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Cervical Chair Adjusting
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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
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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
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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.
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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
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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
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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
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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
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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
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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
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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
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Stabilization Hand Placement
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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.
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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.
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CC – Helpful Hint #1
Always look at the segment you are adjusting
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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