Term
|
Definition
| the only bones connecting the upper extremity and the axial spine |
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Term
| muscles of the rotator cuff |
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Definition
supraspinatus - aBduction infraspinatus - external rotation teres minor - external rotation subscapularis - internal rotation |
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Term
|
Definition
| this artery passes between the anterior and middle scalenes |
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Term
|
Definition
this artery courses the lateral aspect of the forearm supplying blood to the elbow, wrist, dorsal aspect of the hand, and eventually forming the DEEP palmar arterial arch |
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Term
|
Definition
| this artery courses the medial aspect of the forearm supplying blood to the elbow, wrist, dorsal aspect of the hand, and eventually forming the SUPERFICIAL palmar arterial arch |
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Term
| abduction of the shoulder |
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Definition
| for every 3 degree of abduction, the glenohumeral joint movies 2 degrees and the scarpulothoracic joint moves 1 degree |
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Term
| internal and external rotation |
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Definition
| the most common somatic dysfunction of the shoulder is restriction in... |
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Term
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Definition
| A male patient comes into the clinic complaining of neck pain and dull and sometimes shooting pain radiating down his arm with movement. he also complains of variable parethesias. his clavicle is tender. what is the likely diagnosis based on hx? |
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Term
|
Definition
| The special test in Thoracic outlet syndrome in which compression occurs between the scalenes |
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Term
|
Definition
| special test in TOS in which compression occurs between the clavicle and 1st rib |
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Term
|
Definition
| special test in TOS in which compression occurs under pectoralis minor |
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Term
| directed at C2-C7, T1, rib, thoracic inlet, clavicle, and scalenes. exercises to strengthen trapezius and levator scapula |
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Definition
|
|
Term
| (chronic) supraspinatus tendinitis |
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Definition
| a male patient complains of tenderness at the top of the shoulder (tip of acromion) which hurts more when he tries to abduct his arm from 60 - 120 degrees. Xray shows calcification of supraspinatus tendon |
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Term
| tx for supraspinatus tendonitis |
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Definition
| rest, ice, and NSAIDS for the acute stages. Severe: a sling and injection with lidocaine. OMT should be directed at the shoulder complex, upper thoracic and ribs |
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Term
|
Definition
| A 40 yr old male complains of pain his his arm that began after working out at the gym lifting weight, which he hasn't done for quite some time. he describes the pain as in his shoulder and radiates to his biceps. PE shows tenderness over thhe bicipital groove. he said it hurts worse with resisted flexion or supination of the forearm. Dx? |
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Term
| tx for bicipital tenosynovitis |
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Definition
| rest, ice, NSAIDs, for acute. Severe: injection with lidocaine or steriods. OMT to free restrictions in the glenohumeral area and myofascial release |
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|
Term
| rotator cuff tear (supraspinatus) |
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Definition
| A 17 year old athlete complains of a dull pain in his shoulder following a fall on it 3 days prior. He reported that right after, there was a shooting sharp pain but it progressed to a dull pain by today. PE shows tenderness just below the tip of the acromion. He is unable to abduct his arm. + drop arm test. He said it hurts worse at night. |
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Term
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Definition
| a 43 yr old woman comes in complaining of decreased range of motion of her arm with pain. she is unable to fully, abduction or internally or externally rotate her arm passively or actively. she said that after her arm broke 1 year ago, she has been resting it extensively and not moving it unless she absolutely has to. PE shows tenderness on anterior portion of shoulder. |
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Term
tx for adhesive capsulitis |
|
Definition
| PREVENTION --> the earlier the mobilization, the better. in jection of corticosteriods and NSAID's may help. OMT directed at improving motion and lysing adhesions. |
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Term
anteriorly and inferiorly axillary nerve |
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Definition
| a 14 yr old athlete dislocated his shoulder playing football. In which directions did the head of the humerus dislocate from the joint? injury to what nerve can accompany? |
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|
Term
winging of the right scapula long thoracic nerve |
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Definition
| a patient's right scapula protrudes posteriorly while he is pushing on a wall. Dx? What nerve has been injured? |
