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Part 2 Boards > Chiropractic practices > Flashcards

Chiropractic practices Flashcards

1
Q

when we talk about torque what do you think of

A

gonstead

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2
Q

where do we have axial plane facets and TPs

A

horizontal

upper cervicals

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3
Q

where do we have coronal plane facets and TPs

A

lower cervicals, thoracics

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4
Q

where do facets of the spine become sagittal

A

T12

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5
Q

what is facet tropism

A

1 sagittal facet + 1 coronal facet

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6
Q

diversified line of drive (LOD)

A

Posterior to anterior - PA
Lateral to medial - LM
Inferior to superior - IS

except for C1 which is SI

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7
Q

gonstead line of drive (LOD)

A 
Posterior to anterior 
Lateral to medial 
Medial to lateral 
Inferior to superior 
Superior to inferior 
Clockwise 
Counterclockwise
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8
Q

when does gonstead use medial to lateral line of drive

A

mammillary process in lumbar spine only***

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9
Q

gonstead line of drive is always __

what about if we are talking about IS and SI LOD

A

perpendicular to the curve of the spine

above C3 - IS 
*C3- PA 
below C3- SI 
*T6 - PA 
blow T6 - IS 
*L3 - PA 
below L3 - SI
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10
Q

what are static listings

A

fixation, malposition, subluxation

where body or SP is stuck

you can cross them off when you see them - body is malpositioned to the right - body is to the right

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11
Q

what are motion listings

A

diminished
decreased
restrictred

where body or SP can not go

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12
Q

describe disc wedge or lateral bending listings

A

right superior TP/body and left inferior TP/body

always stand on side of convexity

need TORQUE LOD to fix
TORQUE all about lateral bending and disc wedging

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13
Q

describe rotation listings

A

DO NOT TORQUE ROTATION LISTINGS

PR - spinous right
BL - body left

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14
Q

all of gonstead listings start with what

A

P

except atlas then its A

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15
Q

what is the listing formula

A
  1. level base
  2. lateral flexion
    STOP - stand on open wedge side
  3. rotation - motion/static
  4. circle what they asked
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16
Q

Line of drive also can be said as

A

line of correction

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17
Q

open wedge is also up or down on side posture

A

up

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18
Q

T6 has decreased right rotation and anterior right TP

A

PR and BL

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19
Q

decreased right rotation and fixed to the left

A

PR and BL

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20
Q

decreased right sp rotation and malpositioned body to the right

A

PL and BR

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21
Q

tissue prominent on the left

A

PR and BL

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22
Q

patient can’t rotate head to the right and sp is malpositioned to the right

A

PR and BL

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23
Q

paraspinal spasm on the left

A

PR and BL

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24
Q

anterior transverse process on the right

A

PR and BL

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25
Q

body posterior on the right

and diminished right rotation of spinous

A

PL and BR

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26
Q

contracted mulifidi on the left

A

PL and BR

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27
Q

increased left body rotation and decreased right body rotation

A

PR and BL

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28
Q

hypo mobility to the left and sp has decreased rotation to the right

A

PL and BR

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29
Q

static malposition of SP right and right TP is limited from AP

A

PR and BL

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30
Q

concavity on the left

which type of scoliosis is this

A

right scoliosis

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31
Q

contracted intertransverssari on the left and patient is lying with right side up

