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GONSTEAD ME > Exam 1 > Flashcards

Exam 1 Flashcards

1
Q

Clarence selmer gonstead life

A

1898-1978

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2
Q

Gonstead’s family is from

A

Norway

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3
Q

Original family name was

A

Halvorson

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4
Q

Parents gonstead

A

Carl and sarah - farmers - had 6 children

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5
Q

Clarence graduated 8th grade at

A

19 - went to school periodically while working on teh family farm

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6
Q

Gonstead moved away from home and attended engineering school.

A

More than likely an automotive mechanic education since he worked for a company that manufactured automobiles at the time

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7
Q

While in trade school gonstead got sick

A

Acute rheumatoid arthritis

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8
Q

Aunts doctor that came in to take care of gonstead

A

DR. JAcob B. Olson - chiropractor

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9
Q

After trade school young gonstead took a jow wokring as an automotive engineer. The job allowed him to save money to pay for chiro school. He also borrowed

A

$500 against family estate for school tuition

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10
Q

Clarence gonstead graduated

A

From palmer college in 1923 in a class of 800.

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11
Q

How long was chiro schoool

A

1.5 years with no prereqs

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12
Q

Palmer offered a curriculum

A

4 terms of four months.

Each term cost $150 ($7600)

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13
Q

Special lectures in chiro school

A 
Psychology
Obstetrics
Surgical emergencies
First aid to the injured
Care of teeth and mouth
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14
Q

The prevailing theory at the time

A

BJ palmer’s idea that the subluxation was the result of a vertebral bone on nerve causing nerve pressure

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15
Q

What technique did chiros learn in the 20s

A

Full spine, lot on knee chest but modified, adjusting the full spine with a focus on upper cervical

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16
Q

After graduation gonstead

A

Worked briefly for Dr. Olson

Merton gonstead his younger brother joint the practice in 1929.

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17
Q

Collaberation with merton resulted in

A

The gonstead disc concept.

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18
Q

Gonstead concept

A

Vertebral disc with primary culprit of nerve pressure.

Would later become recognized as a model for understanding discogenic back pain

Vertebrae shifts on disc which then causes nerve pressure - abnormal motion can affect the nerve

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19
Q

Gonstead bought his practice

A

In mount horeb from Dr. BJ jones

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20
Q

Married

A

Elvira

Feb 14, 1924

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21
Q

First x-ray machine

A

Feb 1925

First DC in wisconsin to have x-rays

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22
Q

Obtained degree as a naturopath

A

1943-1949

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23
Q

Merton gonstead

A

Younger brother

Joint practice in 1929 and stayed until 1934

Collaboration resulted in gonstead disc concept

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24
Q

Palmer school of chiro lost their leader BJ

A

1961

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25
Q

Under new leadership, palmer faculty

A

Decided to reqrite technique curriculum

Gonstead method bevcame cornerstone of school’s technique department

Today gonstead is represented on chiro national borad

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26
Q

What book was written for palmer college’s new curriculm

A

Gonstead chiropractic science and art - roger hertz one chapter at a time and published that way as well

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27
Q

Gonstead was the first chiro in wisconsin to have an office that was

A

Separate from his home

Stayed in the clinic until 1939

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28
Q

Had central air and carport/garage - something most people didn’t even have at their house

A

Attached garage - second practice on main street

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29
Q

Feeder system

A

Changing room attached to adjsuting room. Light lets doctor know when patient is ready to be seen

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30
Q

Dr. Gonstead built clinic

A

1964 at the age of 65
19,000 sq ft

Karakhal inn hotel

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31
Q

Gonstead was the largest ___ in mt. Horeb

A

Employer and taxpayer

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32
Q

Advertising

A

Gonstead never spent the cost of a stamp on advertising

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33
Q

Gonstead saw

A

150-200 people per day with no appointments

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34
Q

Gonstead worked

A

18-20 hours per day, 6.5 days per week

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35
Q

Associates

A

2, worked same hours - after 1962

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36
Q

More than ___% of patients came from more than 100 miles away. No hotels so towns peopel could rent out rooms.

