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Sublux final > PART II > Flashcards

PART II Flashcards

1
Q

What is the purpose of static palpation?

A

facilitate the analysis of soft or bony tissue

structures within the body.

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2
Q

Define turgidity

A

Intrinsic pressure or resistance offered by a cell or tissue.

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3
Q

What is the direction which you apply pressure in the palpatory tenderness part of deep touch?

A

I-S, P-A on spinous followed by bilateral L-M pressure on spinous.

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4
Q

Define sclerotogenous

A

Pertaining to
ligament, tendon insertion on bone,
disc, periosteal, or zygapophyseal
structures.

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5
Q

On the nervoscope (for our purposes) what setting should the sensitivity switch be set to?

A

Low or medium

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6
Q

T/F

A swing is usually found at one segment

A

False, swings are usually multisegmental

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7
Q

How long does acclimation take?

A

10 minutes, ideally

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8
Q

What is the ideal glide time for scoping the cervicals?

A

18-21 seconds (3 sec/segment)

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9
Q

Where are confirmed breaks marked in the cervicals?

A

1/4” below mid thermocouple well outside of the glide path

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10
Q

Instrument pitch must always be in accordance with…

A

Disc plane line/skin surface

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11
Q

What is the glide speed for thoracolumbar scope?

A

35-38 seconds (2 seconds/segment)

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12
Q

When scoping how do stay in the proper glide path if there are lateral curvatures?

A

Follow the lateral curvatures keeping spinouses in the middle.

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13
Q

Where are confirmed breaks marked in the thoracolumbar region?

A

1/2” above mid thermocouple, well outside of the glide path.

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14
Q

Instrumentation tells us where to adjust, when to adjust, or both?

A

When

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15
Q

What is the break location for occiput - C1?

A

Suboccipital - between the two segments

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16
Q

What is the break location for C2-T3

A

Interspinous space below

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17
Q

What is the break location for T4

A

It’s own spinous level

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18
Q

What is the break location for T5-T9

A

Interspinous space above

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19
Q

What is the the break location for T10-T12

A

At it’s own spinous level

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20
Q

What is the break location for L1-L5?

A

Lower 25% of involved segment

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21
Q

When recording a positive instrumentation finding, how do you document it?

A

Segment involved, direction, amplitude (increments of deflection). E.g. T3/R/4

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22
Q

List the 8 steps for assessment of the VSC and adjustment.

A 
History/symptomatology
Visualization: posture/leg check
Instrumentation
Static/motion palpation
Spinography
Vertebral subluxation complex
Adjust with the appropriate technique
Lifestyle education (4 T's).
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23
Q

What aspect of the PART system does instrumentation satisfy?

A

Tissue/tone

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24
Q

What are some epidermal conditions that can reduce the reliability of instrumentation findings?

A
  • Burn / Sunburn
  • Blemish / Acne
  • Infection
  • Fever
  • Perspiration (IR scatter)
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25
Q

What are some physiologic variabilities that can reduce the reliability of instrumentation findings?

A

Dermatomes / Neuropathies

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26
Q

What is instrumentation assessing?

A

Vasomotor function as a reflection of aberrant
neuromodulaton (gathering information in the dermal
microvasculature)

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27
Q

The Tytron C-3000 gathers information from what aspect of the epidermis?

A

The first 5 mm into the epidermis

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28
Q

T/F

The sympathetic nervous system functions as the result of an antagonist

A

False,

functions without antagonist

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29
Q

Cold receptors are myelinated, which means that the conduction is what?

A

Saltatory

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30
Q

Ambient control is specific to what?

A

Dermatomes

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31
Q

The signal enters the cord where?

A

The dorsal horn at the tract of Lissauer

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32
Q

The tract of Lissauer sorts between what?

A

Pain and temperature

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33
Q

After synapsing in the dorsal horn, where is the next synapse?

A

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

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34
Q

Where does the LST synapse after entering the brain

A

VPL of thalamus

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35
Q

The thalamus then synapses where?

A 
Broddman area 3,1,2, 
Insular cortex (insula/"isle of Reil")
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36
Q

What does the anterior portion of the insular cortex regulate?

A

Viscero-autonomic function

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37
Q

The insula then forwards the message to what structure?

A

The hypothalamus (specifically the adenohypophysis, which regulates autonomic function).

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38
Q

The anterior hypothalamic nucleus (adenohypophysis) then becomes what?

