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%\usepackage{opensans}          % Can't make this work so far. Shame. Would be lovely.
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% Most of the following are not required for the majority
% of cheat sheets but are needed for some symbol support.
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% Document Info
\author{Siffi (Siffi)}
\pdfinfo{
  /Title (dysfunctional-breathing.pdf)
  /Creator (Cheatography)
  /Author (Siffi (Siffi))
  /Subject (Dysfunctional Breathing Cheat Sheet)
}

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% Header and Footer
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\fancyhead[L]{
\noindent
\begin{multicols}{3}
\begin{tabulary}{5.8cm}{C}
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    \vspace{-7pt}
    {\parbox{\dimexpr\textwidth-2\fboxsep\relax}{\noindent
        \hspace*{-6pt}\includegraphics[width=5.8cm]{/web/www.cheatography.com/public/images/cheatography_logo.pdf}}
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\begin{tabulary}{11cm}{L}
    \vspace{-2pt}\large{\bf{\textcolor{DarkBackground}{\textrm{Dysfunctional Breathing Cheat Sheet}}}} \\
    \normalsize{by \textcolor{DarkBackground}{Siffi (Siffi)} via \textcolor{DarkBackground}{\uline{cheatography.com/122609/cs/26001/}}}
\end{tabulary}
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\fancyfoot[L]{ \footnotesize
\noindent
\begin{multicols}{3}
\begin{tabulary}{5.8cm}{LL}
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  \mymulticolumn{2}{p{5.377cm}}{\bf\textcolor{white}{Cheatographer}}  \\
  \vspace{-2pt}Siffi (Siffi) \\
  \uline{cheatography.com/siffi} \\
  \end{tabulary}
\vfill
\columnbreak
\begin{tabulary}{5.8cm}{L}
  \SetRowColor{FootBackground}
  \mymulticolumn{1}{p{5.377cm}}{\bf\textcolor{white}{Cheat Sheet}}  \\
   \vspace{-2pt}Not Yet Published.\\
   Updated 6th January, 2021.\\
   Page {\thepage} of \pageref{LastPage}.
\end{tabulary}
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\columnbreak
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  \vspace{-5pt}
  %\includegraphics[width=48px,height=48px]{dave.jpeg}
  Measure your website readability!\\
  www.readability-score.com
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\end{multicols}}




\begin{document}
\raggedright
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% Set font size to small. Switch to any value
% from this page to resize cheat sheet text:
% www.emerson.emory.edu/services/latex/latex_169.html
\footnotesize % Small font.


