Compression neuropathy lab

Question 1

Cervical: Contralateral Traction, Soft Tissue

Doc: Standing on the _____ side being treated

Patient: Supine

• _____ hand reaches across and contacts paravertebral muscles on side opposite of where you are standing (make sure to be _______ to spinous processes, not on them)
• _______ hand rests on patient’s forehead to stabilize head
• Engage tissue with _____ force and continue to apply traction moving ______ and slightly _____ creating a ______ stretch

Answer 1

opposite caudad lateral cephalad ventral laterally perpendicular

Question 2

Cervical: Sub-occipital Release, Soft Tissue

Physician: Seated at head of table

Patient: Supine

Finger pads placed in sub-occipital region (find occipital ridge and move inferiorly until fingers fall into sub-occipital region) •

Apply _________ pressure into tissues and hold o what to do next?

Answer 2

anterosuperior can then knead or do inhibition

• knead (slow rhythmic pressure until tissue texture changes)
• inhibtion (apply constant pressure for 30sec-1 minute)

Question 3

Cervical: Unilateral Forearm Fulcrum Forward Bending, Soft Tissue

Physician: Standing at head of table

Patient: Supine

• Contact patient’s shoulder with one hand and use same arm to cradle patient’s occiput

o Stretch _________ by rotating and SB patient’s head towards physician’s elbow

o Stretch_________ by rotating and SB patient’s head towards physician’s hand

• Repetitively flex head in a rhythmical pattern to stretch desired muscle by moving the forearm anteriorly for ______ Repeat for 2-3 minutes or until tissue texture changes occurred

Answer 3

trapezius muscle => rotate and SB towards elbow posterior scalene muscle => rotate and SB towards hand 1-2 seconds

Question 4

Cervical: Bilateral Forearm Fulcrum Forward Bending, Soft Tissue

• Arms are crossed under patient’s head and hands placed
• palm down on patient’s shoulders
• Flex patient’s neck to induce a longitudinal stretch of the_______
• Repetitively flex head in a rhythmical pattern to stretch desired muscle by moving forearms anteriorly for _____
• Repeat for 2-3 minutes or until tissue texture changes occurred

Answer 4

paravertebral muscles 1-2 seconds

Question 5

Cervical: OA, MET

Dx F/E; SB and R

Answer 5

Physician: Sitting at head of table

Patient: Supine

• One hand under the occiput with pads of the fingers contact the sub-occipital musculature
• Other hand’s index and middle finger are placed on the patient’s chin beneath the lower lip
• Gently flex or extend the head towards the restrictive barrier of the occiput. Add rotation and sidebending towards the barrier
• Have the patient activate against physician’s resistance, maintain isometric contraction for 3-5 seconds
• Have patient relax and stop and then engage the new restrictive barrier

Repeat this process until no new barriers are reached

Question 6

Cervical: AA, MET

Dx Rotation only

Answer 6

1. fully flex the head
2. rotate towards RB
3. PT activates against resistance nd maintain isometric contraction for 3-5 seconds

Question 7

Cervical: C2-7, MET

Dx F/E, R/SB

Answer 7

• Contact articular pillar of affected segment with 1st MCP
• Put into barrier and have patient
• Have pt activate against resitance and maintain for 3-5 seconds and continule until no new barriers are reached

Question 8

Rib: 1st inhalation SD HVLA

• Doc puts ______ leg on table and drapes patients arm over
• SB head _____ dysfunction
• Touch rib with ______
• Have pt inhalae and exhale.
• PT likes to inhale (rib is sticking out); when _____ => load into first rib. At the end, apply an ______ thrust.

Answer 8

• Doc puts oppsite leg on table and drapes patients arm over
• SB head towards dysfunction
• Touch rib with 2^nd MCP
• Have pt inhalae and exhale.
• PT likes to inhale (rib is sticking out); when exhale => load into first rib. At the end, apply an inferomedial thrust.