A

80%

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37
Q

Gonstead reluctantly taught his first seminar

A

1946 after practicing for 23 years

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38
Q

Seminars were formally organized in

A

1954 with help of Dr. Ted and Phyllis Markham and Lee Vogel

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39
Q

Gonstead searched to correct

A

The cause of disease

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40
Q

Gonstead had a medical lab

A

In his office adn employed a med-tech so he could measure changes

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41
Q

Gonstead consulted with electronic development lab (EDL) to produce

A

Better nervoscope (descent of neurocalometer)

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42
Q

Gonstead refined

A

Knee-chest table

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43
Q

Zenith 210 Hylo table to add

A

Break away thoracic section

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44
Q

X-ray line marking system developed by

A

Dr. Lee Vogel.

Developed pelvis listing particularly IN and EX analysis and lisitngs. Also pull move for EX listing

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45
Q

Chiro x-ray machine,

A

Split screen x-ray film cassettes

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46
Q

Adjusting cervic cal spine in chair position with

A

Posteriority as teh focus of correction

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47
Q

In his 55 years of practice gonstead categorized

A

Visceral conditions were into 2 systems, sympathetic and parasympathetic

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48
Q

Sympathetic response

A

C6-L5

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49
Q

Parasympathetic response

A

C0-C5, sacral segments, ilium

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50
Q

Adjustments were made

A

One segment per visit

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51
Q

Gonstead found he got the best results with

A

Just one bone being corrected at a time.

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52
Q

While there is a case management guideline guideline that tells you areas of teh spine where he got the best results on a certian condition, it is always important to remember

A

That no segment is ever adjusted unless all the criteria exists there

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53
Q

Guideline does not mimic

A

The meric chart

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54
Q

Results were considered

A

Diagnostic

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55
Q

High systolic BP

A

Adjust sympathetic first.

T1-T3 for heart contractility or T10-12 for kidneys

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56
Q

High diastolic BP

A

Adjust upper cervical spine for the tension in the vascular system

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57
Q

High systolic and diastolic BP

A

Adjust sympathetci first, correct it, wait one week then adjust parasympathetic

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58
Q

Find it where you find it

A

Accept it where you find it

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59
Q

A diabetic patient comes for care, you find subluxations at C2, T9 and the right SI joint.

What if anything would a gonstead doctor adjust on the first visit

A

T9

60
Q

Tension headache

A

Correct cervical curve

Suboccipital headaches may be from hypermobility in the upper cervical spine caused by fixation lower C6-T3

61
Q

Headaches upon waking

A

Chemistry problem C6-T3 (thyroid hormone)
T12-L3 (adrenal dysfunction)
Alcohol intake the night before
Strained sleeping positions

62
Q

Cluster headaches

A

Trigeminal nerve dysfunction - atlas/occiput/axis

63
Q

Digestive headaches

A

Occur 1 hour after eating = upper cervical

1-2 hours after eating = T4-L3

64
Q

Classic/common migraine

A

Sympathetic C6-T3, T12-L3

Dietary considerations

65
Q

TMJ headaches

A

Correct cervical curve
Atlas subluxation
TMD

66
Q

Dr. Gonstead’s commitment to chiropractic

A 
3 million adjustments
1.5 million different patients
55 years
6.5 days per week
18 hours per day
One patient at a time
67
Q

