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OPP 3 > treatments > Flashcards

treatments Flashcards

1
Q

FPR for OA & AA supine

A
  1. traction the occiput superiorly while monitoring OA (or AA) & apply axial compression on top of head
  2. then place OA into ease
  3. hold until release - neutral - reassess
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2
Q

FPR typical cervical supine

A
  1. traction occiput superiorly while place index finger of caudad hand over posterior articular pillar w/ palm cupping the neck
  2. cephalad hand on top of head for compression
  3. maintain & place into ease - hold for release - neutral - reassess
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3
Q

Still for OA (or AA) seated

A
  1. index finger caudal hand over inferior occiput w/ palm cupping mandible
  2. cephalad hand on top of head w/ gentle grip
  3. place OA into ease - axial compression - move thru barrier then back to neutral - reassess
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4
Q

Still for typical cervical seated

A
  1. index finger caudal hand over post articular pillar w/ palm cupping neck gently
  2. cephalad hand on top of head
  3. place into ease - compress - move thru barrier then back to neutral - reassess
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5
Q

BLT for OA or AA supine

A
  1. index fingers post to articular pillar of C1 & middle fingers over inferior occiput w/ palms cupping head
  2. place occiput into ease
  3. extend occiput via anterior pressure
  4. R & SB into ease & find balance point
  5. make minor adjustments - release - neutral - reassess
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6
Q

short lever BLT for typical cervical supine

A

1.index fingers on articular pillars of 1 below & middle fingers on level articular pillars
2. extend w/ anterior & superior pressure w/ both middle fingers
3. R into ease via anterior pressure on non posterior pillar
4. SB into ease via translation
5. adjustments in all planes - release - neutral - reassess

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7
Q

long lever BLT for typical cervical supine

A
  1. cephalad hand under posterior articulation of level & one below
  2. ABduct or ADduct to localize
  3. use arm to find balance:
    - protact (contra R) or retract (ipsi R)
    - traction (contra SB) or compress (ipsi SB)
    - flex (IR) or extend (ER)
  4. minor adjustments until balance - release - neutral - reassess
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8
Q

FPR seated thoracic type 1 or type 2

A
  1. fingers of caudal hand over TPs + anterior translation (apex for type 1) to flatten kyphotic curve
  2. contact both shoulders (reach across T5-12, use head for T1-4)
  3. place into neutral
  4. axial compression or traction - maintain - into ease - hold for release (3-5 secs)
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9
Q

seated still thoracic type 1 or type 2

A
  1. caudal hand over posterior TP (apex for type 1)
  2. contact shoulders (reach across pt for T5-12, use head for T1-4)
  3. use shoulders to place into ease
  4. compression force - move through barrier
  5. neutral & reassess
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10
Q

long lever BLT thoracic

A
  1. cephalad hand under articulation of segment on 1 below while caudal hand grabs ipsi arm
  2. ABduct arm to localize inferiorly along spine, ADduct to localize superiorly
  3. fine tune until balance felt
    - protract (contra R) vs retract (ipsi R)
    - compression (ipsi SB) vs traction (SB contralat)
    - flexion (IR) vs extension (ER)
  4. adjust until full balance - wait for release
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11
Q

short lever BLT thoracic supine

A
  1. index fingers on post TP of 1 below & middle fingers on TP of segment
  2. extend via anterior pressure until equal tension point is achieved
  3. R & SB into ease - minor adjustments in all planes until balance - release - neutral - reassess
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12
Q

epigastric thrust HVLA

A
  1. pillow against posterior TP
  2. pts’ hands behind neck - instruct to drop elbows forward & relax so doc takes their weight - reach into their arms
  3. place into barrier (induce ant translation to extend vs slumping them forward more)
  4. inhale - exhale - corrective thrust anterior & superior from epigastrium
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13
Q

knee in back HVLA

A
  1. knee against pillow against posterior TP
  2. pts’ hands behind neck - pt drops elbows forward & relax
  3. place into barrier (induce ant translation with knee to extend vs slumping them forward more)
  4. inhale - exhale - corrective thrust superior, anterior & slightly medial with knee
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14
Q

