AI Flashcards
What are the 11 principles of the AHPRA Code of Conduct?
- Put clients first
- Aboriginal and Torres Strait Islander health
- Respectful and culturally safe practice
- Working with clients
- Working with other practitioners
- Working within the healthcare system
- Minimising risk to clients
- Professional behaviour
- Maintaining practitioner health and wellbeing
- Teaching, supervising and assessing
- Ethical research
True or False: Professionalism in chiropractic practice begins after graduation.
False
What does the principle ‘Put clients first’ entail?
Practitioners should practise safely, effectively, and in partnership with clients.
What is the importance of hygiene in the clinical setting?
To maintain professionalism and prevent the spread of infections.
Fill in the blank: A chiropractor’s responsibility includes maintaining _______ in the practitioner/client relationship.
[trust]
What are boundary violations in the context of chiropractic practice?
Harmful crossings or transgressions of expected boundaries that exploit the client.
What constitutes sexual misconduct in a chiropractor-client relationship?
Sexual contact or a romantic relationship concurrent with the client/physician relationship.
List some good hygiene practices for chiropractors.
- Clean hands and trimmed fingernails
- Fresh clothes and shoes
- Dental and oral hygiene
What is a boundary crossing?
A harmless deviation from classical therapeutic activity that may support therapy.
What should chiropractors do to maintain professional boundaries?
Delineate and maintain boundaries, avoid repeated crossings, and recognize the implications of boundary crossings.
What are the signs of boundary violations?
- Personal disclosures
- Gifts and favors
- Touching and emotional dependence
True or False: Lack of knowledge about responsibilities is an acceptable reason for discriminatory behavior.
False
What is the role of ethical research in chiropractic practice?
To inform quality healthcare and policy development.
Fill in the blank: Practitioners should support the role of _______ in developing the health workforce.
[teaching, supervising, and mentoring]
What is informed consent?
The valid consent of the client to proposed examination or treatment after appropriate advice and information has been provided by the practitioner.
When should the practitioner give informed consent?
Before carrying out any diagnostic or therapeutic procedure on clients.
What can a client do regarding informed consent?
Consent can be withdrawn at any time by the client.
What is one important practice regarding client comfort during treatment?
Check-in over time to ensure the client is okay with the treatment approaches.
What are the five elements of informed consent?
- Diagnosis/Clinical Impression
- Treatment Intervention
- Risks or complications associated with the care
- Alternative treatments or additional diagnostic procedures
- Successes and Failures
What information should be disclosed during informed consent?
All significant clinical information necessary for the client to decide whether to undergo the proposed procedure.
Who can consent for medical treatment?
The adult client, unless there are indications that they are not mentally competent.
Who must give consent for a minor client?
The parent or legal guardian of the client.
What must be documented in the informed consent process?
The client has been part of an informed consent process, material risks have been disclosed, and the client has consented to the procedures.
What is implied consent?
Consent that is assumed based on a client’s presence for information gathering, but does not include permission for treatments.
What should clients be made aware of regarding financial consent?
All fees and charges involved in a course of treatment should be discussed prior to providing the health service.
What is the key principle of informed consent?
The client’s autonomy in making decisions.
What should practitioners do when clients have questions?
Treat all questions with respect and professionalism.
What is the purpose of the ACC guidelines on informed consent?
To minimize concerns, confusion, or misunderstandings regarding the information the client received before care was delivered.
What must be included in a discussion about treatment options?
- Risks and expected outcomes
- Alternative options
- Right to withdraw consent
- Cost of care
What does the client’s rule state regarding information sharing?
It is not a rule that the client must tell the doctor everything about the complaint.
What should be done if the client’s condition changes?
Repeat the informed consent process.
What does the Chiropractors Board of Australia state about informed consent?
It is a person’s voluntary decision about health care made with knowledge and understanding of the benefits and risks involved.
True or False: A signed consent form can replace the conversation about informed consent.
False
Fill in the blank: The five elements of informed consent include Diagnosis, Treatment, Risks, ________, and Successes.
Alternative treatments
What is the primary focus of the learning objectives in TSAC1?
