Exam 3: Quiz 4 Flashcards by Marissa Kline

Symptoms and dysfunction are caused by

Pinched nerves

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Subluxation of a vertebrae is a

Slight deviation from its normal relation to adjacent vertebrae

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The real, primary cause of disease is

Tension

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Cause of tension is

Pressure

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Cause of pressure in 95% of conditions is

Subluxated vertebrae

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Cause in remaining 5% of conditions is

Luxation of other bones (other than vertebral column)

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Spinal subluxations were hypothesized to

Induce NR compression as result of direct anatomic compression w/in IVF

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NR dysfunction is hypothesized to induce dysfunction of

Somatic or visceral tissues

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Prolonged compression was hypothesized to induce

Loss of function

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Moderate compression was hypothesized to cause

Inc neural activity, pain, paresthesias, hypertonic muscles

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Joint subluxations are extremely ____ to pinch NRs at margins of IVF

Unlikely

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“Pinched nerve” notion is NOT

Chiropractic

Used by MDs

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An impinged nerve has pressure on

One side only

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Nerves may be impinged upon by any ___ but pinched only by

Displaced bone; fracture and extreme displacement

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Impingement of a nerve

Increased tension by stretching

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Spinal NRs at interpedicular region are more susceptible to

Pressure, inflamm and ischemia

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____ w/in the interpedicular space are especially susceptible to compressive force

DRGs

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Injured dorsal NRs respond more vigorously to

Mechanical deformation

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It (is/is not) necessary for spinal NRs to be directly compressed to develop pathologic dysfunction

Is NOT

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Other kinds of mechanical stresses can affect nerve tissue because

Arteries, veins, lymphatics, fat, CT also occupy IVF

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density of ____ in DRG cells is relatively high, these regions are unusually excitable

Sodium ion channels

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DRs and DRG are more susceptible to effects of

Mechanical compression

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Joint malposition contributing to dysfunction more likely to occur by

Narrowing more vulnerable interpedicular zone

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Subluxation has greater potential to affect NR function if

It is secondary to other disorders already narrowing lateral recess

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Vertebral subluxation complex

Subluxation presented as a complex multifaceted pathologic entity

Vertebral subluxation syndrome

Clinical disorder identified by presenting symptoms and physical signs

Subluxation =

Biomechanical aberration

Subluxation complex

Pathological consequences

Subluxation syndrome

Physical manifestation

Orthoneurologic exam asses the state of

Pathologic tissue changes and aids in determining prognosis

Biomechanical analysis determines the

Therapeutic prodecures and treatment schedule

Chiropractic adjustment uses short-leverage technique

HVLA

T/F all adjustments are all associated w/ cavitation

False (not always)

Chiropractors commonly used adjustments to

Influence joint and neurophysiologic function

What is central goal in delivery of adjustment

Restoration of motion

When there is a change in structure, there will be a change in

Function

Vertebral hypomobility can cause ______ bc of changes in sensory input

Pain and abnormal spinal mechanics

What things provide best opportunity for optimal healing

Aggressive early care and restoration of motion

Facilitation is the persistend afferent input which induces

Development of pathologic reflexes

Facilitation and sensitization hypothesis views vert joint dysfunction as

Lesions capable of inducing altered proprioceptive and nociceptive input

Somato-somatic reflex hypothesis

Afferent impulses from one body area result in reflex in other areas

Example of somato-somatic hypothesis

Segmental muscle hypertonicity may be associated w/ joint dysfunction

Somato-visceral reflex hypothesis

Afferent impulses in 1 body area result in reflex activity in innervated visceral organ activity

Example of Somato-visceral reflex

Heart palpitations secondary to T joint dysfunction

Viscero-somatic reflex hypothesis

Visceral afferent fibers reflexly cause somatic problems

Example of viscer-somatic reflex hypothesis

Pain and muscle tightness in L shoulder w/ onset of MI

Viscero-visceral hypothesis

Visceral afferent impulses results in activation of visceral efferent output of sym or para motor neurons

Example of viscero-visceral reflex hypothesis

Distention of gut results in inc contraction of gut muscle

Study from AMA on patients w/ ulcers

86% had T6-9 scoliosis and 90% had DDD

Somato-psychic reflex hypothesis

Subluxations can affect upon ascending paths of reticular activating system

Example of somato-psychic reflex hypothesis

Joint dysfunction leading to conditions such as insomnia and restlessness

Psycho-somatic reflex hypothesis

Conscious/unconscious stressors perpetuate sensitization of afferent nerve fibers

Example of Psycho-somatic reflex hypothesis

Patients under emotional distress in car accident showed more neck pain 4 weeks post injury

Neurodystrophic hypothesis

Neural dysfunction/abnormal innervation leads to lowered tissue resistance

3 steps of Selye’s General Adaptation Syndrome

Alarm reaction Stage of resistance Stage of exhaustion

Alarm reaction

Body is modified to defend against stressor

Stage of resistance

Arousal remains high as body tries to defend against and adapt to stressor

Stage of exhaustion

Resources very limited; ability to resist may collapse

Inflammatory and vascular components of the VSC

Vascular congestion Ischemia Inflamm

Localized venous stasis may lead to local

Ischemia Inflamm Joint stiffness

Pain that accompanies inflamm initiates local

Reflex muscle contraction

Persistent inflamm and pain lower pain thresholds which gives rise to

Allodynia Hyperalgesia Sensitization of CNS

Some degree of ____ should be suspected when patient’s pain is constant

Joint or soft tissue inflamm

_______ are needed to see subluxation in all its living forms

Several theories

Homeostasis enables body to stay alive in an

Ever-changing environment

The nervous system is the

Prime controller of homeostasis

Faulty MSK relationships can cause

Dysfunction in nervous system

Chiro hypothesizes that ____ aberrations in complex spinal structures lead to ______

Biomechanical; loss of NS integrity and health elsewhere in body

Most commonly applied chiro therapy

Adjustments

What is the key distinguishing feature of chiro

Adjustments

When treating subluxation which direction is the thrust delivered

Direction of reduced motion

Do bones subluxate?

NO — articulations subluxate

Motion unit is a 3 joint complex

IVD w/ 2 adjacent vertebrae = anterior joint 2 zygaphphyseal joints = posterior joint

Acute subluxation presents w/

Hyperactivity/irritability Motor excitation Sympathetic excitation Sensory excitation

Chronic subluxation presents w/

Hypoactivity/compression Motor depression Sympathetic depression Sensory depression

Motor excitation produces

Hypertonicity | Spasm

Sympathetic excitation produces

Warmth

Sensory excitation produces

Pain | Hyperesthesia

Motor depression produces

Hypotonicity | Weakness

Sympathetic depression produces

Coolness | Trophic changes

Sensory depression produces

Anesthesia

Active ROM

Patient able to accomplish on their own

Passive ROM

Requires external assistance

Zone of physiological movement

Active + passive ROM

Normal physiologic barrier

Point to which patient can actively move any joint

Normal anatomic barrier

Point to which joint can be moved passively beyond physiological barrier

Elastic barrier

Normal barrier to motion when all tension is taken up

Joint play resides in which zone

Paraphysiological zone of movement

HVLA adjustment is delivered at end of

Paraphysiologic movement