Visualization Flashcards
11 Components of VISUALIZATION
- Head tilt/rotation
- High shoulder
- Low shoulder/shoulder drop
- Rib humping
- Dishing
- Loss of smooth lateral thoracic arc (stacking)
- Scoliosis
- Pelvic tilt
- Buttock/Glutes
- Foot flare
- Antalgic posture
What 3 structural changes are caused by a misaligned ilium, seen in POSTURAL assessment?
- Change in gluteal folds
- Change in leg length while weight-bearing and prone
- Foot flare & heel wear
What causes a high shoulder?
- Open wedge in the mid-thoracic spine on the side of the high shoulder
- PS shoulder
- Scapula fixed superiorly on that side
- SC subluxation
- AC subluxation
What would cause a lower PSIS, lower gluteal fold, & higher iliac crest on that side?
- PI ilium
- anatomically short leg
- fallen arch in foot
What causes shoulder drop?
- Paralysis of trapezius
- CN XI, C3/C4
Unilateral toe-out foot flare:
- IN ilium
- PEX tibia
Bilateral toe out foot flare:
- base posterior sacrum
- Knee problem
- overweight children who may outgrow it
Unilateral toe in foot flare:
- EX ilium
- anterior talus (inversion sprain)
- paralysis of the extensor muscles
Bilateral toe in foot flare:
- Posterior S2 tubercle
- HYPERlordosis in pigeon toed children who walk too early
Where is the location of edema during the 4 ilium misalignments?
ASIN–>anterior/superior
PIEX–>Posterior/Superior
PIIN–>anterior/inferior
ASEX–>posterior/inferior
Describe the relationship of sacrum to AS/PI ilium?
AS–>sacrum is posterior
PI–>sacrum is anterior
What occurs with a short leg on the left, and an occiput reading on the left?
Left condyle is raised
What would cause a higher PSIS, higher gluteal fold, & lower iliac crest?
AS ilium
Is edema palpable in an EX ilium?
YES, because it is along the posterior aspect of the joint
What does a flax buttock indicate?
- IN iliium
- Posterior rotated sacrum on involved side
What does a narrow, peaked buttock indicate?
- EX ilium
- Sacrum may be rotated posterior on the opposite side
With an IN ilium, what is the associated pelvic rotation, feet rotation, and head/torso rotation?
Pelvis–>rotated internally
Feet–>rotated externally (‘toe-out”)
Head/torso–>rotaed to fix compensation
What would you check if your patient has antalgic position?
- first check lumbar region
- may be base posterior sacrum if patient is unable to stand up straight
Why is the head held in a neutral position?
because it is a protective mechanism and the individual will be more able to detect and react to changes that affect balance and well-being
How does head position effect balacne and well-being?
- because the vestibular apparatus in the inner ear
- tells brain the head position so that correction may be made if needed
What’s more common, head tilt or rotation?
-Head tilt–>due to how the atlas & occiput articulate
Why is rotation less common than head tilt?
Rotation may be caused by overall spinal rotation or by upper cervical rotation
What happens to the head when there is a posterior rotated atlas?
- it causes the head to be raised on that side
- due to the shape of the superior articular facets
- which results in a higher mastoid on that side
What does scarring indicate in terms of healing process?
if nerve damage has occurred, healing may be haphazard.
What is petechiae?
Broken blood vessels which indicate a possible problme area.
What are varicosities?
- Chronic vasuclar changes
- most common in ksympathetic region (esp. VP to L5)
Where are potential area for decreased hair?
Over a subluxated area
What causes brown or white patches along the spine?
- chronic neurological changes in the sympathetic areas
- they occur on left or right sie because they are neuroloically specific
Where are potential areas for increased hair growth?
- over the sacrum
- over abnormalities, like spina bifida
4 examples of skin condition that can cause unilateral localized temperature change (aka heat swing)?
- burns
- contusions
- sweating reflex
- inflammatory skin lesion
How does skin color change in a parasympathetic dermatomal area?
- (occ-C5 & below L5)
- discoloration
- small red spot in the area
What does skin look like in an acute condition?
There is redness due to:
- Rubbing
- Increased vascularization
- Swollen irritated tissues
- Cutaneous radiation
What usually accompanies varicosities in the VP region?
Dowager’s hump
What do blemishes indicate?
Possible problem area
What are the 7 SKIN CHANGES to look for when VISUALIZING
- brown/white patches
- blemishes
- petechiae
- skin color
- scarring
- varicosities
- hair changes
How do you determine if scoliosis is structural or non-structural?
- use Adam’s test: have patient bend at the waist
- note if scoliosis disappears or stays the same: if it disappears it is mild to moderate scoliosis (less than 25degrees): more functional than structural
What muscle changes does rotary scoliosis have?
more prominent muscle bundle on the side of high TVP
