Cert Test 2 Flashcards
What are the 3 types of spines?
Normal
Normal - Abnormal
Abnormal - Abnormal
What is a normal spine?
This is the ideal spine. You will see the four normal curves when looking at a lateral x-ray and no curves when looking at an A-P x-ray.
What is a normal - abnormal spine?
This is when you have a normal spine that has been subluxated once and the body is compensating correctly. Such as when you have a whiplash injury and C5 causes compensation of the spine.
What is an abnormal - abnormal spine?
This spine already had a previous subluxation and endures yet another type of trauma. This is the patient who has been under non-specific care or in multiple accidents. This patient could potentially take a long time to correct.
Which techniques does PRS utilize?
5th Cervical Key Logan Basic - level foundation HIO Technique - instrumentation Thompson Technique - leg checks Biomechanics Nimmo
Ideal time frame for DTG using infared
20 seconds
Tytron uses ___ to measure heat and the ideal time frame is ___
heat
it is actually distance dependent
Normal skin temperature reading for either one?
93.5
Goals of instrumentation?
To get rid of cold spots
Get the line as straight as possible
Atlas differential as close to 0 as possible
To establish patient’s pattern
What is the 65% category?
These are “easy” because it does not matter what you do for this patient, their symptoms will get better. However, these symptoms will come and go unless the actual problem is addressed. Ex. 30 yr. old with low back pain
What is the 30% category?
This is the group of people who were in the 65% category but did not get their problems corrected. You CAN reverse these problems and change this person’s life. Ex. 45 yr. old with diabetes
What is the 5% category?
Everyone eventually ends up in this category. This is when someone is near death and you cannot reverse their problems anymore, but you can still relief some symptoms and make them more comfortable. Ex. Cancer Patient
Which cervical rules trump ALL rules?
Spinous Rule
IVF Rule
Name all Cervical Rules
I Stand Alone Kink Rule IVF Rule Spinous Rule Joint Space Rule Arthritis Rule Mate Rule Majority Rule Fly - Shit - in pepper Rule
On a neutral lateral film if there is a closed “IVF” at C5/C6, what subluxation would you expect?
C5
On an flexion view, with a completely open “IVF” between C5/C6, what subluxation would you expect?
Completely open IVF indicates movement - no subluxation
In a flexion view, if the spinous’ of C5 and C6 remain approximated, you would adjust?
C5
What is the ideal skin temperature of the body?
93.5
Who did Dr. Pierce Sr collaborate with in making the DTG?
Dr. Stillwagon
What does DTG stand for?
Dermo-thermo-graph
Increase in parasympathetic response indicates ____ reading?
hotter
Increase in sympathetic response indicates _____ reading?
colder
Does PRS use break or pattern analysis?
pattern
Is the Tyrtron TIME or DISTANCE sensitive/dependent?
Is the DTG TIIME or DISTANCE sensitive/dependent?
Tytron is distance; DTG is time
What is considered a significant atlas temperature difference?
0.8 F ….. 0.5 C
List examples of conditions that can lead to a bad or altered thermal instrument reading?
Bra-strap Coffee Jewelry Wet hair Hair Exercise Alcohol Seat Warmers Smoking
PI stands for?
Partial Involvement
Patient education extends from where to where?
Post ANT tubercle —> anterior portion of T2
George’s line should be a ____ line on the back of the VBs
curved
Name the atlas angles:
Inferior (-) < 0 Inferior 0-18 Normal / Superior 18-24 Superior (+) 24-30 Superior (++) >30
Normal Z angle
35-55
What does the Z angle tell you?
Line of Drive
Potential for Normal
KYPHOTIC neck: atlas and white horn angle??
Atlas: Inferior
WH: Negative
C2 LORDOTIC neck: atlas and white horn angle??
Atlas: Superior + / ++
WH: Positive
What injury is typical of a Kyphotic neck?
Car accident; Whiplash
What injury is typical of a C2 Lordotic neck?
Hyperextension; Birth
What injury is typical of a C3 Lordotic neck?
Head trauma
C3 LORDOTIC neck: atlas and white horn angle??
Atlas: normal / inferior
WH: normal / negative
What is normal White Horn’s angle?
+/- 2….mainly 0
What are the cervical mates?
C5 (T8 + L3) C4 / C6 C3 / C7 C2 / T1 C1 / T2 C0 / T3
What is the normal progression of exostosis?
- Inf endplate of subluxated vertebra
- Sup endplate of vertebra below subluxated vertebra
- Inf endplate of vertebra above subluxated vertebra
- Sup endplate of subluxated vertebra
ect
What is the exostosis equation?
of involved vertebra x 5 = ___ + 5 years
Normal Flexion the xray should have:
- George’s line should be curved
- Spinous’ should fan out / close down
- Post Arch should approximate C0, known as 70/30 rule
Normal Extension the xray should have:
NO stacking
C0, C1 and C2 should approximate
Define CHIROPRACTIC
a science, philosophy, and an art of things natural; a system of adjusting teh segments of the spinal column, by hand only for the correction of the cause of dis-ease
Define SUBLUXATION
a condition of a vertebra in which it has lost its proper juxtaposition with the one below, above or both, to an extent less than a luxation, causing impingement of nerves and interference with the transmission of normal mental impulses from brain cell to tissue cell
Define ADJUSTMENT
a scientific concussion of forces given by a chiropractor at the right time and place, and in the proper direction to correct a subluxation
For true correction, it is estimated that the patients body will need…
1 month of care for every year he/she was sick with subluxation
When is abnormal-abnormal spine found most commonly?