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Term
|
Definition
| The most common form of brachial plexus injury. Upper arm paralysis caused by injury to C5 and C6 nerve roots usually during childbirth. Results in paralysis of deltoid, external rotators, biceps, brachioradialis, and supinator muscles. |
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Term
|
Definition
most common nerve injured in the upper extremity due to direct trauma. unable to extend wrist or fingers (wrist drop) and partial paralysis supinating the arm. CRUTCH PALSY: improper use of crutches causes injury. In HUMERAL FRACTURES in which this nerve travels along the spinal groove |
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Term
muscles innervated by median nerve |
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Definition
| flexors of the wrist and hand, pronators, 1st and 2nd lumbricals, thenar eminence except adductor pollicis brevis. originate near medial epicondyle of the humerus |
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Term
| muscles innervated by radial nerve |
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Definition
| extensors of the wrist and fingers, supinator. originate near lateral epicondyle of the humerus |
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Term
|
Definition
| a carrying angle > 15 degrees. also called aBduction of the ulna |
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Term
|
Definition
| a carrying angle < 3 degrees. AKA aDduction of the ulna |
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|
Term
ulna movement: aBduction wrist movement: aDduction |
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Definition
|
|
Term
ulna movement: aDduction wrist movement: aBduction |
|
Definition
|
|
Term
|
Definition
| A boy complains of not being able to move his arm after a fall yesterday. He said he fell while running and landed on his outstretched arm. PE: restricted supination and anterior glide of radial head |
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Term
|
Definition
| a boy complains of not being able to move his arm after being pushed backwards by his brother yesterday. he said he landed on his outstretched arm. PE: restricted in pronation and posterior glide of radial head |
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Term
| carpal tunnel syndrome (median nerve entrapment) |
|
Definition
| A 32 yr old woman complains of pain and weakness of her thumb and her first 2 fingers. She said the pain started a month ago at work where she is a secretary that types all day. She also says sometimes she feels pain shooting down her wrist into her fingertips. PE: atrophy of thenar muscles, + Tinnel's sign, Phalen's sign, and prayer tests. Sent for a nerve conduction study. Dx? |
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|
Term
|
Definition
| splints, NSAIDs, and steriod injections. surgery is conservative failed. OMT - treat rib and upper thoracic SD's to decrease symp tone. also, treat cervical SD's and myofascial restrictions. finally, treat direct release techniques to increase the space in the carpal tunnel |
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|
Term
| lateral epicondylitis (tennis elbow) |
|
Definition
| a 23 yr old male professional carpenter complains of pain when tightening a screw with his screwdriver over the lateral aspect of his elbow and worsens when resistance is applied. he said it radiates to the lateral aspect of his arm and forearm. PE: tenderness over lateral epicondyle. edema in the dorsal forearm over the extensor muscles. |
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|
Term
| medial epicondylitis (golfer's elbow) |
|
Definition
| a young professional golfer complains of pain in his elbow. He said he was playing 18 holes and on the 13th, he began to notice a sharp pain whenever he would begin his backswing. PE: tenderness of medial epicondyle that gets worse with pronation and flexing the forearm. |
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Term
|
Definition
flexion contracture of the MCP and DIP, extension contracture of the PIP. associated with rheumatoid arthritis. |
|
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Term
|
Definition
| entnsion contracture of the MCP and DIP, flexion contracture of the PIP. associated with rheumatoid arthritis |
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Term
|
Definition
| entension of the MCP, flexion of the PIP and DIP. results from median and ulnar injury |
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Term
|
Definition
| similar to claw hand but also a wasting of the thenar eminence and the thumb is adducted |
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Term
|
Definition
| contracture of the last two digits with atrophy of the hypothenar eminence due to ulnar nerve damage |
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Term
|
Definition
| flexion contracture of the MCP and PIP usually seen with contracture of the last two digits. like bishop's, however, due to a contracture of the palmar fascia |
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|
Term
| ligaments of the hip joint |
|
Definition
iliofemoral ligament ishiofemoral ligament pubofemoral ligament capitis femoris - head of femur attaching to acetabular fossa |
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Term
|
Definition
| hip restricted in internal rotation, usually from piriformis or iliopsoas spasm |
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Term
|
Definition
| hip restricted in external rotation, usually due to spasm of internal rotators (gluteus minimus, semimembranosus, semitendinosis, TFL, adductor magnus, adductor longus) |
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|
Term
| ACL (anterior cruciate ligament) |
|
Definition
