Final Exam Flashcards
The only line on pelvic line analysis that is not parallel to the femur head line is the ___ ___ __.
Horizontal Plane Line
When measuring height of pelvis, the taller side is the PI or AS?
PI by the difference between sides
What line on a lateral cervical view runs from the tip to the base of the odontoid process?
Odontoid Line
The odontoid plane line runs perpendicular to which line?
Odontoid line
If the foramen magnum line is diverging posteriorly from the atlas plane line, the occiput is __.
PS
T/F: In an ideal neck curve, all disc plane lines on lateral cervical view should converge to one point.
True
What are the 3 labeled lines on AP Open Mouth view of cervicals?
Transverse condylar line,
transverse atlas line
axis plane line
T/F: To determine occiput rotation, we must first determine atlas rotation.
True
T/F: On AP open mouth view, the wider lateral mass indicates a posteriority.
False: wider lateral mass=anterior
On lateral thoracic/lumbar view, we visualize for atypical ___ ___, stacking, and ___.
Atyp. Disc Wedging; Degeneration
What are the 2 subcategories of degeneration?
Degenerative Disc Disease, Degenerative Joint Disease
On AP Thoracic view, a larger pedicle shadow indicates the more ___ side.
Larger shadow=posterior
Why do we apply headward pressure when doing a leg check?
Removes any potential slack between foot and shoe.
When we conclude an atlas listing we are using what as the reference point?
Anterior tubercle of the atlas (which is why we say AI or AS)
On pelvic film, the wider ilium is rotated externally or internally?
Wider=internal
What should be removed first before running the nervoscope over the cervicals?
Necklaces, glasses, large earrings
What are the 3 steps of active light touch for static palpation?
Sudoriferous changes
Turgidity changes
Surface tonicity changes
What are the 3 steps of deep touch for static palpation?
Tissue prominency
Palpatory tenderness
Deep tonicity changes
T/F: Sunburns, blemishes, fever, and perspiration are all conditions that limit effectiveness of instrumentation readings.
True
____ is an infrared paraspinal thermal imaging system gathering information from the first 5mm of the epidermis.
TyTron C 3000
___ receptors are unmyelinated and ___ receptors are myelinated.
Warmth=unmyelinated
Cold=myelinated (think you need a coat when you’re cold)
Where does the first synapse occur in the neurologic pathway?
Dorsal horn at the Tract of Lissauer
T/F: The Tract of Lissauer sorts between pain and temperature information.
True
What 2 areas will the thalamus relay information to in the neurologic pathway?
BA 3, 1, 2
Insular Cortex/Insula/Isle of Reil
Where does the lateral spinothalamic tract terminate?
VPL (ventral posterolateral) Nucleus of the Thalamus
The anterior portion of the ___ ___ regulates viscera-autonomic function.
Insular cortex
Where is autonomic information forwarded after synapsing in the insula?
Anterior hypothalamic nucleus of the hypothalamus
Where will the preganglionic sympathetic fiber synapse?
Sympathetic paravertebral ganglionic chain
T/F: Once at the sympathetic paravertebral ganglionic chain, the most likely outcome for dermatomal thermoregulation is for it to stay at the same ganglionic level.
True
The pre-gang sympathetic fiber will utilize which neurotransmitter to stimulate the post-gang fiber?
Pre-gang=ACh
Post-gang=epinephrine
Where will the post-gang symp fiber terminate?
Tunica media to constrict the vasculature
T/F: The parasymp NS is the antagonist to the symp NS.
False: Symp has no antagonist, there’s no opposing regulation
From which cord levels do symp originate from?
T1-L3
The Palmer Gonstead System compares to the segment __, whereas the Palmer Upper Cervical Specific compares the ___ ___.
below; foramen magnum
The preferred segmental contact point is what?
The spinous process
PLI-M: What region of the spine is this referencing?
Lumbars
PRI-T: What region of the spine is this referencing?
Thoracics
If we cannot access the spinous in the cervicals, what anatomy do we contact?
Lamina
What is the difference between global wedging and segmental wedging?
Global involves multiple segments
Segmental is only involving one
Scoliosis involves what type of wedging?
Global or multisegmental
Is a curve noted with segmental wedging?
No
It is clinical practice to contact on the side of ___ if wedging is present.
Convexity
T/F: The nervoscope is primarily used for segmental “break” analysis.
True
How can a nervoscope be used for pattern analysis?
Must be connected to a recording unit (analagraph)
T/F: A heat swing is the gradual sweeping of the needle indicating normal physiologic function and is generally multisegmental.
True
A dysfunctional physiology will be refect on the nervoscope as a rapid, reproducible deflection called a ___.
Break
What is the ideal acclimation time before running a nervoscope exam?