Understand various postural and psychomotor skills relevant to clinical practice
This includes describing and understanding the components of GORP OMNI
Why is it important for a health practitioner to look after their own health?
To protect themselves and ensure longevity in their career
What is the ‘Fencer Stance’?
A broad-based stance that saves energy and protects the back
What should practitioners consider to minimize mechanical stress during treatment?
Positions that put the least mechanical stress while providing the best advantage in applying treatment
What does ‘Chirobics’ refer to?
A series of activities to develop psychomotor skills required for manual chiropractic manipulation
List some psychomotor skills included in Chirobics.
- Genie flicks
- Speeder board
- Ball squeeze
- Arch triceps pushups
- Triceps extensions
- Warm up – functional movements
What is the first component of the GORP OMNI mnemonic?
G – Gait
What does the ‘O’ in GORP OMNI stand for?
O – Observation
Fill in the blank: The ‘R’ in GORP OMNI refers to _______.
Range of Motion (Active/Passive/Resisted)
What is the purpose of palpation in clinical practice?
To assess static and motion aspects of the client
What does the ‘P’ in GORP OMNI represent?
P – Palpation (static and motion)
What is the goal of orthopaedic testing in the GORP OMNI process?
To confirm or rule out differential diagnoses
True or False: Neurological testing is always included in the GORP OMNI process.
False
What does the ‘I’ in GORP OMNI refer to?
I – Investigation/Chiropractic special tests
What types of investigations might be included in the ‘I’ of GORP OMNI?
- X-rays
- CT scans
- MRIs
- Diagnostic Ultrasound
- Haematological studies
- Other laboratory work
What is the significance of landmark location in chiropractic analysis?
It is important for the care of the cervical spine.
What features can be identified through landmark location of the cervical spine?
- Osseous landmarks
- Relative location of the vertebrae
Which anatomical landmarks are primarily located at C2, C2/3, C4, and C5/6?
- C2 body = angle of the mandible
- C2/3 disc = hyoid
- C4 body = thyroid cartilage
- C5/6 disc = cricoid cartilage
True or False: The angle of the mandible and hyoid bone are less reliable than thyroid and cricoid cartilage for identifying cervical spinal levels.
False
What should be confirmed to accurately locate C7?
Its relationship to C6.
How can C6 be palpated?
- Stand obliquely behind the client
- Place index finger in interspinous space above C7
- Extend the client’s neck
What is the lowest cervical segment to demonstrate significant anterior glide on neck extension?
C6
What is the method to locate C7 via C6?
- Locate C6 spinous process
- Identify which segment glides anteriorly on extension
- Count down to locate C7
Which cervical segment is immediately superior to C4?
C3
What feature of C2 obscures the spinous process of C3?
The bifid and relatively massive spinous process of C2.
How can the spinous process of C2 be palpated?
Locate the external occipital protuberance (EOP) and palpate inferiorly.
What anatomical structures make up the articular pillars of the cervical spine?
- Superior articular processes
- Inferior articular processes
- Intervening facet joints
How can the articular pillars be located?
Begin at the posterior midline over the spinous processes and palpate anteriorly and laterally.
What is the importance of the inferior tip of the mastoid process?
It is a reference landmark for locating the transverse process of the atlas.
What motion can help locate the tip of the mastoid process?
Laterally flexing the client’s head.
What should be considered when assessing the range of motion in clients?
- Hypermobility
- Degenerative joint disease (DJD)
- Muscle bulk
What are the two types of range of motion assessments?
- Passive Range of Motion (PROM)
- Active Range of Motion (AROM)
Fill in the blank: C1 is usually obscured by the large bifid spinous process of _______.
C2
What can be used to palpate the transverse processes of C1?
Locate the tip of the mastoid process.
True or False: The spinous processes of the cervical vertebrae are important for evaluating rotation, lateral bending, and circumduction.
True
What anatomical landmarks are palpated in the thoracic spine?
- Spinous Processes (SPs)
- Transverse Processes (TPs)
- Ribs
- Scapulae
- Clavicle
Which muscles are commonly palpated in the thoracic region?