Texas twist HVLA

A
  1. stand opposite of post TP
  2. thenar eminence posterior & inferior to post TP, hypothenar of other hand posterior & superior to post TP
  3. thenar does anterior & superior force, hypothenar does inferior force
  4. inhale-exhale-engage barrier-repeat-corrective thrust
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15
Q

FPR lumbar type 1 or type 2

A
  1. fingers caudal hand over TPs (or apex for type 1) - ask pt to relax into lordotic curve
  2. contact shoulders (reach across)
  3. place into neutral
  4. apply compression or traction - maintain - bring into ease - hold for release (usually 3-5 secs)
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16
Q

supine still type 1 lumbar

A
  1. cephalad hand post TP of apex
  2. flex both hips & knees - further flex ipsi hip to 90 until motion isolated at apex
  3. ADduct ipsi leg across midline - then move cephalad hand to knee & caudal hand to ipsi ankle
  4. bring ipsi foot & leg toward doc creating IR of thigh, swing hip superior & produce SB of spine
  5. compress knee toward apex & swing ankle in (ER of thigh) & ABduct at hip then extend leg
    - big circle out
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17
Q

supine still type 2 flexed lumbar

A
  1. cephalad fingers on posterior TP
  2. ipsi knee & hip flexed until motion is felt
  3. knee is then ADducted until ease felt
  4. compress thru knee toward Lspine
  5. circumduct leg into ABduct first, then straighten, maintaining compression
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18
Q

supine still type 2 extended lumbar

A
  1. cephalad hand fingers on posterior TP
  2. ipsi knee & hip flexed until motion is felt
  3. knee is then ABducted until ease felt
  4. compress thru knee toward Lspine
  5. circumduct leg into ADduct first, then straighten, maintaining compression
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19
Q

indirect long lever BLT lumbar supine

A
  1. cephalad hand posterior to Lspine monitor segment / caudal hand ipsi hemipelvis
  2. use hemipelvis:
    - flex by moving hemipelvis posterior (ASIS to head)
    - extend by pelvis anteriorly (ASIS to feet)
    - cephalad closer to shoulder for ipsi SB / caudal to feet for contra SB
    - press pelvis into table for ipsi R / lift pelvis off table for contra R
  3. adjust all planes - release - neutral - reassess
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20
Q

indirect short lever BLT lumbar supine

A
  1. place index fingers posterior to TPs of 1 below & at
  2. extend using anterior pressure
  3. R & SB toward ease
  4. minor adjustments - release - neutral - reassess
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21
Q

BLT respiratory diaphragm supine

A
  1. cephalad hand under post hemidiaphragm & caudal over anterior so fingers parallel to ribs
  2. compressive force toward xiphoid process
  3. find balance point in all 3 planes - hold until release - neutral - reassess
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22
Q

thoracic inlet BLT

A
  1. diagnose thoracic inlet
  2. inferior clavicles/1st/2nd ribs anteriorly & costotransverse junction of T1 posteriorly w/ thumbs
  3. motion test in all 3 planes
  4. engage tissues in balanced position & make minor adjustments if needed - release - neutral - reassess
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23
Q

QL long lever indirect MFR

A
  1. contact QL w/ cephalad hand
  2. caudad hand bring ipsi leg into flex & Abduct (knee in axilla, wrap arm around leg)
  3. use leg as long lever & bring QL into ease
  4. wait for release, should be quick
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24
Q

ME superior rib 1

A
  1. pt seated, stand behind with leg on contra side w/ pts contra arm on top of it
  2. place elbow on ipsi shoulder & hand on head
  3. SB pt’s head toward ipsi while guiding 1st rib anterior
  4. place caudal pressure on posterior rib shaft
  5. have pt try to go into their barrier (SB & R contra) against physician force 3-5 secs
  6. post isometric relaxation - re-engage feather edge - repeat - neutral - reassess
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25
Q

ME anterior subluxed rib (2-10)

