treatments Flashcards
1
Q
HVLA Supine T-Spine (aka Kirksville Crunch)
A
- Stand opposite PTP
- Cross arm over chest, PTP arm on top
- Caudal hand on PTP
- Lean over and have pt’s arms in abdomen
- Cephalad arms lifts pt’s head/neck in restrictive barrier
- Type 1 = SB away from you
- Type 2 = SB towards you
- Inhale & exhale → thrust is anterior to posterior
2
Q
HVLA Prone (aka Texas Twist)
A
- Stand opposite PTP
- Hands - thenar eminence always on PTP
- Type 1 = opposite hand faces down, same hand up
- Type 2 (flexed) = opposite hand faces down, same hand up
- Inhale & exhale follow motion to engage barrier
- Thrust on exhale → downward anterior w twist in direction of fingers
3
Q
Supine Knee Fulcrum HVLA: Upper and Middle Thoracics
A
- Pt clasp fingers behind neck w phys at head of table
- Ipsi knee of PTP at vertebrae
- Phys hands through pt’s arms and grab ribs cage → fingers on rib angles
- Inhale and exhale → on exhale pull chest down and up into thigh
4
Q
Seated Lower T-Spine HVLA
A
- Ipsi hand to PTP behind neck, and hold elbow w other hand
- Stand opposite PTP
- Phys ipsi hand on PTP
- Grab bicep according to type (1 = 1 bicep) & engage RB in all planes
- Inhale and exhale → on exhale engage rotational RB and push anterior on PTP
5
Q
HVLA Seated Knee Fulcrum Technique
A
- Pt clasp hands at neck and phys behind them
- Put ipsi knee to PTP on abnml vertebrae → use pillow
- Pass hands beneath pt’s arms to grab above wrist
- Inhale and exhale → pull superior/posterior to roll PTP over knee
6
Q
Upper Ribs 1-4 HVLA (Chin Pivot)
A
- Pt prone, phys at head opposite side of dysfxn
- Pt cup chin w ipsi hand to SD
- Doc’s hand at rib dysfxn and pt’s head → rotate head toward SD
- Inhale & exhale → load more into barrier on exhale
- Thrust = anterolateral into dysfxnal rib
7
Q
Seated 1st rib Inhalation Dysfunction HVLA (J stroke)
A
- Pt seated w phys behind w opposite foot of dysfxn on table
- Pt arm over knee
- Contact rib w 2nd MCP and put other hand on top of head
- Phys engage barrier by sidebending head toward dysfxn
- Inhale and exhale → on exhale load into 1st rib
- At end of exhale apply inferior/medial thrust on 1st rib
8
Q
Ribs 3-10 Bucket Handle Inhalation Dysfunction HVLA
A
- Pt supine w phys opposite of dysfxn rib
- Pt cross arms over body w dysfxn side on top
- Caudad hand post/sup to angle of dysfxn rib. Other hand on elbows
- Phys apply pressure through elbows
- Inhale & exhale → exhale load barrier
- Thrust = posterior thrust toward thenar eminence
9
Q
Ribs 3-10 Bucket Handle Exhalation Dysfunction HVLA
A
- Pt supine w phys opposite of dysfxn rib
- Pt cross arms over body w dysfxn side on top
- Caudad hand post/inf to angle of dysfxn rib. Other hand on elbows
- Phys apply pressure through elbows
- Inhale & exhale → exhale load barrier
- Thrust = posterior/caudal thrust toward thenar eminence
10
Q
Same Side SD HVLA (Modified Kirksville crunch)
A
- Pt supine w phys same side as dysfxn
- Pt cross arms over chest w PTP arm on top
- Cephalad hand on PTP
- Grab elbows and raise pt til you can feel vector on post hand
- Post hand induce SB
- Inhale and exhale
- Thrust = ant/post through body to PTP
11
Q
HVLA Type 1 Lumbar Lateral Recumbent
A
- Face pt and monitor at apex of curve
- Pull bottom arm forward (sb) and cephalad (rotation)
- Flex hips and knees til motion felt, then straighten bottom leg w top leg in knee
- Cephalad arm in ant shoulder, caudad along line of PSIS to greater trochanter
- Push shoulder back and pelvis forward while pt inhale deeply
- On exhale, anterior thrust at pelvis
12
Q
HVLA type 2 lumbar lateral recumbent
A
- Face pt and monitor at SP of dysfunction and below
- Pull bottom arm forward (sb) and caudal (rotation)
- Flex hips and knees til motion felt
- Extended: bottom leg bent slightly w top leg over bottom
- Flexed: bottom leg straight w top leg in knee
- Caudal forearm from SI joint to greater trochanter, cephalad forearm in ant shoulder
- Roll pelvis forward and pt inhale deeply
- Anterior thrust at pelvis
13
Q
L1-5 Extension/Neutral dysfunction; long lever rotational emphasis
A
- Supine, doc stand opposite PTP
- Hands behind neck & C shape away from you
- Cephalad hand on elbow, caudal on opposite ASIS to stabilize
- Rotate w cephalad hand
- Inhale & exhale. Thrust = rotational
14
Q
Contralateral Traction
A
- Pt supine
- Doc on opposite side w caudal hand on PS ms and cephalad hand on forehead
- Create perpendicular stretch
15
Q
Cradling w traction
A
- Pt supine w doc at head
- Apply tissues anterior lateral force moving cephalad
16
Q
Suboccipital release
A
- Pt supine w doc at head
- Kneading: slow rhythmic antero-sup pressure
- Inhibition: apply constant antero-sup pressure for 1min
17
Q
Bilateral forearm fulcrum forward bend
A
- Pt supine w doc at head
- Cross arms and raise pt up rhythmically for 2-3 minutes
18
Q
OA SD HVLA
OA F RlSr
A
- Contact occiput post to mastoid process on side of SB restriction
- OA E RlSr ⇒ left occiput
- Cradle head w other hand
- SB OA to RB, rotate to RB. Add cephalad traction
- Rot = right; SB = left
- Thrust = medial/anterior/superior
19
Q
AA SD HVLA
AA Rl
A
- Cradle head and contact lateral mass of atlas same side as SD
- Flex c-spine and allow small extension at monitoring finger
- Rotate head to RB
- Rot = right
- Thrust = rotational w both hands
20
Q
C2-7 rotational emphasis
C5 E RlSl
A
- Make little bridge w fingers & touch articular pillars of both vertebrae
- Flex neck til motion felt at segment, then allow small extension
- SB to SD, rotate to RB
- C5 E RlSl ⇒ SB left, rotate right
- Thrust = rotational at level
21
Q
C2-7 side bending emphasis
C4 SrRr
A
- Fingers on articular pillars of affected vertebrae
- Flex til motion felt at segment, then allow small extension
- Rotate to SD, SB to RB
- Rot = right; SB = left
- Thrust
- Upper = to eyes
- Middle = across neck
- Lower = toward chest
22
Q
Thoracic Prone Pressure with Counterpressure
A
23
Q
Lumbar Paraspinal Perpendicular Stretch
A
24
Q
Chapman’s point treatment
A
