Midterm Exam Flashcards by Corey Allen

What are the components to the vertebral subluxation complex?

Kinesiopathology, myopathology, neuropathology, histopathology, and pathophysiology

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How would you evaluate for kinesiopathology?

History, Static/motion palpation, ROM, Posture, and Imaging (radiology/MRI/CT)

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How would you evaluate for myopathology?

History, palpation, motor exam, posture and specialized studies (EMG)

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How would you evaluate for neuropathology?

HIstory, instrumentation, DTRs, sensory/motor exam, and specialized studies (imaging/NCV)

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How would you evaluate for histopathology?

History, palpation, imaging and blood chemistry

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What is the function of the PART system?

To validate the necessity of chiropractic care and to document this necessity

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How does the PART system validate chiropractic?

X-rays used to document subluxation

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What does PART stand for?

Pain and tenderness
Asymmetry or misalignment
Range of motion abnormality
Tissue/tone changes

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Which part(s) of the VSC is associated with asymmetry and range of motion abnormality?

Kinesiopathology

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Pain/tenderness, asymmetry/misalignment and tissue tone changes are grouped together in what part(s) of the VSC?

Neuropathology, Histopathology, and Myopathology

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Postural analysis is categorized as which part of the VSC?

Kinesiopathology

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The term used to describe the measurement of the human individual.

Anthropometrics

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Which reference point(s) is/are used in an anterior view of a patient to determine a listing.

Sternum and baseline

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Which reference point(s) is/are used to determine head tilt?

Glabella, nose and chin

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What is the difference between a list and a lean?

A list is the patient’s overall tendency to favor the right or left. A lean is a patient’s regional tendencies to break from an established baseline vertical.

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Which reference point(s) is/are used to determine thoracic tilt?

AC joints

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To determine a global list from a lateral view, which reference point(s) is/are used?

AC joint to baseline

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Which reference point(s) is/are used to determine head carriage?

EAM and AC joint

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What can cause thoracic kyphosis?

Trauma, degenerative diseases/fractures, endocrine diseases, CT disorders, infection, MD, polio, spina bifida and tumors

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What are symptoms of thoracic kyphosis?

Difficulty breathing (severe cases), fatigue, mild back pain, round back appearance and tenderness/stiffness in the spine

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Which reference point(s) is/are used to determine thoracic rotation?

Chest-back prominence

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Lumbar lordosis can be caused by:

Chronic poor posture, injury, Ricketts, abdominal visceral adiposity, pregnancy and degenerative disease

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Which reference point(s) is/are used to determine head rotation?

Facial prominence (jaw or cheek)

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Which reference point(s) is/are used to determine head translation?

EOP and VP

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Which reference point(s) is/are used to determine a global list in a posterior view?

VP to baseline

Scoliosis is caused by:

Vertebral malformation or fused ribs (congenital), poor muscle tone or paralysis due to disease (neuromuscular), Idiopathic (adolescents MC)

Scoliosis is most common in which gender?

Females

Symptoms of scoliosis.

Difficulty breathing, fatigue, mild back pain, altered curvatures, tenderness/stiffness in spine and compromised visceral function

What reading on a scoliometer would be observed in order to refer the patient to a scoliosis center for evaluation?

Scoliometer reading of 5 degrees or more

Which reference point(s) is/are used to determine scoliosis in a posterior view?

Scapular inferior angles

Which reference point(s) is/are used to determine pelvic tilt?

Iliac crests and PSIS's

Which reference point(s) is/are used to determine pelvic rotation?

Gluteal prominence

What is the most consistent way to do prone leg checks?

Hydraulic HyLo table

When conducting a prone leg check, you should visualize for asymmetry in:

Inversion/eversion, foot flare and plantar flexion/dorsiflexion

Which action should be avoided when doing a prone leg check?

Torsion of the tibia/femur

What is the purpose of static palpation?

To facilitate the analysis of soft or bony tissue structures within the body

Which part(s) of the VSC are utilized when conducting static palpation?

Kinesiopathology (position/motion), myopathology (tonicity changes), histopathology (cytological/inflammation/edema) and neuropathology (moisture changes on skin/sclerotogenous pain provocation)

Static palpation is insightful about which components of the PART system?

PAT

Active light touch detects:

Sudoriferous changes, turgidity changes and surface tonicity

Deep touch detects:

Tissue prominency, palpatory tenderness and deep tonicity changes

A secretory function of the integument involves:

The release of a blood plasma metabolite called sweat

Oily, greasy, slippery, sweaty, clammy or tacky texture can indicate:

Acute VSC

Dry, scaly, flaky or rough skin can indicate:

Chronic VSC

When testing for palpatory tenderness, pressure is firmly applied from:

I-S and P-A direction on the spinous processes

Aside from spinous processes, pressure can also be applied to:

Transverse processes, zygapophyseal joints, costal articulations and mamillary processes

Pain arising in muscle bellies and musculotendinous junctions is called _____ pain.