| originates at the posterior aspect of the femur, and attaches to the anterior aspect of the tibia. IT PREVENTS ANTERIOR TRANSLATION OF THE TIBIA ON THE FEMUR |
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Term
| PCL (posterior cruciate ligament) |
|
Definition
| originates on the anterior aspect of the femur and insets on the posterior aspect of the tibia. IT PREVENTS POSTERIOR TRANSLATION OF THE TIBIA ON THE FEMUR |
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Term
|
Definition
| dorsiflexion, eversion, and abduction. the fibular head will glide anteriorly |
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Term
|
Definition
| plantarflexion, inversion, and adduction. the fibular head will glide posteriorly |
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Term
|
Definition
motor - innervates quads, iliacus, sartorius, and pectineus. sensory - anterior thigh and medial leg |
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Term
|
Definition
two divisions: 1. tibial - motor - hamstrings except the short head of the biceps femoris, most plantar flexors, and toe flexors seonsory - lower leg and plantar aspect of the foot 2. peroneal - motor - short head of biceps femoris, evertos, and dorsiflexors of the foot, and most extensors of the toes sensory - lower leg and dorsum of foot |
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Term
|
Definition
| if angle between the neck and shaft of femur is < 120 degrees |
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Term
|
Definition
| if angle between the neck and shaft of the femur is > 135 degrees |
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Term
|
Definition
| increased Q angle (angle between ASIS and tibial tuberosity). patient appears knock-kneed |
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Term
|
Definition
| a decreased Q angle (the angle between the ASIS and the tibial tuberosity). patient will appear bowlegged |
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|
Term
| Posterior fibular head SD |
|
Definition
proximal head resists anterior spring distal fibula may be anterior and resists posterior springing talus internally rotated causing foot to invert and plantarflex. can cause dysfunction of the common peroneal nerve which lies directly posterior to the fibular head |
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Term
|
Definition
proximal fibular head resists posterior spring distal fibula may be posterior talus externally rotated causing foot to evert and dorsiflex |
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Term
|
Definition
| a woman complains of deep knee pain when climbing her stairs at home. PE: increased Q angle, atrophy of vastus medialis, lateral patellar crepitus. tx: strengthen the vastus medialis muscle |
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Term
|
Definition
| a 16 yr old athlete complains of severe and unrelenting pain in her lower leg, especially the anterior part. she said it started after a trackmeet. PE: anterior tibialis muscle is hard on palpation, pulses are present and stetching the muscle causes severe pain. |
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|
Term
| tx for compartment syndrome |
|
Definition
| ice and myofascial release, to increase venous and lymph return. since muscle necrosis can develop within 4-8 hours, if syndrome remains, surgical fasciotomy is indicated |
|
|
Term
|
Definition
1. ACL 2. MCL 3. medial meniscus |
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|
Term
| anterior talofibular ligament |
|
Definition
| MC injured ligament in the foot, usually after excessive evertion and plantarflexion |
|
|
Term
| factors that will decrease the rate and quality of the CRI |
|
Definition
1. stress 2. depression 3. chronic fatigue 4. chronic infections |
|
|
Term
| factors that will increase the rate and quality of the CRI |
|
Definition
1. vigorous physical exercise 2. systemic fever 3. following OMT to the craniosacral mechanism |
|
|
Term
|
Definition
| foramen magnum, C2, C3, and S2 |
|
|
Term
|
Definition
| a guy got hit in the back of the head by a baseball bat, what kind of craniosacral strain is the most likely? |
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Term
|
Definition
| all viscera above the diaphragm receives PS innervation from |
|
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Term
|
Definition
| PS innervation of entire small bowel, ascending, transverse colon |
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|
Term
|
Definition
PS innervation of descending colon and recto-sigmoid colon |
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|
Term
|
Definition
| PS innervation of lower ureter and bladder |
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|
Term
|
Definition
| PS innervation of ovaries and testes |
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|
Term
|
Definition
| S innervation for head and neck |
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|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
| S innervation of upper GI (stomach, liver, gallbladder, spleen, portions of pancreas and duodenum) |
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Term
|
Definition
| S innervation of middle GI tract (portions of duodenum and pacreas, jejunum, illium, ascending colon and proximal 2/3 of transverse colon |
|
|
Term
|
Definition
| S innervation of lower GI tract (distal 1/3 of transverse colon, descending colon and sigmoid colon, rectum) |
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Term
|
Definition
| S innervation of appendix |
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Term
|
Definition
|
|
Term
|
Definition
| S innervation of adrenal medulla |
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|
Term
|
Definition
| S innervation of upper ureters |
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|
