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DCCJP Final Prep > Part 2 DCCJP Final Exam > Flashcards

Part 2 DCCJP Final Exam Flashcards

1
Q

Richardson: “Arch and ring”

A

Chondrosarcoma

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2
Q

Richardson: “silent sinus”

A

Atelectasis of a sinus

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3
Q

Richardson: “Pain at night, relieved by aspirin”

A

Osteoid osteoma

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4
Q

Richardson: “Wormian bones”

A

Osteogenesis imperfecta

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5
Q

Richardson: “Brown tumor”

A

Something to do with either renal failure or kidney disease

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6
Q

Richardson: “Pseudosubluxation”

A

Swischuk line

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7
Q

Richardson: “Where CBCT falls short”

A

Poor contrast for soft tissue, cannot diagnose Chiari or any soft tissue condition

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8
Q

Distinguish suture and fractures on CBCT

A

Fractures: sharp edges, nonsclerotic borders, often CROSS sutures, increase in diameter as approaching a suture, may widen sutures

Sutures: join other sutures without crossing, do not widen other sutures, uniform in diameter, zigzag, sclerotic borders

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9
Q

Basilar Impressions…

A

Secondary basilar invagination acquired later in life. Rheumatoid Arthritis patients, Osteogenesis Imperfecta (due to frequent microfractures and sclerosis at skull base)

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10
Q

Primary hyperparathyroidism

A

Most common cause is parathyroid adenoma causing hypersecretion of parathyroid hormone; 3% have a brown tumor

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11
Q

Secondary hyperparathyroidism

A

Usually seen in end-stage renal failure; 1.5% have brown tumor. MORE COMMON than primary, so BROWN TUMORS ARE MORE ASSOCIATED WITH SECONDARY HYPERPARATHYROIDISM

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12
Q

Julie: Children develop adult movement by age…

A

Age 8-10

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13
Q

Julie: Fulcrum of the headpiece should be placed…

A

1/8” below the mastoid process

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14
Q

Julie: Motion is greatest in children at which segment?

A

C2/C3

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15
Q

Julie: “The curvatures of the vertebral column increase its resistance to axial compression forces. Loss of the optimum normal curvatures therefore…

A

Results in inability to dissipate normal vertical load and rotatory stress based on the above principles.”

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16
Q

DMX: Number of cervical ligaments that can be evaluated on DMX

A

22

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17
Q

DMX measures…

A

Ligamentous sub-failure

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18
Q

3Ps

A

Painful, progressive, permanent

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19
Q

Alar ligaments withstand up to…

A

200N

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20
Q

CCJ ligaments limiting flexion

A

Nuchal ligament
Tectorial membrane
Transverse Occipital Ligament

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21
Q

CCJ ligaments limiting extension

A

Tectorial membrane
Barkow’s ligament
Anterior atlanto-occcipital membrane

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22
Q

CCJ ligaments limiting rotation

A

Alar ligaments
Accessory atlantoaxial ligament
Transverse Occipital Ligament

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23
Q

CCJ ligaments limiting lateral bending

A

Alar ligaments
Lateral atlantoaxial ligament
Transverse Occipital Ligament

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24
Q

Coupled ________________ was opposite of axial rotation

A

Lateral bending

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25
Q

Left lateral bend creates what kind of coupled motion…

A

Right upper cervical rotation and left subaxial rotation

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26
Q

Right lateral bend creates what kind of coupled motion…

A

Left upper cervical rotation and right subaxial rotation

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27
Q

Developed neurocalometer

A

Dosa Evans

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28
Q

Secret sauce of knee chest

A

Step down method

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29
Q

Reviver of knee chest

A

Michael Kale

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30
Q

Internal component of the medullary lock

A

Dentate ligament

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31
Q

BJ started the knee chest technique by adjusting on which landmark?

A

Transverse process

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32
Q

Description of bone problem

A

stiff in the morning, gets better with movement

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33
Q

Description of muscle problem

A

Achy, spasm, and cramping

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34
Q

Ligament problem description

A

Painful joint motion never gets better

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35
Q

Nerve problem description

A

Burning, sharp, shooting, tingling and weak

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36
Q

Describe a problem that requires a referral

A

None of the symptoms make sense and/or you cannot reproduce the pain

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37
Q

In lower cross syndrome, what needs to be stretched?

