Tucker Questions - Mod 4

Question 1

What muscle causes the slight wing motion of ribs 1 & 2?

Answer 1

Scalene muscles

Question 2

What ribs have the least motion capability?

Answer 2

Ribs 1 & 2

Question 3

Which structures have a stronger effect of opposing the slight wing motion of 1 & 2?

Answer 3

Intercostal muscles

Question 4

Since movements of the ribs can be complicated, what surrounding anatomical structures can a practitioner focus on to help understand rib movement?

Answer 4

Focus the mind on what is happening at the transverse process and the position of the vertebra, tracing back from the points where the fingers lie to those points with the imagination.

Question 5

Which ribs are the most difficult to examine and why?

Answer 5

Ribs 11 & 12 due to their lack of attachment to the sternum

Question 6

As ribs 3-10 move up and out during breathing, what movements occur at the articular facets between rib head and vertebra?

Answer 6

In inspiration, the ribs turn slightly on the transverse processes and slide forward on the lower and backward on the upper facet against the bodies of the vertebrae.

Question 7

Why are ribs 3-10 more restricted in motion than ribs 11 and 12?

Answer 7

,,

Question 8

What are the two possible motion mechanics that can occur at the 3-10th ribs when there is side bending of the body?

Answer 8

1. Movement with the vertebra to which it belongs

2. Tips of the ribs remain relatively stationary on both sides

Question 9

In flexion and extension of the body of the ribs move as in _________________

Answer 9

inspiration and expiration.

Question 10

Where is the best diagnosis of rib lesions made at?

Answer 10

Diagnosis of rib lesons is best made where it exists—at the juncture of the rib with the transverse process.

Question 11

When adjusting the first two ribs, how much should we move the neck?

Answer 11

If necessary swing head and neck in extreme side-bending from left to extreme right; repeat until lesion is reduced

Question 12

Which ribs are limited only by ligaments and muscles?

Answer 12

Ribs 11 & 12

Question 13

According to Tucker, when adjusting the 11th and 12th ribs, deep inspiration may be some assistance. Which two muscles are affected by this deep inspiration?

Answer 13

In deep inspiration, the intercostals muscles are tensed, drawing up and to the spine, and the diaphragm is also tensed, drawing up and on the tip of the rib and transversely across the body.

Question 14

Where are lesions of the cervical vertebrae rarely found?

Answer 14

Bilaterally anterior

Question 15

Why does the literature show a death of lesions of the 7th cervical vertebrae?

Answer 15

Which is probably due to failure to examine or to detect them rather than to great strength of this articulation. Because of the greater difficulty in examining this segment, it should be given greater care.

Question 16

Why do we use graduated force when reducing cervical lesion?

Answer 16

The force used must be so graduated as to go no further than the point of correction. Indiscriminate “cracking” of the neck without definite planning for the correction of a lesion is a danger and often damage to the patient, and should be regarded as little short of criminal.

Question 17

Why are spinous processes of cervical vertebrae unreliable for articular diagnosis of cervicals?

Answer 17

The spinous processes are utterly unreliable for diagnosis in the cervical region. In a seated position, it is extremely difficult to secure perfect relaxation of all muscles.

Question 18

What does Tucker advise doing before articular diagnosis and treatment of the cervical spine?

Answer 18

..

Question 19

What does Tucker say about indiscriminate cracking of the cervical spine?

Answer 19

Indiscriminate “cracking” of the neck without definite planning for the correction of a lesion is a danger and often damage to the patient, and should be regarded as little short of criminal.

Question 20

According to Tucker, which cervical segment is most difficult to examine? Why is there greater difficulty here?

Answer 20

The seventh cervical has been called terra incognita, (Fiske) situated deep in the mass of the shoulder muscles and is difficult of examination both in front and in back. The literature of the profession shows the death of lesions of the seventh cervical, which is probably due to failure to examine or to detect them rather than to great strength of this articulation. Because of the greater difficulty in examining this segment, it should be given greater care.

Question 21

According to Tucker, to examine the occiput in relation with the atlas, the proper point to examine is the relation of the posterior border of the transverse process with:

Answer 21

To examine the occiput in relation with the atlas, the proper point to examine is the relation of the posterior border of the transverse process with the posterior border of the mastoid process of the occiput; which should be almost in line; the margin of the atlas a trifle posterior to the mastoid line, in the average person (the mastoid line is a continuation of the posterior border of the mastoid bone).

Question 22

What is the reason for extreme sensitivity of the joints of the body, especially those of the cervical region, and especially those in lesions?

Answer 22

To examine the occiput in relation with the atlas, the proper point to examine is the relation of the posterior border of the transverse process with the posterior border of the mastoid process of the occiput; which should be almost in line; the margin of the atlas a trifle posterior to the mastoid line, in the average person (the mastoid line is a continuation of the posterior border of the mastoid bone).

Question 23

Which region of vertebrae is more exposed and sensitive to any other region on the spine?

Answer 23

The cervical region is more exposed than any other region of the spine. Nature has therefore made this sensation more acute here. By reason of the nearness of the ear, the shock of correction is carried with great acuteness to the ear, and the unpleasant sensation is redoubled. Care is, therefore, necessary, especially in treating the neck. When a patient is lost because he “could not stand the treatment,” he could not have been more truly or completely lost to the profession if he had died.

Question 24

According to Tucker, what is the principle correction for a dislocated hip?

Answer 24

The principle of correction is traction

Question 25

According to Tucker, what position would you put your patient in to bring the head of the femur to the anterior edge of the notch?

Answer 25

Patient supine; thigh is raised to forty-five degrees, abducted, and leg is also abducted; this brings head of bone to anterior edge of notch; leg is then abducted; this brings head to anterior edge of acetabulum; foot and knee are then abducted together; this carries head to almost the top of notch; foot is then abducted as knee is lowered always at limit of tension centrally; this carries head around upper third of acetabulum; maintaining foot in abduction, the knee is then carried up, out, down, and to normal position.

Question 26

What are some of the movements that signify lesioning in the bicipital tendon?

Answer 26

Inability to raise the arm in front or behind back or laterally, beyond a certain point; soreness over bicipital groove; relaxed state of the outer half of biceps muscle.

Question 27

What occurs within lesions of the ligamentum teres?

Answer 27

The tendon becomes curled the wrong way and cramped on itself.

Question 28

What is one of the two irregularities in the movement of the jaw that may falsely be called lesions?

Answer 28

Irregularities in the movement of the jaw, falsely called lesions, maybe due to irregular contractures of the muscles that move the jaw.
Thrusting the jaw forward on one side, one observes that only one tooth touches the jaw above; contractures of the muscle that produces this motion will bring about this result and other such results in varying degrees.
Thickening of the tissues of the joint also may give the appearance of slight lesions.

The technic for true lesions of the jaw bone is in principle the same as in other lesions. Using one side as a fulcrum, the other side is lifted over the catch; or putting a fulcrum (a cork or spool) between the jaws, the pressure is exerted on the tip so as to stretch the tissues and lift the bone over the point engaged.