Term
|
Definition
| S innervation of lower ureters |
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|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
| S innervation of uterus and cervix |
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|
Term
|
Definition
| S innervation of erectile tissue and clitorus |
|
|
Term
|
Definition
| S innervation of prostate |
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|
Term
ant -at the tip of the right 12th rib post - transverse process of T11 |
|
Definition
| chapman's point for appendix |
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|
Term
ant - 2 in superior and 1 in lateral to the umbilicus post - between the spinous and transverse processes of T11 and T12 |
|
Definition
chapman's point for adrenals |
|
|
Term
| chapman's point for kidneys |
|
Definition
ant - 1in superior and 1 in lateral to umbilicus post - between the spinous processes and transverse processes of T12 and L1 |
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|
Term
| chapman's point for bladder |
|
Definition
|
|
Term
| chapman's point for colon |
|
Definition
| on the lateral thigh within the iliotibial band from the greater trochanter to just above the knee |
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|
Term
| Spurling Test (compression test) |
|
Definition
| special test where the physician pushes down on the top of the patient's head. a + test is one in which pain radiates down into the ipsilateral arm |
|
|
Term
|
Definition
to test for vertebral artery insufficiency. a + test is one in which the patient complains of dizziness, visual changes, lightheadedness, or eye nystagmus |
|
|
Term
|
Definition
| a test where the arm is extended, externally rotated, and slightly abducted. the patient is then asked to take a deep breath and turn their head toward the ipsilateral arm. the test is positive with a severely decreased or absent radial pulse. one of the tests for TOS |
|
|
Term
| wright's test (hyperextension test) |
|
Definition
| hyperabducting the arm above the head with some extension. the test is positive with a severely decreased or absent radial pulse. one of the tests for TOS |
|
|
Term
| costoclavicular syndrome test (military posture test) |
|
Definition
| the examiner palpates the radial pulse while depressing and extending the shoulder. the test is positive with a severely decreased or absent radial pulse. one of the tests for TOS |
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Term
|
Definition
| used to evaluate the range of motion of the shoulder. ask the patient to reach behind their head and touch the opposite shoulder, reach in front of their head and touch their opposite shoulder, and reach behind their head and touch the opposite scapula. |
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Term
|
Definition
| detects tears in the rotator cuff. the patient is instructed to abduct the hould to 90 degrees and then slowly lower the arm. a positive test results if the patient cannot lower their arm smoothly, or if the arm drops to the side from 90 degrees |
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Term
|
Definition
| assesses the biceps tendon in the bicipital groove. the patient full extends the elbow, flexes the shoulder, and supinates the forearm. the physician resists the flexion of the shoulder. a positive test results with tenderness in the bicipital groove |
|
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Term
|
Definition
| determines the stability of the biceps tendon in the bicipital groove. the patient flexes the elbow to 90 degrees while the physician grasps the elbow with one hand and the wrist with the other hand. while pulling downward on the patient's elbow, the physician externally rotates the forearm as the patient resists. a positive test results when pain is elicited as the biceps tendon pops out of the bicipital groove |
|
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Term
|
Definition
| assesses the adequacy of blood supply to the hand by the radial and ulnar arteries. the patient is instructed to open and close the hand being tested several times and then make a tight fist. the physician occludes the radial and ulnar arteries at the wrist. the palms should be pale. the doc releases his grasp and assesses the flush. if it flushes slowly or not at all, then the released artery is not adequately supplying the hand. |
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Term
|
Definition
| test for synovitis in the abductor pollicis brevis tendons at the wrist. the patient makes a fist with the thumb tucked inside the fingers. the physician stabilizes the patient's forearm and deviates the wrist ulnarly. a positive test results when the patient feels pain over the tendons at the wrist |
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Term
|
Definition
| aids in the diagnosis of CTS. the physician maximally flexes the patients wrist and holds this position for one minute. if tingling sensation is felt in the thumb, index finger, middle and lateral portion of the ring fingers, the test is positive and is indicative of CTS |
|
|
Term
| reverse phalen's (prayer test) |
|
Definition
| opposite of phalen's. another test for CTS. a positive is tingling after one minute. |
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|
Term
|
Definition
| used in the diagnosis of CTS. the doc tap on the patient's transverse carpal ligament. a positive test will cause tingling or parethesia into the thumb, index, middle, and later half of the ring finger. |
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Term
|
Definition
| assesses the sidebending ability of the lumbar spine and thoracolumbar junction. normally, the lumbar spine should sidebend toward the side contralateral to the bending knee. the ipsilateral iliac crest should drop more than 20-25 degrees. a positive test is indicated by anything less than a smooth convexity in the lumbar spine, or a drop of the iliac crest of less than 25 degrees, meaning a lumbar SD |
