Chapman's Points & OMM
unilateral extension of sacrum tx
basE Exhalation External rotation of leg
speed test
biceipital tendonitis pt fully extend elbow, flexes shoulder, then supinate forearm. Pt then flexes shoulder against phyisician's resistance += pain in bicipital groove
bilateral sacral flexion
bilateral sacral sulci deep bilateral ILA shallow inc lumbar curve
bilateral sacral extension
bilateral sacral sulci shallow bilateral ILA deep dec lumbar curve
OMM: Post Chap - neck
c3-c7
talar tilt test physician grasps the pt's distal tibia and fibular with one hand and inferior calcaneus with other , blocking motion of the calcaneus on talus. Then invert the talus to evalulate motion + = laxity and inc ROM or pain
calcanofibular or anterior taoofibular ligament pathology for anterior talofibular only, golden is ankle anterior drawer test
frontal bone dysfunction
commonly seen in: sinusitis allergy visual disturbance (eyes reside in orbit)
slow, irregular CRI with little amplitude
compression of SBS AP comppressive force during birth --> sphenoid and occiput forced together
therapeutic pulse felt during CS treatment
consistent with pt's heart rate (suggest vascular response to tissue treated) -correlates with myofascial tissue relaxation and improved treatment response
OMM: Ant Chap - Cerebellum
corocoid process
parietal lift
correction dysfunction at squamous suture
vault hold
index @ greater wing of sphenoid middle finger @ preauricular portion of temporal bone ring finver @ mastroid process little finger @ squamous portion of occiput thumb rests abov surface of cranium
facilitated positional release
indirect, passive OMT (put body in neutral position to diminish tension -->add compression/torsion force -->go into ease---> hold for 3-4 sec--> release
SP of T7
inferior angle of scapula location of TP of T8 (rule of three, T7-9 SP is one full step below their TP)
OMM: Ant Chap - nasal sinuses
inferior clavicle
tight hip adductor
inferior pubic sheer (ant /post rotation of inominate = tight quad/ hamstring )
exhalation somatic dysfunction means rib is restricted in exhalation/inhalation?
inhalation
OMM: Ant Chap - Small intestines
intercostal spaces 8, 9, 10
OMM: Ant Chap - Sinuses
lateral 2nd rib
OMM: Ant Chap - peristalsis
lateral below iliac crest
OMM: Ant Chap - Uterus
lateral to pubic symphisis
OMM: Post Chap - acidity of stomach (body)
left T5
OMM: Post Chap - peristalsis of stomach (pylorus)
left T6
positive straight leg raising test
lumbar nerve root impingement/irritation + = get pain/numbness/tingling radiate down leg when elevating leg
galbreath maneuver
manipulation of mandible to open eustachian tube for *acute OM*
OMM: Post Chap - ocular structures
mastoid process
OMM: Ant Chap - Neck
medial humerus (armpit)
Brudzinski's
meningitis
pterion trauma
middle meningeal artery damage
short leg syndrome lumbar compensation
sidebend away, rotate toward side of short leg also anterior innominate rotation
occipial and sphenoid bone
sphenobasilar synchondrosis - keystone to all cranial movement
calcaneus to navicular
spring ligament
level of T4 SP
sternal angle
level of T2
sternal notch
OMM: Ant Chap - bronchus
sternum at 2nd intercostal space
OMM: Ant Chap - esophagus
sternum at 2nd intercostal space
OMM: Ant Chap - thyroid
sternum at 2nd intercostal space
OMM: Ant Chap - upper lung
sternum at 3rd intercostal space
OMM: Ant Chap - lower lung
sternum at 4th intercostal space
facial nerve
stylomastoid foramen within temporal bone
OMM: Ant Chap - middle ear
superior clavicle
OMM: Ant Chap - ovaries
superior to pubic tubercle
OMM: Post Chap - esophagus, bronchus & thyroid
t2
OMM: Post Chap - lower lung
t4
pterion
temporal, parietal, sphenoid, frontal
