Леон Чейтоу - Искусство пальпации (19).
Fig. 4.26 Assessment of levator scapula shortness involves taking the neck into full flexion and side-bending rotation, away from the tested side, while maintaining firm shoulder pressure on the tested side to prevent this from elevating. Discomfort reported at the upper medial border of the scapula or the upper cervical spine suggests shortness in this muscle, as does nature of the resistance noted during performance of the assessment.
Fig. 8.5 Palpation of retrofiexion (extension) of the thoracic spine.
Fig. 8.6 Palpation of gapping of spinous processes during flexion.
Fig. 8.7 The patient is side-bent (towards the right in this instance) over the palpating thumb which assesses the nature of the 'end-feel'. A sense of unusual 'bind' might indicate a restriction.
Fig. 8.8 Assessment ('shrug test') for restriction in clavicular mobility.
Fig. 8.9 Assessment ('prayer test') for restricted horizontal flexion of the sternoclavicular joint.
Special Topic Fig. 9A Distal phalanx position held as vertical to the palpated surface as possible, as described by Abrams, for percussion ('orthopercussion') assessment.
Special Topic Fig. 9B A finger which is to be used as a pleximeter should have the distal phalanx slightly raised (upper finger) and not resting along its length on the palpated surface (lower finger) [after Abrams]. The arrow represents the ideal point which should be struck for optimal percussion efficiency.
Fig. 9.1 Palpation of the liver (after Barral and Mercier) in which frontal, saggital and transverse planes of motion are sequentially assessed.
Special Topic Fig. 10A Location of pulses (right hand only illustrated) for assessment in Traditional Chinese Medicine.
Special Topic Fig. 10B Taking the pulse in TCM. One finger at a time would apply suitable degrees of pressure to make an assessment, superficially or at depth.
Fig. 10.1 Bring hands as close together as you can without the palms touching each other. Then bring hands apart about 5 cm. Return hands siowiy
to original position. Repeat, and on each repetition separate the palms by an
additional 5 cm, until they are finally 20 cm apart.
Fig. 10.2 When the hands are about 20 cm apart, slowly bring them together. Every 5 cm, test the field between your hands for a sense of bounciness or elasticity.
Fig. 10.3 Map of 'energy (or chakra) fields' of spinal region.
Fig. 11.1 Illustration of Ford's cross restriction areas.
Fig. 11.2 The hand positions which would be used in Ford's treatment of horizontal 'cross-restrictions' - (A) pelvic, (B) diaphragmatic, (C) thoracic outlet and (D) base of skull. By 'projecting' his sense of touch he palpates for 'depth, direction and duration' in order to treat these dysfunctions.