FINAL Added Material Flashcards
Causes of acute low back pain
Myofascial
Discogenic
Vertebrogenic
Category III
Lumbar discogenic subluxation
The acute low back patient
Cat 3 flow
Blocking 10 minutes
SOTO
Lumbar traction procedures
Lumbar subluxation analysis - gluteal fibers and cervical palpation
Lumbar adjustment - side posture or orthopedic blocking
Basic III cranial
Category 3 blocking effectsq
Removes iliac rotation Relaxes low back muscles Passive antalgia 10 minutes Prone
The most important distinction in the differentiation of sciatic neuritis due to piriformis is
Lack of a true neurological deficit
Sacroiliac joint dysfunction with associated piriformis syndrome mimicking IVD syndrome
Disc surgery failed to give results
Chiropractic care worked. Pain free within 10 visits
SOTO better
Piriformis or hip jiont
SOTO worse/no change
Disc or subluxation
Traction is used before the
Manual adjustment
Most cat 3 patients are SB
+
Muscular compensation is automatic and neurologically controlled in the presence of
Pelvic or lumbar subluxation
Cervical and cranial musculature automatically compensates for
Pelvic and lumbar dysfunction, thereby protecting the functional integrity of the visual and vestibular reflexes
Relating especially or wholly to the psinal cord; specifically denoting those nerve cells and their fibers that connect the different segments of the spinal cord with each other
Propriospinal
R+C factors relate to
How sensitivity at the cervical vertebrae may relate to position of lumbar vertebrae.
Sensitivity at the cervical TP related to
An anterior rotation relating to the ipsilateral lumbar vertebrae’s TP
Effect of cervical spinal adjustments on lumbar paraspinal tissue compliance
Evidence for facilitation or intersegmental tonic neck reflexes
Conference paper by Nansel, Cooperstein and Waldorf
Lower cervical adjusting has a definite effect on muscle tone of the lumbar spine
Tissue compliance was measured with a compliance meter
Orthopedic block placement
Lumbar vertebra rotation
Lumbar vertebra inferiority
With lateral cervical TP sensitiviity a pelvic block is placed with the patient prone under the contralateral pelvis (between ASIS and greater trochanter) and pressure is applied to the ipsilateral lumbar SP
Lumbar vertebra rotation
Right C2 TP sensitivity
Pressure to L4 SP from R to L
With lateral cervical SP sensitivity pelvic blocks are placed with the patient prone under the both ASIS (at 45 inferior thorugh ASIS) and pressure is applied to ipsilateral lumbar lamina/mammillary process
Lumbar vertebra inferiority
Right C2 lateral SP sensitivity
Pressure to L4 lamina/mammillary process from I to S as if to decompress and lift the vertebra
Gluteal fibers give you
Side and level of lumbar body rotation
Cervical palpation gives the dr.
The level and listing of the lumbar subluxation
Styloid pain indicates
List of L5
C1 TVP pain indicates
Spinous side of L5
When side posture might be dangerous
Discogenic pain syndrome indicators
No palpatory cervical pain in the presence of severe low back pain
Bilaterally symmetrical palpatory pain in the presence of severe low back pain
Atrophy of muscles of the lower extremities
Flaccidity of the leg on performance of SOTO
Other evidence of disc pathophysiology
Compensatory or primary change in cranial venous drainage, especially out of
Superior sagittal sinus
Cranial component of cat 3
Resulting hypersensitivity of the homonculus of the lumbar spine
Basic 3 cranial is used
At the end of the cat 3 visit
Reduces pressure in the superior sagittal sinus, thereby desensitizing the low back homonculus
Basic 3 cranial
Fingers on parietals 1 1/2” above the ear, separate sagittal suture as you lift parietals - don’t forget to avoid temporal bone
Basic 3 cranial
Category 1
Craniosacral dural dysfunction
The suboccipital muscles are connected to the upper cervical spinal dura mater via the myodural bridges. Recently it was suggested taht they might work as a pump to provide power for
CSF circulation
On the pulsatile nature of intracranial and spinal CSF circulation demonstrated by
MR imgaing
CSF circulation and associated intracranial dynamics
Radiologic investigation using MR imgaing and radionuclide cisternography
Temporal and spatial assessment of normal CSF fluid dynamics with
MR imaging
CSF mechanical pumping model created by
Marc Pick
Concept category 1
Normal dural function is essential to life and health
The 5 phenomena of the primary respiratory mechanism
Inherent motility of the brain and spinal cord
Rhythmic fluctuation of the CSF
Motion of dural membranes
The articular mobility of the bones of the cranium
The articular mobility of the sacrum between the ilia
Cat 1 flow
Basic 1 cranial Check heel tension and prone leg check Opposite sides = adjust atlas/ same side Block cat 1 prone (passive) S or # procedures Vasomotor adjustment Occipital fibers
Prepares the cranial vascular beds for blocking
Basic 1 cranial
Possibly relaxes teh trapezius and SCM muscles
Basic 1 cranial
Hold until pulsation is felt bilaterally and equally
Basic 1 cranial
Traction on the achilles tendon
Will be tight in the presence of dural stress due to decreased inhibition of the gastroc/soleus muscle group secondary to PMRF dysfunction
Heel tension
___ must be the side of greater heel tension. If not, atlas must be adjusted
Prone short leg
Category 1 blocking
Look for balancing of legs
Disappearance of heel tension
Category 1 blocking procedure
Prone 6 minutes Mobilizes SI boots (non-weight bearing part) Breathing provides the motive force Patient passive during block placement
Since the SI joint has two separate functions
Support - CAt 2
Motion - Cat 1
The most important part of category 1 procedure is
Mobilization of the synovial part of the SI joint
Dollar sign
Sacrum, CNS
Crest sign
Ilium
Proprioception
On a visit try to balance muscle ton ein. The ___ area
Crest OR dollar
NOT BOTH
Change tone on the ____ side first then change tone on the other side
Tighter
Never thrust into
A block
Dollar and sign corrections
Gluteal scoop
Ischial thrust
PSIS toggle and
Crest roll
Cough test
SB + or - etc
SB + blocking and ___ response
Vasomotor
The next step of cat 1
Don’t forget the visceral connection
Always look for occipital fibers which will tell you if there is visceral irritation/pathology
Learn CMRT, nutrition, diet, etc
De Jarnette meric chart
T1
Coronary arteries
De Jarnette meric chart
T2
Cardiac muscle
De Jarnette meric chart
T3
Lungs, respiration
De Jarnette meric chart
T4
Gallbladder
De Jarnette meric chart
T5
Stomach
De Jarnette meric chart
T6
Pancreas
De Jarnette meric chart
T7
Spleen
De Jarnette meric chart
T8
Liver
De Jarnette meric chart
T9
Adrenals
De Jarnette meric chart
T10
Small intestine
De Jarnette meric chart
T11-12
Kidneys
De Jarnette meric chart
L1
Iliocecal valve
De Jarnette meric chart
L2
Cecum
De Jarnette meric chart
L3
Reproductive glands
De Jarnette meric chart
L4
Colon
De Jarnette meric chart
L5
Prostate/uterus
Basic I cranial Adjust atlas if needed Block Dollar and crest Vasomotor subluxation adjustment Occipital fibers
Category 1
Foot, ankle, iliofemoral, psoas Sacral cup, anterior trap fibers C1 L5 UMS/LLL Blocking Basic II Long leg, short leg
Category II
Psoas Blocking for pain Cough test and traction Lumbar analysis Orthopedic blocking SOTO Posterior iliofemoral Sitting disc Basic III cranial
Category 3
