Clinic Entrance - Gonstead Flashcards

Sacrum
Terms Definitions
Base Posterior (sacrum)
3 findings:
1) Misalignment is superior/posterior
2) Edematous triangle on the sacral base
3) Gluteal pain
Pt Position: side posture in any side
Dr Stance: face Pt @ 45
Dr Fingers: 45 away from
Dr Contact Hand: inferior
Dr Contact point: pisiform
Pt Segmental Contact: Sacral base (1st sacral
tubercle)
Tissue Pull: I􀃆S
LOD: P􀃆A, S􀃆I (scoop), thru plane line of the disk
NOTE: no torque
Knee Chest: Inferior hand contact, stabilize w/
superior hand
PL/PR
PI-L/PI-R
(Involved side up)
(sacrum)
Pt Positon: Involved side up
Dr Stance: face Pt @ 45
Dr Contact Hand: inferior
Dr Fingers: 90 towards table (away from Dr) fingers down
straight to avoid PSIS. Tips to floor
Dr Contact point: pisiform
Pt Segmental Contact: sacral ala (b/t 2nd tubercle & PSIS)
Tissue Pull: M􀃆L
LOD: P􀃆A, M􀃆L, thru plane line of SI Joint
Torque: PI-L= CW; PI-R= CCW
Note: add I􀃆S tissue pull for inferior listings
PL/PR
PI-L/PI-R
(Involved side down)
(sacrum)
Pt Positon: involved side down
Dr Stance: face Pt @ 45
Dr Contact Hand: inferior
Dr Fingers: 0 or parallel to spine. Fingers across
spine. Elbow out more
Dr Contact point: pisiform
Pt Segmental Contact: sacral ala, b/t 2nd tubercle &
PSIS
Tissue Pull: M􀃆L
LOD: P􀃆A, M􀃆L, thru plane line of SI joint
Torque: PI-L= CW, PI-R=CCW
Note: add I-S tissue pull for inferior listings
PL/PR
PI-l/PI-R
Thenar Alternative
(involved side is always up)
(sacrum)
Pt Positon: involve side is always up
Dr Stance: face Pt @45
Dr Contact Hand: inferior
Dr Fingers: 45 away from Dr
Dr Contact point: thenar eminence
Pt Segmental Contact: sacral ala, b/t 2nd tubercle &
PSIS
Tissue Pull: M􀃆L
LOD: P􀃆A, M􀃆L, thru plane of SI joint
Torque: PI-L=CW, PI-R=CCW
Note: add I􀃆S tissue pull for inferior listings
PI (L/R)
(Ilium)
3 findings:
1) X-ray: Longer femur head, obturator foramen is longer diagonally,
increased lumber lordosis
2) + derefield test, seated/standing gillet, lat. flex (w/thumb on top of
PSIS)
3) Static palpation-edema
Pt Positon: side posture, push move
Dr Stance: face Pt @ 45
Dr Stabilization: superior hand traction top-front shoulder
Dr Contact Hand: inferior
Dr Fingers: point up the spine
Dr Contact point: pisiform
Pt Segmental Contact: inferior border of PSIS
Tissue Pull: I􀃆S, slight M􀃆L
LOD: P􀃆A, I􀃆S
PIIn
(Ilium)
Pt Positon: involve side up
Dr Stance: face Pt @ 45
Dr Stabilization: superior hand traction top-front shoulder
Dr Contact Hand: inferior
Dr Fingers: point 45towards Dr.
