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Subluxation Theory > Exam 1 > Flashcards

Exam 1 Flashcards

1
Q

Bony ankylosis is the result of which stage of subluxation degeneration?

A

Stage 3

“Phase of stabilization”

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2
Q

Which nerve is most likely affected by anterior rotation of the atlas?

  • Hypoglossal
  • Spinal accessory
  • Vagus
  • Optic
A

Vagus

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3
Q

Which structure is responsible for determining the direction of the motion of the motion segment?

  • facet joint
  • IVD
  • costovertebral joint
  • occiput
A

facet joint

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4
Q

Motion of the sacrum during gait is called?

A

Nutation and Counternutation

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5
Q

Which is the term for soft tissue returning to its normal shape after a load has been removed?

  • Eccentric
  • Elasticity
  • Stretch
  • Plasticity
A

Elasticity

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6
Q

Injury to which ligament places the patient at greatest risk of compressive myelopathy?

  • Alar Ligament
  • Apical Ligament
  • Transverse Ligament
  • Nuchal Ligament
A

Transverse Ligament

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7
Q

Accumulation of metabolic wastes, histamine, bradykinins, and cytokines is which component of the subluxation theory?

A

Pathobiochemisty

proinflammatory nociceptive irritants

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8
Q

Which tract is most lateral in spinal cord?

  • spinocerebellar
  • dorsal column
  • Anterolateral system
  • spinoreticular tract
A

Spinocerebellar

or lateral spinothalamic?

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9
Q

How does a subluxation alter the normal size and shape of the IVF?

A

When there is a posterior and inferior component, the elliptical shapeof the IVF becomes irregularly shaped and alteration of the anterior and posterior dimension will effect the nerve roots

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10
Q

Which is the most reliable sign of a nerve compression lesion?

A

fibrofatty consolidation

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11
Q

Which option describes a ligamentous fixation?

A

Chroniclly sore or asymptomatic fixation that seldom cavitates

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12
Q

Which term best describes changes in the vertebral endplate, the shape of the facet joints and the strength of the ligamentous resulting from the subluxation inflammation?

A

pathoanatomy

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13
Q

contraction of the rectus captious posterior muscle has what effect?

A

together: head extension
alone: lateral flexion ipsilateral

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14
Q

Disc block subluxation is caused by

A

nuclear shift

nucleus shifts position with IVD
annular fibers become inflamed and protrusion of the disc puts pressure on the nerve root or spinal cord

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15
Q

lack of ability to fully depolarize the nerve roots in a zone of compression is called…

A

???

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16
Q

Which nerve root is both sensory and motor for the brachioradialis reflex?

A

C6

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17
Q

What structure dissipates force within a joint and protects the joint margins?

A

meniscoids

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18
Q

How does the dentate ligament cord distortion hypothesis explain changes in the inferior vertebral alignment from upper cervical adjustment?

A

spinocerebellar tract distortion results in abnormal reception of spinal position

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19
Q

What is the inferior boundary os the IVF?

A

Pedicle of inferior vertebra

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20
Q

Compression of the vessels supplying the nerve roots results in which phenomenon?

A

microcirculation ischemia

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21
Q

Which of these causes increased concentration of metabolic wastes in the blood and tissues at a site of subluxation?

A

Extraavaation of fluid

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22
Q

Which structure is the fulcrum or pivot point for vertebral motion?

A

nucleus pulposes

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23
Q

Loss of the nutritive inhibition of the IVD results in…

A

inflammation and circumferential tearing

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24
Q

Which nerve root is responsible for skin sensation along medial leg and medial foot

A

L4

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25
Q

Blockage of venous drainage results in…

A
  • as blood backs up on the venous side, the increase in pressure blocks oxygenated blood from flowing into capillaries, increases permeability of vessels, extravasation of fluid (edema), micro hemorrhage
  • water then leaves the blood on venous side and concentration of metabolic wastes increases
  • blood can now reverse flow and transport metabolic wastes back through the capillary
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26
Q

What is the purpose of the aggregate protein in cartilage?

A

Attract water to lubricate the collagen fibers

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27
Q

Which ligaments connects the odontoid process to the foramen magnum?

A

Alar ligament

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28
Q

Excessive motion in some directions and decreased motion in others is called…

A

aberrant motion

29
Q

What is the significance of an increases atlantodental interspace?

A

indicates anterior translation instability

30
Q

What is true about motion in the spine?

