PART II Flashcards
(101 cards)
1
Q
What is the purpose of static palpation?
A
facilitate the analysis of soft or bony tissue
structures within the body.
2
Q
Define turgidity
A
Intrinsic pressure or resistance offered by a cell or tissue.
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.
4
Q
Define sclerotogenous
A
Pertaining to
ligament, tendon insertion on bone,
disc, periosteal, or zygapophyseal
structures.
5
Q
On the nervoscope (for our purposes) what setting should the sensitivity switch be set to?
A
Low or medium
6
Q
T/F
A swing is usually found at one segment
A
False, swings are usually multisegmental
7
Q
How long does acclimation take?
A
10 minutes, ideally
8
Q
What is the ideal glide time for scoping the cervicals?
A
18-21 seconds (3 sec/segment)
9
Q
Where are confirmed breaks marked in the cervicals?
A
1/4” below mid thermocouple well outside of the glide path
10
Q
Instrument pitch must always be in accordance with…
A
Disc plane line/skin surface
11
Q
What is the glide speed for thoracolumbar scope?
A
35-38 seconds (2 seconds/segment)
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.
13
Q
Where are confirmed breaks marked in the thoracolumbar region?
A
1/2” above mid thermocouple, well outside of the glide path.
14
Q
Instrumentation tells us where to adjust, when to adjust, or both?
A
When
15
Q
What is the break location for occiput - C1?
A
Suboccipital - between the two segments
16
Q
What is the break location for C2-T3
A
Interspinous space below
17
Q
What is the break location for T4
A
It’s own spinous level
18
Q
What is the break location for T5-T9
A
Interspinous space above
19
Q
What is the the break location for T10-T12
A
At it’s own spinous level
20
Q
What is the break location for L1-L5?
A
Lower 25% of involved segment
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
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).
23
Q
What aspect of the PART system does instrumentation satisfy?
A
Tissue/tone
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)
25
What are some physiologic variabilities that can reduce the reliability of instrumentation findings?
Dermatomes / Neuropathies
26
What is instrumentation assessing?
Vasomotor function as a reflection of aberrant
neuromodulaton (gathering information in the dermal
microvasculature)
27
The Tytron C-3000 gathers information from what aspect of the epidermis?
The first 5 mm into the epidermis
28
T/F
The sympathetic nervous system functions as the result of an antagonist
False,
functions without antagonist
29
Cold receptors are myelinated, which means that the conduction is what?
Saltatory
30
Ambient control is specific to what?
Dermatomes
31
The signal enters the cord where?
The dorsal horn at the tract of Lissauer
32
The tract of Lissauer sorts between what?
Pain and temperature
33
After synapsing in the dorsal horn, where is the next synapse?
From gray matter to white matter to become the Lateral spinothalamic tract
34
Where does the LST synapse after entering the brain
VPL of thalamus
35
The thalamus then synapses where?
```
Broddman area 3,1,2,
Insular cortex (insula/"isle of Reil")
```
36
What does the anterior portion of the insular cortex regulate?
Viscero-autonomic function
37
The insula then forwards the message to what structure?
The hypothalamus (specifically the adenohypophysis, which regulates autonomic function).
38
The anterior hypothalamic nucleus (adenohypophysis) then becomes what?
A descending autonomic tract
39
Where does the DAT travel?
Passes through the brainstem and travels to the site of original dermatomal thermoregulation (preganglionic sympathetic fiber).
40
What does the preganglionic sympathetic fiber synapse with?
The sympathetic paravertebral ganglionic chain
41
After synapsing with the sympathetic paravertebral CG, what are the 3 possible outcomes of the preganglionic sympathetic fiber?
Ascend to ganglion at higher cord level
Descend to ganglion at lower cord level
Stay at the same ganglionic level
42
PSF will neurotransmit AcH and stimulate which kind of Post ganglionic sympathetic fiber?
Nicotinic
43
The postganglionic fiber in this pathway will release what?
Epinephrine
44
The terminal point of the pathway is where?
Tunica media for vasoconstriction.
45
What does it mean that the thermoregulatory pathway is "unapposed"?
No antagonist
46
Since the sympathetic nervous system is represented by cord levels T1-L2, how does the cervical spine receive sympathetic info?
Sympathetic chain extending upward
47
What does the ascending sympathetic chain represent? What principle does it support?
Represents core activity below. Supports pattern analysis
48
The Tytron C-3000 is primarily used for which kind of analysis?
Pattern analysis
49
T/F
The Tytron C-3000 can't be used for break analysis
False,
It isn't usually, but it can be.
50
What kind of chiropractic utilizes the Tytron C-3000 morso?
Upper cervical techniques (primarily as a periodic evaluation tool)
51
T/F
The Tytron C-3000 is a great tool, but it's not very reproducable.
False
52
The Tytron C-3000 is insightful about which parts of the VSC?
Neuropathology (dermal thermoregulation)
Histopathology (to a smaller sense)
Cytological / Inflammation / Edema
53
The Tytron C-3000 is insightful about which aspect of the PART system?
Tissue/tone changes
54
T/F
Patient placement is identical to
that of running a cervical glide
with a Nervoscope.
True
55
Where does the Tytron scan start and finish?