Dr Contact point: pisiform
Pt Segmental Contact: inferior-medial PSIS
Tissue Pull: I􀃆S, M􀃆L
LOD: P􀃆A, I􀃆S, M􀃆L
In
(Ilium)
3 findings:
1) Pt w/ external toe flare “toe out”
2) Groin pain
3) Obturator foramen more narrow, increase width of ilium
Pt Positon: involve side up
Dr Stance: face Pt @ 45
Dr Stabilization: superior hand traction top-front shoulder
Dr Contact Hand: inferior
Dr Fingers: point 90 towards Dr
Dr Contact point: pisiform
Pt Segmental Contact: medial PSIS
Tissue Pull: M
ASIn
(ilium)
3 findings:
1) Pain on medial knee, coccyx pain
2) acetabular pain
3) DJD on x-ray
Pt Positon: involve side up
Dr Stance: face Pt @ 45
Dr Stablilization: superior hand traction top-front shoulder
Dr Contact Hand: inferior
Dr Fingers: point 45 towards Dr
Dr Contact point: pisiform
Pt Segmental Contact: acetabular ridge
Tissue Pull: S􀃆I, M􀃆L
LOD: P􀃆A, S􀃆I, M􀃆L
AS
(ilium)
3 findings:
1) High gluteal fold
2) Pt prone to hamstring strains/pull
3) Decrease lumber lordosis, obturator foramen decreases, short femur
head
Pt Positon: involve side up
Dr Stance: face Pt @ 45
Dr Stabilization: superior hand traction top-front
shoulder
Dr Contact Hand: inferior
Dr Fingers: point 15 towards Dr
Dr Contact point: pisiform
Pt Segmental Contact: acetabular ridge
Tissue Pull: S􀃆I
LOD: P􀃆A, S􀃆I
Ex
(Ilium)
3 findings:
1) Pt w/ internal toe flare-“toe in”
2) Heel pain/Achilles tendon pain
3) Decrease width of ilium, obturator foramen increase width @ base
Pt Positon: involve side down
Dr Stance: Dr inferior leg parallel to Pt flexed top leg
Dr Stabilization: superior hand traction top-front
shoulder
Dr Contact Hand: inferior
Dr Contact point: fingers w/ pisiform
Pt Segmental Contact: lateral border of PSIS
Tissue Pull: L
Ex-In
(Ilium)
Pt Positon: Ex side down
Dr Stance: Dr inferior leg parallel to Pt flexed top leg
Dr Stabilization: superior hand traction top-front
shoulder
Dr Contact Hand: inferior
Dr Contact point: fingers w/ pisiform
Pt Segmental Contact: lateral PSIS on Ex side
medial PSIS on In side
Tissue Pull: L􀃆M
LOD: L􀃆M
Note: Prior to thrust the Dr inferior leg pushes I􀃆S on
the Pt top leg this increasing the LOC
PIEx
(Ilium)
3 findings:
1) Pain in lateral heel
2) low iliac crest, short leg on involve side
Pt Positon: involve side (PIEx) down
Dr Stance: Dr inferior leg parallel to Pt flexed top leg
Dr Stabilization: superior hand traction top-front
shoulder
Dr Contact Hand: inferior
Dr Contact point: fingers w/ pisiform
Pt Segmental Contact: inferior-lateral border of PSIS
Tissue Pull: L􀃆M, I􀃆S
LOD: L􀃆M, I􀃆S
Note: Prior to thrust shift stance slightly superior to
improve LOC
ASEx
(Ilium)
Pt Positon: involve side (ASEx) down
Dr Stance: Dr inferior leg parallel to Pt flexed top leg
Dr Stabilization: superior hand traction top-front
shoulder
Dr Contact Hand: inferior
Dr Contact point: fingers w/ pisiform
Pt Segmental Contact: acetabular ridge
Tissue Pull: L􀃆M, S􀃆I
LOD: L􀃆M, S􀃆I
Note: Prior to thrust shift stance slightly Inferior to
improve LOC
PL/PR
PLS/PRS
Pisi push, Simple Listing
(Lumber)
3 findings for L5 disc:
1) Motion visualization: common pain when going from sitting to
standing
2) Static visualization: edema in the sacrum
3) Static palp: edema, tenderness, muscle spasm
4) Motion palp: fixation on extension
5) Go-Scope: spikes in go-scope
6) X-ray: break in george’s line
Pt Positon: SP up
Dr Stance: facing Pt
Dr Contact Hand & Contact Point: inferior pisiform
Dr Fingers: 45 away from Dr
Pt Segmental Contact: lateral-posterior tip of SP
Tissue Pull: L
PL-m/PR-m
PLI-m/PRI-m
Pisi push, Rotatory Listing
(Lumber)
Pt Positon: SP down
Dr Stance: facing Pt