Myotogenous

When detecting deep tonicity changes, the primary consideration is _____, while the secondary consideration is _____.

Tonicity change; pain

Instrumentation is used to satisfy which component of the PART system of insurance coding?

T or tissue tone

The neurologic pathway enters the cord as an afferent/efferent sensory/motor input.

Afferent sensory input

True/False: Warmth receptors are myelinated, while cold receptors and unmyelinated.

FALSE, Warmth receptors are UNmyelinated, while cold receptors ARE myelinated

The neurologic pathway synapses where?

The dorsal horn at the Tract of Lissauer

The Tract of Lissauer sorts between:

Pain and temperature

After the Tract of Lissauer, the neurologic pathway synapses:

From the gray matter to white matter to become the lateral spinothalamic tract

The lateral spinothalamic tracts ascends/descends into the brain and terminates at the:

Ascends; terminates at the ventral posterolateral nucleus of the thalamus

The thalamus synapses to which Brodmann areas?

1, 2 and 3

The anterior portion of the insular cortex regulates:

Viscero-autonomic function

The insula forwards the neurologic message to the:

Hypothalamus (Anterior hypothalamic nucleus)

The anterior hypothalamic nucleus becomes a _____, which passes through the brainstem.

Descending autonomic tract

The DAT carries what type of fibers?

Preganglionic sympathetic

Preganglionic sympathetic fibers from the DAT will synapse with the:

Sympathetic paravertebral ganglionic chain

What are the three synapse outcomes of the PSF?

Ascend to higher cord level, descend to lower cord level, stay at the same cord level (staying is most likely outcome)

Which neurotransmitter is released by PSF to stimulate nicotinic postganglionic fibers?

Acetylcholine

When Ach is released and NPGF is stimulated, what is transmitted?

Epinephrine

The postganglionic fibers stimulated by Ach will terminate at the:

Tunica media

The SNS is present at what cord levels?

T1-L3

Which parts of the VSC is the Tytron C-3000 most insightful about?

Neuropathology (dermal thermoregulation) and histopathology (inflamm'n/edema)

Which components of the PART system is the Tytron C-3000 most insightful about?

Tissue/tone changes

True/false: Tytron scanner barrels and the rollers come in contact with the patient's skin.

FALSE, only the rollers touch the patient

A Tytron scan commences at _____ and terminates at _____.

S2; the base of the occiput

Which barrel of the Tytron is used for a fossa reading?

Right barrel

A fossa reading of more than 0.5 degrees C is considered:

Abnormal, not WNL

A fossa reading of 0.5 degrees C or lower is considered:

WNL

A nervoscope is used primarily for:

Segmental "break" analysis

What is the difference between a "swing" and a "break?"

A swing will be observed as a gradual sweeping deflection of the needle over multiple segments. A break will be observed as a rapid, reproducible deflection of the needle over a neurological field (dermatome) as part of dysfunction physiology (usually one segment).

A nervoscope scan begins at _____ and terminates at _____.

Occiput; S2

The patient is seated _____ for a cervical instrumentation, while they are seated _____ for thoraco-lumbar instrumentation.

With the back of the stool; Slightly forward

1 segment/second is indicative of what scan?

Tytron

3 segments/second is indicative of what scan?

Nervoscope- cervical scan

2 segments/second is indicative of what scan?

Nervoscope- thoraco-lumbar scan

When conducting a cervical spine glide with the nervoscope, the barrels should be pointed:

Parallel or slightly inwards

When conducting a thoraco-lumbar spine glide with the nervoscope, the barrels should be pointed:

Parallel or wide open

A cervical spine glide commences at _____ and terminates _____.

T1; 1/2" onto the occiput

Confirmed breaks in a cervical spine glide are marked:

1/4" below mid thermocouple well outside the glide path

A thoraco-lumbar spine glide commences at _____ and terminates at _____.

C7; S2 (between PSIS's)

Confirmed breaks in a thoraco-lumbar spine glide are marked:

1/2" above mid thermocouple well outside the glide path

The general break location of Occ/C1 is:

Suboccipital- between the two segments

The general break location of T10-T12 is:

At its own spinous level

The general break location of C2-T3 is:

Interspinous space below

The general break location of T4 is:

At its own spinous level

The general break location of L1-L5 is:

Lower 25% of involved segment

The general break location of T5-T9 is:

Interspinous space below

What is the proper way to record positive instrumentation findings?

Segment level involved/Direction/Amplitude (increments of deflection) Eg: T5/R/4 C2/L/3

The X-axis involves what motion?

Flexion/extension

The Y-axis involves what motion?

Rotation

The Z-axis involves what motion?

Lateral bend

Which chiropractic principle explains that every cause has an effect and vice versa?

Which principle explains that we should live life to its potential?

Which principle describes innate intelligence as homeostatic?

Which principle says that every living thing has innate intelligence?

Which principle describes limitations and their importance?

Which principle describes the cause of dis-ease, the failure to adapt and transmission of Innate?

Which principle discusses the cause or effect of subluxations/adjusting and describes the 3 T's?