A

Hips and quads

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38
Q

Which muscles of the rotator cuff is responsible for internal rotation?

A

Subscapularis

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39
Q

What levels are involved in the lumbar plexus?

A

T12-L4

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40
Q

Fracture vs suture

A

Suture doesn’t cross the suture line or widen them, sclerotic boarders

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41
Q

Stork tests…

A

Spondy or quadrant
Psoas muscle

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42
Q

How many AC joint injuries are there?

A

6

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43
Q

Painful arch

A

?

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44
Q

Drea study, CSF flow was measured at which levels?

A

C3, T2, T5

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45
Q

Epigenetic/Long term changes

A

Adaptation

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46
Q

Immediate response/change

A

Compensation

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47
Q

What is a transducer?

A

Device that transforms a non-electrical physical quality into an electrical one (like voltage or current)

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48
Q

CO2 sensors

A

Astrocytes

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49
Q

Tensor veil palatine innervation

A

CN V3, not CN 10

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50
Q

Drea study found…

A

CSF flows cephalad with exhalation and venous drainage increases

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51
Q

Glymphatic system is active in…

A

Stage 3 sleep (deep sleep, DELTA WAVE)

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52
Q

Apnea is…

A

The complete cessation of breathing for 10 seconds

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53
Q

What is the definition of occlusion?

A

The end point of the BODY in respect to the plantar surfaces of the FEET, and within these two boundaries, all functional spaces for physiological processes must accommodate

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54
Q

The sphenoid bone contains which structures?

A

All of the above: superior orbital fissure, foramen rotundum, foramen spinosum, and optic canal

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55
Q

Tongue deviation to the left represents which of the following?

A

CN XII weakness on the left

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56
Q

What is the name of specialized connective tissue with a high collagen content but no mineral content?

A

Cartilage

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57
Q

What is the approximate speed (velocity) of the Spinocerebellar pathways

A

100 meters/sec

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58
Q

What is the primary role of the thalamus?

A

Relay system for all sensory information

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59
Q

A Grabb-Oakes measurement of 10mm indicates possible ____?

A

Ventral brainstem compression

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60
Q

What term is used to describe a tortuous and enlarged vertebral artery abutting/compressing the brain stem?

A

Dolichoectasia

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61
Q

When determining the classification of misalignment, the only two orthogonal classification systems to consider head tilt and angular rotation are Orthospinology (alternate) and:

A

NUCCA

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62
Q

The Council on Chiropractic Guidelines – Clinical Compass is considered what type of database?

A

Pre-appraised source

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63
Q

Which of the following is a correct KVP and mA and time setting for a CBCT?

A

5-25 mA, 80-120 kVp, 5-9 seconds

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64
Q

The oxidative phosphorylation system (oxphos) is located where?

A

Inner mitochondrial membrane

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65
Q

Per the Blair radiographic analysis, what two angles are found on the Base Posterior film?

A

Left convergence and right convergence

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66
Q

Assessing for Arnold-Chiari malformations is not possible with CBCT at this time due to _____?

A

Low contrast resolution

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67
Q

Which alar ligament checks the side of rotation and lateral bending?

A

Right alar checks left rotation of C1 on C2

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68
Q

How many ligaments can Digital Motion X-ray identify in the cervical spine?

A

22

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69
Q

At what age would adult motion characteristics of the cervical spine be observed in children?

A

Eight to ten years old

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70
Q

Which statement is true regarding the Ishii et al. 2004 study of in vivo active head rotation?

a. Coupled lateral bending with axial rotation was observed in the opposite direction to that of axial rotation at Oc-C1 (mean, 4.1 +/- 1.4 deg) and C1-C2 (mean 3.8 +/- 3.0 deg)
b. Coupled extension with axial rotation occurred at C0-C1 (mean 13.3 +/- 4.9 deg) and C1-C2 (mean 6.9 +/- 3.0 deg) irrespective of the direction of head rotation
c. Axial rotation of C1-C2 (mean 36.3 deg) was not observed to be coupled with lateral bending at Oc-C1 during head rotation

A

a. Coupled lateral bending with axial rotation was observed in the opposite direction to that of axial rotation at Oc-C1 (mean, 4.1 +/- 1.4 deg) and C1-C2 (mean 3.8 +/- 3.0 deg)
b. Coupled extension with axial rotation occurred at C0-C1 (mean 13.3 +/- 4.9 deg) and C1-C2 (mean 6.9 +/- 3.0 deg) irrespective of the direction of head rotation

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71
Q

As atlas rotates on the axis, which of the following best describes the direction of movement on the vertical plane?