Question 9

Rib: 1st Rib Inhalation SD, MET

1. Contact ____ surface of DSY rib with________
2. ____ head, SB _____, rotate ______ from dysfunctional rib
3. HAve pt breathe in and out
4. follow rib _____ and _____ into exhalation; resist inhalation
5. Repeat 3-5 times

Answer 9

• Contact superior surface of DSY rib with 2nd MCP joint
• Flex head, SB towards, rotate away from dysfunctional rib
• HAve pt breathe in and out
• follow rib down and foaward into exhalation; resist inhalation
• Repeat 3-5 times

Question 10

Rib: 1st Rib Exhalation SD, MET

• Stand on opp side of patient as they are laying down on back
• Place affected dorsom hand on head => rotate head 30 deg away from rib
• Doc
  
  • cephalad hand goes on pts foreead
  • caudad hand grabs superior angle of dysfunctional rib
  • Doc applies inferolateral traction with cadual hand
  • pt flex head and neck
• maintain isometric contraction for 3-5 seconds/3/5times

Question 11

Clavicle: SC Elevated/Adducted SD, MET

• pt lay on back close to side
• doc on same side
• • doc places one hand on proximal clavilar head
• • extend and IR arm by grabbing wrist => tell patient to raise arm for 3-5 seconds/3-5 times to bring into new barrier

Answer 11

pt lay on back close to side

doc on same side

• doc places one hand on proximal clavilar head
• extend and IR arm by grabbing wrist => tell patient to raise arm for 3-5 seconds/3-5 times to bring into new barrier

Question 12

Clavicle: SC Horizontal Extension SD, MET

clavicle head is stuck ANTERIOR (sticking out)

Answer 12

Physician: Standing on same side of dysfunction

Patient: Supine

• Place one hand on the restricted clavicular head and the other hand placed behind axilla to cover the scapula.
• Patient holds physician’s shoulder with the hand of the affected shoulder.
• Pull scapula anterior to flex the clavicle toward the manubrium until movement is palpated in the SC joint
• Apply a posterior force simultaneously to proximal clavicle from anterior to posterior to engage restrictive barrier.
• PT:
  
  • pulling their shoulder down toward the table.
• Repeat 3-5 times or until motion is maximally improved

Question 13

Clavicle: AC Internal Rotation SD, MET

Physician: Standing behind patient

Patient: Seated

• Place one hand on clavicle just medial to AC joint and grasping wrist with the other hand
• DOC:
  
  • Compress (blocking linkage) to stabilize clavicle/AC joint while flexing, abducting (approximately 45°) & ER to restrictive barrier
• PT
  
  • patient IR against physician’s resistance for 3-5 seconds

Repeat 3-5 times or until motion is fully restored

Question 14

Pec minor counterstrain (f-F ADD)

Answer 14

• Pt lays on back; doc on opp or same side
• Contact pec minor TP:
  
  • ​inferomedial to coracoid process
• f-F ADD
  
  • Grab pts shouldre and pull anterior to adduct patients arm across the chest ,
• Hold for 90 seconds and return to neutral

Question 15

OMT for pronator teres syndrome

Answer 15

Pronator teres counterstrain (F PRO Add)

• Pt lays on back or sits up; doc on same side
• Find TP: near medial epicondyle
• F PRO Add
  
  • Flex and pronate elbow (palms face floor); adduct
  • Hold for 90seconds => neutral

Question 16

Wrist: Flexor Retinaculum, MFR

Physician: Standing facing patient

Patient: Seated or supine

• Place thumbs on medial and lateral attachments of the transverse carpal ligament
• Wrap fingers around the dorsal surface of wrist and exert pressure with thumbs on the flexor retinaculum while pushing the thumbs apart
• Maintain pressure for 20-60 seconds as physician drags the skin and fascia with the thumbs
• Continue until tissue creeps
  *

Question 17

Wrist: Extension Carpal SD, HVLA

Wrist: Flextion Carpal SD, FVLA

Answer 17

• -have arm pronated( palm facing down)
• -grabs dorssum of hand and contant proximal carpal bone; take pts wrist all the way into flexion
• Use index fingers to apply a thrust to YOU (thrust from extension => flexion)

Wrist: Flexion Carpal SD, HVLA

pts arms should pronated w palms down

grabs dorssum of hand and contant proximal carpal bone => take wrist into extension and apply a thrust