the ASIS | - palpate from about 2-3 cm ciudad to the ASIS by pushing toward the inferior aspect of the ASIS
49
PC1 inion location
about 1-2 cm inferior to external occipital protuberance, slightly lateral, on insertion of the semispinalis capitis
50
PC1 inion treatment
- cradle head in monitoring head. Place non-monitoring hand on patient's forehead, and flex the patient's neck (with fine tuning) to reach the position of comfort - This is a maverick point
51
Treatment of a maverick point calls for
lengthening the patient's tissues around the tender point rather than shortening/wrapping around them
52
PC1 location
-about 3 cm below inion, and 1 cm medial to occipitomastoid sure; press anteromedially
53
PC2 location
in main muscle mass about 2-3 cm lateral to midline and just below occiput
54
PC1 and 2 treatment
ESARA
55
PC3 location
inferolateral aspects of C2 spinous process
56
PC3 treatment
- FSARA--flex to 45 degrees, sidebend away and rotate away | - may require you to STRA instead
57
PC4-7 location
-on inferolateral aspect of spinous processes, named for spinal nerves which exit below vertebrae (e.g., PC5 point on C4 SP)
58
PC4-7 treatment
-ESARA
59
PC8 location
-same as PC4-7
60
PC8 treatment
FSARA or ESARA, depending on patient
61
PT1-12 location
-on spinous process of respective vertebra
62
PT1-3 treatment
- patient prone, with arms draped over side of table - Doc stands at head of table and cups patients chin with one hand, using the other hand to monitor the tender point - slowly and passively extend patient's neck, fine-tuning with rotation and side bending away from TP
63
PT4-6 treatment
- patient prone, with arms draped over top of table - Doc stands at head of table and cups patient's chin with one hand, using the other hand to monitor the TP - slowly and passively extend the patient's neck, fine-tuning with rotation and side bending "away" from the TP (may be to either side)
64
PT7-9 treatment
- Patient is prone, with arms draped over top of table with a pillow under his/her chest to further extend the thoracic spine. - Doc stands at head of table and cups patient's chin with one hand, using the other hand to monitor the TP - slowly and passively extend the patient's neck, fine-tuning with rotation and side bending "away" from the TP (may be to either side
65
PT10-12 Treatment
- Patient is prone, with arms draped over top of table with a pillow under his/her chest to further extend the thoracic spine - Doc stands at side of table, and grasps the patient's ASIS not he side opposite the dysfunction, raising the patient's hip and inducing extension of the lower T spine
66
PR1 location
-posterior margin of rib head beneath margin of trapezius
67
PR1 treatment
- patient seated, doc standing behind/to the side - Doc places patient's arm on side of dysfunction on doc's knee - Doc sidebends and rotates Patient's head toward the dysfunction, as well as slightly extends - Hold for 120 seconds
68
PR2 location
-superior surface of angles of ribs, at medial border of scapula, about 2 & 1/2 inches lateral to midline
69
PR2 treatment
- patient seated, doc standing behind/to the side - Doc places patient's arm on side of dysfunction on doc's knee - Doc flexes patient's head and sidebands and rotates the trunk away form the dysfunction - Then rotate and sidebands neck away - hold for 120 seconds
70
PR3-6 location
-superior surface of angles of ribs, at medial border of scapula, about 2 & 1/2 inches lateral to midline
71
PR3-6 treatment
- patient seated, doc standing behind/to the side. Doc places patient's arm on side of dysfunction on doc's knee, grasps patient's shoulder (on side of dysfunction), and sidebands and rotates the trunk away at level of dysfunction - hold for 120 seconds
72
PL1-5 SP location
-midline on the spinous processes
73
PL1-5 SP treatment
- patient prone, doc standing on same side of tender point (may stand on opposite side if more comfortable) - Doc extends patient's hip ipsilateral to TP, fine tuning as necessary
74
PL1-3 TP location
-on respective transverse process
75
UPL5/PL5 location
superior medial edge of PSIS
76
PL1-3 TP and UPL5 treatment
- patient prone, doc standing on opposite side of TP (may stand on same side if more comfortable) - Doc extends patient's hip ipsilateral to TP and rotates patient's leg toward the TP, fine tuning as necessary
77
LPL5 location
inferior aspect of PSIS
78
LPL5 treatment
- patient prone with thigh on dysfunctional side suspended over side of table - Doc flexes patient's hip and knee to 90 degrees, then adds adduction and internal rotation of the hip
79
PL3 Lat location
- 2/3 lateral between PSIS and the tensor fascia latae | - associated with gluteus medius
80
PL3 Lat treatment
patient prone, doc at side of table | -doc extends patient's hip on same side of dysfunction and fine tunes as necessary
81
PL4 lat location
- posterior margin of tensor fascia latae | - associated with gluteus medius
82
PL4 lat treatment
- patient prone, doc at side of table | - Doc extends patient's hip on same side of dysfunction and fine turns as necessary (may be less extension than for PL3)
83
PS1 location
-1/2 inch medial to the inferior aspect of the PSIS bilaterally
84
PS1 treatment
- patient prone, doc standing beside patient. | - Doc applies posterior to anterior pressure diagonally opposite location of TP
85
PS2-4 location
midline on sacrum between or below sacral spines
