Biomechanics of the Adjustment Flashcards
According to DD, what is the cause of disease?
Impingement that causes pressure on ONE side of the nerve only
According to DD, what are the only two things that can cause a pinched nerve?
1 fracture
2 extreme displacement
Where did BJ go to prove the debate on whether subluxations can cause pressure upon nerves by working on cadavers?
Germany
The spinal nerve rootlets of what area lack the epieneural covering as they exit the IVF?
Interpedicular region
The spinal nerve rootlets of the interpedicular region are more susceptible to what situations?
1 pressure
2 inflammation
3 ischemia
DRGs are found where and are especially susceptible to what kind of forces?
Interpedicular region; compressive forces
Dorsal NRs in what state respond more vigorously to mechanical deformation?
Chronically injured ones
Is it necessary for spinal NRs to be directly compressed by bony structures to develop pathologic dysfunction?
No
What other structures within the IVF can contribute to mechanical stress that affects the nerve tissue?
Arteries, veins, recurrent meningeal nerve, lymphatics, fat, areolar connective tissue
The density of what structures in the soma and initial segment of the DRG cells is relatively high during nerve compression, and what does that indicate?
Sodium ion channels; indicates unusual excitability
Which are more susceptible to the effects of mechanical compression: DRs and DRGs or peripheral nerves?
DRs and DRGs
Does the orthoneurologic exam or biomechanical analysis assess the state of the pathologic tissue changes and also aid in determining the prognosis?
Orthoneurologic exam
Does the orthoneurologic exam or biomechanical analysis determine the therapeutic procedures that should be used and the treatment schedule?
Biomechanical analysis
According to Faye, what are the two ways in which a chiropractor should examine a person to arrive at a double diagnosis?
Orthroneurologic manner and biomechanical approach
What are the 3 categories of the vertebral subluxation complex?
1 Mechanical components
2 Neurobiology components
3 Inflammatory-vascular components
Which category of the VSC includes derangements or disorders of the somatic structures of the body that lead to altered joint structure and function?
Mechanical components
What kind of actions provide the best opportunity for optimal healing following a mechanical injury?
Aggressive early care and restoration of motion
Everything discussed about DD and BJ’s work on nerve compression/impingement falls under which category of the VSC?
Neurobiological components
What kinds of injury can initiate the inflammatory and vascular components of the VSC?
1 joint injury
2 chronic mechanical join derangement
3 joint immobilization
What are the 3 scientifically accepted facts of the VSC?
1 homeostasis is necessary
2 nervous system = prime controller of homeostasis
3 dysfunction can occur via faulty MSK relationships
What is the most commonly applied chiropractic therapy and is the key distinguishing feature of chiropractic practice?
Adjustments
How many segmental motion units or spinal joints are meant to be influenced by a chiropractic adjustment?
ONE
Does a single vertebra or an articulation itself become subluxated/fixated?
The articulation (bones do not subluxate)
How many joints make up a motion unit?
3-joint complex (IVD surrounded by 2 adjacent vertebrae from anterior joint and 2 zygapophyseal joint form posterior joints)
Which is indicative of an acute subluxation: hyperactivity/irritability or hypoactivity/compression?
Hyperactivity/irritability (spasm, warmth, hyperesthesia, visceral hyperfunction)
Which is indicative of a chronic subluxation: hyperactivity/irritability or hypoactivity/compression?
Hyperactivity/compression (weakness, coolness, numbness, visceral hypo function, MSK degeneration)
Why is it possible to have an asymptomatic site of fixation and a symptomatic joint elsewhere?
Other joint is a compensating hyper mobile joint (over expressed)
Which two stages of motion make up the zone of physiologic movement?
Active and passive ROM
Which gives information on muscles and which gives information on ligaments/capsules: passive or active ROM?
Active ROM = muscles
Passive ROM = ligaments/capsules
Which stage of motion requires external assistance?
Passive ROM
Which stage of motion is that which the patient is able to accomplish on their own?
Active ROM
Which stage of motion is small but precise accessory movement within synovial joints independent of voluntary muscle movements?
Joint play
What is the difference between normal physiologic and normal anatomic barrier?
Normal physiologic = point to which a patient may actively move any given joint
Normal anatomic = point to which a joint may be passively moved beyond physiologic barrier
Which stage of motion is the normal barrier to motion when all tension has been taken up within the joint and its surrounding tissues?
Elastic barrier
Joint play resides in which zone of movement?
Paraphysiologic zone of movement
When is the HVLA chiropractic adjustment delivered?
End of paraphysiologic space
Forces generated during adjustive therapy and also the thrust times have been found to be the least in what region of the spine?
Cervical spine (average of 100N)
What is the term for the formation of vapor and gas bubbles within fluid through the local reduction of pressure?
Cavitation
When does the cracking sound occur with a cavitation?
When the pressure inside the liquid drops below the vapor pressure, the bubble formation and collapse occur
How long is the refractory period that is associated with cavitation of a joint?
20 minutes
What do the bubbles formed within the MP joint cavitation consist of?
Water vapor and blood gases (at 80% CO2)
When does the audible occur when present?
At the paraphysiologic space
What can cause an audible?
Any procedure that produce joint separation
What is usually assumed if an audible isn’t produced via adjustment?
Joint capsule was very tight and not sufficient for joint separation to produce cavitation (reason why some need more than 1 adjustment)
More recently, it has been shown that how many “cracks” are associated with the cavitation seen in the MP joint and cervical spine?
2 (first being product of gas bubble formation, second being associated with rapid collapse of gas bubbles)
What are the postadjustive phenomena associated with cavitation?
1 transitory increase in passive ROM
2 temporary increase in joint space
3 20 minutes refractory period
4 increased joint separation
Is an audible necessary for joint manipulation and an increase in joint space?
No (but research has found greater increase in those with audible present)