A

left lateral flexion

open wedge on right

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32
Q

taut inter transverse ligament on the left

A

right lateral flexion

open wedge on left

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33
Q

lax annular fibers on the left

A

left lateral flexion

open wedge right

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34
Q

superior right TP and body lean left

A

left lateral flexion

open wedge right

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35
Q

decreased right lateral bending and sublimated laterally bending to the left

A

left lateral flexion

open wedge right

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36
Q

stacking on the left

A

right lateral flexion

open wedge left

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37
Q

counter clockwise torque and left stabilization hand

A

right lateral flexion

open wedge left

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38
Q

right towering

A

right lateral flexion

open wedge left

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39
Q

right segmental scoliosis and apical vertebrae on the right

A

left lateral flexion

open body right

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40
Q

stacking occurs on which side of scoliosis or lateral flexion

A

convexity

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41
Q

towering occurs on which side of the scoliosis and lateral flexion

A

concavity

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42
Q

what is the segmental contact for a sp right and scoliosis/left lateral flexion

diversified and gonstead

A

diversified
cervicals - sp
thoracic - double tp***
lumbar - sp

gonstead
cervicals - sp
thoracic - sp
lumbar - sp

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43
Q

what is the segmental contact for a sp left and scoliosis/right lateral flexion

A

diversified
cervicals - body
thoracic - body/double TP*****
lumbar - body

gonstead
cervicals - body
thoracic - body
lumbar - body

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44
Q

what is the segmental contact for a sp right

A

diversified
cervicals - body
thoracic - body
lumbar - body

gonstead
cervicals - sp
thoracic - sp
lumbar - sp

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45
Q

tissue pull is always in what direction

A

LOD or LOC

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46
Q

what is another term we could use for body in cervicals, thoracic, and lumbars

A

cervicals - lamina/pedicle
thoracic - TP
lumbar - mammillary

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47
Q

what are general rules of gonstead

A

contact the superior (open) side of the segmental wedge
except L5 - special listing
thrust through the plane line of the disc
clockwise and counterclockwise torque to close the open wedge

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48
Q

gonstead side posture and single hand instructions

A

side posture - doctor forearm must be in line with thrust

single hand - episternal notch must be in line with thrust

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49
Q

gonstead key terms and question clues

A 
cervical chair
knee chest 
decreased extension 
torque 
P first in listing 
single hand
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50
Q

basic gonstead cervical set up

A

occiput

  • patient - seated
  • PS listing - contact theanr on mastoid or ear - thrust PA and SI in scooping motion
  • AS listing - contact surface of 3rd digit contact glabella - thrust AP and SI in scooping motion

atlas

  • patient - seated
  • contact - tip of thumb on lateral atlas
  • stabilize - base of occiput
  • thrust - PA or AP and lateral to medial

C2-7

  • patient - seated
  • contact - tip of index on lateral spinous or lamina
  • stabilize - cupped hand on segment below
  • thrust - PA through the plane line of the disc
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51
Q

basic gonstead thoracic set up

A

thoracic

  • patient - prone
  • doctor - on side of segmental contact - fencer stance for simple listings and straight away for 4 part listings
  • contact - pisiform on lateral SP or TP
  • stabilize - contact patient wrist
  • thrust - PA through the plane of the disc
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52
Q

basic gonstead lumbar set up

A

always have involved side (side of segmental contact) up except for spinous pull moves

lumbar

  • patient - side posture or knee-chest table
  • push moves - contact pisiform on lateral spinous or mammillary - stabilize shoulder - thigh to thigh - thrust PA through the plane of the disc, lateral to medial, plus any torque
  • pull moves - contact pad of 2/3rd digit on lateral spinous or mammillary - stabilize shoulder to knee - thigh to thigh - thrust PA through the plane line of the disc
  • LOD - spinous = lateral to medial for push and pull moves - mammillary = medial to lateral for push pull techniques
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53
Q

basic gonstead L5 special listing set up

A

if L5 disc wedge (convexity) is on the right,
and scoliosis convexity is opposite of lumbar disc convexity,
then the doctor must contact L5 sp or mammillary ON THE SIDE OF THE SCOLIOSIS

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54
Q

basic gonstead sacrum set up

A

involved side UP

patient - side posture
contact - pisiform contact medial to PSIS (PR and PL) - pisiform contact on the first sacral tubercle (base posterior)
stabilize - shoulder, thigh to thigh
thrust - PA through the SI joint plane

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55
Q

basic gonstead anterior coccyx set up

A

patient - prone
contact - covered thumb tissue pull from base
thrust - superior ward (IS and PA)

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56
Q

diversified occiput set up

A

flexion malposition = extension restriction= AI/PS

  • to adjust extend head
  • prone: hypothenar or thenar

extension malposition = flexion restriction = PI/AS

  • to adjust flex head
  • prone: thenar
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57
Q

diversified atlas and cervicals set up

A

prone cervical - LF subluxation - stand on side of contact - lateral flexion over contact and rotate head opposite of contact, slight flexion - PUSH

supine cervical - rotation subluxation - stand on side of contact - lateral flexion over contact and rotate head opposite of contact, slight flexion - PUSH

seated rotary - rotation subluxation - stand on opposite side of contact - lateral flexion over the contact and rotate head opposite of contact, slight flexion - PULL

master cervical - hyperlordosis - distraction to avoid adjusting into the curve (distraction reduces curve)

