Summary McTimoney College of Chiropractic – Musculoskeletal Medicine (Testing)
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Course
Mctimoney Chiropractic - Musculoskeletal Medicine
Institution
University Of Ulster
This summary contains all MSM testing, but also a overview of generalized answers for conditions categories of cause, epidemiology, examination and NICE guidelines. This means less remembering for each condition and recognizing patterns per category. In my condition summary you will find every cond...
Musculoskeletal Medicine (MSM) Testing + Generalizations of Conditions
,Thoracic
Adam’s (Tx)
Px standing, ask to bend over & touch toes
• Asymmetry & raised hump on 1 side which stays on bending = structural/congenital scoliosis
• Asymmetry & raised hump on 1 side which goes on bending = functional scoliosis
Chest/Rib Expansion
Px seated, stand behind Px & cup the scapulae with web of hand, ask Px to breathe deeply while you follow movement
• Asymmetry or pain = rib / thorax pathology
,Cervical
Cervical Screen
1. Observe - forward head posture, swelling, redness, lumps, bumps, bruises, asymmetry
o Mention the Px is to be unclothed for this
2. Palpate - atlas, Cx & muscles
o Mention you also palpate for warmth, lumps, bumps, swelling, spasm, hypertonicity, tenderness
3. ROM - PROM, AROM, RROM
o AROM pain = muscle issue
o PROM pain = joint / ligament issue
o Mention PROM is always more than AROM
4. Compression - with positive & indication
5. Distraction - with positive & indication
6. Valsalva’s - with positive & indication
Compression
Press down on head with 2 hands in neutral (+ lateral flexion/rotation/extension for maximum compression)
• Local neck pain = facet
• Pain radiating to arms = disc
Distraction
Add traction to lift up head (hands not over ear!)
• Relief = disc
• Local pain = muscle/ligament/soft tissue
Valsalva’s (Cx)
Px upright, thumb in mouth & bear down as if going to toilet/blowing a balloon to raise pressure
• Pain & radiation = disc
, Other Cervical Tests
Lhermitte’s Sign
Px upright, flex chin to chest
• Electric shocks down the spine = cervical myelopathy / early MS
Cervical Arterial Dysfunction (CAD) Test
Px seated, ask if PT experiences any symptoms before doing the test. PT to AROM rotate head L/R & hold for 10 sec (tests vertebrobasilar arteries), then PT
to AROM rotate head L/R combined with extension & hold for 10 sec (tests internal carotid arteries). Return to neutral for 10 sec both times. Testing
ipsilateral artery (R rotation = compromising L BF = testing R artery & vice versa). Requires cervical rotation/extension PROM of PT
• 5 D's & 3N's + LoC = VBAI
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