Exam 2 Philosophy 6 Neurologic Models

Question 1

Who said
“the central issues of chiropractic and “manual medicine” today concern the specific DETAILS of neurological involvement (in the subluxation complex) rather than whether or not it exists”

Answer 1

Charles Lantz

Question 2

What model is this
1. mechanical joint problem
2. DJD
3. radiculopathy and myelopathy

Answer 2

Old Model Murphy

Question 3

What are the steps in New Model Murphy

Answer 3

1. mechanical joint problem
2. chronically stressed tissues
3. afferent discharge
4. efferent reflex (reflex nerve interference)
5. efferent discharge
6. collagen breakdown
7. DJD (irritation nerve interference)
8. radiculopathy and myelopathy (compression)

Question 4

What are the 3 types of nerve interference (Murphy)

Answer 4

1. Reflex
2. Irritation
3. Compression

Question 5

What are the major neurological theories (Haldeman)

Answer 5

• receptor stimulation
• nerve compression (traction)
• reflex effects
• supraspinal effects

Question 6

What are the Neurological Models

Answer 6

• Nerve & Nerve Root compression
• DRG compression
• Cord compression/ traction
• Somatosomatic reflex
• Somatoviseral reflex
• Viscerosomatic reflex
• Neurodystrophic / Neuroimmune

Question 7

Nerve and Nerve Root Compression/ Traction/ Torsion aka…..

Answer 7

Compressive neuropathy

Question 8

IVF distortion due to VSC can cause mechanical compression of spinal nerves “neural complex” with resulting…

Answer 8

neurological injury and dysfunction

Question 9

What can cause traction and torsion injuries to the neural complex

Answer 9

mechanical changes

Question 10

The pressure on a nerve, direct or indirect refers to …

Answer 10

neurothlipsis

Question 11

D.D. Palmer states…
“To____ upon a nerve is to press against it on one side. The _____ of nerves usually increases their function, because of irritation”

Answer 11

1. Impinge
2. Impinging

Question 12

D.D. Palmer states…
“Bones may be displaced, their projecting surfaces _____ the nerves which they strike against”

Answer 12

irritating

Question 13

D.D. Palmer states…
“If we use the word impingement in the sense of _____ and remember that impingement instead of squeezing or pinching a nerve only increases its tension by stretching, we will have an explanation which will explain; one which anatomists cannot gainsay”

Answer 13

pressure

Question 14

Who stated
“nerves may be subject to stretch, constriction, compression, torsion, angulation and ischemia”

Answer 14

Irvin M. Korr

Question 15

Irvin M. Korr says
“the predominant consequence of the more common and more subtle deforming forces… is…

Answer 15

not the loss of excitability and the hyperirritability syndromes that is engenders”

Question 16

Hadley found that ___ and ____ subluxations could produce foraminal encroachment that would cause or at least predispose the spinal nerve roots to compression?
______ is less likely

Answer 16

Cervical and Lumbar
less likely = thoracic

Question 17

Hadley states…
“the only postmortem studies available indicate that…?

Answer 17

subluxation is a factor in compression of nerve roots”

Question 18

Hadley states…
Pathophysiological features at the site of subluxation might include _____ and _____ of an individual fiber or group of fibers, edema of endoneurium, sclerosis of arterioles within the nerve bundle, and damage to the spinal ganglion itself”

Answer 18

demyelination and degeneration

Question 19

Hadley states…
“Any abnormal constriction in the size of a normal intervertebral foramen if not actually causing nerve root pressure, nevertheless, …?

Answer 19

decrease the reserve safety cushion space surrounding that nerve and many predispose to pressure”

Question 20

Hadley states…
“____ can cause spinal nerve root compression and injury”

Answer 20

subluxations

Question 21

Hadley states…
“_____ and ____ regions are MOST susceptible to nerve compression with subluxation”

Answer 21

Cervical and Lumbar

Question 22

Nerve _____ are most sensitive to compression
(Gelfan, Tarlov, Sharpless)

Answer 22

roots

Question 23

Nerve roots lack the ____ ____ ____ of peripheral nerves

Answer 23

connective tissue sheath

Question 24

Nerve roots and sheath occupy ___ to ___% of IVF cross-sectional diameter

Answer 24

35-50%

Question 25

Remaining 50-65% is ____ ____ connective tissue, adipose, other vascular and neural structures

Answer 25

loose areolar

Question 26

Spinal distortion may displace neural complex laterally into the IVF by ____?