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58
Q

diversified says to stabilize the level __

gonstead says to stabilize the level __

A

stabilize level above

stabilize level below

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59
Q

gonstead cervical chair will put the patient into __

A

extension

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60
Q

cervical quiz

seated cervical
cervical chair
prone cervical
supine cervical

which is gonstead

A

seated cervical - PULL - stabilize above - doctor stands on OPPOSITE side of contact - LOD PA LM IS

cervical chair - PUSH - stabilize BELOW - doctor stands on SAME side of contact - LOD PALM IS SI CW CCW

prone cervical - PUSH - stabilize above - doctor stands on SAME side of contact - LOD PA LM IS

supine cervical - PUSH - stabilize above - doctor stands on SAME side of contact - LOD PA LM IS

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61
Q

what is our line of drive for diversified

A

PALM IS

PA
LM
IS

62
Q

how do you fix a PLS cervical chair

A 
GONSTEAD 
patient seated 
doctor behind 
contact left SP 
distal index on left SP
stabilize below
63
Q

how do you fix a body right seated cervical

A 
DIVERSIFIED 
patient seated 
doctor in front 
contact right side 
pad of middle digit in right lamina pedicle junction 
stabilize above
64
Q

diversified thoracic set up

A

AP thoracic (anterior thoracic, anterior-dorsal, flexion, flexion extension disc relationship)

  • patient supine, standing, or seated
  • contact segment BELOW
  • LOD - AP and IS

PA thoracic (extension)

  • patient prone
  • contact SP
  • LOD - PA and IS
65
Q

when do you use knife edge (ulnar surface) contact in diversified

A

thoracic extension malposition

66
Q

when do you used combination moves

A

modified diversified

upper thoracic

fencer stance

stabilization hand is above malar and TRACTION

67
Q

what is the bilateral transverse contact used for

A

diversified

(aka double pisiform or bilateral TP)

USED FOR COUNTERROTATION vertebrae

stand on and contact HIGH TP side or open wedge side

contact both TPs of same segment

68
Q

what is the bilateral thenar contact used for

A

diversified

(aka double pollicis)

lower thoracics

fencer stance

69
Q

what is the bilateral thumb contact used for

A

GONSTEAD

(aka double thumb)

adults knee chest

lumbars

70
Q

what is the unilateral thumb contact used for

A

diversified

(aka covered thumb and thumb pisiform)

decrease amplitude because you contact with thumb and then cover with other hand and thrust through thumb

kyphotic adult
osteporosis
dowager hump

71
Q

what the modified thumb contact used for

A

diversified

(aka bench thumb or thumb move)

lower cervicals and upper thoracic

LOD LM - spinous rotated to right then contact right and blast it to china

72
Q

diversified rib set up

rib prominence is felt where

A

anterior, posterior, seated, standing

PMS most common subluxation - cranky rib - PMS

contact angle of the rib - NOT rib head

rib prominence felt on side of vertebral body rotation

73
Q

first rib usually subluxates __

A

superior

PMS most common

74
Q

diversified lumbar set up

A

side posture preferred

prone or seated can also be done

75
Q

diversified spondylolisthesis adjustment

A

SUPINE knee chest

76
Q

diversified tropism adjustment

A

decreased rotation due sagittal facet

77
Q

thoracic quiz

T4-5 extension malposition
T4-5 flexion subluxation
T6-7 flexion extension disrelationship

Pt position
LOD
contact

A

T4-5 extension malposition
Pt position - prone
LOD - PA IS
contact - T4

T4-5 flexion subluxation
Pt position - supine
LOD - AP IS
contact - T5

T6-7 flexion extension disrelationship
Pt position - supine
LOD - AP IS
contact - T7

78
Q

diversified sacrum set up

A

diversified and Thompson

contact contra apex

RAI

79
Q

gonstead sacrum set up

A

contact ipsilateral base

PIR

80
Q

diversified coccyx set up

A

internal correction held 40 seconds with opposing hand applying external pressure on sacrum

avoid ganglion of impar

no correlation between coccyodynia and coccyx angulation

81
Q

what adjustment is contradicted in spondylolisthesis

A

PRONE

82
Q

prone lumbars are associated with what

A

knee chest

prone knee chest

GONSTEAD

83
Q

pelvic adjustment set up

A

GONSTEAD AND DIVERSIFIED side posture preferred

AS ilium - extension malposition and flexion restriction - supine push down on ASIS and pull in ischial tub - prone push down on the ischial tub - side pull or push

