Visualization and Static Palpation

Kinesiopathology

1.) Abnormal motion or alignment

2.) motion palpation

3.) range of motion

4.) videoflouroscopy

Neuropathophysiology

1.) abnormal nervous system function → various types of skin and infrared temperature devices

2.) thermography

3.) nerve conduction studies

Myopathology

1.) abnormal muscle function

2.) surface EMG

3.) electric muscle testing

Histopathology

1.) abnormal soft tissue findings

2.) static palpation; MRI

Arthropathophysiology

1.) Abnormal bony changes

2.) spinography (chiropractic X-ray findings)

3.) MRI

4.) CT scan

Visualization: posture

head tilt, high shoulder, high hip, gluteals, foot flare, skin folds

visualization: observation

gait, foot flare, S-I fixation

Anterior view

1.) global list → glabella sternum baseline

2.) head tilt → glabella, nose chin

3.) thoracic tilt → AC joints

Posterior view

1.) head rotation → cheek prominence

2.) head translation → EOP to VP

3.) scoliosis → palpate spine, skin folds

4.) pelvic tilt → iliac crest

5.) pelvic rotation → gluteal musculature

Lateral view

1.) global list → ear to midfoot

2.) head carriage → Ear to shoulder

3.) thoracic kyphosis → hunch back

4.) lumbar lordosis → sway back

Static palpation components

1.) skin → asymmetry, temperature, texture

2.) edema

3.) superficial muscle tonicity

4.) tissue prominence

5.) deep muscle tonicity

6.) palpable tenderness

Temperature

1.) hot boxes

2.) nerve tracing

3.) acute → warm; chronic → cool

4.) use back of hands

sudoriferous changes → skin texture

1.) run fingers over spinous processes → autonomic response

2.) acute → sweaty, clammy

3.) chronic → dry

Turgidity

1.) edema → inflammatory process (rubor, dolor)

2.) cross matrix healing (fibrous)

3.) adjusting → allows healing to take place properly. Parallel mobilization does not

4.) thumb web of fist → normal; thumb web of relaxed fist → edema (bruised peach)

5.) thumb web open hand → flaccid (healing)

superficial muscle tonicity

1.) muscle tone below the skin surface

2.) broad fingertip contact of paraspinals

3.) increased tone → spasm; decreased tone → atrophy

Deep muscle tonicity

1.) strumming the paraspinals

2.) deeper pressure

3.) ropey, cable like, spasms

Tissue Prominence

1.) bilateral thumbs or thumb and index finger

2.) feel for one side of spine to “hit bone” or “bottom out” before the other side

3.) prominence possibly correlates to side of posterior body rotation, opposite side of spinous

Point tenderness

1.) palpate spinous tip and sides

2.) compare spinous process and transverse process

3.) in acute presentation → tender, patient is usually aware of the pain

4.) in chronic presentation → response deep dull aching that patient may not be as aware of till palpated

Occiput — C1 Break

Suboccipital → between the 2 segments (upper cervical)

C2-T3 break

interspinous space below

T4 break

at its own spinous level

T5-T9 break

interspinous space above

T10-T12 break

at its own spinous level

L1-L5 break

lower 25% of spinous of involved segment