10 minutes
T/F: Regarding nervoscope, patient is seated to the back of the chair for thoracolumbar, and seated slightly forward for cervicals.
False: cervicals–>back of chair
thoracolumbar–>slightly forward
How is your stance for a cervical nervoscope examination?
Scissored stance (45 degrees or less), knee on outside of chair
What is your stabilization hand doing in cervical nervoscope examination?
Hair sweep or forehead stabilization
What is your stabilization hand doing in thoracolumbar nervoscope examination?
Don’t have one…requires a two-handed grip on the nervoscope
The cervical glide begins on __ and will terminate 1/2” up onto the ___.
T1; occiput
What is your glide speed for a cervical nervoscope examination?
3s/segment–> 18-21s glide time ideally
Where do you mark cervical breaks?
1/4” below mid thermocouple and well outside of glide path
The thoracolumbar nervoscope examination begins at __ and terminates at ___.
C7; S2
T/L glide speed should be _s/segment.
2s/segment–> 35-38s glide time
Where do you mark thoracolumbar breaks?
1/2” above mid thermocouple well outside of glide path
A break is found between C3 and C4, whom does it belong to?
C3 because C2-T3 reflect into ISS below
Which segments reflect their breaks at their own spinous level?
T4, T10-T12
A break is found between T7 and T8, whom does it belong to?
T8 because T5-T9 relect into the ISS above
What is special about breaks found between L1-L5?
The general break location is the lower 25% of the involved segment.
X-rays are insightful about which components of the subluxation complex?
Kinesiopathology
Histopathology
X-rays are insightful about which components of the PART system?
A-asymmetry/misalignment
R-Range of motion
Who developed motion palpation?
Henri Gillet, Belgian chiropractor
T/F: Motion palpation is insightful about the kinesiopathology component of the subluxation complex.
True
T/F: Motion palpation is insightful about all 4 parts of the PART system.
False: Only P, A, R
If C6 was determined to be PRS, which motions would be diminished?
Decr PA extension
Decr R rotation (spinous does not move freely to the left)
Decr R lateral bend
If the spinous does not move laterally and superior to the right, it indicates a wedge on the __ side.
Left side
If T5 was determined to be PLI-T, which motions would be diminished?
Decr PA extension
Decr L rotation (spinous does not move freely to the right)
Decr R lateral bend
What are you feeling for upon lumbar P-A extension?
Assessing joint excursion, NOT for joint approximation
Your patient has ebola, you opt to not adjust and call an ambulance; which chiropractic principle justifies your actions?
24: Limitations of adaptation
Which chiropractic principle accounts for the inborn intelligence within everyone?
20: Innate intelligence
Tom’s a young, healthy individual that comes to you wanting to know why he still got the flu this year despite his rigorous concern for his health, which principle would you refer him to?
30: The Cause of Dis-ease (May be healthy outward but if innate is disrupted, dis-ease may ensue)
Which number chiropractic is dealing with causes and effects?
17
___ is an aberration in biomechanical spinal anatomy that compromises the functional integrity of the nervous system.
Subluxation
Who wrote the 33 Chiropractic Principles?
Ralph W. Stephenson, DC
What are the 4 T’s?
Thoughts, Traumas, Toxins, Threshold
What are the 5 parts of the vertebral subluxation complex?
Kinesiopathology Myopathology Neuropathology Histopathology Pathophysiology
What are the 4 parts of the PART system?
Pain/Tenderness
Asymmetry/Misalignment
Range of Motion Abnormality
Tissue/Tonal changes
Analyzing a patients gait would fall under which part of the PART system?
Asymmetry
Visualizing a spasm is under what part of the PART system?
Tissue/Tonal changes
T/F: Leg length checks are under the Tissue/Tonal changes, not the Range of Motion abnormality category of the PART system.
True
T/F: All four of the VSC (kinesio, myo, histo, neuro) correlate to Asymmetry of the PART system.
True
____pathology is the only one to include Range of Motion Abnormality from the PART system.
Kinesiopathology–>A, R
____ are a manifestation of the body’s failure to adapt to stimulus from a homeostatic perspective.
Symptoms
T/F: It is ok for one to visualize the bottom of the shoes during a leg check as long as you remove the slack.
False: too much variability in the wear of shoes–>unreliable results
If a person is wearing loose sandals for a leg check, what part of the anatomy do you visualize for comparison?
Medial malleolus
T/F: Be sure not to torsion the tibia/femur during a leg check as it can skew the results.
True
With which instrument do you scan from S2 until you “run into” the occiput?
Tytron C3000
A correct mastoid fossa reading starts with the right barrel in the __ fossa, and then the ___ barrel in the __ fossa.
right; right; left
A reading of ___ degrees C or greater is clinically significant for a mastoid fossa reading.
