Assisted Adjusting Midterm

What is the main difference between a stress and pressure test?

stress test makes symptoms worse and pressure tests are corrective

What happens to the reactive leg with stress and pressure test?

RL shortens with stress test, RL lengthens (or goes even) with pressure tests

Are isolation tests stress or pressure tests?

stress

What is possibility 1 for activator?

RL is short that goes long in P2, start with knees and feet

What is possibilty 2 for activator?

RL is short that stays short in P2, start at L4

What is possibilty 3 for activator?

legs are even, start with pubic symphysis

What does the medial knee pattern for activator include?

talus then MCL

What does the lateral knee pattern for activator include?

cuboid then LCL

What are the 3 SCPs for an AS?

base of sacrum, iliac crest, ischial tuberosity

What are the 3 SCPs for a PI?

ischial spine, sacrotuberous ligament, iliac fossa

Would you adjust C1 or C2 if the RL is long in P2?

C1 on RL side

Would you adjust C1 or C2 if the ORL is long in P2?

C2 on ORL side

What thoracics will you have 2 SCPs for? What are they?

T2-T10, TVP of long leg side and contralateral rib

What is the LOC for T1 rib?

straight S-I on middle of superior body

When assessing the right scapula, the right leg is long in P2. What would you adjust?

lateral scapula

When assessing the right scapular, the left leg is long in P2. What would you adjust?

medial scapula

What would you adjust on a medial scapula?

medial to lateral on scapular body, up on deltoid tuberosity, radial head and anterior lunate

What would you adjust on a lateral scapula?

lateral to medial on scapular body, down on deltoid tuberosity, ulna and capitate

What is the most common region for disc herniation?

posterolateral aspect of annulus fibrosis

What is the most common mechanism of injury?

full flexion combined with lateral bending

Why do discs have a long healing time?

they are avascular and aneural

Who are disc herniation MC in?

individuals 40-49 or have DDD

List all the contraindications to LFD.

cauda equina, fracture, dislocation, tumor, infection, systemic diseases, and patients with progressive signs of significant root irritation

What joint is the ankle bar placed at for flexion distraction?

talcrural joint

Patient presents with pain going down the leg into the lateral aspect of the foot, diminished achilles reflex, and weakness with ankle plantarflexion. What NR and disc is affected? Where would you contact?

L5 disc lesion affecting S1 nerve root, spinous of L3 or L4

Patient presents wtih pain doing down the leg into the dorsum of the foot, weakness with ankle dorsiflexion and 1st digit dorsiflexion, and difficulty with heel walk. What NR and disc is affected? Where would you contact?

L4 disc lesion affecting L5 nerve root, spinous of L3 or L2

Patient presents with pain going down the leg into the medial aspect of the foot, with diminished patellar relfex, and weakness on knee extension. What NR and disc is affected? Where would you contact?

L3 disc lesion affecting L4 nerve root, spinous of L2 or L1

All tolerance tests and treatment are done from taut point except

extension in protocol 2

What is taut point?

point you feel the joint tightly isolated under your contact hand (contact with #11 or #10a/b)

Describe protocol 1 (hint: 3x5)

3 sets, 5 reps of flexion only, for 4 seconds each while resting for 10 seconds between sets

When would you move from protocol 1 to protocol 2?

when pain has centralized above the knee or symptoms have decreased by 50%

Describe protocol 2

10 sets of (flexion, lateral bend, circumduction, and extension) 1 second down, 1 second up, with no rest in between

What are the 3 point landing for activator protocol?

thumb across bottom of the foot, index and middle fingers split over lateral malleolus

T or F For the 3 point landing hand placement for activator one finger should be placed on the calcaneal tendon.

false

When are stress tests performed?

when the legs are even in P1

What are the activator settings for extremities on a healthy adult?

activator 2: 3 rings, activator 4/5: setting 2

What are the activator settings for pelvis on most body types?

activator: 6 rings, activator 4/5: setting 4

What is the LOD for talus adjustment?

posterior, superior and lateral

What is the LOD for cuboid adjustment?

posterior, superior and medial

T or F After a few vists if the knee pressure test does not indicate the need for an adjustment, it is not necessary to continue to check them.

true (unless there is new trauma)

What would you pressure test for a pelvic listing first?

AS on ORL, then PI on RL

To begin isolation tests the legs must be...

even

How do you know what side to adjust after preforming an isolation test?

if RL lengthens in P2 adjust RL side, if RL shortens adjust ORL side

When is the upper extremity or scapula test preformed?

after T1 rib test and before C7

L5 isolation test

arm on side of RL

L4 isolation test

arm on oppostie side of RL

L2 isolation test

both arms behind back

T12 isolation test

arm on RL side above head

T8 isolation test

both arms above head

T6 isolation test

(arms back down) turn head toward RL

T4 isolation test

retracts RL shoulder off table

T1 isolation test

roll both shoulders up toward ears

T1 rib isolation test

shrug both shoulders up, back and down

Scapula isolation test

patient squeeze elbow toward RL side

C7 isolation test

face back to neutral

C5 isolation test

look ahead

C1/C2 isolation test

tuck chin to chest

Occiput isolation test

push forehead into table

SCP for lumbar adjustment

inferior articular facet

SCP for cervical adjustment

lamina-pedical junction on side of involvement

T or F you can adjust both scapula.

true

What is flexion-distraction used to treat?

lumbar and cervical disc herniation

Where does the conus medullaris end?

L1/L2

What gives stabilty to the spinal cord and connects conus medullaris to the coccygeal ligament?

filum terminale

What part of the disc have a vascular and nerve supply?

outer 1/3

What is the timeline for transient LBP?

not more than 90 days in a 12 month period

What is the timeline for recurrent LBP?

mulitple episodes that last less than 6 months in a 12 month period

What is the timeline for chronic LBP?

consisten or many episodes that last more than 6 months in a 12 month period

Where should the ASIS be in relation to the distal end of the thoracic piece for flexion distration?

2" superior