Exam 1 Lecture Material

Question 1

What is the historical definition of a subluxation?

Answer 1

A bone (vertebra) of out place pressing on a nerve causing nerve interference

Question 2

What is joint dysfunction?

Answer 2

A joint that has lost a degree of normal movement (hypomobility)

Question 3

How does the medical profession define a subluxation?

Answer 3

Partial dislocation that is unstable and hypermobile due to a loss of ligamentous integrity

Question 4

What is the Meric chart?

Answer 4

A view that mapped specific vertebrae to corresponding visceral structures

Question 5

What is the name of the mapping of vertebrae corresponding to viscera?

Answer 5

Meric chart

Question 6

What is the Meric chart based on?
How valid is this?

Answer 6

Based on observation of early chiropractors and neuroscience understanding at the time
Clinical validity and implications still heavily debated

Question 7

Why is chiropractic management of non-MSK tissues limited?

Answer 7

Scope of practice and the extent of research

Question 8

Research and current views on chiropractic and non-musculoskeletal tissues focuses on the role of…

Answer 8

the sympathetic nervous system

Question 9

What is cavitation?

Answer 9

The process whereby pressure variations in a liquid can in a short period of time cause countless small cavities to form and then implode

Question 10

What is tribonucleation?

Answer 10

Opposing surfaces resist separation until a critical point where they separate rapidly resulting in vapor cavities that do not collapse instantaneously

Question 11

What is the process whereby pressure variations in a liquid in a short period of time cause countless small cavities to form and implode?

Answer 11

Cavitation

Question 12

What is the term for when opposing surfaces resist separation until a critical point where they separate rapidly resulting in vapor cavities that do not collapse instantaneously?

Answer 12

Tribonucleation

Question 13

Is the “pop” produced by pulling digits cavitation or tribonucleation?

Answer 13

Tribonucleation

Question 14

Who coined the term “spinal irritation”?

Answer 14

Thomas Brown in the Glasgow Medical Journal, 1828

Question 15

When did the term “spinal irritation” appear in the American Journal of Medical Sciences?

Answer 15

1832

Question 16

Spinal irritation is the idea that…

Answer 16

tenderness of a vertebra corresponded to a diseased organ

Question 17

Who is the probable contemporary father of the nerve compression hypothesis?

Answer 17

J Evans Riadore in Irritation of Spinal Nerves

Question 18

When did Riadore encourage manipulation to treat spinal irritation in relation to DD Palmer?

Answer 18

2 years before Palmer’s birth

Question 19

What is the thought behind spinal irritation as laid out in Irritation of Spinal Nerves by J. Evans Riadore?

Answer 19

“…if any organ is deficiently supplied with nervous energy or of blood, its functions immediately, and sooner or later its structure, become deranged.”

Question 20

Who is the founder of chiropractic?

Answer 20

DD Palmer

Question 21

Subluxation terminology and the idea of bone out of place is due to…

Answer 21

Palmer’s account of what happened in the first adjustment

Question 22

Were radiographs used in DD Palmer’s time?

Answer 22

No, could not see bone out of place

Question 23

DD Palmer’s first theory was focused on…

Answer 23

inflammation

Question 24

According to DD Palmer’s first theory, what was inflammation?

Answer 24

“the result of displacement of any body part: nerve, artery or vein… bone, ligament or muscle”

Question 25

At first, DD Palmer manipulated ___ to prevent or relieve ___ thought to trigger heat and inflammation

Answer 25

manipulated **any displaced anatomy** to prevent or relieve **friction** thought to trigger heat and inflammation

Question 26

Within 3 years, DD Palmer's inflammation hypothesis was refined and published as...

Answer 26

"Luxation of Bones Cause Disease"

Question 27

According to DD Palmer's "Luxation of Bones Cause Disease" what did he believe?

Answer 27

Muscles, nerves, and bones are key in displacement causing pressure, which could be relieved by adjustments

Question 28

DD Palmer hypothesized that causes of subluxation included:

Answer 28

* Trauma (physical) * Toxins (chemical) * Autosuggestion (psychological/emotional)

Question 29

Soon after DD Palmer hypothesized that subluxation was caused by trauma, toxins, and/or autosuggestion, he added in ___ theory

Answer 29

vibratory

Question 30

What does DD Palmer's vibratory theory state?

Answer 30

Nerves vibrate normally at 200 per minute; this represented the tone of the nervous system

Question 31

What is innate intelligence?

Answer 31

DD Palmer says it's "individualized intelligence which runs all the functions of our bodies"

Question 32

Who is considered the developer of chiropractic?

Answer 32

BJ Palmer

Question 33

In 1934, BJ Palmer established four criteria for subluxation:

Answer 33

* **Misalignment** of vertebra in relation to adjacent segments * **Occlusion of a foramen** (including the canal) * **Pressure** on spinal nerve roots * **Interference** to transmission of mental impulses

Question 34

Later in BJ Palmer's career, what region of the spine did he focus on?

Answer 34

Upper cervical region, focused on C1 (atlas)

Question 35

What was the result of BJ Palmer's focus on C1?

Answer 35

* His hypothesis that a C1 subluxation would cause compression of the spinal cord * His HIO technique

Question 36

Who published "Modernized Chiropractic"?

Answer 36

Langworthy, Smith, and Paxon

Question 37

What was the purpose of the text "Modernized Chiropractic" by Langworthy, Smith, and Paxon?

Answer 37

* Rejected bone out of place theory; too simplistic of an explanation * Favored focus on joint fixation/motion restriction * Used to defend chiropractors arrested for practicing medicine without a license

Question 38

Who is the primary advocate of applying the scientific method to chiropractic practice, research, and education?

