Exam 1 Lecture Material Flashcards
What is the historical definition of a subluxation?
A bone (vertebra) of out place pressing on a nerve causing nerve interference
What is joint dysfunction?
A joint that has lost a degree of normal movement (hypomobility)
How does the medical profession define a subluxation?
Partial dislocation that is unstable and hypermobile due to a loss of ligamentous integrity
What is the Meric chart?
A view that mapped specific vertebrae to corresponding visceral structures
What is the name of the mapping of vertebrae corresponding to viscera?
Meric chart
What is the Meric chart based on?
How valid is this?
Based on observation of early chiropractors and neuroscience understanding at the time
Clinical validity and implications still heavily debated
Why is chiropractic management of non-MSK tissues limited?
Scope of practice and the extent of research
Research and current views on chiropractic and non-musculoskeletal tissues focuses on the role of…
the sympathetic nervous system
What is cavitation?
The process whereby pressure variations in a liquid can in a short period of time cause countless small cavities to form and then implode
What is tribonucleation?
Opposing surfaces resist separation until a critical point where they separate rapidly resulting in vapor cavities that do not collapse instantaneously
What is the process whereby pressure variations in a liquid in a short period of time cause countless small cavities to form and implode?
Cavitation
What is the term for when opposing surfaces resist separation until a critical point where they separate rapidly resulting in vapor cavities that do not collapse instantaneously?
Tribonucleation
Is the “pop” produced by pulling digits cavitation or tribonucleation?
Tribonucleation
Who coined the term “spinal irritation”?
Thomas Brown in the Glasgow Medical Journal, 1828
When did the term “spinal irritation” appear in the American Journal of Medical Sciences?
1832
Spinal irritation is the idea that…
tenderness of a vertebra corresponded to a diseased organ
Who is the probable contemporary father of the nerve compression hypothesis?
J Evans Riadore in Irritation of Spinal Nerves
When did Riadore encourage manipulation to treat spinal irritation in relation to DD Palmer?
2 years before Palmer’s birth
What is the thought behind spinal irritation as laid out in Irritation of Spinal Nerves by J. Evans Riadore?
“…if any organ is deficiently supplied with nervous energy or of blood, its functions immediately, and sooner or later its structure, become deranged.”
Who is the founder of chiropractic?
DD Palmer
Subluxation terminology and the idea of bone out of place is due to…
Palmer’s account of what happened in the first adjustment
Were radiographs used in DD Palmer’s time?
No, could not see bone out of place
DD Palmer’s first theory was focused on…
inflammation
According to DD Palmer’s first theory, what was inflammation?
“the result of displacement of any body part: nerve, artery or vein… bone, ligament or muscle”
At first, DD Palmer manipulated ___ to prevent or relieve ___ thought to trigger heat and inflammation
manipulated any displaced anatomy to prevent or relieve friction thought to trigger heat and inflammation
Within 3 years, DD Palmer’s inflammation hypothesis was refined and published as…
“Luxation of Bones Cause Disease”
According to DD Palmer’s “Luxation of Bones Cause Disease” what did he believe?
Muscles, nerves, and bones are key in displacement causing pressure, which could be relieved by adjustments
DD Palmer hypothesized that causes of subluxation included:
- Trauma (physical)
- Toxins (chemical)
- Autosuggestion (psychological/emotional)
Soon after DD Palmer hypothesized that subluxation was caused by trauma, toxins, and/or autosuggestion, he added in ___ theory
vibratory
What does DD Palmer’s vibratory theory state?
Nerves vibrate normally at 200 per minute; this represented the tone of the nervous system
What is innate intelligence?
DD Palmer says it’s “individualized intelligence which runs all the functions of our bodies”
Who is considered the developer of chiropractic?
BJ Palmer
In 1934, BJ Palmer established four criteria for subluxation:
- Misalignment of vertebra in relation to adjacent segments
- Occlusion of a foramen (including the canal)
- Pressure on spinal nerve roots
- Interference to transmission of mental impulses
Later in BJ Palmer’s career, what region of the spine did he focus on?
Upper cervical region, focused on C1 (atlas)
What was the result of BJ Palmer’s focus on C1?
- His hypothesis that a C1 subluxation would cause compression of the spinal cord
- His HIO technique
Who published “Modernized Chiropractic”?
Langworthy, Smith, and Paxon
What was the purpose of the text “Modernized Chiropractic” by Langworthy, Smith, and Paxon?
- Rejected bone out of place theory; too simplistic of an explanation
- Favored focus on joint fixation/motion restriction
- Used to defend chiropractors arrested for practicing medicine without a license
Who is the primary advocate of applying the scientific method to chiropractic practice, research, and education?