- Rhomboids
- Levator Scapula
- Supraspinatus
- Upper Trapezius
- Pectoralis Minor
- Latissimus Dorsi
- Deltoid
- Infraspinatus
How do you locate the TP of T1-T3?
The TP is one interspinous space above and approximately 2.5 cm lateral to the spinous of the segment palpated.
Where is the TP located for T4?
The TP is 2.5 cm lateral to the upper 1/3 of the T3 spinous.
What is the TP location for T5-T9?
The TP is two interspinous spaces above and approximately 2.5 cm lateral to the spinous of the segment palpated.
How is the TP of T10 located?
The TP of T10 is approximately 2.0 cm lateral to the spinous of T9.
What is unique about the TP of T11-T12?
The TP is one interspinous space above and approximately 1.25 cm lateral to the spinous palpated.
What is the significance of T12 as a transitional vertebra?
T12 resembles a lumbar vertebra and has distinct palpation techniques.
What is the vertebral prominens (VP)?
The VP is usually C7 (70%), but it can also be T1.
How can T1 be located using palpation techniques?
Use the motion properties of the C6 spinous process and count down two interspinous spaces to locate T1.
At what level is the spinous process of T3 located?
At the level of the root of the scapular spine.
What is the vertical dimension of the T10 spinous process?
The smallest among the thoracic vertebrae.
How can the inferior angle of the scapula be found?
By sliding your hand up the client’s side with your thumb pointing upward.
How is the rhomboids muscle palpated?
Palpate along the vertebral border while the patient lifts their hand off their back.
What landmarks are used for palpating the Levator Scapula?
- Superior angle of scapula (insertion)
- Transverse processes of C1-C4 (origin)
What is the palpation technique for the Upper Trapezius?
Place fingers on the top of the shoulder and ask the patient to shrug.
Where is the Supraspinatus muscle located?
In the supraspinous fossa above the spine of the scapula.
What is the insertion point for the Deltoid muscle?
Deltoid tuberosity of the humerus.
How is the Pectoralis Minor palpated?
Locate the coracoid process and move inferomedially to palpate beneath the pectoralis major.
What is the origin of the Latissimus Dorsi?
- Inferior angle of the scapula
- Thoracolumbar fascia
- Iliac crest
What should the clinician do when palpating the Latissimus Dorsi?
Ask the patient to extend, adduct, or internally rotate the shoulder against resistance.
Fill in the blank: The spinous process of T4 typically demonstrates the _______.
[largest vertical dimension]
True or False: The spinous processes of thoracic vertebrae are short and wide.
False
What is the relationship between T6 and the inferior angle of the scapula when the patient is prone?
The spinous process of T6 is at the level of the inferior angle of the scapula.
What should you know for performing postural assessment from posterior and lateral views?
Landmarks required for performing postural assessment.
What general observations should be looked for during postural assessment?
Potential discrepancies in someone’s posture.
What joints are involved in the biomechanics of the upper limb?
- GHJ
- Elbow
- Wrist
- Fingers
What is the importance of considering anatomy and biomechanics in postural assessment?
To understand what other structures may be overworking/underworking to cause postural variation.
What is postural analysis in the context of clinical assessment?
One piece of the puzzle that is the entire clinical picture.
What does the term ‘End Play’ refer to?
Assesses elastic properties of the joint capsule and periarticular soft tissues.
What happens when the elastic limits of a joint are reached during passive movement?
Movement into the ‘end-play zone’ occurs.
What is the physiological barrier in relation to end feel?
The maximum range of physiological motion.
How are end-feel findings documented in a chiropractic setting?
In chiropractic examination notes to assist in determining the appropriate spinal segment to adjust.
What is assessed during spinal end play assessment?
The point at which resistance is encountered, the quality of that resistance, and associated tenderness.
What is the difference between capsular and muscular end feel?
It comes with practice to differentiate between the two.
What does joint play evaluate?
A joint’s resistance to movement in a neutral or ‘loosely packed position.’
What may cause restrictions of joint motion?
