Subluxation Models - Main Notes Flashcards by Kailey Cox

What is the Qualifying feature of Intervertebral Subluxation

Partial Dislocation

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What are some mechanisms involved in causing vertebral subluxations

Postural stress
Trauma
IVD Degeneration
Erosive arthritides and Autoimmune Conditions
Infections
Congenital and Developmental Factors

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T or F

Scientific literature suggests Intervertebral subluxation is a common entity

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______ is the branch of mechanics that deals with the equilibrium of bodies at rest or in motion with zero acceleration

Statics

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Who was the developer of the basic and compensatory distortion model of the spine in chiropractic

Dr. Willard Carver

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Vertebral segments at _____ and ______ of normal and compensatory curves under greater mechanical stress

apices and transitions

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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

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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

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________ 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

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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

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What are Kapandji’s Ideas? What Subluxation Model do his ideas fall under?

Change in central axis of motion

Biomechanical

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What are Mennels Ideas? What subluxation model do his ideas fall under?

Loss of Joint end play

Biomechanical

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What are Suh, Plaugher et al’s ideas and what model do their ideas fit under?

Positional Dyskinesia

Biomechanical

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What does the 4 phase model of subluxation degeneration include?

Biomechanical effects of chronic uncorrected VSC and Biomechanical response to adjustments

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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

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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

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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

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