PI ilium - flexion malposition and extension restriction - prone push down on PSIS and pull up knee - side pull or push - glut max spasm and low gluteal fold

84
Q

explain ilium position and its association with glut max and obturator height and width as well as palpatory tenderness

AS, PI, IN, EX

A

ilium position in relation to GM and obturator

AS - GM short, short obturator

PI - GM long, long obturator

IN - GM flat wide, narrow obturator

EX - GM hunch narrow, wide obturator

ASIN - long leg
PIEX - short leg

palpatory findings 
AS - inferior 
PI - superior 
IN - none 
EX - medial
85
Q

pelvis orientation and iliac crest and femoral head relationship in the prone position and standing xray

A

prone:
- PI - high
- AS - low

standing X-ray:

  • PI - low
  • AS - high
86
Q

ilium listing set up

diversified and gonstead very similar in terms of ilium

PI
AS

A

patient - side posture
EX - involved side down, with digit pull on PSIS
ASEX - involved side down, with digits pull on iliac crest

PI

  • contact PSIS - pull: pisiform / push: 2/3rd digit
  • stabilize shoulder - pull: knee to knee / push: thigh to thigh
  • thrust - PA and IS (IN)

AS

  • contact ischial tuberosity with - pull: 2/3rd digit / push: pisiform
  • stabilize shoulder - pull: knee to knee / push: thigh to thigh
  • thrust - PA and SI (IN)
87
Q

point tenderness along PSIS

pelvic listing?

A

PI

88
Q

gluteal hunching on right
low gluteal fold on right

pelvic listing?

A

Right PIEX

89
Q

toe in
superior PSIS point tenderness

pelvic listing?

A

PIEX

90
Q

superior ASIS on the right

pelvic listing?

A

right PI

91
Q

left lower femoral head on xray

pelvic listing?

A

left PI

92
Q

posterior ischial tuberosity

pelvic listing?

A

AS

93
Q

superior PSIS on left

what is the right ilium listing?

A

right PI

94
Q

flexion fixation of ilium
flat gluteus Maximus

pelvic listing?

A

PI IN

95
Q

tall obturator

pelvic listing?

A

PI

96
Q

wide ilium or inominate

pelvic listing?

A

IN

97
Q

wide obturator

pelvic listing?

A

EX

98
Q

longest inominate on xray

pelvic listing?

A

PI

99
Q

superior PSIS
foot flare

pelvic listing?

A

AS IN

100
Q

short obturator
narrow ilium

pelvic listing?

A

AS EX

101
Q

sacral anterior inferior

pelvic listing?

A

PI

102
Q

extension restriction

pelvic listing?

A

PI

103
Q

what aggravates an SI

A

trochanteric belt

104
Q

side posture thigh to thigh means you’re pushing or pulling

A

push

thigh to thigh is same as drop

105
Q

side posture knee to knee means you’re pushing or pulling

A

pulling

knee to knee is same as kick

106
Q

side posture EX pull is fencer stance or straight stance

A

straight stance

which means perpendicular to the patient

107
Q

elbow above or below contact for ASIN push

A

below

108
Q

elbow above or below contact for PIEX pull

A

above

109
Q

elbow above or below contact for EX pull

A

above

110
Q

L3 PRI-M side posture

pull or push RL or LR

A

pull or push right to left

111
Q

L4 PRS side posture

pull or push RL or LR

A

pull or push right to left

112
Q

L2 body malpositioned in right rotation and left lateral flexion (knee chest)

A

pull or push left to right

113
Q

L4 seated lumbar with decreased right lateral flexion and right rotation

A

pull or push right to left

114
Q

C6 has left SP rotation and left body lateral flexion is ___ body limited rotation and __ scoliosis

gonstead listing

A

L body limited rotation

right scoliosis

PLI - Lamina contact

CW torque

115
Q

C4 body left and inferior has restricted right rotation and limited right lateral bending

contact with doctors __ hand and lateral flex the patients head to the __

gonstead listing

A

Right

right

PRS

CW torque

116
Q

right scoliosis, left SP would have reduced __ leaning and body restricted from rotating to the __

gonstead listing

A

right

left

PLI

CW torque

117
Q

posterior and superior right TP has __ towering and spinous reduced from rotating __

