Sublux Midterm Flashcards
__ refers to the measurement of the human individual. Used as an early tool of anthropology
Anthropometry
What educates the patient about postural distortions/imbalances, indicates areas of biomechanical stress, insightful to chronic VSC areas, explains visually the muscular causes of pain, is an outcome measure for patient and other interested parties, and helps indicate/pinpoint pathologies?
the Postural Analysis
When visualizing posture, it is important to use a frame of reference (such as a gridline) for __ and __?
reliability, reproducibility
T/F: When visualizing posture, you should have a different examiner take measurements for the pre/posttest validity?
False. The same examiner should take the measurements pre/post test, then be confirmed by a 2nd examiner if so applicable.
When visualizing posture, the findings should be documented from whose perspective?
The Patient’s perspective
T/F: Patient stance during a postural analysis should be normal, neutral, and reproducible?
True. Also, best if the patient is gowned so that symmetry/asymmetry can be visualized accurately.
This word was originally a nautical term utilized to describe a ship’s overall appearance or tendency to favor the starboard or portside?
List
Which term means that posturally, a patient’s overall tendency will be to favor their right or left. From anterior view, what are the 2 reference points?
List; 2 reference points anteriorly are sternum & baseline
Which term means to be in or to move into a sloping position? Posturally, this describes a patient’s “regional” tendency to break from an established vertical baseline.
Lean. Regional=Lean *Ant view should be recorded as right, left, neutral.
When assessing Lean, what are the 3 regional areas we utilize from anterior view?
*upper 1/3: glabella-sternum *middle 1/3: sternum-pubic symphysis *lower 1/3: pubic symphysis-baseline
When assessing head tilt (ant. view), what are the 3 reference points?
glabella-nose-chin
When assessing thoracic tilt from anterior view, what is our reference point?
acromioclavicular joints. *Left thoracic tilt would be a shoulder lowered on the left side. Think of a marble rolling downhill, and that is the direction of the tilt.
When assessing postural analysis from lateral view, what are the global list reference points?
AC joints-baseline
How should we record the List on lateral view?
Anterior, Posterior, or Neutral
On lateral lean, what are the 2 regions of reference points?
AC-trochanter, Trochanter-baseline
On head carriage looking from the lateral view, what are our reference points?
EAM-AC joint *Classify as anterior or posterior head carriage
Which clinical condition would give a “rounded back appearance” which utilizes Cobb Angles for the radiological mensuration?
thoracic kyphosis *hyperkyphosis (extremely rounded back like quasimodo-hunchback of notre dame) or hypokyphosis (not enough thoracic anterior curve)
When assessing thoracic rotation from lateral view, what are the 2 reference points?
chest-back prominence
Which clinical condition is the visualization of a “swayback”, an overly posterior curvature of the spine?
lumbar lordosis
In posterior view, what are the 2 reference points for the overall List?
VP-baseline
When looking at our patient from posterior view, we notice that we can see more of the left cheek and/or jaw. What would this be classified as?
Left head rotation *Use facial prominence (jaw or cheek)
For head translation (post. view), what are the 2 reference points?
EOP-VP
___ scoliosis is due to vertebral malformation or fused ribs during development?
Congenital
__ scoliosis is caused by poor muscle tone, or paralysis due to diseases such as cerebral palsy (CP), muscular dystrophy, spina bifida, or polio?
Neuromuscular
__ scoliosis is of unknown cause?
Idiopathic
What is the most common type of scoliosis in adolescents?
Idiopathic scoliosis *more common in tall women
T/F: Scoliotic curves generally correct themselves during growth spurts?
False. Curves generally worsen during growth spurts.
Using this instrument (___) ,if either measure is 5 degrees or more, then consider referral to a scoliosis center.
scoliometer
Scoliometer readings of 5 degrees or more have high likelihood of Cobb angles greater than __ degrees on xray?
10 degrees
T/F: An increased Cobb Angle =worse scoliosis?
TRUE
When visualizing scoliosis, what are our 2 reference points?
spinous processes, scapular inferior angles (& prominency)
When assessing pelvic tilt, what are the 2 reference points?
iliac crests-PSIS’s
If our patient has a Right pelvic tilt, which hip is lower?
the Right hip. Again, think the marble rolling downhill
When assessing pelvic rotation, what is our reference?
gluteal prominence
What is the most consistent way of performing a prone leg check?
the Hydraulic HyLo table
When assessing the prone leg check, which part of the shoe should we use?
either the “seam” of the shoe, or “like points” on both shoes
When doing the prone leg check, we are checking for asymmetry in which 3 structures?
- inversion/eversion 2. foot flare 3. plantar flexion/dorsiflection
Steps in the prone leg check:
- use consistent hand placement 2. apply slight headward pressure to remove “slack” in the shoe 3. flatten the foot so as to neutralize any inversion/eversion 4. do NOT torsion the tibia/femur 5. Visualize the deficient side while maintaining slight headward pressure 6. Record findings… example: 1/4” R/L
When in practice, what is the most important factor to base our procedures on?