A

A descending autonomic tract

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39
Q

Where does the DAT travel?

A

Passes through the brainstem and travels to the site of original dermatomal thermoregulation (preganglionic sympathetic fiber).

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40
Q

What does the preganglionic sympathetic fiber synapse with?

A

The sympathetic paravertebral ganglionic chain

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41
Q

After synapsing with the sympathetic paravertebral CG, what are the 3 possible outcomes of the preganglionic sympathetic fiber?

A

Ascend to ganglion at higher cord level
Descend to ganglion at lower cord level
Stay at the same ganglionic level

42
Q

PSF will neurotransmit AcH and stimulate which kind of Post ganglionic sympathetic fiber?

A

Nicotinic

43
Q

The postganglionic fiber in this pathway will release what?

A

Epinephrine

44
Q

The terminal point of the pathway is where?

A

Tunica media for vasoconstriction.

45
Q

What does it mean that the thermoregulatory pathway is “unapposed”?

A

No antagonist

46
Q

Since the sympathetic nervous system is represented by cord levels T1-L2, how does the cervical spine receive sympathetic info?

A

Sympathetic chain extending upward

47
Q

What does the ascending sympathetic chain represent? What principle does it support?

A

Represents core activity below. Supports pattern analysis

48
Q

The Tytron C-3000 is primarily used for which kind of analysis?

A

Pattern analysis

49
Q

T/F

The Tytron C-3000 can’t be used for break analysis

A

False,

It isn’t usually, but it can be.

50
Q

What kind of chiropractic utilizes the Tytron C-3000 morso?

A

Upper cervical techniques (primarily as a periodic evaluation tool)

51
Q

T/F

The Tytron C-3000 is a great tool, but it’s not very reproducable.

A

False

52
Q

The Tytron C-3000 is insightful about which parts of the VSC?

A

Neuropathology (dermal thermoregulation)

Histopathology (to a smaller sense)
Cytological / Inflammation / Edema

53
Q

The Tytron C-3000 is insightful about which aspect of the PART system?

A

Tissue/tone changes

54
Q

T/F

Patient placement is identical to
that of running a cervical glide
with a Nervoscope.

A

True

55
Q

Where does the Tytron scan start and finish?

A

Commences at S2 and terminates at the base of occiput

56
Q

The Tytron scan should be conducted at a smooth and continuous speed of…

A

1 sec/segment

57
Q

T/F

When you do a Tytron scan, you only do a mastoid fossa reading when your results from the full spine scan are ambiguous.

A

False,

You ALWAYS do a mastoid fossa reading.

58
Q

What information does the mastoid fossa reading provide?

A

More specific information about the upper cervical complex (BUT MOST SPECIFICALLY C2)

59
Q

What is the protcol for a mastoid fossa reading?

A

Pressy “F” key
Right barrel in right fossa
Right barrel in left fossa.
0.5 degrees C is clinically significant

60
Q

Pattern analysis is a system of analysis that takes what into consideration?

A

that thermal shifts on the surface of the skin occur as a part of normal physiology.

61
Q

What is the assumption made if the thermal shifts associated with normal physiology aren’t there?

A

it can be correlated with autonomic dysfunction

and compromised ability to adapt.

62
Q

What is the gold standard in pattern analysis?

A

3 thermal readings (scans) over a 24
hour period with the scans spaced
apart as evenly as possible.

63
Q

What information does the gold stand in pattern analysis tell the doctor?

A

This allows the doctor the
opportunity to see how the body
can / can’t adapt over time.

64
Q

If pattern analysis is apart of your assessment of a patient, what role does the scans upon subsequent visits play in relation to the adjustment?

A

Subsequent scans are compared to the original scan (pattern) and determines whether an adjustment is appropriate.

65
Q

What are the 3 general scan types?

A

Pattern
Adaptive
Stress

66
Q

What are the causes of a stress scan (4)

A

Emotional stress
Physical stress / Pain
Drugs
Caffeine

67
Q

What does the second component of the occiput listing (RS/LS) account for?

A

The coupled misalignment of laterality and superiority

68
Q

What does the final component of the occiput listing (RP/RA) account for?

A

Rotation on the side of laterality

69
Q

AS or AI listing tells us about the misalignment of what?

A

Anterior tubercle of atlas either superior or inferior

70
Q

What does the second part of the atlas listing (R or L) account for?