Learn from others mistakes

A

You can’t live long enough to make them all yourself

68
Q

On gravestone

A

Find the subluxation correct it, leave it alone

69
Q

What year did gonstead graudate from palmer

A

1923

70
Q

How lond did gonstead attend school

A

1.5 years

71
Q

What physical condition inspired him to become a chiropractor

A

Rheumatoid arhtritis - juvenile

72
Q

How many days per week did he see patients

A

6.5 days/week

73
Q

How many hours per day did he work

A

18 hours

74
Q

What was his first theory called

A

Gonstead disc concept

75
Q

What chiro table do we use today that he altered

A

Knee-chest table

76
Q

What town and state was gonsteads clinic located

A

Mt. Horeb wisconsin

77
Q

How many years did he practice

A

55 years

78
Q

What is written on his headstone

A

Find the subluxation, correct it, leave it alone

79
Q

What levels of the spine were measured to have a symptathetic response

A

C6-L5

80
Q

The patient is positioned with R side up spinous L4 contacted and CCW torque

A

PLS pull

81
Q

Pt positioned on knee chest. Listing is T2 PL-T. What adjustment, SCP and torque

A

Single hand, right TP, no torque

82
Q

C5 PL-L LOC

A

PA-IS-RL

83
Q

BP sacrum line of correction

A

Disc adjustment

PA-SI

84
Q

P-L or P-R LOC

A

PA

85
Q

L5 PLS-M what is LOC and torque

A

PA-IS-RL, CCW

86
Q

Gonstead analysis

A 
History
Visualization
Instrumentation
Static palpation
Motion palpation
X-rays
87
Q

History

A

Very important part of learning about your patient

MOI

May have to use your CSI - chiropractic spinal investigator skills

88
Q

Visualization

A 
Posture
Antalgia
Symmetry
Color
Movement
89
Q

Instrumentation

A

Where to adjust, when to adjust, when not to adjust
Heat differential
Procedure - looking for a break in the scoping, rates, direction and levels
Cord pressure
Mistakes of scoping pg 166

90
Q

Multiple glides are required to confirm

A

A break

91
Q

Rescope area of break

A

3 times

92
Q

See if the break fades away

A

False break

93
Q

If the break becomes sharper and distinct

A

True break

94
Q

Static palpation

A 
Soft tissue palpation
Hyperemia or red response
Tenderness
Musculature
Trophic changes - edema
Lateral flexion
95
Q

Motion palpation

A

Abnormal end-feel, abnormal quality of resistance to motion adn reproduction of pain

Three planes for motion - sagittal, frontal, horizontal

Visualization of motion

96
Q

X-rays

A

Acceptability for chiro care
Biomechanical irregularities
Chiro analysis and evaluation

97
Q

Acceptability for chiro care

A

Ruling out conditions that are contraindications for chiropractic care - pathologies, fractures, etc

Conditions that need referrals

98
Q

Biomechanical irregularities

A

Congenital variations
Degenerative changes
Pathologies

99
Q

Chiro analysis and evaluation

A

Determine the appropriate adjusting table
Generate listings and how you are going to adjust your patient - segment, segmental contact point, LOC
Aid in generating a prognosis and determining frequency of care

100
Q

Lateral disc lesion

A

Patient will lean away form the side of pain

101
Q

Medial disc lesion

A

Patient will lean toward side of pain

102
Q

Subrhizal disc lesion

A

At the nerve, toward the nerve, aroudn or directly at a nerve root

Patient will lean forward or not at all

103
Q

Central disc lesion

A

Patient will have bilateral pain or switching pain and antalgias

104
Q

Important to determine what kind of disc lesion a patient has because it will determine

A

How long it may take for symptoms to resolve

105
Q

Lateral disc healing

A

2 weeks

106
Q

Medial disc healing

A

4 weeks

107
Q

Subrhizal disc healing

A

4-6 weeks

108
Q

Central disc healing

A

6 weeks

109
Q

History

A

What happened
Has it ever happened before
OPQRST

110
Q

Ortho/neuro physical exam acute low back

A

Valsalvas/dejerines
SLR + at 45 degeres
Neurological package - mildly + in 50% of disc pts
Pain pattern correlation