CO Watkins
What were some primary beliefs of CO Watkins?
- Chiropractors should generate clinical data and publish clinical research
- Public relations should be modest and should not masquerade as science
Who revitalized the concept of lack of proper joint motion?
Marcel and Henri Gillet (Belgian chiropractors) and Fred Illi (Swiss chiropractor)
According to Gillet(s) and Illi, how does an injured joint become fixated?
Edema develops around strained capsule and tissues leading to joint fixation
Gillet(s) focused on the ___ region and spinal biomechanics
pelvic region
What did Gillet(s) conclude from their focus on the pelvic region and spinal biomechanics?
“…one cannot put a vertebra back into place the way one does a fracture or dislocation. What one really does is: to restore the function of a vertebra”
Who’s definition of chiropractic is this?
“The art and science concerned with the study and treatment of the mechanics, statics and dynamics of the human body, particularly of the vertebral column and pelvis, for the primary purpose of eliminating neuropathological reflexes and their consequences”
Fred Illi
What is germ theory?
The theory that certain diseases are caused by the invasion of the body by microorganisms (too small to be seen except through a microscope)
What did BJ Palmer think about germ theory?
Rejected germ theory and focused on subluxation as the cause of all dis-ease and a precursor to disease
Who wrote The Science and Logic of Chiropractic?
Verner
Who said the following?
“…one cannot put a vertebra back into place the way one does a fracture or dislocation. What one really does is: to restore the function of a vertebra”
Gillet
Verner believed in the impact of chiropractic on ___ as a link to ___
impact of chiropractic on the nervous system as a link to other conditions
In the 1990s, ___ ___ suggested chiropractic adopt wellness care, doing research guided by efforts to restore homeostatic mechanisms in the body
Ian Coulter
What sort of research emerged once chiropractic started focusing on wellness?
- Begun to determine to what extent the body is a self-healing organism
- Departure from the concept of innate in favor of focusing on the neural mechanisms involved
What is the inflammation hypothesis by Lantz, in Leach, 132?
“Tissue and cellular responses to injury in the spine includes infiltration of histamine, protein derived factors, eicosanoids, proinflammatory cytokines, nitric oxide, degradative enzymes, and substance P, and these pre-stage development of spinal lesions”
Who hypothesized that inflammation involves infiltration of histamine, protein derived factors, eicosanoids, proinflammatory cytokines, nitric oxide, degradative enzymes, and substance P?
Lantz (in Leach, 132)
What are the cardinal/classic signs of inflammation?
- Rubor (redness)
- Tumor (swelling)
- Calor (heat, fever)
- Dolor (pain)
- Functio laesa (loss of function)
Which cardinal signs are usually present with acute inflammation?
- Rubor (redness)
- Tumor (swelling)
Describe the aggressive vascular tissue-level response to acute inflammation
- Infiltration of neutrophils and other leukocytes
- Consists of the visible signs
- Capillary wall cells contract and allow exudation
(There might be no actual vascular damage, although there often is)
With acute inflammation, ___ and ___ release histamine
What is the effect of this on capillary cells?
mast cells and platelets release histamine; capillary cells contract and gaps open
What will pass through the gaps in capillaries during acute inflammation?
Leukocytes (by diapedesis or transmigration)
During acute inflammation, which cells travel to the damaged area and how?
Macrophages and neutrophils migrate via chemotaxis (driven by chemotactic stimulants) to phagocytize debris
What is the first biochemical mediator in acute inflammation that stimulates the vascular response?
Histamine
What are the functions of cytokines in acute inflammation?
- Regulate inflammation and immune responses
- Involved in cell differentiation, replication, survival, and death (apoptosis)
- Integral to homeostasis
What is the function of nitric oxide in acute inflammation?
Vasodilation
What are the functions of substance P in acute inflammation?
- Vasodilation
- Involved in cell growth
- Neurotransmitter associated with nociception and pain, anxiety, stress, and more
What are the biochemicals involved in the response to acute inflammation?
- Histamine
- Cytokines
- Nitric oxide
- Substance P
Is chronic inflammation an extension of acute inflammation?
It can be, or it may begin as a chronic inflammatory disorder
Which cells infiltrate during chronic inflammation?
Lymphocytes and macrophages
How does a tissue react to chronic inflammation?
Angiogenesis (new blood vessels) and connective tissue proliferation
How long does chronic inflammation last?
Months to years, or lifelong illness
According to research, is joint cracking more related to cavity formation or bubble collapse?
Cavity formation (tribonucleation)
According to research in biomechanics, spinal manipulative treatments had what effects?
- Reflex responses far from the treatment site
- Movements of vertebral bodies in the “paraphysiological” zone
- Associated with cavitation of facet joints
