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Philosophy III
Philosophy III, Midterm Notes
| Word | Definition |
|---|---|
| orthopedic subluxation | partial or incomplete dislocation |
| chiropractic subluxation | motion segment which alignment, movement integrity, or physiologic function is altered, although the contact between the joint surfaces remains intact |
| subluxation syndrome | aggregate of signs & symptoms |
| subluxation complex | theoretic model of motion segment dysfunction |
| joint dysfunction | joint mechanics showing area disturbances of function w/o structural change |
| joint hypomobility | decreased angular or linear joint movement |
| joint hypermobility | increased angular or linear joint movemnt; aberrent joint movements are typically not present |
| clinical joint instability | increased linear and aberrant joint movement; instaneous axes of rotation & patterns of movement are disturbed |
| what you adjust | joint hypomobility |
| chiropractor's oath | professional conduct |
| chiropractor's oath | keep an open mind |
| chiropractor's oath | serve my patients |
| chiropractor's oath | violating neither his confidences nor his dignity |
| chiropractor's oath | not violate that which is moral and right |
| chiropractor's oath | improve my knowledge & skill |
| chiropractors' oath | responsibility |
| record keeping & reporting | provide quality clinic care |
| record keeping & reporting | assist dr. in reporting or testifying |
| record keeping & reporting | protect from malpractice claims |
| record keeping & reporting | inter- & intra- office communication |
| record keeping & reporting | education & research |
| active rom | motion produced by muscular action |
| passive rom | motion produced by traction or springing the joint-joint play, up to the elastic barrier of resistance |
| paraphysiologic rom | motion beyond the elastic barrier of resistance up to the limit of anatomic integrity |
| pathologic movements | motion beyond the limit of normal anatomic integrity |
| which can hurt the patient? | pathologic movements |
| strain/sprain | pathologic movements |
| strain | injury to muscle |
| sprain | injury to ligament |
| manipulation | manual procedure that involves a directed thrust to move a joint past the physiologic range of motion w/o exceeding the anatomic limit |
| mobilization | movement applied singluarly or repetively within or at the physiologic range of joint motion, w/o imparting a thrust of impulse, with the goal of restoring joint mobility |
| manipulation | elastic barrier into paraphysiologic joint space |
| mobilization | continued to physiologic joint space |
| adjustment | any chiropractic therapeutic procedure that uses controlled force, leverage, direction, amplitude & velocity directec at specific joints or anatomic regions |
| nonmanipulable subluxation | vertebral motion segment or motion segment w/radiological or clincal features indicating that an adjustive force or osseous manipulation to this motion segment would be harmfusl or dangerous & is therefore contraindicated |
| manual therapy contraindicated when procedure may ... | produce injury, worsen associated disorder, delay appropriate curative or life-saving treatment |
| clincial reasons to take x-rays | establish clinical (pathologic) diagnosis |
| clincial reasons to take x-rays | evaulate biomechanics & posture |
| clincial reasons to take x-rays | identify anomalies |
| clincial reasons to take x-rays | screen for contraindications |
| clincial reasons to take x-rays | monitor degenerative processes |
| clinical indications to take x-rays (patient selection) | pateint 50+ years |
| clinical indications to take x-rays (patient selection) | trauma |
| clinical indications to take x-rays (patient selection) | neuromotor deficits |
| clinical indications to take x-rays (patient selection) | unexplained weight loss |
| clinical indications to take x-rays (patient selection) | history of cancer |
| clinical indications to take x-rays (patient selection) | recent visit for same problem, but not improved |
| functional radiographs | persistant s/s or unsatifactory response |
| functional radiographs | persistant segmental dysfunction, suggested by segmental instability |
| functional radiographs | imaging studies inconclusive in the establishing of joint dsyfunction |
| full spine vs. sectional studies | clinical necessity |
| full spine vs. sectional studies | severe postural distortion |
| full spine vs. sectional studies | scoliosis evaluation after clinical assessment |
| full spine vs. sectional studies | mechanical problem - one area adversely affects another |
| full spine vs. sectional studies | specifically evaluate biomechanical or postural disorders (weight bearing conditions) |
| complication | unexpected aggravation of an existing disorder on the onset of an unexpected new disorder as a result of treatment |
| contraindication | problem identified b/f procedure is applied taht would make application of treatment inadvisable b/c of potential cause to harm/delay appropriate treatments |
| absolute contraindication | circumstance which renders a form of treatment or clinicla intervation inappropriate because it places the patient at undue risk |
| relative contraindication | circumstance which may place patient at undue risk unless treatment approach is modified. Decision to TX is dependent on the individual circumstances of the presenting case |
| hypermobility | mobility of a given motion unit which is excessive, but not so extreme as to be life threatening or require surgery |
| hypermobility | typically maintain their stability & function normally under physiologic loads |
| instability | more severe, does threaten the neural elements |
| instability | requires surgical intervention; supporting structures are damaaged therefore danger of neurological complications |
| instability | damage to structures leads to abnormal patterns of translational movements & mutliple planes of aberrant joint movement |
