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INTRODUCTION TO PART IV OF THE NATIONAL BOARD EXAM

  • The National Board Part 4 board exam is essential for acquiring a Chiropractic license.
  • Higher exam scores provide more practice options.
  • Designed to enhance integration, prioritization, and organization of clinical information.
  • Respect the work and copyright of the National Board Specialists, Inc.

TABLE OF CONTENTS

  • PART IV SUMMARY
  • THE LAYOUT
  • EXTRA SHEETS
  • CLINICAL INSTRUCTION
  • HISTORY
    • Case history practice
    • Vitals
  • PHYSICAL EXAMS
    • Skin
    • EENT
    • Endocrinology
    • Genital
    • Lymph
    • PVE
    • Heart
    • Lung
    • Abdomen
    • Musculoskeletal
    • Low back pain
  • SYSTEMIC CONDITIONS
  • ROM (Range of Motion)
  • ORTHO/NEURO
  • NEUROLOGICAL EVALUATION
  • LAB
  • SPECIAL TESTS
  • TREATMENT
  • CHIROPRACTIC TECHNIQUE
  • PHYSIOTHERAPY
  • QUIZ ANSWERS

PART IV EXAM OVERVIEW

Day 1 - Diagnostic Imaging

  • Format: 10 total stations with 2 questions each, 10 options (4 minutes per station).
  • Content Includes:
    • NORMAL RADIOGRAPHIC ANATOMY
    • CONGENITAL ANOMALIES & SKELETAL VARIANTS
    • SKELETAL CURVES
    • STENOSIS, SPONDYLOLISTHESIS, TRAUMA, ARTHRITIDES, TUMORS & TUMOR-LIKE PROCESSES, BONE INFECTIONS.
  • Candidate Expectations:
    1) Diagnose commonly encountered cases.
    2) Identify radiographic findings and terminology.
    3) Understand chiropractic procedures and management.
    4) Know potential complications for each case.

Day 2 - Clinical & Set-ups

  • Format: 25 total stations (90 seconds between stations).
  • 10 Clinical patient performance stations & 10 PEP stations.
  • Candidates perform tests on a simulated patient condition, evaluated by licensed doctor:
    • Skills scored include:
    • Psychosocial skills
    • Clinical performance skills
    • Data collection skills
  • Set-up stations focus on adjusting techniques across various body regions.

CASE HISTORIES AND PERFORMANCE STATIONS

  • EXTRA SHEETS: Details included for different case histories, orthopedic/neuro exams, and physical exams.
  • Prepare questions considering:
    • Chief complaint
    • Family history, past medical history
    • Review of systems

HISTORY TAKING

Key Considerations in Taking History

  • Identifying Data: Name, age, sex, occupation, marital status. Special considerations for minors and emergencies.
  • Chief Complaint: An open-ended question about the condition.
  • Present Illness: Focus on pain location, origins, duration.
    • Use the OPQRST method:
    • O: Onset
    • P: Provocation/Palliation
    • Q: Quality
    • R: Region/Radiation
    • S: Severity
    • T: Timing
  • Past History: Previous illnesses, traumas, medication histories.
  • Family History: Any relevant hereditary conditions.
  • Occupational and Social Histories: Evaluating stressors and lifestyle influences.

PHYSICAL EXAMS

Key Body Areas Examined

  • Skin: General inspection for lesions, color changes, etc.
  • EENT (Eyes, Ears, Nose, Throat): Checking for signs of infection or abnormalities.
  • Endocrinology: Assessing metabolism and hormonal function.
  • Lymphatic system: Checking for swelling or signs of infection.
  • Cardiovascular Exam: Checking pulse, blood pressure, heart sounds.
  • Respiratory Exam: Auscultation of lung sounds.
  • Abdominal Exam: Noting tenderness, distension, bowel sounds, etc.
  • Musculoskeletal Exam: Assessing joint efficacy and pain patterns.

SYSTEMIC CONDITIONS

  • Common systemic conditions discussed include Hypercholesterolemia, Hypertension, Diabetes Mellitus, Alcoholism, and Metastatic Disease. Each condition's S/S, diagnostic methods, and treatment approaches are detailed.

ORTHOPEDIC AND NEUROLOGICAL TESTS

Key Tests

  • Include various tests such as SLR, Valsalva's, Spurling's, and Dermatomes assessment to determine the function and dysfunction of the musculoskeletal and neurological systems.

MANAGEMENT AND REFERRAL LIST

  • Highlight conditions requiring referral to specialists in various disciplines (e.g., neurology, cardiology, and orthopedics).
  • Include considerations for co-care and chiropractic involvement in treatment plans.

CHIROPRACTIC TECHNIQUE AND PHYSIOTHERAPY

  • Detail on various techniques, examinations, adjustments, positions, and treatments utilized in chiropractic practice.

QUIZ AND REVIEW QUESTIONS

  • Comprehensive quiz questions and scenarios included to reinforce learning and understanding of the material.

CONCLUSION

  • NBS urges thorough preparation and respect for the material covered, emphasizing the importance of diligence and knowledge in Chiropractic care.