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|
Term
| straight leg raising (Lasegue's test) |
|
Definition
| used in the evaluation of sciatic nerve compression. raise the leg approx 80 degree. if pain is felt, bring it down a little and dorsiflex the foot. if no more pain, the original pain was due to tight hanstrings. if the is still pain, its a positive result for sciatic impingment |
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Term
|
Definition
| determines if the sacrum is midline. it is often seen in flexion contracture of the iliopsoas (psoas syndrome). a flexion contracture of the right iliopsoas will cause a positive pelvic shift test to the left and vice versa |
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|
Term
|
Definition
| detects a tight tensor fascia lata and iliotibial band. the doc puts the patient in the oppositve side to the affected side. he then flexes the knee to 90 degrees, abducts the hip as far as it'll go, and slightly extends. the doc then releases his control and allows the leg to fall back to the table. a postive test results in the legs remaining in the abducted position indicating a tight iliotibial band |
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|
Term
| patrick's test (FABRE test) |
|
Definition
| used to assess pathology of the sacroiliac and hip joint, especially, osteoarthritis of the hip. a positive test results in pain when pressure is applied. |
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|
Term
|
Definition
| assesses the possibility of a flexion contracture of the hip, usually of iliopsoas origin. a positive test results when the patient's opposite leg raises up indicating a tight iliopsoas muscle. |
|
|
Term
|
Definition
| evaluates problems with full knee extension, usually due tominiscal tears or joint effusions. the doc grabs the ankle and fully flexes the knee. he then lets it go and normally the knee should fully extend and bounce with out restriction. a positive test is if extension is incomplete or there is a rubbery feel to end point extension |
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|
Term
| apley's compression and distraction tests |
|
Definition
| evaluate the meniscus and ligamentous structures of the knee. pain on compression indicates a meniscal tear. pain on distraction indicated ligamentous injury, usually the medial and or lateral colateral ligaments. |
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|
Term
|
Definition
| assesses the stability of the ACL and is somewhat more accurate than the Draw tests. |
|
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Term
|
Definition
| detects tears in the posterior aspect of the menisci. if a palpable or audible click is felt or heard, the test is positive for a posterior (or lateral with internal instead of external roation) tear of the meniscus |
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|
Term
|
Definition
| assesses the posterior articular surfaces of the patella and the possibility of chondromalacia patellae, commonly seen with patello-femoral syndrome. the test is positive if the patient feels pain with contraction of the patella |
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|
Term
| valgus and varus stress test |
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Definition
| used to assess the stability of the collateral ligaments. pushing Laterally on the knee is the vaLgus stress test. if gapping on the opposite side occurs, the MCL is torn. |
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|
Term
|
Definition
| used to assess the medial and lateral ligaments of the ankle, mainly the anterior talofibular ligament, but also the superficial and deep deltoid ligaments. |
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|
Term
|
Definition
Tissue texture change Asymmetry Restriction Tenderness |
|
|
Term
|
Definition
| a point at which the patient can actively move any given joint |
|
|
Term
|
Definition
| a point at which a doc can passively move any givn joint |
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|
Term
| restrictive (pathologic) barrier |
|
Definition
| lies before the physiologic barrier, and prevents full range of motion of that joint |
|
|
Term
| acute somatic dysfunctions |
|
Definition
| edematous, erythematous, boggy, with increased moisture. muscle hypertonic. asymmetry present. restriction present, painful with movement. severe, sharp tenderness |
|
|
Term
| chronic somatic dysfunctions |
|
Definition
| decreased or no edema, no erythema, cool dry skin, with slight tension, decreased muscle tone, flaccid, ropy, fibrotic. asymmetry present with compensation in other areas of the body. restriction present, decreased or no pain. dull, achy, burning tenderness |
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|
Term
| orientation of the superior facets in the axial skeleton |
|
Definition
cervical - backard, upward, medial BUM thoracic - backward, upward, lateral BUL lumbar - backward, medial BM |
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|
Term
|
Definition
| muscle contraction that result in the approx of the muscle's origin and insertion without a change in its tension. the operator's force is less than the patient's force |
|
|
Term
|
Definition
| muscle contraction that results in the increase in tension without an approx of origin or insertion. the operator's force and the patient's force are equal |
|
|
Term
|
Definition
| muscle contraction against resistance while focing the muscle to lengthen. the operator's force is greater than the patient's force |
|
|
Term
| physiologic motion of the spine in flexion and extension |
|
Definition
