Chapter 9

Question 1

How often is atlas misalignment compensatory?

Answer 1

82% of the time

Question 2

Why is atlas subluxation different?

Answer 2

There is no disc

Question 3

Why is nerve pressure different with atlas subluxations?

Answer 3

There is no disc and pressure comes from the capsular ligament

Question 4

Describe the act of subluxation at atlas? Difference from other segments?

Answer 4

Must be an osseous misalignment, damaging interarticular fibers, leading to edema that causes the capsular ligament to swell putting pressure on the nerve.
The capsular ligament is being effected instead of the disc

Question 5

For atlas/occiput where will nerve pressure be found?

Answer 5

Atlas- nerve pressure will be between atlas and axis

Occiput- nerve pressure will be between occiput and atlas

Question 6

2 ways to improve relationship between atlas and occiput?

Answer 6

Correct atlas when subluxated to decrease the compensatory misalignment between atlas and occiput, and “jab like” thrusts setting atlas into motion may also decrease compensatory misalignment between atlas and occiput

Question 7

What subluxates more, atlas or occiput?

Answer 7

Atlas far more

Question 8

Explain foundation principle?

Answer 8

The foundation principle basically explains that you are setting the vertebra above to the vertebra below not the vertebra below the vertebra above because you get support from the vertebra below not the vertebra above

Question 9

What are exceptions to the foundation principle? Why?

Answer 9

Base posterior and coccyx
BP- Because you can’t set an anterior L5 back to sacrum and because there is no weight bearing structure under sacrum so you have to set sacrum under L5
Coccyx- Because coccyx is most inferior so it has to be set to the sacral apex

Question 10

Where will motion be diminished?

Answer 10

It will be greatly diminished

Question 11

When both sides are inflamed, how do you differentiate?

Answer 11

One side will always be more inflamed and protruded than the other

Question 12

What nerve fibers are compressed with an atlas subluxation?

Answer 12

Cervical spinal cord, 1st and 2nd cervical spinal nerves (C1, C2), superior cervical ganglion, vagus, hypoglossal, spinal accessory

Question 13

How does atlas compress nerve fibers?

Answer 13

Protrusion of the articular capsules compress nerve fibers

Question 14

How does atlas compress vagus?

Answer 14

Anterior rotation of the atlas transverse puts pressure on the carotid sheath and compresses the enclosed vagus

Question 15

How does atlas compress super cervical ganglion?

Answer 15

When atlas transverse rotates anterior it can compress SCG

Question 16

How can C2 spinal nerve not be compressed?

Answer 16

When atlas rotation is the major component of the subluxation it is possible for the 2nd spinal nerve to be unaffected

Question 17

What are the functions of the nerves?

Answer 17

Somatic afferent, somatic efferent, visceral afferent, SNS and PSNS

Question 18

How could atlas be responsible for subluxation(s) below?

Answer 18

Subluxation of atlas could cause cord pressure affecting the Gamma Efferent motor fibers causing paravertebral muscle contraction through stretch reflex mechanism. You’d have to correct atlas to clear the cord pressure that would allow those muscles to relax so you can correct the other subluxations

Question 19

Through the parasympathetics how can atlas “cause” nerve pressure below?

Answer 19

PSNS pressure can cause a hypersecretion of various endocrine glands such as the thyroid, adrenals, sex hormones and others. When this happens the synovial membrane and bursae become inflamed and swollen. This may cause the discs to be edematous and protruded causing compression of adjacent spinal nerves

Question 20

When axis/atlas plane lines are not parallel what can you infer?

Answer 20

Atlas has gone anterior

Question 21

What side will nerve pressure be on with an atlas subluxation?

Answer 21

The side of atlas laterality

Question 22

What are 3 ways to determine atlas rotation?

Answer 22

Measuring lateral masses, measuring the radiolucency on the medial borders of the lateral masses, and the atlas and occipital condyle lines converge on the side of anterior rotation

Question 23

How will occiput compensate for an anatomically deficient leg?

Answer 23

The condyle will be elevated on the side of an anatomically short leg

Question 24

Why can’t you use para-odontoid space to determine laterality?

Answer 24

Because atlas laterality is obscured by atlas rotation

Question 25

What has to be ascertained before the segmental level can be determined?

Answer 25

-

Question 26

When will atlas be fixated in subluxation but not have enough swelling to compress C2 spinal nerve?

Answer 26

-

Question 27

Short leg on the left will do what to occipital condyle on left?

Answer 27

Raise the left condyle

Question 28

How does atlas/occciput misalignment effect spinal canal?

Answer 28

AS- makes canal smaller

PS- makes canal larger

Question 29

When occiput/atlas are aligned what is the angle formed on the lateral between the lines? With an AS or PS occiput?

Answer 29

An angle of approx 5 degrees
AS occiput= angle will be decreased
PS occiput= angle will be increased

Question 30

When occiput is subluxated what do you expect to find with atlas and axis on the A-P? Why? What about rotation of occiput?

Answer 30

The atlas and axis lines would be parallel because the principle motion is rotation around the odontoid not laterality.
The rotation of occiput would be opposite of atlas due to compensation