Dr Contact Hand & Contact Point: inferior pisiform
Dr Fingers: 0 or parallel to spine
Pt Segmental Contact: mamillary process
Tissue Pull: M􀃆L, L4/L5=(S􀃆I), L1= (I􀃆S), L2/L3= (P􀃆A)
LOD: P􀃆A, L􀃆M, L4/L5=(S􀃆I), L1= (I􀃆S)
(thru plane line of disc)
Torque: torque CCW when adjusting on the L side
torque CW when adjusting on the R side
Note: Add S􀃆I thrust for L4/L5
Add I􀃆S thrust for L1
SP contacts are always on same laterality. Superior hand
stabilize Pt shoulder
P
PL/PR
PLS/PRS
Finger-Pull
(Lumber)
Pt Positon: SP down
Dr Stance: facing Pt
Dr Contact Hand: inferior
Dr Contact point: “the claw”
Pt Segmental Contact: lateral-posterior tip of SP & oppo. mamillary
w/ rat hole
Tissue Pull: L
P
PL-m/PR-m
PLI-m/PRI-m
Finger-Pull
(Lumber)
Pt Positon: SP down
Dr Stance: facing Pt
Dr Contact Hand: inferior
Dr Contact point: “the claw”
Pt Segmental Contact: lateral-posterior tip of SP & oppo. mamillary
w/ rat hole
Tissue Pull: M
PRI-sp
( L-5 special listing)
Pt Position: L side down
Dr Stance: facing Pt
Dr Contact Hand and Contact point: Inferior pisiform
Dr Fingers: 45 away from Dr
Pt Segmental Contact: R inferior tip of SP
Tissue Pull: L􀃆M, S􀃆I
LOD: P􀃆A, L􀃆M, S􀃆I, thru plane line of the disc, CCW
torque
Note: reminder torque is opposite for PRS-m/PRI-sp
PLI-sp
( L-5 special listing)
Pt Position: R side down
Dr Stance: facing Pt
Dr Contact Hand and Contact point: Inferior pisiform
Dr Fingers: 45 away from Dr
Pt Segmental Contact: L inferior tip of SP
Tissue Pull: L􀃆M, S􀃆I
LOD: P􀃆A, L􀃆M, S􀃆I, thru plane line of the disc, CW
torque
Note: reminder torque is opposite for PRS-m/PRI-sp
PRS-m
( L-5 special listing)
Pt Position: R side down
Dr Stance: facing Pt
Dr Contact Hand and Contact point: Inferior pisiform
Dr Fingers: parallel to the spine
Pt Segmental Contact: L mamillary contact
Tissue Pull: M􀃆L, S􀃆I
LOD: P􀃆A, M􀃆L, S􀃆I, thru plane line of the disc, CW
torque
Note: reminder torque is opposite for PRS-m/PRI-sp
PLS-m
( L-5 special listing)
Pt Position: L side down
Dr Stance: facing Pt
Dr Contact Hand and Contact point: Inferior pisiform
Dr Fingers: parallel to the spine
Pt Segmental Contact: R mamillary
Tissue Pull: M􀃆L, S􀃆I
LOD: P􀃆A, M􀃆L, S􀃆I, thru plane line of the disc, CCW
torque
Note: reminder torque is opposite for PRS-m/PRI-sp
A-L/A-R
(coccyx)
3 findings:
1) Hurts when sitting down, hurts to palpate, no motion finding
2) Broken/fx bone
Pt postion: prone
Dr stance: stand on side of laterality
Dr contact: cornu
LOD: P􀃆A, I􀃆S (more I􀃆S than P􀃆A) no torque
Dr Hand Position: superior hand on cornu (thumb-pisi)
(occiput)
AS
AS-RS
AS-RS-RA
AS-RS-RP
AS-LS
AS-LS-LA
AS-LS-LP
Pt Position: Pt seated on cervical chair. A condyle block is used to
stabilize cervical spine.
Dr Position: Standing behind Pt w/ feet parallel to Pt’s pelvis & stand
midline to Pt
Tissue Pull: the direction of correction
Dr Contact Pt: soft pisi of side of laterality
Segmental Contact Pt: The Glabella
LOD: the thrust is made S
(occiput)
PS
PS-RS
PS-RS-RA
PS-RS-RP
PS-LS
PS-LS-LA
PS-LS-LP
Pt Position: Pt is seated in cervical chair
Dr Position: stand behind Pt on side of laterality
Tissue pull: I􀃆S
Dr Contact Point: Thenar of hand on side of laterality
Segmental Contact Point: posterior to Pt’s mastoid groove, strong L􀃆M
pressure
LOD: the thrust is made S􀃆I & A􀃆P along the surface of condyle.
(“AS” is corrected by the S􀃆I, A􀃆P LOD)
(“LS/RS” is corrected by lateral flexion of occiput)
(“LA/LP” is corrected by rotation of head. “P”: head away, “A”:
head towards)
(Atlas)
AIL/AIR
AILA/AIRA
AILP/AIRP
Pt Position: Pt seated in cervical chair. The strap goes over the stabilizing
shoulder.