0.5 degrees C
Sudoriferous changes correlates to which component of the VSC?
Neuropathology
T/F: Turgidity changes are a result of myopathology
False: Turgidity-histopathology
Both surface tonicity and deep tonicity changes found during static palpation are a relation to which part of the VSC?
Myopathology
Tissue prominency, aka __ prominency is correlated to kinesiopathology b/c the bone is moved out of place.
bony
You suspect an elderly patient of having osteoporosis, is it reasonable to take X-rays?
Yes
A 3rd tri student needs X-rays for an upcoming Toggle class, is it rational to take X-rays?
No
Chiropractic X-rays are taken from - but analyzed -.
Taken A-P,
Analyzed P-A
What three things is a pathology based on?
- Postural distortions
- Palpatory findings
- X-rays
What parts of the PART system do X-ray satisfy?
Asymmetry
Range of Motion
T/F: X-ray satisfies the kinesio and histo components of the VSC.
True
Static palpation is insightful about which components of the PART system?
P,A,T
Innervation of the eccrine glands is through the SNS by ___ and ___ fibers.
cholinergic and adrenergic fibers
Oily, greasy skin texture is indicative of an __ VSC.
acute VSC
The patient indicates pain as you palpate over the spinous of T6, is this myotogenous or sclerotogenous pain?
Sclerotogenous
As you are performing deep tonicity palpation, the patient reports pain upon a ‘ropey’ area, is this myotogenous or sclerotogenous pain?
Myotogenous
A patient reports pain upon a patellar reflex test, is this myotogenous or sclerotogenous pain?
Sclerotogenous, b/c tendon insertions, ligaments, and discs also fall under “bony pain”
What is the difference between a list and a lean?
List is overall favoring
Lean is a regional favoring
For head tilt, what landmarks do you reference?
Glabella, nose, and chin
For which postural analysis subcategory do you reference the AC joints and the parallel grid line?
Thoracic tilt
What landmarks do you reference when judging head carriage?
EAM, AC joint, and parallel grid line
What’s the technical term for “rounded back appearance”?
Thoracic kyphosis
What’s the technical term for “swayback”?
Lumbar lordosis
What postural analysis subcategory uses the EOP, VP and a parallel line grid to assess?
Head translation
What is the most common type of scoliosis in adolescents?
Idiopathic scoliosis
You have a patient with muscular dystrophy; which type of scoliosis are they likely to have?
Neuromuscular scoliosis
___ scoliosis is due to vertebral malformation or fused ribs during development.
Congenital scoliosis
Scoliometer readings of __degrees or more have a high likelihood of Cobb angle greater than __degrees on X-ray.
5; 10
What are the 3 things you should address when doing posture analysis on someone?
- Remove shirt/Gown up
- Remove shoes
- “Going to be working in your personal space”
T/F: You shouldn’t use a nervoscope on moist/sweaty skin, but it’s ok to use a TyTron C3000 on moist skin.
False: moist skin creates scatter on TyTron; allow for acclimation
TyTron C3000 is insightful about what part of the VSC?
Neuropathology (maybe histopathology but not as significant)
T/F: The TyTron C3000 is insightful regarding Tissue/Tonal changes for the PART system.
True
T/F: Only the rollers of the TyTron should touch the skin; scanner barrels should never touch the skin.
True
What is the glide speed for running the TyTron C3000?
1s/segment, smooth and continuous
Why is a fossa reading necessary when doing a TyTron reading?
Hair traps heat and makes data unusable in upper cervicals
What is the gold standard for taking thermal readings with the TyTron C 3000?
3 scans over 24 hours (0hr, 12hr, 24hr)
What are the 3 general scan outcomes for the doctor to consider?
- Pattern (not adapting)
- Adaptive
- Stress (choppy; allow 15 min for patient to settle)
What are 4 things that can cause a stress scan?
Emotional stress
Physical stress/Pain
Drugs
Caffeine
You palpate and find bony prominence at T6. The patient reports pain upon tissue prominency examination at C4 and T6. You run the nervoscope and find heat swings at C4 and L5. What components of the VSC are present at what levels?
C4- Neuropathology from sclerotogenous pain
T6- Kinesiopathology from bony prominence
Neuropathology from sclerotogenous pain
Heat swings (not breaks) normal so no findings from that.
A patient comes in complaining of LBP; you palpate and find edema present at L4. You do feel some surface tonicity changes but can’t even make it through the deep tissue prominency portion b/c of the pain it elicits. There’s a break found at L4. What parts of the VSC are present?
Histopathology (edema) Myopathology (surface tonicity) Neuropathology from myotogenous pain Neuropathology from the break (Break reflects lower 25% of segment)
