Principles Flashcards
neuropathophysiology
biomechanical insult to nerve tissue is proposed to cause neural dysfunction in 3 forms, individually or in combination
includes: irritation, compression, decreased axoplasmic transport
irritation
sustained hyperactivity
results in facilitation
anterior horn irritation
hypertonicity or spasm of muscles
irritation- hypertonicity/spasm
compression- atrophy
lateral horn irritation
which exhibited as vasomotor changes, sudomotor cheanges, includes hypersympaatheticotonia
irritation- sympathetic vasomotor
compresssion- sympathetic atonia
posterior horn irritation
sensory changes
irritation- hyperesthesia
compression- anesthesia
compression/mechanical insult
includes pressure, stretching, angulation, or distortion
in the IVF results in decreased axoplasmic flow
exhibits as muscle atrophy, anesthesia, sympathetic atonia
decreased axoplasmic transport
alters development, growth and maitenance of cells or structures that are dependant on this trophic (growth) influence expressed via the nerve
kinesiopathophysiology
described as hypomobility, diminished or absent joint play, or segmental hypermobility due to compression
lack of appropriate joint motion is proposed to be associated with?
a variety of nociceptive and mechanoreceptive reflex functions that include proprioception
early manifestation of a chronically fixated vertebral articulation?
shortening of ligaments as an adaptation to limited ROM
what is directly affected by the chiropractic adjustment?
kinesiopathophysiology
myopathology
may include spasm or hypertonicity of muscles as a result of compensation, facilitation, Hilton’s law, or any combination
acute myopathology
spasm
chronic myopathology
atrophy
Hilton’s law
nerve supplying a joint also supplies the muscles which moves a joint and the skin covering the articular insertion of those muscles
histopathology
relates to inflammation, including pain, heat and swelling
can result from trauam, hypermobile irritation or can occur as a part of the repair process
5 signs of inflammation
rubor calor tumor dolor functiolaesa
pathophysiology (biochrmical)
hormonal and chemical effects or imbalances
stress syndrome
pro-inflammatory
end result of the VSC of disease
somatosomatic
reflexes whose afferents and efferents are somatic nerve fibers
stimulus at one level of muscukoskeletal system produces relfex activity in the nervous system, which is then exhibited elsewhere in the musculoskeletal system
example of somatosomatic
knee jerk reflex
muscle spasm
tendon, fascia, pain, subluxation, adjustment
viscerovisceral
reflexes whose afferent and efferents are visceral sensory and autonomic nerve fibers
AKA visceroautonomic
example of viscerovisceral
kidney insuficiency leading to HTN
somatovisceral
AKA somatoautonomic
relfexes whose afferents are somatic sensory fibers and whose efferents are autonomic efferent fiers
stimulus to nerves or receptors related to spinal structures produces reflexive responses influencing function in the visceral organs
somatovisceral example
spinal adjusting may be effective for relieving pain and distress of primary dismenorrhea is an example of this reflex ar
viscerosomatic
relfexes whose afferents are visceral sensory fibers and whose efferents are somatic motor nerve fibers
example of viscerosomatic
respiratory or digestive dysfunction such as asthma or colic may cause reflex disturbances in the spine leading to muscle tension and joint subluxation
somatic
refers to skin, bone muscle or nerve
visceral (autonomic)
organs, blood, lymph
psycho
thinking about something
where does the gate theory of control occur?
substantia gelatinosa
what does the degree of opening/closedness of the gate depend on?
the spinal cord
type A beta afferent fibers
greatly depress (inhibit) the pain that travels on type C and A delta fibers
pain fibers terminate where?
dorsal horn of spinal cord in substantia gelatinosa
when in the substantia gelatinosa, when mechanoreceptor axons terminate, what does that cause?
pretynaptic inhibition
vertebrobasilar arterial insufficiency hypothesis
cervical intervertebral subluxations may cause deflection or compression of the vertebral arteries, which alters cerebral circulation
symptoms of VBAI
5Ds and 3Ns diploplia dizziness drop attacks dysarthria dysphagia ataxia of gait nausea numbness on one side of the face/body nystagmus
most common location for compression of the certebral artery is?
