Palpation Quiz #1

PP

Patient Placement

what does PP represent

the way that the patient is positioned for an adjustment or palpation procedure (prone, seated, supine, side posture)

DS

doctor's stance

what does DS describe

the position in which the doctor stands to deliver an adjustment or perform a palpation procedure

CH

contact hand

what does CH represent

the hand the doctor is using to contact the patient's anatomy when delivering an adjustment or palpation procedure

CP

contact point

what does CP represent

the specific point on the doctor's contact hand that contacts the anatomical structure used to deliver the adjustment or perform the motion or joint play procedure

SH

stabilization hand

what does SH represent

the hand that the doctor uses to stabilize the patient during an adjustment or palpation procedure

SP

stabilization point

what does SP represent

the specific point on the doctor's stabilization hand used during an adjustment or palpation procedure

SCP

segmental contact point

what does SCP represent

the anatomy on the patient that the doctor will use to deliver an adjustment or perform a motion palpation procedure

SSP

segmental stabilization point

what does SSP represent

the anatomy on the patient the doctor will use to stabilize to make an adjustment or perform a motion palpation procedure

TP

tissue pull

what is a TP and why is it used? (2)

soft tissue pre-stressing line of correction has the following functions:

1) to guide and direct the segmental level being adjusted

2) to establish a close contact between the contact point and the segmental contact point

LOC

line of correction

what does LOC represent

the direction the segment moves during the adjustment

LOD

line of drive

what does LOD represent

the direction which the doctors arm moves during thrust to correct the misalignment

what is the x-axis:

RIGHT middle finger, flexion and extension

what is the y-axis

RIGHT thumb, rotation

what is the z-axis

RIGHT index finger, lateral bend

x-axis pelvic motion palpation procedures: (3)

1) knee raiser

2) seated sacroiliac flexion

3) sacroiliac fluid motion

y-axis pelvic motion palpation procedures: (3)

1) seated sacroiliac axial rotation

2) seated lumbopelvic lateral bend

3) leg fanning

where are the sacral notches in relation to the sacral apex

1 inch superior and lateral

where are the ischial spines in relation to the sacral apex

2 inches lateral

knee raiser PP

standing and supported

knee raiser DS

standing or seated behind patient

knee raiser CP

thumb pads #9

knee raiser SCP

Both inferior and medial aspects PSIS

knee raiser findings ipsilateral

PSIS should move posterior, inferior, and medial

knee raiser findings contralateral

PSIS should move anterior and superior

in the knee raiser procedure, what indicate a fixation of the SI joint

diminished motion of the PSIS when compared to same motion on the opposite side would indicate fixation of that sacroiliac joint

on left knee raiser the left PSIS (ipsilateral) doesn't move posterior, inferior, and medial as well as the right PSIS (ipsilateral) on right knee raiser, what would this indicate?

fixation of left sacroiliac joint

seated sacroiliac flexion PP

seated toward the front of a backless chair or edge of a bench

seated sacroiliac flexion DS

Seated behind patient

seated sacroiliac flexion CP

thumb pads (#9)

seated sacroiliac flexion SCP

inferior aspect of PSIS

in seated sacroiliac flexion, your right thumb has more excursion, how would you interpret this?

right sacroiliac fixation

sacroiliac fluid motion PP

prone with feet and ankles off the edge of the bench

sacroiliac fluid motion DS

Modified scissor stance

sacroiliac fluid motion CH

superior hand

sacroiliac fluid motion CP

Hook of the hamate on the superior hand #1b

sacroiliac fluid motion SCP

superior medial aspect of PSIS

sacroiliac fluid motion TP

superior to inferior and medial to lateral

sacroiliac fluid motion direction docotr presses

into the joint at a 45-degree angle toward the acetabulum

in left sacroiliac fluid motion, both legs lengthen simultaneously, what does this indicate

left sacroiliac fixation

seated sacroiliac axial rotation PP

seated

seated sacroiliac axial rotation DS

standing on side patient will be rotated toward

seated sacroiliac axial rotation CP

Pads of the 2nd, 3rd, and 4th digits

seated sacroiliac axial rotation SCP

PSIS sacral interspace

seated sacroiliac axial rotation SH

Stabilization hand will be placed on the patient's shoulder and the doctor will rotate the patient toward the side the doctor is standing

seated sacroiliac axial rotation findings: the PSIS on ipsilateral side should move:

lateral to medial

seated sacroiliac axial rotation findings: the PSIS on contralateral side should move:

medial to lateral

seated sacroiliac axial rotation ipsilateral interpretation:

in left and right rotation, the ipsilateral PSISes should move medial the same amount, if left is less on left rotation compared to right PSIS on right rotation = left SI fixation

seated sacroiliac axial rotation contralateral interpretation:

in left and right rotation, the contralateral PSISes should move lateral the same amount, if the right PSIS has less motion on left rotation, compared to the left PSIS on right rotation = right SI fixation

seated lumbopelvic lateral bend PP

seated

seated lumbopelvic lateral bend DS

Standing on side patient will be bent

seated lumbopelvic lateral bend CP

Pads of the 2nd, 3rd, and 4th digits

seated lumbopelvic lateral bend SCP

PSIS sacral interspace

seated lumbopelvic lateral bend findings: the PSIS on the ipsilateral side should move:

lateral to medial

seated lumbopelvic lateral bend findings: the PSIS on the contralateral side should move:

medial to lateral

seated lumbopelvic lateral bend ipsilateral interpretation:

in left and right lateral bend, the ipsilateral PSISes should move medial the same amount, if left is less on left lateral bend compared to right PSIS on right lateral bend = left SI fixation

seated lumbopelvic lateral bend contralateral interpretation:

in left and right lateral bend, the contralateral PSISes should move lateral the same amount, if the right PSIS has less motion on left lateral bend, compared to the left PSIS on right lateral bend = right SI fixation

leg fanning PP

seated at front of chair

leg fanning DS

seated posterior to patient

leg fanning CP

thumb pads #9 (both right and left thumbs)

leg fanning SCP

PSIS sacral interspace

leg fanning abduction findings:

PSIS should move from lateral to medial AND sacral base will rock anterior (sacral nutation)

leg fanning adduction findings:

PSIS should move from medial to lateral AND sacral base will rock posterior (sacral counternutation)

leg fanning abduction interpretation:

on abduction, the left and right PSISs should move medial the same amount

leg fanning abduction interpretation: if the left side has less motion compared to the right =

left SI fixation

leg fanning adduction interpretation:

on adduction, the left and right PSISs should move lateral the same amount

leg fanning adduction interpretation: if the left side has less motion compared to the right =

left SI fixation

T1 landmark

30-40% vertebral prominence

T3 landmark

root of the spine of the scapula

T4 landmark

most prominent thoracic spinous

T5-T9 landmark

imbricated spinous processes

T6 Landmark

inferior angle of the scapula (prone)

T7 landmark

inferior angle of the scapula (seated)

T1-T3 TVP

up one interspinous space

T4 TVP

Across from T3 Spinous (high in T3/T4 interspinous space)

T5-T9 TVP

Up two interspinous spaces

T10 TVP

Across from T9 spinous

T11-T12 TVP

up one interspinous space

L1-L5 landmark

use mammillary processes instead of transverse processes

L1-L5 Mammilary process

up one interspinous space

L4 Landmark

iliac crest (L3-4 male; L4-5 female)

L5 Landmark

smallest lumbar spinous