Muscle spasming, splinting, hypertrophy, aging, or contracture.
What defines active range of motion (AROM)?
Movement that is actively produced by the patient.
What defines passive range of motion (PROM)?
Movements carried through by the clinician without the conscious assistance or resistance of the patient.
What is the elastic barrier in joint motion?
The end of a joint’s elastic limit, after which joint cavitation occurs.
What is the purpose of the palpation hand during motion palpation?
To establish bony or soft tissue contacts over the joint.
What does the indifferent hand do during motion palpation?
Produces or guides movement.
What are the landmarks commonly used in spinal evaluation?
- Spinous processes
- Articular pillars
- Transverse process
- Rib angles
- Mammillary processes
What is the consequence of carrying a joint beyond its anatomic limit?
Injury results.
What is the aim of manual adjusting in terms of velocity and amplitude?
High velocity, low amplitude.
What are the learning objectives for postural assessment?
Understand principles of postural assessment, biomechanics of the upper limb, perform a basic postural assessment, and conduct motion palpation, joint play, and end-feel of the cervical spine.
What should you know for performing postural assessment from posterior and lateral views?
Landmarks required for performing postural assessment.
What is considered ‘good’ posture?
Maintaining alignment of structures in relation to the rest of the body, placing joint structures, muscles, tendons, and ligaments in the least stressful resting position.
What is ‘bad’ posture?
Adaptation of anatomy and biomechanics resulting in excessive stress causing pain/discomfort or impacting quality of life.
What are examples of ‘bad’ posture causes?
- Lifestyle-based (e.g. desk work) * Structural in nature (e.g. scoliosis, structural short leg)
What are the classic postures in postural analysis?
- Standing posture * Sitting posture * Lying posture
What is the ideal sitting posture?
Hips, knees, and elbows bent at 90º with a neutral/straight spine.
What impacts posture?
- Anatomy/Physiology * Behaviors * External factors (e.g. footwear, heavy backpacks) * Clinical conditions (e.g. scoliosis, stroke) * Age
What is the significance of postural changes?
Postural changes can be the cause or effect of a clinical problem.
What are some posterior landmarks to assess during postural analysis?
- EOP * Mastoid process * ACJ * Inferior angle of scapula * Lower rib cage * Iliac crests * PSIS * Greater trochanter * Ischial tuberosities * Popliteal fossa * Achilles
What are some lateral landmarks to assess during postural analysis?
- EAM * Cervical lordosis * Acromion/ACJ * Thoracic Kyphosis * Lumbar Lordosis * Iliac crest * Greater trochanter * Midline of lateral tibiofemoral joint * Lateral malleolus
What methods are used for postural assessment?
- Observation * Inspection * Palpation * Range of motion assessment
What should be considered during postural assessment?
Anatomy, biomechanics, muscle contour, skin condition, and patient comfort.
What are the common signs to observe during postural analysis?
- Antalgia * Deformities of the spine * Spinal symmetry * Alignment and symmetry of body parts * Loss or increase of lordosis and kyphosis
What lifestyle recommendations can be made based on postural assessment?
- Lifestyle advice * Strength training * MSK rehab (yoga and pilates) * Soft tissue therapies * Dry Needling * Adjusting
What is the role of the vestibular system in posture?
It helps maintain balance and spatial orientation.
Fill in the blank: ‘Postural analysis is one piece of the puzzle that is the entire _______.
clinical picture
True or False: ‘Good posture’ is defined by achieving ‘perfect posture’.
False
What is a common impact of sitting posture on the spine?
Sitting puts a lot of stress on the spine.
What should be the position of the spine when lying down?
Neutral with shoulders over the hips and no rotation.
What cognitive process influences posture and gait control?
The cognitive process of posture-gait control as described by Takakusaki K.
What are some examples of daily activities that can impact posture?
- Work posture * Exercise (or lack of) * Mobile device usage (e.g. ‘text neck’)
What are some conditions that can lead to postural changes?
- Scheuermann’s disease * Gibbus deformity * MVA and impact trauma * Surgery * CNS disorders
