Exam 3: Quiz 4 Flashcards
Symptoms and dysfunction are caused by
Pinched nerves
Subluxation of a vertebrae is a
Slight deviation from its normal relation to adjacent vertebrae
The real, primary cause of disease is
Tension
Cause of tension is
Pressure
Cause of pressure in 95% of conditions is
Subluxated vertebrae
Cause in remaining 5% of conditions is
Luxation of other bones (other than vertebral column)
Spinal subluxations were hypothesized to
Induce NR compression as result of direct anatomic compression w/in IVF
NR dysfunction is hypothesized to induce dysfunction of
Somatic or visceral tissues
Prolonged compression was hypothesized to induce
Loss of function
Moderate compression was hypothesized to cause
Inc neural activity, pain, paresthesias, hypertonic muscles
Joint subluxations are extremely ____ to pinch NRs at margins of IVF
Unlikely
“Pinched nerve” notion is NOT
Chiropractic
Used by MDs
An impinged nerve has pressure on
One side only
Nerves may be impinged upon by any ___ but pinched only by
Displaced bone; fracture and extreme displacement
Impingement of a nerve
Increased tension by stretching
Spinal NRs at interpedicular region are more susceptible to
Pressure, inflamm and ischemia
____ w/in the interpedicular space are especially susceptible to compressive force
DRGs
Injured dorsal NRs respond more vigorously to
Mechanical deformation
It (is/is not) necessary for spinal NRs to be directly compressed to develop pathologic dysfunction
Is NOT
Other kinds of mechanical stresses can affect nerve tissue because
Arteries, veins, lymphatics, fat, CT also occupy IVF
density of ____ in DRG cells is relatively high, these regions are unusually excitable
Sodium ion channels
DRs and DRG are more susceptible to effects of
Mechanical compression
Joint malposition contributing to dysfunction more likely to occur by
Narrowing more vulnerable interpedicular zone
Subluxation has greater potential to affect NR function if
It is secondary to other disorders already narrowing lateral recess
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