OMM: Post Chap - clitoris & vagina
upper medial thigh
sacral inhibition
tx dysmenorrhea
OMM: Ant Chap - bladder
umbilicus
chronic somatic dysfunction presentation
*NOT hypertonic muscle (=acute)* cool skin dry, thick skin prolonged blanching dull achy tenderness firbotic tissue texure asymmetry with COMPENSATION in other body areas restriction with little/no pain
petrissage
"to knead" in French deep tissue technique in massage therapy such as knuckling, scissoring, wringing , skin-rolling
temporal bone dysfunction
"trouble maker" responsible for dysfunction of CN5, 7, 8
rule of 3
0,0,0 1/2, 1/2, 1/2 1, 1, 1, 1 1/2 0 T1-T3 TP = SP T4-6 SP is 1/2 seg below T7-9 SP is 1 seg below T10 same as T7-9 T11 same as T4-6 T12 same as T1-3
OMM: Ant Chap - kidneys
1" lateral, 1" superior to umbilicus
OMM: Ant Chap - Adrenals
1" lateral, 2" superior to umbilicus
rib motion
1-5 pump handle 6-10 bucket handle 11-12 caliper
normal CRI
10-14 cycles/min
OMM: Ant Chap - Tonsils
1st intercostal space near manubrium
OMM: Ant Chap - Tongue
2nd rib near sternum
iliacus muscle tenderpoint
7cm medial of ASIS
OMM: Ant Chap - Rectum
Anterio-medial thigh (lesser trochanter)
OMM: Post Chap - middle ear
C1 laterally
OMM: Post Chap - pharynx, tongue, larynx, sinuses, arms
C2 spinous process
OMM: Post Chap - cerebrum
C2-5
CT vs Xray
CT is more expensive more radiation exposure (thus not considered for children/adolescent usually)
unilateral flexion of sacrum tx
ILA Inhalation Internal rot of leg
OMM: Post Chap - spleen
L T7
HVLA set up for FRS(l) at T6 where do you place thenar eminence of thrusting hand?
L transverse process of T6, with fingers pointed *cephalad* , with the other thenar eminence on R transverse process of T6 with fingers pointed caudad
OMM: Post Chap - kidneys
L1
OMM: Post Chap - bladder & abdomen
L2
OMM: Post Chap - urethra
L3
OMM: Ant Chap - Acidity of the stomach (body)
LEFT 5th intercostal space
OMM: Ant Chap - Colon
Laid out over anterolateral thighs
OMM: Ant Chap - Ocular structures
Lateral humerus (shoulder)
OMM: Ant Chap - peristalsis of the stomach (pylorus)
Left 6th intercostal space
OMM: Ant Chap - spleen
Left 7th intercostal space
IT band syndrome
MCC knee pain in athlete, esp long distance runner
OMM: Ant Chap - Larynx
Medial 2nd rib
OMM: Ant Chap - Pylorus
Medial sternum
rolfing
NOT OMT deep tissue technique involving pressure applied through knuckles, fists, elbows to loosen tendon/ligaments
OMM: Post Chap - sciatic nerve
PSIS
OMM: Post Chap - fallopian tubes & seminal vesicles
PSIS & near piriformis
OMM: Post Chap - gallbladder
R T6
OMM: Post Chap - pancreas
R T7
OMM: Post Chap - Pylorus
R T9
OMM: Ant Chap - gallbladder
Right 6th intercostal space
OMM: Ant Chap - pancreas
Right 7th intercostal space
OMM: Post Chap - prostate, broad ligament
S1
OMM: Post Chap - Rectum and groin lymph
SI joint
OMM: Post Chap - hemorrhoids
SI joint & ischium
tapotement
SWEDISH MESSAGE rhythmic percussion administered with cupped hand
OMM: Ant Chap - myocardium
Sternum at 2nd intercostal space
OMM: Post Chap - ovaries
T10
OMM: Post Chap - adrenals
T11
OMM: Post Chap - appendix
T11 on the R
OMM: Post Chap - upper lung & mycocardium
T3
OMM: Post Chap - Small intestines
T8, 9, 10
OMM: Post Chap - large intestines
a triangle from L2-L4 to the iliac crest
cerebral cortex atrophy
alzheimer - diffuse, mild; with progressive memory loss pick - frontotemporal; behavioral change
compression of 4th ventricle (CV4)
enhance CRI relief HA, reduce fever, assist in difficult labor reduce edema *encourage extension and discourge flexion* =operator resist flexion phase of occiput and enhance extension phase until a "still point" is reached. At this point flexion and extension will stop, then restart.