| transvers axis on a sagittal plane |
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|
Term
| physiological motion of the spine in rotation |
|
Definition
| vertical axis on a transverse plane |
|
|
Term
| physiological motion of the spine in sidebending |
|
Definition
| anterior-posterior axis on a coronal plane |
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|
Term
anterior and middle scalenes |
|
Definition
| originate from the posterior tubercle of the transverse processes of the cervical vertebrae and insert onto rib 1. aid in respiration and sidebending/flexing the neck. HELP ELEVATE the FIRST RIB DURING FORCED INHALATION |
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|
Term
|
Definition
| originate same as ant and middle, insert on rib 2. HELP ELEVATE THE SECOND RIB DURING FORCED INHALATION |
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|
Term
|
Definition
unilateral contraction - sidebend towards and rotate away bilateral - flex the neck divides the neck into anterior and posterior triangles. can result in torticollis |
|
|
Term
|
Definition
|
|
Term
|
Definition
| holds the dens in place. Down's and rheumatid arthritis can weaken this ligament. rupture causes profound neurological damage |
|
|
Term
|
Definition
| help support the lateral side of the cervical disc and protects cervical nerve roots from disc herniation. degenerative changes and hypertrophy can lead to foraminal stenosis and nerve root compression |
|
|
Term
orientation of the cervical nerves |
|
Definition
the upper 7 exit above their corresponding vertebrae. ex: C7 nerve root will exit between C6 and C7. C8 exits between C7 and T1 |
|
|
Term
|
Definition
| promary motion is flexion/extension. 50% od F/E of the cervical spine. sidebending and rotation occur on OPPOSITE sides with either flecion or extension |
|
|
Term
|
Definition
| primary motion is rotation. 50% of the rotation of the cervical spine. clinically, only rotation occurs at this joint |
|
|
Term
|
Definition
| sidebending/rotation occur on the same side. acounts for the other 50% of F/E and rotation in cervical spine |
|
|
Term
|
Definition
right translation = left sidebending and vice versa rotation sidebending - look for deep sulci, a right deep sulcus indicates left sidebending, which indicated right roation |
|
|
Term
|
Definition
rotation - flex the head to 45 degrees to lock out C2-C7. look for restriction in rotation side to side |
|
|
Term
|
Definition
| translation - right translation will produce left sidebending, just like OA |
|
|
Term
| cervical foraminal stenosis |
|
Definition
| an elderly 87 yr old female complains of shooting pain and loss of feeling in her arm and neck. Hx - osteoporosis. PE: increased pain with neck extension, positive Spurling's test, paraspinal muscle spasm, posterior and anterior cervical tenderpoints. Xray - osteophyte formation and degenerative changes on AP views, narrowing intervertebral foramina on oblique. |
|
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Term
|
Definition
| the upper ribs 1-5 move primarily in a _________ motion |
|
|
Term
|
Definition
| the middle ribs 6-10 move primarily in a _____ motion |
|
|
Term
|
Definition
| the lower ribs 11 and 12 move primarily in a _____ motion |
|
|
Term
| ribs 1-5 inhalation dysfunction |
|
Definition
| ribs elevated anteriorly. restricted on exhalation. tenderness and tissue texture changes at the costochondral junction, chondrosternal junction, and posterior rib angles |
|
|
Term
|
Definition
| ribs elevated laterally. restricted on expiration. tenderness and tissue texture changes at the intercostal muscles at mid axillary line and posterior rib angles |
|
|
Term
|
Definition
| ribs depressed anteriorly. restricted on inspiration. tenderness and TTC same as I S.D. |
|
|
Term
|
Definition
| ribs depressed laterally. restricted on inspiration. TTC and tenderness same as I S.D. |
|
|
Term
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Definition
| the key rib is the lowest rib of the dysfunction |
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Term
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Definition
| the key rib is the uppermost rib of the dysfunction |
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Term
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Definition
| MC anamaly in the lumbar spine, predisposed to early degenerative changes. |
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Term
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Definition
| no herniation through the defect in closure of the lamina of the vertebral segment. often only physical sign is a course patch of hair over the site. rarely associated with neurological deficits |
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Term
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Definition
| a herniation of meninges through the defect. associated with neurological deficits |
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Term
| spina bifida meningomyelocele |
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Definition
| a herniation of the meninges and the nerve roots through the defect. associated with neuro deficits |
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Term
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Definition
| main motion of the lumbar spine |
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Term
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Definition
| main motion of the thoracic spine |
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Term
| SD of the lumbosacral spine (back strain/sprain) |
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Definition
| a 45 yr old man complains of achy pain in his low back, butt, and thigh and spasms. he said the pain gets worse with running or even sitting in the same spot for a while. - SLR test. DTR's +2/4. |
