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57 Cards in this Set
- Front
- Back
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what is Bat Wing Deformity?
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this is an atypically large transverse process of L5
results in pseudoarthrosis/with sacrum or ilia |
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what is spondylolysis?
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this is a defect in the pars interarticularis
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When looking at the relationship between a 'short leg' and iliac crest, whats the relationship?
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the short leg will be on the same side as the LOWER iliac crest
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Which direction does the pelvic side shift test move more freely to?
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this side of the longer leg....or opposite the tight psoas
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Should soft tissue treatments make the skin boggy or edematous?
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no they should not, the tissues should just relax
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What types of dysfunctions can be treated with Lumbar On Side technique?
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type 2 single segment dysfunctions of T11-L5
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with lumbar on side, what side goes down?
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the dysfunctional side...or the posterior side (rotated right...lays on right side)
goes down lumbar side low! |
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What is the first motion done in the lumbar on side? what is it used for?
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the doc raises the pt's legs as a unit allowing the pelvis to shift inferiorly on the table
this introduces sidebending into the lumbar spine |
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after introducing sidebending in the pelvis and lumbar spine, what is the next move? (lumbar on side)
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the next move is to introduce flexion into the spine up to the dysfunctional segment
this is noted by gapping of the segment from the superior segment |
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after introducing sidebending in the pelvis, and using flexion of both legs to introduce flexion/gapping to the dysfunctional segment, how do you introduce MORE sidebending- the next step (lumbar on side treatment)
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this is accomplished by extending the leg on the table (bottom), and introducing flexion into the top leg....such that the foot of the top leg drops into the popliteal fossa of the inferior leg (like a crane)
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How do you used the upper body to introduce more rotation/extension in the Lumbar on side treatment?
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after sidebending, flexing, MORE sidebending....we add rotation using the upper body, by:
pulling on the arm on the down side (touching the table) THEN- push on the trunk posteriorly, to add extension down to the segment |
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the final motions of lumbar on side are done by rolling the pelvis which direction?
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towards the doctor
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what is the HVLA thrust like for a lumbar on side...FLEXED dysfunction?
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this is done using an arc-like thrust with the caudad forearm (the one on the pelvis)
Force goes down the femur, anterior, and inferior (towards the doc, and inferior) |
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what is the HVLA thrust like for a lumbar on side, EXTENDED dysfunction?
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this is using a body drop of the lower (on pelvis) forearm...moving in a Anterior and Superior direction through the pelvis (towards the doc, and superior)
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what is the ME motion for a lumbar on side set up?
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the pt pushes tries to rotate back to neutral against the force on the pelvis
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What types of dysfunctions is the lumbar walk around used to treat?
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this is used to treat Extended and Flexed dysfunctions
type 2 |
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when using the lumbar walk around technique, what is the first set up maneuver?
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pt clasps hands behind the neck
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how is gapping introduced in the spine using the lumbar walk around?
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the pt slouches forward to introduce flexion
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using the lumbar walk around, after the pt's clasps hands behind neck, and slouches forward...what is the next move?
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you introduce sidebending into the lumbar spine by translation. you side bend INTO the barrier
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when introducing rotation in the lumbar walk around, which direction do you rotate them?
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you rotate them into the barrier
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when using the lumbar walk around, how do you use muscle energy? assuming normal set up
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you have the pt. attempt to raise the side lowered by sidebending (a rotated and sidebent R dysfunction....will involve sidebending LEFT during treatment...so the pt will raise LEFT shoulder)
also the pt should be rotating against your pressure (so rotating to the right in this example) |
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when doing lumbar walk around, whats a stupid trick that may enhance results?
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having the pt turn his head to the side opposite the dysfunction
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how is the lumbar walk around set up different for extended dysfunctions?
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you have the pt extend, using anterior force and by having the pt sit up straight
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when doing ME for psoas spasm, which way do you move the posas? into flexion or extension?
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you EXTEND the posas muscle (pt laying prone, pull the leg up (posterior))
pt. tries to move leg towards table as ME |
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when doing supine ME for a posas spasm, which ASIS do you push on?
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the contralateral one
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Where is the Anterior L1 tender point located
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this is directly over or superior to the ASIS
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where is the anterior L2 tender point located?
