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Subluxation -- Hagen > Midterm- Sublux > Flashcards

Midterm- Sublux Flashcards

1
Q

What does VSC stand for?

A

Vertebral Subluxation Complex

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2
Q

What is the Vertebral Subluxation Complex?

A
  • model of spinal dysfunction
  • organizes thoughts in structured manner
  • provides a common language for chiropractors to discuses various approaches to patient care
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3
Q

What are the 7 components to the VSC?

A
  1. Kinesiopathology
  2. Neuropathology
  3. Myopathology
  4. Histopathology
  5. Pathoanatomy
  6. Pathophysiology
  7. Pathobiochemistry
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4
Q

Which component of the VSC deals with position and motion?

A

Kinesiopathology

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5
Q

What component of the VSC does static palpation and posture fall under?

A

Kinesiopathology observed

(so does history, ROM, motion palpation, and imaging)

myopathology also has palpation and posture

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6
Q

Which component of the VSC does reflexes, altered sensation, and pain fall under?

A

Neuropathology

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7
Q

Which component of the VSC does edema and inflammation fall under?

A

Histopathology

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8
Q

Which component of the VSC does tone, weakness, and atrophy fall under?

A

Myopathology

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9
Q

Which component of the VSC does disruption of normal physiology fall under?

A

Pathophysiology

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10
Q

Which component of the VSC does Nature of Disease: causes, processess, development, and consequences fall under?

A

Pathoanatomy

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11
Q

Which component of the VSC does disruption of Normal biochemistry fall under?

A

Pathobiochemistry

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12
Q

What will pain and instrumentation be for a VSC?

A

neuropathology observed

history, deep tendon reflexes, sensory and motor exam, imaging, nerve conduction velocity

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13
Q

Which part of the VSC does palpation, posture, and a motor exam fall under?

A

myopathology observed

also history, electromyography

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14
Q

Which component of the VSC is “Dis-ease at the tissue level”?

A

Histopathology

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15
Q

Which component of the VSC would an inflammation response fall under? What are key features of this?

A

Histopathology

  • Redness (Rubor)
  • Swelling (Tumor)
  • Heat (Calor)
  • Pain (Dolor)
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16
Q

Which part of the VSC would visualization and palpation be used for?

A

Histopathology observed

also history, imaging, and blood chemistry

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17
Q

What is the P.A.R.T. System?

A

developed by Centers for Medicare and Medicaid Services

Physical exam requirements to demonstrate/document medical necessity

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18
Q

What do the different components of the P.A.R.T. System stand for?

A 
P = pain and tenderness
A = asymmetry or misalignment
R = ROM abnormality
T = tissue tone changes
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19
Q

How many components of the PART system is needed? What must one of them be?

A

2 of the 4 PART components needed

1 must be A-symmetry or R-OM

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20
Q

What is the P component of the PART system, and how is it described?

A

Pain or tenderness

location, quality, and intensity

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21
Q

What is the A component of the PART system? How may it be described?

A

Asymmetry or misalignment

regional and/or segmental level

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22
Q

T/F. Diagnostic imaging (x-ray) may be utilized for the A component of the PART system.

A

True

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23
Q

Describe what would be used for the Regional and Local subcategories of the A component of the PART system.

A

Regional – posture/scoliosis screening

Local – static palpation

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24
Q

T/F. Abnormal ROM may be segmental or regional.

A

True

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25
Q

What could be used to assist with the R component of the PART system?

A
  • hypermobility/ hypomobility
  • instrument assisted documentation
  • diagnostic imaging
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26
Q

What would describing changes in tone of soft tissue such as muscles, tendons, fascia, skin, and ligaments fall under for the PART system?

A

T- Tissue tone

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27
Q

For the T component of the PART system, describe what falls under that category.

A
  • spasms
  • inflammation
  • hypertonicity
  • hypotonicity
  • heat-measuring instruments
  • leg length discrepancy
28
Q

What components of the PART system does Kinesiopathology from the VSC fall under?

A

A - Asymmetry or misalignment

R- ROM

29
Q

What components of the PART system does Neuropathology from the VSC fall under?

A

P- Pain or Tenderness
A - Asymmetry or misalignment
T- Tissue tone

30
Q

What components of the PART system does Myopatholgy from the VSC fall under?

A

P - Pain or Tenderness
A- Asymmetry or misalignment
T- Tissue tone

31
Q

What components of the PART system does Histopathology from the VSC fall under?

A

P- Pain or Tenderness
A- Asymmetry or misalignment
T- Tissue tone

32
Q

What is Posture analysis?

A

a systemic way to describe/document a patient’s structural presentation

33
Q

During posture analysis the document findings are from who’s perspective?

A

patients

34
Q

What is the List - Global?

A

describes patient’s overall tendency to favor the right or left side

35
Q

What describes a patient’s regional tendency to break from vertical?

A

Tilt/lean - regional

36
Q

What is all included in the Anterior view of postural analysis?

A
  • Global List (sternum-baseline)
  • Heat Tilt (glabella-nose-chin)
  • Thoracic Tilt (AC joints)
37
Q

What is all included in the Lateral view of posture analysis?