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Term
| herniated nucleus pulposus (98% occur between L4-L5, or L5-S1) |
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Definition
| a 33 yr old profession power lifter complains of lower back and lower leg pain. he said it gets numb and tingles accompanied by a sharp shooting that goes down his leg, which worsen when he bends over. PE: weakness and decreased reflexes associated with the affected nerve root. sensory deficit over the corresponding dermatone. + SLR test. MRI - disc herniation L4-L5 |
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Term
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Definition
| a 56 yr old truck driver complains of achy low back pain that radiates to his groin with muscle spasms. he says it hurts worse when he's walking or standing. PE: + Thomas test, tenderpt medial to ASIS, L1 ERrSr, positive pelvic shift test to contralateral side, L on L sacral SD, contralater piriformis spasm. |
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Term
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Definition
| ice, counterstrain to the anterior iliopsoas tenderpt, then ME, HVLA to the high lumbar dysfunction. do NOT stretch acute psoas spasms, only CHRONIC. |
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Term
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Definition
| a 77 yr old woman complains of low back and low leg pain. she said it aches all the time, but sometimes it'll shoot a sharp pain with numbness down her leg. it's worse when standing, walking, and lying down. Xray - osteophytes and decreased intervertebral disc space. Foraminal narrowing on oblique view. |
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Term
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Definition
| OMT - decreasing restriction, improving ROM, physical therapy, NSAID's or low dose steroids. surgical laminectomy is conservative not working |
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Term
| spondylolisthesis (anterior displacement, usually occurs at L4 or L5, symptomatic after age of 20) |
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Definition
| a 23 yr old athlete complains of achy pain in his lower back, butt, and the backk of his thigh. he said it gets worse when leans back to yawn. PE: tight hamstrings bilaterally, waddling type gait, short stride, NO NEURO DEFICITS, positive vertebral step off sign. Xray - forward displacement of L4. |
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Term
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Definition
| conservative management, HVLA is contraindicated. weight loss, avoiding high hells, and avoiding flexion exercises |
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Term
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Definition
| defect in the par interarticularis without anterior displacement of the vertebral body. symptoms similar to spondylolisthesis. lateral xrays will not reveal any slippage, but oblique views will idenify the fracture. it is often seen as a "collar" on the neck of the SCOTTY DOG |
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Term
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Definition
| radiographical term for degenerative changes within the intervertebral disc and ankylosing of adjacent vertebral bodies. |
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Term
| cauda equina syndrome (massive central disc herniation) |
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Definition
| a 23 yr old professional NFL player complains of sharp low back pain. he reports that he is completely number around his entire inner thigh, pees and shits himself all the time. PE: decreased deep tendon reflexes. |
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Term
| tx for cauda equina syndrome |
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Definition
| emergent surgical decrompression or irreversible paralysis will prob result. |
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Term
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Definition
| type of scoliosis in which the curve is sidebent to the left |
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Term
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Definition
| type of scoliosis in which the curve is sidebent right |
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Term
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Definition
a spinal curve that is relatively fixed and infleible. it will not correct with sidebending in the opposite direction. associated with vertebral wedging and shortened ligaments and muscles on the concave side of the curve |
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Term
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Definition
| a spinal curve that is flexible andcan be partially or completely corrected with sidebending to the opposite side |
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Term
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Definition
| xray method od measuring the amount of scoliosis in a patient. draw a horizontal line from the top of the most superior vertebral body in the curve and another line at the bottom of the most inferior vertebral body in the curve. next, draw perpendicular l ines from these horizontal lines aqnd measure the acute angle |
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Term
| severity of scoliolis (cobb angles) |
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Definition
mild - 5-15 degrees moderate - 20-45 degrees severe - >50 degrees |
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Term
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Definition
| respiratory function is compromised of the thoracic curvature is.... |
