Diversified

11/30/99

 

Comp Board Review for Diversified on Wed 1/5/00 at 7pm about 2 hours long in SB10—pending approval of the administration

 

Basic

• Start w/assessment
• AP and lateral weight bearing
• Shoulders, arms, knees, hips
• Lordosis, kyphosis
• Table setup depending upon the lumbar Lordosis
• 5 signs
• H—high crest
• E—erector spinae tension
• L—lowest freely movable vertebrae
• P—pain in the SIJ—subjective finding
• S—sacrotuberous ligament tightness—use both thumbs on bare skin—the one that doesn't go up as high is tighter
• Normal table position
• Pelvic piece slightly raised
• Abdominal piece unlocked
• Foot piece up one notch
• Head piece down or level
• Finally, adjust to pt comfort
• Apex
• Primary use—AI sacrum that is unilateral
• Palpate down from PSIS to feel for the pocket
• Hand position
• Elbow down
• Get good ceiling
• Full spine adjusting
• LOD—line of drive
• For the cervical spine, point straight up to the occiput
• As move down the spine, arc the LOD laterally and down
• Do not cross the spine w/LOD
• Sit just below the greater trochanter
• C/s is towards the occiput
• T/s is toward the shoulder
• L/s and pelvis is toward the crest
• Axillary contacts
• In mid thoracic spine
• Use the SP and TP to derotate
• Have spinal nerves going to organs—refer to Meric System
• Notch
• More force
• Affect lumbar spine w/o axillary contacts
• Use same side hand that you are adjusting
• Palpate down from PSIS until fall into a pocket and then move a little further down an out
• LOD does not cross the spine
• Double Notch
• LOD crosses the spine at the base of the spine
• For bilateral AI sacrum—hyperlordosis
• Table positioning—abdominal piece up and locked
• Foot piece all the way down to contract the hamstrings to help pull the sacrum back
• Used to affect the pelvis
• Ulnar
• Use for obese pts or when need more force
• Use for AS (Ankylosing spondylitis)
• Look for dimples at PSIS for AI sacrum
• Dimple will be deeper on the more prominent side of AI sacrum
• Scoliosis
• Muscle contraction—hypertonicity of erectors or iliopsoas
• Muscle pulling—functional scoliosis
• Piriformis
• External rotation of the foot
• Muscle location—anterior sacrum to highest aspect of the greater trochanter
• Contact—one inch superior and anterior from the greater trochanter
• Use inferior hand
• Ceiling is upward
• Erector spinae tension on the L—contact on the R
• Affect insertion of the muscle—inferior LOD
• Affect origin of the muscle—superior LOD
• Used to affect the pelvis
• X-ray
• Leg deficiency could be possible due to pelvis posterior bringing femur up and this would be structural

 

Exams—gowns w/partners

            3 minutes

            One room Diversified

            One room Basic