Spurling's test
extend and ipsilaterally sidebend, apply pressure
OMM: Ant Chap - pharynx
first rib
spencer's technique
for adhesive capsulitis/frozen shoulder syndrome move pt's glenohumeral joint through each plane of motion
dura attachment
foramen magnum C2 C3 S2 coccyx (via filum terminale)
metatarsus adductus - adduction of forefoot at tarsometatarsal joint with normal hindfoot alignment - d/t intra-uterine positioning
forefoot adducted , lateral foot boarder convex, normal hindfoot
atrophy of caudate nucleus
huntington - perosnality change and chorea
common compensatory pattern
in most healthy individual (~80%) OA rotated left cervicothoracic junction rotated R thoracolumbar junction rotated L lumbosacral junction rotated R unhealthy do not show this alternating pattern
sphenobasilar synchondrosis flexion
midline bone flex paired bone externally rotate dura cephalad sacral base counternutate cranium more rounded as AP diameter decrease
Fryette's third law
motion initiated at any vertebral segment in any plane of motion will decrease the mobility of that segment in other two planes of motion
lambdoidal
occipital and parietal bones
CN12 which exit hypoglossal canal infants pass through birth canal *suckling difficulties*
occipital condyles
CN9 and 10 impinged @ jugular foramen this suture connects temporal and occipital bones
occipital mastoid suture
OMM: Post Chap - cerebellum
occiput
HVLA of rib with corresponding affected vertebae by treating vertebrae first where to put thenar eminance
on TP of *rotated* side
lateral femoral condyle
origin of popliteus mm attachment of ACL
Plantar Fasciitis - d/t overuse (long periods of standing), inc exercise, obesity - resolve with time and rest - myofascial release helps (move fist distal to proximal towards calcaneus along plantar fascia) - chronic plantar irritation --> heel spurs
pain in heel at bottom of foot - worse in MORNING or FOLLOWING PERIODS OF REST - worse when bending foot and toe towards shin (stretching the fascia)
tarsal tunnel syndrome - posterior to med malleolus - contains : tibial n, posterior tibial a/v
pain/numbness at bottom of foot mostly at night weakened toe flexion
articulartory techinque
passive direct technique that gaps joints/separate facet low velocity
anterior knee pain , esp when climbing stairs or sitting for prolonged period of time (theater sign)
patello=femoral syndrome - weak vastus medialis mm cause patella to deviate laterally--> pain when knee is flexed - inc Q angle (eg. genus valgus = knee knocked)
Patrick's test / FABERE test
pathology at hip or SI joint (Flexion, abduction , external rotation of hip, with foot on top of contralateral knee --> extension) *in shape of a 4* + = pain
hip scour test
pathology of hip joint including osteoarthritis and labral tears pt in supine with hip and knee flexed to 90. physician internally and externally rotate hip while adding compression of femur towards acetabulum
OMM: Ant Chap - broad ligament
posterior IT band
OMM: Ant Chap - prostate
posterior IT band
worsening scoliosis causes which compromise first - resp or cardiovascular?
resp --> cardio
OMM: Ant Chap - liver
right 5th and 6th intercostal spaces
OMM: Post Chap - liver
right T5-T6
pes anserius
sartorius, gracilis, semitendinosus mm group that attaches to anterior medial aspect of tibia at tibial tubercle
Ober test
test *tight tensor fasia lata* or * IT band syndrome* pt lies in lateral recumbent position with affected side up. Physician flexes the knee to 90, abducts and slightly extends the hip while stablizing the pt's pelvis. Physician slowly allows thigh to fall to table + - thigh remains in abducted position
adson's test
thoracic outlet syndrome + = radial pulse becomes marketly decreased / absent (trying to pinch subclavian artery by contracting the scalene)
wright's hyperextension test
thoracic outlet syndrome d/t compression under pectoralis muscle at coracoid process hyperabducting arm ablove head with some extension += severely dec or absent radial pulse
physician wraps their hand around pt's distal leg, contacting the distal tibia/fibular with both thenar eminence. Physican then squeezes for 2-3 sec and rapidly releases. + = upon squeezing there is pain
tibia / fibular syndesmosis indicative of high ankle sprain
thomas test
tight psoas pt lies supine and brings knee of unaffect side towards chest. + = hip and knee of affected side flex
OMM: Ant Chap - Appendix
tip or 12th right rib
OMM: Post Chap - Uterus
transverse process of L5
Wallenberg's test
vertebral artery insufficiency while pt supine, physician flexes neck for 10sec, then extend for 10 sec. repeat with rotation to R and L with neck flexed and repeat this with neck extended. BASICALLY MOVE NECK THROUGH MOTION OF PHYSIOLOGIC MOVEMENT + = pt feels dizzy, lightheaded, or vision change at any point