A

Inferior

72
Q

When listening to the patient describe their symptoms of “stiff in the morning and gets better with movement” is a key word for what type of problem?

A

Bone

73
Q

Which muscle is not a primary mandible depressor?

A

Posterior belly of the temporalis

74
Q

Colic and the rule of 3’s?

A

Unexplained uncontrollable crying in 0-3 month olds, more than 3 hrs per day, and more than 3 days per week for 3 weeks

75
Q

Colic best responder to chiropractic?

A

Chiropractic is the best responder to colic.

1989 chiropractic colic study, 316 babies were evaluated and adjusted, 94% improvement under avg. of 2 weeks of care and 3 adjustments.

There is no study currently that shows a medicine’s efficaciousness with colic.

76
Q

Passive sub-system

A

Vertebrae, disc, joints, and ligaments - the static stabilizers

77
Q

Active sub-system

A

Muscles, tendons surrounding spine - the applies forces to the spinal column

78
Q

Controlling sub-system

A

CNS (medulla, brainstem, pons, midbrain, spinal cord), PNS (spinal nerves, cranial nerves) - spinal monitoring and various transducer signals, directing the active sub-system to provide the needed

79
Q

What encompasses all three spinal subsystems (passive, active, and controlling)?

A

Fascia

80
Q

A dysfunction/injury of a component of any subsystem may result in:

A

Compensation - response
Adaptation - permanent change express
Injury

81
Q

Malocclusion

A

Solution for a complex adaptive system to remain in equilibrium

82
Q

Monroe-Kelli Doctrine

A

If either blood, CSF, or brain parenchyma increases, one of the others must decrease (compensate) to balance intracranial pressure.

83
Q

Dreha-Kulaczewski CSF conclusion

A

Respiration drives CSF into the brain primarily through forced inspiration

84
Q

Forced inspiration increases venous outflow from the skull and influx of CSF into the skull as…

A

Forced expiration reduces venous outflow and efflux of CSF from the skull

85
Q

Cephalad CSF flow and increased venous drainage during _________ sleep bestows brain parenchymal neuro-protection

A

Delta-wave

86
Q

Disrupted Sleep –> disrupted delta-wave respiration –>…

A

Disruptive CSF flow

87
Q

_______ corrects O2 desaturations in mild OSA

A

Bruxism

88
Q

Animals lacking the water channel _______________ in astrocytes exhibit slowed CSF influx through this system and a ~70% reduction in interstitial solute clearance, suggesting that the bulk fluid flow between these anatomical influx and efflux routes is supported by astrocytic water transport

A

Aquaporin-4 (AQP4)

89
Q

Growth hormone reaches peak during this stage of sleep

A

Stage 4

90
Q

Delta or slow wave sleep stage, also known as neuroprotective sleep…

A

Stage 3 and Stage 4

91
Q

Sleep Architecture

A

Non-REM: Stage 1, transitional phase (5%); Stage 2 Light sleep (50%); Stage 3 & 4, Delta Slow Wave Sleep (20%)

REM Sleep: The Dream Stage (20%)

92
Q

Astrocyte-CO2 sensitivity mechanism

A

With increased blood CO2, there will be increased H+ in tissue, lowering pH; resulting in peeing out the H+

93
Q

How does sleep position affect CSF?

A

The recumbent position increases the inflow of CSF

94
Q

Smallest voxel size

A
  1. or 0.3 micrometer
95
Q

Orthogonal FOV for CBCT

A

23x26cm

96
Q

Blair FOV for CBCT

A

13x15cm

97
Q

BP must be taken within _______ of central ray

A

1/8”

98
Q

On CN III test, catchup siccades are controlled by what?

A

Cerebellum & Pons

99
Q

Describe Prukinje system

A

Purkinje fibers lie on top of outer cerebellar covering sending “don’t do it” signal to inhibit deep cerebellar nuclei - 90% of what the brain does is inhibit and the cerebellum has more neurons than the cerebellum

100
Q

What does autophagy do for the brain?

A

Cleanses brain by removing metabolic waste and inflammation

101
Q

Duel tasking tests what region of the brain?

A

Frontal lobe

102
Q

Describe D1 and D2 pathways. Which indicate basal ganglia breakdown?

