Pregnancy and Pediatrics Week 5

What are the primary areas of subluxation for drop table?

occiput/cervical

Pelvis

Which area of subluxation takes priority in drop technique?

Neither (use clinical judgement to decide which to a just)

What does a positive cerivcal syndrome indicate?

Body rotation subluxation opposite the side of the turned head

What contact in used for every adjustment prior to the age of 5?

Inferior pinky supported by superior pinky 2-6 oz pressure

What direction does the cervical spine primarily subluxate prior to 9 yo according to drop technique?

Posterior

What is the difference in the drop table cervical adjustment after the age of 6?

Contact = LPJ instead of spinous process

DC contact.= Pincher grasp (thumb and index finger)

DC may elect to set a light drop at and above this age

What does a D- indicate?

SAcral subluxation

What % of pelvic subluxations are sacral?

80%

What finding indicates a D-?

Short leg in P1 goes short or level/balanced in P2

How do you confirm an AI sacrum in infants?

Sacral squeeze

What is the positive finding of a sacral squeeze

Gluteal crease deviating left or right when squeezing the glutes indicates the sacrum is AI on the ipsilateral side of deviation

How do you determine an AI sacrum in the weight bearing population?

Tender points

What are the tender points for an AI sacrum?

Ipsilateral to the short leg:

- Proximal aspect of emdoal tibia

- Ischial tuberosity

- PSIS

- Pubic bone area (least used in practice by most DCs)

Contralateral to the short leg

- Thoracic erector spinae from T2-T6

What is the adjustment for an AI sacrum?

A-P on the ipsilateral STL

Inferior pinky contact for 0-7 yo and inferior thumb for older

What is used to confirm D- sacrum in the weight bearing population?

Heel to buttock test

What does a restricted side of a heel to buttock test indicate?

Posterior sacrum on that side

How do you perform a facilitated adjustment?

Inferior pinky with superior hand lifting ipsilateral thigh in an A-P direction

Which segments should be contacted for the posterior sacrum adjustment?

S1, S2, S3 or possibly a combo of two of the segments

When should you use a drop for the posterior sacrum adjustment?

When there is a positive crest sign major

What dose a D+ indicate?

posterior ilium subluxation

What are additional indicators of a posterior ilium?

Low gluteal fold on the involved side

Static palpation - posterior ilium on the low gluteal fold side

What is the LOD for posterior ilium?

Posterior to superior

What is the difference in a PI ilium adjustment over the age of 8?

DC contact = inferior thumb supported by superior thumb (instead of pinkies for facilitated)

Sustained contact of 12-16 oz pressure (instead of 2-6 oz)

DC may elect to set a light drop at and above this age