Answer 26

traction

Question 27

Transforaminal Ligaments (TFL's) are also called...

Answer 27

accessory ligaments

Question 28

True or False accessory ligaments (TFL's), are found to be normal occurrences throughout the spine

Answer 28

True

Question 29

Accessory ligaments (TFL's) are common/ very prevalent in _____ spine?

Answer 29

Lumbar (L5-S1)

Question 30

Accessory ligaments (TFL's) ________ the IVF into a lattice that vessels and nerves must threat through?

Answer 30

compartmentalize

Question 31

Accessory ligaments (TFL's) may _____ the functional S to I diameter of the IVF by 1/3

Answer 31

decrease

Question 32

Ectopic Impulse Hypothesis (Korr) states... deformation sites can be sites where ___ nerve impulses are generated

Answer 32

ectopic

Question 33

Ectopic Impulse Hypothesis (Korr) states... Deformation sites are spontaneous depolarizations that give rise to both ____ and _____ impulses

Answer 33

orthodromic (proper direction) antidromic (wrong direction)

Question 34

True or False Deformation sites have different effects if the involved nerves are sensory or motor

Answer 34

true

Question 35

What are the most common locations of Transforaminal Ligaments in the IVF?

Answer 35

isolating spinal nerve in dural sleeve isolating vein + artery together isolating recurrent meningeal nerve isolating lymphatic vessel

Question 36

In a MOTOR NERVE, the nerve impulses from the deformation site send _____ impulses to the soma?

Answer 36

antidromic impulses

Question 37

In a MOTOR NERVE, the nerve impulses from the deformation site send _____ impulses to the muscle?

Answer 37

orthodromic impulses

Question 38

In a SENSORY NERVE, the nerve impulses from the deformation site send _____ impulses to the DRG?

Answer 38

orthodromic impulses

Question 39

In a SENSORY NERVE, the nerve impulses from the deformation site send _____ impulses to the sense organ?

Answer 39

antidromic impulses

Question 40

Ectopic Impulse Hypothesis (Korr) states... Lateral transmission aka _____ _____ or ____ ____ can also occur at the deformation site.

Answer 40

ephaptic transmission or cross- talk

Question 41

The small electrical feild changes that accompany a normally- propagated impulse can cause ___ of adjacent axons at the deformation site

Answer 41

depolarization

Question 42

In dorsal root ganglion compression... mechanical stresses due to __ can cause injury to the highly sensitive DRG

Answer 42

VSC

Question 43

In dorsal root ganglion compression... True or False DRG are far more sensitive to mechanical stimulation than peripheral nerves and 5x more sensitive to compressive forces

Answer 43

true

Question 44

In dorsal root ganglion compression... when inflamed, DRG become hyperexcitable, and can give rise to ___ ___

Answer 44

spontaneous discharges

Question 45

In dorsal root ganglion compression... a significant irritating factor can be injury/ inflammation/swelling in ___- joints

Answer 45

Z- joints

Question 46

what are osteophytes

Answer 46

extra bone

Question 47

sympathetic nerves and ganglia can be directly impinged by osteophytes extending from the spine as rigid extensions from the vertebrae, a ____ ___ reaching the vicinity of the sympathetic chain perturbs it as motion occurs

Answer 47

claw spur

Question 48

According to the literature review by J. Vertebral Subluxation, There is evidence of nerve compression at the level of the IVF occurring anywhere from __% to ___% of levels inspected

Answer 48

15.4-78%

Question 49

According to the literature review by J. Vertebral Subluxation, Pressures as little as ___ mm Hg can alter then nerve root and dorsal root ganglion's ability to function normally

Answer 49

10 mm Hg

Question 50

According to the literature review by J. Vertebral Subluxation, In the normal range of motion the pressures generated in the IVF may exceed __ mm Hg

Answer 50

30 mm Hg

Question 51

According to the literature review by J. Vertebral Subluxation, The concept that a vertebral subluxation can produce pressure increases at the level of the IVF is supported. The increase is enough to

Answer 51

alter nerve function

Question 52

According to the literature review by J. Vertebral Subluxation, The garden hose theory or hard bone - soft nerve explanation of vertebral subluxation is considered ____ but ____ at least in the cervical spine

Answer 52

archaic but valid

Question 53

Which is more sensitive to compress stress? - spinal nerve or spinal nerve root/ DRG

Answer 53

Spinal nerve root, including the DRG by a factor of 5