00:01
Osteopathic examination in pregnancy.
00:04
So with patients who are pregnant, we want
to double check and see what we could gain
from the patient in a standing position, so we’re
gonna look from a lateral view from the side
and just look at the different spinal curvatures, how
the center of gravity has shifted with pregnancy.
00:22
Is there increased curvatures from the side?
Is there any assymetry?
We could look from the
posterior aspect,
And here again, we’re looking for assymetry,
we’re looking at the how head is oriented,
looking at the shoulders, waist
creases, iliac crest down to the legs.
00:38
We could perform forward bent test
to check for any sort of scoliosis.
00:43
At the same time, you could also screen for any
innominate dysfunctions by doing a standing flexion test.
00:49
So I’m gonna get my fingers on the iliac crest
here and ask the patient to gently forward bend.
00:54
So go ahead and bend forward
and you’re gonna note
which thumb rises higher
Here we have a positive
test on the right side.
01:02
I’m also gonna check for any possible rib humps
and assymetry that make you go into scoliosis.
01:09
And so you could come back
up and stand up, good.
01:12
So that’s how we could start our examination
with the patient in the standing position.
01:18
So we’re gonna continue our
examination in the seated position.
01:21
So what we’re going to do is we’re going to palpate
the spine here and the muscles surrounding the area.
01:28
We’re gonna get our hands underneath the OA here to
kind of assess for any potential muscle restriction.
01:34
You could do a little bit of transitory motion,
you could motion test gently with the head
just to see if you could pick up any
increased muscle hypertonicity or spasms.
01:44
We could move in to the thoracic spine and
the ribs, just kinda gently articulate
what i’m doing here is I'm kind of gently doing pushing
forward and pulling the shoulder back at the same time
assessing the quality of the muscles here and
seeing how much tension are at the muscles
and seeing if there’s increased
resistance that add to your pressure.
02:02
You could also kind of translate along
the spine here and see if you could feel
increased resistance as you’re
gently articulating the spine.
02:11
As we move down towards the lumbosacral area, this
region might be a little bit more hypertonic,
you’d wanna check for possible
viscerosomatic reflexes
by checking for any increased temperature or
warmth or any other tissue type of changes.
02:23
Here by the sacrum, we could
perform a seated flexion test
to check for any sacral dysfunction and
to help us with the sacral diagnosis.
02:31
so when we get our thumbs
underneath the PSIS,
have the patient slowly bend forward
and just note if there is increased,
if one side rises and moves a little
bit farther compared to the other.
02:44
And you can come back up.
02:45
Another way that you could check for sacral
dysfunctions is just kind of monitor
monitor that sulcus and
slowly rotate the patient,
and as you rotate, you should feel motion
in where you’re palpating by the sacrum.
02:58
And you could do that in both sides so you could see
if there is decrease in motion that will tell you
that there might be more of a side
restriction on one side versus the other.
03:07
So that’s how we could utilize our screening
examination with the patient in a seated position.