A

D1 - Makes movement, turns on brain, basal ganglia dysfunction is found here
D2 - Inhibits movement

103
Q

Caudate regulates ________ movement, and putamen regulates ____________ movement

A

Caudate… NONMOTOR
Putamen… MOTOR

104
Q

Early detectors of Parkinson’s…

A

Unresolved constipation (Parkinson’s starts in the gut)
Frozen shoulder without trauma
Progressive micrography (due to D1 breakdown

105
Q

The substantia nigra compacta is related to which of the following in early Parkinson’s?

A

D1 - Putamen

106
Q

Which cranial nerves feed into the ventral vagal system?

A

V, VII, IX, X

107
Q

BJ Palmer was the first to x-ray the spine, which he called a…

A

Spinography

108
Q

What is required for subluxation to manifest?

A

Time, subluxation unchecked will lead to unwinding dysfunction

109
Q

What is the 5th element to subluxation added by BJ Palmer?

A

3-directional torque misalignment
[The other 4: Misalignment, occlusion, pressure, interference]

110
Q

What is the medullary lock?

A

Innate mechanism that secures the medulla in center of both the foramen magnum and upper cervical neural canal

111
Q

Dysfunction of dural attachment or connective tissue bridges at certain locations can cause medullary lock. Give examples.

A

Foramen magnum
C1-C2 posterior arch
RCPm
RCPM
Ligamentum Flavum
OCm
Nuchal ligament
Vertebrodural ligament
To-be-named ligament

112
Q

Distinguish myelinated from nonmyelinated regions of the vagus nerve…

A

Unmyelinated - DORSAL part, origin DORSAL motor nucleus, regulates BELOW DIAPHRAGM

Myelinated - VENTRAL part, origin is nucleus AMBIGUUS, regulates ABOVE DIAPHRAGM (social engagement)

113
Q

Cranial nerves that feed into social engagement…

A

III, V, VII, IX, X, XII

114
Q

The ventral vagus system exerts modulatory control over…

A

The sympathetic nervous system

115
Q

The main contributor to SIDS (in context to polyvagal theory)…

A

Freeze response

116
Q

Dry mouth presentation… sympathetic or parasympathetic?

A

Parasympathetic

117
Q

What the sympathetic system uses for body circulation…

A

Norepinephrine

118
Q

Facial symmetry is regulated by…

A

CN VII

119
Q

Tongue deviation controlled by…

A

CN XII (deviates towards the weak side)

120
Q

Corneal reflex is controlled by…

A

CN V

121
Q

Set of muscles with the most spindles and reason…

A

Suboccipital muscles, stimulates the brain through “tummy time”

122
Q

Microglial cells are WBCs in the brain, which in activation, suggests big problem in the brain. If aluminum aggravates microglial cells, causing over reaction, which polyvagal stage is affected?

A

Pruning

123
Q

Left head tilt indicates a weak ______ cerebellum

A

Weak right cerebellum

“68% of people see a head tilt away from the weak cerebellum”

124
Q

During pregnancy, less of the SI locking mechanism…

A

The more weight bearing falls on the ligaments, leading to increased likelihood of SI strain after pregnancy

125
Q

Proposed brainstem epicenter for start of autism development

A

Dorsal vagal complex

126
Q

Neonate atlas discontinuous _____% of the time

A

80%

127
Q

Odontoid completely fuses with vertebral body at….

A

3 to 6 yoa

128
Q

Primary CCJ ligament stabilizers in development…

A

Tectorial membrane
Alar
Apical
Cruciate

129
Q

Towbin’s key symptom to diagnosing a birthing injury

A

Respiratory distress (latent spinal cord and brain stem injury)

130
Q

Chiropractic and ear infections

A

Frequent infections due to fluid not being drained, due to lymph drainage problem. Chiropractic addresses the lymph problem in the neck adjustment, removing tension, so the drainage can correct.