gonstead listing

A

left

right

PLI

CW torque

118
Q

decreased spinous extension and body has decreased right rotation and right lateral flexion

gonstead listing

A

PRS

CW torque

119
Q

decreased right lateral flexion and left body rotation. motion segment has a right convexity and right posterior TP

gonstead listing

A

PLI

CW torque

120
Q

anterior TP is on right and superior

gonstead listing

A

PRS

CW torque

121
Q

thigh to thigh contact means

knee to knee contact means

A

drop

kick

122
Q

what are motion, gonstead, and static listings

A

motion listings - body reference - where the body is not - restriction

gonstead - SP reference - always starts listing with P

static listings - TP or body reference - where the body is

123
Q

which listings are national or medicare listings

A

static listings

124
Q

LOD for gonstead or diversified?

T8 PRS

A

G - PA LM IS CW

125
Q

LOD for gonstead or diversified?

C4 body right and superior

patient is supine

A

D - PALMIS

126
Q

LOD for gonstead and diversified?

C5 PLI-I

A

G - PA LM SI CW

127
Q

LOD for gonstead and diversified?

use knee chest to adjust L4 which has decreased right body rotation, left lateral flexion, and extension

A

G - PA ML SI CCW

128
Q

LOD for gonstead and diversified?

use double pisiform maneuver for T9 right TP anterior and superior

A

D - PA LM IS

129
Q

LOD for gonstead and diversified?

L2 has PLI-M

A

G - PA ML IS CW

130
Q

right ilium PSIS has superior tenderness and limited foot flare. what is the listing

A

PIEX

131
Q

what is the segmental contact point (SCP)

c4 prs

A

right SP

132
Q

what is the segmental contact point (SCP)

T1 PR

A

right SP

133
Q

what is the segmental contact point (SCP)

T6 posterior right TP

A

right TP

if there is no wedging (contact open wedge), you’re gonna be on the body side! ***

134
Q

what is the segmental contact point (SCP)

PLI M

A

right mammillary process

135
Q

what is the segmental contact point (SCP)

limited ilium flexion

A

ischial tuberosity

136
Q

what is dr stance (same or opp) of contact

modified combo diversified

A

same side

137
Q

what is dr stance (same or opp) of contact

diversified seated cervical

A

opposite side

138
Q

what is dr stance (same or opp) of contact

T1 - PR

A

same side

139
Q

what is dr stance (same or opp) of contact

gonstead cervical chair

A

same side

140
Q

what is dr stance (same or opp) of contact

double thenar

A

same side

141
Q

where to stabilize for gonstead?

cervical chair c4 PRS

A

below

142
Q

where to stabilize for gonstead?

single hand t4 PLI

A

grasp wrist

143
Q

where to stabilize for gonstead?

L4 PRS side posture push

A

stabilize right shoulder
with doctor right hand

(open wedge up!)

144
Q

where to stabilize for gonstead?

seated ASLP atlas

A

occiput with contact hand

145
Q

what hand is used to stabilize for gonstead?

PR sacrum

A

superior hand

cephalad

146
Q

what’s the torque for the listing?

PRS

PI-R sacrum

A

CW

CCW

147
Q

what are the planes and axis of movement

A

sagittal - x - flexion and ext
transverse - y - rotation
coronal - Z - ab and add

148
Q

what are the dozen adjusting rules

A
  1. vertebra = body = vertebral body
  2. D and G both contact superior side of segment or convex side of disc wedge
  3. D will contact high TP and stabilize opposite TP (doctor stands on convex side of wedge)
  4. stand on the side of convexity
  5. put the involved side up or open wedge up
  6. use a push if there’s a correct choice between push and pull
  7. pathology (PI pelvis is accompanied with AI sacrum) and physiology (PI pelvis is accompanied with AS sacrum)
  8. body and SP rotate opposite
  9. anterior TP = SP listing
  10. posterior TP = body listing
  11. static listings - malposition, fixation, subluxation
  12. motion listings - decreased, limited, restrictions
149
Q

sacrum contact point for diversified and Gonstead for a RAI or PI-R sacrum

A

diversified RAI - contra apex

gonstead PI-R- ipsi base

150
Q

for thoracics contact wear and stand where

A

contact high TP

stand on open wedge side

151
Q

when is straight away stance used

A

4 part thoracic listings

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