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Biomechanics > (1) Biomechanics: Adjusting Ergonomics and Physiology > Flashcards

(1) Biomechanics: Adjusting Ergonomics and Physiology Flashcards

1
Q

What group of individuals at a whole are more at risk for low back pain?

A

health care professionals

chiros are a high risk group

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2
Q

What percentage of chiropractors have a lifetime incidence of LBP?

A

74%

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3
Q

What was found to have a significant effect on low back pain for chiropractors?

A

table height

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4
Q

There was a study done on table height, high, medium, and low— what were the findings for each?

A

Medium height table = LEAST strain for Lumbar and Thoracic adjusting

Highest height table = LEAST strain for Cervical adjusting

Lowest height table = sig. increased ALL forces measured in blow back for all adjusting :(

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5
Q

What did having the table height adjusted to match the adjustment done reduce?

A

reduced sagittal flexion by over 20%

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6
Q

What should we utilize as the fulcrum when we bend over?

A

movement of the iliofemoral joint!!!

NOT the lumbar spine

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7
Q

Why should we utilize the iliofemoral joint when we bend over?

A
  • decreases pressure on IVD

- decreases tension at posterior disc and ligaments

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8
Q

What are the MC sites of injury practitioners reported?

A

wrist, hand, shoulder, and low back

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9
Q

What movement provides the most mechanical stability for the wrist?

A

radial deviation and extension

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10
Q

What movement provides the best mechanical stability for the shoulder?

A

external rotation with keeping elbow in toward body

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11
Q

Where should our center of gravity be when adjusting?

A

aligned to your adjusting

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12
Q

What is the definition of a Subluxation offered up by DD Palmer?

A

“subluxation of a vertebra is a slight deviation from its normal relation to adjacent vertebrae causing an alteration and narrowing of IVF”

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13
Q

What is the real primary cause of disease?

A

tension; and the cause of tension is PRESSURE and the cause of pressure in 95% of diseased conditions is SUBLUXATED VERTEBAE

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14
Q

In what percentage of diseased conditions is a subluxated vertebrae the cause? What about he other percent?

A

95% is due to subluxated vertebrae

other 5% is the luxation of other bones besides those in vertebral column

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15
Q

Who offered up the term

“pinged nerve” for chiropractic use?

A

NOT chiropractors–> it was offered up by the Medical doctors

joint subluxations alone are extremely unlikely to “pinch” spinal NRs at margins of IVF

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16
Q

What are spinal subluxations hypothesized to induce?

A

induce NR compression as result of direct anatomic compression of neural elements w/in IVF—> result in NR dysfunction–> induce dysfunction of somatic or visceral tissues they supplied

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17
Q

What was marked or prolonged compression of NRs hypothesized to induce?

A

loss of function

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18
Q

What was more moderate compression of NRs hypothesized to lead to?

A

increased neural activity and increased pain, paresthesias, and hypertonic muscles

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19
Q

What did DD Palmer have to say about the medical doctors using the term “pinged nerve”?

A

“occlusion is not the cause of disease. Nerves are IMPINGED upon, pressed against, NOT squeezed or pinched”

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20
Q

Describe what DD Palmer means by an “impinged nerve” (instead of using “pinched nerve”).

A

an impinged nerve has pressure on ONE SIDE ONLY.

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21
Q

What does the author of Chiropractic state about how nerves can be impinged vs pinched?

A

nerves may be impinged upon by any displaced bone, but PINCHED only by Fx and extreme displacement

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22
Q

What does DD Palmer really say that we need to think of the word “impingement” as?

A

use the word IMPINGEMENT in sense of PRESSURE–> and remember that instead of squeezing or pinching a nerve–> an impingement only increases its tension by stretching

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23
Q

What was the issue with BJ Palmer proving the impact a subluxation has on neural tissue by using cadavers?

A
  • bone is hard and does not shrink much after death
  • brain and nerves are softest body substances and DO shrink as high as 85% after death
  • formaldehyde also shrinks bodies
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24
Q

How did BJ Palmer get around the issue of cadavers not being suitable evidence?