Answer 38

CO Watkins

Question 39

What were some primary beliefs of CO Watkins?

Answer 39

* Chiropractors should generate clinical data and publish clinical research * Public relations should be modest and should not masquerade as science

Question 40

Who revitalized the concept of lack of proper joint motion?

Answer 40

Marcel and Henri Gillet (Belgian chiropractors) and Fred Illi (Swiss chiropractor)

Question 41

According to Gillet(s) and Illi, how does an injured joint become fixated?

Answer 41

Edema develops around strained capsule and tissues leading to joint fixation

Question 42

Gillet(s) focused on the ___ region and spinal biomechanics

Answer 42

pelvic region

Question 43

What did Gillet(s) conclude from their focus on the pelvic region and spinal biomechanics?

Answer 43

"...one cannot put a vertebra back into place the way one does a fracture or dislocation. What one really does is: to restore the function of a vertebra"

Question 44

Who's definition of chiropractic is this? "The art and science concerned with the study and treatment of the mechanics, statics and dynamics of the human body, particularly of the vertebral column and pelvis, for the primary purpose of eliminating neuropathological reflexes and their consequences"

Answer 44

Fred Illi

Question 45

What is germ theory?

Answer 45

The theory that certain diseases are caused by the invasion of the body by microorganisms (too small to be seen except through a microscope)

Question 46

What did BJ Palmer think about germ theory?

Answer 46

Rejected germ theory and focused on subluxation as the cause of all dis-ease and a precursor to disease

Question 47

Who wrote The Science and Logic of Chiropractic?

Answer 47

Verner

Question 48

Who said the following? "...one cannot put a vertebra back into place the way one does a fracture or dislocation. What one really does is: to restore the function of a vertebra"

Answer 48

Gillet

Question 49

Verner believed in the impact of chiropractic on ___ as a link to ___

Answer 49

impact of chiropractic on the nervous system as a link to other conditions

Question 50

In the 1990s, ___ ___ suggested chiropractic adopt wellness care, doing research guided by efforts to restore homeostatic mechanisms in the body

Answer 50

Ian Coulter

Question 51

What sort of research emerged once chiropractic started focusing on wellness?

Answer 51

* Begun to determine to what extent the body is a self-healing organism * Departure from the concept of innate in favor of focusing on the neural mechanisms involved

Question 52

What is the inflammation hypothesis by Lantz, in Leach, 132?

Answer 52

"Tissue and cellular responses to injury in the spine includes infiltration of histamine, protein derived factors, eicosanoids, proinflammatory cytokines, nitric oxide, degradative enzymes, and substance P, and these pre-stage development of spinal lesions"

Question 53

Who hypothesized that inflammation involves infiltration of histamine, protein derived factors, eicosanoids, proinflammatory cytokines, nitric oxide, degradative enzymes, and substance P?

Answer 53

Lantz (in Leach, 132)

Question 54

What are the cardinal/classic signs of inflammation?

Answer 54

* Rubor (redness) * Tumor (swelling) * Calor (heat, fever) * Dolor (pain) * Functio laesa (loss of function)

Question 55

Which cardinal signs are usually present with acute inflammation?

Answer 55

* Rubor (redness) * Tumor (swelling)

Question 56

Describe the aggressive vascular tissue-level response to acute inflammation

Answer 56

* Infiltration of neutrophils and other leukocytes * Consists of the visible signs * Capillary wall cells contract and allow exudation (There might be no actual vascular damage, although there often is)

Question 57

With acute inflammation, ___ and ___ release histamine What is the effect of this on capillary cells?

Answer 57

mast cells and platelets release histamine; capillary cells contract and gaps open

Question 58

What will pass through the gaps in capillaries during acute inflammation?

Answer 58

Leukocytes (by diapedesis or transmigration)

Question 59

During acute inflammation, which cells travel to the damaged area and how?

Answer 59

Macrophages and neutrophils migrate via chemotaxis (driven by chemotactic stimulants) to phagocytize debris

Question 60

What is the first biochemical mediator in acute inflammation that stimulates the vascular response?

Answer 60

Histamine

Question 61

What are the functions of cytokines in acute inflammation?

Answer 61

* Regulate inflammation and immune responses * Involved in cell differentiation, replication, survival, and death (apoptosis) * Integral to homeostasis

Question 62

What is the function of nitric oxide in acute inflammation?

Answer 62

Vasodilation

Question 63

What are the functions of substance P in acute inflammation?

Answer 63

* Vasodilation * Involved in cell growth * Neurotransmitter associated with nociception and pain, anxiety, stress, and more

Question 64

What are the biochemicals involved in the response to acute inflammation?

Answer 64

* Histamine * Cytokines * Nitric oxide * Substance P

Question 65

Is chronic inflammation an extension of acute inflammation?

Answer 65

It can be, or it may begin as a chronic inflammatory disorder

Question 66

Which cells infiltrate during chronic inflammation?

Answer 66

Lymphocytes and macrophages

Question 67

How does a tissue react to chronic inflammation?

Answer 67

Angiogenesis (new blood vessels) and connective tissue proliferation

Question 68

How long does chronic inflammation last?

Answer 68

Months to years, or lifelong illness

Question 69

According to research, is joint cracking more related to cavity formation or bubble collapse?

Answer 69

Cavity formation (tribonucleation)

Question 70

According to research in biomechanics, spinal manipulative treatments had what effects?

Answer 70

* Reflex responses far from the treatment site * Movements of vertebral bodies in the "paraphysiological" zone * Associated with cavitation of facet joints