Practical Video for OB: Osteopathic Screening

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.