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over the medial surface of the AIIS
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where is the anterior L3 tender point located?
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over the lateral surface of the AIIS
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where is the L4 anterior tender point located?
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on the inferior surface of the AIIS
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where is the L5 anterior tender point located
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this is located over the body of the pubic bone
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what position is the pt in for both assessment and treatment of the anterior lumbar tender points?
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the supine (lying on back) position
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when treating anterior tender points, how do you move the legs?
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with the patient supine, lift the legs (kness bent) off the table, and adjust for maximum comfort, while monitoring the tender point
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Where are the PL1-5 tender points located (posterior)
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these are located over the transverse processes or spinous processes of the correspondingly numbered vertebrae
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When treating PL1-5 tender points, when do you use rotation in addition to the normal elevation and extension of the leg?
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rotation is used (external rotation) with treating tenderpoints over the transverse processes
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Where are the L3 and L4 lateral posterior tenderpoints located?
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on the lateral buttocks
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where is the L5 upper pole tender point located? treatment?
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this is located superior medial to the PSIS. treated same as L5 transverse process tender point
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where is the L5 lower pole tenderpoint located? treatment?
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this is located between the PSIS and PIIS.
Leg hangs off table...(Prone pt) Flexed Knee and Hip Slight internal rotation of hip. push knee toward table (adducting the thigh) |
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in the pevlis, what can ligamentous stessors do?
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these can cause lumbo-sacral imbalance
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What can lumbo-sarcal instability cause?
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this can present as iliolumbar ligament irritation....chronic low back pain
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what muscles are included in the Rotator Cuff of the hip?
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Gluteal msucles
quadratus femoris liliopsoas muscle |
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how do you treat an anterior innominate rotation?
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you flex the hip, knee. then ask the pt to use the hamstrings for hip extension
the hammies are attached to the ischeal tuberosities...so the should pull the inominante posterior |
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how do you treat a posterior inominate rotation?
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you lay the leg off the side of the table, similar to a posas ME.
have pt raise leg against pressure to pull inominant anterior using the rectus femoris |
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how do you treat a superior innominate shear?
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this is the leg tug method.
abduct and extend the involved leg (from a supine position) grab just proxminal to the ankle, on the tibia/fibula add some internal rotation, deep breaths by pt, and massive tug. |
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What position do we put the leg in to, to fix an OUTFLARE?
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you flex knee, and adduct the leg
then for Tx, have the pt abduct the leg against force (this will pull the outflare back into line) |
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what position do with put the leg in to fix an INFLARE?
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you abduct the leg, placing it in a figure 4 position
the patent then tries to adduct the leg, thus pulling the inflare outward |
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what is shotgun pubes used to fix?
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this is used to correct issues with the pubic symphysis
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what causes motion in the superior transverse sacral axis?
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respiration
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what causes motion in the middle transverse sacral axis?
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motion of the sacrum ON the lilium
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what causes motion on the inferior transverse axis of the sacrum?
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motion of the lilum on the sacrum
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how are the oblique sacral axes named?
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they are named for the SUPERIOR aspect they exit
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when naming sacral dysfunctions, what is named first?
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the rotation, then what axis it is around
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what does the seated flexion test show?
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the motion of the sacrum upon the lilum
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what determines a positive spring test?
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an inability or lack of spring in the lumbosacral junction
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how does L5 rotate relative to the sacrum?
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this always rotates the opposite direction that the sacrum is rotated
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which way does the lumbar spine sidebend in relation to the engaged axis of the sacrum?
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this sidebends TOWARD the engaged axis....this means Left foot down, left rotation on left axis of sacrum, left sidebending of the lumbar spine.
(convexity faces away from the engaged axis/foot/side) |
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to determine sacral rotation, which portion of the sacrum do we look at?
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the anterior superior aspect (which way is it looking?- this is the direction of rotation)
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how do you determine which axis is engaged on the sacrum?
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after you find which way the sacrum is looking, perform a spring test. IF normal (negative) then it is looking the same way as its axis (left rotation on left axis...normal motion)
if + spring test, sacrum is rotated around the opposite axis that it is looking on (left rotation on right axis) |