A

increased ROM = increased stability

31
Q

Deformation and distortion of spinal cord is greater as a result of what?

A

atlas laterality

32
Q

What covering is the continuation of dura mater covering peripheral nerves?

A

Perineurium

33
Q

What does it mean to be “in pattern”?

A

The patient is no longer adapting to the environment

34
Q

Muscular fixation is commonly associated with which type of motion?

A

Articular fixation

35
Q

Where is the maximum distortion in the spinal cord?

A

Posterior spinal cord tracts from direct compression
or
lateral spinal cord tracts at atlas

36
Q

Which of these results in supine short leg?

A

Spinocerebellar tract distortion and submaximal muscle contraction

37
Q

Which is true of capillaries?

A

nerve capillaries are longer than other capillaries

38
Q

restriction of the nerve root within the IVE causing traction and compression due to what structure?

A

transforaminal ligaments

39
Q

nerve roots arising from which region of the spine arise then drop down then rise up and exit?

A

cervical

40
Q

which of these is most likely DIRECT results of upper cervical adjustment?

A

????

41
Q

Superior border of IVF

A

Pedicle

42
Q

Posterior border of IVF

A

Z joint

43
Q

Anterior border of IVF

A

Posterior aspect of body and disc

44
Q

contents of IVF (6)

A 
nerve root
spinal artery
spinal vein
lymphatics
transforaminal ligamnet
loose adipose and areolar
45
Q

How does the size and shape change when a vertebra sublimates?

A
  • posterior and inferior
  • IVF become irregular shaped (not elliptical anymore)
  • alteration of anterior and posterior dimension will affect nerve roots
46
Q

What are the transformational ligaments (TFLs)?

A

sturdy dense collagenous bands that cross the IVF, holds contents of IVF together

47
Q

What purpose do TFLs serve?

A

divide IVF into separate compartments surrounding the nerve root to fix nerve root in constant position

48
Q

T/F

nerve roots exit superior and horizontal ligament and blood vessels exit inferior

A

FALSE

nerve root = inferior
blood vessels and ligament = superior

49
Q

T/F

Cervical path is superior

A

FALSE

cervical path is inferior

50
Q

T/F

Thoracic path is in the middle

A

TRUE

51
Q

T/F

Lumber path is inferior

A

FALSE

lumber path is superior

52
Q

Why do nerve roots have different approach to IVF in different regions of spine?

A

cervical: slack for arm movement
thoracic: tethered because lack of movement
lumber: path of caudal equina

53
Q

T/F
Compression of peripheral nerves causes a great variation in conduction velocity because there is a reduction in conduction velocity at site of compression.

A

FALSE

causes a SLIGHT variation in velocity

54
Q

T/F

Normal conduction exists prior to the zone of compression and distal to the zone of compression

A

TRUE

55
Q

T/F

peripheral nerves require less compression to get same effect as pressure required to block nerve roots

A

VERY FALSE

56
Q

nerve root is covered in…

A

dura mater

very susceptible to compression

57
Q

peripheral nerves covered in…

A

epineurium and perineurium

not as susceptible to compression

58
Q

How are nerve capillaries different than those in the rest of the body?

A

nerve capillaries are wider, longer, less musculature on arteriole side

59
Q

Why are never capillaries beneficial?

A

easily reduce blood flow through capillaries

60
Q

What moves blood through the capillary?

A

low pressure gradient

61
Q

What process makes nutrient waste exchange possible?

A

simple diffusion

62
Q

What is retrograde blood flow?

A

reverse blood flow

63
Q

What causes retrograde flow?

A

accumulation of fluid

64
Q

What is the results of retrograde flow?

A

transporting waste back into capillaries increases concentration of waste and may diffuse back into tissues. acts as a pro-inflammatory nociceptive irritant

65
Q

What is the results of chronic compression of a nerve?

A

fibrotic changes

66
Q

What anatomical changes happen to a nerve that is chronically compressed?

A

demyelination of axons
fibrosis of epineurium
alter axon shape

67
Q

What is the double crush phenomenon

A

nerve may be compressed at 2 or more sites
(individual compression are asymptomatic, but when both are along the course of a single nerve will results in peripheral nerve symptoms

68
Q

Winsor’s hypothesis

A

minor curves of spine (scoliosis) led to sympathetic malfunction resulting in visceral pathology

Subluxation Theory (2 decks)

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