why are cervicals adjust prone or seated in gonstead

Life University Gonstead Study Club

Cervical Chair Adjusting

2Life University Gonstead Study Club

Three Different Ways To Adjust The Cervical Spine

Seated Cervical Chair Most effective because it allows for a more specific contact

Knee Chestamenable to adjust an anterior rotated atlas

Prone on the Hi-Lo

The KC and Hi-Lo are used:1. when the patient will

not relax sufficiently

2. a more P-A thrust is needed


The Cervical Chair

CC can be utilized for all segments between condyle and third dorsal

Back section of the chair can be adjusted

Depends on patient Ht. Kept in most vertical position

when possible (for pt. relaxation)

Legs of chair come in various lengths

Leg length will depend on height of doctor


Stabilization Strap

Two purposes of the strap To secure the pt against the back of

the chair to prevent forward motion of the pt

To prevent elevation of the shoulder when the thrust is given

When adjusting on the left side, the stabilization is brought under the pts left arm, across the chest, and over the right shoulder.

When adjusting on the right side, the stabilization is brought under the pts right arm , across the chest, and over the left shoulder.


Patient Positioning For CC Adjusting

Patients hands should be in lap Arms should never be crossed and

folded Arms should not hang to the side or

grasp CC handles

Legs should be fully extended at knees Never allow patient to place legs and

feet under the chair

Feet should be rested on their heels Feet should not be flat to prevent any

counter pressure by the pt.

Elevation of shoulder prevented with strap Strap should be drawn inferiorward

before fastening


Contact Points

The contact point on the vertebra will either be the tip of the spinous or lamina. This is indicated in the listing

The vertebra is contacted with the palmer surface of the distal phalanx of the index finger The middle finger is directly

adjacent for added stability Both fingers may be slightly

flexed


Contact Hand Stabilization

The contact hand is stabilized by placing the thumb on the ramus of the mandible, below the TMJ

No pressure is added to the mandible by the thumb

The thumb guides the motion of the contact hand when the thrust is made

When the contact hand is properly placed, an arch should be formed The degree of arch depends on

which segment is being adjusted


The Stabilization Hand

The fingers of the stabilization hand are wrapped around the posterior and lateral portion of the cervical spine.

The stabilization hand should support the vertebra being adjusted, particularly the one below.

Stabilization hand placement will vary depending on which region of the cervical spine is being adjusted.

The function of the stabilization hand is to first stabilize and secondly guide the motion of the head as the thrust is given.

There is NO pulling motion by the stabilization hand


Stabilizing For A Higher Cervical

When a higher cervical is adjusted the thenar eminence will be brought over the ear.

The thumb should run along the angel of the jaw


Stabilizing For A Lower Cervical

When a lower cervical is adjusted the thenar eminence will be below the ear.

The thumb should be below the angel of the jaw


Stabilizing For A Thoracic

When a thoracic is adjusted the thenar eminence will be below the mastoid process

The thumb should run parallel the SCM muscle


Stabilization Hand Placement


Cervical Chair Steps (Chapters)

1. Patient is comfortably seated (relaxed)

2. Dr. stands behind patient favoring side of contact

3. Stabilization hand flexes head forward to separate SP’s

4. Tip of the index finger is placed on the end of the SP below the segment to be adjusted. Then moved up so the contact finger is under and slightly lateral to the SP of the segment to be adjusted.

5. The thumb is then placed on the ramus of the jaw forming an arch.

6. The head is then brought back into a more relaxed position with the stabilization hand.


Cervical Chair Steps (Chapters)

7. The stabilization hand is properly placed along the posterior/lateral portion of the cervical spine.

8. Elevate the chin slightly to separate the anterior portion of the bodies.

9. Laterally flex the neck 10 -15 degrees toward side to be adjusted.

10. Slightly rotate head toward side of contact.

11. Slack should then be reduced by applying pressure on the SP with the contact finger.

12. The thrust is then made very quickly, with a rotational motion of the wrist and forearm, which lifts the spinous superiorward and at the same time anteriorward and lateral.


CC – Helpful Hint #1

Always look at the segment you are adjusting


CC – Helpful Hint #2

The forearm of the contact hand will be in a horizontal position

The forearm of the stabilization hand will be much more vertical

why are cervicals adjust prone or seated in gonstead

Documents