Greenman's Principles of Manual Medicine by DeStefano Lisa A

Author:DeStefano, Lisa A. [DeStefano, Lisa A.]
Language: eng
Format: azw3
Publisher: Wolters Kluwer Health
Published: 2016-01-10T16:00:00+00:00

Figure 13.81 Both hands used to rotate the atlas to the left.

Figure 13.82 Rotary thrust through both hands to the left.

Occipitoatlantal (C0 to C1)

Diagnosis

Position: FSrightRleft

Motion Restriction: Backward bending, left-side bending, and right rotation

1. The patient is supine with the operator sitting at the head of the table.

2. The operator’s left hand cradles the occiput between the web of the thumb and the index finger with a bony contact at the suboccipital region. Do not compress the posterior occipitoatlantal membrane (Fig. 13.83).

3. The operator’s right hand cradles the patient’s chin with the right forearm along the right side of the patient’s mandible and temporal regions (Fig. 13.84). Extension is introduced through both hands by posterior rotation around a transverse axis through the external auditory meatus. Left-side bending and right rotation are introduced through the operator’s right forearm with a slight left-to-right translation (Fig. 13.85).

Note: Rotation is not actively introduced but follows side bending.

4. When all three barriers are engaged, a high-velocity, low-amplitude thrust is applied through the operator’s hands in a cephalic, long-axis extension direction (Fig. 13.86).

Note: The left forearm is caudad to the left hand contact on the occiput for better control of the long-axis extension thrust.

5. Retest.

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