Technic and Practice of ChiropracticLoban, Joy Maxwell
Science
Technic and Practice of Chiropractic
Loban, Joy Maxwell
Chiropractic
If disagreements appear between palpation made in positions A and C,
re-palpate in both positions. If still uncertain call a consultation or
follow finding in position A. The Rotary adjustment may sometimes aid
in deciding difficult questions if gently attempted and free movement
secured. With this adjustment a vertebra will not usually move without
rather extreme force unless the articular process on the side sought
to be moved has lost its apposition with its fellow of the adjacent
vertebra. In any case of disagreement nerve-tracing, the discovery of
sensitive nerves on one side only may aid in decision. A knowledge of
probabilities, previous experience, and the diagnosis may also serve as
partial guides.
TRANSVERSE PALPATION
Palpation of the transverse processes is easiest in the Cervical and
mid-dorsal regions and most difficult in upper Dorsal and Lumbar
regions. It has two uses: first, to assist in making a record by
verifying the work done on the spinous processes; second, to locate
a given transverse process in order to use it as a lever for the
adjustment of the vertebra.
It will be seen that fulfillment of the first purpose requires careful
examination of the _direction_ and _position_ of the transverses as
compared with each other and with the spinous process of the same
vertebra, while the second requires only the discovery of the exact
_location_ of some particular transverse. It will be best to consider
the three divisions of the spine separately, excluding from the present
chapter Atlas palpation, which has been thoroughly described.
Cervicals
These can be best palpated in the position for Atlas palpation; that
is, standing behind the patient and using the palmar surfaces of the
fingers of both hands. From the Atlas transverses follow the anterior
border of the sternomastoid muscle downward, and opposite each spinous
process draw the muscles backward and inward until the tips of the
transverses are found with the middle fingers. Their position on the
two sides may then be easily compared as well as their relation to
those above and below them.
[Illustration: Fig. 4. Locative palpation of Dorsal transverse
processes.]
The transverses of the second Cervical may sometimes be so prominent
laterally that they are, or one of them is, mistaken for an Atlas
transverse. As a rule, however, the width of the Cervicals increases
from the second downward, the second being narrowest. Chassaignac’s
tubercle, on the transverse process of the sixth Cervical and opposite
the lower border of the cricoid cartilage, is a prominent point easily
felt as a rule. The transverses of the fourth are usually opposite the
upper border of the thyroid cartilage.
The Cervical transverses lie very close to the articular processes and
the determination of their relation is a better guide to the condition
of the articulation than is spinous process palpation. It is also more
difficult.
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