Veterbral Subluxation Complex Flashcards
Who was the first person to describe the vertebral subluxation complex?
Faye. Later published and developed by Dishman and then Lantz
What are the five components in Faye’s model?
Biomechanical.
Neurological.
Muscular.
Inflammatory.
Stress response.
What does vertebral subluxation complex describe?
The misalignment as well as connective tissues associated with joint.
What does subluxation complex contain?
Kinesiopathology.
Neuropathophysiology.
Myopathology.
Histopathology.
Vascular dysfunction.
Biochemical changes.
Kinesiopathology
Diseased motion such as hypo mobility, and hyper mobility and instability.
Includes degenerative changes.
Neuropathophysiology.
Reflex or compression based neural irritation that can potentially cause visceral, endocrine, and immune system changes.
Gillet Fixation Theory
Based on work of Henri Gillet who developed motion palpation and technique.
Categorizes fixations (restrictions) into types that are either partial (muscular and ligamentous) or total (bone)
Sustained stress on muscle fibers leads to:
Hypertonicity/spasm.
Joint restriction.
Ligamentous and soft tissue shortening.
Articular adhesions/fibrosis.
Impaired function and joint degeneration
Mennell Joint Dysfunction Theory
Developed by John Mennell MD manual therapist.
Developed series of concepts related to joint dysfunction, especially in peripheral joints.
According to Mennell, what is joint dysfunction?
The loss of joint play movement that cannot be recovered by action of voluntary muscles.
Northeast and MPI use what as basis for extremity joint technique?
Mennell Joint Dysfunction Theory
Articular acute motion segment blockage theory
Meniscoid bodies.
Loose bodies
Articular surface irregularities.
Synovial fluid changes.
Periarticular adhesions.
Acute motion segment blockage theory of discs?
Displaced disc fragment.
What is a loose body?
Foreign material within the joint such as a piece of articular cartilage, bone chip, piece of meniscus.
What are articular surface irregularities?
Roughened surfaces glide past and lock, probably most common in SI joint.
What are capsular/periarticular adhesions?
The result of long standing joint restriction. Manipulation. Tears adhesions.
Acute motion segment blockage theories cause?
Synovial tissue hyperplasia after injury and inflammation, decreased synovial fluid (often seen overlapping with osteoarthritis in older populations)
Disc herniation/intradiscal block?
Annular fiber disruption with nuclear migration into the tear (THINK SARAH’S JELLY DONUT THEORY)
Mechanical effects of manipulation?
Reversing mechanical dysfunction such as hypo mobility, misalignment, compensators.
Reversing or limiting soft tissue pathology such as fibrosis, adaptational shortening, and loss of flexibility/elasticity.
Early stages of manipulation?
Goal is to decrease pain and inflammation, prevent further injury, and promoting flexible healing and good alignment
Later stages of manipulation?
More aggressive treatment. Break up scar tissue formation and restore normal function within kinematic chain.
What do you need to make an adjustment?
Palpation of misalignment along with at least 1-2 other findings such as stiffness on a joint scan or localized tenderness
What are the most significant restrictions?
Demonstrable in more than one postural position.
Detected in more than one direction.
Qualitatively presents as hardest endfeel compared to other restrictions.
Pain exists during end feel analysis.
Reasons for hyper mobility?
Secondary adaptive compensations (lumbar cage).
Post macro trauma (shoulder dislocation).
Repetitive motions or repeated micro trauma (tendinitis).
Congenital (collagen weakness) such as marfan’s syndrome, Down’s syndrome, Ehlers Danlos syndrome.