A

Laterality only

71
Q

What does the final component of the atlas listing (A or P) account for?

A

Rotation on the side of laterality

72
Q

T/F

Motion palpation is reliable as a stand alone tool in assessing for a VSC?

A

False

Without other indicators, plus a good protocol and experience, it’s weak.

73
Q

Motion palpation is insightful about which parts of the VSC?

A

Kinesiopathology (relative position, global ROM

Intersegmental fixation)

74
Q

Motion palpation is insightful about which aspects of the PART system?

A

P – Pain and Tenderness
A – Asymmetry / Misalignment
R – Range of Motion

75
Q

What is a listing system derived from?

A

Spinographic analysis

76
Q

T/F

Motion palpation qualifies the actual misalignment
found on x-ray

A

True

77
Q

The listing system gives what information about the adjustment?

A

Information in choosing the appropriate technique

78
Q

T/F

A listing system fosters reproducibility

A

True

79
Q

3 considerations of a listing system

A

Anatomical variability (Important to have a reproducible analysis)

Static picture of a dynamic entity (important to re-evaluate, proper positioning - neutral)

Protocol is a frame of reference
(Acute patient?)

80
Q

Spinous laterality intrinsically accounts for what else?

A

Body rotation

81
Q

What is the hallmark of the Palmer/Gonstead system considering our purposes?

A

Compare to the segment below

82
Q

What is the hallmark of the Palmer upper cervical specific system, considering our purposes?

A

Compare to foramen magnum

83
Q

Which listing system are we concerning with?

A

Palmer/Gonstead system

84
Q

In what conditions will you see a global wedge?

A

Scoliosis

Lateral curvature

85
Q

T/F

You won’t notice any lateral curvature with a segmental wedge

A

True,

A segmental wedge is stand alone

86
Q

T/F

You can obtain a PS/AS occiput misalignment from APOM view?

A

False,

Only wedging and rotation

87
Q

What is compared in C2 spinous laterality?

A

The distance of the C2 laminar junction to its own

superior lateral border

88
Q

What are the 6 rationale for taking x-rays emphasised in class

A
  1. Pain or neurologic symptoms
  2. Spinal trauma (Falls, Sclerotogenous pain, Fractures, etc..)
  3. Alignment abnormalities / Abnormal curvatures / Scoliosis (Cobb Angles)
  4. Arthropathy
  5. Spine instability or limitation of motion
  6. Osteoporosis
89
Q

How is posteriority determined on lateral thoracic/lumbar x-rays?

A

Visualization

90
Q

What are the other heuristic devices compared with the elusive/abstract nature of subluxation according to the subluxation article (4)?

A

Genes, gravity, ego, life.

91
Q

T/F

According to the article, chiropractic is based on the theory of subluxations.

A

False,

Based on the success of the chiropractic adjustment.

“The empirical or clinical success came first, the
theory attempting to explain the success of the adjustment such as nerve impingement, dis-ease, subluxations and others followed.”

92
Q

For the two alternate thoracic lateral bend and rotation, what segments may be contacted?

A

T1-T3

93
Q

In performing a P-A lumbar extension, what are you assessing for?

A

“Joint excursion”

94
Q

In performing a P-A lumbar extension, the spinous of the involved segment will not glide through normal motion or in other words…

A

Will have loss of resilience at end play.

95
Q

Which of the three Tytron scans is represented by just a yellow line?

A

Stress scan

96
Q

When doing a Tytron scan, what signals you are ready to start scanning?

A

Press trigger and wait for SECOND tone and the screen prompt to read: SCANNING

97
Q

T/F

Hair sweep is not necessary for the Tytron scan

A

False,

Hair sweep (or head stabilization) “on the fly” as you go up into the UPPER THORACIC region.

98
Q

When do you break contact at the termination of the Tytron scan?

A

After releasing the trigger.

99
Q

T/F

Lift up the earlobe to perform the mastroid fossa reading and make contact with the skin for 2 seconds before releasing

A

False,

Barrels are NOT to touch the skin. Must hold for 3 seconds

100
Q

What do you do when the fossa reading is done?

A

Press ESC twice and enter fossa value as your comment to save.

101
Q

T/F

A significant fossa readin (0.5 C or greater) indicates laterality?

A

False,

There is no correlation to segment laterality

Sublux final (2 decks)

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