A
  1. pt seated w/ ipsi hand on contra shoulder
  2. contact MEDIALLY to rib angle while other hand grabs elbow & localizes force at rib
  3. apply POSTEROLAT force on rib angle
  4. have pt pull lateral or inferior for 3-5 sec against force
  5. post isometric relax - reengage barrier - repeat 3x - neutral - reassess
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26
Q

ME posterior subluxed rub (2-10)

A
  1. pt seated w/ ipsi hand on contra shoulder
  2. contact LATERALLY to rib angle while other hand grabs elbow & localizes force at rib
  3. apply ANTEROLAT force on rib angle
  4. have pt pull medial or superior for 3-5 sec against force
  5. post isometric relax - reengage barrier - repeat 3x - neutral - reassess
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27
Q

ME for AP compressed ribs

A
  1. pt sit on edge, doc on opposite side with pts contra arm around shoulder
  2. clasp hands around ribs & SB pt toward dysfunctional side w/ medial compressive force
  3. have pt SB to contra side against force 3-5 s
  4. post isometric relax - reengage - repeat - neutral - reassess
28
Q

ME for lateral compressed ribs

A
  1. pt sit edge of table, stand ipsi side w/ pt ipsi arm across shoulders
  2. thenar eminences on ant & post shaft of rib
  3. SB pt away from dysfunction while applying AP force on the rib
  4. have pt try to SB toward dysfunction - post iso relax - reengage - repeat - neutral - reassess
29
Q

BLT ribcage

A
  1. pt seated, contact rib at ant & post attachments
  2. engage rib either directly or indirectly in order to reach a balance point
  3. make minor adjustments then wait for release (quick) - neutral - reassess
30
Q

Seated still for posterior/exhaled ribs 2-10

A
  1. pt seated, stand behind w/ hand on post rib
  2. extend shoulder until rib relaxes
  3. compress thru arm to rib - move shoulder thru ABduct w/ partial flex to 140 degrees
  4. maintain compression - carry into ADduct - bring arm into abdomen - release - reasses
31
Q

Seated still for anterior/inhaled ribs 2-10

A
  1. pt seated, doc behind -reach across so hand is on anterior rib
  2. begin with arm across body (ADduct)
  3. compress thru arm to rib - move shoulder thru 110 degrees flex/ABduct/extend - release - reassess
32
Q

anterior cervical fascia MFR

A
  1. supine, contact forehead to stabilize
  2. contact lateral hyoid - move side to side to engage fascia
33
Q

auricular drainage

A
  1. cup face, ear b/n 3rd & 4th digit
  2. move CW & CWW for 30 sec - 2 min
34
Q

Galbreath

A
  1. finger pad at angle of mandible
  2. inferior & medial pressure to engage mm
  3. pull anterior, inferior & medial in long axis of mandible - continue until release
35
Q

orbital nerve release

A
  1. pressure over supra & infra orbital foramen for 15-30 secs
36
Q

ischiorectal fossa release - supine

A
  1. find inferior surface of side ischial tuberosity
  2. keep contact w/ medial aspect & turn hand into karate hand parallel w/ pts long axis
  3. gentle pressure superiorly engaging the fascia
  4. inhale & resist inf motion - exhale & follow the diaphragm cephalad inc superior pressure
  5. repeat until no more change - neutral - reassess
37
Q

liver or splenic pump

A
  1. sandwich the organ
  2. compress toward midline & apply medial oscillatory motion at 2 compressions/second for 30 s - 2 min
  3. release then reassess
38
Q

submandibular MFR

A
  1. finger pads 2nd & 3rd fingers medial to inferior edge of mandible
  2. apply superior & lateral force into mandibular fascia & motion test in all 3 planes
  3. hold until creep indicates a release of tissue tension then follow release until no further change
  4. neutral - reassess
39
Q

BLT pericardial ligament

A
  1. pt supine, doc at head of table
  2. cephalad hand contact Tspine, caudal hand on sternum
  3. engage in all planes of motion until balance reached
  4. release - neutral - reassess
40
Q