Commences at S2 and terminates at the base of occiput
56
The Tytron scan should be conducted at a smooth and continuous speed of...
1 sec/segment
57
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.
False,
You ALWAYS do a mastoid fossa reading.
58
What information does the mastoid fossa reading provide?
More specific information about the upper cervical complex (BUT MOST SPECIFICALLY C2)
59
What is the protcol for a mastoid fossa reading?
Pressy "F" key
Right barrel in right fossa
Right barrel in left fossa.
0.5 degrees C is clinically significant
60
Pattern analysis is a system of analysis that takes what into consideration?
that thermal shifts on the surface of the skin occur as a part of normal physiology.
61
What is the assumption made if the thermal shifts associated with normal physiology aren't there?
it can be correlated with autonomic dysfunction
| and compromised ability to adapt.
62
What is the gold standard in pattern analysis?
3 thermal readings (scans) over a 24
hour period with the scans spaced
apart as evenly as possible.
63
What information does the gold stand in pattern analysis tell the doctor?
This allows the doctor the
opportunity to see how the body
can / can’t adapt over time.
64
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?
Subsequent scans are compared to the original scan (pattern) and determines whether an adjustment is appropriate.
65
What are the 3 general scan types?
Pattern
Adaptive
Stress
66
What are the causes of a stress scan (4)
Emotional stress
Physical stress / Pain
Drugs
Caffeine
67
What does the second component of the occiput listing (RS/LS) account for?
The coupled misalignment of laterality and superiority
68
What does the final component of the occiput listing (RP/RA) account for?
Rotation on the side of laterality
69
AS or AI listing tells us about the misalignment of what?
Anterior tubercle of atlas either superior or inferior
70
What does the second part of the atlas listing (R or L) account for?
Laterality only
71
What does the final component of the atlas listing (A or P) account for?
Rotation on the side of laterality
72
T/F
Motion palpation is reliable as a stand alone tool in assessing for a VSC?
False
Without other indicators, plus a good protocol and experience, it's weak.
73
Motion palpation is insightful about which parts of the VSC?
Kinesiopathology (relative position, global ROM
| Intersegmental fixation)
74
Motion palpation is insightful about which aspects of the PART system?
P – Pain and Tenderness
A – Asymmetry / Misalignment
R – Range of Motion
75
What is a listing system derived from?
Spinographic analysis
76
T/F
Motion palpation qualifies the actual misalignment
found on x-ray
True
77
The listing system gives what information about the adjustment?
Information in choosing the appropriate technique
78
T/F
A listing system fosters reproducibility
True
79
3 considerations of a listing system
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
Spinous laterality intrinsically accounts for what else?
Body rotation
81
What is the hallmark of the Palmer/Gonstead system considering our purposes?
Compare to the segment below
82
What is the hallmark of the Palmer upper cervical specific system, considering our purposes?
Compare to foramen magnum
83
Which listing system are we concerning with?
Palmer/Gonstead system
84
In what conditions will you see a global wedge?
Scoliosis
| Lateral curvature
85
T/F
You won't notice any lateral curvature with a segmental wedge
True,
A segmental wedge is stand alone
86
T/F
You can obtain a PS/AS occiput misalignment from APOM view?
False,
Only wedging and rotation
87
What is compared in C2 spinous laterality?
The distance of the C2 laminar junction to its own
| superior lateral border
88
What are the 6 rationale for taking x-rays emphasised in class
1. Pain or neurologic symptoms
2. Spinal trauma (Falls, Sclerotogenous pain, Fractures, etc..)
8. Alignment abnormalities / Abnormal curvatures / Scoliosis (Cobb Angles)
10. Arthropathy
12. Spine instability or limitation of motion
13. Osteoporosis
89
How is posteriority determined on lateral thoracic/lumbar x-rays?
Visualization
90
What are the other heuristic devices compared with the elusive/abstract nature of subluxation according to the subluxation article (4)?
Genes, gravity, ego, life.
91
T/F
According to the article, chiropractic is based on the theory of subluxations.
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
For the two alternate thoracic lateral bend and rotation, what segments may be contacted?
T1-T3
93
In performing a P-A lumbar extension, what are you assessing for?
"Joint excursion"
94
In performing a P-A lumbar extension, the spinous of the involved segment will not glide through normal motion or in other words...
Will have loss of resilience at end play.
95
Which of the three Tytron scans is represented by just a yellow line?
Stress scan
96
When doing a Tytron scan, what signals you are ready to start scanning?
Press trigger and wait for SECOND tone and the screen prompt to read: SCANNING
97
T/F
Hair sweep is not necessary for the Tytron scan
False,
Hair sweep (or head stabilization) "on the fly" as you go up into the UPPER THORACIC region.
98
When do you break contact at the termination of the Tytron scan?
After releasing the trigger.
99
T/F
Lift up the earlobe to perform the mastroid fossa reading and make contact with the skin for 2 seconds before releasing
False,
Barrels are NOT to touch the skin. Must hold for 3 seconds
100
What do you do when the fossa reading is done?
Press ESC twice and enter fossa value as your comment to save.
101
T/F
A significant fossa readin (0.5 C or greater) indicates laterality?
False,
There is no correlation to segment laterality
