Chiro Theory Exam 1

What is metaphysics?

Study of fundamental nature of reality and existence and of the essences of things (ontogeny and cosmology)

What is epistemology?

Study of nature, bases and extent of knowledge

What is Dis-ease?

Result of interference with transmission of innate energy causing a decrease in expression of innate intelligence

What is the acronym for Stephenson definition of subluxation?

MOPI (misalignment/malposition, occlusion/narrowing, pressure/impingement, interference)

*What is the most generally accepted definition of a subluxation?

A subluxation is a complex of function and/or structural and/or pathological articular changes that compromise neural integrity and may influence organ system function and general health

*Where is the most generally accepted definition of a subluxation from?

ACC 1996

What are the 6 doctrines of chiropractic?

Vitalism, Holism, Naturalism, Humanism, Conservatism, Rationalism

What is vitalism?

Nervous system's function in the "self healing" human organism (innate intelligence)

What is holism?

Whole is greater than the sum of its parts, mind body and spirit

What is naturalism?

Presence of natural therapies and avoid drugs/surgery

What is humanism?

Compassionate manner that requires being a people person

What is conservatism?

First do no harm, minimal intervention

What is rationalism?

Invokes logic and evidence for reasoning

What is the medicare primary function of chiropractor description?

Corrector of subluxation

What is WHO listing of segmental and somatic dysfunction?

M99.0

What are the three clinical approaches in chiropractic?

Segmental, Postural/Structural, and Tonal

What makes up the 5 component model of vertebral subluxation?

Kinesiopathology, Myopathology, Histopathology, Neuropathophysiology, Pathophysiology/Biochemical changes

What is Kinesiopathology?

Abnormal motion/position of spinal bones

What is Myopathology?

Abnormal muscle function

What is Histopathology?

Abnormal soft tissue function

What is neuropathophysiology?

Abnormal nervous system function

What is pathophysiology?

Abnormal function of spine and body

Who is the 3 component model attributed to?

Kent

What makes up the 3 component model?

3 Ds Dyskinesia, Dysponesis and Dysautonomia

What is Dyskinesia?

Distortion of, difficult with or impairment of voluntary movement

What is Dysponesis?

Reversible state of misdirected neurophysiologic reactions and the repercussion throughout the organism (Safety-Pin cycle)

What is Dysautonomia?

Abnormal balance between the sympathetic and parasympathetic nervous systems

What are the steps of biomechanical evaluation?

Mechanical etiologies, static and dynamic asymmetries, passive/active joint ROM, imaging

What are the divisions of philosophy?

Metaphysics, epistemology, logic, ethics, aesthetics

What are Carver's distortion pattern apices?

Occiput-C1, C3-C4, C7-T1, T6-T8, T12-L1, L3, L5-S1

Define osteopathy

Manipulation to restore blood flow; A.T. Still

Define homeopathy

Law of similars; minute doses of drugs that induced symptoms similar to the disease; Hahnemann

Define Naturopathy

Disease prevented without the use of drugs; Benedict Lust

Complex organism depend on the _________________ __________ of information between CNS and peripheral cells to adapt to a changing environment in a coordinated manner

Bidirectional flow

What are the 4 main theories/models for subluxation?

Biomechanical, neurologic, trophic (edema, tissue texture, nutrition) and psychosocial evaluation

What is included in the biomechanical subluxation theory?

· Deals with misalignment/abnormal movement of vertebrae

· Degeneration (4 phases)

1. Very early, bony architecture intact (return to normal with care)

2. Young adult, phase 1 + fibrosis, osseous changes (Reversal of some changes possible)

3. Mature adult, major changes (lifetime care)

4. Elderly, fusion of joints (care focused on slowing damage)

What is included in the neurologic subluxation theory?

· Deals with compression of nervous tissues

· Facilitation (Hyperexcitability disruption)

1. Somatosomatic/somatomotor (balance problems)

2. Somatovisceral/somatoautonomic (Inflammation)

3. Viscerosomatic/visceromotor (injury of organs)

· Mechanoreceptor Deafferentation (signals not reaching CNS, immunity and personality)

· Neuroimmune (Subluxation=altered nerve activity, increased infection chance)

What is included in the Trophic subluxation theory?

· Non-impulse based

· Axoplasmic transport block: Pressure inhibits flow of substances without bocking impulses

· Vertebrobasilar A. Insufficiency: Upper cervical misalignments, impede blood to brain

· Intraneural microcirculation ischemia: Squeezing of arteries starve nerves

· Venous/lymphatic stasis: Compression can cause swelling and failure to remove toxins

· Altered CSF flow: Bad flow=bad CNS mojo

What is included in the Psychosocial subluxation theory?

· Somatopsychic: Altered nerves can affect mental state

· Psychogenic: Emotions can cause vertebral subluxation complex

What can joint dysfunction progress towards?

Spinal degeneration

Is the spine perfectly design, but not suited for contemporary environments and behaviors?

Evolutionary Biology

What is the IVD subluxation model?

IVD diminished posterior height which causes spinal nerve impingement or compression

What is Grisel Syndrome?