BLT lower ribcage/diaphragm

A
  1. pt supine, doc on opposite side dysfunction
  2. hands over rib cage if bilat, sandwich unilat
  3. engage in all planes of motion until balance reached
  4. release - neutral - reassess
41
Q

supine still for exhaled/superior rib 1

A
  1. ipsi hand to contra shoulder
  2. contact head of 1st rib
  3. grasp ipsi elbow & ADduct arm until elbow & 1st rib are aligned
  4. compress - bring elbow towards ear (IR)
  5. swing elbow laterally & inferiorly (big circle out) and place into neutral at the side
42
Q

still for inhaled/inferior rib 1

A
  1. bring ipsi arm into flexion & place palm below clavicle
  2. contact head of 1st rib
  3. grasp ipsi elbow & ABduct & extend arm to nipple
  4. compress - bring elbow into ABduct until at pt’s ear
  5. swing elbow into ADduct w/ compression - once at shoulder release 1st rib & grab wrist to bring arm down & across body - neutral - reassess
43
Q

linea alba release

A
  1. fingers along midline over linea alba from xiphoid to umbilicus
  2. posterior pressure along linea alba & assess for restriction or tenderness
  3. celiac 1/3, SMG 1/2, IMG 2/3
  4. inhale & resist, then exhale & take up the creep until next restriction is engaged
  5. repeat until no further change is palpated
44
Q

sigmoid colon release

A
  1. finger pads medial to L ASIS
  2. draw sigmoid & its mesocolon superior & medially
  3. hold pressure until release is obtained - resp assist if needed
  4. release pressure to return sigmoid back to neutral, reassess
45
Q

small bowel mesentery release (tx abd lymph congestion)

A
  1. in LLQ use medial edge of hands, apply pressure in posterior direction collecting the small bowel into hands
  2. draw mesentery superiorly & medially towards the umbilicus
  3. hold pressure until release is obtained - use resp assist if needed
  4. release to bring back to neutral, then reassess
46
Q

colonic milking

A
  1. hands on top of each other in LLQ & advance finger bad into abd-pelvic area
  2. once colon is contacted, apply mild oscillatory pressure
  3. “milk” from proximal to distal (cephalad to caudad) along sigmoid colon
  4. repeat while working along descending, transverse & ascending colon then reassess
47
Q

liver & gallbladder release

A
  1. stand behind the seated pt
  2. left fingers inferior to xiphoid & slightly right of midline
  3. right fingers inferior to pt’s subcostal margin, lat of midline & to R of gallbladder
  4. pt slump forward to release tissue tension, apply post-superior force along underside of liver margin
  5. maintain constant pressure at either ease (indirect) or barrier (direct)
  6. hold & follow the release, resp assist if needed
48
Q

posterior diaphragm BLT

A
  1. caudad hand post to rib 12 & relax hand
  2. cephalad hand posterior to caudad hand
  3. compress anteriorly & lateral to distract along rib shaft
  4. add superior to inferior motion (AB to ADduct) until increased resistance
  5. fine tune in all planes until balance - wait for release (1-2 secs) - neutral
49
Q

direct long lever kidney visceral

A
  1. cephalad hand on QL - contact inferior pole of kidney - pronate hand
  2. caudad hand brings ipsi leg into F, ER & Abduct (causes kidney to rise superiorly)
  3. once kidney is most anterior, inc anterior force from cephalad hand
  4. ADduct & IR thigh then extend bag to neutral
50
Q

4 pole BLT sacrum superior pole supine

A
  1. cephalad hand posterior to ipsi sulcus
  2. caudal hand flex ipsi knee & hip to 90 - contact lat leg with forearm
  3. gap upper limb of SI via ER of hip
  4. use resp assist to bring into balance - release - neutral - reassess
51
Q

