Final Flashcards
PRS
P- segment has gone posterior
R- segment has gone to the right
S- segment has gone superiorly
PRI
P- segment has gone posterior
R- segment has gone to the right
I- segment has gone inferiorly
PLS
P- segment has gone posterior
L- segment has gone to the left
S- segment has gone superiorly
PLI
P- segment has gone posterior
L- segment has gone to the left
I- segment has gone inferiorly
PLI-L. What does the -L mean? Which part of the spine are we on?
the -L means that we need to adjust on the lamina of the segment because the spinous is NOT on the side of convexity. We are in the cervicals.
PRI-T. What does the -T mean? Which part of the spine are we on?
the -T means that we need to adjust on the trasverse process because the spinous is NOT on the side of convexity. We are in the throacics.
PLI-M. What does the -M mean? Which part of the spine are we on?
the -M means that we need to adjust on the mammilary body because the spinous is NOT on the side of convexity. We are in the lumbars.
PRS. What motion palpation would we do to test it?
P- P-A extension
R- right rotation
S- right lateral bend
PLI. What motion palpation would we do to test it?
P- P-A extension
L- left rotation
I- right lateral bend
spinography
used in technique to create a conscientious line of correction
biochemical analysis
study of chemical substances and vital processes occurring in living organisms
What are the benefits of X Ray?
it is very insightful show postural distortions show palpation findings help identify pathologies facilitates safer/consientious care qualifies and quantifies misalignments allows for more specific adjustments
What are the risks of X Ray?
radiation exposure static picture of dynamic spine limited sensitivity to pathologies exposure risk vs benefit financial start up costs maitenence portability
Who and how are X rays used?
It’s used in most techniques and are generally taken weight bearing
How are X rays typically taken?
A-P
How are X rays read?
P-A (functional view)
What must you consider when deciding to take an X Ray?
- Pain or neurologic symptoms?
- trauma to the spine?
- Does the patient plan on having surgery?
- follow up on surgery?
- looking for neoplastic lesions?
- looking for congenital anomalies?
- looking for previously detected anomaly?
- looking for alignment abnormalities?
- looking for infection?
- looking for degenerative disorders?
- looking for arthropathy?
- looking for spine instability?
- looking for osteoporosis?
Which parts of the VSC and PART system are X rays insightful about?
Kinesiopathology
Histopathology
A (asymmetry/misalignment)
R (range of motion, flexion/extension views)
How is X ray kinesiopathology?
shows the relative position of the vertebrae
can do flexion/extension views to see motion
What are the types of X rays you can take for cervicals?
A-P open mouth, P-A cervical, lateral cervical
Vertebral bodies
used to find endplate tips
superior/inferior endplate tips
to determine posteriority of segments
disc space
can show pathologies, avoid drawing lines here
occipital condyle
used w/ C1 line to determine listing for occiput
What do you draw a line along to make the C1 line?
anterior tubercle of C1 and posterior arch of C1
What do you draw a line along to make the odontoid line and odontoid perpendicular line?
tip and base of odontoid process, then draw a perpendicular line from that line
How do you draw the transverse condylar line?
occipital condyles and foramen magnum
How do you tell if a vertebrae is rotated?
Draw lines from laminar junction to uncinate process, shorter one is the side its rotated on
What can we determine from the inferior aspect of vertebral bodies?
tells us whether a vertebrae has laterally bent superiorly or inferiorly
In the thoracic view, where can you draw lines?
endplate tips and avoid disc spaces
On an A-P thoracic view, what parts can you see?
junction of laminae, pedicle shadows, vertebral waist, endplate tips
On a pelvic view, what lines can you draw?
femur head line
horizontal plane line
sacral center line
What other lines/dots do you draw on the pelvic view?
inferior aspect of ischial tuberosities
superior aspect of ilia
S2 tubercle
sacral lines
What findings can you see in a pelvic view?
IN/EX, P-L, P-R, PI/AS
What are the advantages of motion palpation?
it’s used in all chiropractic
not specific to a certain technique
good reliability if there is good protocol and experience
kinematic inforamtion
can be changed for different types of people
can be correlated with X ray findings
What are the disadvantages of motion palpation?
unreliable as an only tool
poor reliability with bad protocol and no experience
acute presentations interfere with outcomes
requires patient interaction with can take time
has become the “major indicator” for most practitioners
Which parts of the VSC and PART system go with motion palpation?
Kinesiopathology
P (pain and tenderness)
A (asymmetry/misalignment
R (ROM)
How does motion palpation work with kinesiopathology?
relative postition, global ROM, intersegmental fixation
What does the listing system require (from the doctor?)
proficiency in rotation, lateral bend and P-A extension of the cervicals, thoracics and lumbars
What is the listing system derived from? What does the listing system do?
spinographic analysis, qualifies misalignments found in X Rays and facilitates the adjustment w/ appropirate technique
What does the listing system require?
A frame of reference
What must happen after creating a listing system?
It must be reproducible and create understanding
When creating a listing system, you must consider…
anatomical variability, importance of re evaluation, proper positioning, which listing system you are using
What are the two types of listing systems?
Gonstead and Palmer Upper Cervical
What are the listing system components?
P, R/L, S/I
What is global wedging?
scoliosis, lateral wedging, curvature
Which side must you adjust on? Why? Where else can you adjust if the spinous isn’t on the correct side?
The side of convexity so you don’t exacerbate the convexity. If the spinous is on the side of concavity, we need to adjust on the lamina/transverse process/mamillary bodies (depending on where in the spine you are).
In the lateral view of an X ray, what are the listing systems you can find?
Occiput: AS/PS
C1: AS/AI
C2-7: P