Exam 3 Subluxation Part 3 Flashcards
T/F: Neural facilitation would respectively manifest as motor excitation, sympathetic vasomotor excitation, and sensory excitation.
True
T/F: Neural facilitation would exhibit as motor depression, sympathetic vasomotor depression, and sensory depression.
False; this is neural inhibition
T/F: When a joint becomes fixated, another joint typically has to compensate for the lack of motion. Therefore, a site of fixation/subluxation is often seen as asymptomatic.
true, meanwhile the compensating hypermobile joint is highly expressive
What are the 6 various stages of motion? Which stages make up the Zone of Physiological Movement?
Active ROM, Passive ROM, Joint Play, Normal Physiologic Barrier, Normal Anatomic Barrier, and Elastic Barrier;
Active and Passive ROMs make up the Zone of Physiological Movement
What stage of motion can be described as the point to which a patient may actively move any given joint?
Normal Physiologic Barrier
Which stage of motion can be described as the normal barrier to motion when all tension has been taken up within the joint and its surrounding tissues?
Elastic Barrier
T/F: Passive ROM can be described as what the patient is able to accomplish on their own.
False; this true of active ROM, Passive requires external assistance
What stage of motion is small but precise accessory movement within synovial joints independent of voluntary muscle movements.
Joint Play
What is the term for the point to which a joint may be passively moved beyond the physiological barrier?
Normal Anatomic Barrier
Where does the zone of Joint Play reside?
Paraphysiological Zone of Movement
Where is the HVLA chiropractic adjustment delivered?
At the end of the paraphysiologic space
When a HVLA thrust is applied and the articular surfaces separate overcoming an elastic barrier of resistance, what is the audible release called that is often heard?
cavitation
T/F: Cavitation is indicative of a successful adjustment.
False, cavitation merely suggests that the ROM of a joint has been extended into the paraphysiological space
T/F: The paraphysiological range of motion is within the limit of anatomical integrity created by capsular ligaments.
True, hence adjustments don’t tear ligaments
T/F: Sprains occur in the paraphysiologic range.
False; sprains occur beyond the paraphysiologic range
Historically, what is the major reason chiropractors are consulted?
treatment of NMS dysfunction and disease
T/F: Extending the length of immobilization has not been shown to slow the healing process.
False; excessive immobilization can retard and impair the healing process
T/F: The specific mechanism by which adjustments effect a reduction in symptoms has not been determined.
True
T/F: While the last decade has seen a significant increase in the evaluation and measurement of the forces produced in the application of HVLA adjustments, information regarding the effects of adjustive forces on biologic tissue is still limited.
True
What two periods characterize a manual HVLA adjustment?
a prethrust (preload) period and a thrust period
T/F: The forces delivered during an adjustment have been measured and correspond to approximately 1/3-2/3 of the treating doctor’s body weight.
True
When measured, the adjustive forces delivered were the lowest in which region of the spine?
cervical spine
Adjustive pretension and peak forces may vary between doctors, but cetain characteristics of HVLA adjustments stand out.
See slide 59 for specifics
T/F: Among experienced/trained chiropractors, there is a consistent small drop in preload force befroe the impulse is delivered.
True
T/F: Even trained/experienced chiropractors do not have the ability to consistently and significantly modify the prethrust tension, peak velocity, and/or duration of their adjustive thrusts.
False; they have been recorded doing just that
T/F: Research has not yet confirmed that spinal segments move during adjustive thrusts.
False; it has however the location and directions of movement may not fully match our clinical assumptions
Spinal movements have been documented on fresh-frozen cadavers following HVLA adjustments. Where is the significant movement localized to?
the contacted segment and motion segments above and below
What type of imaging did Cramer and co-workers use to study the effect of side posture positioning and thrust on Z-joint movement and gapping in the lumbar spine?
MRI
During Cramer’s study, lumbar side posture spinal positioning demonstrated increased separation (gapping) of which joints?
Z-joints
What is the term for “the formation of vapor and gas bubbles within fluid through local reduction of pressure” where the pressure inside the liquid drops below the vapor pressure, bubble formation and collapse occur, and a cracking sound is heard?
cavitation
T/F: At the point of joint cavitation, there is a sudden decrease in joint separation without a proportional increase in the applied load.
False; there is a sudden INCREASE in joint separation
After a joint cavitates, there is an inability to produce another cavitation of the same joint for approximately 20 minutes. What is this 20 minute period called?
the refractory period
T/F: The bubbles formed within the MP joint cavitation consist of water vapor and blood gases and have been measured at 80% nitrogen.
False; 80% carbon dioxide
T/F: Any procedure that produces joint separation has the potential to cause the cracking sound.
True
Where does the cracking sound occur?
paraphysiologic space
What is the most likely reason when an adjustment does not produce cavitation (assuming the adjustment was performed properly)?
the joint capsule is very tight, not allowing for sufficient joint separation to produce cavitation
One theory of cavitation states that the newly formed bubbles within the joint rush from the higher-pressure periphery to the relative low-pressure pocket generated in the center of the distracted joint. What causes the audible cracking sound in this theory?
collapse of the bubbles (postcavitation phenomenon)
One theory of cavitation offers an explanation for why some individuals with very tight or loose joint capsules do not “crack.” According to this theory, the cracking sound come when the capsular ligaments snap away from what?
away from the synovial fluid
T/F: Cavitation is associated with an increase in passive ROM, temporarily increased joint space, a ~20 minute refractory period, and an increased joint separation.
True
T/F: While cavitation is not commonly used by chiropractors as evidence of a successfully delivered adjustment, the process of cavitation is therapeutic in and of itself.
False; While cavitation is commonly used as evidence for success, cavitation is NOT assumed to be therapeutic in and of itself