**Patient preferences**
Research alone does not equal __?
evidence
When a new patient comes through the door, this is the order of assessment ideal to proceed in:
- history/symptomatology 2. visualization (posture/leg check) 3. instrumentation 4. static/motion palpation 5. spinographic analysis
Which portion of the initial assessment (and ongoing assessments) provides us with a patient’s concerns and guides our care plan? Here, we should shift the paradigm so we are not just alleviating pain, but the patient shares other concerns such as visceral functions and wellness/prevention habits. Hint: Dr. Bhogal spends a majority of his time as a clinician in this facet?
Patient History/symptomatology
Which portion of the assessment allows us to see biomechanical awareness and overall function based on their posture/mannerisms?
Visualization
What is the most cost effective method to objectifying neurological function?
instrumentation
Which portion of the assessment makes our work much easier and can be reproducible from one doctor to another?
Instrumentation
What portion of the assessment shows soft tissue changes relative to the VSC? It includes myopathology of muscle hyper/hypotonicity, tissue prominency and palpatory tenderness.
Static palpation
Which portion of the assessment shows kinematic changes relative to the VSC? It includes the kinesiopathology of the global ROM as well as intersegmental fixation.
Motion palpation
Which portion of the assessment utilizes spinal radiography/x-ray analysis to correlate motion palpation findings, postural distortions, and allows more specific adjusting by the DC?
spinography
A conservative and conscientious form of health care that concerns itself (primarily) w/the functional integrity of the nervous system is __?
Chiropractic (Bhogal’s definition)
Homeostasis should be replaced by the word __?
homeodynamics *dynamic=movement, health. homeostasis implies staying the same. not what we want to illustrate to our patients.
An aberration (deviation from the norm) in biomechanical spinal anatomy, such that the functional integrity of the nervous system is compromised (compromised capacity to adapt to a stimulus) is a __?
subluxation (Bhogal’s definition)
A __ __ is what the patient perceives; a pathophysiology.
subluxation syndrome
What is the love of wisdom?
Philosophy
Chiropractic wisdom tells us what?
The body is intelligent, self-regulating (innate intelligence), created by a universal intelligence, has a love/hate relationship with educated intelligence, and how well we utilize Educated facilitates the expression of Innate
Who authored the 33 principles?
Ralph W. Stephenson.
What are the 4 T’s associated w/Chiropractic?
Thoughts, trauma, toxins, threshold (an individual’s ability to adapt to life situations)
What are the 5 components of the Vertebral Subluxation Complex (VSC)?
- Kinesiopathology 2. Myopathology 3. Neuropathology 4. Histopathology 5. Pathophysiology
Which part of the VSC is atypical position or motion?
Kinesiopathology
Which part of the VSC is muscular dysfunction resulting in hypo/hypertonicity?
Myopathology
Which part of the VSC is a dysfunction or disease of the nervous system?
Neuropathology
What is the most important tool in determining neuropathologies?
Instrumentation
Which part of the VSC is a disease or dysfunction at a cytological level?
Histopathology Inflammation
What part of the VSC includes functional changes associated w/disease or injury?
Pathophysiology Patient education crucial at this step
What is the system devised by the Centers for Medicare and Medicaid Services (CMS) to validate the necessity of chiropractic care through either x-ray or physical examination?
the P.A.R.T system
What does the P.A.R.T. system stand for?
P-pain/tenderness A-asymmetry/misalignment R-range of motion abnormality T-tissue/tone changes
Which portion of the PART system uses observation & documentation, palpation or percussion, a visual analog scale (pain 1-10), audio confirmation, and a pain questionnaire to inquire about the patient?
P-pain/tenderness
Which portion of the PART system allows us to observe patient posture or analyze gait, describe the misaligned vertebrae, and using x-rays, CAT scans or MRI’s to identify misalignments?
A-asymmetry/misalignment
Which portion of the PART system shows increased/decreased flexibility via observation, motion palpation, x-rays, or goniometers or inclinometers for specific measurements?
R-range of motion abnormality
Which portion of the PART system has visible changes like spasm, inflammation, swelling, rigidity, palpable edema, documented instrument findings, and **documented leg length, scoliosis contracture, and strength/length of muscles that relate?
T-tissue tone changes tests for length/strength
Which part(s) of the VSC correlates to asymmetry/misalignment and ROM abnormality of the PART system?
Kinesiopathology
Which part(s) of the VSC correlates with pain/tenderness, asymmetry/misalignment, and tissue/tone changes of the PART system?
Myopathology, Neuropathology, Histopathology
A method of using one’s hands to feel and assess several parameters that govern the mobility and health of tissues located near or on the body’s surface. It facilitates the analysis of soft or bony tissue structures within the body. What is being described?
Static palpation
Static palpation is insightful to what parts of the VSC?
Kinesiopathology (position/motion), myopathology (tonicity), histopathology (cytological/inflammation/edema)
Static palpation is insightful to what parts of the PART system?
P-pain/tenderness A-asymmetry/misalignment T-tissue/tone changes
T/F: Static palpation is best utilized before instrumentation?
False. Static palpation is best utilized AFTER instrumentation. An instrumentation “break” will guide our area of static assessment
In terms of turgidity, give examples of places where you would find normal turgidity, hyperturgidity, and hypoturgidity?
.normal turgidity: middle of palm -hyperturgidity: thenar pad; feels spongier than it should -hypoturgidity: back of hand; feels elastic, flaccid, loose; think of elderly skin w/loss of fluid; “tenting”