pregnancy and peds thompson quiz

what is measured when assessing the need for a webster cranial suture adjustment

hemi cranium from glabella to EOP bilaterally

what is observed when assessing the need for a webster cranial suture adjustment

low medial canthus

what does a low medial canthus and enlarged hemi cranium on the same side indicate

dysfunction a the coronal/squamous suture

what is the patient position for cranial suture adjustment

seated on parent's lap as age appropriate

what is the doctor position for cranial suture adjustment

opposite large hemicranium side

what is the doctor contact for cranial suture adjustment

anterior pinky on parietal bone and posterior pinky on frontal bone

what is the patient contact for cranial suture adjustment

coronal/(squamosal) suture

what is the LOC for cranial suture adjustment

scissoring motion with pinkies

repeat 3-4 times

what happens after 2 minutes after the cranial suture adjustment

previously observed abnormalities will be decreased

what should you do if you find a ropey suboccipital muscle

hold fingertips for 30 seconds until uniformity is returned

what is teh 1-2-3 sequence

inter transverse space increases on the side opposite of lateral flexion between C0-C1 and C1-C2

what is the subluxation finding for atlas

segment has gone lateral, superior and slightly posterior

what is the inversion test used for

confirm palpatory findings

how do you perform the inversion test

securely grasp patient's thighs and invert child so head is 1-2 inches off table

what is normal for inversion test

infant is straight with no rotation of head

what indicates subluxation with inversion test

head rotates away from side of subluxated atlas

what are contraindications for inversion test

birth trauma (c-section, forceps, vacuum extraction)

under 10 days old

cranial shunt

torticollis

ear infection

nervous parent

nervous baby

facial/cranial trauma

just fed

dirty diaper

what is the atlas assessment for ambulatory patients

short leg in extension balances out when turning head right or left --> positive cervical syndrome

palpating LPJs OPP of head rotation -> don't feel a nodule --> atlas

patient position for infant atlas correction

Seated

Doctor stance + position for atlas correction

S: seated

P: opposite side of subluxation, toggle board around neck

what is the contact for atlas correction

pinkie contact on lateral tip of C1 TP

(anterior)

what is the LOC for atlas correction

L-M

S-I

2-6 oz pressure

when should the doctor not use toggle boards for atlas

acute ear infection

what is the alternative to toggle atlas adjustment

sustained contact on lateral and posterior aspect of atlas TP

reinforce w/ opp pinkie finger

2-6 oz pressure; L-M, S-I

hold for 12-15 seconds (or moves)

what are the primary areas of subluxation for thompson technique

occiput/cervical

pelvis

Rvw: cervical syndrome

Contraced/short leg in extension

Turn head = even out -> positive

Check LPJ on opposite side

what does thompson technique say about cervical spine subluxations under 9 years old

primarily posterior

what is the cervical adjustment for 0-5 years old

PT prone

doctor in headward lunge on either side

contact *spinous*

DC contact: *inferior pinky* supported by superior pinky

LOC: P-A

sustained contact: 2-6 oz

what is the cervical adjustment for *6 years or older*

PT prone

doctor in headward lunge on either side

contact *LPJ*

DC contact: *pincer grasp* with thumb and index finger

LOC: P-A

sustained contact: 2-6 oz

Could start a light drop

what is a negative derefield

short leg in down position

short to short or short to level/balanced in 90 degrees

(80% cases)

what does a negative derefield represent

sacral subluxation

Not tell if AI or Posterior

what is the sacral squeeze

confirms D- is an anterior inferior sacrum in infants

squeeze gluteal muscles together while patient prone

what is normal for sacral squeeze

gluteal crease points cephalad = normal motion

what indicates an AI sacrum with sacral squeeze

gluteal crease deviates left or right --> ipsilateral AI sacrum

(points to AI)

what are the ipsilateral (to short leg) tender points for the AI sacrum in weightbearing population

proximal aspect of medial tibia

ischial tuberosity

PSIS

pubic bone area

what are the contralateral (to the short leg) tender points for the AI sacrum in weightbearing population

thoracic erector spinae from T2-T6

what is the adjustment for AI sacrum

A -P on sacral tuberous ligament

-inferior pinky contact for 0-5/7 years old, backup with superior

-inferior thumb for older

how do you confirm D- is posterior sacrum

heel to buttock test

side of resistance in posterior sacrum

what is the posterior sacrum adjustment in 0-5/7 years old

PT prone

DC standing on affected side

PT contact: lateral portion of subluxated segment

DC contact: *inferior pinky* supported by superior pinky

LOC: P-A

sustained contact 2-6 oz

what is the faciliated part of posterior sacrum adjustment in 0-5/7

inferior pinky contact with superior hand lifting ipsilateral thigh A-P

what is the posterior sacrum adjustment in *8 years or older*

PT prone

DC standing on affected side

PT contact: lateral portion of subluxated segment

DC contact: inferior *thumb* supported by superior thumb

LOC: P-A

sustained contact 2-6 oz

Could add a light drop

Sacrum anatomy to remember for post. Sacrum

Not fused. Could be one or multiple segments (S1-S3), use light shallow drops til older

what does a positive derefield indicate

PI ilium (20%)

how do you find a D+

short leg in down position

short to longer than OPP in 90 degree position

what are other indicates for PI ilium

low gluteal fold on involved side

palpated PI ilium on low gluteal fold side

(Or more chunkadunks?)

what is the PI adjustment in 0-5/7 years old

PT prone

DC standing on affected side

PT contact: posterior inferior PSIS

DC contact: *inferior pinky* supported by superior pinky

LOC: P-A

sustained contact 2-6 oz

what is the faciliated part of PI adjustment in 0-5/7

inferior pinky contact with superior hand lifting ipsilateral thigh in A-P direction

what is the PI adjustment for *8 years and older*

PT prone

DC standing on affected side

PT contact: posterior inferior PSIS

DC contact: *inferior thumb* supported by superior thumb

LOC: P-A

sustained contact 2-6 oz

Could add a light drop