Atlantoaxial joint C1-2
Patient supine • Rotation thrust
♦ Contact point. Right posterior arch of atlas.
♦ Applicator. Lateral border, proximal or middle phalanx.
♦ Patient positioning. Supine with the neck in a neutral relaxed position.
♦ Operator stance. Head of couch, feet spread slightly.
♦ Palpation of contact point.
♦ Fixation of contact point.
♦ Chin hold. Ensure your left forearm is over or slightly anterior to the ear.
♦ Vertex contact. Optional.
♦ Positioning for thrust. Step to the right and stand across the right corner of the couch. Use primary leverage of rotation with minimal secondary leverage. Your direction of thrust is towards the patient's mouth and into rotation (Fig. B 1.3.3).
♦ Adjustments to achieve appropriate pre-thrust tension.
♦ Immediately pre-thrust. Relax and adjust your balance.
♦ Delivering the thrust. The thrust is directed towards the corner of the patient's mouth. Simultaneously, apply a rapid low-amplitude increase of head rotation to the left. The occiput and atlas move as one unit during the thrust (Fig. B 1.3.4).
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