A
  • deep-freeze bodies IMMEDIATELY at death
  • therefore NO shrinkage of body
  • proved brain FILLED cranial cavity; spinal cord FILLED neural canal; nerves FILLED IVF
  • any sufficient occlusion COULD produce pressure and interference w/ normal flow of nerve force
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25
Q

What structure do the DRGs lie within? What are they lacking? What does this make the susceptible to?

A

w/in the interpedicular region (lacking epineural covering as exit IVF)

compressive forces from pressure, inflammation, ischemia

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26
Q

Will acute or chronically injured dorsal NRs respond more vigorously to mechanical deformation?

A

chronically injured

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27
Q

T/F. It is necessary for spinal NRs to be directly compressed by bony structures in order to develop pathologic dysfunction.

A

FALSE– it is NOT necessary

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28
Q

What may sustained misalignment or inflammation of the spinal motion segment due to the local vascular structures? What does this lead to?

A

may stretch or compress local vascular structures—-> leading to disruption of neural blood supply and neuroischemia

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29
Q

Are the density of the sodium ion channels in the soma and initial segment of DRG cells relatively high or low? What may this cause?

A

density of sodium ion channels is relatively HIGH

may be unusually excitable

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30
Q

What is more susceptible to effects of mechanical compression, DRG or peripheral nerves? Why?

A

DRG– b/c impaired or altered function is produced at substantially lower pressures

31
Q

Joint malposition contributing to dysfunction of the spinal NRs is more likely to occur by narrowing the more vulnerable________.

A

interpedicular zone

32
Q

What is the name of the guy that suggested the Vertebral Subluxation Complex as a conceptualization for organizing essential info relevant to Tx?

A

John Faye

33
Q

What are the two approaches that the Vertebral Subluxation complex allows for chiropractors to use to examine a person?

A

Orthoneurologic Exam

Biomechanical analysis

34
Q

Which approach for the VSC, assesses the state of the pathologic tissue changes and also aids in determining the prognosis?

A

Orthoneurologic exam

35
Q

Which approach for the VSC, determines the therapeutic procedures to be used and the treatment schedule?

A

Biomechanical Analysis

ROM assessment

36
Q

Does chiropractic use a long-leverage or short-leverage technique?

A

short-leverages

37
Q

T/F. Adjustments are commonly associated with cavitation that always produces an audible.

A

False- it MAY produce an audible

38
Q

T/F. When there is a change in structure, there will be a change in function.

A

True

39
Q

What can Vertebral Hypomobility cause?

A

pain and abnormal spinal mechanics–> b/c of changes in sensory input from spinal and paraspinal tissues

40
Q

When is the timing for the best opportunity for optimal healing?

A

aggressive EARLY are and restoration of motion

41
Q

What is Facilitation?

A

persistent afferent input triggers a segmental cord response–> which induces development of pathologic reflexes

42
Q

What is the term for when lesions capable of inducing chronically altered proprioceptive and nociceptive input?

A

sensitization

43
Q

What theory of altered reflexes involves when afferent impulses from one body area can result in reflex activity in other body areas?

A

Somato-Somatic Reflex Hypothesis

44
Q

What theory is segmental muscle hypertonicity that may be associated with joint dysfunction an example of?

A

Somato-Somatic Reflex Hypothesis

45
Q

What theory of altered reflexes involves afferent impulses in one body area resulting in reflex activity in corresponding innervated visceral organ activity?

A

Somato-visceral Reflex Hypothesis

46
Q

What theory of altered reflexes is Heart palpations secondary to thoracic joint dysfunction an example of?

A

Somato-visceral Reflex Hypothesis

47
Q

What theory of altered reflexes involves visceral afferent fibers reflexly causing somatic problems?

A

Viscero-somatic Reflex Hyposthesis

48
Q

What theory of altered reflexes is pain and muscle tightness in the left shoulder with onset of MI an example of?

A

Viscero-somatic reflex hyposthesis

49
Q

What theory of altered reflexes involves visceral afferent impulses resulting in activation of visceral efferent output of the sympathetic of parasympathetic motor neurons?

A

Viscero-Visceral Reflex Hypothesis

50
Q

What theory of altered reflexes is distention of the gut resulting in increased contraction of the gut muscles an example of?

