Subluxation Models - Main Notes Flashcards
What is the Qualifying feature of Intervertebral Subluxation
Partial Dislocation
What are some mechanisms involved in causing vertebral subluxations
- Postural stress
- Trauma
- IVD Degeneration
- Erosive arthritides and Autoimmune Conditions
- Infections
- Congenital and Developmental Factors
T or F
Scientific literature suggests Intervertebral subluxation is a common entity
T
______ is the branch of mechanics that deals with the equilibrium of bodies at rest or in motion with zero acceleration
Statics
Who was the developer of the basic and compensatory distortion model of the spine in chiropractic
Dr. Willard Carver
Vertebral segments at _____ and ______ of normal and compensatory curves under greater mechanical stress
apices and transitions
What are the most vulnerable areas if the apices and transitions are under the most mechanical stress?
Occ-C1-C2 C4 C7-T1 T7-T8 T12 L3 and Lumbosacral
** these areas are predisposed to injury and partial subluxation
What are some of the things that are thought to cause fixation/Hypomobility in the Biomechanical Model/Hypothesis?
1) Adhesion in Synovial Joints (Rahlman)
2) Meniscoid Entrapment (Lewit, Bogduk, Giles)
3) IVD Degeneration and Fragmentation (Cyriax, Sandoz)
4) Postural Muscle Hypertonicity (Korr)
5) Inflammation/Edema in Facet Joints
________ is a branch of mechanics that studies
with the relationship between the forces acting on a body and the changes they produce in the motion of the body
Kinetics
What is the concept of Compensation reactions and who thought of it?
Jirout, Kirkaldy-Willis
the concept that hypomobility in a motion segment leads to compensatory hypermobility elsewhere
What are Kapandji’s Ideas? What Subluxation Model do his ideas fall under?
Change in central axis of motion
Biomechanical
What are Mennels Ideas? What subluxation model do his ideas fall under?
Loss of Joint end play
Biomechanical
What are Suh, Plaugher et al’s ideas and what model do their ideas fit under?
Positional Dyskinesia
Biomechanical
What does the 4 phase model of subluxation degeneration include?
Biomechanical effects of chronic uncorrected VSC and Biomechanical response to adjustments
What occurs in phase 1 of the 4 phase model of subluxation degeneration
Motility Aberrations are present, Bony Architecture is intact, there are initial soft tissue changes and if adjust the body will return to near normal with care in weeks to months
What occurs in phase 2 of the 4 phase model of subluxation degeneration
Phase 1 changes are present plus fibrosis, early osseous changes are seen on x-ray, disc bony outlines change and if adjusted the body will see significant improvements but long term care over several years is required to halt degeneration
Under which phase of the 4 phase model of subluxation degeneration will the patient require lifetime care because their response to adjustments are slow and mostly geared towards retarding the progression of degeneration
Phase 3
What kinds of symptoms are seen in phase 3 of the 4 phase model of subluxation degeneration
Major degenerative changes and regenerative changes, beginning of bony fusion in anterior and posterior motor units
In which phase of the 4 phase model of subluxation degeneration does the body return to near normal after only a few weeks/months of adjustments
Phase 1
What does phase 4 of the 4 phase model of subluxation degeneration look like in a patient
They are elderly and have total fusions of motor units plus all the changes from the last 3 phases.
their body does not respond to adjustments but at this point we are trying to retard the progression of degeneration in those segments in which are not yet in phase 4
What are the 3 phases of the Unified (3-phase) model of VSC
1) Segmental Dysfunction (Kinesiopathology)
2) Instability (“true” Subluxation, histopathology)
3) Stabilization (Significant DJD, Anylosis)
In the Unified (3 phase model) for VSC in which phase is there considered to be “true” subluxation that can be radiographically demonstrable
2nd Phase (Instability)
In which phase of the Unified (3-phase model) for VSC is there significant DJD and Anylosis?
3rd Phase ( Stabilization)
in version 1 of the Unified (3-phase model) for VSC what is the initiation factor? What is the initiating factor for Version 2
Version 1 Trauma
Version 2 - Immobilization
*** no “true” subluxation present in version 2 - immobilization causes “facilitative” lesion due to chronic muscle contracture and impaired circulation to joint
How does IVF encroachment cause degenerative changes
1) Stimulates small Primary Afferent Fibers
2) Substance P of VIP is released in IVF and Facet Joints
3) Synthesis of proteolytic enzymes occurs
4) Degenerative Changes occur which cause further encroachment and structural changes leading to subluxation
Which Subluxation Model do Nerve root and nerve root compression/traction/torsion fit under? A) Biomechanical B) Neurological C) Trophic D) Psychosocial
B) Neurologic
what does the term Neurothipsis refer to?
pressure on a nerve direct or indirect
DRG and Nerve roots are summarized to be ___x more sensitive to compressive forces as compared to peripheral nerves
5x
DRG cells are known to become ___________ when inflamed, and may even give rise to spontaneous neural dishcarges
hyperexciteable
with exception of the first two spinal nerves all DRG lie within _____ in close association with the joint
IVF
what is the term for spinal compression/traction
myelopathy
subluxations of the cervical spine, particularly C1,
can cause the stabilizing attachments of the
___________ to distort the cord by traction,
leading to neural dysfunction (Grostic)
dentate ligaments
What is the dorsal column responsible for?
kinesthesia, fine touch, fine pressure, vibration
historically, it was felt by researchers such as Irvin Korr,
that the highly-innervated tissues around spinal joints,
including _________, may become irritated,
leading to reflex modifications in postural muscle
tonus and neural integration of postural activities
proprioceptors
which reflex hypothesis has to do with proprioceptive insult?
Somatosomatic
In the somatosomatic model what happens?
somatic afferent bombardment of the dorsal horn leads to a fascilitated cord segment and resultant somatic effects such as muscle spasm, pain, hypermobility and misalignment
T of F
The somatosomatic reflex hypothesis is self-inhibiting
(i.e proprioceptive irritation leads to muscle spasm which inhibits further proprioceptive irritation)
F
It is Self-Sustaining
- positive feedback cycle
_________ may be a more immediate/acute result of spinal fixation;
A) Stimulation of Proprioceptors
B) Stimulation of Nociceptors
C) Inhibition of Mechanoreceptors
C) Inhibition of Mechanoreceptors
** Deprices CNS of much needed feedback
What is Seemans idea of “Dysafferentation”
that nociceptor input is increased and Mechanorecepto input is decreased which reduces the ability to inhibit pain in the spinal cord and may magnify symptoms resulting from nociceptor input
What is the Somatoautonomic reflex Hypothesis
Afferent Bombardment due to VSC can cause lateral horn cells to be fascilitated (SNS) leading to visceral dysfunction