Dr Position: stand behind Pt to side of laterality
Tissue Pull: thumb contact from the mastoid to the contact on the atlas.
Dr Contact Point: hand is flat & horizontal, w/ the thumb held tight to the palm.
Contact is w/ the distal-lateral-palmer tip of the thumb.
Segmental Contact Point: lateral tip of C1 TP
LOD: the thrust is made L􀃆M (along the surface of C2 facet)
(“A” is corrected by contacting the anterior tip of C1)
(“I” is corrected by lifting the Pt;s chin & torque- R􀃆CCW, L􀃆CW)
(“L/R” is corrected by L􀃆M LOD)
(“A/P” is corrected by rotation of Pt’s head. “P”: head away, “A”: head
towards)
(Atlas)
ASL/ASR
ASLA/ASRA
ASLP/ASRP
Pt Position: Pt seated in cervical chair. The strap goes over the stabilizing
shoulder.
Dr Position: stand behind Pt to side of laterality
Tissue Pull: thumb contact from the mastoid to the contact of Atlas
Dr Contact Point: hand is flat & horizontal, w/ thumb held tight to the palm.
Contact is the distal-lateral-palmer tip of the thumb
Segmental Contact Point: the lateral tip of C1
LOD: the thrust is made L􀃆M (along the surface of C2 facet)
(“A” is corrected by contacting the anterior tip of C1 TP)
(“S” is corrected by tucking the Pt’s chin in & torque- R􀃆CW, L􀃆CCW)
(“L/R” is corrected by L􀃆M LOD)
(“A/P” is corrected by rotation of Pt head. “P”: head away, “A”: head
towards)
PL/PR
PLS/PRS
(C2-C7)
Pt Position: Pt seated on cervical Chair. Strap is over the stabilizing
shoulder
Dr Position: stand behind Pt to side of Laterality- L/R
Tissue Pull: I􀃆S, M􀃆L (using index finger of side of laterality- L/R)
Dr Contact Point: the lateral-palmer tip of side of laterality- L/R
finger. The same side thumb will support the Pt’s head by
contacting the angle of jaw.
Segmental Contact Point: lateral, inferior side of laterality R/L
portion of C2 SP
LOD: L􀃆M, I􀃆S, P􀃆A through plane line of disk, (torque: L􀃆CCW,
R􀃆CW)
PLI-l /PRI-l
(C2-C7)
Pt Position: Pt seated on cervical Chair. Strap is over the stabilizing
shoulder
Dr Position: stand behind Pt to side of Laterality- L/R
Tissue Pull: I􀃆S, M􀃆L (using index finger of side of laterality- L/R)
Dr Contact Point: the lateral-palmer tip of side of laterality- L/R
finger. The same side thumb will support the Pt’s head by
contacting the angle of jaw.
Segmental Contact Point: lamina-pedicle junction of C2
LOD: L􀃆M, I􀃆S, P􀃆A through plane line of disk, (torque: L􀃆CCW,
R􀃆CW)
PL/PR
PLS/PRS
(Single-Hand, double thumb, double thenar, single thumb contact for
thoracic)
Pt Position: Prone on the knee-chest table
Dr Position: stand to side of laterality
Tissue Pull: depends on side of laterality, if “R”: R􀃆L, “L”: L􀃆R; in the direction of
correction, & rolled onto the superior aspect of SP.
Dr Contact Point:
1) Upper thoracic(T4-T9)- superior hand pisiform (fingers cross spine @
45)
2) Lower thoracic(T10-T12)- inferior hand pisiform (fingers cross spine @
45)
Dr Stabilization: non-adjusting hand is placed on the wrist of the adjusting hand
Segmental Contact Point: lateral, superior portion of the SP
LOD:
1) Upper thoracic(T4-T9): S􀃆I, L􀃆M, P􀃆A (through the plane line of the
disk)
2) Lower thoracic(T10-T12): I􀃆S, L􀃆M, P􀃆A (through the plane line if
the disk)
3) PLS/PRS: CCW(up the spine)/CW (down the spine)
PL-t/PR-t
PLI-t/PRI-t
(Single-Hand, double thumb, double thenar, single thumb contact for
thoracic)
Pt Position: prone on Knee chest table
Dr Position: stand on side of SP laterality, reached across to other side & contact
TP.
Tissue Pull: depends on side of laterality, if “R”: R
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Term:
Definition:
Definition:

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