Cert Test 2 Flashcards by Lauren Smedley

What are the 3 types of spines?

Normal
Normal - Abnormal
Abnormal - Abnormal

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What is a normal spine?

This is the ideal spine. You will see the four normal curves when looking at a lateral x-ray and no curves when looking at an A-P x-ray.

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What is a normal - abnormal spine?

This is when you have a normal spine that has been subluxated once and the body is compensating correctly. Such as when you have a whiplash injury and C5 causes compensation of the spine.

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What is an abnormal - abnormal spine?

This spine already had a previous subluxation and endures yet another type of trauma. This is the patient who has been under non-specific care or in multiple accidents. This patient could potentially take a long time to correct.

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Which techniques does PRS utilize?

5th Cervical Key
Logan Basic - level foundation 
HIO Technique - instrumentation
Thompson Technique - leg checks
Biomechanics
Nimmo

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Ideal time frame for DTG using infared

20 seconds

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Tytron uses ___ to measure heat and the ideal time frame is ___

heat

it is actually distance dependent

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Normal skin temperature reading for either one?

93.5

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Goals of instrumentation?

To get rid of cold spots
Get the line as straight as possible
Atlas differential as close to 0 as possible
To establish patient’s pattern

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What is the 65% category?

These are “easy” because it does not matter what you do for this patient, their symptoms will get better. However, these symptoms will come and go unless the actual problem is addressed. Ex. 30 yr. old with low back pain

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What is the 30% category?

This is the group of people who were in the 65% category but did not get their problems corrected. You CAN reverse these problems and change this person’s life. Ex. 45 yr. old with diabetes

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What is the 5% category?

Everyone eventually ends up in this category. This is when someone is near death and you cannot reverse their problems anymore, but you can still relief some symptoms and make them more comfortable. Ex. Cancer Patient

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Which cervical rules trump ALL rules?

Spinous Rule

IVF Rule

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Name all Cervical Rules

I Stand Alone
Kink Rule
IVF Rule
Spinous Rule
Joint Space Rule
Arthritis Rule
Mate Rule
Majority Rule
Fly - Shit - in pepper Rule

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On a neutral lateral film if there is a closed “IVF” at C5/C6, what subluxation would you expect?

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On an flexion view, with a completely open “IVF” between C5/C6, what subluxation would you expect?

Completely open IVF indicates movement - no subluxation

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In a flexion view, if the spinous’ of C5 and C6 remain approximated, you would adjust?

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What is the ideal skin temperature of the body?

93.5

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Who did Dr. Pierce Sr collaborate with in making the DTG?

Dr. Stillwagon

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What does DTG stand for?

Dermo-thermo-graph

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Increase in parasympathetic response indicates ____ reading?

hotter

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Increase in sympathetic response indicates _____ reading?

colder

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Does PRS use break or pattern analysis?

pattern

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Is the Tyrtron TIME or DISTANCE sensitive/dependent?

Is the DTG TIIME or DISTANCE sensitive/dependent?

Tytron is distance; DTG is time

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What is considered a significant atlas temperature difference?

0.8 F ..... 0.5 C

List examples of conditions that can lead to a bad or altered thermal instrument reading?

``` Bra-strap Coffee Jewelry Wet hair Hair Exercise Alcohol Seat Warmers Smoking ```

PI stands for?

Partial Involvement

Patient education extends from where to where?

Post ANT tubercle ---> anterior portion of T2

George's line should be a ____ line on the back of the VBs

curved

Name the atlas angles:

``` Inferior (-) < 0 Inferior 0-18 Normal / Superior 18-24 Superior (+) 24-30 Superior (++) >30 ```

Normal Z angle

35-55

What does the Z angle tell you?

Line of Drive | Potential for Normal

KYPHOTIC neck: atlas and white horn angle??

Atlas: Inferior WH: Negative

C2 LORDOTIC neck: atlas and white horn angle??

Atlas: Superior + / ++ WH: Positive

What injury is typical of a Kyphotic neck?

Car accident; Whiplash

What injury is typical of a C2 Lordotic neck?

Hyperextension; Birth

What injury is typical of a C3 Lordotic neck?

Head trauma

C3 LORDOTIC neck: atlas and white horn angle??

Atlas: normal / inferior WH: normal / negative

What is normal White Horn's angle?

+/- 2....mainly 0

What are the cervical mates?

``` C5 (T8 + L3) C4 / C6 C3 / C7 C2 / T1 C1 / T2 C0 / T3 ```

What is the normal progression of exostosis?

1. Inf endplate of subluxated vertebra 2. Sup endplate of vertebra below subluxated vertebra 3. Inf endplate of vertebra above subluxated vertebra 4. Sup endplate of subluxated vertebra ect

What is the exostosis equation?

of involved vertebra x 5 = ___ + 5 years

Normal Flexion the xray should have:

1. George's line should be curved 2. Spinous' should fan out / close down 3. Post Arch should approximate C0, known as 70/30 rule

Normal Extension the xray should have:

NO stacking | C0, C1 and C2 should approximate

Define CHIROPRACTIC

a science, philosophy, and an art of things natural; a system of adjusting teh segments of the spinal column, by hand only for the correction of the cause of dis-ease

Define SUBLUXATION

a condition of a vertebra in which it has lost its proper juxtaposition with the one below, above or both, to an extent less than a luxation, causing impingement of nerves and interference with the transmission of normal mental impulses from brain cell to tissue cell

Define ADJUSTMENT

a scientific concussion of forces given by a chiropractor at the right time and place, and in the proper direction to correct a subluxation

For true correction, it is estimated that the patients body will need...

1 month of care for every year he/she was sick with subluxation

When is abnormal-abnormal spine found most commonly?

Multiple accident victims | Nonspecific over adjusting

What are the 3 classifications of subluxations and when did they occur?

Chronic: 0-15 Subacute: 15-25 Acute: 25+

What are the MOST common subluxations and their order of occurrence?

