Assisted Adjusting - Final

How much do drop tables elevate?

½ inch

What is the #1 reason to use a drop?

Patient preference

What are other reasons to use a drop?

Doctor/patient preference, patient size/tone, reduced physical stress on doctor, patient prefers a lighter force, and less force required

What amplifies the amount of adjustive force in a drop piece?

Counter forces that occur at point of contact when the drop table motion terminates

What are important things to educate your patient on?

Patient does not hear a cavitation when performing the drop.

Drop noise and falling nature may startle the patient.

What is the ideal drop table height?

1 inch above the patella

Why is the drop table height important?

Mechanical advantage

Proper leverage

Minimize physical stress on doctor’s body

What position should the drop table be in to start?

Uncocked/flat position

Where should the force of a drop thrust come from?

Primarily triceps, minimal pec contraction

How many thrusts should be applied?

1-3

When do you set the drop?

Before each thrust

T/F: You should NOT recoil with a drop table adjustment.

True

T/F: You should thrust beyond the drop.

False - thrust with the drop to termination

Why should you not thrust beyond the drop?

Painful for patient

Too much joint motion

Where should the ASIS be in relation to the pelvic piece?

superior end of pelvic piece 1” below the ASIS

How much space should be between the thoracic and pelvic/lumbopelvic drop?

2 fingers or 1”

If the drop immediately falls, how much should you turn the tension knob?

1.5 times clockwise - 3 half turns!

What is the ideal tension?

3 half turns beyond the patient’s mass dropping the table

How do you test the tension?

Place hands on both sides of the patient (lateral) and thrusting down

Do not thrust on pt to test the tension!

On what segments do you use a cervical drop piece?

C2-T3

On what segments do you use a thoracic drop piece?

C7-L2

On what segments do you use a lumbar drop piece?

T8 to superior ilium/sacrum

On what segments do you use a pelvic drop piece?

Lumbar and pelvic adjustments

What drop piece(s) do you use for the following adjustment: PI ilium?

Lumbar and pelvic piece

What drop piece(s) do you use for the following adjustment: BP sacrum

Lumbar and pelvic

What drop piece(s) do you use for the following adjustment: SAL/SAR?

Pelvic piece

What drop piece(s) do you use for the following adjustment: AS?

Pelvic piece

What drop piece(s) do you use for the following adjustment: EX

Pelvic piece

What is your CP for a PI ilium - diversified?

SCP?

Stab?

CP - hamate (#1b)

SCP: medial/inferior PSIS

Stab: wraparound stabilization

What is your CP for a IN ilium - diversified?

SCP?

Stab?

CP - hamate (#1b)

SCP: medial superior PSIS

Stab: pisiform over pisiform

What is your CP for a P-L ilium - diversified?

SCP?

Stab?

CP - hook of hamate (#1b) of inferior hand

SCP - lateral to S2 tubercle on side of contact

Stab - wrap around stabilization

What is your CP for a AS ilium - diversified?

SCP?

Stab?

CP - hamate (#1b) of superior hand

SCP - superior aspect of ischial tuberosity

Stab - pisiform over pisiform

What is your CP for a EX ilium - diversified?

SCP?

Stab?

CP - hamate (#1b) of superior hand

SCP - lateral inferior aspect of PSIS

Stab - pisiform over pisiform

What is your CP for a PI ilium - diversified?

SCP?

Stab?

C - hook of hamate (#1b) of inferior hand on sacral notch and hook of hamate of superior hand on PSIS

SCP - dual contact - sacral notch on side of deviation and medial PSIS on side of apex deviation

REMEMBER THIS RULE:

SUPERMAN 42

Superior hand - T4-L2

Inferior Hand - T1-3, L3-5

What is your CP for a lumbar SHC - simple?

SCP?

Stab?

CP - hamate (1b) of superior hand for L1/2, inferior hand for L3-5 (fingers will cross over!)

SCP - inferior lateral aspect of spinous

Stab - pisiform/knuckles over pisiform

What is your CP for a lumbar SHC - rotatory?

SCP?

Stab?

CP - hamate (#1b) of superior/inferior hand, fingers will NOT cross over spinous

SCP - mamillary process on side opposite spinous laterality

Stab - pisiform/knuckles over pisiform

What is your CP for a lumbar - DTH?

SCP?

Stab?

CP - thumb pad (#9) of superior hand

SCP - mamillary process on side of posterior body rotation

Stab - thumb pad (#9) of inferior hand

Which upper thoracic diversified moves require head piece deflection?

DP, MDP, MTM

Require 15-20 degrees

T/F: For a Gonstead prone adjustment with drop, the headpiece should be neutral.

True

T/F: If you are using the table with a swing-away, you need to unlock the swing-away when performing mid-lower thoracic adjustments.

True

What is your CP for a thoracic - SHC - simple?

SCP?

Stab?

CP - hamate (#1b) of sup/inf hand, fingers will cross over

SCP - inferior/superior lateral aspect of spinous (depends on CH)

Stab - pisiform/knuckles over pisiform

What is your CP for a thoracic - SHC - rotatory?

SCP?

Stab?

CP - hamate (#1b) of sup/inf hand

SCP - TVP on side opposite spinous laterality

Stab - pisiform/knuckles over pisiform

What is your CP for a thoracic - DTh?

SCP?

Stab?

CP - #10a/b of superior hand

SCP - TVP on side of posterior body rotation

Stab - #10a/b of inferior hand

What is your CP for a MDP?

SCP?

Stab?

CP - hamate (#1b) of inferior hand

SCP - TVP on side of posterior body rotation

Stab - segment above contact with thenar of superior hand

What is your CP for a DP?

SCP?

Stab?

CP - hamate (#1b) of inferior hand

SCP - inferior lateral aspect of spinous

Stab - thenar (#10a/b) of superior hand on spinous above contact

Which cervical diversified move requires head piece deflection?

Requires 10-15 degrees

PD

What is your CP for a cervical - PD?

SCP?

Stab?

CP - #7/8 of superior hand

SCP - lam-ped jxn on side of posterior body rotation

Stab - #11 on segment above

What is your CP for a cervical - DTh - simple?

SCP?

Stab?

CP - #9 (thumb pad) of superior hand

SCP - inferior lateral aspect of spinous

Stab - #9 of inferior hand over CP #9

What is your CP for a cervical - SHC - rotatory?

SCP?

Stab?

CP - #9 of superior hand

SCP - lamina on side opposite spinous laterality

Stab - #9 of inferior hand on opposite lamina

How should you set a table for an anterior antalgic lean?

Crank pelvic piece upward & elevate swing-away

If supine - elevate headrest and raise angle of headrest

How should you set a table for a pregnant patient?

Prone - unlock swing-away and slightly crank pelvic piece upward

How should you set a table for a severely hyperkyphotic patient?

Patient is supine

Raise headrest I-S