over the posterior arch of C1
what causes the most compression to the vertebral artery?
rotation and extension of C1 and C2
what is considered the significant neuologic disorder accompanying vertebral subluxations?
spinal nerve root compression
axoplasmic transport
how were spinal subluxations hypothesized to induce NR compression?
as a result of direct anatomic compression of neural elements within the IVF
what predisposes someone to NR compression
degenerative changes of the bony structures in the IVF
bone on nerve causes what?
pain in dermatomal patterns
decreased DTR
paresthesia
muscle atrophy
what do the nerve rootlets lack?
epineural covering of the NRs as they exit the IVF
what are the nerve rootlets more susceptible to?
pressure
inflammation
ischemia
what lies within the IVF?
DRG
axoplasmic transport
non-impulse mechanism based not on transmission of signals along the surface of the neuron but rather on the intra-axonal transport and exchange of macromolecular materials
trophic substances
chemicals transported by axoplasmic transport
what is essential for maintenance of proper tissue function
trophic substances
what does trophic function influence
the development and maintenance of chemiccal changes in cells supplied by the nerve
describe how the chemicals move in axoplasmic flow
carried the full length of the axon to the terminals, after which materials from the terminals are returned to the cell body for reprocessing
is axoplasmic flow slow or fast?
slow
anterograde axoplasmic transport
forward moving cell body to terminal
nerve growth (troophic)
faster
more common
retrograde axoplasmic flow
backward moving
brings products/wastes to cell body
slower
less common
clinical implications of axoplasmic transport
any factor causing derangement of transport mechanisms in the axon could cause trophic influences to become detrimental
alteraltions in axoplasmic transport produce what?
aberrations of structure, function and metabolism
contributes to dysfunction and disease
compressive myelopathy/cord comrpession refers to?
descruction of spinal cord tissue caused by pressure from neoplasms, hematomas, congenital defects, extreme trauma
facilitation hypothesis AKAs
fixation theory segmental facilitation segmental hypothesis gamma motor gain proprioceptive insult sympatheticotonia
segmental facilitation
lowered threshold for firing in a spinal cord segment as a result of afferent bombardment associated with spinal lesions
Korr focused on muscle spindles as what?
coordinator that may increase or decrease muscle contraction according to the direction of motion of the joint
facilitation
continuous firing of nociception makes it easier to get to the brain
propriceptive insult
constant bombardment of nociception lowers the threshold for firing in the segment
Korr explained that a vertebra could be “stuck”, but also have normal range of motion, why?
due to muscle spasm producing hypomobility and nociception
neurodystrophic hypothesis
spinal biomechanical insult to nerves may affect intra-neural axoplasmic transport mechanisms and, in turn, affect the quality of neurotrophic influence and molecular (chemical) changes in cells
neural dysfunction causes lowered tissue resistance, which does what?
modified the immune responses and alter the trophic function of the inolved nerves
general adaptation syndrome
exposure under optimum conditions, the body can respond to various stressors by adapting to them
distress
negative stress
eustress
positive stress
hypothalamic-pituitary-adrenal axis system
system whereby the body copes with stress
stages of adaptation
alarm
resist
adapt
exhaust
alarm stage
upon encoutering a stressor, body reacts with fight or flight response and sympathetic nervous system is acvivated
hormones such as cortisol and adrenalin released into the blood stream to meet the threat or danger
body’s resources are mobilized
resistance
parasympathetic NS returns many physiological function to normal levels while body focuses resources against the stressor
blood glucose levels remain high, cortisol and adrenalin continue to circulate at elevated levels, but outward appearance of organism seems normal
increase HR, BP, breathing
body remains on red alert
exhaustion
stressor continues behond body’s capasity, organsim exhausts resources and becomes susceptible to disease and death
response to stress is coordinated by?
neuroendocrine mechanism
