Practices Section Up to Pg 7

What are gonstead (spinous) listings?

Named by how the subluxated segment misaligns to the segment below

What is always the first letter in a gonstead listing?

P which refers to posteriority

What is the second letter in gonstead listings?

Refers to spinous rotation, which will be an R or an L

What is the third letter in gonstead listings?

Lateral flexion or wedging of the segment on the side of the spinous rotation, which will be either an S or an I

How is an open wedge corrected in gonstead listings?

By using clockwise or counterclockwise torque; typically gonstead will contact on the side of the open wedge

What is Sp in gonstead listings?

Spinous

What is La in gonstead listings?

Lamina

What is Tp in gonstead listings?

Transverse process

What is M in gonstead listings?

Mammillary

What are national (body) listings?

Refer to body rotation

What is the first letter of national (body) listings?

R or L

What is always the second letter of national (body) listings?

P, which refers to posteriority

What is the third letter of national (body) listings?

S or and I, which refers to lateral flexion or wedging on the side of body rotation

What are dynamic listings?

From motion palpation findings, also classified as kinetic listings

What do dynamic listings refer to?

Vertebral body

What does fixed mean in dynamic listings?

Segment is stuck in that position that is being described

What does restricted or decreased mean in dynamic listings?

Segment can’t move to the position that is described (Opposite of fixated)

How are medicare listings written as?

Malpositions

What is malposition?

What is seen off of the x-ray, the “wrong” position the segment is in at that moment, also described as a fixation in dynamic listings

What is flexion malposition?

Increased interspinous space between the involved segment and the segment below with decreased interspinous space between the involved segment and the segment above

What is extension malposition?

Decreased interspinous space between the involved segment and the segment below with increased interspinous space between the involved segment and the segment above

What is the reference structure when adjusting?

Vertebral body unless otherwise noted; contact side of open wedge

What side do you adjust if the patient has scoliosis?

Contact side of convexity

What side does the doctor stand on?

Side of contact

In seated cervical, what side does the doctor stand on if performing diversified?

Opposite side of contact

In seated cervical, what side does the doctor stand on if performing gonstead?

Posterior to seated patient

How do you note open wedge torque on the right?

CW torque

How do you note open wedge torque on the left?

CCW torque

What is extension restriction/flexion fixation in Medicare “malposition” listing?

Flexion malposition

What is flexion restriction/extension fixation in Medicare “malposition” listing?

Extension malposition

What is right rotation restriction/left rotation fixation in Medicare “malposition” listing?

Left rotation malposition

What is right rotation restriction/left rotation fixation in National “body” listing?

LP

What is right rotation restriction/left rotation fixation in Gonstead “spinous” listing?

PR

What is left rotation restriction/right rotation fixation in Medicare “malposition” listings?

Right rotation malposition

What is left rotation restriction/right rotation fixation in National “body” listings?

RP

What is left rotation restriction/right rotation fixation in Gonstead “spinous” listings?

PL

What is right lateral flexion restriction/left lateral flexion fixation in Medicare “malposition” listings?

Left lateral flexion malposition

What is left lateral flexion restriction/right lateral flexion fixation in Medicare “malposition” listings?

Right lateral flexion malposition

What is right rotation and right lateral flexion restriction/left rotation and left lateral flexion fixation in Medicare “malposition” listings?

Right rotation and left lateral flexion malposition

What is right rotation and right lateral flexion restriction/left rotation and left lateral flexion fixation in National “body” listings?

RPI

What is right rotation and right lateral flexion restriction/left rotation and left lateral flexion fixation in Gonstead “spinous” listings?

PLS

What is right rotation and left lateral flexion restriction/left rotation and right lateral flexion fixation in Medicare “malposition” listings?

Right rotation and left lateral flexion malposition

What is right rotation and left lateral flexion restriction/left rotation and right lateral flexion fixation in National “body” listings?

RPS

What is right rotation and left lateral flexion restriction/left rotation and right lateral flexion fixation in Gonstead “spinous” listings?

PLI

What is left rotation and left lateral flexion restriction/right rotation and right lateral flexion fixation in Medicare “malposition” listings?

Left rotation and left lateral flexion malposition

What is left rotation and left lateral flexion restriction/right rotation and right lateral flexion fixation in National “body” listings?

LPI

What is left rotation and left lateral flexion restriction/right rotation and right lateral flexion fixation in Gonstead “spinous” listings?

PRS

What is left rotation and right lateral flexion restriction/right rotation and left lateral flexion fixation in Medicare “malposition” listings?

Left rotation and right lateral flexion malposition

What is left rotation and right lateral flexion restriction/right rotation and left lateral flexion fixation in National “body” listings?

LPS

What is left rotation and right lateral flexion restriction/right rotation and left lateral flexion fixation in Gonstead “spinous” listings?

PRI

In Lovett Positive Classification of Scoliosis, what is normal compensatory deviation?