86
PS2-4 treatment
- patient prone, doc standing beside patient | - Doc applies pressure posterior to anterior on midline apex or base of sacrum to produce transverse axis rotation
87
PS5 location
1/4 inch medial and superior to ILA bilaterally
88
PS5 treatment
- patient prone, doc standing beside patient. | - Doc applies posterior to anterior pressure diagonally opposite location of TP
89
High Ilium (HI) location
-located by pressing against lateral aspect of PSIS
90
HI treatment
- patient prone, doc standing on same side as dysfunction | - While monitoring TP, doc extend's patient hip and fine tunes as necessary with ab/adduction
91
High Ilium flare-out (HIFO) location
-approximately 1 3/4 inches below and 1/4 inch medial to lower edge of PSIS
92
HIFO treatment
patient prone, doc on whichever side of patient is more comfortable -Doc extends patient's leg ipsilateral to dysfunction, enough to clear the opposite leg, then induces moderate to marked adduction and slight external rotation
93
Piriformis location
-about 1/2-2/3 of the distance from ILA to greater trochanter
94
Piriformis treatment
- patient prone, doc seated on same side of dysfunction - While monitoring TP, doc flexes patient's leg over side of table to 135 degrees, abducting and externally rotating the patient's hip
95
Flare-in sacroiliac (FISI) location
-approximately 4 inches below PSIS, slightly lateral (related to gluteus maximus attachment)
96
FISI Treatment
- patient prone, doc on side of dysfunction. Doc abducts patient hip, flexing the hip only enough to allow the knee to clear the table. - Fine-tune with external rotation
97
Medial Meniscus TP
- located at the level of the lower edge of patella, at the medial meniscus - Push medial to lateral
98
Knee Extender TPs
3 TPs: on patellar ligament/tendon, in front of medial meniscus, on front of medial surface of tibia -push anterior to posterior
99
Plantar Navicular (NAV) TP
-plantar surface of the navicular bone close to the cuboid
100
Plantar Cuboid (CUB) TP
- tuberosity of the cuboid bone | - about 2 cm posterior and medial to base of the 5th metatarsal
101
Flexed Calcaneus (FCALC) TP
anteromedial plantar surface of calcaneus
102
Infraspinatus TP
- low: one cm from the medial margin and 5 cm inferior to the spine of the scapula - upper: 2-3 cm below the spine and 3 cm more lateral than the lower one
103
Teres Minor TM TP
- Lateral border of the scapula under the arm | - back of the head of the humerus
104
Teres Major TP
-lateral and posterior surface of the scapula, at the inferior angle
105
Medial Coracoid TP
- superior medial surface of the front of the coracoid process - Pectoralis minor muscle
106
Big 3 muscles to evaluate in Tension head ache
- trapezius, levator scapulae, SCM | - if symptoms resolve with counterstain then do more comprehensive evaluation
107
Headache/Neck Pain//TMJ tender points to evaluate:
-trapezius, levator scapulae, SCM, anterior and posterior cervical, cranial points
108
Common offenders in anterior shoulder pain
-biceps, pec major and minor, infraspinatus, supraspinatus, deltoid, scalenes
109
Common offenders in posterior shoulder pain
-levator scapulae, teres major and minor, supraspinatus, trapezius, subscapularis, serratus posterior superior (referral pattern is to the shoulder)
110
Anterior Thoracic TPs
- cardiopulmonary etiology is priority until proven otherwise - atypical chest pain often respond to treatment of counterstain points - common points: pectorals major, serratus anterior, T2-6 points - may include anterior rib points if pain is more lateral on anterior chest wall
111
Common points in forearm/wrist/hand pain
- often due to extension of a myofascial pain pattern from shoulder - triceps (long head most common) - medial elbow--pronator teres, flexor carpi radialis and ulnaris, palmaris longus (Pt4 and/or PR4) - Lateral elbow-supinator (radial head), extensor carpi radialis/anconeus/common extensor tendon (PT1 and/or PR1)
112
AL1 in
internal oblique
113
AL2 in
lower external oblique
114
AL3 and 4 in
iliopsoas
115
AL5 in
rectus abdominus and pyramidalis
116
Tips related to GI conditions
-external oblique, lower rectus and iliacus
117
Deep pelvic pain:
-obturator internus, and externus, adductor magnus, lower external abdominal oblique
118
Anterior hip pain
-pectineus (inguinal ligament), lower external abdominal oblique
119
TP associated with restless leg syndrome
-point on superior surface of symphysis
120
Common muscles that refer to pelvis
-quadratus lumborum, longissimus thoracic, iliocostalis lumborum
121
Anterior Knee common offenders
rectus femoris, vastus medialis | -adductor longus/brevis less commonly
122
Lateral knee offenders
vastus lateralis, iliotibial band
123
Posterior knee TP
- gastrocnemius - pain when knee is extended and ankle dorsiflexed--extension ankle point - biceps femoris (athletes), soleus (more posterior calf pain), semimembranosus, semitendinosis, popliteus, and plantaris
124
Ankle Muscle pain
- fibularis longus and brevis (lateral) - tibialis anterior (medial) - soleus/posterior tibialis/gastrocnemius (posterior)
125
Plantar heel pain
-quadratus plantae
126
Foot (bunion region) pain
-flexor digitorum brevis, adductor hallicis, flexor hallicis brevis
127
Dorsum of foot pain
-extensor digitorum brevis and extensor hallicis brevis

OS3 Exam II (10 decks)

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