Thoracic And Lumbar ME/ART OSCE

Question 1

What is the hand position for ART upper thoracic type 2

Answer 1

Doc places thenar eminence of the posterior hand on the proximal paraspinal thoracic tissues in the dysfunctional area

Doc then induces a gentle side bending motion of the head to the physician while the posterior hand applies a spinging force perpendicular to the length of the vertebral column

Question 2

What is the hand position for ART lower thoracic Type 1

Answer 2

Patient is sitting

Place ipsilateral hand on the PTP behind their neck

Physician monitors the PTP of the affected vertebra using the pads of thumb and index finger, while monitoring the vertebral segment below with the middle finger

Then induced SB and R in to the restriction like any ART

Question 3

What is the position for ART lower thoracic type 2 extension or flexion

Answer 3

Doc places arm over the patient anterior shoulder

Doc then stabilizes the lower of the two vertebrae by grasping the spinous process with the index finger and the thumb

Induce patient into flexion or extension and perform an ART

Question 4

What is the set up for ART lower thoracic SB seated

Answer 4

Doc puts arm across patients anterior shoulders

Thenar eminence at the TP of the dysfunctional vertebra on the ipsilateral side to the doc

Doc induces a sidebending force by pressing downward with his axialla while simultaneously thenar eminence

Question 5

What is the position for the ART lower thoracic rotation seated

Answer 5

Doc behind patient with arm across anterior shoulders

Thenar eminence at the TP of the dysfunctional vertebra on the contralateral side to the doc

Doc induces a rotation force by pulling anteriorly while pressing anteriorly with the thenar eminence

Question 6

What is the position for MET upper thoracic Type 1 SD seated

Answer 6

Doc behind patient on the contralateral side of the dysfunctional PTP

Doc monitors TPs of apex of dysfunctional group curve with thumb and index finger while the middle finger monitors SP of the segment below

Doc then places other hand on the patient’s head and induces a SB into the RB by draping patient;s arm over the thigh

Induces rotation by by rotating the head toward the doc

Have patient try to return to neutral

Question 7

What is the position for MET lower thoracic Type 1 and Type 2

Answer 7

Patient seated with doc at side opposite the DPTP

Physician monitors TPs at the apex of the group as well as the TP below

Doc passes arm on top of one arm (type1) and over both arms (type 2)

Induces R/SB into barrier and instructs patient to move into ease of motion

Question 8

What is the position for ART lumbar side bending SD, LR

Answer 8

Flex patient’s kjnees and hips to 90 degrees

Left hand palpates spinous processes of the lumbar spine

Doc lifts patient’s ankles toward ceiling and induces a left sidebending

Question 9

What is the position for ART lumbar type 2 flexion or extension and extension SD

Answer 9

Doc places arm over patient’s anterior shoulder

Stabilize segment inferior to dysfunction by grasping the spinous process with fingers and thumb, use hand as a fulcrum while inducing extension or flexion

Question 10

What is the position for MET Lumbar Type 1 seated

Answer 10

Doc monitors apex of curve with caudad hand while cephalad hand passes under the patient’s arm on the non-dysfunctional side to grasp dysfunctional arm

Induce R/SB and have patient try to go back to neutral