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25 Cards in this Set

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If patient is swaying L-->R, what category?
Category II
How do you CHALLENGE for a Category II?
Patient Standing or Prone
TL 1 SI joint then the other
Test indicator muscle
If patient swaying A-P, what category?
Category I
How do you CHALLENGE for a Category I?
-One hand on each SI joint.
-If indicator muscle goes weak then have pt TL with both hands to 1 SI joint then both hands to other SI joint. (this determines primary side)
-Apply pressure anteriorly on PSIS and opposite Ischial Tuberosity (do both sides)
How do you CORRECT a Category I?
-Place blocks OPPOSITE to positive challenge
-Pump unblocked, non-primary side 20x and re-test
What is the CHALLENGE for a Category III?
Pull A-P on ischium and push on L5 spinous in the same direction as ischium, at same time. .
Test indicator muscle
How do you CORRECT a Category III?
-Palpate spinous of L5, 5th sacral nerve & sciatic nerve for tenderness.
-Place block at 90 degrees under the ASIS on the side you pushed L5 spinous
-Place 2nd block at opposite isch tub at angle that reduces pain the most.
-re-challenge
When testing for a Sacral Wobble...if muscle tests weak with hands in prayer position on sacrum what do you do next?
Have patient inspire & re-test then have patient expire & re-test
If INSPIRATION abolished weakness of Sacral Wobble test how would you CORRECT it?
-Contact sacrum on posterior lower 1/3 of opposite ASIS & approximate the two (4-5 respirations)
(do correction on side that strengthened indicator muscle on inspiration)
-re-test
If EXPIRATION abolished weakness of Sacral Wobble test how would you CORRECT it?
Pull posterior on sacral apex and push anterior on opposite sacral base (4-5 respirations)
(do correction on side that strengthened indicator muscle on held expiration)
If Sacral Wobble is present what else is often present?
Occipital-Atlanto Counter Torque on same side
What is the CHALLENGE for AOCT?
Press mastoid & atlas in opposite direction
- Mastoid anterior & atlas posterior - fix on INSPIRATION
- Mastoid posterior & atlas anterior - fix on EXPIRATION
Muscle weakness with L4 nerve root, L3-4 disc?
Rectus Femoris, Tibialis Anterior
Muscle weakness with L5 nerve root, L4-5 disc?
TFL, Glut Med
Muscle weakness with S1 nerve root, L5-S1 disc?
Gastroc, Glut Max
What is the CHALLENGE & CORRECTION for Lumbar Disc?
Separate or approximate two vertebrae involved. The directions of involvement are then couple with the phase of respiration that negates the challenge. (10-15 cycles)
With a Lumbar Disc what should you check? (2)
Psoas & ileocecal valve
What is the CHALLENGE & CORRECTION for Facet Imbrication
CHALLENGE: quick tug on leg
CORRECT: slow rhythmic tractioning and/or sharp thrust to separate the vertebrae
What happens to the muscles in Piriformis Syndrome?
Piriformis & Iliacus fail to inhibit in gait stance
If Piriformis & Iliacus fail to inhibit during gait stance have patient TL spine for what? (4)
1. Sacral Fixation (subluxation)
2. Iliac Fixation (subluxation)
3. L5 fixation
4. Iliolumbar ligament problem
Intraosseous Subluxation
1) correct any prob in area and balance all related muscles
2) Palpate bone in question for tenderness
3) TL by using a finger from each hand to touch different parts of same bone then test indicator muscle and test for phase of respiration
4) Separate/approximate two parts of that bone
5) Treat by firmly thrusting in the direction found on phase of respiration found
6) re-palpate for reduction in tenderness
Iliolumbar ligament
1) Press ends of ligament toward each other and test indicator muscle
2) Palpate I&O of GLUT MAX for presence of strain/counterstrain
3) Place patient in Strain/Counterstrain position for glut max and press ends of ligament together....hold for 20 sec while patient holds breath in full EXPIRATION
Why would someone need a Meningeal Release - Coccyx?
Unexplained muscle tension of paravertebral muscles
What is the CHALLENGE for Meningeal Release?
Contact over coccyx and use skin stretch pulling cephalad. Vary angle of challenge and re-palpate paraspinals for reduction in palpable tenderness
- Have patient TL to coccyx and apply inferior pressure. Test strong muscle for weakening.
What is the TREATMENT for Meningeal Release?
- Contact skin over coccyx and pull in challenge direction found.
- Apply this pressure in cephalad direction while patient INSPIRES
- Simultaneously, pull INFERIOR on ATLAS
(8-10 respirations)