Any C1-C2 subluxation associated with inflammatory ligamentous laxity

Who found upper respiratory tract infections strongly associated with occiput, C1, C2 dysfunction?

Gutmann (1987)

Who found that tonsilitis goes hand in hand with movement restriction between occiput and atlas?

Lewit (1991)

What is statics?

The branch of mechanics that deals with equilibrium of bodies at rest, or in motion with zero acceleration, origin of modern POSTURAL clinical approach (full spine)

Who is associated with statics model?

Willard Carver

What did Carver postulate about pelvic unleveling?

Causes predictable effects of the double S curve in scoliosis from an un-level sacrum which lead to additional apices and transitional areas

What are the three general categories of spinal fixation hypotheses?

Periarticular mechanisms, intraarticular mechanisms, and IVD mechanism

What are Meniscoids?

Intraarticular synovial fold inclusions which can become entrapped in Z joints (Lewit)

What did DeJarnette hypothesis?

Improper CSF flow can cause CNS issues

What is Kinetics?

Branch of mechanics which deals with forces on bodies

What can Meniscoids lead to?

Locked Back Syndrome (Kos & Wolf)

What does compression do to IVD?

Forces waste out of IVD

Who found cervical spine subluxation can lead to dentate ligament distortion of cord?

Grostic

What does de-compression do to IVD?

Brings nutrition in

Who founded facilitation of muscle spindle/gamma motor neuron pathway (intrafusal fibers)?

Korr

Who founded nociceptive spasm or the facilitation of nociceptor afferents, reflexively stimulating alpha motor neurons?

Seaman

Who is the chiropractic pioneer in biomechanics focusing on relationship between forces acting on body and changes they produce in motion of body (KINETICS)?

Dr. Fred Illi

What did Jirout and Kirkaldy-Willis find in the compensation reaction?

Hypo-mobility in a motion segment leads to compensatory hyper-mobility in motion segments immediately adjacent to those segments

What is Kapandji assosciated with?

Change in central axis of motion (a characteristic of affected segments is displacement of the normal axis of rotation in one or more planes

Who first mentioned the change in central axis of motion not being lodged in a fixed and permanent position but being shifted off field of motion?

Langworthy, Paxson and Smith in Modernized Chiropractic 1906

Who found loss of joint play?

Mennell

Who found positional dyskinesia in which a subluxated vertebrae almost always has improper motion?

Suh, Plaugher

What is Phase 1 of degeneration phase?

Occurs 0 to 20 years, motion dysfunction, possible misalignment

What is Phase 2 of degeneration phase?

20 to 40 years, fibrosis in soft-tissues, early bone changes seen, biomechanics response to care, some reversal

What is Phase 3 of degeneration phase?

40 to 60 years, chronic soft tissue changes, major bone and joint changes (beginning fusion), slow progression with lifetime care

What is Phase 4 of degeneration phase?

60+ years, major bone changes (complete fusion), no response, direct care to segments in earlier phases or those to compensation

Care goal in neurological or functional more so than biomechanical

What are three steps of unified model for phases of VSC? (Sandoz & Kirklady-Willis)

Segmental Dysfunction, instability and stabilization

What can IVF encroachment lead to the release of?

Substance P

What are the two conceptual models of disc degeneration?

Inflammation/Immobilization Model and IVF encroachment/Neurologic Model

What are Murphy's three types of nerve interferene?

Reflex, Irritation, Compression

What can IVF distortion cause?

Nerve and Nerve Root Compression, Traction and Torsion

What is neurothlipsis?

Pressure on a nerve, direct or indirect

Impinging a nerve does what to their function?

Increases function because of irritation

Nerves become hypoerxcitable or hyperexcitable when impinged?

Hyper-excitable (hyperirritability)

Who found evidence that cervical and lumbar subluxations could produce foramina encroachment that would cause the spinal nerve roots to compress?

Hadley

What are the most sensitive to compression?

Nerve Roots (lack connective tissue sheath of peripheral nerves)

What are transforaminal ligaments (TFL)?

Accessory ligaments around the IVF, common L5 to S1, which can decrease space of IVF

What are accessory ligaments around the IVF, common L5 to S1, which can decrease space of IVF?

Transforaminal Ligaments (TFL)

Who developed the ectopic impulse hypothesis? What is it?

Korr

Deformation sites can be sites where ectopic nerve impulses are generated, give rise to both orthodromic (proper direction) and antidromic (wrong direction) impulses

What is Lateral Transmission?

Part of Korrs ectopic impulse hypothesis, small electrical field changes from one deformation site can influence surrounding axons

Dorsal Root Ganglion are how much more sensitive to mechanical stimulation than peripheral nerves?

5X

What else can impinge nerves besides TFL?

Osteophytes (Triano)

What is the garden hose theory?

Bone on nerve direct contact causes interference (could be true in lower cervical spine)

What is the subluxation concept?

Model of motion segment dysfunction that incorporates pathological changes in all tissue types

What is subluxation syndrome?

The aggregation of signs/symptoms that point to subluxation