Least offending scoliosis

In Lovett Positive Classification of Scoliosis, what is on the same side at the PI ilium (short leg)?

Anterior inferior sacrum

In Lovett Positive Classification of Scoliosis, what the towards the side of the AI sacrum/PI ilium?

Convex side of the scoliosis

In Lovett Positive Classification of Scoliosis, how does the spinous deviate?

Away from the convexity side

In Lovett Positive Classification of Scoliosis, when should a heel lift be used?

On the side of the PI ilium

In Lovett Positive Classification of Scoliosis, when should a sole lift be used?

On the side of the AS ilium

What are absolute contraindications to adjusting?

Malignancies, tumors, infections, fractures (exception Clay Shoveler’s), abdominal aortic aneurysm, recent surgery

What are relative contraindications to adjusting?

Osteoporosis, spondylolisthesis, rheumatoid arthritis, cardiovascular predisposing factors, congenital anomalies, acute spastic muscle region

In lower cross syndrome, how does a balanced pelvis look like?

The ASIS’s are in the same vertical plane as the symphysis pubis

In lower cross syndrome, how does anterior pelvic tilt look like?

The ASIS move anterior to the pubic symphysis; hyperlordosis

What are lengthened/inhibited muscles in anterior pelvic tilt?

Hamstrings, gluteals, abdominals

What are hypertonic/facilitated muscles in anterior pelvic tilt?

Psoas, quadriceps, errector spinae

In lower cross syndrome, how does posterior pelvic tilt look like?

The ASIS move posterior to the pubic symphysis

What are the lengthened/inhibited muscles in posterior pelvic tilt?

Psoas, quadriceps, errector spinae

What are hypertonic/facilitated muscles in posterior pelvic tilt?

Hamstrings, gluteals, abdominals

What are hypertonic/facilitated muscles in upper cross syndrome?

Levator scapulae, pectoralis major, upper trapezius, sternocleidomastoid, scalenes, suboccipitals

What are lengthened/inhibited muscles in upper cross syndrome?

Rhomboids, lower and middle trapezius, serratus anterior, teres minor, longus coli and capitus

What is close-packed position?

Occurs when the joint capsule and ligaments are maximally tightened, this is the maximal contact between articular surfaces making the joint very stable and difficult

What are finger DIP’s closed packed position?

Maximal extension

What are finger PIP’s closed packed position?

Maximal extension

What are finger MCP’s closed packed position?

Maximal flexion

What are the inter-metacarpal joints closed packed position?

Maximal opposition

What are the inter-carpal joints closed packed position?

Maximal dorsiflexion

What are the radiounlar joints closed packed position?

5 degrees of supination

What are the ulnohumeral joints closed packed position?

Extension in supination

What are the radiohumeral joints closed packed position?

Flexion in supination

What is the glenohumeral joint’s closed packed position?

Abduction and external rotation

What is the AC joint’s closed packed position?

90 degrees of abduction

What is the sternoclavicular joint’s closed packed position?

Maximal elevation

What are the toes DIP’s closed packed position?

Maximal extension

What are the toes PIP’s closed packed position?

Maximal extension

What are the toes MTP’s closed packed position?

Maximal extension

What are the intermetatarsal joint’s closed packed position?

Maximal opposition

What is the tarsometatarsal joint closed packed position?

Maximal inversion

What is the tibiotalar joint closed packed position?

Maximal dorsiflexion

What is the tibiofemoral joint closed packed position?

Maximal extension and external rotation

What is the coxafemoral joint closed packed position?

Maximal extension, internal rotation, and abduction

What are open chain exercises?

Performed typically where the hand or foot is free to move; these exercises are typically non-weight bearing, with movement occurring at the elbow or knee joint; if there is weight applied it is to the distal portion of the limb (bench press, biceps curl, leg extension)

What are closed chain exercises?

Performed where the hand or foot is fixed and cannot move; the hand/foot remains in constant contact with the surface, usually the ground or the base of a machine; these exercises are typically weight bearing where an exercises uses their own body weight and/or external weight (pushups, pull-ups, squats, lunges)

What is included in anterior postural analysis?

Head tilt or rotation, shoulder height, arm carriage, hip height, knee angle, foot malposition

What is included in gravity weight line (lateral)?

External auditory meatus, anterior body of C7, middle of shoulder, anterior 1/3 of sacral base, middle of the hip joint, posterior to the patella, 1’ anterior to lateral malleolus

What is included in posterior postural analysis?

Scapula winging, scapula flaring, scoliosis

What plane are cervical facets in?

Transverse

What plane are thoracic facets in?

Coronal

What plane are lumbar facets in?

Sagittal

What plane are lumbrosacral facets in?

Coronal

What motion do cervical facets do?

Rotation

What motion do thoracic facets do?

Lateral flexion

What motion do lumbar facets do?

Flexion/extension

What motion do lumbrosacral facets do?

Lateral flexion