Subluxation

Question 1

Differentiate between chiropractic and spinal manipulation.

Answer 1

Chiropractic can only be done by Doctors of Chiropractic. Spinal manipulation can be applied to animals and is done by those other than DCs

Question 2

Define restriction as it applies to spinal manipulation

Answer 2

Loss of range of motion with the joint surfaces still in contact

Question 3

!!Know the definitions of: motion segment !!

Answer 3

Functional unit made of 2 adjacent articulating surfaces ant he connecting tissue surrounding them

Question 4

Know the definitions of: manipulable lesion

Answer 4

An altered alignment, movement integrity, and/or physiologic function of a motion unit although contact between the joint surfaces remains intact

Question 5

Know the definitions of: manipulation

Answer 5

manual procedure that involves a directed thrust to move a joint past the physiologic range of motion without exceeding the anatomic limit

Question 6

Know the definitions of: directed thrust

Answer 6

Thrust in the plane of the joint surfaces

Question 7

Know the definitions of: HVLA

Answer 7

High velocity low amplitude; type of thrust used in manipulation. Speed is the vital component of the HVLA thrust

Question 8

Know the definitions of: paraphysiologic space

Answer 8

Small ROM beyond the active and passive range of motion. It is just before anatomic barriers are breached

Question 9

Know the definitions of: listing

Answer 9

3 parts:

• Which bone
• Reference point
• Direction

Question 10

What are the effects of a restriction? What are the local effects (3)?

Answer 10

1. Cartilage degeneration
2. Adhesions
3. Circulation

Question 11

What are the effects of a restriction? What are the effects on the nervous system?

Answer 11

1. Decrease in cortical stimulation
2. Decrease in sympathetic/nociceptive inhibition
3. Pain
4. Peripheral nerve function

Question 12

What are the effects of a restriction? What are the compensatory effects (on three structures)?

Answer 12

1. Adjacent motion units
2. Muscles
3. Tendons

Question 13

How does a restriction lead to cartilage degeneration?

Answer 13

When movement in inhibited the cartilage is not nourished properly

Question 14

How does a restriction lead to intra-articular adhesions?

Answer 14

Immobilization leads to adhesions withing the joint. Synovial fluid begins a fibrofatty consolidation.

Question 15

How does a restriction lead to decreased circulation (3 ways)?

Answer 15

1. 1. Decreased circulation due to diminished motion
2. Muscle splinting or spasm
3. Autonomic nervous system stimulation creating vasoconstriction

Question 16

How does a restriction affect the cortex?

Answer 16

Cortex needs sensory output to be healthy. Restrictions of the joint decrease movement of that part and oftentimes of the whole animal. This diminished input leads to a diminished cortex which leads to less output to the muscles which leads to less movement

Question 17

How does a restriction affect the sympathetics?

Answer 17

Cortical output and movement inhibits the sympathetics

Question 18

How does a restriction affect Nociception?

Answer 18

If nociceptive fibers are not inhibited they tend to branch out and can attached to mechanoreceptors. Now movement that stimulates the mechanoreceptors also stimulate the nociceptors.

Question 19

How can pain from a restriction affect nerves (2 ways)?

Answer 19

1. Local inflammation

2. Lack of circulation

Question 20

What effect does a restriction have on the adjacent motion segments?

Answer 20

When one motion segment is restricted in its ROM the adjacent segments must compensate. They do this by increasing their ROM

Question 21

How does the restriction affect the muscles?

Answer 21

Muscles around the restriction become hypertonic due to pain, segmental spasm, or somatosomatic reflex

Question 22

What injury can occur from a hypertonic muscle? A hypotonic muscle?

Answer 22

Hypertonic muscles are prone to injury because of their lack of elasticity. They stay contracted when they need to stretch, ending in tearing of the fibers.

Question 23

How can tendon injury occur secondary to a restriction?

Answer 23

Hypotonic muscles fail to stabilize the joints, allowing excess range of motion which leads to damage to both soft tissue and bone

Question 24

What can cause tendon injury within the normal ROM?

Answer 24

Hypertonic muscles are less elastic and this puts more strain on the tendons and ligaments (Injury within normal ROM)

Question 25

What can cause tendon injury beyond the normal ROM?

Answer 25

Hypotonic muscles fail to protect joints form excessive ROM causing overloading of the tendons and ligaments leading ot injury.

Question 26

Know at least 10 reasons it is important to clear restrictions. (There are 15 reasons)

Answer 26

1. 1. Horse can move freely, bend laterally in both directions
2. Prevent cartilage degeneration from lack of nourishment
3. Prevent adhesions from forming in the joint
4. Restore normal circulation to the joint and surrounding tissues
5. Restore normal muscle tone
6. Restore normal movement to “feed” to cortex
7. Inhibit the sympathetics
8. Inhibit nociception
9. Prevent nociceptive fibers fron branching to mechanoreceptors
10. Prevent pain from both direct/indirect effects
11. Maintain normal peripheral nerve function
12. Prevent compensatory hypermobility in adjacent motion segments
13. Prevent muscle hypotonicity leading to joint laxity, DJD and tendon strain
14. Prevent muscle hypertonicity leading to muscle and tendon strain
15. Prevent tendon injury due to aberrant tonicity in the muscle