111
Q

Chiro exam acute low back

A 
Scope 
Static palpation
Motion palpation
Percussion/vibration
X-ray
112
Q

Scope

A

Sympathetic reaction to pain may be inconclusive

113
Q

Static palpation

A

A lot of fluid and muscle fuarded/spasms

114
Q

Motion palpation

A

Difficult to perform but is still done

115
Q

Percussion/vibration

A

Positive on spinous of involved segment - start tapping spinous

116
Q

X-ray

A

APOM, full spine 14x36, lateral full spine

117
Q

You may perform a standing lumbar regional series ONLY IF

A

Patient is leaned over too much with an antalgic position to get a proper full sine view

118
Q

Chiro management low back

A

Pt placed on hi-lo table which can be distorted to their antalgia

Ice over affected disc for analgesic effect

Pump the disc (passive motion) by contacting spinous of affected segment - repeat until patient can tolerate it well

Raise pt off hi-lo table

Side posture pull adjustment contacting spinous below the affected disc

119
Q

Patient home care instructions

A

Pt can be seen 2x/day (6 hours apart) - everday until symptoms are noticeably improved and antalgia is redcuced or gone

Instructed to ice 20 minutes/hour

Instructed to walk at least 5 min/hour
Mild stretching of the lower back

No sitting

120
Q

Follow up care low back

A

With improvement = adjust 1x/day afternoon or evening

When symptosm subside = re x-ray and continue subluxation correction

121
Q

What is the mechanism of fixation in gonstead system

A

Cross fiber adhesions in annular fibers

122
Q

A break is seen on instrumentation. A break is

A

A deviation and return of the needle to the starting point within one segment level

123
Q

The proper way to scope for a break is

A

Glide instrument from T1 up and C7 down

124
Q

Which motion is greatest in the lumbar spine

A

Flexion and extension

125
Q

In a standing patient (or sitting up straight) what is the coupled motion of right lateral flexion in the lumbar spine

A

Right spinous rotation

126
Q

Which of the following are the components of analysis in the gonstead system

A 
Visualization
Instrumentation
Static palapation
Motion palpation
X-ray
127
Q

What is a pit of edema

A

Interstitial fluid built up around the facet joint

128
Q

What ortho tests are important for evaluating a patient with acute low back pain

A

SLR
Valsalva
Dejerine’s triad

129
Q

Your patient presents with left antalgia and pain readiating down left leg. What kind of disc herniation is this likely

A

Medial

130
Q

Why might it be important to know what type of disc bulge your patient has

A

Tells you the length of time it will take to get better

131
Q

The patient has pain that extends from the low back to the big toe. What neurologic package is this?

A

L4?

132
Q

What is preferred x-ray used in gonstead to evaluate a patient with acute lower back

A

A-P and lateral full spine standing

133
Q

What does a D1 disc look like

A

Level disc with possible increase disc space

134
Q

What should you do to patient before pump teh individual disc

A

Put ice on the lower back for 20 minutes

135
Q

What adjustment is used in Gonstead for a patient with acute low back

A

Side posture

136
Q

After the adjustment, the patient is instructed to

A

Walk for at least 5 minutes

137
Q

How often is a patient seen when they are very acute and antalgic

A

Twice a day, morning and afternoon

138
Q

What home instructions should the patient follow

A

All of the above - ice 2- minutes every 1-2 hours; walk at least 5 minutes per hour; don’t sit

139
Q

Your ability to detect an instrumentation break with scoping in the acute lower back patient will

A

Be diminished because of the edema and increased heat in the area but you will use the scope and look for the break

140
Q

What is the order of care for the acute lower back patient on first visit

A

Ice, pump the disc, adjust the segment below

141
Q

Describe the type of x-ray that a gonstead chiro takes for acute lower back patient

A

A-p full spine, lateral full spine

142
Q

D1

A

Swollen disc

143
Q

D2

A

Slightly decreased at posterior

144
Q

D3

A

Disc that is even more narrow at posterior

145
Q

D4

A

Level disc with decreased disc space at about 1/3

146
Q

D5

A

Decreased disc space at about 2/3

147
Q

D6

A

Almost completely flat

GONSTEAD ME (5 decks)

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