Multiple accident victims
Nonspecific over adjusting
What are the 3 classifications of subluxations and when did they occur?
Chronic: 0-15
Subacute: 15-25
Acute: 25+
What are the MOST common subluxations and their order of occurrence?
1st ATLAS 2nd SACRUM 3rd C3 4th T1 5th C4,C5,C6
How does atlas subluxate and what is its order of occurrence?
Childbirth - 1
How does sacrum subluxate and what is its order of occurrence?
months - 3 years learning to walk
falling sideways on steps
- 2
How does T1 subluxate and what is its order of occurrence?
Falling on hands learning to walk - 4
How does C3 subluxate and what is its order of occurrence?
Trampoline
Moving faster = hitting head more
- 3
How does C4/C5/C6 subluxate and what is its order of occurrence?
Teen years = sports, car accidents, PI
Subluxated vertebra always affects 3 vertebra -
One above
One below
It’s mate
Causes of a deformed atlas?
Breached Birth
Hanging type injury
Which segments will you rarely see arthritis on?
Atlas and/or axis
If only C1 is subluxated, and patient gets a hyperflexion / hyperextension type injury, the cervical spine will whip at _____
C5
If C1 and C3 are subluxated, the cervical spine will whip at ___
C6
Most common form of subluxation
posterior cervical spine subluxation
Post xrays should be limited to:
areas of subluxation
document changes which have occured
Benefits of visualizer
Less radiation
More information on flexion / extension
Benefits of static xrays
Detect pathologies
Obtain listings
Atlas can be subluxated and show any atlas angle
TRUE
Lateral cervical lines of mensuration
Education Line George's Line Atlas Angle Z Angle Whitehorne's Angle Gravity Weight Line Kink / Vector Intersection Exostosis
Atlas angle is drawn:
Ant and Post Arch of C1
+
Anterior arch dot parallel to floor
Z angle is drawn
Tangent line across posterior body of subluxated cervical vertebra
+
Tangent line across inferior zygapophysis of same vertebra
Optimum Z angle
45
Whitehorne’s angle is drawn:
Line Inferior body of C2
+
Line Parallel to floor
Gravity Weight Line is drawn:
Anterior ST perpendicular to bottom of film
…should fall slightly anterior to C5 body
For every inch the gravity weight line falls anterior, the head will…
…take on an apparent weight of 10 lb (normal head weight is already 10 lbs)
How far away from the skin should the DTG be held?
1/2 inch
When using a DTG scan, which fossa do you read first?
Left, then Right
How many degree difference from the sacrum to atlas would be considered ‘normal’?
1 degree
Atlas readings can be greater than 2 degrees, indicating a very sick patient
FALSE - atlas readings will never be more than 2 degrees –> rescan them
What are the 9 Rules for the Normal PELVIS?
- Even ilium widths
- Heart shaped pelvic opening
3-6. Level: Ischial tuberosities, iliac crests, femoral heads, sacral base - Almond shaped obturators
- Sacrum in the center, coccyx 1.5 inch above pubic symphysis
- Normal lumbar curve 19-24 degrees
______ is often the end of a perfect compensation, usually due to a _____
Double PI; C5
What would the Xray presentations be for a DOUBLE PI?
Smaller pelvic opening, tall obturators, low illiac crests and ischial tuberosities, with a DECREASE in the lumbar curve
On the major side of a PI….
Short leg, sacrum points AWAY, lumbar bodies rotate TOWARD
How would you adjust a PI?
Patient is supine, and you would contact the superior pubic rami
How does the ala appear in an EX ilium versus an IN ilium?
EX ilium appears narrower, and the IN ilium appears wider
Obturator looks like what in an EX ilium? An IN ilium?
EX = wider; IN = narrower
The coccyx will usually deviate towards the ____ side
EX
The pelvic opening on the EX side is usually ___
less
You ALWAYS adjust on the side of lumbar body rotation
true
In a false IN / EX, lumbar body rotation will be to the ___ side
IN
Static films are always sufficient to determine pelvic listings
TRUE
The ____ spine is often visible on the side of IN rotation
Lumbar
Pierce pelvic analysis is different from other analyses because it recognizes the ability of one ilum to rotate while the other remains ____
NORMAL
Atlas can subluxate without any trauma, and any cervical vertebra can rotate without posteriority
TRUE
Total involvement occurs when ____ and ____ occur, and is commonly found in a ______ neck (__cm)
Atlas has gone inferior;
No vertebral bodies touch the 17+cm arc;
Kyphotic (-17cm)
List the measurements of a curve regression
+17cm –> 500cm —> -500cm –> -17cm
Which is the most common and easily corrected neck? Which vertebra is usually the subluxated one?
Kyphotic; C5
Name the characteristics of a COMBO neck
- atlas angle: sup (+) / (++)
- whitehorne’s: positive
- Usually has a distinct kink