4 pole BLT sacrum inferior pole supine

A
  1. cephalad hand posterior to ipsi ILA
  2. caudal hand flex ipsi knee & hip to 90 - contact medial leg with forearm
  3. gap lower limb of SI via IR of hip
  4. use resp assist to bring into balance - release - neutral - reassess
52
Q

seated BLT for innominate

A
  1. take pts ankles & lift legs to destabilize
  2. compress one into pelvis, then do the other
  3. have pt rotate torso to one side then other
  4. find equal tension point
  5. look at leg lengths - tell pt to rotate their torso towards shorter leg to fine tune the balance
  6. hold until release - neutral - reassess
53
Q

seated BLT pelvic diaphragm

A
  1. both hands under ischial tuberos - slide fingers medially (lift hips up one at a time to place finger pads on tuberosities)
  2. with ipsi hand match tension of tissues in diaphragm (inhaled or exhaled)
  3. other hand then matches tension
  4. hold balanced position until feel shift in tissues
  5. back to neutral & reassess
54
Q

supine BLT lumbosacral dysfunctions

A
  1. cephalad hand under Lspine on SPs of Lspine
  2. caudal hand under sacrum w/ fingertips at base & palm cupping apex
  3. motion test in all planes into or away from barrier
  4. wait for release - should occur quickly
55
Q

LCS 1 - spinal dysrhythmia

A
  1. bend forward at waist from standing then slowly return to standing - look for hitch or altered motion
    BAD: E of lumbar occurs before post R of innom / pain on return without pain in flexion
56
Q

LCS 2 - pelvic clock

A
  1. supine w/ hips & knees flexed - monitor ASIS bilat - hips up to head (12) post tilt - hips to toes (6) ant tilt
    BAD: need to engage abs & reassess
57
Q

LCS - pelvic tilt heel slide

A
  1. supine - monitor bilat ASIS - hold 12 before move - slide one heel inferiorly without losing 12
    BAD: imbalance b/n abs & iliopsoas
58
Q

LCS 4 - hip ABduction

A

GOOD: glute med - TFL - ipsi QL
1. on side w/ bottom leg flexed, top leg extended - raise leg toward ceiling
BAD: hip hike w/ premie firing QL & ES
BAD: hip flex & IR by overactive TFL

59
Q

LCS 5 - hip extension

A

GOOD: IL hamstring - IL glute max - CL QL - IL QL
1. prone, fully extend leg off table, lift up
BAD: hyperactive hamstrins & thoracolumbar ES
BAD: CL trunk rotation w/ hypotonic glute max

60
Q

UCS 1 - cervical flexion

A
  1. supine w/ legs extended - raise head off table to look at feet
    BAD: chin protrusion anteriorly (uses deep cervical flexors instead of SCM / hypertonic suboccipital mm)
61
Q

UCS 2 - scapular ABduction

A
  1. seated, raise arms up bilat - then unilat while palpating Bilat QLs
    GOOD: only CL QL shoulder fire in full ABduction
    (supra - deltoid & infra - middle & lower trap - CL QL)
    BAD: inhibited lower trap, serr ant, supra –> upper trap & lev scap (early firing CL QL or firing of IL QL at any time)
62
Q

UCS 3 - scapular stabilization

A
  1. on table on all 4s, bend elbows - look for medial border winging of scapulas
    BAD: winging - inhibition of lower trap, serr ant, rhomboids
63
Q

UCS 4 - scapular depression

A
  1. prone w/ arm flexed & slight ADduct overhead - lift arm off table while monitor lower trap for activation
64
Q

UCS 5 - supine shoulder flexion

A
  1. supine with arms flexed overhead - look for asymmetry in flexion
    BAD: hypertonic unilat lat dorsi unable to flex fully
    bAD: lumbar extension - hypertonic lat dorsi
65
Q

UCS 6 - pec minor & posterior capsule

A
  1. see which shoulder anterior when supine
  2. do AP glide of GHJ to confirm post capsule tight
  3. inferior glide ant ribs 3-5 = pec minor hypertonic
  4. if post capsule hypertonic, lie on side of restriction, flex shoulder to 9 & IR to limit
66
Q

UCS 7 - shoulder circles

A
  1. lie on side on floor with knees & hips flexed to 90
  2. make circles on ground

OPP 3 (2 decks)

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