A
  • Global List (AC-baseline)
  • Head carriage (EAM-AC)
  • Thoracic kyphosis (back-check prominence)-(hypo,hyper, WNL)
  • lumbar lordosis (hypo,hyper, WNL)
38
Q

What is all included in the Posterior View of posture analysis?

A
  • Head rotation (facial prominence)
  • Head translation (EOP-VP)
  • Lateral curvature (scapular prominence, skin fold, palpate spine)
  • Scapular Tilt (inf. angle)
  • Pelvic tilt (crest or PSIS)
  • Pelvic rotation (Gluteal prominence)
39
Q

What can we use to look at leg length on a prone leg check?

A

(need “good shoes” on)

  • can use medial malleolus
  • visualize like points in areas that don’t wear
40
Q

How does one perform a prone leg check?

A
  1. Place thumbs on bottom of shoe and fingers up lateral portion of ankle
  2. Take inversion/eversion out
  3. apply headward pressure to “seat” shoe to foot
  4. axially load leg and don’t introduce any plantar/dorsiflexion
  5. visualize area of shoe that is equally comparable
41
Q

What component of the PART system does instrumentation fill?

A

“T” - Tissue tone

42
Q

T/F. The use of instrumentation tells us where to adjust.

A

FALSE!!! Tells us when to adjust, NOT WHERE! Need to do further evaluation for the where

43
Q

When was the first Neurocalometer (NCM) introduced?

A

1924 by BJ Palmer

44
Q

Who developed the “Pattern System” of analysis and when?

A

BJ Palmer and Lyle Sherman D.C. in 1930’s

45
Q

Who developed the “Break System” of analysis and when?

A

Clarence Gonstead D.C. in 1950’s

46
Q

What does instrumentation help us measure?

A
  • thermoregulation
  • minute heat diff along spine
  • vasoconstriction and vasodilation as indicator of neurlogic dysfunction
  • dermal thermic asymmetry
47
Q

Temperature changes causes CNS to message what structure?

A

hypothalamus

48
Q

In order to cool down what does the body do?

A

sweat, vasodilation (SNS)

49
Q

In order to warm up, what does the body do?

A

vasoconstriction (SNS), thermogenesis (Mechanical-shivering)(hormonal-metabolism)

50
Q

Are warm receptors myelinated or unmyelinated? What about cold receptors?

A

warm receptors = unmyelinated

cold recepors = myelinated

51
Q

T/F. Skin temperatures fluctuate, but are symmetrical paraspinally in healthy partients

A

True

52
Q

What will vertebral subluxations produce when it comes to skin temperatures?

A

will produce asymmetrical presentations and/or patterns

53
Q

Epinephrine is released to do what to blood vessels?

What causes blood vessels to dilate?

A

constrict

absence of epinephrine

54
Q

If we nerve block a specific nerve (taking control away) what would we expect the areas that it is supplying to do temperature wise? Why?

A

get warmer–> b/c in presence of SNS (release Epi), the blood vessels constrict; therefore in ABSENCE of SNS, there is NO Epi, and blood vessels will therefore be dilated and would increase warmth

55
Q

The nerve controls blood flow, and the instruments are measuring that blood flow has been effected, what is our job then?

A

to ID what is being effected and how that blood flow has changed

56
Q

On the patients encounter, when would Static Palpation come into play?

A

(step 4)

  1. history
  2. exam
  3. instrumentation
    * *4. static and motion palpation
  4. diagnosis imaging if warranted
  5. diagnosis and prognosis
  6. treatment
57
Q

What are the six Static Palpation Components?

A
  1. Skin (visualize, temp, sebaceous, sudoriferous)
  2. Edema
  3. Muscle tonicity (superficial)
  4. Muscle Tonicity (deep)
  5. Tissue prominence (Bone)
  6. Palpable Tenderness
58
Q

What part of Static Palpation is paraspinal palpation for increased tissue density from possible osseous misalignment fall under?

A

Tissue Prominence (bone)

59
Q

Side of tissue prominence has possible correlation to what?

A

side of posterior body rotation (always opposite of spinous rotation)

60
Q

For tissue prominence where are we palpating along the spine?

A

bilateral lamina, transverse, or mammillary processess

61
Q

For tissue prominence, in total how many parts do we end up pushing on?

A

4 (two per each segment)

62
Q

For palpable tenderness how many parts do we end up pushing on?

A

6 (3 per segment: lamina/TVP/mammillary and spinous)

63
Q

If one has palpable tenderness, then what?

A

have them rank it 0-10

always compare to other parts

64
Q

Palpable tenderness will always be _____ in nature.

A

Sclerotogenous = pain is pertaining to ligaments, tendons, discs, periosteum, and apophyseal joints

65
Q

What components of the VSC are we testing with Static Palpation?

A

Kinesiopathology (postion/motion) – tissue prominence
Neuropathology (pain) – palpable tenderness
Myopathology (tone)–Muscle Tonicity Superficial and Deep
Histopathology (edema/inflam.) – edema, temp, skin color)

66
Q

What components of the PART system does Static Palpation cover?

A

P-(pain) – palpable tenderness
A- (asymmetry)–tissue prominence
T-(tissue and tone) –edema, muscle tonicity (superficial and deep), skin changes…

Subluxation -- Hagen (4 decks)

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