| Hieronymus | 1746, 1st author discussing subluxation in terms of loss of joint motion |
| Hieronymus criteria | decreased motion in joints, pain, change in joint alignment |
| palpation | gentle application of hand or fingers to surface of body for purpose of determining condition of surface & adjacent parts of a certain locality or organ of the body |
| static palpation | soft tisse, bony |
| soft tissue | tenderness, edema, temp |
| soft tissue | moisture, m.tone, motility |
| soft tissue | hyperemia response, trophic change |
| bony | tenderness, malposition, anomolies |
| motion palpation | active/passive segmental rom, accessory motions |
| active/passive segemental rom | tenderness, quanity, quality |
| accessory motions | joint play, end play (feel), joint challenge/tenderness |
| joint play | accessory motion, necessary for normal arom & prom, represents amount of capsular laxity within a joint |
| joint play reduced | arom restricted or abnormal & may be painful |
| end play (feel) | assessment of resistance supplied by elastic barrier, assesed at end of prom & tests integrity of capsular & ligamentous fibers |
| end play (feel) is | assesed at end of prom & tests integrity of capsular & ligamentous fibers |
| radiographic classification of subluxation | static intersegmental misalignments, kinetic intersegemental dysfucntions, sectional subluxations, paravertebral subluxations |
| statis intersegmental misalignments | flex, ext, lat flex, rotational malpositions; antereo-, spondylo-, retro-, latero- listhesis; dec. interosseous spacing, formainal encroachments |
| kinetic intersegmental dysfunctions | hypo-, hyper-mobility, aberrant motion |
| sectional subluxations | scoliosis secondary to m. imbalance & structural asymmetry, decompensation of adaptational curavatures, abnormalities of global motion |
| paravertebral subluxations | costovertebral, costotransverse, sacroiliac |
| radicular pain | pain arising from dorsal root or drg usually causes pain to be referred along portion of course of n. or nn. formed from affected dorsal root; a dermatomal pattern |
| somatic referred pain | dull ache, difficult to localize, rather constant in nature |
| PARTS | mnemonic for identifying characteristics of joint dysfunctions |
| P | pain/tendersness |
| A | asymmetry/alignment |
| R | range of motion abnormality |
| T | tone/texture/temp. of soft tissue |
| S | special tests |
| Sandoz chart | 4 stages of range of movement in diarthrodial joints |
| goals of manual therapy | mechanical, soft tissue, neurologic, psychologic effects |
| mechanical effects - mechanical effects produce changes in ... | joint alignments, dysfunction of motion |
| mechanical effects - mechanical effects produce changes in ... | spinal curvature dynamics, entrapment or extrapment of synovial fold |
| soft tissue effects | changes in tone & strength of supporting musculature |
| soft tissue effects | influences dynamics of supportive capsuloligamentous CT |
| neurologic effects | pain reduction |
| neurologic effects | altering motor & sensory function |
| neurologic effects | influencing autonomic nervous system regulation |
| psychologic effects | laying on of hangs |
| psychologic effects | placebo effect, patient satisfaction |
| radiography | not to be used as a general screening procedure w/o clinical indications |
| non-clinical reasons for taking x-rays | financial gain |
| non-clinical reasons for taking x-rays | force of habit |
| non-clinical reasons for taking x-rays | mediolegal advantage |
| non-clinical reasons for taking x-rays | patient education |
| spinography | analyzing spine radiographs for postural & structural abnormalities |
| 1910, B.J. Palmer introduced | spinography |
| 1918-1936 | full spine radiographic techniques |
| radiography structural study | static |
| radiography functional study | movement |
| functional films | cerival, lumbar |
| functional films | used to establish presence of local segmental or global hypermobility or fixation and post surgical anthrodesis |
| functional films (instability) | 3-5 mm translation on f/e may be indicative of ligamentous laxity (instability) |
| instability | ligamentous laxity - do not adjust |
| Myerding's methods | used to measure slippage in spondylolithesis; sacrum/inferior vertebrae is divided into 4 seg.; location that back of slipping vert. indicates the grade of spondylolisthesis |
| George's line | drawn to detect evidence of anterolithesis or retrolithesis; continuous vertical line drawn along posterior margins of vertebral bodies; used for lumbars & cervicals |
| Lumbosacral base angle | line drawn across top of sacrum base |
| lumbar gravitational line | draw X through L3 body and draw line straight down; should fall in front of sacrum. If posterior - post. weight bearing & vice versa |
| cervical spine center of gravity | superior pt. of odontoid, draw line down, should intersect C7 body |
| cervical f/e overlay | trace nuetral bodies onto f/e film to check for excessive/abnormal motion |
| disc angles | lines drawn at sup. & inf. IVD |
| D.D. Palmer | father of chiropractic |
| D.D. Palmer | used manipulation to improve nervous system |
| Andrew Still | father of osteopathy |
| Andrew Still | used manipulation to improve blood & lymph |
| hypermobility | increase in joint motion reversible |
| tropism | mostly at L5-S1 |
| tropism | anomalous condition which articular facings are asymmetric (1 side facing saggital; 1 side facing coronal) |
| tropism | facets guid motion |
| tropism | asymmetrical facects disrupt normal biomechanics |
| tropism-clincial context: | complicationg factor; modification of adjustment to accomodate joint planes |
| down's syndrome | integrity of transverse ligament |
| down's syndrome | up to 20% born w/o transverse ligament |
| down's syndrome | flexion radiography used for validation of condition |
| down's syndrome-normal atlantodental interspace | 1-3mm - adults; 1-5mm children |
Created by:
JYarger
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