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Term
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Definition
| CV function is compromised if the thoracic curvature is .... |
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Term
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Definition
| conservative tx that consists of physical therapy, Konstancin exercises and OMT. The goal is to improve flexibility and strengthen trunk and abdominal muscles. OMT is not intended to completely straighten scoliotic curves. |
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Term
| tx for moderate scoliosis |
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Definition
| all the conservative therapy plus bracing with a spinal orthotic is often indicated |
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Term
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Definition
| surgery is often indicated if there is respiratory compromise or if the scoliotic curve progresses quickly despite conservative management |
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Term
| signs and symptoms of short leg sndrome (MC cause of hip replacement) |
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Definition
sacral base unleveling - lower on the side of the short leg anterior innominate on side of short leg posterior innominate on side of long leg lumbar spine will sidebend away, and rotate toward side of short leg ferguson's angle will increase 2-3 degrees |
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Term
| tx for short leg syndrome |
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Definition
omt directed at the spine and lower extremities done to remove or decrease as much SD as possible. if the short leg still persists... obtain standing postural xrays to quantify differences in the heights of the femoral head. of femoral head difference is >5mm then consider a heel lift |
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Term
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Definition
1. the hell lift should be applied to the side of the short leg 2. the final lift height should be 1/2 - 3/4 of the measured leg length discrepancy, unless there was a recent sudden cause, if this is the case, lift the full amount 3. the "fragile" patient should begin with a 1/16 inch heel lift and increase 1/16 in every 2 weeks 4. the flexible patient should begin with 1/8 in heel lift and increase 1/8 in every two weeks |
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Term
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Definition
| divides the greater and lesser sciatic foramen |
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Term
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Definition
often the first ligament to become painful in lumbosacral decompensation |
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Term
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Definition
the sacral base moves posterior |
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Term
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Definition
| the sacral base moves anterior |
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Term
| physiologic axes of the sacrum and innominates |
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Definition
dynamic - motion while walking, weght bearing on left leg will cause a left sacral axis to be engaged and vice versa respiratory - inhalation - post, exhalation - ant inherent - craniosacral flexion - post, craniosacral extention - ant postural - bending forward causes sacrum to move ant until maximum is achieved then moves post |
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Term
| right anterior innominate |
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Definition
| PE: standing flexion + on right. ASIS inferior on right, PSIS superior on right. |
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Term
| right posterior innominate |
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Definition
| + standing flexion test on right, ASIS superior on right, PSIS inferior on right |
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Term
| right superior innominate shear |
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Definition
| + standing flexion test on right, right ASIS and PSIS superior on right. |
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Term
left inferior innominate shear |
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Definition
| + standing flexion test on left, ASIS and PSIS inferior on left |
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Term
| left superior pubic shear |
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Definition
+ standing flexion test on left, ASIS level, PSIS level, public bone superior on left |
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Term
right inferior pubic shear |
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Definition
| + standing flexion test on right, ASIS level, PSIS level, pubic bone inferior on left |
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Term
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Definition
| + standing flexion test on right, right ASIS more medial. |
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Term
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Definition
| + standing flexion test on left, left ASIS more lateral |
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Term
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Definition
1. when L5 is sidebent, a sacral oblique axis is engaged on the same side as sidebending 2. when L5 is rotated, the sacrum rotates the opposite way on an oblique axis 3. the seated flexion test is found on the opposite side of the oblique axis |
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