Master Zink's Common Compensatory Pattern with Picmonic for Medicine

There are various transitional zones along the spine in which fascial preferences can shift one way or another. The most superior transitional zone is where the head meets the neck, also known as the occipito-atlantal junction (OA). The OA is most commonly shifted left in healthy individuals (80% of the time), and uncommonly can be shifted right (20%). The associated diaphragm is the tentorium cerebelli.

The second most superior transitional zone is where the neck meets the thorax, also known as the cervicothoracic junction. This junction is most commonly shifted right in healthy individuals (80%), and shifted left uncommonly (20%). The associated diaphragm is Sibson’s fascia, which covers the thoracic inlet.

The second most inferior transitional zone is where the thorax turns into the lumbar spine, also known as the thoracolumbar junction. This junction is most commonly shifted left in healthy individuals (80%), and shifted right less commonly (20%). The associated diaphragm is the respiratory diaphragm.

The most inferior transitional zone is where the lumbar spine meets the sacrum. This is usually referred to as the lumbo-sacral junction, and in healthy people its fascia is most commonly shifted right and less commonly shifted left. The associated diaphragm is the pelvic diaphragm or pelvic floor.

This fascial pattern is the most common in the healthy populace; 80% of healthy individuals have the common compensatory pattern. In the common compensatory pattern, the fascia is rotated left at the occipitoatlantal zone, rotated right at the cervicothoracic zone, rotated left at the thoracolumbar zone, and rotated right at the lumbosacral zone.

20% of healthy individuals have the uncommon compensatory pattern. The uncommon compensatory pattern is the opposite of the common compensatory pattern. It is characterized as rotated right at the occipitoatlantal zone, rotated left at the cervicothoracic zone, rotated right at the thoracolumbar zone, and rotated left at the lumbosacral zone.

Unhealthy individuals typically have uncompensated fascial patterns. Uncompensated generally means that each fascial zone does not alternate, rotated left or right from superior to inferior. An example of this would be if a patient’s fascia was rotated right in all four transitional zones. Uncompensated fascial patterns are common in hospitalized patients and trauma patients.