``` 1st ATLAS 2nd SACRUM 3rd C3 4th T1 5th C4,C5,C6 ```

How does atlas subluxate and what is its order of occurrence?

Childbirth - 1

How does sacrum subluxate and what is its order of occurrence?

months - 3 years learning to walk falling sideways on steps - 2

How does T1 subluxate and what is its order of occurrence?

Falling on hands learning to walk - 4

How does C3 subluxate and what is its order of occurrence?

Trampoline Moving faster = hitting head more - 3

How does C4/C5/C6 subluxate and what is its order of occurrence?

Teen years = sports, car accidents, PI

Subluxated vertebra always affects 3 vertebra -

One above One below It's mate

Causes of a deformed atlas?

Breached Birth | Hanging type injury

Which segments will you rarely see arthritis on?

Atlas and/or axis

If only C1 is subluxated, and patient gets a hyperflexion / hyperextension type injury, the cervical spine will whip at _____

If C1 and C3 are subluxated, the cervical spine will whip at ___

Most common form of subluxation

posterior cervical spine subluxation

Post xrays should be limited to:

areas of subluxation | document changes which have occured

Benefits of visualizer

Less radiation | More information on flexion / extension

Benefits of static xrays

Detect pathologies | Obtain listings

Atlas can be subluxated and show any atlas angle

TRUE

Lateral cervical lines of mensuration

``` Education Line George's Line Atlas Angle Z Angle Whitehorne's Angle Gravity Weight Line Kink / Vector Intersection Exostosis ```

Atlas angle is drawn:

Ant and Post Arch of C1 + Anterior arch dot parallel to floor

Z angle is drawn

Tangent line across posterior body of subluxated cervical vertebra + Tangent line across inferior zygapophysis of same vertebra

Optimum Z angle

Whitehorne's angle is drawn:

Line Inferior body of C2 + Line Parallel to floor

Gravity Weight Line is drawn:

Anterior ST perpendicular to bottom of film | ...should fall slightly anterior to C5 body

For every inch the gravity weight line falls anterior, the head will...

...take on an apparent weight of 10 lb (normal head weight is already 10 lbs)

How far away from the skin should the DTG be held?

1/2 inch

When using a DTG scan, which fossa do you read first?

Left, then Right

How many degree difference from the sacrum to atlas would be considered 'normal'?

1 degree

Atlas readings can be greater than 2 degrees, indicating a very sick patient

FALSE - atlas readings will never be more than 2 degrees --> rescan them

What are the 9 Rules for the Normal PELVIS?

1. Even ilium widths 2. Heart shaped pelvic opening 3-6. Level: Ischial tuberosities, iliac crests, femoral heads, sacral base 7. Almond shaped obturators 8. Sacrum in the center, coccyx 1.5 inch above pubic symphysis 9. Normal lumbar curve 19-24 degrees

______ is often the end of a perfect compensation, usually due to a _____

Double PI; C5

What would the Xray presentations be for a DOUBLE PI?

Smaller pelvic opening, tall obturators, low illiac crests and ischial tuberosities, with a DECREASE in the lumbar curve

On the major side of a PI....

Short leg, sacrum points AWAY, lumbar bodies rotate TOWARD

How would you adjust a PI?

Patient is supine, and you would contact the superior pubic rami

How does the ala appear in an EX ilium versus an IN ilium?

EX ilium appears narrower, and the IN ilium appears wider

Obturator looks like what in an EX ilium? An IN ilium?

EX = wider; IN = narrower

The coccyx will usually deviate towards the ____ side

The pelvic opening on the EX side is usually ___

less

You ALWAYS adjust on the side of lumbar body rotation

true

In a false IN / EX, lumbar body rotation will be to the ___ side

Static films are always sufficient to determine pelvic listings

TRUE

The ____ spine is often visible on the side of IN rotation

Lumbar

Pierce pelvic analysis is different from other analyses because it recognizes the ability of one ilum to rotate while the other remains ____

NORMAL

Atlas can subluxate without any trauma, and any cervical vertebra can rotate without posteriority

TRUE

Total involvement occurs when ____ and ____ occur, and is commonly found in a ______ neck (__cm)

Atlas has gone inferior; No vertebral bodies touch the 17+cm arc; Kyphotic (-17cm)

List the measurements of a curve regression

+17cm --> 500cm ---> -500cm --> -17cm

Which is the most common and easily corrected neck? Which vertebra is usually the subluxated one?

Kyphotic; C5

Name the characteristics of a COMBO neck

- atlas angle: sup (+) / (++) - whitehorne's: positive - Usually has a distinct kink