A

viscero-visceral reflex hypothesis

51
Q

In a study done of 100 patients with gastric or duodenal ulcers what percentage of the patients had T6-T9 scoliosis and what percentage had DDD?

A

86% had T6-9 scoliosis

90% had DDD

52
Q

In a study done of 100 patients with gastric or duodenal ulcers what percentage of the patients did the processes of the vertebral column seem to play a part in the peptic ulcers?

A

90%

53
Q

What theory of altered reflexes involves subluxations affecting upon the ascending paths of the reticular activating joints?

A

Somato-Psychic Reflex Hypothesis

54
Q

What theory of altered reflexes is joint dysfunction leading to conditions such as insomnia and restlessness an example of?

A

Somato-psychic reflex hypothesis

55
Q

What theory of altered reflexes involves significant conscious or unconscious stressors perpetuating sensitization of afferent nerve fibers, amplification of signals by amygdala and anterior cingulate cortex and reinforcement of efferent signals in the ANS?

A

Psycho-somatic reflex hypothesis

56
Q

What theory of altered reflexes is patients under significant emotional distress at the time of a car accident showing more neck pain 4 weeks post injury and example of?

A

Psycho-somatic reflex hypothesis

57
Q

Who proposed the Neurodystrophic Hypothesis?

A

Robert Leach DC

58
Q

What theory proposes that neural dysfunction/abnormal innervation is stressful to the viscera and other body structures and leads to lowered tissue resistance?

A

Neurodystrophic Hypothesis

by Robert Leach DC

59
Q

What theory is kinetic aberration in T6-T9 through fatigue or central inhibitory affects may decrease the neuronal stimulation of the adrenals with resultant decrease of “resistance”?

A

Neurodystrophic Hypothesis

60
Q

What theory involves the three stages, Alarm Reaction, Stage of Resistance, and Stage of Exhaustion?

A

Selye’s General Adaptation Syndrome

think “GAS”–> b/c you run out of “gas”

61
Q

What are the three stages in the General Adaptation Syndrome theory?

A
  1. Alarm Reaction– body modify to defend against stressor
  2. Stage of Resistance– adrenaline rush to defend
  3. Stage of Exhaustion– limited resources and may collapse
62
Q

What may joint injury, chronic mechanical joint derangement, or joint immobilization initiate?

A

the Inflammatory and Vascular Components of the VSC

63
Q

What are the three inflammatory and vascular components of the VSC?

A
  1. vascular congestion
  2. ischemia
  3. inflammation
64
Q

What will the potential for motion segment dysfunction or associated inflammation impeding blood flow through segmental venous structure lead to?

A

localized venous stasis—> that may lead to local ischemia, inflammation, and potential associated joint stiffness

65
Q

What may pain accompanying inflammation initiate? What may this lead to overtime?

A

local muscle contraction—> which overtime may lead to local ischemia and potentially MORE pain and muscle splinting

66
Q

What may the persistent inflammation and pain causing plastic changes in PNS and CNS lowering pain thresholds, give rise to?

A
  1. Allodynia
  2. Hyperalgesia
  3. Sensitization
    of CNS

(see with chronic pain)

67
Q

What should be suspected when a patient’s pain is constant?

A

some degree of joint or soft tissue inflammation

68
Q

What is the term for CNS sensitization?

A

Allodynia

69
Q

What is the term for enhanced pain response?

A

Hyperalgesia

70
Q

What is the term for conditioned response to stimuli?

A

sensitization

71
Q

Out of all the subluxation theories, which is correct?

A

no ONE true or CORRECT theory!!!

theory is state while reality is dynamic

each theory represents portion of whole picture

72
Q

What are 3 scientifically accepted facts when it comes to the Vertebral Subluxation Complex?

A
  1. Homeostasis– enables body to stay alive in changing env.
  2. Nervous System– prime controller of homeostasis
  3. Dysfunction of NS– can be caused by faulty MSK relationships
73
Q

Due to the three scientifically accepted facts of the VSC, what does chiropractic hypothesize?

A

that BIOMECHANICAL aberrations in complex spinal structures can lead to LOSS OF NS integrity and the LOSS of health elsewhere in the body

Biomechanics (6 decks)

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