Atlas of Osteopathic Techniques (2nd Edition) by Alexander S. Nicholas, Evan A. Nicholas

By Alexander S. Nicholas, Evan A. Nicholas

This hugely praised atlas provides suggestions generally taught and utilized in osteopathic scientific schooling and perform, serving as an authoritative reference for examination instruction and medical rotations. step by step directions, richly illustrated with full-color figures, consultant the learner via greater than 350 manipulative tools.

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2. The physician stands to the side of the patient so as to view the patient in a sagittal plane (Fig. 38). 3. The patient is instructed to bend forward and attempt to touch the toes without bending the knees to the functional and pain-free limitation of motion (Fig. 39). 38. Step 2. 4. The degree of active forward bending (flexion) is noted. Normal flexion for the lumbar spine is 70 to 90 degrees. 5. Motion is then tested for backward bending in the lumbar region. The patient stands in a neutral position with feet a shoulder width apart.

This is repeated to the opposite side (Fig. 43). 41. Step 2. 4. The degree of active side bending is noted. Normal side bending in the lumbar spine is 25 to 30 degrees. 42. Step 3, active side bending right. 43. Step 3, active side bending left. indd 25 2/24/2011 10:42:28 AM 26 PART 1 | OSTEOPATHIC PRINCIPLES IN DIAGNOSIS LUMBAR SPINE Side Bending, Passive, with Active Hip Drop Test 1. The patient stands in a neutral position with feet a shoulder width apart. 2. The physician stands behind the patient so as to view the patient in a coronal plane.

Philadelphia, PA: Philadelphia College of Osteopathic Medicine, 2006. indd 27 2/24/2011 10:42:33 AM 4 Osteopathic Layer-by-Layer Palpation EXAMINATION SEQUENCE 1. 2. 3. 4. 5. 6. 7. 8. Observation Temperature Skin topography and texture Fascia Muscle Tendon Ligament Erythema friction rub OBSERVATION Prior to touching the patient, the physician should visualize the area to be examined for evidence of trauma, infection, anomalies, gross asymmetries, skin lesions, and/or anatomic variations. The patient should be positioned comfortably so that the most complete examination can be performed.

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