131
Q

________ determine biomechanical properties of CCJ, while _________ determine biomechanical properties of C1-C2

A

Bony structures… CCJ
Ligaments… C1-C2

132
Q

Ligament that prevents odontoid from impinging spinal canal

A

Tectorial membrane

133
Q

Ligament with high proprioceptive fiber count

A

Nuchal ligament

134
Q

Tensile strength of lateral atlanto-occipital ligament

A

37.5 N

135
Q

In rotation, occiput __________ relative to atlas

A

Occiput… rises

136
Q

In rotation, atlas moves ________ relative to axis

A

Atlas… inferior

137
Q

Coupled motion with left rotation

A

Right lateral bend and extension

138
Q

Coupled motion with right rotation

A

Left lateral bend and extension

139
Q

In ligamental sub-failure, bones and joints degenerate…

A

6 to 10 time faster

140
Q

5th element of subluxation

A

3d torque

141
Q

Needed for subluxation to manifest

A

Time

142
Q

Convexity of the C0-C1 joint determines the level of ____________ in a subluxation

A

Rotation

143
Q

The characteristic of the atlas misalignment is determined by the…

A

Track side condyle

144
Q

Six steps to knee chest adjustment:

A

Doctor/Patient position
Contact
Tissue Pull
Roll in
Step Down
Body Drop

145
Q

Primarily responsible for stabilizing the GH joint…

A

Supraspinatus

146
Q

Main external rotator in shoulder…

A

Infraspinatus

147
Q

Main internal rotator in shoulder…

A

Subscapularis

148
Q

Levels involved in the brachial plexus…

A

C5-T1

149
Q

Sacral Plexus levels

A

L4-Coo

150
Q

What to strengthen in lower cross syndrome…

A

Psoas
Core
Gluts
Hamstrings

151
Q

Stretching for upper cross syndrome…

A

Pec stretch
Thoracic mobility

152
Q

What to strengthen for upper cross syndrome…

A

Deep neck flexor
Mid and lower back
Subscapularis
Serratus Anterior

153
Q

Innervation for the tensor veli palatini

A

CN V3

154
Q

CN V3 innervates this muscle responsible for keeping the bolus out of the nasopharynx

A

Tensor Veli Palatini

155
Q

Mandible depressors are primarily innervated by CN V3, except for…

A

Mylohyoid (Cervical Plexus C1)

156
Q

Specialized cells in the brainstem that detect increase CO2 and will send a signal to make musculoskeletal, cardiorespiratory, and nervous system changes to accomodate

A

Astrocytes

157
Q

Pharyngeal space insufficiency may lead the body to…

A

Shift forward, forward head carriage, to open up space

158
Q

Main driver for CSF exiting the skull into the spinal cord

A

Cardiac systole

159
Q

Main driver for CSF moving into the skull

A

Respiration inhalation

160
Q

Disordered or obstructed sleep breathing interrupts normal respiratory tidal pressure gradients in the ____________ and leads to aberrant and disruptive CSF flow

A

Thoracic cavity

161
Q

Light controls the body clock by activating the…

A

Suprachiasmatic Nucleus

162
Q

Neuroprotective sleep occurs…

A

Delta wave sleep (Stage 3 & 4)

163
Q

Deep sleep can be totally absent by age…

A

40-60

164
Q

Stage of sleep where problem solving can occur during…

A

REM sleep

165
Q

Body paralysis and dream sleep can occur during…

A

REM sleep

166
Q

Pioneered CT scanner

A

Hounsfield

167
Q

The lower the voxel…

A

the better the resolution

168
Q

If requesting a CBCT, voxels between ________ is acceptable.

A

0.3 - 0.2 micrometers

(Note: if not on exam, pick the lowest)

169
Q

Initial neurotransmitter release following a blow to the head

A

Glutamate

170
Q

NMDA leads to calcium influx into the cell. What keeps thus receptor in check, which is often deficient in concussion??

A

Magnesium

171
Q

After the initial hypermetabolic state, a sub-acute hypometabolic state is unregulated through inflammation genes and ____________, which usually lasts 7 to 10 days, but may persist up to 30.

A

Cytokines

172
Q

Period of greatest metabolic imbalance following a concussion…

A

3 days post injury

173
Q

Astrocyte found in the white matter

A

Fibrous astrocyte

174
Q

Astrocyte found in the grey matter

A

Protoplasmic astrocyte

175
Q

Describe astrocytes function

A

Remove waste around neurons
Store emergency glycogen, can produce glucose, and lactate for cell respiration
Produce glutathione against oxidative stress
A part of the repair process, but cost is producing beta-amyloid proteins

176
Q

What balances an influx of Ca2+, meaning what controls in efflux of Ca2+?

A

Mitochondria

DCCJP Final Prep (9 decks)

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