\begin{tabularx}{17.67cm}{X}
\SetRowColor{DarkBackground}
\mymulticolumn{1}{x{17.67cm}}{\bf\textcolor{white}{Anatomy}}  \tn
\SetRowColor{LightBackground}
\mymulticolumn{1}{p{17.67cm}}{\vspace{1px}\centerline{\includegraphics[width=5.1cm]{/web/www.cheatography.com/public/uploads/siffi_1609947968_Diaphragm1.png}}} \tn 
\hhline{>{\arrayrulecolor{DarkBackground}}-}
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\mymulticolumn{1}{x{17.67cm}}{- Important for core stability \newline - Intraabdominal pressure is important for spinal stability (increased =  improved spinal stability) \newline - Serves a roof of canister}  \tn 
\hhline{>{\arrayrulecolor{DarkBackground}}-}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{17.67cm}{p{1.727 cm} p{1.727 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{17.67cm}}{\bf\textcolor{white}{Functional Anatomy}}  \tn
% Row 0
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{17.67cm}}{- IAP determined by strength of muscles around it} \tn 
% Row Count 1 (+ 1)
% Row 1
\SetRowColor{white}
\mymulticolumn{2}{x{17.67cm}}{- Front and sides: transverse abdominous and intercostal muscles} \tn 
% Row Count 3 (+ 2)
% Row 2
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{17.67cm}}{- Back: paraspinal muscles - ES to multifidi} \tn 
% Row Count 4 (+ 1)
% Row 3
\SetRowColor{white}
\mymulticolumn{2}{x{17.67cm}}{- Bottom: pelvic floor} \tn 
% Row Count 5 (+ 1)
% Row 4
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{17.67cm}}{- Roof: diaphragm} \tn 
% Row Count 6 (+ 1)
% Row 5
\SetRowColor{white}
\mymulticolumn{2}{x{17.67cm}}{- Requires synergy of all the muscles mentioned} \tn 
% Row Count 7 (+ 1)
% Row 6
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{17.67cm}}{- Diaphragm contracts and compresses abdominal cavity, pelvic floor co-activates} \tn 
% Row Count 9 (+ 2)
% Row 7
\SetRowColor{white}
\mymulticolumn{2}{x{17.67cm}}{- Then eccentric contraction of abdominal wall, lx extensors} \tn 
% Row Count 11 (+ 2)
% Row 8
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{17.67cm}}{- CNS needs to automatically "brace" the trunk (hard for some people during repetitive and sustained movements)} \tn 
% Row Count 14 (+ 3)
% Row 9
\SetRowColor{white}
\mymulticolumn{2}{x{17.67cm}}{- instability of diaphragm can cause LBP, spinal disorders; strain, disc lesion and spondylolisthesis, over active spinal erectors} \tn 
% Row Count 17 (+ 3)
\hhline{>{\arrayrulecolor{DarkBackground}}--}
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\begin{tabularx}{17.67cm}{p{1.727 cm} p{1.727 cm} }
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\mymulticolumn{2}{x{17.67cm}}{\bf\textcolor{white}{Presentation}}  \tn
% Row 0
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\mymulticolumn{2}{x{17.67cm}}{- Observation of breathing patterns} \tn 
% Row Count 1 (+ 1)
% Row 1
\SetRowColor{white}
\mymulticolumn{2}{x{17.67cm}}{- Elevation of upper rib cage} \tn 
% Row Count 2 (+ 1)
% Row 2
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{17.67cm}}{- Inadequate or asymmetrical lateral rib cage expansion} \tn 
% Row Count 4 (+ 2)
% Row 3
\SetRowColor{white}
\mymulticolumn{2}{x{17.67cm}}{- Nasal flaring} \tn 
% Row Count 5 (+ 1)
% Row 4
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{17.67cm}}{- Laboured breathing} \tn 
% Row Count 6 (+ 1)
% Row 5
\SetRowColor{white}
\mymulticolumn{2}{x{17.67cm}}{- Frequent yawning} \tn 
% Row Count 7 (+ 1)
% Row 6
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{17.67cm}}{- Hyperventilation} \tn 
% Row Count 8 (+ 1)
% Row 7
\SetRowColor{white}
\mymulticolumn{2}{x{17.67cm}}{- Mouth breathing} \tn 
% Row Count 9 (+ 1)
% Row 8
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{17.67cm}}{- Excessive paraspinal muscle contraction/initiation of breathing from chest than abdomen} \tn 
% Row Count 11 (+ 2)
\hhline{>{\arrayrulecolor{DarkBackground}}--}
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\begin{tabularx}{17.67cm}{p{1.727 cm} p{1.727 cm} }
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\mymulticolumn{2}{x{17.67cm}}{\bf\textcolor{white}{Techniques}}  \tn
% Row 0
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\mymulticolumn{2}{x{17.67cm}}{- Get patient to lie supine with knees bent with one hand over sternum and other over umbilicus then deep breath} \tn 
% Row Count 3 (+ 3)
% Row 1
\SetRowColor{white}
\mymulticolumn{2}{x{17.67cm}}{- Deep breath should start in the abdomen, minimal chest elevation} \tn 
% Row Count 5 (+ 2)
% Row 2
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{17.67cm}}{- On a prone patient, breathing should cause a wave like pattern of spinal flexion from diaphragm upwards} \tn 
% Row Count 8 (+ 3)
% Row 3
\SetRowColor{white}
\mymulticolumn{2}{x{17.67cm}}{- Stand behind patient and place thumbs on paraspinal muscles with second and third fingers over patient's lower ribs, fourth and fifth fingers over abdominal wall \{\{nl\}\} {\bf{Assess for:}} Thoracolumbar paraspinal muscle contraction, rib movement, abdominal wall resistance} \tn 
% Row Count 14 (+ 6)
% Row 4
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{17.67cm}}{- Breathing and IAP should be assessed during squatting/other functional movements} \tn 
% Row Count 16 (+ 2)
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\begin{tabularx}{17.67cm}{p{1.727 cm} p{1.727 cm} }
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\mymulticolumn{2}{x{17.67cm}}{\bf\textcolor{white}{Management}}  \tn
% Row 0
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\mymulticolumn{2}{x{17.67cm}}{- Breathing patterns should be fixed before core stability exercises are given} \tn 
% Row Count 2 (+ 2)
% Row 1
\SetRowColor{white}
\mymulticolumn{2}{x{17.67cm}}{- Myofascial release of accessory muscles of breathing (upper traps, scalenes, ls, SCM and pecs)} \tn 
% Row Count 4 (+ 2)
% Row 2
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{17.67cm}}{- SMT of Tx/costovertebral joints} \tn 
% Row Count 5 (+ 1)
% Row 3
\SetRowColor{white}
\mymulticolumn{2}{x{17.67cm}}{- Educate patient on how breathing patterns contribute to their symptoms} \tn 
% Row Count 7 (+ 2)
% Row 4
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{17.67cm}}{- Get the patient to palpate the area of dysfunction whilst they are breathing, get them to breath infront of a mirror} \tn 
% Row Count 10 (+ 3)
% Row 5
\SetRowColor{white}
\mymulticolumn{2}{x{17.67cm}}{- Educate on idea breathing ratio (1:2 - inhalation and exhalation) - 3s of inhalation, 6s of exhalation} \tn 
% Row Count 13 (+ 3)
% Row 6
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{17.67cm}}{- Instruct patient to lightly compress their abdomen when they breathe in, then relax when breathing out} \tn 
% Row Count 16 (+ 3)
% Row 7
\SetRowColor{white}
\mymulticolumn{2}{x{17.67cm}}{- Start supine, standing, then dynamic movements} \tn 
% Row Count 17 (+ 1)
% Row 8
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{17.67cm}}{- Then move onto rehab programs/core stability - abdominal bracing, planks, bird dogs, dead busg} \tn 
% Row Count 19 (+ 2)
\hhline{>{\arrayrulecolor{DarkBackground}}--}
\end{tabularx}
\par\addvspace{1.3em}



\end{document}